WorldWideScience

Sample records for pretreatment severity function

  1. Cumulative Lung Dose for Several Motion Management Strategies as a Function of Pretreatment Patient Parameters

    International Nuclear Information System (INIS)

    Hugo, Geoffrey D.; Campbell, Jonathon; Zhang Tiezhi; Yan Di

    2009-01-01

    Purpose: To evaluate patient parameters that may predict for relative differences in cumulative four-dimensional (4D) lung dose among several motion management strategies. Methods and Materials: Deformable image registration and dose accumulation were used to generate 4D treatment plans for 18 patients with 4D computed tomography scans. Three plans were generated to simulate breath hold at normal inspiration, target tracking with the beam aperture, and mid-ventilation aperture (control of the target at the mean daily position and application of an iteratively computed margin to compensate for respiration). The relative reduction in mean lung dose (MLD) between breath hold and mid-ventilation aperture (ΔMLD BH ) and between target tracking and mid-ventilation aperture (ΔMLD TT ) was calculated. Associations between these two variables and parameters of the lesion (excursion, size, location, and deformation) and dose distribution (local dose gradient near the target) were also calculated. Results: The largest absolute and percentage differences in MLD were 1.0 Gy and 21.5% between breath hold and mid-ventilation aperture. ΔMLD BH was significantly associated (p TT was significantly associated with excursion, deformation, and local dose gradient. A linear model was constructed to represent ΔMLD vs. excursion. For each 5 mm of excursion, target tracking reduced the MLD by 4% compared with the results of a mid-ventilation aperture plan. For breath hold, the reduction was 5% per 5 mm of excursion. Conclusions: The relative difference in MLD among different motion management strategies varied with patient and tumor characteristics for a given dosimetric target coverage. Tumor excursion is useful to aid in stratifying patients according to appropriate motion management strategies.

  2. Prognostic Utility of Clinical Epilepsy Severity Score Versus Pretreatment Hypsarrhythmia Scoring in Children With West Syndrome.

    Science.gov (United States)

    Sehgal, Rachna; Gulati, Sheffali; Sapra, Savita; Tripathi, Manjari; Pandey, Ravinder Mohan; Kabra, Madhulika

    2017-07-01

    This cross-sectional study assessed the impact of clinical epilepsy severity and pretreatment hypsarrhythmia severity on epilepsy and cognitive outcomes in treated children with West syndrome. Thirty-three children, aged 1 to 5 years, with infantile spasms were enrolled if pretreatment EEG records were available, after completion of ≥1 year of onset of spasms. Neurodevelopment was assessed by Development Profile 3 and Gross Motor Function Classification System. Epilepsy severity in the past 1 year was determined by the Early Childhood Epilepsy Severity Score (E-Chess). Kramer Global Score of hypsarrhythmia severity was computed. Kramer Global Score (≤8) and E-Chess (≤9) in the past 1 year were associated with favorable epilepsy outcome but not neurodevelopmental or motor outcome.

  3. Lignocellulose pretreatment severity – relating pH to biomatrix opening

    DEFF Research Database (Denmark)

    Pedersen, Mads; Meyer, Anne S.

    2010-01-01

    different pH values, temperatures, types of catalysts, and holding times. The consequences of the pretreatment on lignocellulosic biomass are described with special emphasis on the chemical alterations of the biomass during pretreatment, especially highlighting the significance of the pretreatment pH. We...... present a new illustration of the pretreatment effects encompassing the differential responses to the pH and temperature. A detailed evaluation of the use of severity factor calculations for pretreatment comparisons signifies that the multiple effects of different pretreatment factors on the subsequent...... the hydrolysis yields (glucose, xylose) and the pretreatment pH, but no correlation with the pretreatment temperature (90–200 °C). A better recognition and understanding of the factors affecting biomatrix opening, and use of more standardized evaluation protocols, will allow for the identification of new...

  4. Hypoxic pretreatment protects against neuronal damage of the rat hippocampus induced by severe hypoxia.

    Science.gov (United States)

    Gorgias, N; Maidatsi, P; Tsolaki, M; Alvanou, A; Kiriazis, G; Kaidoglou, K; Giala, M

    1996-04-01

    The present study investigates whether under conditions of successive hypoxic exposures pretreatment with mild (15% O(2)) or moderate (10% O(2)) hypoxia, protects hippocampal neurones against damage induced by severe (3% O(2)) hypoxia. The ultrastructural findings were also correlated with regional superoxide dismutase (SOD) activity changes. In unpretreated rats severe hypoxia induced ultrastructural changes consistent with the aspects of delayed neuronal death (DND). However, in preexposed animals hippocampal damage was attenuated in an inversely proportional way with the severity of the hypoxic pretreatment. The ultrastructural hypoxic tolerance findings were also closely related to increased regional SOD activity levels. Thus the activation of the endogenous antioxidant defense by hypoxic preconditioning, protects against hippocampal damage induced by severe hypoxia. The eventual contribution of increased endogenous adenosine and/or reduced excitotoxicity to induce hypoxic tolerance is discussed.

  5. Process and analytical studies of enhanced low severity co-processing using selective coal pretreatment

    Energy Technology Data Exchange (ETDEWEB)

    Baldwin, R.M.; Miller, R.L.

    1990-01-01

    The objectives of the project are to investigate various coal pretreatment techniques and to determine the effect of these pretreatment procedures on the reactivity of the coal. Reactivity enhancement will be evaluated under both direct hydroliquefaction and co-processing conditions. Coal conversion utilizing low rank coals and low severity conditions (reaction temperatures generally less than 350{degrees}C) are the primary focus of the liquefaction experiments, as it is expected that the effect of pretreatment conditions and the attendant reactivity enhancement will be greatest for these coals and at these conditions. This document presents a comprehensive report summarizing the findings on the effect of mild alkylation pretreatment on coal reactivity under both direct hydroliquefaction and liquefaction co-processing conditions. Results of experiments using a dispersed catalyst system (chlorine) are also presented for purposes of comparison. IN general, mild alkylation has been found to be an effective pretreatment method for altering the reactivity of coal. Selective (oxygen) methylation was found to be more effective for high oxygen (subbituminous) coals compared to coals of higher rank. This reactivity enhancement was evidenced under both low and high severity liquefaction conditions, and for both direct hydroliquefaction and liquefaction co-processing reaction environments. Non-selective alkylation (methylation) was also effective, although the enhancement was less pronounced than found for coal activated by O-alkylation. The degree of reactivity enhancement was found to vary with both liquefaction and/or co-processing conditions and coal type, with the greatest positive effect found for subbituminous coal which had been selectively O-methylated and subsequently liquefied at low severity reaction conditions. 5 refs., 18 figs., 9 tabs.

  6. Pre-treatment Social Anxiety Severity Moderates the Impact of Mindfulness-Based Stress Reduction and Aerobic Exercise

    OpenAIRE

    Jazaieri, Hooria; Lee, Ihno A.; Goldin, Philippe R.; Gross, James J.

    2015-01-01

    We examined whether social anxiety severity at pre-treatment would moderate the impact of Mindfulness-Based Stress Reduction (MBSR) or Aerobic Exercise (AE) for generalized social anxiety disorder. MBSR and AE produced equivalent reductions in weekly social anxiety symptoms. Improvements were moderated by pre-treatment social anxiety severity.

  7. Chemical Preconversion: Application of Low-Severity Pretreatment Chemistries for Commoditization of Lignocellulosic Feedstock

    Energy Technology Data Exchange (ETDEWEB)

    David N. Thompson; Timothy Campbell; Bryan Bals; Troy Runge; Farzaneh Teymouri

    2013-05-01

    Securing biofuels project financing is challenging, in part because of risks in feedstock supply. Commoditization of the feedstock and decoupling its supply from the biorefinery will promote greater economies of scale, reduce feedstock supply risk and reduce the need for overdesign of biorefinery pretreatment technologies. We present benefits and detractions of applying low-severity chemical treatments or ‘chemical preconversion treatments’ to enable this approach through feedstock modification and densification early in the supply chain. General structural modifications to biomass that support cost-effective densification and transportation are presented, followed by available chemistries to achieve these modifications with minimal yield loss and the potential for harvesting value in local economies. A brief review of existing biomass pretreatment technologies for cellulolytic hydrolysis at biorefineries is presented, followed by a discussion toward economically applying the underlying chemistries at reduced severity in light of capital and operational limitations of small-scale feedstock depots.

  8. Pre-treatment social anxiety severity moderates the impact of mindfulness-based stress reduction and aerobic exercise.

    Science.gov (United States)

    Jazaieri, Hooria; Lee, Ihno A; Goldin, Philippe R; Gross, James J

    2016-06-01

    We examined whether social anxiety severity at pre-treatment would moderate the impact of mindfulness-based stress reduction (MBSR) or aerobic exercise (AE) for generalized social anxiety disorder. MBSR and AE produced equivalent reductions in weekly social anxiety symptoms. Improvements were moderated by pre-treatment social anxiety severity. Mindfulness-based stress reduction (MBSR) and aerobic exercise (AE) are effective in reducing symptoms of social anxiety. Pre-treatment social anxiety severity can be used to inform treatment recommendations. Both MBSR and AE produced equivalent reductions in weekly levels of social anxiety symptoms. MBSR appears to be most effective for patients with lower pre-treatment social anxiety symptom severity. AE appears to be most effective for patients with higher pre-treatment social anxiety symptom severity. © 2015 The British Psychological Society.

  9. Biorefining of wheat straw: accounting for the distribution of mineral elements in pretreated biomass by an extended pretreatmentseverity equation

    DEFF Research Database (Denmark)

    Le, Duy Michael; Sørensen, Hanne Risbjerg; Knudsen, Niels Ole

    2014-01-01

    ) Silicon, iron, copper, aluminum correlated with lignin and cellulose levels, but the levels of these constituents showed no severity-dependent trends. For the first group, an expanded pretreatment-severity equation, containing a specific factor for each constituent, accounting for variability due...

  10. High Titer and Yields Achieved with Novel, Low-Severity Pretreatment Strategy

    Energy Technology Data Exchange (ETDEWEB)

    2016-03-01

    NREL researchers obtained high concentration sugar syrups in enzymatic hydrolysis that are fermentable to ethanol and other advanced biofuels and intermediate products at high yields. The novel DMR process is simpler and bypasses all severe pretreatment methods, thus reducing the environmental impact. The results are unprecedented. Researchers achieved a high concentration of sugars (230g/L of monomeric sugar and 270 g/L total sugar) and this low toxicity, highly fermentable syrup yielded 86 g/L ethanol (> 90 percent conversion). In addition, the lignin streams from this process can readily be converted to jet or renewable diesel blendstocks through a hydrodeoxygenation step. The NREL-developed, low severity DMR process may potentially replace higher severity chemical pretreatments and associated expensive reactors constructed of exotic alloys with a simpler process, using commercial-scale equipment commonly associated with the pulp and paper industry, to produce high concentration, low toxicity sugar streams and highly reactive lignin streams from non-food renewable biomass for biological and catalytic upgrading to advanced biofuels and chemicals. The simpler DMR process with black liquor recycling could reduce environmental and life-cycle impacts, and repurpose shuttered pulp and paper mills to help revitalize rural economies.

  11. Convex trace functions of several variables

    DEFF Research Database (Denmark)

    Hansen, Frank

    2002-01-01

    We prove that the function (x1,...,xk)¿Tr(f(x1,...,xk)), defined on k-tuples of symmetric matrices of order (n1,...,nk) in the domain of f, is convex for any convex function f of k variables. The matrix f(x1,...,xk) is defined by the functional calculus for functions of several variables, and it ...

  12. Exenatide Pretreatment Improved Graft Function in Nonhuman Primate Islet Recipients Compared to Treatment after Transplant Only

    Directory of Open Access Journals (Sweden)

    Jill L. Buss

    2012-01-01

    Full Text Available The GLP-1 receptor agonist, exenatide, has previously been shown to improve insulin secretion, protect beta cells from apoptosis, and promote beta cell regeneration. We propose that pretreatment with exenatide will promote islet graft survival and improve graft function. Pancreatectomized cynomolgus monkeys underwent islet allotransplantation and were treated with exenatide beginning on day 0 or day −2. A third group of animals was treated with an immunosuppressive regimen while a fourth group remained untreated. Fasting blood glucose (FBG was used to evaluate graft function along with intravenous glucose tolerance tests (IVGTTs performed at study endpoint (day 10 for untreated and posttransplant exenatide or day 90 for pretreatment exenatide and immunosuppression. The average FBG for pre-treated animals day 5 following transplant was 52.7±14.8 mg/dl, compared to 154.3±105.5 mg/dl for animals treated only following transplant, 59.4 mg/dl ±12.1 for animals treated with immunosuppression, and 265.5±172.3 mg/dl for untreated animals. IVGTTs performed at study endpoint showed normal glucose and insulin curves in the pre-treated exenatide and immunosuppression groups only, with beta cell function actually improving after transplant in the pre-treated group. We conclude, therefore, that exenatide pre-treatment can successfully maintain islet graft survival in nonhuman primates.

  13. Convex trace functions of several variables

    DEFF Research Database (Denmark)

    Hansen, Frank

    2002-01-01

    We prove that the function (x1,...,xk)¿Tr(f(x1,...,xk)), defined on k-tuples of symmetric matrices of order (n1,...,nk) in the domain of f, is convex for any convex function f of k variables. The matrix f(x1,...,xk) is defined by the functional calculus for functions of several variables, and it ......We prove that the function (x1,...,xk)¿Tr(f(x1,...,xk)), defined on k-tuples of symmetric matrices of order (n1,...,nk) in the domain of f, is convex for any convex function f of k variables. The matrix f(x1,...,xk) is defined by the functional calculus for functions of several variables...

  14. Functions and requirements for Project W-236B, Initial Pretreatment Module: Revision 1

    International Nuclear Information System (INIS)

    Swanson, L.M.

    1994-01-01

    Hanford Site tank waste supernatants will be pretreated to separate the low-level and high-level fractions. The low-level waste fraction, containing the bulk of the chemical constituents, must be processed into a vitrified waste product which will be disposed of onsite, in a safe, environmentally sound, and cost effective manner. The high-level waste fraction separated during supernatant pretreatment (primarily cesium) will be recombined with an additional high-level waste fraction generated from pretreatment of the tank waste sludges and solids. This combined high-level waste fraction will be immobilized as glass and disposed in a geological repository. The purpose of this document is to establish the functional requirements baseline for Project W-236B, Initial Pretreatment Module, by defining the level 5 and 6 functions and requirements for the project. A functional analysis approach has been used to break down the program functions and associated physical requirements that each function must meet. As the systems engineering process evolves, the design requirements document will replace this preliminary functions and requirements document. The design requirements document (DRD) will identify key decisions and associated uncertainties that impact the project. A revision of this document to a DRD is not expected to change the performance requirements or open issues. However, additional requirements and issues may be identified

  15. Eating disorder severity and functional impairment

    DEFF Research Database (Denmark)

    Davidsen, Annika Helgadóttir; Hoyt, William T.; Poulsen, Stig Bernt

    2017-01-01

    Purpose: The aim was to examine duration of illness and body mass index as possible moderators of the relationship between eating disorder severity and functional impairment, as well as psychological distress as a possible mediator of this relationship. Methods: The study included 159 patients...... diagnosed with bulimia nervosa, binge eating disorder or eating disorder not otherwise specified. Regression analysis was applied to assess the effect of the hypothesized moderators and mediators. Eating disorder severity was measured with the Eating Disorder Examination Questionnaire, functional impairment...... was measured with the Sheehan Disability Scale, and psychological distress was measured with the Symptom Check List-90-R. Duration of illness and body mass index were assessed clinically. Results: Duration of illness significantly moderated the relationship between eating disorder severity and functional...

  16. Pretreatment organ function in patients with advanced head and neck cancer: clinical outcome measures and patients' views

    Directory of Open Access Journals (Sweden)

    Rasch Coen RN

    2009-11-01

    Full Text Available Abstract Background Aim of this study is to thoroughly assess pretreatment organ function in advanced head and neck cancer through various clinical outcome measures and patients' views. Methods A comprehensive, multidimensional assessment was used, that included quality of life, swallowing, mouth opening, and weight changes. Fifty-five patients with stage III-IV disease were entered in this study prior to organ preserving (chemoradiation treatment. Results All patients showed pretreatment abnormalities or problems, identified by one or more of the outcome measures. Most frequent problems concerned swallowing, pain, and weight loss. Interestingly, clinical outcome measures and patients' perception did no always concur. E.g. videofluoroscopy identified aspiration and laryngeal penetration in 18% of the patients, whereas only 7 patients (13% perceived this as problematic; only 2 out of 7 patients with objective trismus actually perceived trismus. Conclusion The assessment identified several problems already pre-treatment, in this patient population. A thorough assessment of both clinical measures and patients' views appears to be necessary to gain insight in all (perceived pre-existing functional and quality of life problems.

  17. Analytic functions of several complex variables

    CERN Document Server

    Gunning, Robert C

    2009-01-01

    The theory of analytic functions of several complex variables enjoyed a period of remarkable development in the middle part of the twentieth century. After initial successes by Poincaré and others in the late 19th and early 20th centuries, the theory encountered obstacles that prevented it from growing quickly into an analogue of the theory for functions of one complex variable. Beginning in the 1930s, initially through the work of Oka, then H. Cartan, and continuing with the work of Grauert, Remmert, and others, new tools were introduced into the theory of several complex variables that resol

  18. Function theory of several complex variables

    CERN Document Server

    Krantz, Steven G

    2001-01-01

    The theory of several complex variables can be studied from several different perspectives. In this book, Steven Krantz approaches the subject from the point of view of a classical analyst, emphasizing its function-theoretic aspects. He has taken particular care to write the book with the student in mind, with uniformly extensive and helpful explanations, numerous examples, and plentiful exercises of varying difficulty. In the spirit of a student-oriented text, Krantz begins with an introduction to the subject, including an insightful comparison of analysis of several complex variables with th

  19. Effect of low severity dilute-acid pretreatment of barley straw and decreased enzyme loading hydrolysis on the production of fermentable substrates and the release of inhibitory compounds

    NARCIS (Netherlands)

    Panagiotopoulos, I.A.; Lignos, G.D.; Bakker, R.R.C.; Koukios, E.G.

    2012-01-01

    The objective of this work was to investigate the feasibility of combining low severity dilute-acid pretreatment of barley straw and decreased enzyme loading hydrolysis for the high production of fermentable substrates and the low release of inhibitory compounds. For most of the pretreatments at 160

  20. [Magnetic micro-/nano-materials: functionalization and their applications in pretreatment for food samples].

    Science.gov (United States)

    Gao, Qiang; Feng, Yuqi

    2014-10-01

    Magnetic solid phase extraction technique, based on functional magnetic materials, is currently a hot topic in the separation and analysis of complex samples. This paper reviews the reported methods for the functionalization of magnetic micro-/nano-materials, such as sur- face grafting organic groups, coating carbon or inorganic oxide, grafting or coating polymer, being loaded to the surface or pores of supports, being introduced into the skeleton of sup- ports, and physically co-mixing methods. Moreover, we briefly introduce the applications of the functional magnetic micro-/nano-materials in pretreatment for food samples.

  1. Fibrinogen function after severe burn injury.

    Science.gov (United States)

    Schaden, Eva; Hoerburger, David; Hacker, Stefan; Kraincuk, Paul; Baron, David M; Kozek-Langenecker, Sibylle

    2012-02-01

    Evidence regarding hypercoagulability in the first week after burn trauma is growing. This hypercoagulable state may partly be caused by increased fibrinogen levels. Rotational thrombelastometry offers a test which measures functional fibrinogen (FIBTEM(®)). To test the hypothesis that in patients with severe burn injury fibrinogen function changes over time, we simultaneously measured FIBTEM(®) and fibrinogen concentration early after burn trauma. After Ethics Committee approval consecutive patients with severe burn trauma admitted to the burn intensive care unit of the General Hospital of Vienna were included in the study. Blood examinations were done immediately and 12, 24 and 48 h after admission. At each time point fibrinogen level (Clauss) and 4 commercially available ROTEM(®) tests were performed. 20 consecutive patients were included in the study. Fibrinogen level and FIBTEM(®) MCF were within the reference range until 24 h after burn trauma but increased significantly 48 h after trauma. There was a significant correlation between FIBTEM(®) MCF and fibrinogen level (R=0.714, p<0.001). The results of this prospective observational clinical study show that fibrinogen function changes early after burn trauma and can be visualized by ROTEM(®) with the fibrinogen-sensitive FIBTEM(®) test. Copyright © 2010 Elsevier Ltd and ISBI. All rights reserved.

  2. The Dual Role of Oxygen Functions in Coal Pretreatment and Liquefaction: Crosslinking and Cleavage Reactions

    Energy Technology Data Exchange (ETDEWEB)

    Michael Serio; Erik Kroo; Sylvie Charpenay; Peter Solomon

    1993-09-30

    The overall objective of this project was to elucidate and model the dual role of oxygen functions in thermal pretreatment and liquefaction of low rank coals through the application of analytical techniques and theoretical models. The project was an integrated study of model polymers representative of coal structures, raw coals of primarily low rank, and selectively modified coals in order to provide specific information relevant to the reactions of real coals. The investigations included liquefaction experiments in microautoclave reactors, along with extensive analysis of intermediate solid, liquid and gaseous products. Attempts were made to incorporate the results of experiments on the different systems into a liquefaction model.

  3. Improved ethanol yield and reduced minimum ethanol selling price (MESP by modifying low severity dilute acid pretreatment with deacetylation and mechanical refining: 2 Techno-economic analysis

    Directory of Open Access Journals (Sweden)

    Tao Ling

    2012-09-01

    Full Text Available Abstract Background Our companion paper discussed the yield benefits achieved by integrating deacetylation, mechanical refining, and washing with low acid and low temperature pretreatment. To evaluate the impact of the modified process on the economic feasibility, a techno-economic analysis (TEA was performed based on the experimental data presented in the companion paper. Results The cost benefits of dilute acid pretreatment technology combined with the process alternatives of deacetylation, mechanical refining, and pretreated solids washing were evaluated using cost benefit analysis within a conceptual modeling framework. Control cases were pretreated at much lower acid loadings and temperatures than used those in the NREL 2011 design case, resulting in much lower annual ethanol production. Therefore, the minimum ethanol selling prices (MESP of the control cases were $0.41-$0.77 higher than the $2.15/gallon MESP of the design case. This increment is highly dependent on the carbohydrate content in the corn stover. However, if pretreatment was employed with either deacetylation or mechanical refining, the MESPs were reduced by $0.23-$0.30/gallon. Combing both steps could lower the MESP further by $0.44 ~ $0.54. Washing of the pretreated solids could also greatly improve the final ethanol yields. However, the large capital cost of the solid–liquid separation unit negatively influences the process economics. Finally, sensitivity analysis was performed to study the effect of the cost of the pretreatment reactor and the energy input for mechanical refining. A 50% cost reduction in the pretreatment reactor cost reduced the MESP of the entire conversion process by $0.11-$0.14/gallon, while a 10-fold increase in energy input for mechanical refining will increase the MESP by $0.07/gallon. Conclusion Deacetylation and mechanical refining process options combined with low acid, low severity pretreatments show improvements in ethanol yields and

  4. Effect of pretreatment severity in continuous steam explosion on enzymatic conversion of wheat straw: Evidence from kinetic analysis of hydrolysis time courses.

    Science.gov (United States)

    Monschein, Mareike; Nidetzky, Bernd

    2016-01-01

    Focusing on continuous steam explosion, the influence of pretreatment severity due to varied acid loading on hydrolysis of wheat straw by Trichoderma reesei cellulases was investigated based on kinetic evaluation of the saccharification of each pretreated substrate. Using semi-empirical descriptors of the hydrolysis time course, key characteristics of saccharification efficiency were captured in a quantifiable fashion. Not only hydrolysis rates per se, but also the transition point of their bi-phasic decline was crucial for high saccharification degree. After 48h the highest saccharification was achieved for substrate pretreated at relatively low severity (1.2% acid). Higher severity increased enzyme binding to wheat straw, but reduced the specific hydrolysis rates. Higher affinity of the lignocellulosic material for cellulases does not necessarily result in increased saccharification, probably because of lignin modifications occurring at high pretreatment severities. At comparable severity, continuous pretreatment produced a substrate more susceptible to enzymatic hydrolysis than the batch process. Copyright © 2015 Elsevier Ltd. All rights reserved.

  5. Suitability of steam exploded residual softwood for the production of binderless panels. Effect of the pre-treatment severity and lignin addition

    Energy Technology Data Exchange (ETDEWEB)

    Angles, M.N.; Ferrando, F.; Farriol, X.; Salvado, J. [Universitat Rovira i Virgili, Tarragona (Spain). Escola Tecnica Superior d' Enginyeria

    2001-07-01

    A steam explosion pre-treatment was applied at various severities to softwood residual substrate to determine the most suitable pre-treatment for the manufacture of binderless panels. The effect of adding acid to the pre-treatment of fibres was also evaluated. The changes in the chemical composition and morphology of the original material were investigated by fractionation analyses and scanning electron micrographs. High severities caused defibrillation of the material allowing to build links to form the panels. Prehydrolysis with acid had a great effect of the structure of the material even at low acid concentration, The physical and mechanical properties of the panel improved with as the severity of the pre-treatment increased up to a point where mechanical properties deteriorated. The composites with highest internal bond had a high cellulose content and a medium lignin content, All these factors suggested that steamed pre-treated residual could be improved by adding a natural binder to produce the panels. A test of producing panels with addition of several kinds of lignin (up to 20%) was performed. With no significant changes in density, water stability (thickness swelling and water absorption) internal bond and mechanical properties were greatly improved., Results after accelerated ageing test were also enhanced. (Author)

  6. Functionality of colinergic systems in rats pre-treatment with triiodothyronine

    International Nuclear Information System (INIS)

    Almeida, O.M.S. de.

    1990-01-01

    In order to investigate the influence of experimental hiperthyroidism in the colinergic activity, rats were injected daily, during 1, 5, 19 or 20 days, with triiodothyronine (0 to 100 ug/kg, s.c.). The hiperthyroidism was evaluated by the decrease of the body weight and the increase of the body temperature and serum hormonal levels (T3). After the administration of the cholinergic agonists (pilocarpine and oxotremorine) or a anticholinesterase drug (eserine), the cholinergic behavioural and pharmacologic activity was evaluated recording the rectal temperature, locomotor activity, catalepsy, tremor and cromodacryorrhea. The results suggests that T3 pre-treatment may induce in rats changes in the functionality of the central cholinergic post-sinaptic receptors. However, the administration of this hormone does not seem to induce any alterations in the periferic cholinergic receptors, implicated in cromodacryorrhea effect. (author)

  7. Performance and techno-economic assessment of several solid-liquid separation technologies for processing dilute-acid pretreated corn stover.

    Science.gov (United States)

    Sievers, David A; Tao, Ling; Schell, Daniel J

    2014-09-01

    Solid-liquid separation of pretreated lignocellulosic biomass slurries is a critical unit operation employed in several different processes for production of fuels and chemicals. An effective separation process achieves good recovery of solute (sugars) and efficient dewatering of the biomass slurry. Dilute acid pretreated corn stover slurries were subjected to pressure and vacuum filtration and basket centrifugation to evaluate the technical and economic merits of these technologies. Experimental performance results were used to perform detailed process simulations and economic analysis using a 2000 tonne/day biorefinery model to determine differences between the various filtration methods and their process settings. The filtration processes were able to successfully separate pretreated slurries into liquor and solid fractions with estimated sugar recoveries of at least 95% using a cake washing process. A continuous vacuum belt filter produced the most favorable process economics. Copyright © 2014 Elsevier Ltd. All rights reserved.

  8. Functional Recovery After Severe Traumatic Brain Injury

    DEFF Research Database (Denmark)

    Hart, Tessa; Kozlowski, Allan; Whyte, John

    2014-01-01

    recovery was best modeled with linear, cubic, and quadratic components: relatively steep recovery was followed by deceleration of improvement, which attenuated prior to discharge. Slower recovery was associated with older age, longer coma, and interruptions to rehabilitation. Patients admitted at lower...... functional levels received more treatment and more treatment was associated with slower recovery, presumably because treatment was allocated according to need. Thus, effects of treatment on outcome could not be disentangled from effects of case mix factors. CONCLUSIONS: FIM gain during inpatient recovery...

  9. Improved ethanol yield and reduced Minimum Ethanol Selling Price (MESP by modifying low severity dilute acid pretreatment with deacetylation and mechanical refining: 1 Experimental

    Directory of Open Access Journals (Sweden)

    Chen Xiaowen

    2012-08-01

    Full Text Available Abstract Background Historically, acid pretreatment technology for the production of bio-ethanol from corn stover has required severe conditions to overcome biomass recalcitrance. However, the high usage of acid and steam at severe pretreatment conditions hinders the economic feasibility of the ethanol production from biomass. In addition, the amount of acetate and furfural produced during harsh pretreatment is in the range that strongly inhibits cell growth and impedes ethanol fermentation. The current work addresses these issues through pretreatment with lower acid concentrations and temperatures incorporated with deacetylation and mechanical refining. Results The results showed that deacetylation with 0.1 M NaOH before acid pretreatment improved the monomeric xylose yield in pretreatment by up to 20% while keeping the furfural yield under 2%. Deacetylation also improved the glucose yield by 10% and the xylose yield by 20% during low solids enzymatic hydrolysis. Mechanical refining using a PFI mill further improved sugar yields during both low- and high-solids enzymatic hydrolysis. Mechanical refining also allowed enzyme loadings to be reduced while maintaining high yields. Deacetylation and mechanical refining are shown to assist in achieving 90% cellulose yield in high-solids (20% enzymatic hydrolysis. When fermentations were performed under pH control to evaluate the effect of deacetylation and mechanical refining on the ethanol yields, glucose and xylose utilizations over 90% and ethanol yields over 90% were achieved. Overall ethanol yields were calculated based on experimental results for the base case and modified cases. One modified case that integrated deacetylation, mechanical refining, and washing was estimated to produce 88 gallons of ethanol per ton of biomass. Conclusion The current work developed a novel bio-ethanol process that features pretreatment with lower acid concentrations and temperatures incorporated with deacetylation

  10. Process and analytical studies of enhanced low severity co-processing using selective coal pretreatment. Quarterly technical progress report, March--May 1990

    Energy Technology Data Exchange (ETDEWEB)

    Baldwin, R.M.; Miller, R.L.

    1990-12-31

    The objectives of the project are to investigate various coal pretreatment techniques and to determine the effect of these pretreatment procedures on the reactivity of the coal. Reactivity enhancement will be evaluated under both direct hydroliquefaction and co-processing conditions. Coal conversion utilizing low rank coals and low severity conditions (reaction temperatures generally less than 350{degrees}C) are the primary focus of the liquefaction experiments, as it is expected that the effect of pretreatment conditions and the attendant reactivity enhancement will be greatest for these coals and at these conditions. This document presents a comprehensive report summarizing the findings on the effect of mild alkylation pretreatment on coal reactivity under both direct hydroliquefaction and liquefaction co-processing conditions. Results of experiments using a dispersed catalyst system (chlorine) are also presented for purposes of comparison. IN general, mild alkylation has been found to be an effective pretreatment method for altering the reactivity of coal. Selective (oxygen) methylation was found to be more effective for high oxygen (subbituminous) coals compared to coals of higher rank. This reactivity enhancement was evidenced under both low and high severity liquefaction conditions, and for both direct hydroliquefaction and liquefaction co-processing reaction environments. Non-selective alkylation (methylation) was also effective, although the enhancement was less pronounced than found for coal activated by O-alkylation. The degree of reactivity enhancement was found to vary with both liquefaction and/or co-processing conditions and coal type, with the greatest positive effect found for subbituminous coal which had been selectively O-methylated and subsequently liquefied at low severity reaction conditions. 5 refs., 18 figs., 9 tabs.

  11. Characterization of agave bagasse as a function of ionic liquid pretreatment

    International Nuclear Information System (INIS)

    Perez-Pimienta, Jose A.; Lopez-Ortega, Monica G.; Chavez-Carvayar, Jose A.; Varanasi, Patanjali; Stavila, Vitalie; Cheng, Gang; Singh, Seema; Simmons, Blake A.

    2015-01-01

    Previous studies of agave bagasse (AGB-byproduct of tequila industry) presented unidentified crystalline peaks that are not typical from common biofuel feedstocks (e.g. sugarcane bagasse, switchgrass or corn stover) making it an important issue to be addressed for future biorefinery applications. Ionic liquid (IL) pretreatment of AGB was performed using 1-ethyl-3-methylimidazolium acetate ([C 2 mim][OAc]) at 120, 140 and 160 °C for 3 h and a mass fraction of 3% in order to identify these peaks. Pretreated samples were analyzed by powder X-ray diffraction (XRD), Fourier transform infrared (FT-IR) spectroscopy, field emission scanning electronic microscopy (FE-SEM), thermal analysis (TGA-DSC) and wet chemistry methods. Previous unidentified XRD peaks on AGB at 2θ = 15°, 24.5° and 30.5°, were found to correspond to calcium oxalate (CaC 2 O 4 ) in a monohydrated form. IL pretreatment with [C 2 mim][OAc] was observed to remove CaC 2 O 4 and decrease cellulose crystallinity. At 140 °C, IL pretreatment significantly enhances enzymatic kinetics and leads to ∼8 times increase in sugar yield (6.66 kg m −3 ) when compared to the untreated samples (960 g m −3 ). These results indicate that IL pretreatment can effectively process lignocellulosic biomass with high levels of CaC 2 O 4 . - Highlights: • Chemical behavior of agave bagasse pretreated by ionic liquid (IL) is assessed. • Previously unidentified XRD peaks correspond to calcium oxalate (CaC 2 O 4 ). • Total sugar yield and initial enzymatic hydrolysis rate were higher at 140 °C. • IL pretreatment can effectively process biomass with high levels of CaC 2 O 4. • Increasing the temperature of IL pretreatment causes the agglomeration of CaC 2 O 4

  12. Ascitic fluid of experimental severe acute pancreatitis modulates the function of peritoneal macrophages.

    Science.gov (United States)

    Satoh, A; Shimosegawa, T; Masamune, A; Fujita, M; Koizumi, M; Toyota, T

    1999-10-01

    Although the pathophysiology of acute pancreatitis appears to be greatly influenced by the production of ascites, little is known about the mechanism. To investigate the effects of pancreatitis-associated ascitic fluid (PAAF) on macrophage function, we examined the effects of PAAF obtained from a rat model of severe acute pancreatitis on the ability of peritoneal macrophages to produce tumor necrosis factor-alpha (TNF-alpha). In addition, we compared the responses of PAAF-treated and PAAF-untreated macrophages to lipopolysaccharide (LPS) by evaluating their TNF-alpha production and nuclear factor-kappaB (NFkappaB) activation. Incubation of peritoneal macrophages with the PAAF led to the rapid and prolonged activation of NF-kappaB and to TNF-alpha production. Pyrrolidine dithiocarbamate, a potent inhibitor of NF-kappaB activation, attenuated the macrophage TNF-alpha production by PAAF. Macrophages produced TNF-alpha in response to LPS, but the cytokine production was significantly reduced when macrophages were pretreated with PAAF. The suppression of TNF-alpha production by PAAF pretreatment accompanied the impairment of NF-kappaB activation in response to LPS. These results indicate that the PAAF of severe acute pancreatitis may play important roles in the pathologic course of this disease through its effects on macrophage function.

  13. Preparation and functional evaluation of antihypertensive polypeptides from rice based on ultrasonic pretreatment

    Science.gov (United States)

    Enzymolysis was used for preparation of antihypertensive peptide from rice. Following studies were conducted:ultrasonic pretreatment of substrate protein, ultrafilter of hydrolysate and test of anti-digestive enzyme degradation and one-time feeding of spontaneously hypertensive rats (SHR) of antihyp...

  14. Social functioning in youth with anxiety disorders: association with anxiety severity and outcomes from cognitive-behavioral therapy.

    Science.gov (United States)

    Settipani, Cara A; Kendall, Philip C

    2013-02-01

    Social functioning was assessed using the Child Behavior Checklist and Teacher Report Form for children with anxiety disorders who participated in a randomized clinical trial (N = 161, aged 7-14). Significant relationships were found between severity of children's principal anxiety disorder and most measures of social functioning, such that poorer social functioning was associated with more severe anxiety. Among youth who received cognitive-behavioral therapy (n = 111), significant associations were found between parent-reported social competence and both absence of principal anxiety disorder and lower anxiety severity at posttreatment and 1-year follow-up, controlling for the severity of the child's principal anxiety disorder at pretreatment. Findings support a relationship between anxiety severity and social difficulties, and suggest the importance of social competence for a favorable treatment response.

  15. Carbonic Acid Pretreatment of Biomass

    Energy Technology Data Exchange (ETDEWEB)

    G. Peter van Walsum; Kemantha Jayawardhana; Damon Yourchisin; Robert McWilliams; Vanessa Castleberry

    2003-05-31

    This project sought to address six objectives, outlined below. The objectives were met through the completion of ten tasks. 1) Solidify the theoretical understanding of the binary CO2/H2O system at reaction temperatures and pressures. The thermodynamics of pH prediction have been improved to include a more rigorous treatment of non-ideal gas phases. However it was found that experimental attempts to confirm theoretical pH predictions were still off by a factor of about 1.8 pH units. Arrhenius experiments were carried out and the activation energy for carbonic acid appears to be substantially similar to sulfuric acid. Titration experiments have not yet confirmed or quantified the buffering or acid suppression effects of carbonic acid on biomass. 2) Modify the carbonic acid pretreatment severity function to include the effect of endogenous acid formation and carbonate buffering, if necessary. It was found that the existing severity functions serve adequately to account for endogenous acid production and carbonate effects. 3) Quantify the production of soluble carbohydrates at different reaction conditions and severity. Results show that carbonic acid has little effect on increasing soluble carbohydrate concentrations for pretreated aspen wood, compared to pretreatment with water alone. This appears to be connected to the release of endogenous acids by the substrate. A less acidic substrate such as corn stover would derive benefit from the use of carbonic acid. 4) Quantify the production of microbial inhibitors at selected reaction conditions and severity. It was found that the release of inhibitors was correlated to reaction severity and that carbonic acid did not appear to increase or decrease inhibition compared to pretreatment with water alone. 5) Assess the reactivity to enzymatic hydrolysis of material pretreated at selected reaction conditions and severity. Enzymatic hydrolysis rates increased with severity, but no advantage was detected for the use of carbonic

  16. Correlation of Thyroid Functions with Severity and Outcome of ...

    African Journals Online (AJOL)

    Background: During normal pregnancy, changes in thyroid function are well documented; however, information regarding thyroid function in preeclampsia is scanty. Aim: The present study was planned to study thyroid hormones in mild and severe preeclamptic women and normotensive women and correlate them with ...

  17. An Efficient Process for Pretreatment of Lignocelluloses in Functional Ionic Liquids

    Directory of Open Access Journals (Sweden)

    Shi-Jia Dong

    2015-01-01

    Full Text Available Background and Aims. The complex structure of the lignocelluloses is the main obstacle in the conversion of lignocellulosic biomass into valuable products. Ionic liquids provide the opportunities for their efficient pretreatment for biomass. Therefore, in this work, pretreatment of corn stalk was carried out in ultrasonic-assisted ionic liquid including 1-butyl-3-methylimidazolium chloride [BMIM]Cl, 1-H-3-methylimidazolium chloride [HMIM]Cl, and 1-(1-propylsulfonic-3-imidazolium chloride [HSO3-pMIM]Cl at 70°C for 2 h. We compared the pretreatments by ionic liquid with and without the addition of deionized water. Fourier transform infrared spectroscopy (FTIR and scanning electron microscopy (SEM were employed to analyze the chemical characteristics of regenerated cellulose-rich materials. Results. [HMIM]Cl and [HSO3-pMIM]Cl were effective in lignin extraction to obtain cellulose-rich materials. FTIR analysis and SEM analysis indicated the effective lignin removal and the reduced crystallinity of cellulose-rich materials. Enzymatic hydrolysis of cellulose-rich materials was performed efficiently. High yields of reducing sugar and glucose were obtained when the corn stalk was pretreated by [HMIM]Cl and [HSO3-pMIM]Cl. Conclusions. Ionic liquids provided the ideal environment for lignin extraction and enzymatic hydrolysis of corn stalk and [HMIM]Cl and [HSO3-pMIM]Cl proved the most efficient ionic liquids. This simple and environmentally acceptable method has a great potential for the preparation of bioethanol for industrial production.

  18. Captopril pretreatment protects the lung against severe acute pancreatitis induced injury via inhibiting angiotensin II production and suppressing Rho/ROCK pathway.

    Science.gov (United States)

    Yu, Qi-Hong; Guo, Jie-Fang; Chen, Yan; Guo, Xiao-Rong; Du, Yi-Qi; Li, Zhao-Shen

    2016-09-01

    Acute pancreatitis (AP) usually causes acute lung injury, which is also known as acute pancreatitis associated lung injury (APALI). This study aimed to investigate whether captopril pretreatment was able to protect lung against APALI via inhibiting angiotensin II (Ang II) production and suppressing Rho/ROCK (Rho kinase) pathway in rats. Severe AP (SAP) was introduced to rats by bile-pancreatic duct retrograde injection of 5% sodium taurocholate. Rats were randomly divided into three groups. In the sham group, sham operation was performed; in the SAP group, SAP was introduced; in the pre-cpl + SAP group, rats were intragastrically injected with 5 mg/kg captopril 1 hour prior to SAP induction. Pathological examination of the lung and pancreas, evaluation of pulmonary vascular permeability by wet/dry ratio and Evans Blue staining, detection of serum amylase, Western blot assay for Ang II receptor type 1 (AT1), RhoA, ROCK (Rho kinase), and MLCK (myosin light chain kinase) were performed after the animals were sacrificed at 24 hours. After the surgery, characteristic findings of pancreatitis were observed, accompanied by lung injury. The serum amylase, Ang II, and lung expression of AT1, RhoA, ROCK, and MLCK increased dramatically in SAP rats. However, captopril pretreatment improved the histological changes, reduced the pathological score of the pancreas and lung, inhibited serum amylase and Ang II production, and decreased expression of AT1, RhoA, ROCK, and MLCK in the lung. These findings suggest that captopril pretreatment is able to protect the lung against APALI, which is, at least partially, related to the inhibition of Ang II production and the suppression of the Rho/ROCK pathway. Copyright © 2016. Published by Elsevier Taiwan.

  19. Biomass pretreatment

    Science.gov (United States)

    Hennessey, Susan Marie; Friend, Julie; Elander, Richard T; Tucker, III, Melvin P

    2013-05-21

    A method is provided for producing an improved pretreated biomass product for use in saccharification followed by fermentation to produce a target chemical that includes removal of saccharification and or fermentation inhibitors from the pretreated biomass product. Specifically, the pretreated biomass product derived from using the present method has fewer inhibitors of saccharification and/or fermentation without a loss in sugar content.

  20. Correlation between audiovestibular function tests and hearing outcomes in severe to profound sudden sensorineural hearing loss.

    Science.gov (United States)

    Wang, Chi-Te; Huang, Tsung-Wei; Kuo, Shih-Wei; Cheng, Po-Wen

    2009-02-01

    This study investigated whether audiovestibular function tests, namely auditory brain stem response (ABR) and vestibular-evoked myogenic potential (VEMP) tests were correlated to hearing outcomes after controlling the effects of other potential confounding factors in severe to profound sudden sensorineural hearing loss (SSHL). Eighty-eight patients with severe to profound SSHL were enrolled in this study. Pretreatment hearing levels, results of audiovestibular function tests, and final hearing outcomes were recorded from retrospective chart reviews. Other factors, including age, gender, delay of treatment, vertigo, diabetes mellitus, and hypertension, were collected as well. Comparative analysis between multiple variables and hearing outcomes was conducted using the cumulative logits model in overall subjects. Further, multivariate analysis of prognostic factors was conducted in the stratified groups of severe (70 dB HL 90 dB HL) SSHL. Multivariate analysis showed that pretreatment hearing levels, presence of vertigo, and results of ABR and VEMP testing were significant outcome predictors in the overall subjects. Stratification analysis demonstrated that both the presence of ABR and VEMP waveforms were significantly correlated with better hearing outcomes in the group of severe SSHL [ABR: adjusted odds ratio (aOR) = 14.7, 95% confidence interval (CI) = 1.78 to 122, p = 0.01; VEMP: aOR = 5.91, 95% CI = 1.18 to 29.5, p = 0.03], whereas the presence of vertigo was the only significant negative prognostic factor in the group of profound SSHL (aOR = 0.24, 95% CI = 0.06 to 0.95, p = 0.04). Other variables, including age, gender, diabetes mellitus, hypertension, and delay of treatment, were not significantly related to hearing outcomes in both groups (p > 0.05). A predictive hearing recovery table with the combined ABR and VEMP results was proposed for the group of severe SSHL. ABR and VEMP tests should be included in the battery of neurootological examinations in

  1. Long-term functional health status of severely injured patients

    NARCIS (Netherlands)

    Holtslag, H. R.; Post, M. W.; Lindeman, E.; Van der Werken, Chr.

    Background: Studies of the consequences of major trauma have traditionally focused on mortality rates. The aims of this study were, firstly, to investigate the long-term functional health status in a large, unselected group of severely injured patients and to compare this with normative data, and

  2. Liver function tests in Nigerian women with severe preeclampsia

    Directory of Open Access Journals (Sweden)

    Ifeoma C Udenze

    2014-01-01

    Full Text Available Background: Preeclampsia is a common complication of pregnancy with high maternal and perinatal morbidity and mortality. The new American College of Obstetricians and Gynecologists (ACOG guideline now includes elevation of liver enzymes as a criterion for the diagnosis of preeclampsia. Objectives: The objectives of this study is to compare liver function tests in preeclampsia and normotensive pregnancy and determine their relationship with systolic and diastolic blood pressure, plasma creatinine, and uric acid levels in Nigerian women with severe preeclampsia. Materials and Methods: This was a case-control study of 46 women with severe preeclampsia and 21 pregnant women as controls. These women attended the Antenatal Clinic at the Lagos University Teaching Hospital, Lagos where women were consecutively recruited. Results: There was a statistically significant difference in the systolic blood pressure (P = 0.002, diastolic blood pressure (P = 0.004, plasma creatinine (P = 0.007, uric acid (P = 0.0001, plasma albumin (P = 0.029, alkaline phosphatase (ALP (P = 0.0001, aspartate aminotransferase (AST (P = 0.0001, γ-glutamyl transferase (GGT (P = 0.035, and unconjugated bilirubin (P = 0.023 between the group with severe preeclampsia and the normotensive pregnancy control group. Alanine aminotransferase (ALT was however not significantly elevated. AST elevation was the most common anomaly in severe preeclampsia occurring in 54.3% of cases. There was no association between systolic and diastolic blood pressure, plasma creatinine, and uric acid in severe preeclampsia with and without abnormal liver function tests. Conclusion: Elevation of AST, ALP, GGT, and unconjugated bilirubin are common in Nigerian women with severe preeclampsia but may not all be of liver origin. These parameters were also not associated with indices of disease severity. The use of liver enzyme concentrations as adjuncts in preeclampsia diagnosis should be applied with caution in

  3. Mindfulness-Based Cognitive Therapy for severe Functional Disorders

    DEFF Research Database (Denmark)

    Fjorback, Lone Overby

    with cognitive therapy. Aim: To examine the efficacy of Mindfulness-Based Cognitive Therapy in severe Functional disorders, defined as severe Bodily Distress Disorder. Method: 120 patients are randomised to either Mindfulness Based Cognitive Therapy: a manualized programme with eight weekly 3 ½ hour group......  MINDFULNESS-BASED COGNITIVE THERAPY FOR FUNCTIONAL DISORDERS- A RANDOMISED CONTROLLED TRIAL Background: Mindfulness-Based Stress Reduction (MBSR) is a group skills-training program developed by Kabat-Zinn. It is designed to teach patients to become more aware of and relate differently...... to their thoughts, feelings, and bodily sensations. Randomised controlled studies of MBSR have shown mitigation of stress, anxiety, and dysphoria in general population and reduction in total mood disturbance and stress symptoms in a medical population. In Mindfulness Based Cognitive Therapy MBSR is recombined...

  4. Mindfulness-Based Cognitive Therapy for severe Functional Disorders

    DEFF Research Database (Denmark)

    Fjorback, Lone Overby

    with cognitive therapy. Aim: To examine the efficacy of Mindfulness-Based Cognitive Therapy in severe Functional disorders, defined as severe Bodily Distress Disorder. Method: 120 patients are randomised to either Mindfulness Based Cognitive Therapy: a manualized programme with eight weekly 3 ½ hour group......MINDFULNESS-BASED COGNITIVE THERAPY FOR FUNCTIONAL DISORDERS- A RANDOMISED CONTROLLED TRIAL   Background: Mindfulness-Based Stress Reduction (MBSR) is a group skills-training program developed by Kabat-Zinn. It is designed to teach patients to become more aware of and relate differently...... to their thoughts, feelings, and bodily sensations. Randomised controlled studies of MBSR have shown mitigation of stress, anxiety, and dysphoria in general population and reduction in total mood disturbance and stress symptoms in a medical population. In Mindfulness Based Cognitive Therapy MBSR is recombined...

  5. Assessment of muscle function in severely burned children.

    Science.gov (United States)

    Alloju, Shashi M; Herndon, David N; McEntire, Serina J; Suman, Oscar E

    2008-06-01

    The posttraumatic response to a severe burn leads to marked and prolonged skeletal muscle catabolism and weakness, which persist despite standard rehabilitation programs of occupational and physical therapy. We investigated the degree to which the prolonged skeletal muscle catabolism affects the muscle function of children 6 months after severe burn. Burned children, with >40% total body surface area burned, were assessed at 6 months after burn in respect to lean body mass and leg muscle strength at 150 degrees /s. Lean body mass was assessed using dual-energy X-ray absorptiometry. Leg muscle strength was assessed using isokinetic dynamometry. Nonburned children were assessed similarly, and served as controls. We found that severely burned children (n=33), relative to nonburned children (n=46) had significantly lower lean body mass. Additionally they had significantly lower peak torque as well total work performance using the extensors of the thigh. Our results serve as an objective and a practical clinical approach for assessing muscle function and also aid in establishing potential rehabilitation goals, and monitoring progress towards these goals in burned children.

  6. Association Between Functional Dyspepsia And Severity Of Depression

    International Nuclear Information System (INIS)

    Jamil, O.; Sarwar, S.; Hussain, Z.; Fiaz, R. O.; Chaudary, R. D.

    2016-01-01

    Objective: To determine the association between functional dyspepsia and the severity of depression. Study Design: Cross-sectional study. Place and Duration of Study: Department of Medicine, King Edward Medical University/Mayo Hospital, Lahore, from September 2012 till January 2013. Methodology: After taking informed written consent, patients with symptoms of dyspepsia fulfilling the Rome III criteria were included in the study. All patients were evaluated for depression, using Hamilton depression rating scale (HDRS). Upper gastrointestinal endoscopy was done. Fischers' exact test and independent t-test were used for determining significance of association. Result: One hundred and one patients with mean age of 35.81 14.81) years and male to female ratio of 1.41:1 (54/47) were included. Predominant symptoms were early satiety (72.3 percentage), epigastric pain (65.3 percentage), bloating (49.5 percentage), postprandial fullness (40.6 percentage), and regurgitation (40.6 percentage). Alarm symptoms were positive in 44 (43.6 percentage) patients. Dyspepsia were classified as epigastric pain syndrome (EPS, 69.3 percentage), and postprandial distress syndrome (PDS, 30.7 percentage). Significantly more females had PDS (p=0.04), with positive endoscopic findings in EPS (p=0.03). Positive endoscopic findings noted were esophagitis in 21.8 percentage, and gastritis in 48.5 percentage patients. All patients except one had depression, mild in 22.8 percentage, moderate in 33.7 percentage, severe in 31.7 percentage, and very severe in 10.9 percentage patients. Severe depression was seen in 32 (45.7 percentage) patients with EPS and PDS; whereas very severe depression was in 11 (15.7 percentage) patients of EPS, while 11 (35.4 percentage) patients of PDS had severe depression but the difference was not significant. Conclusion: Functional dyspepsia is associated with depression, while positive endoscopic findings are more likely in patients with EPS. Very severe depression

  7. Right ventricular function during acute exacerbation of severe equine asthma.

    Science.gov (United States)

    Decloedt, A; Borowicz, H; Slowikowska, M; Chiers, K; van Loon, G; Niedzwiedz, A

    2017-09-01

    Pulmonary hypertension has been described in horses with severe equine asthma, but its effect on the right ventricle has not been fully elucidated. To evaluate right ventricular structure and function after a 1-week period of pulmonary hypertension secondary to acute exacerbation of severe equine asthma. Prospective study. A clinical episode of severe equine asthma was induced experimentally in six susceptible horses. Examinations in remission and on day 7 of the clinical episode included a physical examination with clinical scoring, echocardiography, arterial blood gas measurements, venous blood sampling for cardiac biomarkers, intracardiac pressure measurements, right ventricular and right atrial myocardial biopsies, airway endoscopy and bronchoalveolar lavage. After 1 month of recovery, physical examination, echocardiography and cardiac biomarker analysis were repeated. Echocardiographic and pressure measurements were compared with those in 10 healthy control horses. All horses developed clinical signs of acute pulmonary obstruction. Right heart pressures increased significantly. Altered right ventricular function could be detected by tissue Doppler and speckle tracking echocardiography. Cardiac troponin concentrations did not increase significantly, but were highly elevated in one horse which exercised in the paddock prior to sampling. Focal neutrophil infiltration was present in two myocardial samples. Even in remission, asthmatic horses showed a thicker right ventricular wall, an increased left ventricular end-systolic eccentricity index at chordal level and decreased right ventricular longitudinal strain compared with controls. The induced clinical episode was rather mild and the number of horses was limited because of the invasive nature of the study. Pulmonary obstruction in asthmatic horses induces pulmonary hypertension with right ventricular structural and functional changes. © 2017 EVJ Ltd.

  8. Real analysis series, functions of several variables, and applications

    CERN Document Server

    Laczkovich, Miklós

    2017-01-01

    This book develops the theory of multivariable analysis, building on the single variable foundations established in the companion volume, Real Analysis: Foundations and Functions of One Variable. Together, these volumes form the first English edition of the popular Hungarian original, Valós Analízis I & II, based on courses taught by the authors at Eötvös Loránd University, Hungary, for more than 30 years. Numerous exercises are included throughout, offering ample opportunities to master topics by progressing from routine to difficult problems. Hints or solutions to many of the more challenging exercises make this book ideal for independent study, or further reading. Intended as a sequel to a course in single variable analysis, this book builds upon and expands these ideas into higher dimensions. The modular organization makes this text adaptable for either a semester or year-long introductory course. Topics include: differentiation and integration of functions of several variables; infinite numerica...

  9. Functional neurologic recovery in two dogs diagnosed with severe

    Directory of Open Access Journals (Sweden)

    Mônica Vicky Bahr Arias

    2015-04-01

    Full Text Available Traumatic injuries to the vertebral column, spinal cord, and cauda equina nerve roots occur frequently in human and veterinary medicine and lead to devastating consequences. Complications include partial or complete loss of motor, sensory, and visceral functions, which are among the main causes of euthanasia in dogs. The present case report describes neurological functional recovery in two dogs that were treated surgically for severe spinal fracture and vertebral luxation. In the first case, a stray, mixed breed puppy was diagnosed with thoracolumbar syndrome and Schiff-Scherrington posture, as well as a T13 caudal epiphyseal fracture with 100% luxation between vertebrae T13 and L1; despite these injuries, the animal did show deep pain sensation in the pelvic limbs. Decompression through hemilaminectomy and spinal stabilization with vertebral body pins and bone cement were performed, and the treatment was supplemented with physiotherapy and acupuncture . In the second case, a mixed breed dog was diagnosed with a vertebral fracture and severe luxation between L6 and L7 after a vehicular trauma, but maintained nociception and perineal reflex. Surgical stabilization of the spine was performed using a modified dorsal segmental fixation technique Both patients showed significant recovery of neurological function. Complete luxation of the spinal canal observed radiographically does not mean a poor prognosis, and in some cases, motor, sensory, and visceral functions all have the potential for recovery. In the first case the determining factor for good prognosis was the presence of deep pain perception, and in the second case the prognosis was determined by the presence of sensitivity and anal sphincter tone during the initial neurological examination

  10. Analysis of Levator Function and Ptosis Severity in Involutional Blepharoptosis.

    Science.gov (United States)

    Lai, Hsin-Ti; Weng, Shih-Feng; Chang, Chih-Hau; Huang, Shu-Hung; Lee, Su-Shin; Chang, Kao-Ping; Lai, Chung-Sheng

    2017-03-01

    Involutional blepharoptosis is the most common type of acquired blepharoptosis. The etiology is believed to be the degeneration of the levator aponeurosis, and levator superioris muscle function was believed to be normal. However, there are a few studies analyzing levator function (LF) in involutional blepharoptosis. Our study aimed to access the LF abnormality in involutional blepharoptosis and analyze the correlation between LF and ptosis severity in involutional blepharoptosis in Taiwan. We reviewed the medical records of patients who underwent ptosis correction surgery between October 2011 and December 2015 after receiving a diagnosis of involutional blepharoptosis. This study examined patient sex and age, preoperative LF, margin reflex distance of the upper eyelid (MRD1), and ptosis severity. Linear regression was performed for statistical analysis. Levator muscle specimen was sent for pathologic examination. We analyzed 231 eyelids of 126 patients. Average MRD1 was 0.43 ± 2.15 mm. Average LF was 14.30 ± 2.51 mm. Overall, 77.1% (178/231) of involutional blepharoptotic eyelids had normal LF (more than 12 mm). Forty-three (18.6%) of 231 were good (10-12 mm), and 10 (4.3%) of 231 were fair (6-9 mm). No patients with poor levator function (≤5 mm) were observed in our case series. A positive correlation between LF and MRD1 was observed after statistical analysis. On average, a 0.6-mm reduction in LF was observed for each 1.0-mm decrease in MRD1. Fat infiltration in levator muscle is observed both grossly and microscopically in most cases with varied degrees. Levator function and MRD1 were positively correlated in patients with involutional blepharoptosis. In our study, 77.1% (178/231) of eyelids had normal levator function, which meant there was 23.0% (53/231) of eyelids had abnormal LF, in contrast to current literature. Fat infiltration was common in our series. In Asian involutional blepharoptosis, LF was not always excellent and it had positive correlation

  11. Understanding changes in lignin of Panicum virgatum and Eucalyptus globulus as a function of ionic liquid pretreatment.

    Science.gov (United States)

    Varanasi, Patanjali; Singh, Priyanka; Arora, Rohit; Adams, Paul D; Auer, Manfred; Simmons, Blake A; Singh, Seema

    2012-12-01

    Ionic liquids (ILs) have shown great potential for the reduction of lignin in biomass after pretreatment. Although dilute acid and base pretreatments have been shown to result in pretreated biomass with substantially different lignin composition, there is scarce information on the composition of lignin of IL pretreated biomass. In this work, temperature dependent compositional changes in lignin after IL pretreatment were studied to develop a mechanistic understanding of the process. Panicum virgatum and Eucalyptus globulus were pretreated with 1-ethyl-3-methylimidazolium acetate ([C(2)mim][OAc]). Measurement of syringyl and guaiacyl ratio using pyrolysis-GC/MS and Kamlet-Taft properties of [C(2)mim][OAc] at 120 °C and 160 °C strongly suggest two different modes of IL pretreatment. Preferential breakdown of S-lignin in both eucalyptus and switchgrass at high pretreatment temperature (160 °C) and breakdown of G-lignin for eucalyptus and no preferential break down of either S- or G-lignin in switchgrass was observed at lower pretreatment temperatures (120 °C). Copyright © 2012. Published by Elsevier Ltd.

  12. Loss of δ-catenin function in severe autism.

    Science.gov (United States)

    Turner, Tychele N; Sharma, Kamal; Oh, Edwin C; Liu, Yangfan P; Collins, Ryan L; Sosa, Maria X; Auer, Dallas R; Brand, Harrison; Sanders, Stephan J; Moreno-De-Luca, Daniel; Pihur, Vasyl; Plona, Teri; Pike, Kristen; Soppet, Daniel R; Smith, Michael W; Cheung, Sau Wai; Martin, Christa Lese; State, Matthew W; Talkowski, Michael E; Cook, Edwin; Huganir, Richard; Katsanis, Nicholas; Chakravarti, Aravinda

    2015-04-02

    Autism is a multifactorial neurodevelopmental disorder affecting more males than females; consequently, under a multifactorial genetic hypothesis, females are affected only when they cross a higher biological threshold. We hypothesize that deleterious variants at conserved residues are enriched in severely affected patients arising from female-enriched multiplex families with severe disease, enhancing the detection of key autism genes in modest numbers of cases. Here we show the use of this strategy by identifying missense and dosage sequence variants in the gene encoding the adhesive junction-associated δ-catenin protein (CTNND2) in female-enriched multiplex families and demonstrating their loss-of-function effect by functional analyses in zebrafish embryos and cultured hippocampal neurons from wild-type and Ctnnd2 null mouse embryos. Finally, through gene expression and network analyses, we highlight a critical role for CTNND2 in neuronal development and an intimate connection to chromatin biology. Our data contribute to the understanding of the genetic architecture of autism and suggest that genetic analyses of phenotypic extremes, such as female-enriched multiplex families, are of innate value in multifactorial disorders.

  13. Assessment of Dengue Fever Severity Through Liver Function Tests

    International Nuclear Information System (INIS)

    Ahmed, A.; Alvi, A. H.; Nawaz, A. A.; Butt, A.; Hanif, A.

    2014-01-01

    Objective: To assess the utility of liver function tests (LFTs) for early recognition and prediction of severity of Dengue fever in hospitalized patients. Study Design: An analytical study. Place and Duration of Study: Services Institute of Medical Science and Fatima Memorial Hospital, Lahore, from September - December 2010. Methodology: Admitted cases of Dengue fever were divided into 3 groups; mild, moderate and severe increases in aminotransferases. Elevation in LFTs was co-related with good or bad outcome i.e. (survival or complication free stay) or (death or complications). Results were analyzed in SPSS version 18. Results: Out of the 353 patients with mean age of 37.12 +- 15.45 years, 245 (69.4%) were males and 108 (30.6%) were females. Seventy five patients (21.2%) had mild elevation of aminotransferases (2 fold increases), 265 patients (75.1%) had moderate increases (3 to 4 fold) and 13 (3.7%) had severe (> 4 fold increase). ALT was statistically higher in patients with septicemia, hepatic and renal failure (p-value 0.05). AST was higher in almost all complications. Prolonged hospital stay was associated with raised LFTs and greater complications and mortality. AST was found to be twice as much raised as ALT. Conclusion: AST and ALT were statistically higher in patients with worse outcome thus can lead to early recognition of high risk cases. (author)

  14. Evaluation of a Pre-Treatment Assessment to Select Mand Topographies for Functional Communication Training

    Science.gov (United States)

    Ringdahl, Joel E.; Falcomata, Terry S.; Christensen, Tory J.; Bass-Ringdahl, Sandie M.; Lentz, Alison; Dutt, Anuradha; Schuh-Claus, Jessica

    2009-01-01

    Recent research has suggested that variables related to specific mand topographies targeted during functional communication training (FCT) can affect treatment outcomes. These include effort, novelty of mands, previous relationships with problem behavior, and preference. However, there is little extant research on procedures for identifying which…

  15. Characterization of white poplar and eucalyptus after ionic liquid pretreatment as a function of biomass loading using X-ray diffraction and small angle neutron scattering.

    Science.gov (United States)

    Yuan, Xueming; Duan, Yonghao; He, Lilin; Singh, Seema; Simmons, Blake; Cheng, Gang

    2017-05-01

    A systematic study was performed to understand interactions among biomass loading during ionic liquid (IL) pretreatment, biomass type and biomass structures. White poplar and eucalyptus samples were pretreated using 1-ethyl-3-methylimidazolium acetate (EmimOAc) at 110°C for 3h at biomass loadings of 5, 10, 15, 20 and 25wt%. All of the samples were chemically characterized and tested for enzymatic hydrolysis. Physical structures including biomass crystallinity and porosity were measured by X-ray diffraction (XRD) and small angle neutron scattering (SANS), respectively. SANS detected pores of radii ranging from ∼25 to 625Å, enabling assessment of contributions of pores with different sizes to increased porosity after pretreatment. Contrasting dependences of sugar conversion on white poplar and eucalyptus as a function of biomass loading were observed and cellulose crystalline structure was found to play an important role. Copyright © 2017 Elsevier Ltd. All rights reserved.

  16. Pretreatment Serum Cystatin C Levels Predict Renal Function, but Not Tumor Characteristics, in Patients with Prostate Neoplasia

    Directory of Open Access Journals (Sweden)

    Feilong Yang

    2017-01-01

    Full Text Available To evaluate the role of Cystatin C (Cys-C in tumorigenesis and progression of prostate cancer (PCa, we retrospectively collected the clinical information from the records of 492 benign prostatic hyperplasia (BPH, 48 prostatic intraepithelial neoplasia (PIN, and 173 PCa patients, whose disease was newly diagnosed and histologically confirmed. Pretreatment serum Cys-C levels were compared across the various groups and then analyzed to identify relationships, if any, with clinical and pathological characteristics of the PCa patient group. There were no significant differences in serum Cys-C levels among the three groups (P > 0.05. In PCa patients with normal SCr levels, patient age was correlated with serum Cys-C level (P ≤ 0.001 but did not correlate with alkaline phosphatase (AKP, lactate dehydrogenase (LDH, prostate specific antigen (PSA, Gleason score, or bone metastasis status (P > 0.05. Age and SCr contributed in part to the variations in serum Cys-C levels of PCa patients (r = 0.356, P ≤ 0.001; r = 0.520, P ≤ 0.001. In conclusion, serum Cys-C levels predict renal function in patients with prostate neoplasia, but were not a biomarker for the development of prostate neoplasia, and were not correlated with the clinicopathological characteristics of PCa.

  17. Family functioning and psychopathology among adolescents with severe emotional disturbances.

    Science.gov (United States)

    Prange, M E; Greenbaum, P E; Silver, S E; Friedman, R M; Kutash, K; Duchnowski, A J

    1992-02-01

    Family psychosocial functioning and its relation to psychopathology among adolescents with severe emotional disturbances (SED) was assessed. Subjects were 353 adolescents with SED, ages 12-18, and their parents. During a semi-structured interview, adolescents were administered Family Adaptability and Cohesion Evaluation Scale (FACES-III), Diagnostic Interview Schedule for Children-Child Version (DISC-C), and the Self-Derogation Scale. Parents were administered FACES-IIII and the Child Behavior Checklist (CBCL) in a phone interview. Results indicated that on the FACES-IIII cohesion dimension, both parents and adolescents perceived their family relations as more disengaged and less connected than did normative families (p less than .001). In contrast, only parent FACES-IIII adaptability scores were significantly more extreme than a normative sample (p less than .01). Additionally, both parent and adolescent cohesion scores were significantly correlated with adolescent psychopathology measures: DISC-C conduct disorder (p less than .01), depression (p less than .05), alcohol/marijuana (p less than .01), and CBCL externalizing symptoms (p less than .01). These relationships did not deviate from linearity.

  18. Management and outcomes in patients with moderate or severe functional mitral regurgitation and severe left ventricular dysfunction

    DEFF Research Database (Denmark)

    Samad, Zainab; Shaw, Linda K; Phelan, Matthew

    2015-01-01

    AIMS: The management and outcomes of patients with functional moderate/severe mitral regurgitation and severe left ventricular (LV) systolic dysfunction are not well defined. We sought to determine the characteristics, management strategies, and outcomes of patients with moderate or severe mitral...

  19. Relations among several nuclear and electronic density functional reactivity indexes

    Science.gov (United States)

    Torrent-Sucarrat, Miquel; Luis, Josep M.; Duran, Miquel; Toro-Labbé, Alejandro; Solà, Miquel

    2003-11-01

    An expansion of the energy functional in terms of the total number of electrons and the normal coordinates within the canonical ensemble is presented. A comparison of this expansion with the expansion of the energy in terms of the total number of electrons and the external potential leads to new relations among common density functional reactivity descriptors. The formulas obtained provide explicit links between important quantities related to the chemical reactivity of a system. In particular, the relation between the nuclear and the electronic Fukui functions is recovered. The connection between the derivatives of the electronic energy and the nuclear repulsion energy with respect to the external potential offers a proof for the "Quantum Chemical le Chatelier Principle." Finally, the nuclear linear response function is defined and the relation of this function with the electronic linear response function is given.

  20. On Chebyshev-Markov rational functions over several intervals

    NARCIS (Netherlands)

    Lukashov, AL

    1998-01-01

    Chebyshev-Markov rational functions are the solutions of the following extremal problem [GRAPHICS] with K being a compact subset of R and omega(n)(x) being a fixed real polynomial of degree less than n, positive on K. A parametric representation of Chebyshev-Markov rational functions is found for K

  1. Spirometry quality in adults with very severe lung function impairment.

    Science.gov (United States)

    Torre-Bouscoulet, Luis; Velázquez-Uncal, Mónica; García-Torrentera, Rogelio; Gochicoa-Rangel, Laura; Fernández-Plata, Rosario; Enright, Paul; Pérez-Padilla, Rogelio

    2015-05-01

    Some technologists worry that patients with very severe lung disease are unable to complete several spirometry maneuvers, which require considerable effort. We retrospectively selected all spirometry tests with an FEV1 30,000 subjects tested during the 3-y period) had adequate quality spirometry. Subjects with airway obstruction were less likely to meet FVC repeatability goals. A poor spirometry quality grade was associated with a very low FVC and a low body mass index, but not older age. Severe lung disease should not be used as an excuse for not meeting spirometry quality goals. Copyright © 2015 by Daedalus Enterprises.

  2. Function of the omasum in several ruminant species

    NARCIS (Netherlands)

    Prins, R.A.; Hungate, R.E.; Prast, E.R.

    1972-01-01

    1. The main function of the omasum is to represent an arrangement for continuance of the fermentation in all species. 2. The pH of omasal contents of sheep and cattle is near neutral and the rate of fermentation equals the rate in the rumen. 3. Omasal contents of deer have a lower pH and show

  3. Pheochromocytoma with Markedly Abnormal Liver Function Tests and Severe Leukocytosis

    Directory of Open Access Journals (Sweden)

    Chai Ryoung Eun

    2014-03-01

    Full Text Available Pheochromocytoma is a rare neuroendocrine tumor arising from the medulla of the adrenal glands, which causes an overproduction of catecholamines. The common symptoms are headache, palpitations, and sweating; however, various other clinical manifestations might also be present. Accurate diagnosis of pheochromocytoma is important because surgical treatment is usually successful, and associated clinical problems are reversible if treated early. A 49-year-old man with a history of uncontrolled hypertension and diabetes mellitus presented with chest pain, fever, and sweating. His liver function tests and white blood cell counts were markedly increased and his echocardiography results suggested stress-induced cardiomyopathy. His abdominal computed tomography showed a 5×5-cm-sized tumor in the left adrenal gland, and laboratory tests confirmed catecholamine overproduction. After surgical resection of the left adrenal gland, his liver function tests and white blood cell counts normalized, and echocardiography showed normal cardiac function. Moreover, his previous antihypertensive regimen was deescalated, and his previously uncontrolled blood glucose levels normalized without medication.

  4. Effect of respiratory function training on respiratory function of patients with severe cerebrovascular disease

    Directory of Open Access Journals (Sweden)

    Ming GUO

    2017-07-01

    Full Text Available Objective To investigate the effect of respiratory function training on respiratory function and conscious state of patients with severe cerebrovascular disease (SCVD.  Methods A total of 27 patients with SCVD were divided into control group (N = 17 and observation group (N = 10. Control group received routine drug and rehabilitation treatment, and observation group was added respiratory function training based on routine treatment. The respiratory rate, tidal volume (TV, heart rate, blood pressure and artery oxygen saturation (SaO2 of patients were monitored by breathing machine before and after 4-week treatment. Meanwhile, arterial blood gas analysis was used to detect arterial partial pressure of oxygen (PaO2, oxygenation index, partial pressure of carbon dioxide (PaCO2 and pH value. At the same time, Glasgow Coma Scale (GCS was used to evaluate the conscious state of patients.  Results All patients successfully completed 4-week rehabilitation training, without asphyxia, arrhythmia or other adverse events. Compared with before training, the respiratory rate (P = 0.006 and pH value (P = 0.010 were significantly decreased, while SaO2 (P = 0.001, oxygenation index (P = 0.000 and GCS scores (P = 0.004, 0.017 were significantly increased in both groups of patients after training. There was no statistically significant difference between 2 groups on respiratory function indexes and GCS scores after training (P > 0.05, for all. Conclusions Respiratory function training did not significantly improve the respiratory function and conscious state of patients with SCVD, yet to be further studied. Randomized controlled clinical trials with larger, layered samples and long-term prognosis observation are needed. Examination method of respiratory function of SCVD patients is also a topic to be explored.  DOI: 10.3969/j.issn.1672-6731.2017.04.007

  5. Severe impaired respiratory ciliary function in Wegener granulomatosis.

    Science.gov (United States)

    Ullrich, S; Gustke, H; Lamprecht, P; Gross, W L; Schumacher, U; Ambrosch, P; Laudien, M

    2009-06-01

    The pathogenesis of granulomatous inflammation in the respiratory tract and autoimmunity in Wegener granulomatosis (WG) are poorly understood. Since mucociliar clearance represents the first major line of defence in the respiratory tract and its breakdown facilitates chronic inflammation, we investigated ciliary beat frequency (CBF) in WG. Nasal epithelial cells were obtained from 30 patients with WG with involvement of the upper respiratory tract, 12 patients with other inflammatory rheumatic disease and 10 healthy controls. CBF was measured at 5 and 24 h after collection. were correlated with clinical data. Results: CBF was significantly reduced in WG compared to disease and healthy controls after 5 and 24 h. In WG, CBF almost stagnated after 24 h. Reduction of CBF correlated with the cumulative number of immunosuppressive agents in WG, but not in disease controls. No correlation was found between CBF impairment and cyclophosphamide levels, disease extent, disease activity, disease duration, serological and microbiological findings, or inflammation markers. CBF is severely impaired in WG, potentially influenced by immunosuppressive treatment. To what extent CBF impairment and subsequent barrier dysfunction are caused by other factors still has to be elucidated. Supportive measures to improve mucociliary clearance should be discussed in patients with WG.

  6. Changes in symptom severity, schemas and modes in heterogeneous psychiatric patient groups following short-term schema cognitive-behavioural group therapy: a naturalistic pre-treatment and post-treatment design in an outpatient clinic.

    Science.gov (United States)

    van Vreeswijk, M F; Spinhoven, P; Eurelings-Bontekoe, E H M; Broersen, J

    2014-01-01

    Schema therapy has proven to be an effective treatment for patients with borderline personality disorder. However, little is known of its merits in other psychiatric (personality) disorders. This study investigated whether schema therapy in a group setting (group schema cognitive-behavioural therapy [SCBT-g]) was associated with changes in symptom and schema and mode severity. Furthermore, the aim was to search for baseline predictors and possible mediators of treatment outcome. Sixty-three heterogeneous psychiatric outpatients who attended the SCBT-g were included as participants. In this naturalistic pre-treatment and post-treatment design, data were available on the Symptom Checklist 90, the Schema Questionnaire and the Young-Atkinson Mode Inventory. All outcome measurements showed changes with moderate to high effect sizes, with 53.2% of the patients showing a significant reduction in severity of psychiatric symptoms and schemas and modes. Higher pre-treatment levels of the schema domain Other Directedness predicted greater symptom reduction. Pre-treatment to mid-treatment changes in schema severity predicted subsequent symptom improvement, but change in symptoms and schemas proved to be strongly correlated. In this naturalistic study, SCBT-g was associated with reduced symptom and schema and mode severity in more than half of the psychiatric outpatients. Furthermore, the results suggest that changes in schemas and symptomatology mutually reinforce each other. Over 50% of ambulatory patients show clinical improvement after treatment in a short-term schema therapy group. Other Directedness seems to be a predictor of schema group therapy success. More randomized controlled trial studies and prediction and mediation studies on (short-term) schema group therapy are sorely needed. Copyright © 2012 John Wiley & Sons, Ltd.

  7. Pretreatment measures of brain structure and reward-processing brain function in cannabis dependence: an exploratory study of relationships with abstinence during behavioral treatment.

    Science.gov (United States)

    Yip, Sarah W; DeVito, Elise E; Kober, Hedy; Worhunsky, Patrick D; Carroll, Kathleen M; Potenza, Marc N

    2014-07-01

    Cannabis is widely abused, and efficacies of therapeutics for cannabis dependence remain suboptimal. Magnetic resonance imaging (MRI) may aid in the identification of biological markers for successful treatment outcomes (i.e., abstinence). Twenty men with cannabis dependence and twenty non-substance-using healthy comparison (HC) men underwent MRI scanning. Cannabis-dependent individuals then participated in a 12-week randomized clinical trial of behavioral treatments (contingency management (CM), cognitive behavioral therapy (CBT) or both). Pretreatment functional and structural data were compared between the cannabis-dependent and HC participants. In addition, individuals with cannabis dependence were subdivided based on the successful achievement of 21 days of consecutive abstinence during treatment to assess whether abstinent versus non-abstinent cannabis-dependent participants displayed different pretreatment functional and structural characteristics when compared to HC participants. In comparison to HC participants, cannabis-dependent participants demonstrated greater ventral striatal activation during the receipt of losing outcomes and smaller putamenal volumes. Cannabis-dependent participants who did not subsequently achieve 21 days of consecutive abstinence had increased activity within the striatum during the receipt of losing outcomes, relative to HC participants. Cannabis-dependent participants who did not achieve 21 days of abstinence had decreased bilateral putamen volumes prior to treatment, relative to HC participants. Individual differences in pretreatment striatal function and structure may relate to individual differences in treatment responses for cannabis dependence. While mechanisms underlying these associations require further exploration, the striatum might mediate treatment responses via its role in associative reward-learning (e.g., through skills training in CBT or reinforcement of abstinence in CM). Copyright © 2014 Elsevier Ireland Ltd

  8. Pretreatment measures of brain structure and reward-processing brain function in cannabis dependence: An exploratory study of relationships with abstinence during behavioral treatment*

    Science.gov (United States)

    Yip, Sarah W.; DeVito, Elise E.; Kober, Hedy; Worhunsky, Patrick D.; Carroll, Kathleen M.; Potenza, Marc N.

    2014-01-01

    Background Cannabis is widely abused, and efficacies of therapeutics for cannabis dependence remain suboptimal. Magnetic resonance imaging (MRI) may aid in the identification of biological markers for successful treatment outcomes (i.e., abstinence). Methods Twenty men with cannabis dependence and twenty non-substance-using healthy comparison (HC) men underwent MRI scanning. Cannabis-dependent individuals then participated in a 12-week randomized clinical trial of behavioral treatments (contingency management (CM), cognitive behavioral therapy (CBT) or both). Pretreatment functional and structural data were compared between the cannabis-dependent and HC participants. In addition, individuals with cannabis dependence were subdivided based on the successful achievement of 21 days of consecutive abstinence during treatment to assess whether abstinent versus nonabstinent cannabis-dependent participants displayed different pretreatment functional and structural characteristics when compared to HC participants. Results In comparison to HC participants, cannabis-dependent participants demonstrated greater ventral striatal activation during the receipt of losing outcomes and smaller putamenal volumes. Cannabis-dependent participants who did not subsequently achieved 21 days of consecutive abstinence had increased activity within the striatum during the receipt of losing outcomes, relative to HC participants. Cannabis-dependent participants who did not achieve 21 days of abstinence had decreased bilateral putamen volumes prior to treatment, relative to HC participants. Conclusions Individual differences in pretreatment striatal function and structure may relate to individual differences in treatment responses for cannabis dependence. While mechanisms underlying these associations require further exploration, the striatum might mediate treatment responses via its role in associative reward-learning (e.g., through skills training in CBT or reinforcement of abstinence in CM

  9. Age and Adaptive Functioning in Children and Adolescents with ASD: The Effects of Intellectual Functioning and ASD Symptom Severity

    Science.gov (United States)

    Hill, Trenesha L.; Gray, Sarah A. O.; Kamps, Jodi L.; Enrique Varela, R.

    2015-01-01

    The present study examined the moderating effects of intellectual functioning and ASD symptom severity on the relation between age and adaptive functioning in 220 youth with autism spectrum disorder (ASD). Regression analysis indicated that intellectual functioning and ASD symptom severity moderated the relation between age and adaptive…

  10. Intensive insulin therapy improves insulin sensitivity and mitochondrial function in severely burned children.

    Science.gov (United States)

    Fram, Ricki Y; Cree, Melanie G; Wolfe, Robert R; Mlcak, Ronald P; Qian, Ting; Chinkes, David L; Herndon, David N

    2010-06-01

    To institute intensive insulin therapy protocol in an acute pediatric burn unit and study the mechanisms underlying its benefits. Prospective, randomized study. An acute pediatric burn unit in a tertiary teaching hospital. Children, 4-18 yrs old, with total body surface area burned > or =40% and who arrived within 1 wk after injury were enrolled in the study. Patients were randomized to one of two groups. Intensive insulin therapy maintained blood glucose levels between 80 and 110 mg/dL. Conventional insulin therapy maintained blood glucose < or =215 mg/dL. Twenty patients were included in the data analysis consisting of resting energy expenditure, whole body and liver insulin sensitivity, and skeletal muscle mitochondrial function. Studies were performed at 7 days postburn (pretreatment) and at 21 days postburn (posttreatment). Resting energy expenditure significantly increased posttreatment (1476 +/- 124 to 1925 +/- 291 kcal/m(2) x day; p = .02) in conventional insulin therapy as compared with a decline in intensive insulin therapy. Glucose infusion rate was identical between groups before treatment (6.0 +/- 0.8 conventional insulin therapy vs. 6.8 +/- 0.9 mg/kg x min intensive insulin therapy; p = .5). Intensive insulin therapy displayed a significantly higher glucose clamp infusion rate posttreatment (9.1 +/- 1.3 intensive insulin therapy versus 4.8 +/- 0.6 mg/kg x min conventional insulin therapy, p = .005). Suppression of hepatic glucose release was significantly greater in the intensive insulin therapy after treatment compared with conventional insulin therapy (5.0 +/- 0.9 vs. 2.5 +/- 0.6 mg/kg x min; intensive insulin therapy vs. conventional insulin therapy; p = .03). States 3 and 4 mitochondrial oxidation of palmitate significantly improved in intensive insulin therapy (0.9 +/- 0.1 to 1.7 +/- 0.1 microm O(2)/CS/mg protein/min for state 3, p = .004; and 0.7 +/- 0.1 to 1.3 +/- 0.1 microm O(2)/CS/mg protein/min for state 4, p < .002), whereas conventional

  11. Eating disorder severity and functional impairment: moderating effects of illness duration in a clinical sample.

    Science.gov (United States)

    Davidsen, Annika Helgadóttir; Hoyt, William T; Poulsen, Stig; Waaddegaard, Mette; Lau, Marianne

    2017-09-01

    The aim was to examine duration of illness and body mass index as possible moderators of the relationship between eating disorder severity and functional impairment, as well as psychological distress as a possible mediator of this relationship. The study included 159 patients diagnosed with bulimia nervosa, binge eating disorder or eating disorder not otherwise specified. Regression analysis was applied to assess the effect of the hypothesized moderators and mediators. Eating disorder severity was measured with the Eating Disorder Examination Questionnaire, functional impairment was measured with the Sheehan Disability Scale, and psychological distress was measured with the Symptom Check List-90-R. Duration of illness and body mass index were assessed clinically. Duration of illness significantly moderated the relationship between eating disorder severity and functional impairment; the relationship was strongest for patients with a shorter duration of illness. Psychological distress partly mediated the relationship between eating disorder severity and functional impairment. Duration of illness significantly moderated the relationship between psychological distress and functional impairment; the strongest relationship was seen for patients with a shorter duration of illness. Body mass index was not a significant moderator of the relationship between ED severity and functional impairment. Overall, this study established a link between ED severity, psychological distress and functional impairment indicating that both eating disorder severity and psychological distress are more strongly related to impaired role functioning for patients with more recent onset of an eating disorder. More research in the complex relationship between ED severity and functional impairment is needed.

  12. Effect of acute intermittent hypoxia on motor function in individuals with chronic spinal cord injury following ibuprofen pretreatment: A pilot study.

    Science.gov (United States)

    Lynch, Meaghan; Duffell, Lynsey; Sandhu, Milap; Srivatsan, Sudarshan; Deatsch, Kelly; Kessler, Allison; Mitchell, Gordon S; Jayaraman, Arun; Rymer, William Zev

    2017-05-01

    Acute intermittent hypoxia (AIH) enhances lower extremity motor function in humans with chronic incomplete spinal cord injury (SCI). AIH-induced spinal plasticity is inhibited by systemic inflammation in animal models. Since SCI is frequently associated with systemic inflammation in humans, we tested the hypothesis that pretreatment with the anti-inflammatory agent ibuprofen enhances the effects of AIH. A randomized, double-blinded, placebo-controlled crossover design was used. Nine adults (mean age 51.1 ± 13.1 years) with chronic motor-incomplete SCI (7.7 ± 6.3 years post-injury) received a single dose of ibuprofen (800 mg) or placebo, 90 minutes prior to AIH. For AIH, 9% O 2 for 90 seconds was interspersed with 21% O 2 for 60 seconds. Maximal voluntary ankle plantar flexion isometric torque was assessed prior to, and at 0, 30, and 60 minutes post-AIH. Surface electromyography (EMG) of plantar flexor muscles was also recorded. Torque increased significantly after AIH at 30 (P = 0.007; by ∼20%) and 60 (P Ibuprofen did not augment the effects of AIH. EMG activity did not increase significantly after AIH; however, there was a significant association between increases in torque and EMG in both gastrocnemius (R 2  = 0.17, P ibuprofen pretreatment. Our study re-confirms the ability of AIH to enhance leg strength in persons with chronic incomplete SCI.

  13. Corrections Regarding the Impedance of Distance Functions for Several g(d) Functions

    Science.gov (United States)

    Beaman, Jay

    1976-01-01

    Five functions were introduced for modeling travel behavior in the Beaman article "Distance and the 'Reaction' to Distance as a Function of Distance" published in Vol. 6, No. 3 of "Journal of Leisure Research" with the graphs of the functions printed incorrectly. This is a corrected version. (MM)

  14. The extremity function index (EFI), a disability severity measure for neuromuscular diseases: psychometric evaluation.

    Science.gov (United States)

    Bos, Isaäc; Wynia, Klaske; Drost, Gea; Almansa, Josué; Kuks, Jan B M

    2018-06-01

    To adapt and to combine the self-report Upper Extremity Functional Index and Lower Extremity Function Scale, for the assessment of disability severity in patients with a neuromuscular disease and to examine its psychometric properties in order to make it suitable for indicating disease severity in neuromuscular diseases. A cross-sectional postal survey study was performed among patients diagnosed with a neuromuscular disease. Patients completed both adapted extremity function scales, questionnaires for psychometric evaluation, and disease-specific questions. Confirmatory factor analysis was performed, and reliability and validity were examined. Response rate was 70% (n = 702). The Extremity Function Index model with a two-factor structure - for upper and lower extremities - showed an acceptable fit. The Extremity Function Index scales showed good internal consistency (alphas: 0.97-0.98). The known-groups validity test confirmed that Extremity Function Index scales discriminate between categories of "Extent of limitations" and "Quality of Life." Convergent and divergent validity tests confirmed that Extremity Function Index scales measure the physical impact of neuromuscular diseases. Relative validity tests showed that the Extremity Function Index scales performed well in discriminating between subgroups of patients with increasing "Extent of limitations" compared to concurrent measurement instruments. The Extremity Function Index proved to be a sound and easy to apply self-report disability severity measurement instrument in neuromuscular diseases. Implications for rehabilitation The Extremity Function Index reflects the functioning of all muscles in the upper and lower extremities involved in activities of daily living. The Extremity Function Index is an easy to administer and patient-friendly disability severity measurement instrument that has the ability to evaluate differences in disability severity between relevant neuromuscular disease subgroups. The

  15. Family Functioning in First-Episode and Chronic Psychosis: The Role of Patient's Symptom Severity and Psychosocial Functioning.

    Science.gov (United States)

    Koutra, Katerina; Triliva, Sofia; Roumeliotaki, Theano; Basta, Maria; Lionis, Christos; Vgontzas, Alexandros N

    2016-08-01

    The aim of the present study was to assess the relationship between illness-related characteristics, such as symptom severity and psychosocial functioning, and specific aspects of family functioning both in patients experiencing their first episode of psychosis (FEP) and chronically ill patients. A total of 50 FEP and 50 chronic patients diagnosed with schizophrenia or bipolar disorder (most recent episode manic severe with psychotic features) and their family caregivers participated in the study. Family functioning was evaluated in terms of cohesion and flexibility (FACES IV Package), expressed emotion (FQ), family burden (FBS) and caregivers' psychological distress (GHQ-28). Patients' symptom severity (BPRS) and psychosocial functioning (GAS) were assessed by their treating psychiatrist within 2 weeks from the caregivers' assessment. Increased symptom severity was associated with greater dysfunction in terms of family cohesion and flexibility (β coefficient -0.13; 95 % CI -0.23, -0.03), increased caregivers' EE levels on the form of emotional overinvolvement (β coefficient 1.03; 95 % CI 0.02, 2.03), and psychological distress (β coefficient 3.37; 95 % CI 1.29, 5.45). Family burden was found to be significantly related to both symptom severity (β coefficient 3.01; 95 % CI 1.50, 4.51) and patient's functioning (β coefficient -2.04; 95 % CI -3.55, -0.53). No significant interaction effect of chronicity was observed in the afore-mentioned associations. These findings indicate that severe psychopathology and patient's low psychosocial functioning are associated with poor family functioning. It appears that the effect for family function is significant from the early stages of the illness. Thus, early psychoeducational interventions should focus on patients with severe symptomatology and impaired functioning and their families.

  16. Determining risk of severe gastrointestinal toxicity based on pretreatment gut microbial community in patients receiving cancer treatment : a new predictive strategy in the quest for personalized cancer medicine

    NARCIS (Netherlands)

    Wardill, Hannah R.; Tissing, Wim J. E.

    Purpose of review Currently, our ability to accurately predict a patient's risk of developing severe gastrointestinal toxicity from their cancer treatment is limited. Risk stratification continues to rely on traditional patient-related and treatment-related factors including age, ethnicity, sex,

  17. Donor pretreatment with carbamylated erythropoietin in a brain death model reduces inflammation more effectively than erythropoietin while preserving renal function

    NARCIS (Netherlands)

    Nijboer, Willemijn N.; Ottens, Petra J.; van Dijk, Antony; van Goor, Harry; Ploeg, Rutger J.; Leuvenink, Henri G. D.

    Objective: We hypothesized that donor treatment of deceased brain dead donors would lead to a decrease in inflammatory responses seen in brain death and lead to a restoration of kidney function. Design: A standardized slow-induction rat brain death model followed by evaluation of kidney function in

  18. Association between Global Assessment of Functioning scores and indicators of functioning, severity, and prognosis in first-time schizophrenia

    DEFF Research Database (Denmark)

    Köhler-Forsberg, Ole; Horsdal, Henriette Thisted; Baandrup, Lone

    2016-01-01

    are associated with other indicators of functioning, severity, and hospitalization. METHODS: A Danish population-based cohort study of adults (≥18 years) with a recorded GAF-F score at first-time schizophrenia diagnosis during 2004-2011 was performed. The internal validity of GAF-F was evaluated by assessing its...... association with other baseline measures of functioning and illness severity. Risk of schizophrenia hospitalization within 2 years was evaluated using Cox regression stratified by sex and adjusted for age, year of diagnosis, and inpatient/outpatient status at diagnosis. RESULTS: We identified 2,837 cases...... of schizophrenia with a GAF-F score at first-time diagnosis (73.0% inpatients; 62.6% males). GAF-F was associated with several baseline measures of functioning and illness severity, such as female sex, being in work, and a longer baseline hospitalization. Lower GAF-F scores were associated with higher...

  19. MODULAR HYBRID MEMETIC ALGORITHM FOR FINDING A CONDTIONAL GLOBAL EXTREMUM FOR FUNCTIONS OF SEVERAL VARIABLES

    Directory of Open Access Journals (Sweden)

    2016-01-01

    Full Text Available This paper presents a hybrid memetic algorithm for finding a conditional global extremum of functions. The algorithm combines such characteristics as modularity and adaptability which provides flexibility and controllability of the algorithm and reduces the influence of parameters. On the basis of the proposed algorithm the software complex is formed in the C# language. The method effectiveness is demonstrated on several well-known model examples of finding a conditional global extremum for functions of several variables.

  20. Left ventricular diastolic function is associated with symptom status in severe aortic valve stenosis

    DEFF Research Database (Denmark)

    Dahl, Jordi S; Christensen, Nicolaj L; Videbæk, Lars

    2014-01-01

    BACKGROUND: In aortic valve stenosis (AS), the occurrence of heart failure symptoms does not always correlate with severity of valve stenosis and left ventricular (LV) function. Therefore, we tested the hypothesis that symptomatic patients with AS have impaired diastolic, longitudinal systolic...... atrial volume index, and deceleration time were still associated with the presence of symptoms. CONCLUSIONS: The present study demonstrates that symptomatic status in severe AS is associated with impaired diastolic function, LV hypertrophy, concentric remodeling, and left atrial dilatation when corrected...

  1. Mild, moderate, meaningful? Examining the psychological and functioning correlates of DSM-5 eating disorder severity specifiers.

    Science.gov (United States)

    Gianini, Loren; Roberto, Christina A; Attia, Evelyn; Walsh, B Timothy; Thomas, Jennifer J; Eddy, Kamryn T; Grilo, Carlos M; Weigel, Thomas; Sysko, Robyn

    2017-08-01

    This study evaluated the DSM-5 severity specifiers for treatment-seeking groups of participants with anorexia nervosa (AN), the purging form of bulimia nervosa (BN), and binge-eating disorder (BED). Hundred and sixty-two participants with AN, 93 participants with BN, and 343 participants with BED were diagnosed using semi-structured interviews, sub-categorized using DSM-5 severity specifiers and compared on demographic and cross-sectional clinical measures. In AN, the number of previous hospitalizations and the duration of illness increased with severity, but there was no difference across severity groups on measures of eating pathology, depression, or measures of self-reported physical or emotional functioning. In BN, the level of eating concerns increased across the severity groups, but the groups did not differ on measures of depression, self-esteem, and most eating pathology variables. In BN, support was also found for an alternative severity classification scheme based upon number of methods of purging. In BED, levels of several measures of eating pathology and self-reported physical and emotional functioning increased across the severity groups. For BED, however, support was also found for an alternative severity classification scheme based upon overvaluation of shape and weight. Preliminary evidence was also found for a transdiagnostic severity index based upon overvaluation of shape and weight. Overall, these data show limited support for the DSM-5 severity specifiers for BN and modest support for the DSM-5 severity specifiers for AN and BED. © 2017 Wiley Periodicals, Inc.

  2. Postural Care for People with Intellectual Disabilities and Severely Impaired Motor Function: A Scoping Review

    Science.gov (United States)

    Robertson, Janet; Baines, Susannah; Emerson, Eric; Hatton, Chris

    2018-01-01

    Background: Poor postural care can have severe and life-threatening complications. This scoping review aims to map and summarize existing evidence regarding postural care for people with intellectual disabilities and severely impaired motor function. Method: Studies were identified via electronic database searches (MEDLINE, CINAHL, PsycINFO and…

  3. Family Functioning, Self-Concept, and Severity of Adolescent Externalizing Problems

    Science.gov (United States)

    Henderson, Craig E.; Dakof, Gayle A.; Schwartz, Seth J.; Liddle, Howard A.

    2006-01-01

    We investigated direct and shared effects of family functioning and self-concept on the severity of adolescent externalizing problems in a sample of 224 clinically referred adolescents. Structural equation modeling (SEM) revealed strong, direct relationships between problem behaviors and both family functioning and self-concept. Using R. M. Baron…

  4. Continuity in Λ-variation of functions of several variables and convergence of multiple Fourier series

    International Nuclear Information System (INIS)

    Bakhvalov, A N

    2002-01-01

    The behaviour of rectangular partial sums of the Fourier series of functions of several variables having bounded Λ-variation is considered. It is proved that if a continuous function is also continuous in harmonic variation, then its Fourier series uniformly converges in the sense of Pringsheim. On the other hand, it is demonstrated that in dimensions greater than 2 there always exists a continuous function of bounded harmonic variation with Fourier series divergent over cubes at the origin

  5. Cognitive function, functional performance and severity of depression in Chinese older persons with late-onset depression.

    Science.gov (United States)

    Tam, C W C; Lam, L C W

    2012-03-01

    OBJECTIVES. The relationship between cognitive status and depressive symptoms and their liability to cause functional decline are of clinical and public health importance as it appears to be common, frequently coexists, and may be treatable. This study examined the relationship of depression severity and cognitive performance and the impact of such an interaction on functional ability in Chinese elderly subjects with late-onset depression. METHODS. A total of 105 non-demented elderly patients with late-onset depression were recruited. Impairment in instrumental activities of daily living and severity of depression were respectively assessed with the Disability Assessment for Dementia scale and the 24-item Hamilton Depression Rating Scale. Various cognitive domains were assessed including global cognitive function, delayed episodic memory, and executive functions. The relationship between specific cognitive impairment and mood symptom severity was assessed. The clinical correlates of functional performance were also examined. RESULTS. Increasingly severe depression was associated with lower scores in the Mini-Mental State Examination, delayed recall, and poorer performance in the Trail Making Test-Part A (after adjusting for the effect of age and education). The severity of apathy correlated negatively with the Mini-Mental State Examination scores only. Among the depressed subjects, greater levels of depression and apathy, poorer performance in Trail Making Test-Part B, and mild parkinsonian signs were associated with lower functional scores. CONCLUSIONS. Lack of interest and motivation, depressive mood, compounded by behavioural abnormalities resulting from executive dysfunction, accounted for functional disability in elderly subjects with late-onset depression. These relationships may provide the background for developing interventions targeting functional deficits associated with specific cognitive dysfunctions and depression.

  6. Relationship of Renal Function Tests and Electrolyte Levels with Severity of Dehydration in Acute Diarrhea.

    Science.gov (United States)

    Gauchan, E; Malla, K K

    2015-01-01

    Acute diarrheal illness constitutes a major cause of morbidity and mortality in children in developing countries. Most of the complications of diarrhea occur due to excessive fluid and electrolyte loss; adverse complications are seen more with increasing severity of dehydration. This study was conducted to identify the relation of renal function and electrolyte abnormalities in children with varying severity of dehydration. This study was carried out in Manipal Teaching Hospital, Pokhara, Nepal over duration of one year. The aims were to find out the association of renal function and electrolyte disturbances with type of diarrhea, severity of dehydration and their relation to outcome. All children more than one month and less than 15 years with acute diarrhea were included in the study. Data were entered and analyzed by SPSS version 19. Statistical analysis applied was Chi-square test. A p-value of Dehydration was associated more with Acute Watery Diarrhea than with Invasive Diarrhea. Renal function and electrolyte abnormalities were seen more in Acute Watery Diarrhea with increasing levels of blood urea, serum creatinine and abnormal levels of serum sodium seen with increased severity of dehydration. Abnormalities in renal function and electrolytes correlated significantly with severity of dehydration. The outcome of patients correlated with severity of dehydration with mortality occurring in 18.1% of patients with Severe dehydration, 0.8% of Some dehydration with no mortality in the No dehydration group.

  7. Association of Body Mass Index with Asthma Severity and Pulmonary Function among Asthmatic Children

    Directory of Open Access Journals (Sweden)

    Rasuol Nasiri Kalmarzi

    2016-09-01

    Full Text Available Background Asthma is a chronic inflammatory disease in respiratory system and obesity is another inflammatory disease which incidence rate is increasing. Although, many studies have been conducted on severity of asthma and its relationship with obesity, but different results have been obtained. This study aimed to determine a relationship between asthma severity, Body Mass Index (BMI and pulmonary function in Kurdistan province, Iran. Materials and Methods: In this cross sectional study 90 asthmatic patients referred to referral hospital in Kurdistan, North West of Iran, were selected by simple random method. BMI was calculated by dividing weight by height.Pulmonary Function Test (PFT and bronchial-stimulation-test were used for confirmation and investigation of asthma severity. Data were analyzed using SPSS-15 and Chi-square and spearman correlation coefficient tests. Results: Relationship between BMI and severity of asthma (mild, medium and severe was evaluated, there was a relationship and positive relationship between them (P

  8. Laterality of cerebral hemispheres on CT scan and gross motor function in severely handicapped children

    Energy Technology Data Exchange (ETDEWEB)

    Iwasaki, Nobuaki; Hamano, Kenzo; Nakamoto, Natsue; Okada, Yusuke [Tsukuba Univ., Ibaraki (Japan); Takeya, Toshiki

    1997-06-01

    The relation between brain damage and gross motor function in severely handicapped children (spastic type) was studied. The subjects were fifteen cases with laterality in their cerebral hemisphere CT scans (laterality group) and 28 cases with no laterality (control group). All cases were divided into four groups according to the level of gross motor function. The grade of brain damage was estimated based on CT scan analysis using the following parameters and index: maximum frontal extracerebral space (ES), maximum width of Sylvian fissure (SY), Evans` ratio, and cella media index. In the laterality group, the parameters and index were measured for both cerebral hemispheres, respectively. In the more severely disturbed hemisphere of the laterality group, ES and SY were significantly enlarged compared with those of the cases with the same level of motor function in the control group (p<0.01). In the less severely disturbed hemisphere of the laterality group, the ES, SY, Evans` ratio and cell media index were not significantly enlarged compared to cases with the same level of motor function as the control group. These findings may indicate that gross motor function of severely handicapped children is closely related to the less severely disturbed cerebral hemisphere. (author)

  9. Winter severity determines functional trait composition of phytoplankton in seasonally ice-covered lakes.

    Science.gov (United States)

    Özkundakci, Deniz; Gsell, Alena S; Hintze, Thomas; Täuscher, Helgard; Adrian, Rita

    2016-01-01

    How climate change will affect the community dynamics and functionality of lake ecosystems during winter is still little understood. This is also true for phytoplankton in seasonally ice-covered temperate lakes which are particularly vulnerable to the presence or absence of ice. We examined changes in pelagic phytoplankton winter community structure in a north temperate lake (Müggelsee, Germany), covering 18 winters between 1995 and 2013. We tested how phytoplankton taxa composition varied along a winter-severity gradient and to what extent winter severity shaped the functional trait composition of overwintering phytoplankton communities using multivariate statistical analyses and a functional trait-based approach. We hypothesized that overwintering phytoplankton communities are dominated by taxa with trait combinations corresponding to the prevailing winter water column conditions, using ice thickness measurements as a winter-severity indicator. Winter severity had little effect on univariate diversity indicators (taxon richness and evenness), but a strong relationship was found between the phytoplankton community structure and winter severity when taxon trait identity was taken into account. Species responses to winter severity were mediated by the key functional traits: motility, nutritional mode, and the ability to form resting stages. Accordingly, one or the other of two functional groups dominated the phytoplankton biomass during mild winters (i.e., thin or no ice cover; phototrophic taxa) or severe winters (i.e., thick ice cover; exclusively motile taxa). Based on predicted milder winters for temperate regions and a reduction in ice-cover durations, phytoplankton communities during winter can be expected to comprise taxa that have a relative advantage when the water column is well mixed (i.e., need not be motile) and light is less limiting (i.e., need not be mixotrophic). A potential implication of this result is that winter severity promotes different

  10. Caregiver availability for severe stroke results in improved functional ability at discharge from inpatient rehabilitation.

    Science.gov (United States)

    Mirkowski, Magdalena; Pereira, Shelialah; Janzen, Shannon; Mehta, Swati; Meyer, Matthew; McClure, Andrew; Speechley, Mark; Teasell, Robert

    2018-02-01

    To evaluate the predictive capacity of caregiver availability on functional ability at time of discharge from inpatient rehabilitation in individuals with severe first-time stroke. A retrospective chart review was conducted of severe stroke inpatients admitted to a stroke rehabilitation unit between April 2005 and December 2009. Follow-up telephone interviews were conducted with patients to determine caregiver availability at time of discharge. Hierarchical linear regression analysis was performed to assess the predictive capacity of caregiver availability on functional ability at discharge from an inpatient rehabilitation unit after controlling for covariates. Data from 180 individuals were included in the analysis. Individuals with a caregiver had significantly higher levels of functional ability at discharge compared to those without (85.8 ± 23.6 versus 72.9 ± 20.3; p availability explained 1.3% of additional variance, with the final model explaining 41.3% of total variance for functional ability at discharge (F (5,174) = 26.21, p availability of a caregiver at time of discharge from inpatient rehabilitation is predictive of improved functional ability at discharge in individuals with severe stroke. The presence of an available caregiver positively influences the functional recovery of individuals with severe stroke and may be an important element to successful rehabilitation.

  11. Factors related to acupuncture response in patients with chronic severe functional constipation: Secondary analysis of a randomized controlled trial.

    Directory of Open Access Journals (Sweden)

    Xingyue Yang

    Full Text Available Acupuncture has been demonstrated to be effective and safe for chronic severe functional constipation (CSFC. However, which patients with CSFC will have a better response to acupuncture remains unclear.To explore factors related to acupuncture response in patients with CSFC.We performed a secondary analysis of a previous multicenter randomized controlled trial consisting of a 2-week run-in period, 8-week treatment, and 12-week follow-up without treatment in which patients with CSFC were randomly allocated to an electroacupuncture group or a sham electroacupuncture group. Responders were defined as participants with an increase of at least one complete spontaneous bowel movement (CSBM in week 20 compared with the baseline period. The CSBM responder rate in both groups was described, and the baseline characteristics of participants potentially related to acupuncture response were mainly analyzed using logistic regression analysis with bootstrapping techniques.A total of 1021 participants were analyzed in this study, of whom 516 (50.5% were classified as responders. The CSBM responder rate in week 20 was significantly greater in the electroacupuncture group than in the sham electroacupuncture group (62.9% vs. 37.9%, respectively; P<0.001. Both age and comorbidity were negatively associated with clinical response: with every one-year increase in age, the likelihood of clinical response was reduced by 1.2% (OR 0.988, 95%CI 0.980 to 0.996; P = 0.005, and patients with comorbidities were approximately 42% less likely to respond to treatment (OR 0.581, 95%CI 0.248 to 0.914; P = 0.001.CSFC patients with increasing age and comorbidity may be less likely to respond to acupuncture. These findings contribute to guiding clinical practice in terms of pretreatment patient selection. Further research is needed to confirm the association.

  12. Impact of functional severity on self concept in young people with spina bifida.

    OpenAIRE

    Minchom, P E; Ellis, N C; Appleton, P L; Lawson, V; Böll, V; Jones, P; Elliott, C E

    1995-01-01

    This study examines the relationship between medical and functional severity of disability and levels of self esteem and self concept in 79 young people with spina bifida. Greater feelings of global self worth and of self esteem in physical appearance were associated with greater severity of disability. This was only in part an effect of lower IQ among the most disabled young people. Many of the least disabled had marked impairment of self esteem. Analysis of the impact of individual aspects ...

  13. Trauma center designation correlates with functional independence after severe but not moderate traumatic brain injury.

    Science.gov (United States)

    Brown, Joshua B; Stassen, Nicole A; Cheng, Julius D; Sangosanya, Ayodele T; Bankey, Paul E; Gestring, Mark L

    2010-08-01

    The mortality of traumatic brain injury (TBI) continues to decline, emphasizing functional outcomes. Trauma center designation has been linked to survival after TBI, but the impact on functional outcomes is unclear. The objective was to determine whether trauma center designation influenced functional outcomes after moderate and severe TBI. Trauma subjects presenting to an American College of Surgeons (ACS) Level I or II trauma center with a Glasgow Coma Score (GCS) independence (FI) defined as a modified functional independence measure (FIM) of 12, and independent expression (IE) defined as a FIM component of 4. These were compared between Level I and Level II centers in subjects with both moderate (GCS 9-12) and severe (GCS severe TBI). After adjusting for covariates, ACS Level I designation was associated with FI (odds ratio: 1.16; confidence interval: 1.07-1.24, p < 0.01) and IE (1.10; 1.03-1.17, p < 0.01) after severe TBI. Trauma center designation was not associated with FI or IE after moderate TBI. ACS trauma center designation is significantly associated with FI and IE after severe, but not moderate TBI. Prospective study is warranted to verify and explore factors contributing to this discrepancy.

  14. Exercise and cognitive functions in Parkinson's disease: Gender differences and disease severity

    Directory of Open Access Journals (Sweden)

    Claudia Teixeira-Arroyo

    2014-12-01

    Full Text Available This study investigated the effect of a multimodal exercise program on executive functions and memory in people with Parkinson's disease, taking into account disease severity and gender. Twenty-three patients with Parkinson's disease (PD were evaluated before and after a 6-month exercise program to improve executive functions and memory. We observed the effects of the intervention on executive functions (ability to abstract: p = .01, immediate memory (p= .04 and declarative episodic memory (p < .001. Women showed higher scores on declarative episodic memory (p = .03 than men, however there was no interaction between gender and the intervention. Regardless of sex and disease severity, these preliminary results indicate that the multimodal exercise seems to be effective in improving cognitive functions in patients with PD, suggesting that this program can be indicated as a preventive strategy to mitigate progressive cognitive deficits in the later stages of the disease.

  15. A COGNITIVE-BEHAVIOURAL GROUP TREATMENT IMPROVED WORK ABILITY IN PATIENTS WITH SEVERE FUNCTIONAL SOMATIC SYNDROMES

    OpenAIRE

    Schröder, Andreas; Ørnbøl, Eva; Jensen, Jens Søndergaard; Fink, Per

    2014-01-01

    Objective: Functional somatic syndromes (FSS) such as fibromyalgia, irritable bowel and chronic fatigue syndrome often disrupt employment and may lead to long-term dependence on social benefits and permanently reduced work ability. Cognitive-behavioural treatments (CBT) relief symptoms and improve functioning in FSS, but their effect on work ability is unclear. The aim of this study was to estimate the long-term effect of group CBT on work ability in patients with severe FSS. Methods: 120 Pa...

  16. Cognitive and social functioning correlates of employment among people with severe mental illness

    OpenAIRE

    Saavedra, Javier; López, Marcelino; González, Sergio; Arias, Samuel; Crawford, Paul

    2015-01-01

    We assess how social and cognitive functioning is associated to gaining employment for 213 people diagnosed with severe mental illness taking part in employment programs in Andalusia (Spain). We used the Repeatable Battery for the Assessment of Neuropsychological Status and the Social Functioning Scale and conducted two binary logistical regression analyses. Response variables were: having a job or not, in ordinary companies (OCs) and social enterprises (SEs), and working in and OC or not. Th...

  17. The application of a mathematical model linking structural and functional connectomes in severe brain injury

    Directory of Open Access Journals (Sweden)

    A. Kuceyeski

    2016-01-01

    Full Text Available Following severe injuries that result in disorders of consciousness, recovery can occur over many months or years post-injury. While post-injury synaptogenesis, axonal sprouting and functional reorganization are known to occur, the network-level processes underlying recovery are poorly understood. Here, we test a network-level functional rerouting hypothesis in recovery of patients with disorders of consciousness following severe brain injury. This hypothesis states that the brain recovers from injury by restoring normal functional connections via alternate structural pathways that circumvent impaired white matter connections. The so-called network diffusion model, which relates an individual's structural and functional connectomes by assuming that functional activation diffuses along structural pathways, is used here to capture this functional rerouting. We jointly examined functional and structural connectomes extracted from MRIs of 12 healthy and 16 brain-injured subjects. Connectome properties were quantified via graph theoretic measures and network diffusion model parameters. While a few graph metrics showed groupwise differences, they did not correlate with patients' level of consciousness as measured by the Coma Recovery Scale — Revised. There was, however, a strong and significant partial Pearson's correlation (accounting for age and years post-injury between level of consciousness and network diffusion model propagation time (r = 0.76, p < 0.05, corrected, i.e. the time functional activation spends traversing the structural network. We concluded that functional rerouting via alternate (and less efficient pathways leads to increases in network diffusion model propagation time. Simulations of injury and recovery in healthy connectomes confirmed these results. This work establishes the feasibility for using the network diffusion model to capture network-level mechanisms in recovery of consciousness after severe brain injury.

  18. Effects of the severity of menopausal symptoms on sexual function in postmenopausal women

    Directory of Open Access Journals (Sweden)

    S. Nazarpour

    2016-10-01

    Full Text Available Background: Sexual function can be affected by several factors. Menopause and its symptoms including somatic, psychological, and urogenital symptoms can be associated with sexual dysfunction during menopause. Objective: The aim of this study was to determine the effects of the severity of menopausal symptoms on sexual function in postmenopausal women. Methods: This analytical study was conducted in 405 postmenopausal women -40 to 60 years old- in Nowshahr and Chaloos during 2013 and 2014. Subjects were selected by multi-stage random sampling method. Data were collected using the Female Sexual Function Index (FSFI, the Menopause Rating Scale (MRS, and a researcher-made questionnaire. Data were analyzed using Pearson's correlation coefficient, Spearman correlation coefficient, T-test, multiple linear regression and logistic regression. Findings: Sixty one percent of the subjects had sexual dysfunction. The most severe menopausal symptoms were related to psychological domain and the lowest score was related to urogenital domain. All domains of MRS and the MRS total score had significantly negative correlation with the FSFI total score. The urogenital score (r=0.283, P<0.001 and the MRS total score (r=0.116, P=0.020 had significantly positive correlation with sexual dissatisfaction. Urogenital score and MRS total score were significantly higher in women with decreased sexuality and sexual relationship after menopause compared to others. The severity of menopausal symptoms was negative predictor of all domains of sexual function except for satisfaction and the FSFI total score. The MRS total score was a predictor of variation in sexuality and sexual relationship after menopause and satisfaction. Conclusion: The severity of menopausal symptoms could have a negative effect on sexual function. Controlling these symptoms should be noted to improve sexual function for women's health policy making.

  19. Transcatheter Aortic Valve Replacement Results in Improvement of Pulmonary Function in Patients With Severe Aortic Stenosis.

    Science.gov (United States)

    Gilmore, Richard C; Thourani, Vinod H; Jensen, Hanna A; Condado, Jose; Binongo, José Nilo G; Sarin, Eric L; Devireddy, Chandan M; Leshnower, Bradley; Mavromatis, Kreton; Syed, Amjad; Guyton, Robert A; Block, Peter C; Simone, Amy; Keegan, Patricia; Stewart, James; Rajaei, Mohammad; Kaebnick, Brian; Lerakis, Stamatios; Babaliaros, Vasilis C

    2015-12-01

    Chronic obstructive pulmonary disease (COPD) has been identified as a risk factor for morbidity and mortality after transcatheter aortic valve replacement (TAVR). We hypothesized that a portion of pulmonary dysfunction in patients with severe aortic stenosis may be of cardiac origin, and has potential to improve after TAVR. A retrospective analysis was made of consecutive TAVR patients from April 2008 to October 2014. Of patients who had pulmonary function testing and serum B-type natriuretic peptide data available before and after TAVR, 58 were found to have COPD (26 mild, 14 moderate, and 18 severe). Baseline variables and operative outcomes were explored along with changes in pulmonary function. Multiple regression analyses were performed to adjust for preoperative left ventricular ejection fraction and glomerular filtration rate. Comparison of pulmonary function testing before and after the procedure among all COPD categories showed a 10% improvement in forced vital capacity (95% confidence interval: 4% to 17%) and a 12% improvement in forced expiratory volume in 1 second (95% confidence interval: 6% to 19%). There was a 29% decrease in B-type natriuretic peptide after TAVR (95% confidence interval: -40% to -16%). An improvement of at least one COPD severity category was observed in 27% of patients with mild COPD, 64% of patients with moderate COPD, and 50% of patients with severe COPD. There was no 30-day mortality in any patient group. In patients with severe aortic stenosis, TAVR is associated with a significant improvement of pulmonary function and B-type natriuretic peptide. After TAVR, the reduction in COPD severity was most evident in patients with moderate and severe pulmonary dysfunction. Copyright © 2015 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

  20. Long-term psychological functioning of adults with severe congenital facial disfigurement

    NARCIS (Netherlands)

    Passchier, J.; Versnel, S.L.; Plomp, R.G.; Duivenvoorden, H.J.; Mathijssen, I.M.

    2012-01-01

    BACKGROUND: In adults with severe congenital facial disfigurement, assessment of long-term psychological impact remains limited. This study determines the long-term psychological functioning in these patients and evaluates differences compared with patients with acquired facial disfigurement and a

  1. Application of the Mitrofanoff principle in children with severe impairment of bladder function

    NARCIS (Netherlands)

    Heij, H. A.; Ekkelkamp, S.; Moorman-Voestermans, C. G.; Vos, A.

    1997-01-01

    Treatment of children with severe impairment of bladder function requires a large-volume, low-pressure reservoir combined with a continent, easily catheterizable valve. The Mitrofanoff principle (MP) appears to meet these requirements. Between 1986 and 1993, the MP was applied in 15 children (4

  2. Relation of osteoprotegerin in severe aortic valve stenosis to postoperative outcome and left ventricular function

    DEFF Research Database (Denmark)

    Dahl, Jordi S; Videbæk, Lars; Poulsen, Mikael K

    2013-01-01

    ventricular (LV) function and remodeling and to evaluate the significance of preoperative OPG on long-term outcome in terms of survival and symptomatic improvement in 124 patients with severe AS scheduled for aortic valve replacement (AVR). Patients were divided according to tertiles of preoperative OPG...

  3. Psychometric properties of the Dutch Short Musculoskeletal Function Assessment (SMFA) questionnaire in severely injured patients

    NARCIS (Netherlands)

    C.C.H.M. van Delft-Schreurs (C. C H M); M.A.C. van Son; M.A.C. de Jongh (Mariska); T. Gosens; M.H.J. Verhofstad (Michiel); J. de Vries (Jolanda)

    2016-01-01

    textabstractIn this cross-sectional study the psychometric properties are examined of the adapted Dutch translation of the Short Musculoskeletal Function Assessment (SMFA) questionnaire in severely injured patients (ISS. >. 15). Patients and methods: Patients (N = 173) completed the SMFA, the World

  4. Psychometric properties of the Dutch Short Musculoskeletal Function Assessment (SMFA) questionnaire in severely injured patients

    NARCIS (Netherlands)

    van Delft-Schreurs, C. C. H. M.; van Son, M.A.C.; de Jongh, M.A.C.; Gosens, T.; Verhofstad, M. H. J.; de Vries, J.

    2016-01-01

    In this cross-sectional study the psychometric properties are examined of the adapted Dutch translation of the Short Musculoskeletal Function Assessment (SMFA) questionnaire in severely injured patients (ISS > 15). Patients and methods Patients (N = 173) completed the SMFA, the World Health

  5. Association between vitamin D status and physical function in the severely obese.

    LENUS (Irish Health Repository)

    Ahern, T

    2014-07-01

    Mortality is 85% higher in severely obese subjects (body mass index [BMI] > 40 kg\\/m(2)) than in subjects with a healthy BMI; poor physical function may be contributory. Hypovitaminosis D is common in obese subjects and is associated with physical dysfunction in the elderly.

  6. Behavioral Support for Students with Severe Disabilities: Functional Assessment and Comprehensive Intervention.

    Science.gov (United States)

    Horner, Robert H.; Carr, Edward G.

    1997-01-01

    Two major advances in the provision of behavioral support to students with severe disabilities include: (1) procedures for conducting functional assessment, and (2) design of comprehensive interventions. The research foundation for these advances, implications for clinicians, and future research directions are presented. (Author/DB)

  7. Using Functional Analysis Methodology to Evaluate Effects of an Atypical Antipsychotic on Severe Problem Behavior

    Science.gov (United States)

    Danov, Stacy E.; Tervo, Raymond; Meyers, Stephanie; Symons, Frank J.

    2012-01-01

    The atypical antipsychotic medication aripiprazole was evaluated using a randomized AB multiple baseline, double-blind, placebo-controlled design for the treatment of severe problem behavior with 4 children with intellectual and developmental disabilities. Functional analysis (FA) was conducted concurrent with the medication evaluation to…

  8. Functional Status Examination in Patients with Moderate to Severe Traumatic Brain Injuries.

    Science.gov (United States)

    Machamer, Joan; Temkin, Nancy; Manley, Geoffrey; Dikmen, Sureyya

    2018-02-07

    The assessment of functional status after traumatic brain injury (TBI) is important. The Glasgow Outcome Scale (GOS) and its revised version Glasgow Outcome Scale Extended (GOSE) have been used most frequently in TBI research but there are concerns about the sensitivity of these measures. The current study evaluated the psychometric properties of the Functional Status Examination (FSE) using a sample of 448 moderately to severely injured subjects with traumatic brain injury (TBI). The FSE is significantly related to other measures of functional status including the GOSE, Short Form Health Survey and EuroQol Checklist(p < .001), is sensitive to TBI severity (p < .001), and is responsive to recovery from 3 to 6 months post-injury (p < .001). In addition, there was a significant agreement (r = .817, p < .001) between the patient and significant other's assessment of functional status on the FSE at 6-months post-injury. The FSE may be a valuable measure of functional status after TBI given its strong psychometric properties including validity, sensitivity to brain injury severity, and recovery over time.

  9. Myocardial function and effects of biologic therapy in patients with severe psoriasis

    DEFF Research Database (Denmark)

    Ahlehoff, O.; Hansen, P. R.; Gislason, G. H.

    2016-01-01

    function in patients with severe psoriasis who initiated biologic therapy. Methods Between November 1 2013 and May 31 2014 the study subjects underwent physical, laboratory and comprehensive echocardiographic examination at baseline and after 3 months of treatment. Pearson correlation coefficients...... and Student's t-test were applied to assess changes in diastolic function (defined as the E/e' ratio) and global longitudinal strain (GLS). Results Eighteen patients with severe psoriasis treated with biologic therapy with a mean follow-up of 85.6 ± 18.2 days were included. The patients had a baseline.......74). Likewise, no changes were seen in total cholesterol, low density lipoprotein cholesterol, high density lipoprotein cholesterol, estimated glomerular filtration rate and glycosylated haemoglobin. Conclusion In patients with severe psoriasis treatment with biologic therapy was associated with improved PASI...

  10. Glutamine granule-supplemented enteral nutrition maintains immunological function in severely burned patients.

    Science.gov (United States)

    Peng, Xi; Yan, Hong; You, Zhongyi; Wang, Pei; Wang, Shiliang

    2006-08-01

    Glutamine is an important energy source for immune cells. It is a necessary nutrient for cell proliferation, and serves as specific fuel for lymphocytes, macrophages, and enterocytes when it is present in appropriate concentrations. The purpose of this clinical study was to observe the effects of enteral nutrition supplemented with glutamine granules on immunologic function in severely burned patients. Forty-eight severely burned patients (total burn surface area 30-75%, full thickness burn area 20-58%) who met the requirements of the protocol joined this double-blind randomized controlled clinical trail. Patients were randomly divided into two groups: burn control group (B group, 23 patients) and glutamine treated group (Gln group, 25 patients). There was isonitrogenous and isocaloric intake in both groups, Gln and B group patents were given glutamine granules or placebo (glycine) at 0.5 g/kgd for 14 days with oral feeding or tube feeding, respectively. The plasma level of glutamine and several indices of immunologic function including lymphocyte transformation ratio, neutrophil phagocytosis index (NPI), CD4/CD8 ratio, the content of immunoglobulin, complement C3, C4 and IL-2 levels were determined. Moreover, wound healing rate of burn area was observed and then hospital stay was recorded. The results showed significantly reduced plasma glutamine and damaged immunological function after severe burn Indices of cellular immunity function were remarkably decreased from normal controls. After taking glutamine granules for 14 days, plasma glutamine concentration was significantly higher in Gln group than that in B group (607.86+/-147.25 micromol/L versus 447.63+/-132.38 micromol/L, P0.05). In addition, wound healing was better and hospital stay days were reduced in Gln group (46.59+/-12.98 days versus 55.68+/-17.36 days, Pfeeding or tube feeding abate the degree of immunosuppression, improve immunological function especially cellular immunity function, ameliorate wound

  11. Association Between Severe Vitamin D Deficiency, Lung Function and Asthma Control.

    Science.gov (United States)

    Beyhan-Sagmen, Seda; Baykan, Ozgur; Balcan, Baran; Ceyhan, Berrin

    2017-04-01

    To examine the relationship between severe vitamin D deficiency, asthma control, and pulmonary function in Turkish adults with asthma. One hundred six asthmatic patients underwent pulmonary function tests skin prick test, peripheral blood eosinophil counts, IgE, body mass index and vitamin D levels were determined. Patients were divided into 2 subgroups according to vitamin D levels (vitamin D level<10ng/ml and vitamin D level≥10 ng/ml). Asthma control tests were performed. The mean age of subgroup i (vitamin D level<10) was 37±10 and the mean age of subgroup ii (vitamin D level≥10ng/ml) was 34±8. Sixty-six percent of patients had severe vitamin D deficiency (vitamin D level<10 ng/ml). There was a significant trend towards lower absolute FEV 1 (L) values in patients with lower vitamin D levels (P=.001). Asthma control test scores were significantly low in the severe deficiency group than the other group (P=.02). There were a greater number of patients with uncontrolled asthma (asthma control test scores<20) in the severe vitamin D deficiency group (P=.040). Patients with severe vitamin D deficiency had a higher usage of inhaled corticosteroids than the group without severe vitamin D deficiency (P=.015). There was a significant trend towards lower absolute FEV 1 (L) (P=.005, r=.272) values in patients with lower vitamin D levels. Vitamin D levels were inversely related with body mass index (P=.046). The incidence of severe vitamin D deficiency was high in adult Turkish asthmatics. In addition, lower vitamin D levels were associated with poor asthma control and decreased pulmonary function. Copyright © 2016 SEPAR. Publicado por Elsevier España, S.L.U. All rights reserved.

  12. Factors predicting functional and cognitive recovery following severe traumatic, anoxic, and cerebrovascular brain damage.

    Science.gov (United States)

    Smania, Nicola; Avesani, Renato; Roncari, Laura; Ianes, Patrizia; Girardi, Paolo; Varalta, Valentina; Gambini, Maria Grazia; Fiaschi, Antonio; Gandolfi, Marialuisa

    2013-01-01

    To compare demographic data, clinical data, and rate of functional and cognitive recovery in patients with severe traumatic, cerebrovascular, or anoxic acquired brain injury (ABI) and to identify factors predicting discharge home. Three hundred twenty-nine patients with severe ABI (192 with traumatic, 104 with cerebrovascular, and 33 with anoxic brain injury). Longitudinal prospective study of inpatients attending the intensive Rehabilitation Department of the "Sacro Cuore" Don Calabria Hospital (Negrar, Verona, Italy). Etiology, sex, age, rehabilitation admission interval, rehabilitation length of stay, discharge destination, Glasgow Coma Scale, Disability Rating Scale (DRS), Glasgow Outcome Scale, Levels of Cognitive Functioning, and Functional Independence Measure. Predominant etiology was traumatic; male gender was prevalent in all the etiologic groups; patients with traumatic brain injury were younger than the patients in the other groups and had shorter rehabilitation admission interval, greater functional and cognitive outcomes on all considered scales, and a higher frequency of returning home. Patients with anoxic brain injury achieved the lowest grade of functional and cognitive recovery. Age, etiology, and admission DRS score predicted return home. Patients with traumatic brain injury achieved greater functional and cognitive improvements than patients with cerebrovascular and anoxic ABI. Age, etiology, and admission DRS score can assist in predicting discharge destination.

  13. Methods for pretreating biomass

    Science.gov (United States)

    Balan, Venkatesh; Dale, Bruce E; Chundawat, Shishir; Sousa, Leonardo

    2017-05-09

    A method for pretreating biomass is provided, which includes, in a reactor, allowing gaseous ammonia to condense on the biomass and react with water present in the biomass to produce pretreated biomass, wherein reactivity of polysaccharides in the biomass is increased during subsequent biological conversion as compared to the reactivity of polysaccharides in biomass which has not been pretreated. A method for pretreating biomass with a liquid ammonia and recovering the liquid ammonia is also provided. Related systems which include a biochemical or biofuel production facility are also disclosed.

  14. Sexual functioning of men and women with severe obesity before bariatric surgery.

    Science.gov (United States)

    Steffen, Kristine J; King, Wendy C; White, Gretchen E; Subak, Leslee L; Mitchell, James E; Courcoulas, Anita P; Flum, David R; Strain, Gladys; Sarwer, David B; Kolotkin, Ronette L; Pories, Walter; Huang, Alison J

    2017-02-01

    Obesity may impair sexual function through multiple mechanisms, but little is known about sexual dysfunction among adults with severe obesity seeking bariatric procedures. To describe sexual function and associated factors before bariatric surgery. Ten U.S. clinical facilities. Before bariatric surgery, 2225 of 2458 Longitudinal Assessment of Bariatric Surgery-2 study participants (79% female, median age 45 years and median body mass index 46 kg/m 2 ) completed a survey about sexual function over the past month. Mixed effects ordinal logistic regression models were used to identify factors independently related to 4 domains of sexual function. One third of women (34%) and one quarter of men (25%) were not sexually active, alone or with a partner, in the past month. Twenty-six percent of women and 12% of men reported no sexual desire. Physical health limited sexual activity at least moderately in 38% of women and 44% of men. About one half of the women (49%) and the men (54%) were moderately or very dissatisfied with their sexual life. Among women, older age, being Caucasian, urinary incontinence, depressive symptoms, and antidepressant medication use were associated with poorer sexual function in multiple domains. In men, older age, not being married, depressive symptoms, and antidepressant medication use were associated with poorer sexual function in multiple domains. Before bariatric surgery, approximately one half of women and men with severe obesity are dissatisfied with their sexual life. Older age, severity of depressive symptoms, and antidepressant medication use are associated with poorer sexual function in both sexes. Copyright © 2016. Published by Elsevier Inc.

  15. When Is the Optimal Timing of Surgical Intervention for Severe Functional Tricuspid Regurgitation?

    Directory of Open Access Journals (Sweden)

    Nobuhiro Nakanishi

    2017-01-01

    Full Text Available Functional tricuspid regurgitation (TR is a serious pathology to be noted for severe right heart failure (HF and poor prognosis; however, the conventional assessment of TR has some limitations and the optimal timing of surgical intervention remains unclear. A 79-year-old Japanese female was admitted to our hospital to undergo cardiac surgery, because edema gradually got worse despite the increase in diuretics. She had a history of atrial fibrillation (AF and chronic HF due to severe TR and had been treated with a furosemide for leg edema 4 years ago. A transthoracic echocardiogram (TTE, transesophageal echocardiogram, cardiac magnetic resonance imaging, and cardiac pool scintigraphy demonstrated severe functional TR with tricuspid annular dilation, insufficient tricuspid valve coaptation, and reduced right ventricular ejection fraction (EF but preserved left ventricular EF. In addition, Swan-Ganz catheter study showed normal pulmonary arterial wedge pressure and mean pulmonary arterial pressure. Tricuspid ring annuloplasty was performed with MC3 ring. Postoperative TTE showed trivial TR, and she had no edema with normal sinus rhythm two months later. Annuloplasty to severe functional TR caused by tricuspid annular dilation due to AF dramatically improved right HF. Cardiologist should pay strict attention to the optimal timing of surgical intervention for TR.

  16. Multiple cluster axis II comorbidity and functional outcome in severe patients with borderline personality disorder.

    Science.gov (United States)

    Palomares, Nerea; McMaster, Antonia; Díaz-Marsá, Marina; de la Vega, Irene; Montes, Ana; Carrasco, José Luis

    2016-11-01

    Current literature suggests that personality disorder comorbidity negatively contributes to both the severity and prognosis of other disorders; however, little literature has been devoted to its influence on borderline personality disorder (BPD). The objective of the present work is to study comorbidity with other personality disorders in a severe clinical sample of patients with BPD, and its relationship with global functionality. A sample of 65 patients with severe borderline personality disorder was included in the study. Clinical and functionality measures were applied in order to study comorbidity of BPD with other disorders and its relationship with functionality. Associations with other comorbid PDs were analyzed with t-tests and linear correlations. Most patients (87%) presented comorbidity with other PDs. Almost half of the sample (42%) presented more than two PDs, and cluster A (paranoid) and C (obsessive and avoidant) PD were more frequent than cluster B (histrionic and antisocial). Only the presence of avoidant PD predicted a worse functional outcome in the long term (U Mann Withney ppersonality disorder might negatively predict for prognosis.

  17. Genetic and environmental components of female depression as a function of the severity of the disorder.

    Science.gov (United States)

    Rusby, James S M; Tasker, Fiona; Cherkas, Lynn

    2016-10-01

    Both clinical care and genome-wide studies need to account for levels of severity in the etiology of depression. The purpose of the study is to estimate the genetic and environmental components of female depression as a function of the severity of the disorder. A genetic and environmental model analysis of depression incidence was made using the IOP Depression Severity Measure (IDSM). Details of lifetime depression incidence were obtained by questionnaire from twins on the DTR registry. Data from 1449 matched female twin pairs in the age range 19-85 years in four ordinal categories of increasing severity were employed in the analysis. Estimates of additive and dominance genetic components of 27% and 25% were found when all three levels of depression were included, and near zero and 33% when the recurrent/severe level was excluded. Shared environmental effects were not significant in either case, but the estimate for random environmental effects was greater when the severe level was excluded. These results suggest that the incidence of severe depression is associated with homozygotic alleles and the less severe with heterozygotic alleles. This is in accord with the finding that the hereditary component of severe depression is relatively high and that milder forms are more dependent on life-time environmental factors. Such conclusions have clinical implications for the diagnosis and treatment of the disorder by practicing psychiatrists. They also lead to the importance of focusing future genome-wide and linkage studies on those females with severe levels of depression if progress in identifying genetic risk loci is to be made.

  18. Functional analysis of challenging behavior in people with severe intellectual disabilities.

    Science.gov (United States)

    Delgado-Casas, C; Navarro, J I; Garcia-Gonzalez-Gordon, R; Marchena, E

    2014-12-01

    Challenging behaviors exhibited by individuals with developmental disabilities often hinder the acquisition of academic, social, and life skills. Functional analysis has been useful for assessing challenging behavior in various settings. The purpose of this study was to implement an operant methodology for recognizing the functional properties of challenging behavior in people with intellectual disabilities. Four adults diagnosed with profound intellectual disability received assessment under several experimental conditions using a functional analysis methodology: social attention as positive reinforcement, negative reinforcement such as the termination of demands, positive tangible reinforcements, absence of social contingencies, and escape from noisy stimuli. Results showed that different types of reinforcement or avoiding contingencies affected the rate of aggression, self-injury, disruption, stereotypy, or socially offensive behaviors, and functional analysis may potentially be a viable alternative for identifying challenging behaviors.

  19. Long-term psychological functioning of adults with severe congenital facial disfigurement.

    Science.gov (United States)

    Versnel, Sarah L; Plomp, Raul G; Passchier, Jan; Duivenvoorden, Hugo J; Mathijssen, Irene M J

    2012-01-01

    In adults with severe congenital facial disfigurement, assessment of long-term psychological impact remains limited. This study determines the long-term psychological functioning in these patients and evaluates differences compared with patients with acquired facial disfigurement and a non-facially disfigured reference group. Also explored is the extent to which psychological functioning of the congenital group is related to satisfaction with facial appearance, fear of negative appearance evaluation by others, self-esteem, and severity of the facial deformity. Fifty-nine adults with severe congenital facial disfigurement, 59 adults with a traumatically acquired facial deformity in adulthood, and 120 non-facially disfigured adults completed standardized psychological, physical, and demographic questionnaires, including the Fear of Negative Appearance Evaluation Scale, the Rosenberg Self-Esteem Scale, the Hospital Anxiety and Depression Scale, the Achenbach Adult Self-Report, the 36-Item Short-Form Health Survey, and a visual analogue scale. Adults with severe congenital facial disfigurement had relatively normal psychological functioning but appeared more prone to internalizing problems than the non-facially disfigured adults. Compared with patients with an acquired facial deformity, the congenital group displayed fewer problems on the physical component score of quality of life only. Satisfaction with facial appearance, fear of negative appearance evaluation, and self-esteem were good predictors of the different aspects of psychological functioning, with the exception of the physical component score of quality of life. Improving satisfaction with facial appearance (by surgery), enhancing self-esteem, or lowering fear of negative appearance evaluation (by psychological support) may enhance long-term psychological functioning. Future research should focus on the individual patient and risk factors for maladjustment. Risk, II.

  20. Integrated analysis of hydrothermal flow through pretreatment

    Directory of Open Access Journals (Sweden)

    Archambault-Leger Veronique

    2012-07-01

    Full Text Available Abstract Background The impact of hydrothermal flowthrough (FT pretreatment severity on pretreatment and solubilization performance metrics was evaluated for three milled feedstocks (corn stover, bagasse, and poplar and two conversion systems (simultaneous saccharification and fermentation using yeast and fungal cellulase, and fermentation by Clostridium thermocellum. Results Compared to batch pretreatment, FT pretreatment consistently resulted in higher XMG recovery, higher removal of non-carbohydrate carbon and higher glucan solubilization by simultaneous saccharification and fermentation (SSF. XMG recovery was above 90% for FT pretreatment below 4.1 severity but decreased at higher severities, particularly for bagasse. Removal of non-carbohydrate carbon during FT pretreatment increased from 65% at low severity to 80% at high severity for corn stover, and from 40% to 70% for bagasse and poplar. Solids obtained by FT pretreatment were amenable to high conversion for all of the feedstocks and conversion systems examined. The optimal time and temperature for FT pretreatment on poplar were found to be 16 min and 210°C. At these conditions, SSF glucan conversion was about 85%, 94% of the XMG was removed, and 62% of the non carbohydrate mass was solubilized. Solubilization of FT-pretreated poplar was compared for C. thermocellum fermentation (10% inoculum, and for yeast-fungal cellulase SSF (5% inoculum, cellulase loading of 5 and 10 FPU/g glucan supplemented with β-glucosidase at 15 and 30 U/g glucan. Under the conditions tested, which featured low solids concentration, C. thermocellum fermentation achieved faster rates and more complete conversion of FT-pretreated poplar than did SSF. Compared to SSF, solubilization by C. thermocellum was 30% higher after 4 days, and was over twice as fast on ball-milled FT-pretreated poplar. Conclusions XMG removal trends were similar between feedstocks whereas glucan conversion trends were significantly

  1. Functional outcome following rehabilitation in chronic severe traumatic brain injury patients: A prospective study

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    Anupam Gupta

    2012-01-01

    Full Text Available Objective: The objective was to assess functional outcome of rehabilitation in chronic severe traumatic brain injury (TBI in-patients. Setting: The study was performed at university tertiary research hospital. Study Design: A prospective cross-sectional study Materials and Methods: Forty patients (34 men with mean age of 30.1 years (range 6--60, SD 10.8, severe TBI (Glasgow coma scale 3--8, duration of coma > 6 hours, post-traumatic amnesia> 1 day postinjury were admitted in rehabilitation unit minimum 3 months (mean 7.7±4.6 months, range 3--22 months following injury falling in Glasgow outcome scale (GOS of 3. Functional recovery was assessed using the Barthel Index (BI score and disability rating scores (DRS. Data Analysis: Paired Student′s t-test was used for the assessment of functional recovery using mean BI scores at admission and discharge. The Wilcoxon nonparametric test was used for the assessment of functional recovery by comparing admission and discharge DRS scores. Results: Mean duration of stay was 30.8 days (range 18--91, SD15.6. Significant functional recovery observed in patients comparing BI and DRS scores at admission and discharge (mean BI admission 50.5±25.4, range 0--85 vs. mean discharge BI score 61.1±25.3, range 0--95, P<0.001, mean DRS admission score 7.57±4.1, range 2.5--21.0 vs. mean discharge DRS score 6.36±4.3, range 1.0-21.0, P<0.001. Conclusion: Patients with severe TBI continue to show functional recovery even in chronic phase with rehabilitation. They are left with significant residual physical and cognitive deficits and would require long-term care and assistance from care givers for the daily activities, as suggested by the mean DRS score at discharge.

  2. Anticipated discrimination is related to symptom severity, functionality and quality of life in schizophrenia.

    Science.gov (United States)

    Üçok, Alp; Karadayı, Gülşah; Emiroğlu, Birgül; Sartorius, Norman

    2013-10-30

    The aim of this study is to evaluate a possible relationship between the level of anticipated discrimination with severity of symptoms and functionality. We included 103 patients with schizophrenia. Severity of symptoms was measured by PANSS and Calgary Depression Scale for Schizophrenia. Quality of life (QL) and functionality were measured by using QLS, PSP and Functional Remission of General Schizophrenia Scale (FROGS). Anticipated/experienced discrimination was evaluated with four selected items from Discrimination and Stigma Scale. First, variables related to each item were determined by using t-test and later the variables that have an independent contribution to anticipated discrimination subscale of DISC were evaluated with linear regression analysis. Results showed that those who stated that they felt the need to conceal their diagnosis more had shorter duration of illness, lower PANNS scores, higher scores on professional performance subscale of QLS, a lower number of suicide attempts and higher current employment rates. Participants who reported that they had been avoided or shunned more had higher depression scores. While patients with lower level of functionality tended to stop themselves more, patients with high level of functionality tended to conceal their diagnosis. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  3. Measuring personality functioning in older adults: construct validity of the Severity Indices of Personality Functioning - Short Form (SIPP-SF).

    Science.gov (United States)

    Rossi, Gina; Debast, Inge; van Alphen, S P J

    2017-07-01

    The dimensional personality disorders model in the Diagnostic and Statistical Manual (DSM)-5 section III conceptually differentiates impaired personality functioning (criterion A) from the presence of pathological traits (criterion B). This study is the first to specifically address the measurement of criterion A in older adults. Moreover, the convergent/divergent validity of criterion A and criterion B will be compared in younger and older age groups. The Severity Indices of Personality Functioning - Short Form (SIPP-SF) was administered in older (N = 171) and younger adults (N = 210). The factorial structure was analyzed with exploratory structural equation modeling. Differences in convergent/divergent validity between personality functioning (SIPP-SF) and pathological traits (Personality Inventory for DSM-5; Dimensional Assessment of Personality Pathology-Basic Questionnaire) were examined across age groups. Identity Integration, Relational Capacities, Responsibility, Self-Control, and Social Concordance were corroborated as higher order domains. Although the SIPP-SF domains measured unique variation, some high correlations with pathological traits referred to overlapping constructs. Moreover, in older adults, personality functioning was more strongly related to Psychoticism, Disinhibition, Antagonism and Dissocial Behavior compared to younger adults. The SIPP-SF construct validity was demonstrated in terms of a structure of five higher order domains of personality functioning. The instrument is promising as a possible measure of impaired personality functioning in older adults. As such, it is a useful clinical tool to follow up effects of therapy on levels of personality functioning. Moreover, traits were associated with different degrees of personality functioning across age groups.

  4. Pretreatment of microbial sludges

    Science.gov (United States)

    Rivard, Christopher J.; Nagle, Nicholas J.

    1995-01-01

    Methods are described for pretreating microbial sludges to break cells and disrupt organic matter. One method involves the use of sonication, and another method involves the use of shear forces. The pretreatment of sludge enhances bioconversion of the organic fraction. This allows for efficient dewatering of the sludge and reduces the cost for final disposal of the waste.

  5. Olfactory functions are not associated with autism severity in autism spectrum disorders

    Directory of Open Access Journals (Sweden)

    Dudova I

    2013-11-01

    Full Text Available Iva Dudova, Michal HrdlickaDepartment of Child Psychiatry, University Hospital Motol, Prague, Czech RepublicBackground: Changes in olfactory functions have been found in many neurodegenerative and psychiatric disorders, including autism spectrum disorders (ASDs. The aim of the present study was to evaluate the relationship between olfactory functions (odor-detection thresholds, odor identification, and odor preference and autism severity and sensory-related behavior in children and adolescents with ASD.Subjects and methods: Our sample consisted of 35 high-functioning patients with ASD (mean age 10.8±3.6 years, 31 boys. Olfactory testing (threshold and identification used the Sniffin' Sticks test. Odor pleasantness was assessed on a 5-point scale using the Identification part of the Sniffin’ Sticks test. The severity of autistic psychopathology was measured using the Childhood Autism Rating Scale (CARS.Results: Using Spearman’s correlation, we found no significant correlations between autism severity (as expressed by total CARS score and odor-detection thresholds (R=0.144, P=0.409, odor identification (R=0.07, P=0.966, or odor pleasantness (R=-0.046, P=0.794. There was also no significant relationship between CARS item 9 (“Taste, smell, and touch response and use” and odor-detection thresholds (R=0.170, P=0.330, odor identification (R=0.282, P=0.100, or odor pleasantness (R=0.017, P=0.923.Conclusion: We did not find any significant relationship between the severity of autistic psychopathology and olfactory functions.Keywords: autism spectrum disorders, psychopathology, Sniffin’ Sticks, odor threshold, odor identification, odor pleasantness

  6. The Relationship between Symptom Severity and Cognitive Functions with Obesity in Fibromyalgia Syndrome

    OpenAIRE

    Selçuk Sayılır

    2017-01-01

    Objective: To investigate the relationship between obesity with symptom severity and cognitive functions in Fibromyalgia syndrome (FMS) patients. Materials and Methods: The study comprised 33 FMS patients (mean age 41.21±7.6 years). The patients who have hypertension, hypercholesterolaemia or diabetes, chronic inflammatory disorders, cardiovascular-pulmonary diseases, rheumatological/endocrine diseases, using anticoagulant therapy or have thrombotic disorders, malignancies and pregnant wom...

  7. Severe headache as a presenting complaint in sigmoid sinus thrombosis complicated by functional overlay.

    Science.gov (United States)

    Chaudhary, Pradhyuman; Banwari, Girish; Parikh, Nimesh; Gandhi, Hitendra

    2015-01-01

    An otherwise serious and potentially fatal organic condition may present with a co-existing strong functional component. We encountered a female patient who presented with bouts of severe headache over the occipital region, associated with blurring of vision. Initially, non-contrast computed tomography (CT) scan (Brain) showed normal study, and she was deemed as having functional symptoms. Later, magnetic resonance imaging (MRI) (Brain) showed filling defect in right sigmoid sinus and magnetic resonance (MR) venography confirmed right sigmoid sinus thrombosis. On adequate anticoagulation, she did not improve and still had bouts of severe headache, although no longer associated with impaired vision. The treating neurophysician concluded that symptoms could no longer be accounted for by the organic condition. Overt and covert psychosocial stressors were found to be present in a detailed psychological exploration. Psychological intervention effectively controlled the headache. Thus, functional overlay can complicate the clinical picture in a severe organic condition and may require active psychiatric intervention over and above medical treatment.

  8. Severe headache as a presenting complaint in sigmoid sinus thrombosis complicated by functional overlay

    Directory of Open Access Journals (Sweden)

    Pradhyuman Chaudhary

    2015-01-01

    Full Text Available An otherwise serious and potentially fatal organic condition may present with a co-existing strong functional component. We encountered a female patient who presented with bouts of severe headache over the occipital region, associated with blurring of vision. Initially, non-contrast computed tomography (CT scan (Brain showed normal study, and she was deemed as having functional symptoms. Later, magnetic resonance imaging (MRI (Brain showed filling defect in right sigmoid sinus and magnetic resonance (MR venography confirmed right sigmoid sinus thrombosis. On adequate anticoagulation, she did not improve and still had bouts of severe headache, although no longer associated with impaired vision. The treating neurophysician concluded that symptoms could no longer be accounted for by the organic condition. Overt and covert psychosocial stressors were found to be present in a detailed psychological exploration. Psychological intervention effectively controlled the headache. Thus, functional overlay can complicate the clinical picture in a severe organic condition and may require active psychiatric intervention over and above medical treatment.

  9. Onset of Coagulation Function Recovery Is Delayed in Severely Injured Trauma Patients with Venous Thromboembolism.

    Science.gov (United States)

    McCully, Belinda H; Connelly, Christopher R; Fair, Kelly A; Holcomb, John B; Fox, Erin E; Wade, Charles E; Bulger, Eileen M; Schreiber, Martin A

    2017-07-01

    Altered coagulation function after trauma can contribute to development of venous thromboembolism (VTE). Severe trauma impairs coagulation function, but the trajectory for recovery is not known. We hypothesized that enhanced, early recovery of coagulation function increases VTE risk in severely injured trauma patients. Secondary analysis was performed on data from the Pragmatic Randomized Optimal Platelet and Plasma Ratio (PROPPR) trial, excluding patients who died within 24 hours or were on pre-injury anticoagulants. Patient characteristics, adverse outcomes, and parameters of platelet function and coagulation (thromboelastography) were compared from admission to 72 hours between VTE (n = 83) and non-VTE (n = 475) patients. A p value value (48 vs 24 hours), α-angle (no recovery), maximum amplitude (24 vs 12 hours), and clot lysis at 30 minutes (48 vs 12 hours). Platelet function recovery mediated by arachidonic acid (72 vs 4 hours), ADP (72 vs 12 hours), and collagen (48 vs 12 hours) was delayed in VTE patients. The VTE patients had lower mortality (4% vs 13%; p < 0.05), but fewer hospital-free days (0 days [interquartile range 0 to 8 days] vs 10 days [interquartile range 0 to 20 days]; p < 0.05) and higher complication rates (p < 0.05). Recovery from platelet dysfunction and coagulopathy after severe trauma were delayed in VTE patients. Suppressed clot lysis and compensatory mechanisms associated with altered coagulation that can potentiate VTE formation require additional investigation. Copyright © 2017 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

  10. Investigating executive functions in children with severe speech and movement disorders using structured tasks

    Directory of Open Access Journals (Sweden)

    Kristine eStadskleiv

    2014-09-01

    Full Text Available Executive functions are the basis for goal-directed activity and include planning, monitoring, and inhibition, and language seems to play a role in the development of these functions. There is a tradition of studying executive function in both typical and atypical populations, and the present study investigates executive functions in children with severe speech and motor impairments who are communicating using communication aids with graphic symbols, letters and/or words. There are few neuropsychological studies of children in this group and little is known about their cognitive functioning, including executive functions. It was hypothesized that aided communication would tax executive functions more than speech. 29 children using communication aids and 27 naturally speaking children participated. Structured tasks resembling everyday activities, where the action goals had to be reached through communication with a partner, were used to get information about executive functions. The children a directed the partner to perform actions like building a Lego tower from a model the partner could not see and b gave information about an object without naming it to a person who had to guess what object it was. The executive functions of planning, monitoring and impulse control were coded from the children’s on-task behavior. Both groups solved most of the tasks correctly, indicating that aided communicators are able to use language to direct another person to do a complex set of actions. Planning and lack of impulsivity was positively related to task success in both groups. The aided group completed significantly fewer tasks, spent longer time and showed more variation in performance than the comparison group. The aided communicators scored lower on planning and showed more impulsivity than the comparison group, while both groups showed an equal degree of monitoring of the work progress. The results are consistent with the hypothesis that aided language

  11. Replicating Patient-Specific Severe Aortic Valve Stenosis With Functional 3D Modeling.

    Science.gov (United States)

    Maragiannis, Dimitrios; Jackson, Matthew S; Igo, Stephen R; Schutt, Robert C; Connell, Patrick; Grande-Allen, Jane; Barker, Colin M; Chang, Su Min; Reardon, Michael J; Zoghbi, William A; Little, Stephen H

    2015-10-01

    3D stereolithographic printing can be used to convert high-resolution computed tomography images into life-size physical models. We sought to apply 3D printing technologies to develop patient-specific models of the anatomic and functional characteristics of severe aortic valve stenosis. Eight patient-specific models of severe aortic stenosis (6 tricuspid and 2 bicuspid) were created using dual-material fused 3D printing. Tissue types were identified and segmented from clinical computed tomography image data. A rigid material was used for printing calcific regions, and a rubber-like material was used for soft tissue structures of the outflow tract, aortic root, and noncalcified valve cusps. Each model was evaluated for its geometric valve orifice area, echocardiographic image quality, and aortic stenosis severity by Doppler and Gorlin methods under 7 different in vitro stroke volume conditions. Fused multimaterial 3D printed models replicated the focal calcific structures of aortic stenosis. Doppler-derived measures of peak and mean transvalvular gradient correlated well with reference standard pressure catheters across a range of flow conditions (r=0.988 and r=0.978 respectively, P3D printing, we demonstrate that patient-specific models can replicate both the anatomic and functional properties of severe degenerative aortic valve stenosis. © 2015 American Heart Association, Inc.

  12. Pulmonary function tests and impulse oscillometry in severe chronic obstructive pulmonary disease patients′ offspring

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    Babak Amra

    2015-01-01

    Full Text Available Background: Several studies have showed an increased prevalence of airflow obstruction in first degree relatives of individuals with chronic obstructive pulmonary disease (COPD. Considering no specific research had evaluated airway resistance in offspring of patients with severe COPD, we utilized a spirometry and a impulse oscillometry (IO to evaluate this population. Materials and Methods: In this case control study, from November 2011 to July 2012, we consecutively evaluated 54 offsprings of severe COPD patients (case group admitted in the pulmonary ward, affiliated to the Isfahan University of Medical Sciences and control group. Pulmonary function tests and the IO were obtained for both groups. Student′s t-test was used for inter-group comparisons, and P values below 0.05 were taken as significant. Results: Abnormal increased airway resistance was seen in cases in comparison with controls (R5 Hz [46.29%, P = 0.01], R25 Hz [42.59%, P < 0.001]. Also, considering the spirometry, case group had pulmonary function parameters less than control group (forced vital capacity [FVC]; P = 0.02, forced expiratory volume in 1 st s; P < 0.001, forced expiratory flow (FEF 25-75; P < 0.001, FEF 25-75/FVC; P < 0.001 but they were in normal range. Conclusion: This study demonstrated increased airway resistance among the severe COPD offsprings. The IO may be a sensitive tool for detection of high risk subjects in families with COPD.

  13. Improving arm function by prosthetic limb replacement in a patient with severe arthrogryposis multiplex congenita.

    Science.gov (United States)

    Salminger, Stefan; Roche, Aidan D; Sturma, Agnes; Hruby, Laura A; Aszmann, Oskar C

    2016-10-05

    In patients with severe bilateral congenital arm deficiencies, even simple activities of daily living, such as feeding, may be major challenges. We report here a case of a patient with arthrogryposis multiplex congenita affecting all 4 extremities, who underwent prosthetic replacement after elective transhumeral amputation of his right functionless arm. A 22-year-old man with arthrogryposis multiplex congenita had severe deficits of his upper limbs. Previous surgeries for upper and lower limbs had enabled this patient to walk without aids; however, his upper limbs remained severely impaired. After prosthetic rehabilitation, including nerve and muscle transfers, a carefully planned elective amputation, signal processing and a comprehensive rehabilitation programme, the patient was able to independently conduct normal activities of daily living that had hitherto been impossible. The Disabilities of the Arm, Shoulder and Hand measure improved from 73.3 to 44.2, the Action Research Arm Test improved from 10 to 18 out of 57 points and the Southampton Hand Assessment Procedure improved from 8 to 23 after prosthetic replacement. Prosthetic replacement can improve upper limb function in patients with severe congenital limb deficiencies. In the case reported here, functional rehabilitation had a positive impact on the patient's quality of life and self-confidence, as he integrated the prosthesis into his body image.

  14. A study on quantifying COPD severity by combining pulmonary function tests and CT image analysis

    Science.gov (United States)

    Nimura, Yukitaka; Kitasaka, Takayuki; Honma, Hirotoshi; Takabatake, Hirotsugu; Mori, Masaki; Natori, Hiroshi; Mori, Kensaku

    2011-03-01

    This paper describes a novel method that can evaluate chronic obstructive pulmonary disease (COPD) severity by combining measurements of pulmonary function tests and measurements obtained from CT image analysis. There is no cure for COPD. However, with regular medical care and consistent patient compliance with treatments and lifestyle changes, the symptoms of COPD can be minimized and progression of the disease can be slowed. Therefore, many diagnosis methods based on CT image analysis have been proposed for quantifying COPD. Most of diagnosis methods for COPD extract the lesions as low-attenuation areas (LAA) by thresholding and evaluate the COPD severity by calculating the LAA in the lung (LAA%). However, COPD is usually the result of a combination of two conditions, emphysema and chronic obstructive bronchitis. Therefore, the previous methods based on only LAA% do not work well. The proposed method utilizes both of information including the measurements of pulmonary function tests and the results of the chest CT image analysis to evaluate the COPD severity. In this paper, we utilize a multi-class AdaBoost to combine both of information and classify the COPD severity into five stages automatically. The experimental results revealed that the accuracy rate of the proposed method was 88.9% (resubstitution scheme) and 64.4% (leave-one-out scheme).

  15. Diaphragmatic function in severely malnourished patients with anorexia nervosa. Effects of renutrition.

    Science.gov (United States)

    Murciano, D; Rigaud, D; Pingleton, S; Armengaud, M H; Melchior, J C; Aubier, M

    1994-12-01

    The effects of malnutrition and refeeding on nutritional indices, pulmonary function, and diaphragmatic contractile properties were studied in severely malnourished patients with anorexia nervosa. Fifteen patients were evaluated upon hospital admission (Day 0) and on Days 7, 30, and 45 after starting feeding. Spirometry, lung volumes, and arterial blood gases were measured at each time interval, as were contractile properties of the diaphragm as assessed by transdiaphragmatic pressure generated during electrical phrenic nerve stimulation (Pdistim) and a maximal sniff maneuver (Pdisniff). Anthropomorphic and biochemical measurements were performed at each time interval. Patients were severely malnourished upon admission; mean body weight was 37.1 +/- 4.7 kg (63% ideal body weight). During nutritional support, body weight increased significantly to 42.9 +/- 4.6 kg on Day 45 (p 42 mm Hg) at Day 0, which returned to normal by Day 30. Diaphragmatic contractility was severely depressed initially; Pdistim, 15.9 +/- 1.4 cm H2O; Pdisniff, 65.4 +/- 5 cm H2O; but it significantly increased with nutritional support by Day 30 to 22.5 +/- 1.9 and 84.6 +/- 4.7 cm H2O, respectively. We conclude that diaphragmatic function is severely impaired in malnuorished patients free of other coexisting

  16. Validation of the baseline severity stratification of objective functional impairment in lumbar degenerative disc disease.

    Science.gov (United States)

    Stienen, Martin N; Smoll, Nicolas R; Joswig, Holger; Corniola, Marco V; Schaller, Karl; Hildebrandt, Gerhard; Gautschi, Oliver P

    2017-05-01

    OBJECTIVE The Timed Up and Go (TUG) test is a simple, objective, and standardized method to measure objective functional impairment (OFI) in patients with lumbar degenerative disc disease (DDD). The objective of the current work was to validate the OFI baseline severity stratification (BSS; with levels of "none," "mild," "moderate," and "severe"). METHODS Data were collected in a prospective IRB-approved 2-center study. Patients were assessed with a comprehensive panel of scales for measuring pain (visual analog scale [VAS] for back and leg pain), functional impairment (Roland-Morris Disability Index [RMDI] and Oswestry Disability Index [ODI]), and health-related quality of life (HRQOL; EQ-5D and SF-12). OFI BSS was determined using age- and sex-adjusted cutoff values. RESULTS A total of 375 consecutive patients scheduled for lumbar spine surgery were included. Each 1-step increase on the OFI BSS corresponded to an increase of 0.53 in the back pain VAS score, 0.69 in the leg pain VAS score, 1.81 points in the RMDI, and 5.93 points in the ODI, as well as to a decrease in HRQOL of -0.073 in the EQ-5D, -1.99 in the SF-12 physical component summary (PCS), and -1.62 in the SF-12 mental component summary (MCS; all p measure of functional impairment for use in daily clinical practice. The presence of OFI indicates the presence of significant functional impairment on subjective outcome measures.

  17. Predictors of mortality and poor functional outcome in severe spontaneous intracerebral hemorrhage: a prospective observational study.

    Science.gov (United States)

    Ferrete-Araujo, A M; Egea-Guerrero, J J; Vilches-Arenas, Á; Godoy, D A; Murillo-Cabezas, F

    2015-10-01

    To analyze mortality and functional outcome in patients with severe spontaneous intracerebral hemorrhage (ICH), and identify the clinical characteristics, radiological findings and therapeutic procedures predictive of mortality in the Intensive Care Unit (ICU) and during hospitalization, as well as of poor functional results at 6 months. A prospective, observational study was carried out. Neurocritical Care Unit of a university hospital. Patients diagnosed with ICH were included over a period of 23 months. Demographic characteristics, cardiovascular risk factors, regular medication, laboratory test parameters, cranial CT findings, therapeutic procedures and outcome data. None. A total of 186 patients with ICH met the inclusion criteria. Surgery to evacuate ICH was performed in 25.8% of the patients. The mortality rate was 46.7%. The modified Rankin score at 6 months was 5 (RI: 4.6). Multivariate Cox regression analysis showed the presence of diabetes, prior anticoagulation, as well as APACHE II severity and the type of bleeding on the cranial CT scan to be predictors of mortality and poor functional outcomes. On the other hand, neurosurgical procedures and intracranial pressure (ICP) monitoring were associated with better outcomes. The presence of comorbidities such as diabetes, or previous anticoagulation, as well as the CT findings were associated to poorer outcomes. In contrast, ICP monitoring and early neurosurgery were predictive of longer survival and better functional outcomes. Copyright © 2014 Elsevier España, S.L.U. and SEMICYUC. All rights reserved.

  18. On computational algorithms for real-valued continuous functions of several variables.

    Science.gov (United States)

    Sprecher, David

    2014-11-01

    The subject of this paper is algorithms for computing superpositions of real-valued continuous functions of several variables based on space-filling curves. The prototypes of these algorithms were based on Kolmogorov's dimension-reducing superpositions (Kolmogorov, 1957). Interest in these grew significantly with the discovery of Hecht-Nielsen that a version of Kolmogorov's formula has an interpretation as a feedforward neural network (Hecht-Nielse, 1987). These superpositions were constructed with devil's staircase-type functions to answer a question in functional complexity, rather than become computational algorithms, and their utility as an efficient computational tool turned out to be limited by the characteristics of space-filling curves that they determined. After discussing the link between the algorithms and these curves, this paper presents two algorithms for the case of two variables: one based on space-filling curves with worked out coding, and the Hilbert curve (Hilbert, 1891). Copyright © 2014 Elsevier Ltd. All rights reserved.

  19. Cognitive and Social Functioning Correlates of Employment Among People with Severe Mental Illness.

    Science.gov (United States)

    Saavedra, Javier; López, Marcelino; González, Sergio; Arias, Samuel; Crawford, Paul

    2016-10-01

    We assess how social and cognitive functioning is associated to gaining employment for 213 people diagnosed with severe mental illness taking part in employment programs in Andalusia (Spain). We used the Repeatable Battery for the Assessment of Neuropsychological Status and the Social Functioning Scale and conducted two binary logistical regression analyses. Response variables were: having a job or not, in ordinary companies (OCs) and social enterprises, and working in an OC or not. There were two variables with significant adjusted odds ratios for having a job: "attention" and "Educational level". There were five variables with significant odds ratios for having a job in an OC: "Sex", "Educational level", "Attention", "Communication", and "Independence-competence". The study looks at the possible benefits of combining employment with support and social enterprises in employment programs for these people and underlines how both social and cognitive functioning are central to developing employment models.

  20. Severity of coronary artery disease is an independent risk factor for decline in kidney function.

    Science.gov (United States)

    Turak, Osman; Afsar, Baris; Siriopol, Dimitrie; Yayla, Cagri; Oksuz, Fatih; Cagli, Kumral; Burlacu, Alexandru; Covic, Adrian; Kanbay, Mehmet

    2016-09-01

    Chronic kidney disease (CKD) and cardiovascular disease are closely interrelated and the presence of one condition synergistically affects the prognosis of the other, in a negative manner. There are surprisingly very few data on the relationship between baseline coronary artery disease (CAD) severity and subsequent decline in kidney function. We aimed to evaluate for the first time whether baseline coronary artery lesion severity predicts the decline in kidney function. The study population was derived from a series of consecutive patients presenting with stable angina pectoris or angina equivalents, who underwent coronary angiography. SYNTAX score for each patient was calculated to define severity of CAD. Change in kidney function was defined by calculating the rates of change in eGFR. Among the 823 patients included in our study, the mean age was 59.2±10.7years, 78.4% were males, and 32% had diabetes. The mean baseline eGFR was 87.3±24.9ml/min/1.73m(2) and the median Syntax score was 14 (IQR=10-20). The median length of follow-up was 2.75years (IQR=2.42-3.50). The mean yearly change for eGFR in the entire study population was 4.06 (95% CI: 3.59-4.51)ml/min/1.73m(2). A higher Syntax score was associated with a significantly faster decline in eGFR in all (unadjusted and adjusted) models. During the follow-up, 103 patients developed CKD. A higher Syntax score, analyzed both as continuous and categorical variable, was associated with incident CKD in all models. We have demonstrated for the first time that severity of CAD is an independent risk factor for the decline in kidney function. Studies are needed to highlight the potential mechanisms regarding the association between severity of CAD and decline in kidney function. Copyright © 2016 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.

  1. Techniques and practices for pretreatment of low and intermediate level solid and liquid radioactive wastes

    International Nuclear Information System (INIS)

    1987-01-01

    An overall waste management strategy generally includes several components: pretreatment, treatment, conditioning, transport and disposal. Benefits of pretreatment are improved safety, lower radiation exposures and significantly lower costs in subsequent waste management operations. This publication reviews current practices in the pretreatment of wastes in different countries and may assist the specialist in selection of appropriate pretreatment techniques

  2. Pretreatment of woody biomass for biofuel production: energy efficiency, technologies, and recalcitrance

    Science.gov (United States)

    J.Y. Zhu; Xuejun Pan; Ronald S. Jr. Zalesny

    2010-01-01

    This mini review discusses several key technical issues associated with cellulosic ethanol production from woody biomass: energy consumption for woody biomass pretreatment, pretreatment energy efficiency, woody biomass pretreatment technologies, and quantification of woody biomass recalcitrance. Both total sugar yield and pretreatment energy efficiency, defined as the...

  3. Multidisciplinary Treatment of Severe Osteogenesis Imperfecta: Functional Outcomes at Skeletal Maturity.

    Science.gov (United States)

    Montpetit, Kathleen; Palomo, Telma; Glorieux, Francis H; Fassier, François; Rauch, Frank

    2015-10-01

    To determine the functional outcomes associated with long-term multidisciplinary treatment, intravenous bisphosphonate treatment, orthopedic surgery, and rehabilitation in children with severe osteogenesis imperfecta (OI) (diagnosed clinically as OI types III or IV). Retrospective study where outcomes were measured prospectively. Pediatric orthopedic hospital. Adolescents (N=41; age range, 15-21y) with severe OI (OI type III: n=17; OI type IV: n=24) who had started therapy before the age of 6 years, had received treatment for at least 10 years, and had achieved final height. Intravenous bisphosphonate treatment, orthopedic surgery, and rehabilitation. Pediatric Evaluation of Disability Inventory. At the time of the last available follow-up examination, none of the individuals diagnosed with OI type III (most severely affected group) was able to ambulate without ambulation aids, whereas 20 (83%) patients with OI type IV were able to ambulate without ambulation aids. Regarding self-care, we specifically assessed 8 skills that we deemed essential for living independently (grooming; dressing; toileting; bed, chair, toilet, tub, and car transfers). Only 6 (35%) of the youths with OI type III were able to complete all 8 items, whereas 23 (96%) individuals with OI type IV managed to perform all tasks. Teens with OI type III often needed assistance for the transfer to toilet, tub, and car and for personal hygiene and clothing management associated with toileting, usually because of limitations in upper-extremity function. These observations suggest that further improvements in the functional status of the most severely affected children with OI are contingent on advances in the clinical management of upper-extremity issues. Copyright © 2015 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  4. Abnormal prefrontal cortex resting state functional connectivity and severity of internet gaming disorder.

    Science.gov (United States)

    Jin, Chenwang; Zhang, Ting; Cai, Chenxi; Bi, Yanzhi; Li, Yangding; Yu, Dahua; Zhang, Ming; Yuan, Kai

    2016-09-01

    Internet Gaming Disorder (IGD) among adolescents has become an important public concern and gained more and more attention internationally. Recent studies focused on IGD and revealed brain abnormalities in the IGD group, especially the prefrontal cortex (PFC). However, the role of PFC-striatal circuits in pathology of IGD remains unknown. Twenty-five adolescents with IGD and 21 age- and gender-matched healthy controls were recruited in our study. Voxel-based morphometric (VBM) and functional connectivity analysis were employed to investigate the abnormal structural and resting-state properties of several frontal regions in individuals with online gaming addiction. Relative to healthy comparison subjects, IGD subjects showed significant decreased gray matter volume in PFC regions including the bilateral dorsolateral prefrontal cortex (DLPFC), orbitofrontal cortex (OFC), anterior cingulate cortex (ACC) and the right supplementary motor area (SMA) after controlling for age and gender effects. We chose these regions as the seeding areas for the resting-state analysis and found that IGD subjects showed decreased functional connectivity between several cortical regions and our seeds, including the insula, and temporal and occipital cortices. Moreover, significant decreased functional connectivity between some important subcortical regions, i.e., dorsal striatum, pallidum, and thalamus, and our seeds were found in the IGD group and some of those changes were associated with the severity of IGD. Our results revealed the involvement of several PFC regions and related PFC-striatal circuits in the process of IGD and suggested IGD may share similar neural mechanisms with substance dependence at the circuit level.

  5. Severe hyposmia and aberrant functional connectivity in cognitively normal Parkinson's disease.

    Directory of Open Access Journals (Sweden)

    Noritaka Yoneyama

    Full Text Available Severe hyposmia is a risk factor of dementia in Parkinson's disease (PD, while the underlying functional connectivity (FC and brain volume alterations in PD patients with severe hyposmia (PD-SH are unclear.We examined voxel-based morphometric and resting state functional magnetic resonance imaging findings in 15 cognitively normal PD-SH, 15 cognitively normal patients with PD with no/mild hyposmia (PD-N/MH, and 15 healthy controls (HCs.Decreased gray matter volume (GMV was observed in the bilateral cuneus, right associative visual area, precuneus, and some areas in anterior temporal lobes in PD-SH group compared to HCs. Both the PD-SH and PD-N/MH groups showed increased GMV in the bilateral posterior insula and its surrounding regions. A widespread significant decrease in amygdala FC beyond the decreased GMV areas and olfactory cortices were found in the PD-SH group compared with the HCs. Above all, decreased amygdala FC with the inferior parietal lobule, lingual gyrus, and fusiform gyrus was significantly correlated with both reduction of Addenbrooke's Cognitive Examination-Revised scores and severity of hyposmia in all participants. Canonical resting state networks exhibited decreased FC in the precuneus and left executive control networks but increased FC in the primary and high visual networks of patients with PD compared with HCs. Canonical network FC to other brain regions was enhanced in the executive control, salience, primary visual, and visuospatial networks of the PD-SH.PD-SH showed extensive decreased amygdala FC. Particularly, decreased FC between the amygdala and inferior parietal lobule, lingual gyrus, and fusiform gyrus were associated with the severity of hyposmia and cognitive performance. In contrast, relatively preserved canonical networks in combination with increased FC to brain regions outside of canonical networks may be related to compensatory mechanisms, and preservation of brain function.

  6. Composite cerebellar functional severity score: validation of a quantitative score of cerebellar impairment.

    Science.gov (United States)

    du Montcel, Sophie Tezenas; Charles, Perrine; Ribai, Pascale; Goizet, Cyril; Le Bayon, Alice; Labauge, Pierre; Guyant-Maréchal, Lucie; Forlani, Sylvie; Jauffret, Celine; Vandenberghe, Nadia; N'guyen, Karine; Le Ber, Isabelle; Devos, David; Vincitorio, Carlo-Maria; Manto, Mario-Ubaldo; Tison, François; Hannequin, Didier; Ruberg, Merle; Brice, Alexis; Durr, Alexandra

    2008-05-01

    Reliable and easy to perform functional scales are a prerequisite for future therapeutic trials in cerebellar ataxias. In order to assess the specificity of quantitative functional tests of cerebellar dysfunction, we investigated 123 controls, 141 patients with an autosomal dominant cerebellar ataxia (ADCA) and 53 patients with autosomal dominant spastic paraplegia (ADSP). We evaluated four different functional tests (nine-hole pegboard, click, tapping and writing tests), in correlation with the scale for the assessment and rating of cerebellar ataxia (SARA), the scale of functional disability on daily activities (part IV of the Huntington disease rating scale), depression (the Public Health Questionnaire PHQ-9) and the EQ-5D visual analogue scale for self-evaluation of health status. There was a significant correlation between each functional test and a lower limb score. The performance of controls on the functional tests was significantly correlated with age. Subsequent analyses were therefore adjusted for this factor. The performances of ADCA patients on the different tests were significantly worse than that of controls and ADSP patients; there was no difference between ADSP patients and controls. Linear regression analysis showed that only two independent tests, the nine-hole pegboard and the click test on the dominant side (P functional severity (CCFS) score calculated as follows: [Formula: see text]. The CCFS score was significantly higher in ADCA patients compared to controls (1.12 +/- 0.18 versus 0.85 +/- 0.05, P(c) < 0.0001) and ADSP patients (1.12 +/- 0.18 versus 0.90 +/- 0.08, P(c) < 0.0001) and was correlated with disease duration (P < 0.0001) but independent of self-evaluated depressive mood in ADCA. Among genetically homogeneous subgroups of ADCA patients (Spinocerebellar ataxia 1, 2, 3), SCA3 patients had significantly lower (better) CCFS scores than SCA2 (P(c) < 0.04) and the same tendency was observed in SCA1. Their CCFS scores remained

  7. Mannose binding lectin (MBL levels predict lung function decline in severe asthma

    Directory of Open Access Journals (Sweden)

    Ilonka. H. van Veen

    2006-12-01

    Full Text Available There is increasing evidence that activation of the complement system in asthma contributes to ongoing inflammation, tissue damage and airway remodeling. Mannose binding lectin (MBL is a pattern recognition molecule that serves as the key mediator of the lectin pathway of complement activation. MBL levels are genetically determined and vary widely amongst individuals. In the present study we hypothesized that high MBL levels in asthma are associated with increased loss of lung function over time, as a consequence of inflammatory tissue damage. We measured serum MBL levels by ELISA in 68 patients with severe asthma and prospectively determined the change in post-bronchodilator (pb FEV1 over a mean period of 5.7 years. The relationship between MBL and change in pbFEV1 (FEV1 was analysed using (multiple regression analysis and corrected for possible confounders (age, sex, age of onset, asthma duration, and pbFEV1. The median (range MBL level was 332 (10.8-3587 ng·ml–1. MBL was significantly associated with FEV1 (p<0.04. Patients with a high MBL level (332 ng·ml–1 had an increased risk of lung function decline compared to those with low MBL levels (OR (CI: 3.16 (1.14-8.79, p = 0.027; the excess decline being 42 ml·yr–1 (p = 0.01. We conclude that a high MBL level is associated with an increased decline in lung function in patients with severe asthma. MBL might provide a clue towards better understanding of the pathophysiology of ongoing inflammation and subsequent decline in lung function of patients with severe asthma.

  8. Investigating executive functions in children with severe speech and movement disorders using structured tasks.

    Science.gov (United States)

    Stadskleiv, Kristine; von Tetzchner, Stephen; Batorowicz, Beata; van Balkom, Hans; Dahlgren-Sandberg, Annika; Renner, Gregor

    2014-01-01

    Executive functions are the basis for goal-directed activity and include planning, monitoring, and inhibition, and language seems to play a role in the development of these functions. There is a tradition of studying executive function in both typical and atypical populations, and the present study investigates executive functions in children with severe speech and motor impairments who are communicating using communication aids with graphic symbols, letters, and/or words. There are few neuropsychological studies of children in this group and little is known about their cognitive functioning, including executive functions. It was hypothesized that aided communication would tax executive functions more than speech. Twenty-nine children using communication aids and 27 naturally speaking children participated. Structured tasks resembling everyday activities, where the action goals had to be reached through communication with a partner, were used to get information about executive functions. The children (a) directed the partner to perform actions like building a Lego tower from a model the partner could not see and (b) gave information about an object without naming it to a person who had to guess what object it was. The executive functions of planning, monitoring, and impulse control were coded from the children's on-task behavior. Both groups solved most of the tasks correctly, indicating that aided communicators are able to use language to direct another person to do a complex set of actions. Planning and lack of impulsivity was positively related to task success in both groups. The aided group completed significantly fewer tasks, spent longer time and showed more variation in performance than the comparison group. The aided communicators scored lower on planning and showed more impulsivity than the comparison group, while both groups showed an equal degree of monitoring of the work progress. The results are consistent with the hypothesis that aided language tax

  9. Examining Profiles of Family Functioning in Pediatric Asthma: Longitudinal Associations With Child Adjustment and Asthma Severity.

    Science.gov (United States)

    Al G Hriwati, Nour; Winter, Marcia A; Everhart, Robin S

    2017-05-01

    Identify profiles of functioning in families of children with asthma and examine whether profile membership predicts subsequent child mental and physical well-being. Primary caregivers and children ( N  = 1,030) from the Childhood Asthma Management Program completed questionnaires assessing family functioning and child adaptation at five time points. Asthma severity was also assessed via spirometry. Latent profile analyses identified a four-profile solution as best fitting the data: cohesive, permissive, controlling/disengaged, and controlling/enmeshed families. Distal outcome analyses using Bolck-Croon-Hagenaars techniques suggested that children from families that were more cohesive had fewer internalizing and externalizing symptoms. These associations remained stable across time. Family profiles did not differ with regards to child asthma severity. Results highlight the importance of looking beyond the effects of distinct components of family functioning and instead using pattern-based approaches. Recommendations for incorporating screenings and services for families in pediatric care settings are provided. © The Author 2016. Published by Oxford University Press on behalf of the Society of Pediatric Psychology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

  10. Executive functioning in relation to coping in mild versus moderate-severe traumatic brain injury.

    Science.gov (United States)

    Rakers, Sandra E; Scheenen, Myrthe E; Westerhof-Evers, Herma J; de Koning, Myrthe E; van der Horn, Harm J; van der Naalt, Joukje; Spikman, Jacoba M

    2018-02-01

    To examine associations between executive functioning (EF) and coping styles, separately for mild and moderate-severe traumatic brain injury (TBI) in the chronic phase postinjury. Patients with mild (n = 47) and moderate-severe TBI (n = 59) were included, in addition to healthy controls (HCs; n = 51). Assessment consisted of EF tests (Trail Making Test, Zoo Map Test, Controlled Oral Word Association Test) and questionnaires examining EF (Dysexecutive Questionnaire) and coping styles (Utrecht Coping List). Moderate-severe TBI patients showed significant more EF deficits, lower active coping and higher passive coping than mild TBI patients and HCs, whereas mild TBI patients did not differ from HCs. In the moderate-severe TBI group, a higher number of self-reported EF problems was related to lower levels of active coping, r = -.43, p < .01 and higher levels of passive coping, r = .58, p < .001, with proxy-reports relating to lower levels of active coping, r = -.33, p < .05. For mild TBI, a higher amount of self-reported EF problems was related to lower levels of active coping, r = -.38, p < .05 and higher levels of passive coping, r = .55, p < .001, with proxy-reports relating to higher levels of passive coping, r = .39, p < .05. Except for mental flexibility, EF performances were not associated with coping. This study shows strong associations between reported EF problems in daily life and coping styles. For moderate-severe TBI, proxy-reports may reflect EF impairments that complicate active problem-solving. However, reported EF problems by mild and moderate-severe TBI patients are also likely to reflect a psychological distress related to the way patients are inclined to deal with stressing situations that put a demand on their executive abilities. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

  11. Brief executive function training for individuals with severe mental illness: Effects on EEG synchronization and executive functioning.

    Science.gov (United States)

    Best, Michael W; Gale, Daniel; Tran, Tanya; Haque, Mashal K; Bowie, Christopher R

    2017-09-18

    Executive Functioning (EF) is an important factor for community functioning for people with severe mental illness. Cognitive remediation programs often improve EF, but do so by using multiple therapeutic techniques. Little is known regarding how individual treatment elements promote cognitive improvement. Oscillatory brain activity is a potential neurophysiological mechanism that may change as a result of targeted training on computerized exercises. The current study aimed to examine the effects of a brief EF training program on EEG and neurocognitive measures. 25 people with severe mental illness were randomized to either 2weeks of computerized EF training or control training. Training consisted of 1h training sessions 3 times per week and 40min of daily home training. Assessments examined EEG theta and alpha band oscillatory power during EF tasks and neurocognitive measures of EF. EF training resulted in greater frontal theta power and reduced posterior alpha power during computerized EF tasks than control training. Power in the alpha frequency band over frontal electrode sites did not significantly differ between the two groups as a result of training. Additionally, participants in the EF training experienced significantly greater improvement in EF ability as measured by neurocognitive tests than the control condition. Two weeks of EF training is sufficient to produce neurophysiological and neurocognitive change. Frontal theta power and posterior alpha power may be important neurophysiological markers to consider in cognitive remediation studies, and the addition of a brief executive function training procedure to other psychosocial interventions is worth examining. Copyright © 2017 Elsevier B.V. All rights reserved.

  12. GDNF plasma levels in spina bifida: correlation with severity of spinal damage and motor function.

    Science.gov (United States)

    Chiaretti, Antonio; Rendeli, Claudia; Antonelli, Alessia; Barone, Giuseppe; Focarelli, Benedetta; Tabacco, Fabrizia; Massimi, Luca; Ausili, Emanuele

    2008-12-01

    Glial-derived neurotrophic factor (GDNF) is one of several powerful survival factors for spinal motoneurons that play a key role in sprouting, synaptic plasticity, and reorganization after spinal cord damage. The aim of this study was to investigate the expression of GDNF in plasma of children with spina bifida (SB) and to determine its correlation with both the severity of spinal cord damage and the motor function of these patients. To measure the GDNF expression, we collected plasma samples from 152 children with SB and in 149 matched controls. Endogenous GDNF levels were quantified using a two-site immuno-enzymatic assay. The statistical analysis was performed using the Mann-Whitney two-tailed two-sample test. In children with SB the mean levels of GDNF (131.2 +/- 69.6 pg/mL) were significantly higher (p spine injury.

  13. The Relationship between Symptom Severity and Cognitive Functions with Obesity in Fibromyalgia Syndrome

    Directory of Open Access Journals (Sweden)

    Selçuk Sayılır

    2017-01-01

    Full Text Available Objective: To investigate the relationship between obesity with symptom severity and cognitive functions in Fibromyalgia syndrome (FMS patients. Materials and Methods: The study comprised 33 FMS patients (mean age 41.21±7.6 years. The patients who have hypertension, hypercholesterolaemia or diabetes, chronic inflammatory disorders, cardiovascular-pulmonary diseases, rheumatological/endocrine diseases, using anticoagulant therapy or have thrombotic disorders, malignancies and pregnant women were excluded from the study. Fibromyalgia Impact Questionnaire (FIQ, Perceived Stress Scale (PSS-10 and Mini Mental State Examination tests were used. The data of FMS patients were recorded by the same physician. Results: There were not statistically significant differences between PSS-10 and MMSE with body mass index (BMI levels. There was a statistically significant difference between FIQ and BMI values. Conclusion: In conclusion, the result of this study showed a statistical relationship between the increased BMI levels and FMS symptom severity that could be beneficial in clinical practice.

  14. Loss of Renal Function After Retrograde Ureteral Placement of an Allium Stent for Severe Ureteral Stricture.

    Science.gov (United States)

    Salciccia, Stefano; Sciarra, Alessandro; Polese, Milena; Giorgio, Alpi; Maggi, Martina; Gentilucci, Alessandro; Ciccariello, Mauro; D'Eramo, Giuseppe; Shahabadi, Houssain; Lai, Silvia; Ricciuti, Gian Piero

    2018-01-01

    Background: Ureteral strictures are a recurrent chronic condition that leads to severe side effects and poor quality of life. Management of ureteral stricture is a great challenge for urologists and no specific guidelines exist. Retrograde Allium ® ureteral stent (AUS) is a newly developed ureteral stent to treat either bulbar urethral or ureteral stenosis. Case Presentation: We describe a case of a 74-year-old Caucasian adult male presenting with a severe ureteral stricture secondary to an ureteroscopy for stone disease. Treatment with retrograde AUS placement produced a complete loss of renal function after 36 months, probably because of the development of a long achalasic stretch of the ureter. Conclusions: AUS is a new and promising device for the treatment of ureteral stenosis. However, a lack of standardization of the technique recommends a close instrumental follow-up after the procedure to decide the optimal time for stent removal.

  15. Low-frequency severe-intensity interval training improves cardiorespiratory functions.

    Science.gov (United States)

    Nakahara, Hidehiro; Ueda, Shin-Ya; Miyamoto, Tadayoshi

    2015-04-01

    The present study investigated the effects of severe-intensity interval training at a frequency of once a week on cardiorespiratory function at rest and during exercise. Fourteen young healthy males were randomly assigned to either an interval training group or control group. Cardiorespiratory function was investigated by incremental maximal exercise test and constant work rate submaximal exercise test before and after the intervention period in all subjects. Submaximal exercise test was conducted at two work rates (80% ventilatory threshold (VT) level and 100% VT level plus 50% of the difference between VT and peak oxygen consumption (V˙O2)) for 8 min; the same work rates and duration were used before and after training. Left ventricular adaptations were assessed by echocardiography under supine resting conditions before and after training. In the interval training group, seven subjects performed cycle ergometer training once per week for 3 months. The training consisted of three bouts of exercises to volitional fatigue at 80% maximum work rate. Increased V˙O2max (+13%, P = 0.015), VT (+21%, P = 0.001), and left ventricular posterior wall thickness (+18%, P = 0.002) and reduced minute ventilation (-12%, P = 0.032) and blood lactate concentration (-16%, P = 0.025) during high-intensity exercise were observed after the training program compared with baseline. Although not significant, V˙O2 and cycling economy (V˙O2 per work rate) during high-intensity exercise decreased slightly after training. The present results indicate that severe-intensity interval training, even when performed at a low frequency, markedly improves cardiorespiratory function as well as induces cardiac morphological adaptations involving left ventricular hypertrophy and cardiorespiratory metabolic response during submaximal exercise. The present findings may provide new insights for low-frequency, severe-intensity interval training in the field of sports science.

  16. Prediction of the survival and functional ability of severe stroke patients after ICU therapeutic intervention

    Directory of Open Access Journals (Sweden)

    Aoun-Bacha Zeina

    2008-06-01

    Full Text Available Abstract Background This study evaluated the benefits and impact of ICU therapeutic interventions on the survival and functional ability of severe cerebrovascular accident (CVA patients. Methods Sixty-two ICU patients suffering from severe ischemic/haemorrhagic stroke were evaluated for CVA severity using APACHE II and the Glasgow coma scale (GCS. Survival was determined using Kaplan-Meier survival tables and survival prediction factors were determined by Cox multivariate analysis. Functional ability was assessed using the stroke impact scale (SIS-16 and Karnofsky score. Risk factors, life support techniques and neurosurgical interventions were recorded. One year post-CVA dependency was investigated using multivariate analysis based on linear regression. Results The study cohort constituted 6% of all CVA (37.8% haemorrhagic/62.2% ischemic admissions. Patient mean(SD age was 65.8(12.3 years with a 1:1 male: female ratio. During the study period 16 patients had died within the ICU and seven in the year following hospital release. The mean(SD APACHE II score at hospital admission was 14.9(6.0 and ICU mean duration of stay was 11.2(15.4 days. Mechanical ventilation was required in 37.1% of cases. Risk ratios were; GCS at admission 0.8(0.14, (p = 0.024, APACHE II 1.11(0.11, (p = 0.05 and duration of mechanical ventilation 1.07(0.07, (p = 0.046. Linear coefficients were: type of CVA – haemorrhagic versus ischemic: -18.95(4.58 (p = 0.007, GCS at hospital admission: -6.83(1.08, (p = 0.001, and duration of hospital stay -0.38(0.14, (p = 0.40. Conclusion To ensure a better prognosis CVA patients require ICU therapeutic interventions. However, as we have shown, where tests can determine the worst affected patients with a poor vital and functional outcome should treatment be withheld?

  17. Change in Pain and Physical Function Following Bariatric Surgery for Severe Obesity

    Science.gov (United States)

    King, Wendy C.; Chen, Jia-Yuh; Belle, Steven H.; Courcoulas, Anita P.; Dakin, Gregory F.; Elder, Katherine A.; Flum, David R.; Hinojosa, Marcelo W.; Mitchell, James E.; Pories, Walter J.; Wolfe, Bruce M.; Yanovski, Susan Z.

    2016-01-01

    IMPORTANCE The variability and durability of improvements in pain and physical function following Roux-en-Y gastric bypass (RYGB) or laparoscopic adjustable gastric banding (LAGB) are not well described. OBJECTIVES To report changes in pain and physical function in the first 3 years following bariatric surgery, and to identify factors associated with improvement. DESIGN, SETTING, AND PARTICIPANTS The Longitudinal Assessment of Bariatric Surgery-2 is an observational cohort study at 10 US hospitals. Adults with severe obesity undergoing bariatric surgery were recruited between February 2005 and February 2009. Research assessments were conducted prior to surgery and annually thereafter. Three-year follow-up through October 2012 is reported. EXPOSURES Bariatric surgery as clinical care. MAIN OUTCOMES AND MEASURES Primary outcomes were clinically meaningful presurgery to postsurgery improvements in pain and function using scores from the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36) (ie, improvement of ≥5 points on the norm-based score [range, 0–100]) and 400-meter walk time (ie, improvement of ≥24 seconds) using established thresholds. The secondary outcome was clinically meaningful improvement using the Western Ontario McMaster Osteoarthritis Index (ie, improvement of ≥9.7 pain points and ≥9.3 function points on the transformed score [range, 0–100]). RESULTS Of 2458 participants, 2221 completed baseline and follow-up assessments (1743 [78.5%] were women; median age was 47 years; median body mass index [BMI] was 45.9; 70.4% underwent RYGB; 25.0% underwent LAGB). At year 1, clinically meaningful improvements were shown in 57.6% (95% CI, 55.3%-59.9%) of participants for bodily pain, 76.5% (95% CI, 74.6%-78.5%) for physical function, and 59.5% (95% CI, 56.4%-62.7%) for walk time. Additionally, among participants with severe knee or disability (633), or hip pain or disability (500) at baseline, approximately three-fourths experienced joint

  18. Is kyphoplasty better than vertebroplasty at restoring form and function after severe vertebral wedge fractures?

    Science.gov (United States)

    Landham, Priyan R; Baker-Rand, Holly L A; Gilbert, Samuel J; Pollintine, Phillip; Annesley-Williams, Deborah J; Adams, Michael A; Dolan, Patricia

    2015-04-01

    The vertebral augmentation procedures, vertebroplasty and kyphoplasty, can relieve pain and facilitate mobilization of patients with osteoporotic vertebral fractures. Kyphoplasty also aims to restore vertebral body height before cement injection and so may be advantageous for more severe fractures. The purpose of this study was to compare the ability of vertebroplasty and kyphoplasty to restore vertebral height, shape, and mechanical function after severe vertebral wedge fractures. This is a biomechanical and radiographic study using human cadaveric spines. Seventeen pairs of thoracolumbar "motion segments" from cadavers aged 70-98 years were injured, in a two-stage process involving flexion and compression, to create severe anterior wedge fractures. One of each pair underwent vertebroplasty and the other kyphoplasty. Specimens were then compressed at 1 kN for 1 hour to allow consolidation. Radiographs were taken before and after injury, after treatment, and after consolidation. At these same time points, motion segment compressive stiffness was assessed, and intervertebral disc "stress profiles" were obtained to characterize the distribution of compressive stress on the vertebral body and neural arch. On average, injury reduced anterior vertebral body height by 34%, increased its anterior wedge angle from 5.0° to 11.4°, reduced intradiscal (nucleus) pressure and motion segment stiffness by 96% and 44%, respectively, and increased neural arch load bearing by 57%. Kyphoplasty caused 97% of the anterior height loss to be regained immediately, although this reduced to 79% after consolidation. Equivalent gains after vertebroplasty were significantly lower: 59% and 47%, respectively (pconsolidation, but these mechanical effects were similar for kyphoplasty and vertebroplasty. After severe vertebral wedge fractures, vertebroplasty and kyphoplasty were equally effective in restoring mechanical function. However, kyphoplasty was better able to restore vertebral height

  19. Preseason Functional Movement Screen Component Tests Predict Severe Contact Injuries in Professional Rugby Union Players.

    Science.gov (United States)

    Tee, Jason C; Klingbiel, Jannie F G; Collins, Robert; Lambert, Mike I; Coopoo, Yoga

    2016-11-01

    Tee, JC, Klingbiel, JFG, Collins, R, Lambert, MI, and Coopoo, Y. Preseason Functional Movement Screen component tests predict severe contact injuries in professional rugby union players. J Strength Cond Res 30(11): 3194-3203, 2016-Rugby union is a collision sport with a relatively high risk of injury. The ability of the Functional Movement Screen (FMS) or its component tests to predict the occurrence of severe (≥28 days) injuries in professional players was assessed. Ninety FMS test observations from 62 players across 4 different time periods were compared with severe injuries sustained during 6 months after FMS testing. Mean composite FMS scores were significantly lower in players who sustained severe injury (injured 13.2 ± 1.5 vs. noninjured 14.5 ± 1.4, Effect Size = 0.83, large) because of differences in in-line lunge (ILL) and active straight leg raise scores (ASLR). Receiver-operated characteristic curves and 2 × 2 contingency tables were used to determine that ASLR (cut-off 2/3) was the injury predictor with the greatest sensitivity (0.96, 95% confidence interval [CI] = 0.79-1.0). Adding the ILL in combination with ASLR (ILL + ASLR) improved the specificity of the injury prediction model (ASLR specificity = 0.29, 95% CI = 0.18-0.43 vs. ASLR + ILL specificity = 0.53, 95% CI = 0.39-0.66, p ≤ 0.05). Further analysis was performed to determine whether FMS tests could predict contact and noncontact injuries. The FMS composite score and various combinations of component tests (deep squat [DS] + ILL, ILL + ASLR, and DS + ILL + ASLR) were all significant predictors of contact injury. The FMS composite score also predicted noncontact injury, but no component test or combination thereof produced a similar result. These findings indicate that low scores on various FMS component tests are risk factors for injury in professional rugby players.

  20. Lung function decline and variable airway inflammatory pattern: longitudinal analysis of severe asthma.

    Science.gov (United States)

    Newby, Christopher; Agbetile, Joshua; Hargadon, Beverley; Monteiro, Will; Green, Ruth; Pavord, Ian; Brightling, Christopher; Siddiqui, Salman

    2014-08-01

    Eosinophilic airway inflammation measured by using induced sputum is an important treatment stratification tool in patients with severe asthma. In addition, sputum eosinophilia has been shown to be associated with severe exacerbations and airflow limitation. We sought to identify whether eosinophilic inflammation in sputum is associated with FEV₁ decrease in patients with severe asthma and whether we could identify subgroups of decrease behavior based on the variation of eosinophilic airway inflammation over time. Ninety-seven patients with severe asthma from the Glenfield Asthma Cohort were followed up with scheduled 3-month visits; the median duration of follow-up and number of visits was 6 years (interquartile range, 5.6-7.6 years) and 2.7 visits per year. Induced sputum was analyzed for eosinophilic inflammation at scheduled visits. Linear mixed-effects models were used to identify variables associated with lung function and overall decrease. In addition, using individual patients' mean and SD sputum eosinophil percentages over time, a 2-step cluster analysis was performed to identify patient clusters with different rates of decrease. FEV₁ decrease was -25.7 mL/y in the overall population. Postbronchodilator FEV₁ was also dependent on exacerbations, age of onset, height, age, sex, and log10 sputum eosinophil percentages (P < .001). Three decrease patient clusters were identified: (1) noneosinophilic with low variation (mean decrease, -14.0 mL/y), (2) eosinophilic with high variation (mean decrease, -40.9 mL/y), and (3) hypereosinophilic with low variation (mean decrease in lung function, -19.2 mL/y). The amplitude of sputum eosinophilia was associated with postbronchodilator FEV₁ in asthmatic patients. In contrast, high variability rather than the amplitude at baseline or over time of sputum eosinophils was associated with accelerated FEV₁ decrease. Copyright © 2014 American Academy of Allergy, Asthma & Immunology. Published by Mosby, Inc. All rights

  1. Poor Executive Functions among Children with Moderate-into-Severe Asthma: Evidence from WCST Performance.

    Science.gov (United States)

    Taha, Haitham

    2017-01-01

    Executive functions (EFs) measures of 27 asthmatic children, with general learning difficulties, were tested by using the Wisconsin card sorting test (WCST), and were compared to the performances of 30 non-asthmatic children with general learning difficulties. The results revealed that the asthmatic group has poor performance through all the WCST psychometric parameters and especially the perseverative errors one. The results were discussed in light of the postulation that poor EFs could be associated with the learning difficulties of asthmatic children. Neurophysiological framework has been suggested to explain the etiology of poor EFs among children with moderate into severe asthma.

  2. A COGNITIVE-BEHAVIOURAL GROUP TREATMENT IMPROVED WORK ABILITY IN PATIENTS WITH SEVERE FUNCTIONAL SOMATIC SYNDROMES

    DEFF Research Database (Denmark)

    Schröder, Andreas; Ørnbøl, Eva; Jensen, Jens Søndergaard

    2014-01-01

    Objective: Functional somatic syndromes (FSS) such as fibromyalgia, irritable bowel and chronic fatigue syndrome often disrupt employment and may lead to long-term dependence on social benefits and permanently reduced work ability. Cognitive-behavioural treatments (CBT) relief symptoms and improve...... functioning in FSS, but their effect on work ability is unclear. The aim of this study was to estimate the long-term effect of group CBT on work ability in patients with severe FSS. Methods: 120 Patients from a recently published randomised controlled trial comparing group CBT with enhanced usual care (EUC...... before to 3 years after treatment by means of random effects modelling allowing individual levels and slopes. Results: Compared with the general population, FSS patients showed a continuous decline in self-support, leading to markedly reduced work ability at trial entry. In the following years, EUC...

  3. Assessing the reliability of predictive activity coefficient models for molecules consisting of several functional groups

    Directory of Open Access Journals (Sweden)

    R. P. Gerber

    2013-03-01

    Full Text Available Currently, the most successful predictive models for activity coefficients are those based on functional groups such as UNIFAC. In contrast, these models require a large amount of experimental data for the determination of their parameter matrix. A more recent alternative is the models based on COSMO, for which only a small set of universal parameters must be calibrated. In this work, a recalibrated COSMO-SAC model was compared with the UNIFAC (Do model employing experimental infinite dilution activity coefficient data for 2236 non-hydrogen-bonding binary mixtures at different temperatures. As expected, UNIFAC (Do presented better overall performance, with a mean absolute error of 0.12 ln-units against 0.22 for our COSMO-SAC implementation. However, in cases involving molecules with several functional groups or when functional groups appear in an unusual way, the deviation for UNIFAC was 0.44 as opposed to 0.20 for COSMO-SAC. These results show that COSMO-SAC provides more reliable predictions for multi-functional or more complex molecules, reaffirming its future prospects.

  4. Reduced functional connectivity of fronto-parietal sustained attention networks in severe childhood abuse.

    Directory of Open Access Journals (Sweden)

    Heledd Hart

    Full Text Available Childhood maltreatment is associated with attention deficits. We examined the effect of childhood abuse and abuse-by-gene (5-HTTLPR, MAOA, FKBP5 interaction on functional brain connectivity during sustained attention in medication/drug-free adolescents. Functional connectivity was compared, using generalised psychophysiological interaction (gPPI analysis of functional magnetic resonance imaging (fMRI data, between 21 age-and gender-matched adolescents exposed to severe childhood abuse and 27 healthy controls, while they performed a parametrically modulated vigilance task requiring target detection with a progressively increasing load of sustained attention. Behaviourally, participants exposed to childhood abuse had increased omission errors compared to healthy controls. During the most challenging attention condition abused participants relative to controls exhibited reduced connectivity, with a left-hemispheric bias, in typical fronto-parietal attention networks, including dorsolateral, rostromedial and inferior prefrontal and inferior parietal regions. Abuse-related connectivity abnormalities were exacerbated in individuals homozygous for the risky C-allele of the single nucleotide polymorphism rs3800373 of the FK506 Binding Protein 5 (FKBP5 gene. Findings suggest that childhood abuse is associated with decreased functional connectivity in fronto-parietal attention networks and that the FKBP5 genotype moderates neurobiological vulnerability to abuse. These findings represent a first step towards the delineation of abuse-related neurofunctional connectivity abnormalities, which hopefully will facilitate the development of specific treatment strategies for victims of childhood maltreatment.

  5. Parenting stress in pediatric IBD: relations with child psychopathology, family functioning, and disease severity.

    Science.gov (United States)

    Gray, Wendy N; Graef, Danielle M; Schuman, Shana S; Janicke, David M; Hommel, Kevin A

    2013-05-01

    Parenting stress in pediatric inflammatory bowel disease (IBD) has been under-examined. Data validating use of the Pediatric Inventory for Parents (PIP), a measure of parenting stress associated with caring for a chronically ill child, in chronic diseases with intermittent, unpredictable disease courses, such as IBD, are needed. This study presents validity data in support of the PIP in pediatric IBD and examines relations between parenting stress and important psychosocial and medical outcomes. Adolescents (N = 130) with IBD and their caregivers across 3 sites completed measures of parenting stress, family functioning, and emotional/behavioral functioning. Disease severity was also assessed for each participant. The PIP demonstrates excellent internal consistency. Parenting stress was significantly higher among those with unhealthy general family functioning and those with children with borderline or clinically elevated internalizing symptoms. Caregiving stress was greater among parents of youth with more active Crohn's disease. Results supported the reliability and validity of the PIP for assessing caregiving stress in pediatric IBD. Routine assessment of parenting stress is recommended, particularly among parents reporting unhealthy family functioning and parents of youth with borderline or clinically elevated internalizing symptoms and more active disease.

  6. Role of Acute Lesion Topography in Initial Ischemic Stroke Severity and Long-Term Functional Outcomes.

    Science.gov (United States)

    Wu, Ona; Cloonan, Lisa; Mocking, Steven J T; Bouts, Mark J R J; Copen, William A; Cougo-Pinto, Pedro T; Fitzpatrick, Kaitlin; Kanakis, Allison; Schaefer, Pamela W; Rosand, Jonathan; Furie, Karen L; Rost, Natalia S

    2015-09-01

    Acute infarct volume, often proposed as a biomarker for evaluating novel interventions for acute ischemic stroke, correlates only moderately with traditional clinical end points, such as the modified Rankin Scale. We hypothesized that the topography of acute stroke lesions on diffusion-weighted magnetic resonance imaging may provide further information with regard to presenting stroke severity and long-term functional outcomes. Data from a prospective stroke repository were limited to acute ischemic stroke subjects with magnetic resonance imaging completed within 48 hours from last known well, admission NIH Stroke Scale (NIHSS), and 3-to-6 months modified Rankin Scale scores. Using voxel-based lesion symptom mapping techniques, including age, sex, and diffusion-weighted magnetic resonance imaging lesion volume as covariates, statistical maps were calculated to determine the significance of lesion location for clinical outcome and admission stroke severity. Four hundred ninety subjects were analyzed. Acute stroke lesions in the left hemisphere were associated with more severe NIHSS at admission and poor modified Rankin Scale at 3 to 6 months. Specifically, injury to white matter (corona radiata, internal and external capsules, superior longitudinal fasciculus, and uncinate fasciculus), postcentral gyrus, putamen, and operculum were implicated in poor modified Rankin Scale. More severe NIHSS involved these regions, as well as the amygdala, caudate, pallidum, inferior frontal gyrus, insula, and precentral gyrus. Acute lesion topography provides important insights into anatomic correlates of admission stroke severity and poststroke outcomes. Future models that account for infarct location in addition to diffusion-weighted magnetic resonance imaging volume may improve stroke outcome prediction and identify patients likely to benefit from aggressive acute intervention and personalized rehabilitation strategies. © 2015 American Heart Association, Inc.

  7. Alexithymia, Assertiveness and Psychosocial Functioning in HIV: Implications for Medication Adherence and Disease Severity.

    Science.gov (United States)

    McIntosh, Roger C; Ironson, Gail; Antoni, Michael; Fletcher, Mary Ann; Schneiderman, Neil

    2016-02-01

    Psychosocial function and adherence to antiretroviral regimen are key factors in human immunodeficiency virus (HIV) disease management. Alexithymia (AL) is a trait deficit in the ability to identify and describe feelings, emotions and bodily sensations. A structural equation model was used to test whether high levels of AL indirectly relate to greater non-adherent behavior and HIV disease severity via psychosocial dysfunction. Blood draws for HIV-1 viral load and CD4 T-lymphocyte, along with psychosocial surveys were collected from 439 HIV positive adults aged 18-73 years. The structural model supports significant paths from: (1) AL to non-active patient involvement, psychological distress, and lower social support, (2) psychological distress and non-active involvement to non-adherent behavior, and (3) non-adherence to greater HIV disease severity (CFI = .97, RMSEA = .04, SRMR = .05). A second model confirmed the intermediary effect of greater patient assertiveness on the path from AL to social support and non-active patient involvement (CFI = .94, RMSEA = .04, SRMR = .05). Altogether, AL is indirectly linked with HIV disease management through it's association with poor psychosocial function, however greater patient assertiveness buffers the negative impact of AL on relationship quality with healthcare providers and members of one's social support network.

  8. Clinical and Functional Lung Parameters Associated With Frequent Exacerbator Phenotype in Subjects With Severe COPD.

    Science.gov (United States)

    Capozzolo, Alberto; Carratù, Pierluigi; Dragonieri, Silvano; Falcone, Vito Antonio; Quaranta, Vitaliano Nicola; Liotino, Vito; D'Alba, Giuseppina; Castellana, Giorgio; Resta, Onofrio

    2017-05-01

    COPD is currently recognized as a syndrome associated with a high prevalence of comorbidities and various phenotypes. Exacerbations are very important events in the clinical history of COPD because they drive the decline in lung function. In the present study, we aim to identify whether there are any clinical and functional specific features of frequent exacerbators in a population of patients with severe COPD. We conducted a cross-sectional, case control study. All subjects had Global Initiative for Chronic Obstructive Lung Disease (GOLD) stage 3 or 4 COPD (FEV 1 lower inspiratory capacity percentage predicted. The Motley index (residual volume/total lung capacity percentage) was significantly increased in frequent exacerbators. Infrequent exacerbators had lower Modified Medical Research Council dyspnea scale and BODE index than frequent exacerbators. In the multivariate model, a reduced inspiratory capacity percentage predicted and an increase of residual volume/total lung capacity percentage, BODE index and Modified Medical Research Council dyspnea scale were associated with the frequent exacerbation phenotype. Static hyperinflation and respiratory disability, measured by Motley index and Modified Medical Research Council dyspnea scale, respectively, in the same way as the multidimensional BODE index staging system, were independently associated with frequent exacerbation status in subjects with severe COPD. Copyright © 2017 by Daedalus Enterprises.

  9. Surgical options for the management of severe functional constipation in children.

    Science.gov (United States)

    Wood, Richard J; Yacob, Desale; Levitt, Marc A

    2016-06-01

    Constipation is a very common problem in pediatrics with both the severity of presentations and treatments varying across a broad spectrum. The majority of children with functional constipation are managed successfully without the need for specialized testing and surgical intervention. Those who present with intractable constipation, with or without fecal soiling, require referrals for motility testing that helps determine both medical and surgical management, and interventions. The literature was reviewed for publications on surgical approaches to children with severe constipation, including assessing the quality and levels of evidence and the use of objective measures to determine outcomes. There is very little in the way of recent studies evaluating surgical indications or treatment approaches for functional constipation, apart from one systematic review and one recent expert review. Although the systematic review was published in the last year, most of the studies it analyzes are older. The vast majority of studies comprise level 4 and 5 evidence. The indication for most surgical procedures is 'failed' medical management, yet no standardized definition for this exists. Many surgical procedures are proposed with little evidence to show outcomes. We recommend that the surgical evaluation and treatment of children with constipation needs to be protocolized and studied in a prospective manner using validated outcomes measures. Our center's current protocol is described.

  10. Interhemispheric Resting-State Functional Connectivity Predicts Severity of Idiopathic Normal Pressure Hydrocephalus

    Directory of Open Access Journals (Sweden)

    Yousuke Ogata

    2017-09-01

    Full Text Available Idiopathic normal pressure hydrocephalus (iNPH is characterized by a clinical triad (gait disturbance, dementia, and urinary incontinence, and by radiological findings of enlarged ventricles reflecting disturbance of central spinal fluid circulation. A diagnosis of iNPH is sometimes challenging, and the pathophysiological mechanisms underlying the clinical symptoms of iNPH remain largely unknown. Here, we used an emerging MRI technique, resting-state functional connectivity MRI (rsfcMRI, to develop a subsidiary diagnostic technique and to explore the underlying pathophysiological mechanisms of iNPH. rsfcMRI data were obtained from 11 patients with iNPH and 11 age-matched healthy volunteers, yielding rsfcMRI-derived functional connectivity (FC from both groups. A linear support vector machine classifier was trained to distinguish the patterns of FCs of the patients with iNPH from those of the healthy volunteers. After dimensional reduction, the support vector machine successfully classified the two groups with an accuracy of 80%. Moreover, we found that rsfcMRI-derived FC carried information to predict the severity of the triad in iNPH. FCs relevant to the classification of severity were mainly based on interhemispheric connectivity, suggesting that disruption of the corpus callosum fibers due to ventricular enlargement may explain the triad of iNPH. The present results support the usefulness of rsfcMRI as a tool to understand pathophysiology of iNPH, and also to help with its clinical diagnosis.

  11. Plasma Zonulin and its Association with Kidney Function, Severity of Heart Failure, and Metabolic Inflammation.

    Science.gov (United States)

    Dschietzig, Thomas B; Boschann, Felix; Ruppert, Jana; Armbruster, Franz P; Meinitzer, Andreas; Bankovic, Dragic; Mitrovic, Veselin; Melzer, Christoph

    2016-12-01

    The tight junction regulator zonulin has attracted clinical attention as a biomarker of increased gastrointestinal permeability. Recent work also suggests zonulin to represent a general regulator of tissue barriers and a player in metabolic inflammation. Here, we investigated the associations of zonulin with chronic heart failure (CHF), kidney function, and metabolic inflammation. Using multiple linear regression (Generalized Linear Model), this study determined the association of plasma zonulin with different laboratory and clinical parameters in 225 patients carrying automatic implantable cardioverters/defibrillators (AICD) for primary or secondary prevention. In another 115 patients with diastolic or systolic CHF, we investigated a possible relationship between zonulin and CHF severity. In the AICD cohort, zonulin associated inversely with serum creatinine (p = 0.013), carboxymethyl-lysine calprotectin (p zonulin increased significantly with high-sensitivity CRP (p = 0.014). In the CHF cohort, we found a highly significant rise of NT-proBNP, but not of zonulin with NYHA functional classes I-IV or other parameters of CHF severity. The inverse associations of zonulin with creatinine and markers of cardio-vascular risk (high CMLcalprotectin and kynurenine, low homoarginine) are novel findings that need further experimental and clinical clarification. Our study indicates zonulin involvement in metabolic inflammation in T2D, but no association with disease status in CHF.

  12. Aiming for the complete utilization of sugar-beet pulp: Examination of the effects of mild acid and hydrothermal pretreatment followed by enzymatic digestion

    Directory of Open Access Journals (Sweden)

    Gruppen Harry

    2011-05-01

    Full Text Available Abstract Background Biomass use for the production of bioethanol or platform chemicals requires efficient breakdown of biomass to fermentable monosaccharides. Lignocellulosic feedstocks often require physicochemical pretreatment before enzymatic hydrolysis can begin. The optimal pretreatment can be different for different feedstocks, and should not lead to biomass destruction or formation of toxic products. Methods We examined the influence of six mild sulfuric acid or water pretreatments at different temperatures on the enzymatic degradability of sugar-beet pulp (SBP. Results We found that optimal pretreatment at 140°C of 15 minutes in water was able to solubilize 60% w/w of the total carbohydrates present, mainly pectins. More severe treatments led to the destruction of the solubilized sugars, and the subsequent production of the sugar-degradation products furfural, hydroxymethylfurfural, acetic acid and formic acid. The pretreated samples were successfully degraded enzymatically with an experimental cellulase preparation. Conclusions In this study, we found that pretreatment of SBP greatly facilitated the subsequent enzymatic degradation within economically feasible time ranges and enzyme levels. In addition, pretreatment of SBP can be useful to fractionate functional ingredients such as arabinans and pectins from cellulose. We found that the optimal combined severity factor to enhance the enzymatic degradation of SBP was between log R'0 = -2.0 and log R'0 = -1.5. The optimal pretreatment and enzyme treatment solubilized up to 80% of all sugars present in the SBP, including ≥90% of the cellulose.

  13. Study of association of severity of sleep disordered breathing and functional outcome in stroke patients.

    Science.gov (United States)

    Kumar, Rohit; Suri, J C; Manocha, Rajesh

    2017-06-01

    Sleep disordered breathing (SDB) is a prevalent yet underrecognized condition that may have major adverse consequences for those affected by it. We performed a prospective observational study to seek a correlation of severity of SDB with the severity of stroke and its functional outcome. Patients with history of recent-onset stroke were recruited and underwent overnight polysomnography (PSG) after the acute phase of the stroke was over; for defining hypopneas, 3% and 4% desaturation limits were used, and the apnea-hypopnea index was respectively calculated as AHI 3% and AHI 4% . Stroke severity was graded using the Scandinavian Stroke Scale. Functional disability and neurological impairment was evaluated six weeks after the PSG using the Barthel Index (2 = poor outcome; ≤2 = good outcome). A total of 50 patients were enrolled, 30 (60%) with ischemic stroke and 20 (40%) with hemorrhagic strokes. Of the patients, 39 (78%) had an AHI 4% of >5/h, 23 (46%) had an AHI 4% of >15/h, and 9 (18%) had an AHI 4% of >30/h. Multivariate analysis showed that body mass index (odds ratio [OR] = 1.26; 95% confidence interval [CI] = 1.04-1.54, p = 0.019) and Scandinavian Stroke Scale score (stroke severity) (OR = 0.86; 95% CI = 0.76-0.96, p = 0.009) were significant risk factors for predicting SDB (AHI 4%  > 15) in patients of stroke. When we looked for factors predicting outcomes, only AHI 4% (OR = 1.20; 95% CI 1.01-1.43, p value 0.041) was predictive of the functional dependence (based on Barthel Index) of the patient and AHI 4% (OR = 1.14; 95% CI 1.03-1.25, p = 0.008) and body mass index (OR = 0.75; 95% CI 0.59-0.96, p = 0.024) were found to be predictive of poor outcome (based on modified Rankins Scale). We obtained similar results, regardless of the hypopnea definition used. In conclusion, given the high frequency of SDB in stroke patients and its correlation with poor outcome, screening for obstructive sleep apnea in all stroke and transient

  14. Detection of Cd, Pb, and Cu in Non-Pretreated Natural Waters and Urine with Thiol Functionalized Mesoporous Silica and Nafion Composite Electrodes

    OpenAIRE

    Yantasee, Wassana; Charnhattakorn, Busarakum; Fryxell, Glen E.; Lin, Yuehe; Timchalk, Charles; Addleman, R. Shane

    2008-01-01

    Electrochemical sensors have great potential for environmental monitoring of toxic metal ions in waters due to their portability, field-deployability and excellent detection limits. However, electrochemical sensors employing mercury-free approaches typically suffer from binding competition for metal ions and fouling by organic substances and surfactants in natural waters, making sample pretreatments such as wet ashing necessary. In this work, we have developed mercury-free sensors by coating ...

  15. Severe congenital malformations, family functioning and parents' separation/divorce: a longitudinal study.

    Science.gov (United States)

    Brenner, M; Côté, S M; Boivin, M; Tremblay, R E

    2016-01-01

    We aim to explore the association of a severe congenital malformation (SCM) with postnatal family functioning and parents' separation/divorce and to examine if this association might be moderated by birth order of the child and parental level of education. SCM refers to malformations that, without medical intervention, cause handicap or death. Using the Quebec Longitudinal Study of Child Development, an ongoing population-based birth cohort study initiated in 1998, we compared 1675 families of children with and without a SCM to identify if having a child with a SCM was associated with maternal perception of family functioning. We examined if an SCM was associated with parents' separation and examined parents' education level and birth order of the children to evaluate whether these factors had any moderating effect on the results. There were no significant differences in family functioning between families with and without a SCM child at 5 and 17 months. At 5 months, family functioning was significantly better (P = 0.03) for families with a SCM firstborn child than for families with a SCM child that is not firstborn. For parental separation, no significant differences were observed at 5 and 29 months and 4 years. No significant moderating effects were observed for birth order and parental education on parental separation. Families of children with a SCM do not appear to be at higher risk of family dysfunction within the first 17 months after birth nor of parental separation within the first 4 years after birth. Family functioning tends to be worst in families where the child with SCM is the second or subsequent child born. © 2015 John Wiley & Sons Ltd.

  16. Interpersonal traits change as a function of disease type and severity in degenerative brain diseases

    Science.gov (United States)

    Sollberger, Marc; Neuhaus, John; Ketelle, Robin; Stanley, Christine M.; Beckman, Victoria; Growdon, Matthew; Jung, Jang; Miller, Bruce L.; Rankin, Katherine P.

    2010-01-01

    Background Different degenerative brain diseases result in distinct personality changes as a result of divergent patterns of brain damage, however, little is known about the natural history of these personality changes throughout the course of each disease. Objective To investigate how interpersonal traits change as a function of degenerative brain disease type and severity. Methods Using the Interpersonal Adjective Scales, informant ratings of retrospective premorbid and current scores for dominance, extraversion, warmth, and ingenuousness were collected annually for one to four years on 188 patients [67 behavioural variant frontotemporal dementia (bvFTD), 40 semantic dementia (SemD), 81 Alzheimer’s disease (AD)] and 65 older healthy controls. Using random coefficient models, interpersonal behaviour scores at very mild, mild, or moderate-to-severe disease stages were compared within and between patient groups. Results Group-level changes from premorbid personality occurred as a function of disease type and severity, and were apparent even at a very mild disease stage (Clinical Dementia Rating=0.5) for all three diseases. Decreases in interpersonal traits associated with emotional affiliation (i.e., extraversion, warmth, and ingenuousness) and more rigid interpersonal behaviour differentiated bvFTD and SemD patients from AD patients. Conclusions Specific changes in affiliative interpersonal traits differentiate degenerative brain diseases even at a very mild disease stage, and patterns of personality change differ across bvFTD, SemD, and AD with advancing disease. This study describes the typical progression of change of interpersonal traits in each disease, improving the ability of clinicians and caregivers to predict and plan for symptom progression. PMID:21172858

  17. Interpersonal traits change as a function of disease type and severity in degenerative brain diseases.

    Science.gov (United States)

    Sollberger, Marc; Neuhaus, John; Ketelle, Robin; Stanley, Christine M; Beckman, Victoria; Growdon, Matthew; Jang, Jung; Miller, Bruce L; Rankin, Katherine P

    2011-07-01

    Different degenerative brain diseases result in distinct personality changes as a result of divergent patterns of brain damage; however, little is known about the natural history of these personality changes throughout the course of each disease. To investigate how interpersonal traits change as a function of degenerative brain disease type and severity. Using the Interpersonal Adjective Scales, informant ratings of retrospective premorbid and current scores for dominance, extraversion, warmth and ingenuousness were collected annually for 1 to 4 years on 188 patients (67 behavioural variant frontotemporal dementia (bvFTD), 40 semantic dementia (SemD), 81 Alzheimer's disease (AD)) and 65 older healthy controls. Using random coefficient models, interpersonal behaviour scores at very mild, mild or moderate-to-severe disease stages were compared within and between patient groups. Group-level changes from premorbid personality occurred as a function of disease type and severity, and were apparent even at a very mild disease stage (Clinical Dementia Rating=0.5) for all three diseases. Decreases in interpersonal traits were associated with emotional affiliation (ie, extraversion, warmth and ingenuousness) and more rigid interpersonal behaviour differentiated bvFTD and SemD patients from AD patients. Specific changes in affiliative interpersonal traits differentiate degenerative brain diseases even at a very mild disease stage, and patterns of personality change differ across bvFTD, SemD and AD with advancing disease. This study describes the typical progression of change of interpersonal traits in each disease, improving the ability of clinicians and caregivers to predict and plan for symptom progression.

  18. Smell identification function as a severity and progression marker in Alzheimer's disease.

    Science.gov (United States)

    Velayudhan, Latha; Pritchard, Megan; Powell, John F; Proitsi, Petroula; Lovestone, Simon

    2013-07-01

    Olfactory dysfunction, impaired smell identification in particular, is known as a diagnostic and a marker of conversion in Alzheimer's disease (AD). We aimed to evaluate the associations of olfactory identification impairments with cognition, illness severity, and progression in AD patients. Fifty-seven outpatients with late onset mild to moderate AD and 24 elderly non-demented controls (NDC) were assessed, at baseline and after three months, for Mini-Mental State Examination (MMSE), University of Pennsylvania Smell Identification Test (UPSIT), and Bristol Activities of Daily Living and Neuropsychiatry Inventory. AD participants were classified as Rapid Cognitive Decliners (RCD) defined on a priori with a loss of ≥2 points in MMSE within the previous six months. AD participants had lower olfactory scores than NDC. RCD had lower olfaction scores compared with Non-Rapid Cognitive Decliners (NRCD). Although the baseline UPSIT scores were associated with baseline MMSE scores, it did not interact significantly with change in MMSE over the follow-up period. Using a median split for olfactory scores, the AD participants were classified as Rapid Olfactory Progressors (ROP) (UPSIT ≤ 15) and Slow Olfactory Progressors correlating significantly with RCD/NRCD groups. The ROP group with higher olfactory impairment indicated more symptomatic illness or severity, i.e. lower cognition, higher functional dependence, and presence of behavioral symptoms. Our study supports association of smell identification function with cognition and its utility as an adjunct clinical measure to assess severity in AD. Further work, including larger longitudinal studies, is needed to explore its value in predicting AD progression.

  19. Clinical heterogeneity among people with high functioning autism spectrum conditions: evidence favouring a continuous severity gradient

    Directory of Open Access Journals (Sweden)

    Woodbury-Smith Marc

    2008-02-01

    Full Text Available Abstract Background Autism Spectrum Conditions (ASCs are characterized by a high degree of clinical heterogeneity, but the extent to which this variation represents a severity gradient versus discrete phenotypes is unclear. This issue has complicated genetic studies seeking to investigate the genetic basis of the high hereditability observed clinically in those with an ASC. The aim of this study was to examine the possible clustering of symptoms associated with ASCs to determine whether the observed distribution of symptom type and severity supported either a severity or a symptom subgroup model to account for the phenotypic variation observed within the ASCs. Methods We investigated the responses of a group of adults with higher functioning ASCs on the fifty clinical features examined in the Autism Spectrum Quotient, a screening questionnaire used in the diagnosis of higher functioning ASCs. In contrast to previous studies we have used this instrument with no a priori assumptions about any underlying factor structure of constituent items. The responses obtained were analyzed using complete linkage hierarchical cluster analysis. For the members of each cluster identified the mean score on each Autism Spectrum Quotient question was calculated. Results Autism Spectrum Quotient responses from a total of 333 individuals between the ages of 16.6 and 78.0 years were entered into the hierarchical cluster analysis. The four cluster solution was the one that generated the largest number of clusters that did not also include very small cluster sizes, defined as a membership comprising 10 individuals or fewer. Examination of these clusters demonstrated that they varied in total Autism Spectrum Quotient but that the profiles across the symptoms comprising the Autism Spectrum Quotient did not differ independently of this severity factor. Conclusion These results are consistent with a unitary spectrum model, suggesting that the clinical heterogeneity observed

  20. Disengagement from tasks as a function of cognitive load and depressive symptom severity.

    Science.gov (United States)

    Bowie, Christopher R; Milanovic, Melissa; Tran, Tanya; Cassidy, Sarah

    2017-01-01

    Depression is associated with impairment in cognition and everyday functioning. Mechanisms of cognitive dysfunction in depression and the factors that influence strategic deployment of cognitive abilities in complex environments remain elusive. In this study we investigated whether depression symptom severity is associated with disengagement from a working memory task (Paced Auditory Serial Addition Task; PASAT) with parametric adjustment of task difficulty. 235 participants completed the Beck Depression Inventory, low and high cognitive load conditions of the PASAT, and quality of life. Cognitive disengagement was the sum of consecutive items in which participants did not proffer a response to the trial. Individuals with higher depression severity showed more cognitive disengagement on the high but not low cognitive load trial of the PASAT; they did not differ in number of correct responses. Increased disengagement from the low to high cognitive load was associated with more impaired quality of life. Depression severity is associated with increased disengagement from tasks as difficulty increases. These findings suggest the importance of measuring how cognitive skills are avoided in complex environments in addition to considering performance accuracy. Individuals with depressive symptoms might preferentially avoid cognitive tasks that are perceived as more complex in spite of intact ability.

  1. Application of a simplified definition of diastolic function in severe sepsis and septic shock.

    Science.gov (United States)

    Lanspa, Michael J; Gutsche, Andrea R; Wilson, Emily L; Olsen, Troy D; Hirshberg, Eliotte L; Knox, Daniel B; Brown, Samuel M; Grissom, Colin K

    2016-08-04

    Left ventricular diastolic dysfunction is common in patients with severe sepsis or septic shock, but the best approach to categorization is unknown. We assessed the association of common measures of diastolic function with clinical outcomes and tested the utility of a simplified definition of diastolic dysfunction against the American Society of Echocardiography (ASE) 2009 definition. In this prospective observational study, patients with severe sepsis or septic shock underwent transthoracic echocardiography within 24 h of onset of sepsis (median 4.3 h). We measured echocardiographic parameters of diastolic function and used random forest analysis to assess their association with clinical outcomes (28-day mortality and ICU-free days to day 28) and thereby suggest a simplified definition. We then compared patients categorized by the ASE 2009 definition and our simplified definition. We studied 167 patients. The ASE 2009 definition categorized only 35 % of patients. Random forest analysis demonstrated that the left atrial volume index and deceleration time, central to the ASE 2009 definition, were not associated with clinical outcomes. Our simplified definition used only e' and E/e', omitting the other measurements. The simplified definition categorized 87 % of patients. Patients categorized by either ASE 2009 or our novel definition had similar clinical outcomes. In both definitions, worsened diastolic function was associated with increased prevalence of ischemic heart disease, diabetes, and hypertension. A novel, simplified definition of diastolic dysfunction categorized more patients with sepsis than ASE 2009 definition. Patients categorized according to the simplified definition did not differ from patients categorized according to the ASE 2009 definition in respect to clinical outcome or comorbidities.

  2. Tailoring Wet Explosion Process Parameters for the Pretreatment of Cocksfoot Grass for High Sugar Yields

    DEFF Research Database (Denmark)

    Njoku, Stephen Ikechukwu; Ahring, Birgitte Kiær; Uellendahl, Hinrich

    2013-01-01

    The pretreatment of lignocellulosic biomass is crucial for efficient subsequent enzymatic hydrolysis and ethanol fermentation. In this study, wet explosion (WEx) pretreatment was applied to cocksfoot grass and pretreatment conditions were tailored for maximizing the sugar yields using response su...... when applying less severe pretreatment conditions C (160 °C, 5 min, 0.2 % dilute sulfuric acid). Therefore, the choice of the most suitable pretreatment conditions is depending on the main target product, i.e., hexose or pentose sugars....

  3. Decannulation and Functional Outcome After Tracheostomy in Patients with Severe Stroke (DECAST): A Prospective Observational Study.

    Science.gov (United States)

    Schneider, Hauke; Hertel, Franziska; Kuhn, Matthias; Ragaller, Maximilian; Gottschlich, Birgit; Trabitzsch, Anne; Dengl, Markus; Neudert, Marcus; Reichmann, Heinz; Wöpking, Sigrid

    2017-08-01

    Tracheostomy is performed in ventilated stroke patients affected by persisting severe dysphagia, reduced level of consciousness, or prolonged mechanical ventilation. The study aim was to determine the frequency and predictors of successful decannulation and long-term functional outcome in tracheotomized stroke patients. A prospective single-center observational study recruited ventilated patients with ischemic stroke, intracerebral hemorrhage, and subarachnoid hemorrhage. Follow-up visits were performed at hospital discharge, 3, and 12 months. Competing risk analyses were performed to identify predictors of decannulation. We included 53 ventilated stroke patients who had tracheostomy. One year after tracheostomy, 19 patients were decannulated (median [IQR] time to decannulation 74 [58-117] days), 13 patients were permanently cannulated, and 21 patients died without prior removal of the cannula. Independent predictors for decannulation in our cohort were patient age (HR 0.95 [95% CI: 0.92-0.99] per one year increase, p = 0.003) and absence of sepsis (HR 4.44 [95% CI: 1.33-14.80], p = 0.008). Compared to surviving patients without cannula removal, decannulated patients had an improved functional outcome after one year (median modified Rankin Scale score 4 vs. 5 [p tracheostomy and was associated with better functional outcome compared to patients without decannulation. Further prospective studies with larger sample sizes are needed to confirm our results.

  4. Development and functional demonstration of a wireless intraoral inductive tongue computer interface for severely disabled persons.

    Science.gov (United States)

    N S Andreasen Struijk, Lotte; Lontis, Eugen R; Gaihede, Michael; Caltenco, Hector A; Lund, Morten Enemark; Schioeler, Henrik; Bentsen, Bo

    2017-08-01

    Individuals with tetraplegia depend on alternative interfaces in order to control computers and other electronic equipment. Current interfaces are often limited in the number of available control commands, and may compromise the social identity of an individual due to their undesirable appearance. The purpose of this study was to implement an alternative computer interface, which was fully embedded into the oral cavity and which provided multiple control commands. The development of a wireless, intraoral, inductive tongue computer was described. The interface encompassed a 10-key keypad area and a mouse pad area. This system was embedded wirelessly into the oral cavity of the user. The functionality of the system was demonstrated in two tetraplegic individuals and two able-bodied individuals Results: The system was invisible during use and allowed the user to type on a computer using either the keypad area or the mouse pad. The maximal typing rate was 1.8 s for repetitively typing a correct character with the keypad area and 1.4 s for repetitively typing a correct character with the mouse pad area. The results suggest that this inductive tongue computer interface provides an esthetically acceptable and functionally efficient environmental control for a severely disabled user. Implications for Rehabilitation New Design, Implementation and detection methods for intra oral assistive devices. Demonstration of wireless, powering and encapsulation techniques suitable for intra oral embedment of assistive devices. Demonstration of the functionality of a rechargeable and fully embedded intra oral tongue controlled computer input device.

  5. Improvement of Functional Properties by Sever Plastic Deformation on Parts of Titanium Biomaterials

    Science.gov (United States)

    Czán, Andrej; Babík, Ondrej; Daniš, Igor; Martikáň, Pavol; Czánová, Tatiana

    2017-12-01

    Main task of materials for invasive implantology is their biocompatibility with the tissue but also requirements for improving the functional properties of given materials are increasing constantly. One of problems of materials biocompatibility is the impossibility to improve of functional properties by change the percentage of the chemical elements and so it is necessary to find other innovative methods of improving of functional properties such as mechanical action in the form of high deformation process. This paper is focused on various methods of high deformation process such as Equal Channel Angular Pressing (ECAP) when rods with record strength properties were obtained.The actual studies of the deformation process properties as tri-axial compress stress acting on workpiece with high speed of deformation shows effects similar to results obtained using the other methods, but in lower levels of stress. Hydrostatic extrusion (HE) is applying for the purpose of refining the structure of the commercially pure titanium up to nano-scale. Experiments showed the ability to reduce the grain size below 100 nm. Due to the significant change in the performance of the titanium materials by severe plastic deformation is required to identify the processability of materials with respect to the identification of created surfaces and monitoring the surface integrity, where the experimental results show ability of SPD technologies application on biomaterials.

  6. Analytic function theory of several variables elements of Oka’s coherence

    CERN Document Server

    Noguchi, Junjiro

    2016-01-01

    The purpose of this book is to present the classical analytic function theory of several variables as a standard subject in a course of mathematics after learning the elementary materials (sets, general topology, algebra, one complex variable). This includes the essential parts of Grauert–Remmert's two volumes, GL227(236) (Theory of Stein spaces) and GL265 (Coherent analytic sheaves) with a lowering of the level for novice graduate students (here, Grauert's direct image theorem is limited to the case of finite maps). The core of the theory is "Oka's Coherence", found and proved by Kiyoshi Oka. It is indispensable, not only in the study of complex analysis and complex geometry, but also in a large area of modern mathematics. In this book, just after an introductory chapter on holomorphic functions (Chap. 1), we prove Oka's First Coherence Theorem for holomorphic functions in Chap. 2. This defines a unique character of the book compared with other books on this subject, in which the notion of coherence appear...

  7. Leptin in pediatrics: A hormone from adipocyte that wheels several functions in children

    Directory of Open Access Journals (Sweden)

    Ashraf T Soliman

    2012-01-01

    Full Text Available The protein leptin, a pleiotropic hormone regulates appetite and energy balance of the body and plays important roles in controlling linear growth, pubertal development, cardiovascular function, and immunity. Recent findings in the understanding of the structure, functional roles, and clinical significance of conditions with increased and decreased leptin secretion are summarized. Balance between leptin and other hormones is significantly regulated by nutritional status. This balance influences many organ systems, including the brain, liver, and skeletal muscle, to mediate the essential adaptation process. The aim of this review is to summarize the possible physiological functions of leptin and its signaling pathways during childhood and adolescence including control of food intake, energy regulation, growth and puberty, and immunity. Moreover, its secretion and possible roles in the adaptation process during different disease states (obesity, malnutrition, eating disorders, delayed puberty, congenital heart diseases and hepatic disorders are discussed. The clinical manifestations and the successful management of patients with genetic leptin deficiency and the application of leptin therapy in other diseases including lipodystrophy, states with severe insulin resistance, and diabetes mellitus are discussed.

  8. The early functional outcome of Mau osteotomy for the correction of moderate-severe hallux valgus

    Directory of Open Access Journals (Sweden)

    Tanujan Thangarajah

    2013-11-01

    Full Text Available Hallux valgus is one of the commonest conditions of the foot and has been reported to affect nearly half of the adult population. It is most effectively treated by a corrective osteotomy of which there a numerous subtypes. The Mau osteotomy confers the greatest structural stability but is not thought to provide adequate correction of moderate-severe deformities. Accordingly, complications such as under correction and non-union are common. The aim of this study was to determine the functional outcome in patients with moderate-severe hallux valgus following a Mau osteotomy. A retrospective review of 23 patients with moderate-severe hallux valgus treated by Mau osteotomy was conducted. Patients were assessed clinically by the American Orthopedic Foot and Ankle Society (AOFAS scoring system and radiologically by measuring the first intermetatarsal (IM and hallux abductovalgus angles (HAV. The mean AOFAS score had improved from 47 preoperatively to 92 postoperatively (P<0.01. Additionally, preoperative HAV and IM angles improved from 39° and 15° respectively to 15° and 9° respectively (P<0.01. There were no cases of undercorrection or non-union. In this series, the Mau osteotomy was able to achieve good correction of the IM and HAV angles in patients with moderate-severe hallux valgus. This was reflected in a significantly higher postoperative AOFAS score. Contrary to other studies there were no cases of undercorrection and despite allowing patients to fully weight-bear postoperatively there were no cases of non-union.

  9. Papillary Muscle Free Strain in Patients with Severe Degenerative and Functional Mitral Regurgitation.

    Science.gov (United States)

    Kılıcgedik, Alev; Kahveci, Gokhan; Gurbuz, Ahmet Seyfeddin; Karabay, Can Yucel; Guler, Ahmet; Efe, Suleyman Cagan; Aung, Soe Moe; Arslantas, Ugur; Demir, Serdar; Izgi, Ibrahim Akin; Kirma, Cevat

    2017-04-01

    The role of papillary muscle function in severe mitral regurgitation with preserved and reduced left ventricular ejection fraction and the method of choice to evaluate PM have still been the subjects of controversy. To evaluate and compare papillary muscle function in and between patients with severe degenerative and functional mitral regurgitation by using the free strain method. 64 patients with severe mitral regurgitation - 39 patients with degenerative mitral regurgitation (DMR group) and 25 patients with severe functional mitral regurgitation (FMR group) - and 30 control subjects (control group) were included in the study. Papillary muscle function was evaluated through the free strain method from apical four chamber images of the anterolateral papillary muscle (APM) and from apical three chamber images of the posteromedial papillary muscle (PPM). Global left ventricular longitudinal and circumferential strains were evaluated by applying 2D speckle tracking imaging. Global left ventricular longitudinal strain (DMR group, -17 [-14.2/-20]; FMR group, -9 [-7/-10.7]; control group, -20 [-18/-21] p papel da função do músculo papilar na regurgitação mitral grave com fração de ejeção do ventrículo esquerdo preservada e reduzida e o método de escolha para avaliar PM ainda são objetos de controvérsia. Avaliar e comparar a função dos músculos papilares entre pacientes com insuficiência mitral funcional e degenerativa pelo método free strain. 64 pacientes com insuficiência mitral grave - 39 pacientes com insuficiência mitral degenerativa grave (grupo IMD) e 25 com insuficiência mitral funcional grave (grupo IMF) - e 30 indivíduos controle (grupo controle) foram incluídos no estudo. A função dos músculos papilares foi avaliada pelo método free strain a partir de imagens apicais quatro-câmaras do músculo papilar anterolateral (MPA) e imagens apicais três-câmaras do músculo papilar posteromedial (MPP). Strains circunferenciais e longitudinais

  10. Structural and functional differences in the cingulate cortex relate to disease severity in anorexia nervosa

    Science.gov (United States)

    Bär, Karl-Jürgen; de la Cruz, Feliberto; Berger, Sandy; Schultz, Carl Christoph; Wagner, Gerd

    2015-01-01

    Background The dysfunction of specific brain areas might account for the distortion of body image in patients with anorexia nervosa. The present study was designed to reveal brain regions that are abnormal in structure and function in patients with this disorder. We hypothesized, based on brain areas of altered activity in patients with anorexia nervosa and regions involved in pain processing, an interrelation of structural aberrations in the frontoparietal–cingulate network and aberrant functional activation during thermal pain processing in patients with the disorder. Methods We determined pain thresholds outside the MRI scanner in patients with anorexia nervosa and matched healthy controls. Thereafter, thermal pain stimuli were applied during fMRI imaging. Structural analyses with high-resolution structural T1-weighted volumes were performed using voxel-based morphometry and a surface-based approach. Results Twenty-six patients and 26 controls participated in our study, and owing to technical difficulties, 15 participants in each group were included in our fMRI analysis. Structural analyses revealed significantly decreased grey matter volume and cortical thickness in the frontoparietal–cingulate network in patients with anorexia nervosa. We detected an increased blood oxygen level–dependent signal in patients during the painful 45°C condition in the midcingulate and posterior cingulate cortex, which positively correlated with increased pain thresholds. Decreased grey matter and cortical thickness correlated negatively with pain thresholds, symptom severity and illness duration, but not with body mass index. Limitations The lack of a specific quantification of body image distortion is a limitation of our study. Conclusion This study provides further evidence for confined structural and functional brain abnormalities in patients with anorexia nervosa in brain regions that are involved in perception and integration of bodily stimuli. The association of

  11. Experimental functional analysis of severe skin-picking behavior in Prader-Willi syndrome.

    Science.gov (United States)

    Hall, Scott S; Hustyi, Kristin M; Chui, Clara; Hammond, Jennifer L

    2014-10-01

    Skin picking is an extremely distressing and treatment resistant behavior commonly shown by individuals with Prader-Willi syndrome (PWS). However, with the exception of a limited number of published single-case and survey studies, little is known about the environmental determinants of skin picking in this population. In this study, functional analyses were conducted with thirteen individuals with PWS, aged 6-23 years, who engaged in severe skin-picking behavior. In addition to the conditions typically employed in a functional analysis (i.e., alone, attention, play, demand), we included an ignore condition to examine potential effects of stimulus control by the presence of an adult. Twelve participants engaged in skin picking during the functional analysis, with the highest levels occurring in the alone and ignore conditions for eight participants, suggesting that skin picking in these participants was maintained by automatic reinforcement. For the remaining four participants, an undifferentiated pattern of low-rate skin picking was observed across conditions. These data confirm previous studies indicating that skin picking in PWS may be maintained most often by automatically produced sensory consequences. There were no associations between demographic characteristics of the participants (e.g., sex, age, IQ or BMI) and levels of skin picking observed in the functional analysis. Additional investigations are needed to identify the nature of the sensory consequences produced during episodes of skin picking in PWS. Behavioral interventions designed to extinguish or compete with the potential sensory consequences arising from skin picking in PWS are also warranted. Copyright © 2014 Elsevier Ltd. All rights reserved.

  12. Improvement in executive function after unilateral carotid artery stenting for severe asymptomatic stenosis.

    Science.gov (United States)

    Mendiz, Oscar A; Sposato, Luciano A; Fabbro, Nicolás; Lev, Gustavo A; Calle, Analía; Valdivieso, León R; Fava, Carlos M; Klein, Francisco R; Torralva, Teresa; Gleichgerrcht, Ezequiel; Manes, Facundo

    2012-01-01

    Executive functions are crucial for organizing and integrating cognitive processes. While some studies have assessed the effect of carotid artery stenting (CAS) on cognitive functioning, results have been conflicting. The object of this study was to assess the effect of CAS on cognitive status, with special interest on executive functions, among patients with severe asymptomatic internal carotid artery (ICA) stenosis. The authors prospectively assessed the neuropsychological status of 20 patients with unilateral asymptomatic extracranial ICA stenosis of 60% or more by using a comprehensive assessment battery focused on executive functions before and after CAS. Individual raw scores on neuropsychological tests were converted into z scores by normalizing for age, sex, and years of education. The authors compared baseline and 3-month postoperative neuropsychological scores by using Wilcoxon signed-rank tests. The mean preoperative cognitive performance was within normal ranges on all variables. All patients underwent a successful CAS procedure. Executive function scores improved after CAS, relative to baseline performance as follows: set shifting (Trail-Making Test Part B: -0.75 ± 1.43 vs -1.2 ± 1.48, p = 0.003) and processing speed (digit symbol coding: -0.66 ± 0.85 vs -0.97 ± 0.82, p = 0.035; and symbol search: -0.24 ± 1.32 vs -0.56 ± 0.77, p = 0.049). The benefit of CAS for working memory was marginally significant (digit span backward: -0.41 ± 0.61 vs -0.58 ± 0.76, p = 0.052). Both verbal (immediate Rey Auditory Verbal Learning Test: 0.35 ± 1.04 vs -0.22 ± 0.82, p = 0.011) and visual (delayed Rey-Osterrieth Complex Figure: 0.27 ± 1.26 vs -0.22 ± 1.01, p = 0.024) memory improved after CAS. The authors found a beneficial effect on executive function and memory 3 months after CAS among their prospective cohort of consecutive patients with unilateral and asymptomatic ICA stenosis of 60% or more.

  13. Holonomic functions of several complex variables and singularities of anisotropic Ising n-fold integrals

    Science.gov (United States)

    Boukraa, S.; Hassani, S.; Maillard, J.-M.

    2012-12-01

    Focusing on examples associated with holonomic functions, we try to bring new ideas on how to look at phase transitions, for which the critical manifolds are not points but curves depending on a spectral variable, or even fill higher dimensional submanifolds. Lattice statistical mechanics often provides a natural (holonomic) framework to perform singularity analysis with several complex variables that would, in the most general mathematical framework, be too complex, or simply could not be defined. In a learn-by-example approach, considering several Picard-Fuchs systems of two-variables ‘above’ Calabi-Yau ODEs, associated with double hypergeometric series, we show that D-finite (holonomic) functions are actually a good framework for finding properly the singular manifolds. The singular manifolds are found to be genus-zero curves. We then analyze the singular algebraic varieties of quite important holonomic functions of lattice statistical mechanics, the n-fold integrals χ(n), corresponding to the n-particle decomposition of the magnetic susceptibility of the anisotropic square Ising model. In this anisotropic case, we revisit a set of so-called Nickelian singularities that turns out to be a two-parameter family of elliptic curves. We then find the first set of non-Nickelian singularities for χ(3) and χ(4), that also turns out to be rational or elliptic curves. We underline the fact that these singular curves depend on the anisotropy of the Ising model, or, equivalently, that they depend on the spectral parameter of the model. This has important consequences on the physical nature of the anisotropic χ(n)s which appear to be highly composite objects. We address, from a birational viewpoint, the emergence of families of elliptic curves, and that of Calabi-Yau manifolds on such problems. We also address the question of singularities of non-holonomic functions with a discussion on the accumulation of these singular curves for the non-holonomic anisotropic full

  14. Holonomic functions of several complex variables and singularities of anisotropic Ising n-fold integrals

    International Nuclear Information System (INIS)

    Boukraa, S; Hassani, S; Maillard, J-M

    2012-01-01

    Focusing on examples associated with holonomic functions, we try to bring new ideas on how to look at phase transitions, for which the critical manifolds are not points but curves depending on a spectral variable, or even fill higher dimensional submanifolds. Lattice statistical mechanics often provides a natural (holonomic) framework to perform singularity analysis with several complex variables that would, in the most general mathematical framework, be too complex, or simply could not be defined. In a learn-by-example approach, considering several Picard–Fuchs systems of two-variables ‘above’ Calabi–Yau ODEs, associated with double hypergeometric series, we show that D-finite (holonomic) functions are actually a good framework for finding properly the singular manifolds. The singular manifolds are found to be genus-zero curves. We then analyze the singular algebraic varieties of quite important holonomic functions of lattice statistical mechanics, the n-fold integrals χ (n) , corresponding to the n-particle decomposition of the magnetic susceptibility of the anisotropic square Ising model. In this anisotropic case, we revisit a set of so-called Nickelian singularities that turns out to be a two-parameter family of elliptic curves. We then find the first set of non-Nickelian singularities for χ (3) and χ (4) , that also turns out to be rational or elliptic curves. We underline the fact that these singular curves depend on the anisotropy of the Ising model, or, equivalently, that they depend on the spectral parameter of the model. This has important consequences on the physical nature of the anisotropic χ (n) s which appear to be highly composite objects. We address, from a birational viewpoint, the emergence of families of elliptic curves, and that of Calabi–Yau manifolds on such problems. We also address the question of singularities of non-holonomic functions with a discussion on the accumulation of these singular curves for the non

  15. Effects of Temperament, Symptom Severity and Level of Functioning on Maternal Stress in Greek Children and Youth with ASD

    Science.gov (United States)

    Konstantareas, M. Mary; Papageorgiou, Vaya

    2006-01-01

    This study examined the effect of child temperament, symptom severity, verbal ability and level of functioning on maternal stress in 43 Greek mothers of children and young people with autism spectrum disorder. Symptom severity was assessed by the CARS, level of functioning by the PEP, temperament by the Dimensions of Temperament Scale (DOTS-R) and…

  16. Association between Air Pollution Exposure, Cognitive and Adaptive Function, and ASD Severity among Children with Autism Spectrum Disorder

    Science.gov (United States)

    Kerin, Tara; Volk, Heather; Li, Weiyan; Lurmann, Fred; Eckel, Sandrah; McConnell, Rob; Hertz-Picciotto, Irva

    2018-01-01

    Prenatal exposure to air pollution has been associated with autism spectrum disorder (ASD) risk but no study has examined associations with ASD severity or functioning. Cognitive ability, adaptive functioning, and ASD severity were assessed in 327 children with ASD from the Childhood Autism Risks from Genetics and the Environment study using the…

  17. Severe functional difficulties and disabilities in children and adolescents and the Sustainable Development Goals

    Directory of Open Access Journals (Sweden)

    Filipa De Castro

    2017-07-01

    Full Text Available Objective. To report prevalence of severe child functional difficulties and disability (CFD in a nationally representative sample of 2 to 17 year-old children in Mexico and describe the inequities faced by children with CFD in relation to a set of Sustainable Development Goals (SDG-related outcomes. Materials and methods. Using data from the National Survey of Children and Women (ENIM 2015 we estimate prevalence with 95% confidence intervals for the selected indicators. We use chi-square test and confidence intervals inspection to report significant differences between children with and without CFD. Results. 8% of children present at least one CFD. CFD is associated with higher prevalence of underweight and child labor and lower prevalence of adequate early child development. Conclusion. Children with CFD present worst outcomes and require targeted efforts to ensure they meet health and wellbeing targets in the frame of the SDGs.

  18. [Functions of the splenic remnant after subtotal splenectomy for treatment of severe splenic injuries].

    Science.gov (United States)

    Resende, Viviam; Petroianu, Andy

    2002-01-01

    To evaluate clinical and laboratory variables in patients submitted to subtotal splenectomy. 34 patients with severe trauma of the spleen and its pedicle were studied: 25 patients were submitted to subtotal splenectomy, preserving only the upper pole of the spleen (Group I), 9 were submitted to total splenectomy (Group II), and other 22 people with intact spleen were the control (Group III). Immediate and late postoperative complications were investigated. Laboratory exams were performed in the late postoperative period (red blood cells, hemoglobin, white blood cells, platelets and Howell-Jolly bodies). We studied the B- and T-lymphocyte counts and the immunoglobulins A, G and M (IgA, IgG and IgM) levels. Splenic scintigraphy with technetium 99mTc sulfur colloid was carried out on all patients. Group II presented Howell-Jolly bodies increased and low level of immunoglobulin M. The splenic scintigraphy demonstrated the viability and the filtering function of the splenic remnant in Group I. Subtotal splenectomy is a surgical alternative technique for treatment of severe distal injuries of the spleen or when its main vessels are damaged.

  19. The Role of Cerebrovascular Disease on Cognitive and Functional Status and Psychosis in Severe Alzheimer's Disease.

    Science.gov (United States)

    Kim, Julia; Schweizer, Tom A; Fischer, Corinne E; Munoz, David G

    2017-01-01

    The pathophysiology behind psychosis in patients with Alzheimer's disease (AD) remains unknown. Recently, vascular risk factors have been recognized as important modifiers of the clinical presentation of AD. The purpose of our study is to investigate the mechanism through which vascular risk factors mediate psychosis and whether or not it involves cerebrovascular lesions. Data was provided by the National Alzheimer's Coordinating Centre. The Uniform Data Set was used to collect information on subject-reported history of vascular risk factors, clinician-reported state of cognitive performance, and presence of psychosis based on the Neuropsychiatric Inventory Questionnaire (NPI-Q). The Neuropathology Data Set was used to evaluate the presence of vascular lesions and the severity of AD pathology. Subjects with high probability of AD based on the NIA/AA Reagan criteria were included in the analysis. We identified 1,459 patients with high probability of AD and corresponding NPI-Q scores. We confirmed the association between hypertension and diabetes on psychosis, specifically in delusions and the co-occurrence of delusions and hallucinations. Furthermore, the presence of white matter rarefaction based on pathological evaluation was associated with hallucinations. A history of vascular risk factors was positively associated with vascular lesions. However, vascular lesions in the presence of vascular risk factors did not increase the likelihood of psychosis. Furthermore, vascular lesions were not associated with greater cognitive or functional impairments in this group with severe AD pathology. Vascular risk factors and vascular lesions are independently associated with psychosis in patients with severe AD. However, vascular lesions are not the mechanism through which vascular risk factors mediate psychosis.

  20. Recovering the function and esthetics of fractured teeth using several restorative cosmetic approaches. Three clinical cases.

    Science.gov (United States)

    Anchieta, Rodolfo B; Rocha, Eduardo P; Watanabe, Maurício U; de Almeida, Erika O; Freitas-Junior, Amilcar C; Martini, Ana P; Barioni, Sônia R P

    2012-04-01

    The teeth most commonly affected by trauma are the maxillary central incisors. The most frequent types of traumatic dental injuries to permanent teeth are enamel fractures, enamel and dentine fractures, and enamel and dentine fractures with pulp involvement. This article describes three clinical cases with different levels of traumatized maxillary incisors and several cosmetic approaches for recovery of the esthetics and the masticatory function, as well as the social/psychological aspects of treatment. All cases involved young adult men. The three clinical cases involve dentin and enamel fractures, dentin and enamel fractures with pulp exposure, and dentin and enamel fractures with pulp exposure associated with root fracture. The cosmetic treatments used to resolve fractures were direct composite resin by layering technique, indirect all-ceramic restorations (laminate veneer and ceramic crowns over the teeth), and immediate implant after extraction followed by immediate loading (ceramic abutments with ceramic crown over implant). In all three cases, excellent functional and esthetic results were achieved by use of these treatment modalities. The patients were very satisfied with the results. © 2011 John Wiley & Sons A/S.

  1. Initial effect of enalapril on kidney function in patients with moderate to severe chronic nephropathy

    DEFF Research Database (Denmark)

    Kamper, A L; Thomsen, H S; Nielsen, S L

    1990-01-01

    Angiotensin converting enzyme (ACE) inhibitors has been suggested to halt the progression of chronic renal failure. As the initial step of a controlled trial of this hypothesis, it was investigated whether start of enalapril in patients with severe chronic nephropathy might cause a critical fall...... in their renal function. Thirty-one patients were studied, 26 on chronic antihypertensive treatment with drugs other than ACE inhibitors and 5 untreated normotensive. 51Cr-EDTA plasma clearance and renal technetium-99m dimercaptosuccinic acid (99mTc-DMSA) scintigraphy were made before and 24 h after start...... of enalapril, mean dose 9 mg. Blood pressure fell from median 148/88 to 119/78 mmHg (p less than 0.01). Glomerular filtration rate (GFR) fell from median 14 to 12 ml/min/1.73 m2 (p less than 0.01). The median change in GFR was -14% (range -44% to +10%). The split renal function was unchanged...

  2. COPD phenotypes on computed tomography and its correlation with selected lung function variables in severe patients

    Directory of Open Access Journals (Sweden)

    da Silva SMD

    2016-03-01

    Full Text Available Silvia Maria Doria da Silva, Ilma Aparecida Paschoal, Eduardo Mello De Capitani, Marcos Mello Moreira, Luciana Campanatti Palhares, Mônica Corso PereiraPneumology Service, Department of Internal Medicine, School of Medical Sciences, State University of Campinas (UNICAMP, Campinas, São Paulo, BrazilBackground: Computed tomography (CT phenotypic characterization helps in understanding the clinical diversity of chronic obstructive pulmonary disease (COPD patients, but its clinical relevance and its relationship with functional features are not clarified. Volumetric capnography (VC uses the principle of gas washout and analyzes the pattern of CO2 elimination as a function of expired volume. The main variables analyzed were end-tidal concentration of carbon dioxide (ETCO2, Slope of phase 2 (Slp2, and Slope of phase 3 (Slp3 of capnogram, the curve which represents the total amount of CO2 eliminated by the lungs during each breath.Objective: To investigate, in a group of patients with severe COPD, if the phenotypic analysis by CT could identify different subsets of patients, and if there was an association of CT findings and functional variables.Subjects and methods: Sixty-five patients with COPD Gold III–IV were admitted for clinical evaluation, high-resolution CT, and functional evaluation (spirometry, 6-minute walk test [6MWT], and VC. The presence and profusion of tomography findings were evaluated, and later, the patients were identified as having emphysema (EMP or airway disease (AWD phenotype. EMP and AWD groups were compared; tomography findings scores were evaluated versus spirometric, 6MWT, and VC variables.Results: Bronchiectasis was found in 33.8% and peribronchial thickening in 69.2% of the 65 patients. Structural findings of airways had no significant correlation with spirometric variables. Air trapping and EMP were strongly correlated with VC variables, but in opposite directions. There was some overlap between the EMP and AWD

  3. Bronchodilator response of advanced lung function parameters depending on COPD severity

    Directory of Open Access Journals (Sweden)

    Jarenbäck L

    2016-11-01

    Full Text Available Linnea Jarenbäck,1 Göran Eriksson,1 Stefan Peterson,2 Jaro Ankerst,1 Leif Bjermer,1 Ellen Tufvesson1 1Respiratory Medicine and Allergology, Department of Clinical Sciences Lund, Lund University, 2Regional Cancer Center South, Skåne University Hospital, Lund, Sweden Background: COPD is defined as partly irreversible airflow obstruction. The response pattern of bronchodilators has not been followed in advanced lung function parameters. Purpose: The aim of this study was to investigate bronchodilator response pattern in advanced lung function parameters in a continuous fashion along forced expiratory volume in 1 second (FEV1 percent predicted (%p in COPD patients and controls. Patients and methods: Eighty-one smokers/ex-smokers (41 controls and 40 COPD performed spirometry, body plethysmography, impulse oscillometry and single-breath helium dilution carbon monoxide diffusion at baseline, after salbutamol inhalation and then after an additional inhalation of ipratropium. Results: Most pulmonary function parameters showed a linear increase in response to decreased FEV1%p. The subjects were divided into groups of FEV1%p <65 and >65, and the findings from continuous analysis were verified. The exceptions to this linear response were inspiratory capacity (IC, forced vital capacity (FVC, FEV1/FVC and expiratory resistance (Rex, which showed a segmented response relationship to FEV1%p. IC and FVC, with break points (BP of 57 and 58 FEV1%p respectively, showed no response above, but an incresed slope below the BP. In addition, in patients with FEV1%p <65 and >65, response of FEV1%p did not correlate to response of volume parameters. Conclusion: Response of several advanced lung function parameters differs depending on patients’ baseline FEV1%p, and specifically response of volume parameters is most pronounced in COPD patients with FEV1%p <65. Volume and resistance responses do not follow the flow response measured with FEV1 and may thus be used as a

  4. Human CalDAG-GEFI gene (RASGRP2) mutation affects platelet function and causes severe bleeding.

    Science.gov (United States)

    Canault, Matthias; Ghalloussi, Dorsaf; Grosdidier, Charlotte; Guinier, Marie; Perret, Claire; Chelghoum, Nadjim; Germain, Marine; Raslova, Hana; Peiretti, Franck; Morange, Pierre E; Saut, Noemie; Pillois, Xavier; Nurden, Alan T; Cambien, François; Pierres, Anne; van den Berg, Timo K; Kuijpers, Taco W; Alessi, Marie-Christine; Tregouet, David-Alexandre

    2014-06-30

    The nature of an inherited platelet disorder was investigated in three siblings affected by severe bleeding. Using whole-exome sequencing, we identified the culprit mutation (cG742T) in the RAS guanyl-releasing protein-2 (RASGRP2) gene coding for calcium- and DAG-regulated guanine exchange factor-1 (CalDAG-GEFI). Platelets from individuals carrying the mutation present a reduced ability to activate Rap1 and to perform proper αIIbβ3 integrin inside-out signaling. Expression of CalDAG-GEFI mutant in HEK293T cells abolished Rap1 activation upon stimulation. Nevertheless, the PKC- and ADP-dependent pathways allow residual platelet activation in the absence of functional CalDAG-GEFI. The mutation impairs the platelet's ability to form thrombi under flow and spread normally as a consequence of reduced Rac1 GTP-binding. Functional deficiencies were confined to platelets and megakaryocytes with no leukocyte alteration. This contrasts with the phenotype seen in type III leukocyte adhesion deficiency caused by the absence of kindlin-3. Heterozygous did not suffer from bleeding and have normal platelet aggregation; however, their platelets mimicked homozygous ones by failing to undergo normal adhesion under flow and spreading. Rescue experiments on cultured patient megakaryocytes corrected the functional deficiency after transfection with wild-type RASGRP2. Remarkably, the presence of a single normal allele is sufficient to prevent bleeding, making CalDAG-GEFI a novel and potentially safe therapeutic target to prevent thrombosis. © 2014 Canault et al.

  5. GREET Pretreatment Module

    Energy Technology Data Exchange (ETDEWEB)

    Adom, Felix K. [Argonne National Lab. (ANL), Argonne, IL (United States). Energy Systems Division; Dunn, Jennifer B. [Argonne National Lab. (ANL), Argonne, IL (United States). Energy Systems Division; Han, Jeongwoo [Argonne National Lab. (ANL), Argonne, IL (United States). Energy Systems Division

    2014-09-01

    A wide range of biofuels and biochemicals can be produced from cellulosic biomass via different pretreatment technologies that yield sugars. Process simulations of dilute acid and ammonia fiber expansion pretreatment processes and subsequent hydrolysis were developed in Aspen Plus for four lignocellulosic feedstocks (corn stover, miscanthus, switchgrass, and poplar). This processing yields sugars that can be subsequently converted to biofuels or biochemical. Material and energy consumption data from Aspen Plus were then compiled in a new Greenhouses Gases, Regulated Emissions, and Energy Use in Transportation (GREETTM) pretreatment module. The module estimates the cradle-to-gate fossil energy consumption (FEC) and greenhouse gas (GHG) emissions associated with producing fermentable sugars. This report documents the data and methodology used to develop this module and the cradle-to-gate FEC and GHG emissions that result from producing fermentable sugars.

  6. Human IκBα Gain of Function: a Severe and Syndromic Immunodeficiency.

    Science.gov (United States)

    Boisson, Bertrand; Puel, Anne; Picard, Capucine; Casanova, Jean-Laurent

    2017-07-01

    Germline heterozygous gain-of-function (GOF) mutations of NFKBIA, encoding IκBα, cause an autosomal dominant (AD) form of anhidrotic ectodermal dysplasia with immunodeficiency (EDA-ID). Fourteen unrelated patients have been reported since the identification of the first case in 2003. All mutations enhanced the inhibitory activity of IκBα, by preventing its phosphorylation on serine 32 or 36 and its subsequent degradation. The mutation certainly or probably occurred de novo in 13 patients, whereas it was inherited from a parent with somatic mosaicism in one patient. Eleven mutations, belonging to two groups, were identified: (i) missense mutations affecting S32, S36, or neighboring residues (8 mutations, 11 patients) and (ii) nonsense mutations upstream from S32 associated with the reinitiation of translation downstream from S36 (3 mutations, 3 patients). Thirteen patients had developmental features of EDA, the severity and nature of which differed between cases. All patient cells tested displayed impaired NF-κB-mediated responses to the stimulation of various surface receptors involved in cell-intrinsic (fibroblasts), innate (monocytes), and adaptive (B and T cells) immunity, including TLRs, IL-1Rs, TNFRs, TCR, and BCR. All patients had profound B-cell deficiency. Specific immunological features, found in some, but not all patients, included a lack of peripheral lymph nodes, lymphocytosis, dysfunctional α/β T cells, and a lack of circulating γ/δ T cells. The patients had various pyogenic, mycobacterial, fungal, and viral severe infections. Patients with a missense mutation tended to display more severe phenotypes, probably due to higher levels of GOF proteins. In the absence of hematopoietic stem cell transplantation (HSCT), this condition cause death before the age of 1 year (one child). Two survivors have been on prophylaxis (at 9 and 22 years). Six children died after HSCT. Five survived, four of whom have been on prophylaxis (3 to 21 years post HSCT

  7. Motor Imagery as a Function of Disease Severity in Multiple Sclerosis: An fMRI Study

    Directory of Open Access Journals (Sweden)

    Andrea Tacchino

    2018-01-01

    Full Text Available Motor imagery (MI is defined as mental execution without any actual movement. While healthy adults usually show temporal equivalence, i.e., isochrony, between the mental simulation of an action and its actual performance, neurological disorders are associated with anisochrony. Unlike in patients with stroke and Parkinson disease, only a few studies have investigated differences of MI ability in multiple sclerosis (MS. However, the relationship among disease severity, anisochrony and brain activation patterns during MI has not been investigated yet. Here, we propose to investigate MI in MS patients using fMRI during a behavioral task executed with dominant/non-dominant hand and to evaluate whether anisochrony is associated with disease severity. Thirty-seven right-handed MS patients, 17 with clinically isolated syndrome (CIS suggestive of MS and 20 with relapsing-remitting MS (RR-MS and 20 right-handed healthy controls (HC underwent fMRI during a motor task consisting in the actual or imaged movement of squeezing a foam ball with the dominant and non-dominant hand. The same tasks were performed outside the MRI room to record the number of actual and imagined ball squeezes, and calculate an Index of performance (IP based on the ratio between actual and imagined movements. IP showed that a progressive loss of ability in simulating actions (i.e., anisochrony more pronounced for non-dominant hand, was found as function of the disease course. Moreover, anisochrony was associated with activation of occipito-parieto-frontal areas that were more extensive at the early stages of the disease, probably in order to counteract the changes due to MS. However, the neural engagement of compensatory brain areas becomes more difficult with more challenging tasks, i.e., dominant vs. non-dominant hand, with a consequent deficit in behavioral performance. These results show a strict association between MI performance and disease severity, suggesting that, at early

  8. Microbial Community Structure and Function Indicate the Severity of Chromium Contamination of the Yellow River

    Directory of Open Access Journals (Sweden)

    Yaxin Pei

    2018-01-01

    Full Text Available The Yellow River is the most important water resource in northern China. In the recent past, heavy metal contamination has become severe due to industrial processes and other anthropogenic activities. In this study, riparian soil samples with varying levels of chromium (Cr pollution severity were collected along the Gansu industrial reach of the Yellow River, including samples from uncontaminated sites (XC, XGU, slightly contaminated sites (LJX, XGD, and heavily contaminated sites (CG, XG. The Cr concentrations of these samples varied from 83.83 mg⋅kg-1 (XGU to 506.58 mg⋅kg-1 (XG. The chromate [Cr (VI] reducing ability in the soils collected in this study followed the sequence of the heavily contaminated > slightly contaminated > the un-contaminated. Common Cr remediation genes chrA and yieF were detected in the XG and CG samples. qRT-PCR results showed that the expression of chrA was up-regulated four and threefold in XG and CG samples, respectively, whereas the expression of yieF was up-regulated 66- and 7-fold in the same samples after 30 min treatment with Cr (VI. The copy numbers of chrA and yieF didn’t change after 35 days incubation with Cr (VI. The microbial communities in the Cr contaminated sampling sites were different from those in the uncontaminated samples. Especially, the relative abundances of Firmicutes and Bacteroidetes were higher while Actinobacteria was lower in the contaminated group than uncontaminated group. Further, potential indicator species, related to Cr such as Cr-remediation genera (Geobacter, PSB-M-3, Flavobacterium, and Methanosarcina; the Cr-sensitive genera (Skermanella, Iamia, Arthrobacter, and Candidatus Nitrososphaera were also identified. These data revealed that Cr shifted microbial composition and function. Further, Cr (VI reducing ability could be related with the expression of Cr remediation genes.

  9. A cohort study of functioning and disability among women after severe maternal morbidity.

    Science.gov (United States)

    Silveira, Carla; Parpinelli, Mary A; Pacagnella, Rodolfo C; Andreucci, Carla B; Ferreira, Elton C; Angelini, Carina R; Bussadori, Jamile C; Santos, Juliana P; Zanardi, Dulce M; Cecchino, Gustavo N; Souza, Renato T; Costa, Maria L; Camargo, Rodrigo S; Cecatti, Jose G

    2016-07-01

    To assess functioning and disability related to severe maternal morbidity (SMM) via the WHO Disability Assessment Schedule 2.0 (WHODAS 2.0). In a retrospective cohort study, women with or without a history of SMM who delivered at a tertiary public hospital in Brazil between July 2008 and June 2012, completed the WHODAS 2.0 questionnaire by individual interview between August 2012 and November 2013. General WHODAS scores were evaluated by maternal and neonatal characteristics, and specific domain scores according to SMM event. Overall, 638 women were enrolled (315 with SMM and 323 without SMM). The mean general WHODAS score was higher among women with SMM (19.04±16.18) than among women without SMM (15.77±14.46; P=0.015). Domain scores were also higher in the SMM group for mobility (16.00±20.22 vs 11.63±17.51; P=0.003), household activities (26.79±30.16 vs 20.09±26.08; P=0.005), participation (23.55±21.72 vs 17.27±19.17; P<0.001), and work/school activities for women currently studying or working (20.52±26.64 vs 11.66±19.67; P=0.001). Excluding SMM, a parity of two or more was the only factor significantly associated with higher scores overall (P=0.013) and for domain 4 (getting along with people; P=0.017). By comparison with women without childbirth complications, SMM impaired self-reported functioning among women 1-5years after delivery. Copyright © 2016. Published by Elsevier Ireland Ltd.

  10. Feasibility of Hydrothermal Pretreatment on Maize Silage for Bioethanol Production

    DEFF Research Database (Denmark)

    Xu, Jian; Thomsen, Mette Hedegaard; Thomsen, Anne Belinda

    2010-01-01

    The potential of maize silage as a feedstock to produce bioethanol was evaluated in the present study. The hydrothermal pretreatment with five different pretreatment severity factors (PSF) was employed to pretreat the maize silage and compared in terms of sugar recovery, toxic test, and ethanol...... the liquors from the five conditions were not toxic to the Baker’s yeast. Pretreatment under 195°C for 7 min had the similar PSF with that of 185°C for 15 min, and both gave the higher ethanol concentration of 19.92 and 19.98 g/L, respectively. The ethanol concentration from untreated maize silage was only 7...

  11. Developmental trajectories of symptom severity and adaptive functioning in an inception cohort of preschool children with autism spectrum disorder.

    Science.gov (United States)

    Szatmari, Peter; Georgiades, Stelios; Duku, Eric; Bennett, Teresa A; Bryson, Susan; Fombonne, Eric; Mirenda, Pat; Roberts, Wendy; Smith, Isabel M; Vaillancourt, Tracy; Volden, Joanne; Waddell, Charlotte; Zwaigenbaum, Lonnie; Elsabbagh, Mayada; Thompson, Ann

    2015-03-01

    Symptom severity and adaptive functioning are fundamental domains of the autism spectrum disorder (ASD) phenotype. To date, the longitudinal association between these 2 domains has not been examined. To describe the developmental trajectories of autistic symptom severity and adaptive functioning in a large inception cohort of preschool children with ASD. The sample consisted of 421 newly diagnosed preschool children with ASD 2 to 4 years old (355 boys; mean age at study enrollment, 39.87 months) participating in a large Canadian multisite longitudinal study (Pathways in ASD Study). Prospective data collected at 4 points from time of diagnosis to age 6 years were used to track the developmental trajectories of children. Autistic symptom severity was indexed using the Autism Diagnostic Observation Schedule. Adaptive functioning was indexed using the Vineland Adaptive Behavior Scales, Second Edition. Two distinct trajectory groups provided the best fit to the autistic symptom severity data. Group 1 (11.4% of the sample) had less severe symptoms and an improving trajectory (P adaptive functioning data. Group 1 (29.2% of the sample) showed lower functioning and a worsening trajectory, group 2 (49.9% of the sample) had moderate functioning and a stable trajectory, and group 3 (20.9% of the sample) had higher functioning and an improving trajectory (P adaptive functioning groups was low (φ = 0.13, P adaptive functioning trajectories. Trajectories of both symptom severity and adaptive functioning predicted several different outcomes at age 6 years. Findings confirm the heterogeneous nature of developmental trajectories in ASD. Change in adaptive functioning suggests that improvement is possible in roughly 20% of the sample. Autistic symptom severity appears to be more stable, with roughly 11% of the sample showing a marked decrease in symptom severity. During the preschool years, there appears to be only a small amount of "yoking" of developmental trajectories

  12. Impact of cognitive function and dysarthria on spoken language and perceived speech severity in multiple sclerosis

    Science.gov (United States)

    Feenaughty, Lynda

    Purpose: The current study sought to investigate the separate effects of dysarthria and cognitive status on global speech timing, speech hesitation, and linguistic complexity characteristics and how these speech behaviors impose on listener impressions for three connected speech tasks presumed to differ in cognitive-linguistic demand for four carefully defined speaker groups; 1) MS with cognitive deficits (MSCI), 2) MS with clinically diagnosed dysarthria and intact cognition (MSDYS), 3) MS without dysarthria or cognitive deficits (MS), and 4) healthy talkers (CON). The relationship between neuropsychological test scores and speech-language production and perceptual variables for speakers with cognitive deficits was also explored. Methods: 48 speakers, including 36 individuals reporting a neurological diagnosis of MS and 12 healthy talkers participated. The three MS groups and control group each contained 12 speakers (8 women and 4 men). Cognitive function was quantified using standard clinical tests of memory, information processing speed, and executive function. A standard z-score of ≤ -1.50 indicated deficits in a given cognitive domain. Three certified speech-language pathologists determined the clinical diagnosis of dysarthria for speakers with MS. Experimental speech tasks of interest included audio-recordings of an oral reading of the Grandfather passage and two spontaneous speech samples in the form of Familiar and Unfamiliar descriptive discourse. Various measures of spoken language were of interest. Suprasegmental acoustic measures included speech and articulatory rate. Linguistic speech hesitation measures included pause frequency (i.e., silent and filled pauses), mean silent pause duration, grammatical appropriateness of pauses, and interjection frequency. For the two discourse samples, three standard measures of language complexity were obtained including subordination index, inter-sentence cohesion adequacy, and lexical diversity. Ten listeners

  13. Discrete-Trial Functional Analysis and Functional Communication Training with Three Individuals with Autism and Severe Problem Behavior

    Science.gov (United States)

    Schmidt, Jonathan D.; Drasgow, Erik; Halle, James W.; Martin, Christian A.; Bliss, Sacha A.

    2014-01-01

    Discrete-trial functional analysis (DTFA) is an experimental method for determining the variables maintaining problem behavior in the context of natural routines. Functional communication training (FCT) is an effective method for replacing problem behavior, once identified, with a functionally equivalent response. We implemented these procedures…

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

    Science.gov (United States)

    Lax Pericall, Maria Teresa; Taylor, Eric

    2014-01-01

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

  15. Advances in aluminum pretreatment

    Energy Technology Data Exchange (ETDEWEB)

    Sudour, Michel; Maintier, Philippe [PPG Industries France, 3 Z.A.E. Les Dix Muids, B.P. 89, F-59583 Marly (France); Simpson, Mark [PPG Industries Inc., 1200 Piedmont Troy, Michigan 48083 (United States); Quaglia, Paolo [PPG Industries Italia, Via Garavelli 21, I-15028 Quattordio (Italy)

    2004-07-01

    As automotive manufacturers continue to look for ways to reduce vehicle weight, aluminum is finding more utility as a body panel component. The substitution of cold-rolled steel and zinc-coated substrates with aluminum has led to new challenges in vehicle pretreatment. As a result, changes to traditional pretreatment chemistries and operating practices are necessary in order to produce an acceptable coating on aluminum body panels. These changes result in increased sludging and other undesirable characteristics. In addition to the chemistry changes, there are also process-related problems to consider. Many existing automotive pretreatment lines simply were not designed to handle aluminum and its increased demands on filtration and circulation equipment. To retrofit such a system is capital intensive and in addition to requiring a significant amount of downtime, may not be totally effective. Thus, the complexities of pre-treating aluminum body panels have actually had a negative effect on efforts to introduce more aluminum into new vehicle design programs. Recent research into ways of reducing the negative effects has led to a new understanding of the nature of zinc phosphate bath -aluminum interactions. Many of the issues associated with the pretreatment of aluminum have been identified and can be mitigated with only minor changes to the zinc phosphate bath chemistry. The use of low levels of soluble Fe ions, together with free fluoride, has been shown to dramatically improve the efficiency of a zinc phosphate system processing aluminum. Appearance of zinc phosphate coatings, coating weights and sludge are all benefited by this chemistry change. (authors)

  16. Accuracy of automated classification of major depressive disorder as a function of symptom severity

    Directory of Open Access Journals (Sweden)

    Rajamannar Ramasubbu, MD, FRCPC, MSc

    2016-01-01

    Conclusions: Binary linear SVM classifiers achieved significant classification of very severe depression with resting-state fMRI, but the contribution of brain measurements may have limited potential in differentiating patients with less severe depression from healthy controls.

  17. Rapidly restoring biological soil crusts and ecosystem functions in a severely disturbed desert ecosystem.

    Science.gov (United States)

    Chiquoine, Lindsay P; Abella, Scott R; Bowker, Matthew A

    2016-06-01

    Restoring biological soil crusts (biocrusts) in degraded drylands can contribute to recovery of ecosystem functions that have global implications, including erosion resistance and nutrient cycling. To examine techniques for restoring biocrusts, we conducted a replicated, factorial experiment on recently abandoned road surfaces by applying biocrust inoculation (salvaged and stored dry for two years), salvaged topsoil, an abiotic soil amendment (wood shavings), and planting of a dominant perennial shrub (Ambrosia dumosa). Eighteen months after treatments, we measured biocrust abundance and species composition, soil chlorophyll a content and fertility, and soil resistance to erosion. Biocrust addition significantly accelerated biocrust recovery on disturbed soils, including increasing lichen and moss cover and cyanobacteria colonization. Compared to undisturbed controls, inoculated plots had similar lichen and moss composition, recovered 43% of total cyanobacteria density, had similar soil chlorophyll content, and exhibited recovery of soil fertility and soil stability. Inoculation was the only treatment that generated lichen and moss cover. Topsoil application resulted in partial recovery of the cyanobacteria community and soil properties. Compared to untreated disturbed plots, topsoil application without inoculum increased cyanobacteria density by 186% and moderately improved soil chlorophyll and ammonium content and soil stability. Topsoil application produced 22% and 51% of the cyanobacteria density g⁻¹ soil compared to undisturbed and inoculated plots, respectively. Plots not treated with either topsoil or inoculum had significantly lower cyanobacteria density, soil chlorophyll and ammonium concentrations, and significantly higher soil nitrate concentration. Wood shavings and Ambrosia had no influence on biocrust lichen and moss species recovery but did affect cyanobacteria composition and soil fertility. Inoculation of severely disturbed soil with native

  18. Nonhazardous Urine Pretreatment Method

    Science.gov (United States)

    Akse, James R.; Holtsnider, John T.

    2012-01-01

    A method combines solid phase acidification with two non-toxic biocides to prevent ammonia volatilization and microbial proliferation. The safe, non-oxidizing biocide combination consists of a quaternary amine and a food preservative. This combination has exhibited excellent stabilization of both acidified and unacidified urine. During pretreatment tests, composite urine collected from donors was challenged with a microorganism known to proliferate in urine, and then was processed using the nonhazardous urine pre-treatment method. The challenge microorganisms included Escherichia coli, a common gram-negative bacteria; Enterococcus faecalis, a ureolytic gram-positive bacteria; Candida albicans, a yeast commonly found in urine; and Aspergillus niger, a problematic mold that resists urine pre-treatment. Urine processed in this manner remained microbially stable for over 57 days. Such effective urine stabilization was achieved using non-toxic, non-oxidizing biocides at higher pH (3.6 to 5.8) than previous methods in use or projected for use aboard the International Space Station (ISS). ISS urine pretreatment methods employ strong oxidants including ozone and hexavalent chromium (Cr(VI)), a carcinogenic material, under very acidic conditions (pH = 1.8 to 2.4). The method described here offers a much more benign chemical environment than previous pretreatment methods, and will lower equivalent system mass (ESM) by reducing containment volume and mass, system complexity, and crew time needed to handle pre-treatment chemicals. The biocides, being non-oxidizing, minimize the potential for chemical reactions with urine constituents to produce volatile, airborne contaminants such as cyanogen chloride. Additionally, the biocides are active under significantly less acidic conditions than those used in the current system, thereby reducing the degree of required acidification. A simple flow-through solid phase acidification (SPA) bed is employed to overcome the natural buffering

  19. Teaching a Child with Autism and Severe Language Delays to Reject: Direct and Indirect Effects of Functional Communication Training

    Science.gov (United States)

    Martin, Christian A.; Drasgow, Erik; Halle, James W.; Brucker, Jennifer M.

    2005-01-01

    We used functional communication training to teach Bob, a 10-year-old student with autism and severe language delays, to reject items by touching an icon. Our initial assessment revealed that Bob's behaviours serving a rejecting function consisted of pushing away, yelling, bear hugging-grabbing, and leaving. We used prompting, differential…

  20. Social Functioning in Youth with Anxiety Disorders: Association with Anxiety Severity and Outcomes from Cognitive-Behavioral Therapy

    Science.gov (United States)

    Settipani, Cara A.; Kendall, Philip C.

    2013-01-01

    Social functioning was assessed using the Child Behavior Checklist and Teacher Report Form for children with anxiety disorders who participated in a randomized clinical trial (N = 161, aged 7-14). Significant relationships were found between severity of children's principal anxiety disorder and most measures of social functioning, such that poorer…

  1. Pretreatment of woody biomass for biofuel production: energy efficiency, technologies, and recalcitrance.

    Science.gov (United States)

    Zhu, J Y; Pan, Xuejun; Zalesny, Ronald S

    2010-07-01

    This mini review discusses several key technical issues associated with cellulosic ethanol production from woody biomass: energy consumption for woody biomass pretreatment, pretreatment energy efficiency, woody biomass pretreatment technologies, and quantification of woody biomass recalcitrance. Both total sugar yield and pretreatment energy efficiency, defined as the total sugar recovery divided by total energy consumption for pretreatment, should be used to evaluate the performance of a pretreatment process. A post-chemical pretreatment wood size-reduction approach was proposed to significantly reduce energy consumption. The review also emphasizes using a low liquid-to-wood ratio (L/W) to reduce thermal energy consumption for any thermochemical/physical pretreatment in addition to reducing pretreatment temperature.

  2. Neuropsychological Functioning and Severity of ADHD in Early Childhood: A Four-Year Cross-Lagged study

    OpenAIRE

    Rajendran, Khushmand; Rindskopf, David; O’Neill, Sarah; Marks, David J.; Nomura, Yoko; Halperin, Jeffrey M.

    2013-01-01

    Children with Attention Deficit/Hyperactivity Disorder (ADHD) have poorer neuropsychological functioning relative to their typically-developing peers. However, it is unclear whether early neuropsychological functioning predicts later ADHD severity and/or the latter is longitudinally associated with subsequent neuropsychological functioning; and whether these relations are different in children with and without early symptoms of ADHD. This study aimed to examine the longitudinal associations b...

  3. Pretreatment of Biomass by Aqueous Ammonia for Bioethanol Production

    Science.gov (United States)

    Kim, Tae Hyun; Gupta, Rajesh; Lee, Y. Y.

    The methods of pretreatment of lignocellulosic biomass using aqueous ammonia are described. The main effect of ammonia treatment of biomass is delignification without significantly affecting the carbohydrate contents. It is a very effective pretreatment method especially for substrates that have low lignin contents such as agricultural residues and herbaceous feedstock. The ammonia-based pretreatment is well suited for simultaneous saccharification and co-fermentation (SSCF) because the treated biomass retains cellulose as well as hemicellulose. It has been demonstrated that overall ethanol yield above 75% of the theoretical maximum on the basis of total carbohydrate is achievable from corn stover pretreated with aqueous ammonia by way of SSCF. There are two different types of pretreatment methods based on aqueous ammonia: (1) high severity, low contact time process (ammonia recycle percolation; ARP), (2) low severity, high treatment time process (soaking in aqueous ammonia; SAA). Both of these methods are described and discussed for their features and effectiveness.

  4. Biomass shock pretreatment

    Science.gov (United States)

    Holtzapple, Mark T.; Madison, Maxine Jones; Ramirez, Rocio Sierra; Deimund, Mark A.; Falls, Matthew; Dunkelman, John J.

    2014-07-01

    Methods and apparatus for treating biomass that may include introducing a biomass to a chamber; exposing the biomass in the chamber to a shock event to produce a shocked biomass; and transferring the shocked biomass from the chamber. In some aspects, the method may include pretreating the biomass with a chemical before introducing the biomass to the chamber and/or after transferring shocked biomass from the chamber.

  5. Early endocrine alterations reflect prolonged stress and relate to one year functional outcome in patients with severe brain injury

    DEFF Research Database (Denmark)

    Marina, Djordje; Klose, Marianne; Nordenbo, Annette

    2015-01-01

    OBJECTIVE: Severe brain injury poses a risk of developing acute and chronic hypopituitarism. Pituitary hormone alterations developed in the early recovery phase after brain injury may have implications for long-term functional recovery. The objective was to assess the pattern and prevalence...... of pituitary hormone alterations three months after severe brain injury with relation to functional outcome at one year follow-up. DESIGN: Prospective study at a tertiary university referral centre. METHODS: A total of 163 patients admitted to neurorehabilitation after severe traumatic (N=111) or non......-traumatic (N=52) brain injury were included. Main outcome measures were endocrine alterations 3.3 months (median) after the brain injury and their relationship to functioning and ability of the patients at one year follow-up, as measured by Functional Independence Measure and Glasgow Outcome Scale...

  6. Le fonctionnalisme parmi quelques theories syntaxiques (Functionalism among Several Syntactic Theories)

    Science.gov (United States)

    Faita, Daniel

    1977-01-01

    A sketch of the development of functionalism in relation to other linguistic theories and a brief analysis of the present state of the research. Topics covered are: form versus function; the impasse between distributional and transformational grammar; and transformational grammar according to Harris. (Text is in French.) (AMH)

  7. What Attributes Determine Severity of Function in Autism? A Web-Based Survey of Stakeholders

    Science.gov (United States)

    Di Rezze, Briano; Rosenbaum, Peter; Zwaigenbaum, Lonnie

    2012-01-01

    Service providers and researchers in autism spectrum disorders (ASD) are challenged to categorize clinical variation in function. Classification systems for children with cerebral palsy have enabled clinicians and families to describe levels of function. A web-based survey engaged international ASD stakeholders to advise on considerations of…

  8. A Functional Assessment of Handmouthing among Persons with Severe and Profound Intellectual Disability

    Science.gov (United States)

    Swender, Stephen L.; Matson, Johnny L.; Mayville, Stephen B.; Gonzalez, Melissa L.; McDowell, Donald

    2006-01-01

    Background: The behavioural function of handmouthing has been assessed across various studies utilising analogue functional analyses. The aim of the current study was to expand upon research on this relatively understudied behaviour by examining the relationship between handmouthing and "Gastro-Esophageal Reflux Disorder" (GERD), and the potential…

  9. The dual role of oxygen functions in coal pretreatment and liquefaction: Crosslinking and cleavage reactions. Seventh quarterly report, September 30, 1992--December 31, 1992

    Energy Technology Data Exchange (ETDEWEB)

    Serio, M.A.; Kroo, E.; Charpenay, S.; Solomon, P.R.

    1992-12-31

    The work during the past quarter under Task 2 has focused on the investigation of FT-IR methods for measuring carboxyl and phenolic functions. Fourier transform infrared (FT-IR) spectra of coal contain a wealth of information that can be utilized in the development of quantitative analysis routines based on least squares curvefitting. Because of the importance of the carboxylate groups in retrogressive reactions, recent efforts have focused on the C=O stretching region. Raw and modified coal samples (acid washed, demineralized, and cation exchanged) were analyzed in order to validate the proposed band assignments in the C=O stretching region. This parameter set differentiates free carbonyl (B2) and hydrogen-bonded carbonyl (B4) from carboxylic acid carbonyl (B3) and carboxylate (B7). One test of these assignments, which are based on literature data, is to plot B3 versus B7. This should be linear, assuming that the sum of the free carboxyl and carboxylate groups is constant and that the intensity of the overlapped aromatic ring band in B7 is also constant. This relationship was found to hold for a set of raw, acid washed, and acid washed/cation-exchanged Zap coals. The work under Task 3 has involved (1) completion of the synthesis of the -C-C-0- linked, methoxy substituted lignin-network polymer, -- C{sub 6}H{sub 3}(o-OMe)-O-CH{sub 2}CH{sub 2}]{sub {eta}} -- polymer, (2) Analysis of the polymer via depolymerization under pyrolysis-FIMS (Py-FIMS) conditions, and (3) testing of several routes to selective cleavage of the O-Methyl bond so that the relative crosslinking tendencies of the methylated and unmethylated versions of the polymer could be determined.

  10. Microwave pretreatment of switchgrass for bioethanol production

    Science.gov (United States)

    Keshwani, Deepak Radhakrishin

    conditions, 82% glucose and 63% xylose yields were achieved for switchgrass, and 87% glucose and 59% xylose yields were achieved for coastal bermudagrass following enzymatic hydrolysis of the pretreated biomass. The optimum enzyme loadings were 15 FPU/g and 20 CBU/g for switchgrass and 10 FPU/g and 20 CBU/g for coastal bermudagrass. Dielectric properties for dilute sodium hydroxide solutions were measured and compared to solid loss, lignin reduction and reducing sugar levels in hydrolyzates. Results indicate that the dielectric loss tangent of alkali solutions is a potential indicator of the severity of microwave-based pretreatments. Modeling of pretreatment processes can be a valuable tool in process simulations of bioethanol production from lignocellulosic biomass. Chapter 4 discusses three different approaches that were used to model delignification and carbohydrate loss during microwave-based pretreatment of switchgrass: statistical linear regression modeling, kinetic modeling using a time-dependent rate coefficient, and a Mamdani-type fuzzy inference system. The dielectric loss tangent of the alkali reagent and pretreatment time were used as predictors in all models. The statistical linear regression model for delignification gave comparable root mean square error (RMSE) values for training and testing data and predictions were approximately within 1% of experimental values. The kinetic model for delignification and xylan loss gave comparable RMSE values for training and testing data sets and predictions were approximately within 2% of experimental values. The kinetic model for cellulose loss was not as effective and predictions were only within 5-7% of experimental values. The time-dependent rate coefficients of the kinetic models calculated from experimental data were consistent with the heterogeneity (or lack thereof) of individual biomass components. The Mamdani-type fuzzy inference system was shown to be an effective means to model pretreatment processes and gave

  11. Speech clinicians' attribution of personality traits as a function of stuttering severity.

    Science.gov (United States)

    Turnbaugh, K R; Guitar, B E; Hoffman, P R

    1979-03-01

    Thirty-six speech-language pathologists participated in a study to evaluate clinicians' preconceptions of persons who stutter. Each rated a designated construct (the normally fluent individual, the mild stutterer, the moderate stutterer, the severe stutterer) using a personality trait scale. Results indicated that clinicians stereotypically assign negative personality traits to all levels of stuttering severity relative to normal. Their ratings further demonstrated that stutterers are generally considered to be a homogenous group. Differentiation amongst stutterers was made only between the polar ends of the stuttering severity continuum (that is, mild vs. severe). Clinicians' sterotypical trait assignment was not related to their professional experience. Results are discussed with reference to their clinical implications.

  12. Child labor and severe functioning difficulties and disability in Mexican children and adolescents 5-17 years of age.

    Science.gov (United States)

    Villalobos, Aremis; de Castro, Filipa; Rojas, Rosalba; Allen-Leigh, Betania; Hubert, Celia; Avendaño-Badillo, Diana; Romero, Martín; Vázquez-García, Agustín; Barrientos-Gutiérrez, Tonatiuh; Lazcano-Ponce, Eduardo

    2017-01-01

    To describe the characteristics of Mexican children and adolescents 5-17 years with severe functioning difficulties and disability and explore their participation in child labor. Using data from the National Survey of Boys, Girls and Women in Mexico 2015 we estimated prevalence of functioning difficulties and disability and used logistic regression to explore the association between this condition and child labor. While 11.2% of Mexicans 5-17 years-old has severe functioning difficulties or disability, 13.4% work. The functioning difficulty and disability domains with the highest prevalence are experiencing anxiety (5.4%) and depression (1.5%) daily. Children and adolescents with severe functioning difficulties and disability are 70% more likely to do child labor [OR=1.7, 95%CI:1.2,2.4]. Educational lag doubles the likelihood of doing child labor [OR=2.2, 95%CI:1.5,3.3]. Guaranteeing educational opportunities and respect for the rights of children with severe functioning difficulties and disability is essential to achieve development of their full potential.

  13. Child labor and severe functioning difficulties and disability in Mexican children and adolescents 5-17 years of age

    Directory of Open Access Journals (Sweden)

    Aremis Villalobos

    2017-07-01

    Full Text Available Objective. To describe the characteristics of Mexican children and adolescents 5-17 years with severe functioning difficulties and disability and explore their participation in child labor. Materials and methods. Using data from the National Survey of Boys, Girls and Women in Mexico 2015 we estimated prevalence of functioning difficulties and disability and used logistic regression to explore the association between this condition and child labor. Results. While 11.2% of Mexicans 5-17 years-old has severe functioning difficulties or disability, 13.4% work. The functioning difficulty and disability domains with the highest prevalence are experiencing anxiety (5.4% and depression (1.5% daily. Children and adolescents with severe functioning difficulties and disability are 70% more likely to do child labor [OR=1.7, 95%CI:1.2,2.4]. Educational lag doubles the likelihood of doing child labor [OR=2.2, 95%CI:1.5,3.3]. Conclusions. Guaranteeing educational opportunities and respect for the rights of children with severe functioning difficulties and disability is essential to achieve development of their full potential.

  14. Loss of Renal Function After Retrograde Ureteral Placement of an Allium Stent for Severe Ureteral Stricture

    OpenAIRE

    Salciccia, Stefano; Sciarra, Alessandro; Polese, Milena; Giorgio, Alpi; Maggi, Martina; Gentilucci, Alessandro; Ciccariello, Mauro; D'Eramo, Giuseppe; Shahabadi, Houssain; Lai, Silvia; Ricciuti, Gian Piero

    2018-01-01

    Abstract Background: Ureteral strictures are a recurrent chronic condition that leads to severe side effects and poor quality of life. Management of ureteral stricture is a great challenge for urologists and no specific guidelines exist. Retrograde Allium® ureteral stent (AUS) is a newly developed ureteral stent to treat either bulbar urethral or ureteral stenosis. Case Presentation: We describe a case of a 74-year-old Caucasian adult male presenting with a severe ureteral stricture secondary...

  15. Determinants of functional status among survivors of severe sepsis and septic shock: One-year follow-up

    Directory of Open Access Journals (Sweden)

    Mustafa S Al Khalaf

    2015-01-01

    Full Text Available RATIONALE: Sepsis is a leading cause of intensive care unit (ICU admissions worldwide and a major cause of morbidity and mortality. Limited data exist regarding the outcomes and functional status among survivors of severe sepsis and septic shock. OBJECTIVES: This study aimed to determine the functional status among survivors of severe sepsis and septic shock a year after hospital discharge. METHODS: Adult patients admitted between April 2007 and March 2010 to the medical-surgical ICU of a tertiary hospital in Saudi Arabia, were included in this study. The ICU database was investigated for patients with a diagnosis of severe sepsis or septic shock. Survival status was determined based on hospital discharge. Patients who required re-admission, stayed in ICU for less than 24 hours, had incomplete data were all excluded. Survivors were interviewed through phone calls to determine their functional status one-year post-hospital discharge using Karnofsky performance status scale. RESULTS: A total of 209 patients met the eligibility criteria. We found that 38 (18.1% patients had severe disability before admission, whereas 109 (52.2% patients were with severe disability or died one-year post-hospital discharge. Only one-third of the survivors had good functional status one-year post-discharge (no/mild disability. After adjustment of baseline variables, age [adjusted odds ratio (aOR = 1.03, 95% confidence interval (CI = 1.01-1.04] and pre-sepsis functional status of severe disability (aOR = 50.9, 95% CI = 6.82-379.3 were found to be independent predictors of functional status of severe disability one-year post-hospital discharge among survivors. CONCLUSIONS: We found that only one-third of the survivors of severe sepsis and septic shock had good functional status one-year post-discharge (no/mild disability. Age and pre-sepsis severe disability were the factors that highly predicted the level of functional status one-year post-hospital discharge.

  16. [The Psychoanalytic-interactional Method (PIM): A Psychodynamic Treatment for Adolescents with Severe Disorders of Personality Functioning].

    Science.gov (United States)

    Cropp, Carola

    2017-07-01

    The Psychoanalytic-interactional Method (PIM): A Psychodynamic Treatment for Adolescents with Severe Disorders of Personality Functioning The psychoanalytic-interactional method (PIM) was developed as a psychodynamic treatment for adult patients with severe disorders of personality functioning (Streeck u. Leichsenring, 2015). However, it is also well suited for the treatment of adolescent patients because its techniques fit with specific conditions of adolescence. A modified version of the PIM for adolescents (Streeck-Fischer, Cropp, Streeck, Salzer, 2016) has proven to be efficacious. The paper describes the basic principles of the PIM and names aspects that have to be taken into account in the treatment of adolescents with severe disorders of personality functioning. Finally, previous empirical results regarding the PIM treatment in adolescence are presented.

  17. Effects of a multimodal exercise program on the functional capacity of Parkinson's disease patients considering disease severity and gender

    Directory of Open Access Journals (Sweden)

    Diego Orcioli-Silva

    2014-03-01

    Full Text Available The purpose of this study was to investigate the effects of a multimodal exercise program (MEP on the functional capacity of patients with Parkinson's disease (PD according to disease severity and gender. Fourteen patients with PD participated in the study and were distributed into groups according to 1 stage of disease and 2 gender. Functional capacity was evaluated before and after 6 months of intervention. The overall PD patient group improved their coordination and strength. Men and women improved in strength performance after exercise. Men also improved on coordination. For severity of disease, the unilateral group improved in strength, while the bilateral group improved in strength, balance, coordination and the UPDRS-functional score. In conclusion, a MEP is efficient in improving components of functional capacity in patients with PD, especially in strength. Gender may be considered in the exercise program. Individuals in the bilateral disease group appeared to benefit more from exercise.

  18. Test-retest reliability of maximal leg muscle power and functional performance measures in patients with severe osteoarthritis (OA)

    DEFF Research Database (Denmark)

    Villadsen, Allan; Roos, Ewa M.; Overgaard, Søren

    Abstract : Purpose To evaluate the reliability of single-joint and multi-joint maximal leg muscle power and functional performance measures in patients with severe OA. Background Muscle power, taking both strength and velocity into account, is a more functional measure of lower extremity muscle...... and scheduled for unilateral total hip (n=9) or knee (n=11) replacement. Patients underwent a test battery on two occasions separated by approximately one week (range 7 to 11 days). Muscle power was measured using: 1. A linear encoder, unilateral lower limb isolated single-joint dynamic movement, e.g. knee...... activity compared with the traditionally used isometric and/or isokinetic muscle strength. More functional measures are preferred to determine muscle function and as outcomes in exercise studies in patients with OA. Methods Subjects: 20 patients (mean age 68.7±7.2, BMI 29.0±3.9) diagnosed with severe OA...

  19. Family functioning in severe brain injuries: correlations with caregivers' burden, perceived social support and quality of life.

    Science.gov (United States)

    Tramonti, Francesco; Bonfiglio, Luca; Di Bernardo, Carolina; Ulivi, Chiara; Virgillito, Alessandra; Rossi, Bruno; Carboncini, Maria Chiara

    2015-01-01

    Severe brain injuries have long-term consequences on functional status and psychosocial functioning. Family life can be greatly influenced as well, and features of high caregiver burden can emerge. Although the data on caregivers' distress are constantly increasing, less information is available about the role of family functioning. Thirty caregivers of hospitalised patients with severe brain injuries received questionnaires for the evaluation of caregiver burden, family functioning and perceived social support. A semi-structured interview was performed for the evaluation of quality of life. Family cohesion and adaptability positively correlated with caregivers' quality of life and perceived social support. Partner caregivers' scores were significantly higher on the time-dependent burden than those of sons and daughters, whereas the latter scored higher on the emotional burden.

  20. The association of functional oral intake and pneumonia in patients with severe traumatic brain injury

    DEFF Research Database (Denmark)

    Hansen, T.S.; Larsen, K.; Engberg, Anders

    2008-01-01

    OBJECTIVES: To investigate the incidence and onset time of pneumonia for patients with severe traumatic brain injury (TBI) in the early phase of rehabilitation and to identify parameters associated with the risk of pneumonia. DESIGN: Observational retrospective cohort study. SETTING: Subacute reh...

  1. Human CalDAG-GEFI gene (RASGRP2) mutation affects platelet function and causes severe bleeding

    NARCIS (Netherlands)

    Canault, Matthias; Ghalloussi, Dorsaf; Grosdidier, Charlotte; Guinier, Marie; Perret, Claire; Chelghoum, Nadjim; Germain, Marine; Raslova, Hana; Peiretti, Franck; Morange, Pierre E.; Saut, Noemie; Pillois, Xavier; Nurden, Alan T.; Cambien, François; Pierres, Anne; van den Berg, Timo K.; Kuijpers, Taco W.; Alessi, Marie-Christine; Tregouet, David-Alexandre

    2014-01-01

    The nature of an inherited platelet disorder was investigated in three siblings affected by severe bleeding. Using whole-exome sequencing, we identified the culprit mutation (cG742T) in the RAS guanyl-releasing protein-2 (RASGRP2) gene coding for calcium- and DAG-regulated guanine exchange factor-1

  2. Functional promoter variant in zinc finger protein 202 predicts severe atherosclerosis and ischemic heart disease

    DEFF Research Database (Denmark)

    Frikke-Schmidt, R.; Nordestgaard, Børge; Grande, Peer

    2008-01-01

    Objectives This study was designed to test the hypotheses that single nucleotide polymorphisms ( SNPs), in zinc finger protein 202 ( ZNF202), predict severe atherosclerosis and ischemic heart disease ( IHD). Background ZNF202 is a transcriptional repressor controlling promoter elements in genes...

  3. Visual impairments in people with severe and profound multiple disabilities: An inventory of visual functioning

    NARCIS (Netherlands)

    van den Broek, E.G.C.; Janssen, C.G.C.; van Ramshorst, T.; Deen, L.

    2006-01-01

    Background: The prevalence of visual impairments in people with severe and profound multiple disabilities (SPMD) is the subject of considerable debate and is difficult to assess. Methods: In a typical Dutch care organization, all clients with SPMD (n = 76) participated in the study and specific

  4. rTMS: A Treatment to Restore Function After Severe TBI

    Science.gov (United States)

    2017-10-01

    months after severe TBI. The approach is to determine the neurobehavioral effect of rTMS, the relationship between neurobehavioral changes and net...Ben Dirlikov Project Role: Co-Investigator/EEG Technician Nearest person month worked: 1 Contribution to Project: Oversaw finance

  5. The limits of adaptation of functional protein synthesis to severe undernutrition

    International Nuclear Information System (INIS)

    Forrester, T.; Jahoor, F.; Reeds, P.

    1996-01-01

    This project was designed to investigate the limits of adaptation of protein metabolism in the stree of severe childhood malnutrition, representing as it does chronic dietary insufficiency of macronutrients and superimposed infection. The tasks included measurement of concentrations and rates of synthesis of nutrient transport proteins and hepatic acute phase proteins inseverely malnourished children during their acute illness and a recovery

  6. Neuropsychological assessment of a new computerized cognitive task that developed for training several cognitive functions simultaneously.

    Directory of Open Access Journals (Sweden)

    Satoe eIchihara-Takeda

    2016-04-01

    Full Text Available Recent studies have indicated that computerized cognitive training is effective as therapy for reducing the cognitive decline with aging and the dysfunction associated with neuropsychiatric illness. Although cognitive trainings that targets a specific function and multi-domain cognitive training have both been shown to have significant effects, we need one simple behavioral training paradigm to improve multiple domains of cognitive functions easily and simultaneously. We had developed a new computerized task that seeks to engage the cognitive functions of planning, mental calculation, and divergent thinking based on a working memory task in a single task. The purpose of this study was to assess the cognitive features of our new task by comparing the scores of seven known neuropsychological batteries in healthy elderly subjects. The relationships between performance in our task and the scores obtained by the neuropsychological batteries were examined. The percentage of correct performance on our task was correlated with the scores on the category fluency test, the digit span backward task, and the Trail making test B. Stepwise multiple regression analyses revealed that the scores on the category fluency test and the Trail making test B showed significant positive correlations with the percentage of correct performance on our task. Although the present study did not show high correlations between the percentage of correct performance on our task and working memory functions as a primary target, we did observe mid-level correlations between the percentage of correct performance on our task and functions for divided attention and word fluency. Our new task could not measure subject’s working memory capacity specifically, but could measure the abilities of attention and divergent thinking. Thus, this task might be a useful tool for training multiple cognitive functions simultaneously.

  7. Gain in lung function after weight reduction in severely obese children

    NARCIS (Netherlands)

    van de Griendt, E.J.; van der Baan-Slootweg, O.H.; van Essen-Zandvliet, E.E.; van der Palen, Jacobus Adrianus Maria; Tamminga-Smeulders, C.L.; Benninga, M.A.; van Aalderen, W.M.

    2012-01-01

    AIM: The primary objective of this prospective cohort study was to determine the effect of weight loss on pulmonary function values in extremely obese children. METHODS: Obese children participated in a 26-week in-hospital or outpatient multidisciplinary treatment programme. Waist circumference was

  8. Executive functions and social information processing in adolescents with severe behavior problems

    NARCIS (Netherlands)

    van Nieuwenhuijzen, M.; van Rest, M.M.; Embregts, P.J.C.M.; Vriens, A.; Oostermeijer, S.; van Bokhoven, I.; Matthys, W.

    2017-01-01

    One tradition in research for explaining aggression and antisocial behavior has focused on social information processing (SIP). Aggression and antisocial behavior have also been studied from the perspective of executive functions (EFs), the higher-order cognitive abilities that affect other

  9. Mindful creativity matters: trajectories of reported functioning after severe traumatic brain injury as a function of mindful creativity in patients' relatives: a multilevel analysis.

    Science.gov (United States)

    Haller, Chiara S; Bosma, Colin M; Kapur, Kush; Zafonte, Ross; Langer, Ellen J

    2017-04-01

    The objective of the present investigation was to examine the association of mindful creativity with the trajectory of recovery (emotional, interpersonal, cognitive, and total functioning) of patients with severe TBI. This was drawn from a subsample of an adult prospective cohort study on severe TBI in Switzerland; patients and their relatives were assessed at 3, 6, and 12 months (patients N = 176, relatives N = 176). Predictor measures were assessed using Mindful Creativity Scale-short form and time (trajectory of functioning of the patient over time). Outcome measures were assessed using Patient Competency Rating Scale for Neuro-rehabilitation (PCRS-NR; measuring emotional, interpersonal, cognitive, and total functioning post-injury). All measures were assessed at each time point. Mixed linear models were run separately for ages >50 and ≤50 (i.e., bimodal distribution). Patients' mindful creativity showed no significant association with patients' functioning across time in any of the models. In all age groups, interpersonal functioning decreased across time (slope >50  = -4.66, p = .037; slope ≤50  = -7.19, p = .007). Interestingly, in age group ≤50, interpersonal functioning increased when looking at relative mindful creativity by time (slope = 1.69, p = .005). Additionally, relatives mindful creativity was significantly associated with patients' functioning in age group ≤50: (a) patients' total functioning (slope = 0.18, p = .03) and (b) cognitive functioning (slope = 0.72, p = .020). Relatives' mindful creativity was significantly associated with patients' functioning after severe TBI. Implications for treatment and future research are discussed.

  10. Initial effect of enalapril on kidney function in patients with moderate to severe chronic nephropathy

    DEFF Research Database (Denmark)

    Kamper, A L; Thomsen, H S; Nielsen, S L

    1990-01-01

    Angiotensin converting enzyme (ACE) inhibitors has been suggested to halt the progression of chronic renal failure. As the initial step of a controlled trial of this hypothesis, it was investigated whether start of enalapril in patients with severe chronic nephropathy might cause a critical fall...... and the scintigrams showed no intrarenal activity defects. In conclusion, enalapril caused a fall in GFR, which was clinically acceptable in most of the patients....

  11. rTMS: A Treatment to Restore Function After Severe TBI

    Science.gov (United States)

    2015-10-01

    consciousness 3 to 12 months after severe TBI. This will be achieved by determining the neurobehavioral and neural effects of repetitive transcranial...devastating with some survivors recovering full consciousness swiftly while others remain in states of seriously impaired consciousness (SIC). Both...then translated to the clinical setting. If successful, it will be the first demonstration that human brain imaging coupled with surrogate animal

  12. Emergency Interventions After Severe Traumatic Brain Injury in Rats: Effect on Neuropathology and Functional Outcome

    Science.gov (United States)

    2000-01-01

    particularly since our isoflurane vs fentanyl study showed such a Anesthetic/Sedative Dose Isoflurane 1% by inhalation for 1 h Pentobarbital 50 mg...Diseases, ST Ohnishi (ed), CRC Press, Boca Raton , Florida, 4:247-254,1995. 26. Kochanek PM, Clark RS, Adelson PD, Marion DW: Severe Traumatic Brain...Characerization of cerebral blood flow during anesthesia with fentanyl, isoflurane, or pentobarbital in normal rats. Int Soc Mag Res Med (in

  13. Organosolv pretreatment of olive tree biomass for fermentable sugars

    Energy Technology Data Exchange (ETDEWEB)

    Diaz, M.J.; Cara, C.; Castro, E. [Department of Chemical, Environmental and Materials Engineering, Campus Las Lagunillas, University of Jaen, Jaen (Spain); Huijgen, W.J.J.; Van der Laan, R.R.; Reith, J.H. [ECN Biomass, Coal and Environmental Research, Petten (Netherlands)

    2011-03-15

    Olive tree pruning biomass is one of the main agricultural residues available in Mediterranean countries and is currently lacking commercial applications. To take advantage of its sugar content, a pretreatment is necessary to enhance enzyme accessibility of the cellulose fraction of the residue. This paper describes for the first time the use of organosolv pretreatment in this regard. The main process variables such as pretreatment temperature, residence time, and solvent composition (aqueous ethanol) are studied. Results show that organosolv pretreatment causes delignification and hydrolysis of hemicelluloses and improves the enzymatic digestibility of olive tree pruning biomass. A higher pretreatment severity and ethanol content of the solvent were found to increase delignification (up to 64% at 66% w/w aqueous ethanol, 210C, 60 min). By contrast, xylan hydrolysis was promoted by a lower ethanol content (maximum 92%). The highest enzymatic hydrolysis yield (90% of the structural glucan present in the raw material) has been obtained after pretreatment with 43% w/w aqueous ethanol at 210C for 15 min. Organosolv pretreatment was found to be the most effective pretreatment for enzymatic hydrolysis of olive tree pruning biomass.

  14. Manual physical therapy combined with high-intensity functional rehabilitation for severe lower extremity musculoskeletal injuries: a case series.

    Science.gov (United States)

    Crowell, Michael S; Deyle, Gail D; Owens, Johnny; Gill, Norman W

    2016-02-01

    Severe lower extremity trauma accounts for large healthcare costs and often results in elective amputation and poor long-term outcomes. The purpose of this case series is to describe an orthopedic manual physical therapy (OMPT) approach combined with a return to run (RTR) clinical pathway consisting of high-intensity functional rehabilitation with a custom energy-storing orthosis. Three consecutive male patients, aged 21-23 years, with severe lower extremity musculoskeletal injuries were treated with a combined intervention that included a mean (SD) of 12 (2·1) OMPT sessions and 24 (8·7) functional rehabilitation sessions over a mean of 6 weeks (1·0). Additional training with a custom energy-storing orthosis consisted of a mean of 15 (1·2) additional sessions over 4 weeks. Patient self-report outcome measures and a variety of physical performance tests captured change in function. Baseline lower extremity functional scale (LEFS) and foot and ankle ability measure activities of daily living subscale (FAAM-ADL) scores indicated severe disability. All patients exceeded the minimal clinically important difference (MCID) in at least one self-report outcome or physical performance test without a brace. Two of three patients exceeded the MCID for at least two physical performance tests after training with and utilizing a custom energy-storing orthosis. Clinically meaningful changes in self-reported function or physical performance were observed in all patients. A multi-modal approach, including manual therapy and functional exercise, may address the entire spectrum of impairments in patients with severe lower extremity trauma, resulting in improvements in both braced and un-braced function.

  15. Structural and Functional Analyses of the Severe Acute Respiratory Syndrome Coronavirus Endoribonuclease Nsp15

    Energy Technology Data Exchange (ETDEWEB)

    Bhardwaj, Kanchan; Palaninathan, Satheesh; Alcantara, Joanna Maria Ortiz; Yi, Lillian Li; Guarino, Linda; Sacchettini, James C.; Kao, C. Cheng (TAM)

    2008-03-31

    The severe acute respiratory syndrome (SARS) coronavirus encodes several RNA-processing enzymes that are unusual for RNA viruses, including Nsp15 (nonstructural protein 15), a hexameric endoribonuclease that preferentially cleaves 3' of uridines. We solved the structure of a catalytically inactive mutant version of Nsp15, which was crystallized as a hexamer. The structure contains unreported flexibility in the active site of each subunit. Substitutions in the active site residues serine 293 and proline 343 allowed Nsp15 to cleave at cytidylate, whereas mutation of leucine 345 rendered Nsp15 able to cleave at purines as well as pyrimidines. Mutations that targeted the residues involved in subunit interactions generally resulted in the formation of catalytically inactive monomers. The RNA-binding residues were mapped by a method linking reversible cross-linking, RNA affinity purification, and peptide fingerprinting. Alanine substitution of several residues in the RNA-contacting portion of Nsp15 did not affect hexamer formation but decreased the affinity of RNA binding and reduced endonuclease activity. This suggests a model for Nsp15 hexamer interaction with RNA.

  16. Adverse childhood experiences and their impact on frequency, severity, and the individual function of nonsuicidal self-injury in youth.

    Science.gov (United States)

    Kaess, Michael; Parzer, Peter; Mattern, Margarete; Plener, Paul L; Bifulco, Antonia; Resch, Franz; Brunner, Romuald

    2013-04-30

    This study aimed to investigate a specific relationship between nonsuicidal self-injury (NSSI) and a variety of adverse childhood experiences (ACEs) over and above childhood abuse and their impact on frequency, severity, and functions of NSSI. A sample of 125 inpatients (aged 13 to 26) was consecutively recruited within a psychiatric university hospital. Frequency, methods and functions of NSSI were assessed by the Functional Assessment of Self-Mutilation (FASM), ACEs were assessed by the Childhood Experiences of Care and Abuse Questionnaire (CECA.Q). The 12 month prevalence of NSSI in this representative, clinical sample was 60.0%. Engagement in NSSI was significantly related to ACEs with highest associations for maternal antipathy and neglect. Whilst ACEs were not associated with frequency or severity of NSSI, some ACEs were significantly related to the automatic functions of NSSI (e.g., affect regulation, anti-dissociative function or self-punishment) as well as to a peer identification function. NSSI represents a frequent phenomenon among young clinical populations and seems to be specifically related to ACEs with maternal antipathy or neglect commonly featured over and above experiences of abuse. Since ACEs also influence the functions of NSSI such factors need to be examined as part of clinical care planning. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  17. Body Functions and Structures Pertinent to Infrared Thermography-Based Access for Clients with Severe Motor Disabilities

    Science.gov (United States)

    Memarian, Negar; Venetsanopoulos, Anastasios N.; Chau, Tom

    2011-01-01

    Infrared thermography has been recently proposed as an access technology for individuals with disabilities, but body functions and structures pertinent to its use have not been documented. Seven clients (2 adults, 5 youth) with severe disabilities and their primary caregivers participated in this study. All clients had a Gross Motor Functional…

  18. Cross-Sectional Study of Women with Trichotillomania: A Preliminary Examination of Pulling Styles, Severity, Phenomenology, and Functional Impact

    Science.gov (United States)

    Flessner, Christopher A.; Woods, Douglas W.; Franklin, Martin E.; Keuthen, Nancy J.; Piacentini, John

    2009-01-01

    The current study utilized a cross-sectional design to examine pulling severity, phenomenology, functional impact, and "focused" and "automatic" pulling styles in women with TTM across a wide age spectrum. "Automatic" pulling refers to pulling occurring primarily out of one's awareness, while "focused" pulling refers to pulling with a compulsive…

  19. Psychometric Evaluation of the Symptoms and Functioning Severity Scale (SFSS) Short Forms with Out-of-Home Care Youth

    Science.gov (United States)

    Gross, Thomas J.; Duppong Hurley, Kristin; Lambert, Matthew C.; Epstein, Michael H.; Stevens, Amy L.

    2015-01-01

    Background: There is a need for brief progress monitoring measures of behavioral and emotional symptoms for youth in out-of-home care. The Symptoms and Functioning Severity Scale (SFSS; Bickman et al. in Manual of the peabody treatment progress battery. Vanderbilt University, Nashville, 2010) is one measure that has clinician and youth short forms…

  20. Comparing pain severity vs. pain location in the MOBILIZE Boston Study: Chronic pain and lower extremity function

    NARCIS (Netherlands)

    Eggermont, L.H.P.; Bean, J.F.; Guralnik, J.M.; Leveille, S.G.

    2009-01-01

    Background. This study compared measures of chronic pain, for example, number of pain sites and overall pain severity, in relation to lower extremity function in the older population. Methods. Six hundred older adults (mean age 77.9 years, 64% female) were queried about presence of chronic pain.

  1. College students with depressive symptoms with and without fatigue: Differences in functioning, suicidality, anxiety, and depressive severity

    Science.gov (United States)

    Nyer, Maren; Mischoulon, David; Alpert, Jonathan E.; Holt, Daphne J.; Brill, Charlotte D.; Yeung, Albert; Pedrelli, Paola; Baer, Lee; Dording, Christina; Huz, Ilana; Fisher, Lauren; Fava, Maurizio; Farabaugh, Amy

    2015-01-01

    BACKGROUND We examined whether fatigue was associated with greater symptomatic burden and functional impairment in college students with depressive symptoms. METHODS Using data from the self-report Beck Depression Inventory (BDI), we stratified a group of 287 students endorsing significant symptoms of depression (BDI score ≥13) into 3 levels: no fatigue, mild fatigue, or moderate/severe fatigue. We then compared the 3 levels of fatigue across a battery of psychiatric and functional outcome measures. RESULTS Approximately 87% of students endorsed at least mild fatigue. Students with moderate/severe fatigue had significantly greater depressive symptom severity compared with those with mild or no fatigue and scored higher on a suicide risk measure than those with mild fatigue. Students with severe fatigue evidenced greater frequency and intensity of anxiety than those with mild or no fatigue. Reported cognitive and functional impairment increased significantly as fatigue worsened. CONCLUSIONS Depressed college students with symptoms of fatigue demonstrated functional impairment and symptomatic burden that worsened with increasing levels of fatigue. Assessing and treating symptoms of fatigue appears warranted within this population. PMID:25954936

  2. Compromised neutrophil function and severe bovine E.coli mastitis: is C5a the missing link?

    Science.gov (United States)

    Around the periparturient period and during early lactation dairy cows have an elevated risk for clinical mastitis. The severity of Gram-negative infections during these periods has been correlated with reduced neutrophil functions. In this review we focus on the potential role of C5a in the develop...

  3. Functional reserves of myocardial perfusion in chronic coronary patients with coronary arterial lesions of varying severity

    International Nuclear Information System (INIS)

    Ehventov, A.Z.; Pisareva, N.A.; Matveeva, L.S.; Krol, V.A.; Maevskaya, E.G.; Samojlenko, L.E.

    1986-01-01

    A comparative study of data provided by coronaroangiography and myocardial perfusion scintigraphy (resting and exercise test), and clinical/electrocardiographic results of the exercise test in 102 chronic coronary patients demonstrated that noninvasive myocardial perfusion 201 Tl scintigraphy combined with threshold bicycle-ergometric exercise adds considerably to the clinico-electrocardiographic assessment of the exercise test and thus helps to detect myocardial blood supply (perfusion) disorders in some of coronary patients with doubtful or negative test results. Reduced functional reserves of myocardial blood supply, as reflected in dificient perfusion at the peak threshold exercise, are seen in all coronary arteries and in most patients with both are so-called ''functionally-insignificant'' and marked coronary arterial stenosis (94.7 and 88.3 %, respectively)

  4. C-terminal agrin fragment (CAF) reflects renal function in patients suffering from severe sepsis or septic shock.

    Science.gov (United States)

    Drey, Michael; Behnes, Michael; Kob, Robert; Lepiorz, Dominic; Hettwer, Stefan; Bollheimer, Cornelius; Sieber, Cornel C; Bertsch, Thomas; Hoffmann, Ursula

    2015-01-01

    One of the main causes of acute kidney injury (AKI) in patients treated on an intensive care unit (ICU) is sepsis. The identification of new biomarkers indicating the early development and future course of AKI are of utmost medical interest. The C-terminal agrin fragment (CAF) is measurable in blood serum and might reflect kidney function. Therefore, this study evaluates CAF in patients presenting to an internal ICU with severe sepsis or septic shock. Serum levels of CAF are correlated with biomarkers of kidney function, markers of systemic inflammation, and the presence of AKI and renal replacement therapy (RRT). 61 patients suffering from severe sepsis or septic shock were included during the first 24 hours of ICU treatment and blood samples for biomarker measurements, i.e., CAF, creatinine, cystatin C, procalcitonin (PCT), interleukin 6, C reactive protein (CRP), and white blood cells (WBC) were collected on the first day of intensive care treatment. The number of RRT days and the incidence of AKI were documented. 13% of the patients (8/61) suffered from SIRS/sepsis, 20% (12/61) from severe sepsis, and 67% (41/61) from septic shock. Serum levels of CAF significantly correlated with creatinine (r = 0.623, p patients suffering from severe sepsis and septic shock, serum levels of CAF were significantly associated with kidney function and RRT and were not influenced by severe septic conditions.

  5. Gastric emptying of water in children with severe functional fecal retention

    Directory of Open Access Journals (Sweden)

    V.P.I. Fernandes

    2013-03-01

    Full Text Available The objective of this study was to evaluate gastric emptying (GE in pediatric patients with functional constipation. GE delay has been reported in adults with functional constipation. Gastric emptying studies were performed in 22 children with chronic constipation, fecal retention and fecal incontinence, while presenting fecal retention and after resuming regular bowel movements. Patients (18 boys, median age: 10 years; range: 7.2 to 12.7 years were evaluated in a tertiary pediatric gastroenterology clinic. Gastric half-emptying time of water (reference range: 12 ± 3 min was measured using a radionuclide technique immediately after first patient evaluation, when they presented fecal impaction (GE1, and when they achieved regular bowel movements (GE2, 12 ± 5 weeks after GE1. At study admission, 21 patients had reported dyspeptic symptoms, which were completely relieved after resuming regular bowel movements. Medians (and interquartile ranges for GE1 and GE2 were not significantly different [27.0 (16 and 27.5 (21 min, respectively (P = 0.10]. Delayed GE seems to be a common feature among children with chronic constipation and fecal retention. Resuming satisfactory bowel function and improvement in dyspeptic symptoms did not result in normalization of GE data.

  6. Gastric emptying of water in children with severe functional fecal retention

    Directory of Open Access Journals (Sweden)

    V.P.I. Fernandes

    Full Text Available The objective of this study was to evaluate gastric emptying (GE in pediatric patients with functional constipation. GE delay has been reported in adults with functional constipation. Gastric emptying studies were performed in 22 children with chronic constipation, fecal retention and fecal incontinence, while presenting fecal retention and after resuming regular bowel movements. Patients (18 boys, median age: 10 years; range: 7.2 to 12.7 years were evaluated in a tertiary pediatric gastroenterology clinic. Gastric half-emptying time of water (reference range: 12 ± 3 min was measured using a radionuclide technique immediately after first patient evaluation, when they presented fecal impaction (GE1, and when they achieved regular bowel movements (GE2, 12 ± 5 weeks after GE1. At study admission, 21 patients had reported dyspeptic symptoms, which were completely relieved after resuming regular bowel movements. Medians (and interquartile ranges for GE1 and GE2 were not significantly different [27.0 (16 and 27.5 (21 min, respectively (P = 0.10]. Delayed GE seems to be a common feature among children with chronic constipation and fecal retention. Resuming satisfactory bowel function and improvement in dyspeptic symptoms did not result in normalization of GE data.

  7. The tight junction protein Z O-2 has several functional nuclear export signals

    International Nuclear Information System (INIS)

    Gonzalez-Mariscal, Lorenza; Ponce, Arturo; Alarcon, Lourdes; Jaramillo, Blanca Estela

    2006-01-01

    The tight junction (TJ) protein ZO-2 changes its subcellular distribution according to the state of confluency of the culture. Thus in confluent monolayers, it localizes at the TJ region whereas in sparse cultures it concentrates at the nucleus. The canine sequence of ZO-2 displays four putative nuclear export signals (NES), two at the second PDZ domain (NES-0 and NES-1) and the rest at the GK region (NES-2 and NES-3). The functionality of NES-0 and NES-3 was unknown, hence here we have explored it with a nuclear export assay, injecting into the nucleus of MDCK cells peptides corresponding to the ZO-2 NES sequences chemically coupled to ovalbumin. We show that both NES-0 and NES-3 are functional and sensitive to leptomycin B. We also demonstrate that NES-1, previously characterized as a non functional NES, is rendered capable of nuclear export upon the acquisition of a negative charge at its Ser369 residue. Experiments performed injecting at the nucleus WT and mutated ZO-2-GST fusion proteins revealed the need of both NES-0 and NES-1, and NES-2 and NES-3 for attaining an efficient nuclear exit of the respective amino and middle segments of ZO-2. Moreover, the transfection of MDCK cells with full-length ZO-2 revealed that the mutation of any of the NES present in the molecule was sufficient to induce nuclear accumulation of the protein

  8. Kidney function is associated with severity of white matter hyperintensity in patients with acute ischemic stroke/TIA.

    Science.gov (United States)

    Zong, Lixia; Yao, Ming; Ni, Jun; Zhou, Lixin; Yuan, Jing; Peng, Bin; Zhu, Yi-Cheng; Cui, Liying

    2016-10-06

    Previous studies suggested the potential interactions between cerebrovascular diseases and impaired renal function. However, the relationship between renal function and white matter hyperintensity (WMH), marker of cerebral small vessel disease, in patients with acute ischemic stroke (AIS) or transient ischemic attack (TIA) remains unknown. We consecutively enrolled 1632 subjects with AIS or TIA who underwent brain MRI for this analysis. The severity of WMH in both of periventricular (PVH) and deep subcortical white matter (SDWMH) was evaluated using Fazekas scale. Estimated glomerular filtration rate (eGFR) was calculated by the equation of the Modification Diet for Renal Disease. Multinomial logistic regression was performed to evaluate the association between the severity of WMH and eGFR. Advanced age and hypertension were independently associated with the severity of both PVH and SDWMH (all p stroke. This results highlighted different pathological mechanism and risk factors of PVH and SDWMH.

  9. Communication subjective assessments of patients undergoing compulsory treatment with the severity of negative symptoms and cognitive functioning level

    Directory of Open Access Journals (Sweden)

    Kabanov T.N.

    2015-04-01

    Full Text Available The article presents the results of studies on the relationship of subjective assessments of the mentally ill with the severity of negative symptoms and cognitive functioning level. The features of patients perception of various aspects of compulsory treatment and subjective satisfaction with treatment. In a study of 94 male patients with a diagnosis of organic mental disorder and schizophrenia was used diagnostic system, consisting of patopsihologicheskogo study, formal survey map, the scale of assessment of negative symptoms SANS, questionnaire symptom levels SCL-90, self-existing problems, as well as - in Test authoring tool sheet to treatment and hospital stay (VG Bulygin, Kabanov, TN, 2011. The differences in subjective assessments of aspects of compulsory treatment and social functioning of patients with varying degrees of severity of negative symptoms and dependence of subjective assessments of the level of cognitive functioning.

  10. The association of functional oral intake and pneumonia in patients with severe Traumatic Brain Injury

    DEFF Research Database (Denmark)

    Schow, Trine; Larsen, Klaus; Engberg, Aase Worså

    Abstract Objective(s): This study investigates the incidence and onset time of pneumonia for patients with severe Traumatic Brain Injury (TBI) in the early phase of rehabilitation, and identifies parameters associated with the risk of pneumonia. Design: Observational retrospective cohort study......: None Main Outcome Measure(s): Pneumonia. Results: Twenty-seven percent (27%) of the patients admitted to the BIU were in treatment for pneumonia and 12% developed pneumonia during rehabilitation, all but one within 19 days of admission. Of these patients, 81% received nothing by mouth. Three factors...... identified patients at highest risk of pneumonia: Glasgow Coma score (GCS) pneumonia...

  11. The DSM-5 Levels of Personality Functioning and Severity of Iranian Patients With Antisocial and Borderline Personality Disorders.

    Science.gov (United States)

    Amini, Mehdi; Pourshahbaz, Abbas; Mohammadkhani, Parvaneh; Khodaie Ardakani, Mohammad Reza; Lotfi, Mozhgan

    2015-08-01

    Fundamental problems with Personality Disorders (PD) diagnostic system in the previous version of DSM, led to the revision of DSM. Therefore, a multidimensional system has been proposed for diagnosis of personality disorder features in DSM-5. In the dimensional approach of DSM-5, personality disorders diagnosis is based on levels of personality functioning (Criteria A) and personality trait domains (Criteria B). The purpose of this study was firstly, to examine the DSM-5 levels of personality functioning in antisocial and borderline personality disorders, and second, to explore which levels of personality functioning in patients with antisocial and borderline personality disorders can better predicted severity than others. This study had a cross sectional design. The participants consisted of 252 individuals with antisocial (n = 122) and borderline personality disorders (n = 130). They were recruited from Tehran prisoners, and clinical psychology and psychiatry centers of Razi and Taleghani Hospitals, Tehran, Iran. The sample was selected based on judgmental sampling. The SCID-II-PQ, SCID-II and DSM-5 levels of personality functioning were used to diagnose and assess personality disorders. The data were analyzed by correlation and multiple regression analysis. All statistical analyses were performed using the SPSS 16 software. Firstly, it was found that DSM-5 levels of personality functioning have a strong correlation with antisocial and borderline personality symptoms, specially intimacy and self-directedness (P < 0.001). Secondly, the findings showed that identity, intimacy and self-directedness significantly predicted antisocial personality disorder severity (P < 0.0001). The results showed that intimacy and empathy were good predictors of borderline personality disorder severity, as well (P < 0.0001). Overall, our findings showed that levels of personality functioning are a significant predictor of personality disorders severity. The results partially confirm

  12. "Fire Moss" Cover and Function in Severely Burned Forests of the Western United States

    Science.gov (United States)

    Grover, H.; Doherty, K.; Sieg, C.; Robichaud, P. R.; Fulé, P. Z.; Bowker, M.

    2017-12-01

    With wildfires increasing in severity and extent throughout the Western United States, land managers need new tools to stabilize recently burned ecosystems. "Fire moss" consists of three species, Ceratodon purpureus, Funaria hygrometrica, and Bryum argentum. These mosses colonize burned landscapes quickly, aggregate soils, have extremely high water holding capacity, and can be grown rapidly ex-situ. In this talk, I will focus on our efforts to understand how Fire Moss naturally interacts with severely burned landscapes. We examined 14 fires in Arizona, New Mexico, Washington, and Idaho selecting a range of times since fire, and stratified plots within each wildfire by winter insolation and elevation. At 75+ plots we measured understory plant cover, ground cover, Fire Moss cover, and Fire Moss reproductive effort. On plots in the Southwest, we measured a suite of soil characteristics on moss covered and adjacent bare soil including aggregate stability, shear strength, compressional strength, and infiltration rates. Moss cover ranged from 0-75% with a mean of 16% across all plots and was inversely related to insolation (R2 = .32, p = soil stability, locations for targeting moss restoration efforts, and suggest that Fire Moss could be a valuable tool to mitigate post wildfire erosion.

  13. Assessment of Myocardial Function and Injury by Echocardiography and Cardiac Biomarkers in African Children With Severe Plasmodium falciparum Malaria.

    Science.gov (United States)

    Kotlyar, Simon; Olupot-Olupot, Peter; Nteziyaremye, Julius; Akech, Samuel O; Uyoga, Sophie; Muhindo, Rita; Moore, Christopher L; Maitland, Kathryn

    2018-03-01

    Perturbed hemodynamic function complicates severe malaria. The Fluid Expansion as Supportive Therapy trial demonstrated that fluid resuscitation, involving children with severe malaria, was associated with increased mortality, primarily due to cardiovascular collapse, suggesting that myocardial dysfunction may have a role. The aim of this study was to characterize cardiac function in children with severe malaria. A prospective observational study with clinical, laboratory, and echocardiographic data collected at presentation (T0) and 24 hours (T1) in children with severe malaria. Cardiac index and ejection fraction were calculated at T0 and T1. Cardiac troponin I and brain natriuretic peptide were measured at T0. We compared clinical and echocardiographic variables in children with and without severe malarial anemia (hemoglobin 0.1 ng/mL) in n equals to 50, (48%), and median brain natriuretic peptide was within normal range (69.1 pg/mL; interquartile range, 48.4-90.8). At T0, median Cardiac index was significantly higher in the severe malarial anemia versus nonsevere malarial anemia group (6.89 vs 5.28 L/min/m) (p = 0.001), which normalized in both groups at T1 (5.60 vs 5.13 L/min/m) (p = 0.452). Cardiac index negatively correlated with hemoglobin, r equals to -0.380 (p 96%) of children with severe malaria have preserved myocardial systolic function. Although there is evidence for myocardial injury (elevated cardiac troponin I), this does not correlate with cardiac dysfunction.

  14. Clinical significance of sleep bruxism on several occlusal and functional parameters.

    Science.gov (United States)

    Ommerborn, Michelle A; Giraki, Maria; Schneider, Christine; Fuck, Lars Michael; Zimmer, Stefan; Franz, Matthias; Raab, Wolfgang Hans-michael; Schaefer, Ralf

    2010-10-01

    The aim of this study was to evaluate the association between various functional and occlusal parameters and sleep bruxism. Thirty-nine (39) sleep bruxism patients and 30 controls participated in this investigation. The assessment of sleep bruxism was performed using the Bruxcore Bruxism-Monitoring Device (BBMD) combined with a new computer-based analyzing method. Sixteen functional and/or occlusal parameters were recorded. With a mean slide of 0.95 mm in the sleep bruxism group and a mean slide of 0.42 mm in the control group (Mann Whitney U test; p<0.003), results solely demonstrated a significant group difference regarding the length of a slide from centric occlusion to maximum intercuspation. The results suggest that the slightly pronounced slide could be of clinical importance in the development of increased wear facets in patients with current sleep bruxism activity. Following further evaluation including polysomnographic recordings, the BBMD combined with this new analyzing technique seems to be a clinically feasible instrument that allows the practitioner to quantify abrasion over a short period.

  15. Functional Budd-Chiari Syndrome Associated With Severe Polycystic Liver Disease

    Directory of Open Access Journals (Sweden)

    Precil Diego Miranda de Menezes Neves

    2017-06-01

    Full Text Available A 50-year-old woman with end-stage renal disease secondary to autosomal dominant polycystic kidney disease was referred to a quaternary care center due to significantly increased abdominal girth. Her physical examination revealed tense ascites and abdominal collateral veins. A 10-L paracentesis improved abdominal discomfort and disclosed a transudate, suggestive of portal hypertension. A computed tomographic scan revealed massive hepatomegaly caused by multiple cysts of variable sizes, distributed throughout all hepatic segments. Contrast-enhanced imaging uncovered extrinsic compression of hepatic and portal veins, resulting in functional Budd-Chiari syndrome and portal hypertension. Although image-guided drainage followed by sclerosis of dominant cysts could potentially lead to alleviation of the extrinsic compression, the associated significant risk of cyst hemorrhage and infection precluded this procedure. In this scenario, the decision was to submit the patient to a liver-kidney transplantation. After 1 year of this procedure, the patient maintains normal liver and kidney function and refers significant improvement in quality of life.

  16. The association of functional oral intake and pneumonia in patients with severe traumatic brain injury

    DEFF Research Database (Denmark)

    Hansen, T.S.; Larsen, K.; Engberg, Anders

    2008-01-01

    MEASURE: Pneumonia. RESULTS: Twenty-seven percent of the patients admitted to the brain injury unit were in treatment for pneumonia; pneumonia developed in 12% of the patients during rehabilitation; the condition occurred within 19 days of admission in all but 1 patient. Of these patients, 81% received......OBJECTIVES: To investigate the incidence and onset time of pneumonia for patients with severe traumatic brain injury (TBI) in the early phase of rehabilitation and to identify parameters associated with the risk of pneumonia. DESIGN: Observational retrospective cohort study. SETTING: Subacute...... nothing by mouth. Three factors identified patients at highest risk of pneumonia: Glasgow Coma Scale score less than 9 (1 day after cessation of sedation); Rancho Los Amigos Scale score less than 3 (on admission); and no oral intake on admission. Having a tracheotomy tube and/or feeding tube was also...

  17. Pilot study of lithium to restore intestinal barrier function in severe graft-versus-host disease.

    Directory of Open Access Journals (Sweden)

    Gideon Steinbach

    Full Text Available Severe intestinal graft-vs-host disease (GVHD after allogeneic hematopoietic cell transplantation (HCT causes mucosal ulceration and induces innate and adaptive immune responses that amplify and perpetuate GVHD and the associated barrier dysfunction. Pharmacological agents to target mucosal barrier dysfunction in GVHD are needed. We hypothesized that induction of Wnt signaling by lithium, an inhibitor of glycogen synthase kinase (GSK3, would potentiate intestinal crypt proliferation and mucosal repair and that inhibition of GSK3 in inflammatory cells would attenuate the deregulated inflammatory response to mucosal injury. We conducted an observational pilot study to provide data for the potential design of a randomized study of lithium. Twenty patients with steroid refractory intestinal GVHD meeting enrollment criteria were given oral lithium carbonate. GVHD was otherwise treated per current practice, including 2 mg/kg per day of prednisone equivalent. Seventeen patients had extensive mucosal denudation (extreme endoscopic grade 3 in the duodenum or colon. We observed that 8 of 12 patients (67% had a complete remission (CR of GVHD and survived more than 1 year (median 5 years when lithium administration was started promptly within 3 days of endoscopic diagnosis of denuded mucosa. When lithium was started promptly and less than 7 days from salvage therapy for refractory GVHD, 8 of 10 patients (80% had a CR and survived more than 1 year. In perspective, a review of 1447 consecutive adult HCT patients in the preceding 6 years at our cancer center showed 0% one-year survival in 27 patients with stage 3-4 intestinal GVHD and grade 3 endoscopic appearance in the duodenum or colon. Toxicities included fatigue, somnolence, confusion or blunted affect in 50% of the patients. The favorable outcomes in patients who received prompt lithium therapy appear to support the future conduct of a randomized study of lithium for management of severe GVHD with

  18. Changes in illness perceptions mediated the effect of cognitive behavioural therapy in severe functional somatic syndromes

    DEFF Research Database (Denmark)

    Christensen, Sara Sletten; Frostholm, Lisbeth; Ørnbøl, Eva

    2014-01-01

    Objective Although there is substantial evidence that cognitive behavioural therapy alleviates symptoms in functional somatic syndromes, the mechanisms of change are less investigated. This study examined whether changes in illness perceptions mediated the effect of cognitive behavioural therapy....... Methods We analysed additional data from a randomised controlled trial comparing completers of cognitive behavioural group therapy (46 patients) to an enhanced usual care group (66 patients). Proposed mediators (illness perceptions) and primary (physical health) and secondary (somatic symptoms and illness...... worry) outcomes were assessed by means of questionnaires at referral, baseline, end of treatment, and 10 and 16 months after randomisation. Multiple mediation analysis determined whether (1) changes in specific illness perceptions during treatment mediated the effect of cognitive behavioural therapy...

  19. Evaluation of functional severity of coronary artery disease and fluid dynamics' influence on hemodynamic parameters: A review.

    Science.gov (United States)

    Govindaraju, Kalimuthu; Badruddin, Irfan Anjum; Viswanathan, Girish N; Ramesh, S V; Badarudin, A

    2013-05-01

    Coronary Artery Disease (CAD) is responsible for most of the deaths in patients with cardiovascular diseases. Diagnostic coronary angiography analysis offers an anatomical knowledge of the severity of the stenosis. The functional or physiological significance is more valuable than the anatomical significance of CAD. Clinicians assess the functional severity of the stenosis by resorting to an invasive measurement of the pressure drop and flow. Hemodynamic parameters, such as pressure wire assessment fractional flow reserve (FFR) or Doppler wire assessment coronary flow reserve (CFR) are well-proven techniques to evaluate the physiological significance of the coronary artery stenosis in the cardiac catheterization laboratory. Between the two techniques mentioned above, the FFR is seen as a very useful index. The presence of guide wire reduces the coronary flow which causes the underestimation of pressure drop across the stenosis which leads to dilemma for the clinicians in the assessment of moderate stenosis. In such condition, the fundamental fluid mechanics is useful in the development of new functional severity parameters such as pressure drop coefficient and lesion flow coefficient. Since the flow takes place in a narrowed artery, the blood behaves as a non-Newtonian fluid. Computational fluid dynamics (CFD) allows a complete coronary flow simulation to study the relationship between the pressure and flow. This paper aims at explaining (i) diagnostic modalities for the evaluation of the CAD and valuable insights regarding FFR in the evaluation of the functional severity of the CAD (ii) the role of fluid dynamics in measuring the severity of CAD. Copyright © 2012 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

  20. A Single Nucleotide Polymorphism in the Il17ra Promoter Is Associated with Functional Severity of Ankylosing Spondylitis

    Science.gov (United States)

    Vidal-Castiñeira, Jose Ramón; López-Vázquez, Antonio; Diaz-Peña, Roberto; Diaz-Bulnes, Paula; Martinez-Camblor, Pablo; Coto, Eliecer; Coto-Segura, Pablo; Bruges-Armas, Jacome; Pinto, Jose Antonio; Blanco, Francisco Jose; Sánchez, Alejandra; Mulero, Juan; Queiro, Ruben; Lopez-Larrea, Carlos

    2016-01-01

    The aim of this study was to identify new genetic variants associated with the severity of ankylosing spondylitis (AS). We sequenced the exome of eight patients diagnosed with AS, selected on the basis of the severity of their clinical parameters. We identified 27 variants in exons and regulatory regions. The contribution of candidate variants found to AS severity was validated by genotyping two Spanish cohorts consisting of 180 cases/300 controls and 419 cases/656 controls. Relationships of SNPs and clinical variables with the Bath Ankylosing Spondylitis Disease Activity and Functional Indices BASDAI and BASFI were analyzed. BASFI was standardized by adjusting for the duration of the disease since the appearance of the first symptoms. Refining the analysis of SNPs in the two cohorts, we found that the rs4819554 minor allele G in the promoter of the IL17RA gene was associated with AS (p<0.005). This variant was also associated with the BASFI score. Classifying AS patients by the severity of their functional status with respect to BASFI/disease duration of the 60th, 65th, 70th and 75th percentiles, we found the association increased from p60 to p75 (cohort 1: p<0.05 to p<0.01; cohort 2: p<0.01 to p<0.005). Our findings indicate a genetic role for the IL17/ILRA axis in the development of severe forms of AS. PMID:27415816

  1. A Single Nucleotide Polymorphism in the Il17ra Promoter Is Associated with Functional Severity of Ankylosing Spondylitis.

    Directory of Open Access Journals (Sweden)

    Jose Ramón Vidal-Castiñeira

    Full Text Available The aim of this study was to identify new genetic variants associated with the severity of ankylosing spondylitis (AS. We sequenced the exome of eight patients diagnosed with AS, selected on the basis of the severity of their clinical parameters. We identified 27 variants in exons and regulatory regions. The contribution of candidate variants found to AS severity was validated by genotyping two Spanish cohorts consisting of 180 cases/300 controls and 419 cases/656 controls. Relationships of SNPs and clinical variables with the Bath Ankylosing Spondylitis Disease Activity and Functional Indices BASDAI and BASFI were analyzed. BASFI was standardized by adjusting for the duration of the disease since the appearance of the first symptoms. Refining the analysis of SNPs in the two cohorts, we found that the rs4819554 minor allele G in the promoter of the IL17RA gene was associated with AS (p<0.005. This variant was also associated with the BASFI score. Classifying AS patients by the severity of their functional status with respect to BASFI/disease duration of the 60th, 65th, 70th and 75th percentiles, we found the association increased from p60 to p75 (cohort 1: p<0.05 to p<0.01; cohort 2: p<0.01 to p<0.005. Our findings indicate a genetic role for the IL17/ILRA axis in the development of severe forms of AS.

  2. The impact of non-severe burn injury on cardiac function and long-term cardiovascular pathology.

    Science.gov (United States)

    O'Halloran, Emily; Shah, Amit; Dembo, Lawrence; Hool, Livia; Viola, Helena; Grey, Christine; Boyd, James; O'Neill, Tomas; Wood, Fiona; Duke, Janine; Fear, Mark

    2016-10-03

    Severe burn injury significantly affects cardiovascular function for up to 3 years. However, whether this leads to long-term pathology is unknown. The impact of non-severe burn injury, which accounts for over 80% of admissions in developed countries, has not been investigated. Using a rodent model of non-severe burn injury with subsequent echocardiography we showed significantly increased left ventricular end systolic diameter (LVESD) and ventricular wall thickness at up to 3 months post-injury. Use of propranolol abrogated the changes in cardiac measures observed. Subsequently we investigated changes in a patient cohort with non-severe injury. Echocardiography measured at baseline and at 3 months post-injury showed increased LVESD at 3 months and significantly decreased posterior wall diameter. Finally, 32 years of Western Australian hospital records were used to investigate the incidence of cardiovascular disease admissions after burn injury. People who had experienced a burn had increased hospital admissions and length of stay for cardiovascular diseases when compared to a matched uninjured cohort. This study presents animal, patient and population data that strongly suggest non-severe burn injury has significant effects on cardiovascular function and long-term morbidity in some burn patients. Identification of patients at risk will promote better intervention and outcomes for burn patients.

  3. The limits of adaptation of functional protein synthesis to sever undernutrition

    International Nuclear Information System (INIS)

    Jahoor, F.; Bhattiprolu, S.; Reeds, P.; Forrester, T.; Boyne, M.

    1994-01-01

    Our goal is to determine how the stress of infections alters the adaptation to reduced food intake in children. We think that an important element is the need for hepatic synthesis of rapidly turning over acute-phase proteins, a critical factor in overall maintenance of host defenses. When the child's prior intake has been adequate, even though growth may temporarily cease, the presence of adequate amino acid stores in tissues allows the hepatic response to stress to be maintained at the same time as an adequate rate of synthesis of nutrient transport proteins. However, when the immune system is activated in a children whose nutrition is already suboptimal the ability of the liver to synthesize nutrient transport proteins is compromised thereby further impeding nutrient utilization. We will use stable isotope tracer methodology to determine the effects of severe protein energy malnutrition, with and without infection, on the rates of synthesis of nutrient transport proteins and acute-phase proteins in undernourished children at three time points during treatment; in the early resuscitative period, after appetite has returned, and at the end of the catch-up growth phase when normal growth has resumed. (author). 12 refs, 1 fig., 1 tab

  4. Functional Data Analysis Applied to Modeling of Severe Acute Mucositis and Dysphagia Resulting From Head and Neck Radiation Therapy

    Energy Technology Data Exchange (ETDEWEB)

    Dean, Jamie A., E-mail: jamie.dean@icr.ac.uk [Joint Department of Physics, The Institute of Cancer Research and The Royal Marsden NHS Foundation Trust, London (United Kingdom); Wong, Kee H. [Head and Neck Unit, The Royal Marsden NHS Foundation Trust, London (United Kingdom); Gay, Hiram [Department of Radiation Oncology, School of Medicine, Washington University in St Louis, St Louis, Missouri (United States); Welsh, Liam C.; Jones, Ann-Britt; Schick, Ulrike [Head and Neck Unit, The Royal Marsden NHS Foundation Trust, London (United Kingdom); Oh, Jung Hun; Apte, Aditya [Department of Medical Physics, Memorial Sloan Kettering Cancer Center, New York, New York (United States); Newbold, Kate L.; Bhide, Shreerang A.; Harrington, Kevin J. [Head and Neck Unit, The Royal Marsden NHS Foundation Trust, London (United Kingdom); Division of Radiotherapy and Imaging, The Institute of Cancer Research, London (United Kingdom); Deasy, Joseph O. [Department of Medical Physics, Memorial Sloan Kettering Cancer Center, New York, New York (United States); Nutting, Christopher M. [Head and Neck Unit, The Royal Marsden NHS Foundation Trust, London (United Kingdom); Division of Radiotherapy and Imaging, The Institute of Cancer Research, London (United Kingdom); Gulliford, Sarah L. [Joint Department of Physics, The Institute of Cancer Research and The Royal Marsden NHS Foundation Trust, London (United Kingdom)

    2016-11-15

    Purpose: Current normal tissue complication probability modeling using logistic regression suffers from bias and high uncertainty in the presence of highly correlated radiation therapy (RT) dose data. This hinders robust estimates of dose-response associations and, hence, optimal normal tissue–sparing strategies from being elucidated. Using functional data analysis (FDA) to reduce the dimensionality of the dose data could overcome this limitation. Methods and Materials: FDA was applied to modeling of severe acute mucositis and dysphagia resulting from head and neck RT. Functional partial least squares regression (FPLS) and functional principal component analysis were used for dimensionality reduction of the dose-volume histogram data. The reduced dose data were input into functional logistic regression models (functional partial least squares–logistic regression [FPLS-LR] and functional principal component–logistic regression [FPC-LR]) along with clinical data. This approach was compared with penalized logistic regression (PLR) in terms of predictive performance and the significance of treatment covariate–response associations, assessed using bootstrapping. Results: The area under the receiver operating characteristic curve for the PLR, FPC-LR, and FPLS-LR models was 0.65, 0.69, and 0.67, respectively, for mucositis (internal validation) and 0.81, 0.83, and 0.83, respectively, for dysphagia (external validation). The calibration slopes/intercepts for the PLR, FPC-LR, and FPLS-LR models were 1.6/−0.67, 0.45/0.47, and 0.40/0.49, respectively, for mucositis (internal validation) and 2.5/−0.96, 0.79/−0.04, and 0.79/0.00, respectively, for dysphagia (external validation). The bootstrapped odds ratios indicated significant associations between RT dose and severe toxicity in the mucositis and dysphagia FDA models. Cisplatin was significantly associated with severe dysphagia in the FDA models. None of the covariates was significantly associated with severe

  5. Functional Data Analysis Applied to Modeling of Severe Acute Mucositis and Dysphagia Resulting From Head and Neck Radiation Therapy

    International Nuclear Information System (INIS)

    Dean, Jamie A.; Wong, Kee H.; Gay, Hiram; Welsh, Liam C.; Jones, Ann-Britt; Schick, Ulrike; Oh, Jung Hun; Apte, Aditya; Newbold, Kate L.; Bhide, Shreerang A.; Harrington, Kevin J.; Deasy, Joseph O.; Nutting, Christopher M.; Gulliford, Sarah L.

    2016-01-01

    Purpose: Current normal tissue complication probability modeling using logistic regression suffers from bias and high uncertainty in the presence of highly correlated radiation therapy (RT) dose data. This hinders robust estimates of dose-response associations and, hence, optimal normal tissue–sparing strategies from being elucidated. Using functional data analysis (FDA) to reduce the dimensionality of the dose data could overcome this limitation. Methods and Materials: FDA was applied to modeling of severe acute mucositis and dysphagia resulting from head and neck RT. Functional partial least squares regression (FPLS) and functional principal component analysis were used for dimensionality reduction of the dose-volume histogram data. The reduced dose data were input into functional logistic regression models (functional partial least squares–logistic regression [FPLS-LR] and functional principal component–logistic regression [FPC-LR]) along with clinical data. This approach was compared with penalized logistic regression (PLR) in terms of predictive performance and the significance of treatment covariate–response associations, assessed using bootstrapping. Results: The area under the receiver operating characteristic curve for the PLR, FPC-LR, and FPLS-LR models was 0.65, 0.69, and 0.67, respectively, for mucositis (internal validation) and 0.81, 0.83, and 0.83, respectively, for dysphagia (external validation). The calibration slopes/intercepts for the PLR, FPC-LR, and FPLS-LR models were 1.6/−0.67, 0.45/0.47, and 0.40/0.49, respectively, for mucositis (internal validation) and 2.5/−0.96, 0.79/−0.04, and 0.79/0.00, respectively, for dysphagia (external validation). The bootstrapped odds ratios indicated significant associations between RT dose and severe toxicity in the mucositis and dysphagia FDA models. Cisplatin was significantly associated with severe dysphagia in the FDA models. None of the covariates was significantly associated with severe

  6. Functional Data Analysis Applied to Modeling of Severe Acute Mucositis and Dysphagia Resulting From Head and Neck Radiation Therapy.

    Science.gov (United States)

    Dean, Jamie A; Wong, Kee H; Gay, Hiram; Welsh, Liam C; Jones, Ann-Britt; Schick, Ulrike; Oh, Jung Hun; Apte, Aditya; Newbold, Kate L; Bhide, Shreerang A; Harrington, Kevin J; Deasy, Joseph O; Nutting, Christopher M; Gulliford, Sarah L

    2016-11-15

    Current normal tissue complication probability modeling using logistic regression suffers from bias and high uncertainty in the presence of highly correlated radiation therapy (RT) dose data. This hinders robust estimates of dose-response associations and, hence, optimal normal tissue-sparing strategies from being elucidated. Using functional data analysis (FDA) to reduce the dimensionality of the dose data could overcome this limitation. FDA was applied to modeling of severe acute mucositis and dysphagia resulting from head and neck RT. Functional partial least squares regression (FPLS) and functional principal component analysis were used for dimensionality reduction of the dose-volume histogram data. The reduced dose data were input into functional logistic regression models (functional partial least squares-logistic regression [FPLS-LR] and functional principal component-logistic regression [FPC-LR]) along with clinical data. This approach was compared with penalized logistic regression (PLR) in terms of predictive performance and the significance of treatment covariate-response associations, assessed using bootstrapping. The area under the receiver operating characteristic curve for the PLR, FPC-LR, and FPLS-LR models was 0.65, 0.69, and 0.67, respectively, for mucositis (internal validation) and 0.81, 0.83, and 0.83, respectively, for dysphagia (external validation). The calibration slopes/intercepts for the PLR, FPC-LR, and FPLS-LR models were 1.6/-0.67, 0.45/0.47, and 0.40/0.49, respectively, for mucositis (internal validation) and 2.5/-0.96, 0.79/-0.04, and 0.79/0.00, respectively, for dysphagia (external validation). The bootstrapped odds ratios indicated significant associations between RT dose and severe toxicity in the mucositis and dysphagia FDA models. Cisplatin was significantly associated with severe dysphagia in the FDA models. None of the covariates was significantly associated with severe toxicity in the PLR models. Dose levels greater than

  7. How does family functioning effect the outcome of family based treatment for adolescents with severe anorexia nervosa?

    Science.gov (United States)

    Wallis, Andrew; Miskovic-Wheatley, Jane; Madden, Sloane; Rhodes, Paul; Crosby, Ross D; Cao, Li; Touyz, Stephen

    2017-01-01

    The aim of this research was to investigate the relationship between family functioning, adolescent-parent attachment and remission, as well as changes in these variables over time for adolescents with severe anorexia nervosa treated with family based treatment (FBT). Understanding how families respond to treatment is important because the family will be the ongoing context for psychosocial development in the longer term. The relationship between family functioning and outcome is also an important variable because it is potentially modifiable during treatment and this may improve outcome. Fifty-seven female adolescents treated with FBT in a randomised controlled trial were assessed at baseline, FBT session 20 and 12-months post FBT session 20. Data on family functioning and adolescent-parent attachment was collected from patients and their parents at each time point. A series of regression analyses were used to determine the relationship between family functioning and comorbidity at baseline, and the relationship with remission status over time. Repeat measure mixed-effects models were used to assess changes in family functioning and attachment quality over time. Greater adolescent perceived family functioning impairment was positively related to psychiatric comorbidity at the start of treatment. Conversely, better family functioning predicted higher self-esteem and stronger attachment quality. Adolescent's reporting better general family functioning, communication and problem solving were more likely to be remitted at session 20, but not at 12-month follow-up. There was no overall improvement in family functioning for any respondent either during treatment or at follow-up, and no significant relationship between change and remission at either session 20 or follow-up. The adolescent's perspective on family functioning at the start of treatment impacts on a positive outcome. Addressing family issues earlier in FBT may be important for some patients. Further

  8. Comparisons of severity classification systems for oropharyngeal dysfunction in children with cerebral palsy: Relations with other functional profiles.

    Science.gov (United States)

    Goh, Yu-Ra; Choi, Ja Young; Kim, Seon Ah; Park, Jieun; Park, Eun Sook

    2018-01-01

    This study aimed to investigate the relationships between various classification systems assessing the severity of oropharyngeal dysphagia and communication function and other functional profiles in children with cerebral palsy (CP). This is a prospective, cross-sectional, study in a university-affiliated, tertiary-care hospital. We recruited 151 children with CP (mean age 6.11 years, SD 3.42, range 3-18yr). The Eating and Drinking Ability Classification System (EDACS) and the dysphagia scales of Functional Oral Intake Scale (FOIS), Swallow Function Scales (SFS), and Food Intake Level Scale (FILS) were used. The Communication Function Classification System (CFCS) and Viking Speech Scale (VSS) were employed to classify communication function and speech intelligibility, respectively. The Pediatric Evaluation of Disability Inventory (PEDI) with the Gross Motor Function Classification System (GFMCS) and the Manual Ability Classification System (MACS) level were also assessed. Spearman correlation analysis to investigate the associations between measures and univariate and multivariate logistic regression models to identify significant factors were used. Median GMFCS level of participants was III (interquartile range II-IV). Significant dysphagia based on EDACS level III-V was noted in 23 children (15.2%). There were strong to very strong relationships between the EDACS level with the dysphagia scales. The EDACS presented strong associations with MACS, CFCS, and VSS, a moderate association with GMFCS level, and a moderate to strong association with each domain of the PEDI. In multivariate analysis, poor functioning in EDACS were associated with poor functioning in gross motor and communication functions. Copyright © 2017. Published by Elsevier Ltd.

  9. Longitudinal strain predicts left ventricular mass regression after aortic valve replacement for severe aortic stenosis and preserved left ventricular function.

    Science.gov (United States)

    Gelsomino, Sandro; Lucà, Fabiana; Parise, Orlando; Lorusso, Roberto; Rao, Carmelo Massimiliano; Vizzardi, Enrico; Gensini, Gian Franco; Maessen, Jos G

    2013-11-01

    We explored the influence of global longitudinal strain (GLS) measured with two-dimensional speckle-tracking echocardiography on left ventricular mass regression (LVMR) in patients with pure aortic stenosis (AS) and normal left ventricular function undergoing aortic valve replacement (AVR). The study population included 83 patients with severe AS (aortic valve area regression (all P regression in patients with pure AS undergoing AVR. Our findings must be confirmed by further larger studies.

  10. Cognitive Impairment, Oral Self-care Function and Dental Caries Severity in Community-dwelling Older Adults

    Science.gov (United States)

    Chen, Xi; Clark, Jennifer JJ; Chen, Hong; Naorungroj, Supawadee

    2013-01-01

    Objective To investigate whether oral self-care function mediates the associations between cognitive impairment and caries severity in community-dwelling older adults. Background Cognitive impairment significantly affects activities of daily living and compromises oral health, systemic health and quality of life in older adults. However, the associations among cognitive impairment, oral self-care capacity and caries severity remain unclear. This increases difficulty in developing effective interventions for cognitively impaired patients. Materials and methods Medical, dental, cognitive and functional assessments were abstracted from the dental records of 600 community-dwelling elderly. 230 participants were selected using propensity score matching and categorised into normal, cognitive impairment but no dementia (CIND) and dementia groups based on their cognitive status and a diagnosis of dementia. Multivariable regressions were developed to examine the mediating effect of oral self-care function on the association between cognitive status and number of caries or retained roots. Results Cognitive impairment, oral self-care function and dental caries severity were intercorrelated. Multivariable analysis showed that without adjusting for oral self-care capacity, cognition was significantly associated with the number of caries or retained roots (p = 0.003). However, the association was not significant when oral self-care capacity was adjusted (p = 0.125). In contrast, individuals with impaired oral self-care capacity had a greater risk of having a caries or retained root (RR = 1.67, 95% CI 1.15, 2.44). Conclusion Oral care capacity mediates the association between cognition and dental caries severity in community-dwelling older adults. PMID:23758583

  11. Functional and Aesthetic Full Mouth Rehabilitation of a Severely Worn Dentition to Restore Vertical Dimension: A Case Report.

    Science.gov (United States)

    Singh, Raj Gaurav; Sinha, Pooja

    2014-12-01

    Deterioration or malfunction of any part should be viewed as an effect that has the direct or indirect result of one or more identifiable cause. The establishment of definitive goals is the foundation for the full mouth rehabilitation. Severe wear is common in prosthodontic patients whose teeth have been held in functional interference for long period of time. This case report presents a description of a patient's oral rehabilitation with metal ceramic restorations to increase vertical dimension while achieving canine guided occlusion.

  12. Olfactory identification and its relationship to executive functions, memory, and disability one year after severe traumatic brain injury.

    Science.gov (United States)

    Sigurdardottir, Solrun; Andelic, Nada; Skandsen, Toril; Anke, Audny; Roe, Cecilie; Holthe, Oyvor Oistensen; Wehling, Eike

    2016-01-01

    To explore the frequency of posttraumatic olfactory (dys)function 1 year after severe traumatic brain injury (TBI) and determine whether there is a relationship between olfactory identification and neuropsychological test performance, injury severity and TBI-related disability. A population-based multicenter study including 129 individuals with severe TBI (99 males; 16 to 85 years of age) that could accomplish neuropsychological examinations. Olfactory (dys)function (anosmia, hyposmia, normosmia) was assessed by the University of Pennsylvania Smell Identification Test (UPSIT) or the Brief Smell Identification Test (B-SIT). Three tests of the Delis-Kaplan Executive Function System (D-KEFS) were used to assess processing speed, verbal fluency, inhibition and set-shifting, and the California Verbal Learning Test-II was used to examine verbal memory. The Glasgow Outcome Scale-Extended (GOSE) was used to measure disability level. Employing 2 different smell tests in 2 equal-sized subsamples, the UPSIT sample (n = 65) classified 34% with anosmia and 52% with hyposmia, while the B-SIT sample (n = 64) classified 20% with anosmia and 9% with hyposmia. Individuals classified with anosmia by the B-SIT showed significantly lower scores for set-shifting, category switching fluency and delayed verbal memory compared to hyposmia and normosmia groups. Only the B-SIT scores were significantly correlated with neuropsychological performance and GOSE scores. Brain injury severity (Rotterdam CT score) and subarachnoid hemorrhage were related to anosmia. Individuals classified with anosmia demonstrated similar disability as those with hyposmia/normosmia. Different measures of olfaction may yield different estimates of anosmia. Nevertheless, around 1 third of individuals with severe TBI suffered from anosmia, which may also indicate poorer cognitive outcome. (c) 2015 APA, all rights reserved).

  13. [Defense mechanisms as outcome measure in short-term psychotherapy related to symptoms, severity and overall functioning: a preliminary study].

    Science.gov (United States)

    Coccanari de' Fornari, Maria Antonietta; Piccione, Michele; Maiello, Luca; Giampà, Alessio

    2011-01-01

    The assessment of defense mechanisms in psychotherapy is currently one of the most used ways to evaluate the effectiveness of psychotherapy. In literature there are few reports on defense mechanisms changes by short-term treatments. To determine whether the defense mechanisms are changed after twelve sessions of short-term psychotherapy related to psychopathological symptoms, severity and overall functioning. Twenty patients (12 F and 8 M; age 38.4) affected by anxiety and mood disorders were recruited to the study between November 2008 and July 2009 and were assessed with the Defense Style Questionnaire-88 (DSQ-88), scale Symptom Checklist-90-Revised (SCL-90-R), scale Clinical Global Impression (CGI) and scale Valutazione Globale del Funzionamento (VGF) at the beginning and after short-term psychotherapy. Half the sample also assumed drugs. The treatment was supportive-expressive psychotherapy of Luborsky, a short focal dynamic therapy, characterized by the integration of supportive and expressive techniques. Both patients showed a significant decrease in immature defenses and a significant-increase in mature defenses (p defenses were significantly correlated with severity (r = -0632; p = 0.003) and overall functioning (r = 0529; p = 0.01). Immature and mature defenses seem to be a useful outcome measure in short-term psychotherapy as well as severity and overall functioning and the combined treatment may be most effective in reducing immature defenses.

  14. Nephrotic range proteinuria as a strong risk factor for rapid renal function decline during pre-dialysis phase in type 2 diabetic patients with severely impaired renal function.

    Science.gov (United States)

    Kitai, Yuichiro; Doi, Yohei; Osaki, Keisuke; Sugioka, Sayaka; Koshikawa, Masao; Sugawara, Akira

    2015-12-01

    Proteinuria is an established risk factor for progression of renal disease, including diabetic nephropathy. The predictive power of proteinuria, especially nephrotic range proteinuria, for progressive renal deterioration has been well demonstrated in diabetic patients with normal to relatively preserved renal function. However, little is known about the relationship between severity of proteinuria and renal outcome in pre-dialysis diabetic patients with severely impaired renal function. 125 incident dialysis patients with type 2 diabetes were identified. This study was aimed at retrospectively evaluating the impact of nephrotic range proteinuria (urinary protein-creatinine ratio above 3.5 g/gCr) on renal function decline during the 3 months just prior to dialysis initiation. In total, 103 patients (82.4 %) had nephrotic range proteinuria. The median rate of decline in estimated glomerular filtration rate (eGFR) in this study population was 0.98 (interquartile range 0.51-1.46) ml/min/1.73 m(2) per month. Compared to patients without nephrotic range proteinuria, patients with nephrotic range proteinuria showed significantly faster renal function decline (0.46 [0.24-1.25] versus 1.07 [0.64-1.54] ml/min/1.73 m(2) per month; p = 0.007). After adjusting for gender, age, systolic blood pressure, serum albumin, calcium-phosphorus product, hemoglobin A1c, and use of an angiotensin-converting enzyme inhibitor or an angiotensin II receptor blocker, patients with nephrotic range proteinuria showed a 3.89-fold (95 % CI 1.08-14.5) increased risk for rapid renal function decline defined as a decline in eGFR ≥0.5 ml/min/1.73 m(2) per month. Nephrotic range proteinuria is the predominant renal risk factor in type 2 diabetic patients with severely impaired renal function receiving pre-dialysis care.

  15. Abnormal Intrinsic Functional Hubs in Severe Male Obstructive Sleep Apnea: Evidence from a Voxel-Wise Degree Centrality Analysis.

    Science.gov (United States)

    Li, Haijun; Li, Lan; Shao, Yi; Gong, Honghan; Zhang, Wei; Zeng, Xianjun; Ye, Chenglong; Nie, Si; Chen, Liting; Peng, Dechang

    2016-01-01

    Obstructive sleep apnea (OSA) has been associated with changes in brain structure and regional function in certain brain areas. However, the functional features of network organization in the whole brain remain largely uncertain. The purpose of this study was to identify the OSA-related spatial centrality distribution of the whole brain functional network and to investigate the potential altered intrinsic functional hubs. Forty male patients with newly confirmed severe OSA on polysomnography, and well-matched good sleepers, participated in this study. All participants underwent a resting-state functional MRI scan and clinical and cognitive evaluation. Voxel-wise degree centrality (DC) was measured across the whole brain, and group difference in DC was compared. The relationship between the abnormal DC value and clinical variables was assessed using a linear correlation analysis. Remarkably similar spatial distributions of the functional hubs (high DC) were found in both groups. However, OSA patients exhibited a pattern of significantly reduced regional DC in the left middle occipital gyrus, posterior cingulate cortex, left superior frontal gyrus, and bilateral inferior parietal lobule, and DC was increased in the right orbital frontal cortex, bilateral cerebellum posterior lobes, and bilateral lentiform nucleus, including the putamen, extending to the hippocampus, and the inferior temporal gyrus, which overlapped with the functional hubs. Furthermore, a linear correlation analysis revealed that the DC value in the posterior cingulate cortex and left superior frontal gyrus were positively correlated with Montreal cognitive assessment scores, The DC value in the left middle occipital gyrus and bilateral inferior parietal lobule were negatively correlated with apnea-hypopnea index and arousal index in OSA patients. Our findings suggest that OSA patients exhibited specific abnormal intrinsic functional hubs including relatively reduced and increased DC. This expands

  16. Abnormal functional connectivity of brain network hubs associated with symptom severity in treatment-naive patients with obsessive-compulsive disorder: A resting-state functional MRI study.

    Science.gov (United States)

    Tian, Lin; Meng, Chun; Jiang, Ying; Tang, Qunfeng; Wang, Shuai; Xie, Xiyao; Fu, Xiangshuai; Jin, Chunhui; Zhang, Fuquan; Wang, Jidong

    2016-04-03

    Abnormal brain networks have been observed in patients with obsessive-compulsive disorder (OCD). However, detailed network hub and connectivity changes remained unclear in treatment-naive patients with OCD. Here, we sought to determine whether patients show hub-related connectivity changes in their whole-brain functional networks. We used resting-state functional magnetic resonance imaging data and voxel-based graph-theoretic analysis to investigate functional connectivity strength and hubs of whole-brain networks in 29 treatment-naive patients with OCD and 29 age- and gender-matched healthy controls. Correlation analysis was applied for potential associations with OCD symptom severity. OCD selectively targeted brain regions of higher functional connectivity strength than the average including brain network hubs, mainly distributed in the cortico-striato-thalamo-cortical (CSTC) circuits and additionally parietal, occipital, temporal and cerebellar regions. Moreover, affected functional connectivity strength in the cerebellum, the medial orbitofrontal cortex and superior occipital cortex was significantly associated with global OCD symptom severity. Our results provide the evidence about OCD-related brain network hub changes, not only in the CSTC circuits but more distributed in whole brain networks. Data suggest that whole brain network hub analysis is useful for understanding the pathophysiology of OCD. Copyright © 2015 Elsevier Inc. All rights reserved.

  17. Altered Brain Functional Activity in Infants with Congenital Bilateral Severe Sensorineural Hearing Loss: A Resting-State Functional MRI Study under Sedation

    Directory of Open Access Journals (Sweden)

    Shuang Xia

    2017-01-01

    Full Text Available Early hearing deprivation could affect the development of auditory, language, and vision ability. Insufficient or no stimulation of the auditory cortex during the sensitive periods of plasticity could affect the function of hearing, language, and vision development. Twenty-three infants with congenital severe sensorineural hearing loss (CSSHL and 17 age and sex matched normal hearing subjects were recruited. The amplitude of low frequency fluctuations (ALFF and regional homogeneity (ReHo of the auditory, language, and vision related brain areas were compared between deaf infants and normal subjects. Compared with normal hearing subjects, decreased ALFF and ReHo were observed in auditory and language-related cortex. Increased ALFF and ReHo were observed in vision related cortex, which suggest that hearing and language function were impaired and vision function was enhanced due to the loss of hearing. ALFF of left Brodmann area 45 (BA45 was negatively correlated with deaf duration in infants with CSSHL. ALFF of right BA39 was positively correlated with deaf duration in infants with CSSHL. In conclusion, ALFF and ReHo can reflect the abnormal brain function in language, auditory, and visual information processing in infants with CSSHL. This demonstrates that the development of auditory, language, and vision processing function has been affected by congenital severe sensorineural hearing loss before 4 years of age.

  18. Altered Brain Functional Activity in Infants with Congenital Bilateral Severe Sensorineural Hearing Loss: A Resting-State Functional MRI Study under Sedation

    Science.gov (United States)

    Che, Jing; Li, Qiang; Chai, Chao; Zheng, Meizhu; Shen, Wen

    2017-01-01

    Early hearing deprivation could affect the development of auditory, language, and vision ability. Insufficient or no stimulation of the auditory cortex during the sensitive periods of plasticity could affect the function of hearing, language, and vision development. Twenty-three infants with congenital severe sensorineural hearing loss (CSSHL) and 17 age and sex matched normal hearing subjects were recruited. The amplitude of low frequency fluctuations (ALFF) and regional homogeneity (ReHo) of the auditory, language, and vision related brain areas were compared between deaf infants and normal subjects. Compared with normal hearing subjects, decreased ALFF and ReHo were observed in auditory and language-related cortex. Increased ALFF and ReHo were observed in vision related cortex, which suggest that hearing and language function were impaired and vision function was enhanced due to the loss of hearing. ALFF of left Brodmann area 45 (BA45) was negatively correlated with deaf duration in infants with CSSHL. ALFF of right BA39 was positively correlated with deaf duration in infants with CSSHL. In conclusion, ALFF and ReHo can reflect the abnormal brain function in language, auditory, and visual information processing in infants with CSSHL. This demonstrates that the development of auditory, language, and vision processing function has been affected by congenital severe sensorineural hearing loss before 4 years of age. PMID:28255465

  19. Severity of cognitive impairment as a prognostic factor for mortality and functional recovery of geriatric patients with hip fracture.

    Science.gov (United States)

    Tarazona-Santabalbina, Francisco José; Belenguer-Varea, Ángel; Rovira Daudi, Eduardo; Salcedo Mahiques, Enmanuel; Cuesta Peredó, David; Doménech-Pascual, Juan Ramón; Gac Espínola, Homero; Avellana Zaragoza, Juan Antonio

    2015-03-01

    To identify how the severity of dementia influences functional recovery and mortality in elderly patients hospitalized for hip fracture. An observational retrospective study of 1258 patients aged older than 69 years and diagnosed with hip fracture who received care within an orthogeriatrics unit from 2004 to 2008 was carried out. During a 12-month follow-up period, functional recovery and mortality outcomes were measured. Dementia was present in 383 (28.1%) patients: it was mild in 183 (48%), moderate in 102 (26.5%) and severe in 98 (25.5%). Compared with patients with preserved cognitive status, patients with dementia had the following statistically significant differences (means [standard deviation] or percentage): older age (preserved, 82.29 years [6.5 years]; mild, 83.63 years [6.1 years]; moderate, 83.47 years [5.9 years]; severe, 84.46 years [6.1 years]; P recovery at discharge (OR 0.272, 95% CI 0.140-0.526, P recovery with increasing severity of dementia. © 2014 Japan Geriatrics Society.

  20. Functional platelet defects in children with severe chronic ITP as tested with 2 novel assays applicable for low platelet counts.

    Science.gov (United States)

    van Bladel, Esther R; Laarhoven, Annemieke G; van der Heijden, Laila B; Heitink-Pollé, Katja M; Porcelijn, Leendert; van der Schoot, C Ellen; de Haas, Masja; Roest, Mark; Vidarsson, Gestur; de Groot, Philip G; Bruin, Marrie C A

    2014-03-06

    Immune thrombocytopenia (ITP) is an autoimmune disease with a complex heterogeneous pathogenesis and a bleeding phenotype that is not necessarily correlated to platelet count. In this study, the platelet function was assessed in a well-defined cohort of 33 pediatric chronic ITP patients. Because regular platelet function test cannot be performed in patients with low platelet counts, 2 new assays were developed to determine platelet function: first, the microaggregation test, measuring in platelets isolated from 10 mL of whole blood the platelet potential to form microaggregates in response to an agonist; second, the platelet reactivity assay, measuring platelet reactivity to adenosine diphosphate (ADP), convulxin (CVX), and thrombin receptor activator peptide in only 150 μL of unprocessed whole blood. Patients with a severe bleeding phenotype demonstrated a decreased aggregation potential upon phorbol myristate acetate stimulation, decreased platelet degranulation following ADP stimulation, and a higher concentration of ADP and CVX needed to activate the glycoprotein IIbIIIa complex compared with patients with a mild bleeding phenotype. In conclusion, here we have established 2 functional tests that allow for evaluation of platelet function in patients with extremely low platelet counts (<10(9)). These tests show that platelet function is related to bleeding phenotype in chronic ITP.

  1. A numerical investigation of the functionality of coronary bifurcation lesions with respect to lesion configuration and stenosis severity.

    Science.gov (United States)

    Pagiatakis, Catherine; Tardif, Jean-Claude; L'Allier, Philippe L; Mongrain, Rosaire

    2015-09-18

    The intervention of coronary bifurcation lesions is associated with higher rates of peri- and post-procedural clinical events compared to the treatment of isolated lesions. Overall, the factors that influence the dynamics of these types of configurations are still not well understood. A geometric multiscale model, consisting of a 3D representation of the left main coronary artery bifurcation and a 0D representation of the rest of the cardiovascular system, was developed. Computational fluid dynamics simulations of the 3D domain were executed by implementing the multiscale algorithm, in order to characterize the functionality of different multilesional configurations as a function of stenosis severity. The investigation found that coronary branch steal has a significant impact on the functionality of the disease and can render a two-lesion configuration more severe compared to a three-lesion configuration. As a result of the complexity of this phenomenon, it was also suggested that certain lesion configurations could result in false negatives in diagnosis when employing a pullback pressure recording across the tandem lesions. In conclusion, this study showed that coronary bifurcation lesions are subject to intricate haemodynamic interactions which render the characterization of their functionality complex and could have significant clinical implications with regards to their diagnosis and prognosis. Copyright © 2015 Elsevier Ltd. All rights reserved.

  2. Function-structure connectivity in patients with severe brain injury as measured by MRI-DWI and FDG-PET.

    Science.gov (United States)

    Annen, J; Heine, L; Ziegler, E; Frasso, G; Bahri, M; Di Perri, C; Stender, J; Martial, C; Wannez, S; D'ostilio, K; Amico, E; Antonopoulos, G; Bernard, C; Tshibanda, F; Hustinx, R; Laureys, S

    2016-11-01

    A vast body of literature exists showing functional and structural dysfunction within the brains of patients with disorders of consciousness. However, the function (fluorodeoxyglucose FDG-PET metabolism)-structure (MRI-diffusion-weighted images; DWI) relationship and how it is affected in severely brain injured patients remains ill-defined. FDG-PET and MRI-DWI in 25 severely brain injured patients (19 Disorders of Consciousness of which 7 unresponsive wakefulness syndrome, 12 minimally conscious; 6 emergence from minimally conscious state) and 25 healthy control subjects were acquired here. Default mode network (DMN) function-structure connectivity was assessed by fractional anisotropy (FA) and metabolic standardized uptake value (SUV). As expected, a profound decline in regional metabolism and white matter integrity was found in patients as compared with healthy subjects. Furthermore, a function-structure relationship was present in brain-damaged patients between functional metabolism of inferior-parietal, precuneus, and frontal regions and structural integrity of the frontal-inferiorparietal, precuneus-inferiorparietal, thalamo-inferioparietal, and thalamofrontal tracts. When focusing on patients, a stronger relationship between structural integrity of thalamo-inferiorparietal tracts and thalamic metabolism in patients who have emerged from the minimally conscious state as compared with patients with disorders of consciousness was found. The latter finding was in line with the mesocircuit hypothesis for the emergence of consciousness. The findings showed a positive function-structure relationship within most regions of the DMN. Hum Brain Mapp 37:3707-3720, 2016. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

  3. The characteristic changes of betung bamboo (Dendrocalamus asper pretreated by fungal pretreatment

    Directory of Open Access Journals (Sweden)

    Widya Fatriasari

    2014-05-01

    Full Text Available Normal 0 false false false IN X-NONE X-NONE MicrosoftInternetExplorer4 The fungal pretreatment effect on chemical structural and morphological changes of Betung Bamboo was evaluated based on its biomass components after being cultivated by white rot fungi, Trametes versicolor. Betung bamboo powder (15 g was exposed to liquid inoculum of white rot fungi and incubated at 270C for 15, 30 and 45 days. The treated samples were then characterized by FT-IR spectroscopy, X-Ray diffraction and SEM-EDS analyses. Cultivation for 30 days with 5 and 10% loadings retained greater selectivity compared to that of the other treatments. FTIR spectra demonstrated that the fungus affected the decreasing of functional group quantities without changing the functional groups. The decrease in intensity at wave number of 1246 cm-1 (guaiacyl of lignin was greater than that at wave number of 1328 cm-1 (deformation combination of syringyl and xylan after fungal treatment. X-ray analysis showed the pretreated samples had a higher crystallinity than the untreated ones which might be due to the cleavage of amorphous fractions of cellulose. The pretreated samples have more fragile than the untreated ones confirmed by SEM. Crystalline allomorph calculated by XRD analysis showed that fungus pretreatment for 30 days has transformed triclinic structure of cellulose to monoclinic structure.

  4. Corrosion protection and adhesion properties of the epoxy coating applied on the steel substrate pre-treated by a sol-gel based silane coating filled with amino and isocyanate silane functionalized graphene oxide nanosheets

    Science.gov (United States)

    Parhizkar, Nafise; Ramezanzadeh, Bahram; Shahrabi, Taghi

    2018-05-01

    This research has focused on the effect of graphene oxide (GO) nano-fillers embedded in the sol-gel based silane coating on the corrosion protection and adhesion properties of the epoxy coating applied on the steel substrate pre-treated by silane coatings. For this purpose, a mixture of Methyltriethoxysilane (MTES) and Tetraethylorthosilicate (TEOS) silane precursors was used for preparation of composite matrix and the GO nanosheets, which are covalently functionalized with 3-(Triethoxysilyl)propyl isocyanate (TEPI, IGO nano-fillers) and 3-aminopropyltriethoxysilane (APTES, AGO nano-fillers), were used as filler. The GO, AGO and IGO nanosheets were characterized by Fourier Transform Infrared Spectroscopy (FT-IR), UV-Visible analysis and field emission-scanning electron microscopy techniques. The performance of the silane/epoxy coatings was investigated by pull-off adhesion, cathodic delamination, salt spray and electrochemical impedance spectroscopy (EIS) tests. Results revealed that AGO and IGO nano-fillers significantly improved the corrosion resistance and adhesion properties of the top epoxy coating due to better compatibility with silane matrix, excellent barrier properties and the formation of covalent bonds with the top epoxy coating.

  5. The impact of depressive and bipolar symptoms on socioeconomic status, core symptoms, function and severity of fibromyalgia.

    Science.gov (United States)

    Gota, Carmen E; Kaouk, Sahar; Wilke, William S

    2017-03-01

    To evaluate the prevalence of depressive and bipolar symptoms in a cohort of consecutive fibromyalgia (FM) patients seen in a tertiary care center and to determine the relationship between depressive and manic symptoms with FM symptoms, socioeconomic status, severity and function. Three hundred and five FM patients were enrolled; demographic, clinical and questionnaire data were collected. Depressive symptoms were measured by the Patient Health Questionnaire (PHQ-9), manic symptoms by the Mood Disorders Questionnaire (MDQ). The FM cohort had the following characteristics: age 43.53 (11.7) years; 86.5% white; 82.7% female; PHQ-9 ≥ 10, 59.7%, mean 11.9 (7.3); no depression 11.4%, mild 29.1%, moderate 27.5%, moderate severe 17.7%, severe 14%; anxiety 41.6%; 21.3% had either an MDQ score ≥ 7 and/or reported a past diagnosis of bipolar disorder (BD). Increasing levels of depression severity, as well as a positive screen for BD were significantly associated with increasing prevalence and severity of FM symptoms, longer duration of morning stiffness, and increased severity of FM. Increasing levels of depression were significantly associated with increase in prevalence of reported past sexual abuse, and a decline in socioeconomic status, including higher disability and unemployment rates. Patients with severe FM disease activity, high load of symptoms, prolonged morning stiffness, increased disability, lower socioeconomic status and those who take a lot of medications for FM should be evaluated for depressive and manic symptoms. © 2015 Asia Pacific League of Associations for Rheumatology and Wiley Publishing Asia Pty Ltd.

  6. FMECA about pre-treatment system for purge gas of test blanket module in ITER

    International Nuclear Information System (INIS)

    Fu Wanfa; Luo Deli; Tang Tao

    2012-01-01

    The pre-treatment system for purge gas of TBM will be installed in Port Cell for installing TBM in ITER, the function of which includes filtering purge gas, removing HTO, cooling, and adjusting flow rate, etc. The purge gas treated will be conveyed into TES (Tritium Extraction System). The technological process and system components in pre-treatment system were introduced. Tritium releasing risk was regarded as failure criterion; failure mode, effects and criticality analysis (FMECA) were carried out and several weaknesses or failure mode in the system were found. Besides, risk priority number (RPN) and failure mode criticality were calculated. Finally, some design improvement measures and usage compensation measures were given. At last, four important potential failure modes were found out. The analysis will provide the design basis for reducing risk of excessive tritium releasing, which is also a useful assist for safety analysis about other tritium system. (authors)

  7. Pre-treatment ASPECTS-DWI score has a relation with functional outcome at 3 months following intravenous rt-PA therapy

    International Nuclear Information System (INIS)

    Nezu, Tomohisa; Koga, Masatoshi; Naganuma, Masaki

    2009-01-01

    The clinical importance of early ischemic changes (EIC) on diffusion-weighted imaging (DWI) before recombinant tissue-plasminogen activator (rt-PA) thrombolysis has not been elucidated well. The present study aimed evaluating whether Alberta Stroke Programme Early CT Score (ASPECTS)-DWI before rt-PA therapy could predict chronic independent outcome. Consecutive stroke patients treated with rt-PA from October 2005 through July 2008 were registered from 10 major stroke centers located without regional imbalance in Japan. Before rt-PA IV infusion, we assessed EIC on DWI by using ASPECTS-DWI (11 points). Independent outcome was defined by modified Rankin Scale score (mRS) 0-2 at 3 months after stroke onset. A total of 420 patients (280 men, 71±11 years in age) were studied, and 221 (52.6%) of them were independent (mRS 0-2) at 3 months. The independent patients were younger, had less hypertension and atrial fibrillation, lower baseline National Institutes of Health Stroke Scale (NIHSS) score, higher ASPECTS-DWI, less internal carotid artery occlusion than dependent patients (mRS 3-6, P<0.05 for all). The optimal cutoff score of ASPECTS-DWI to predict independent outcome was ≥7 with a sensitivity of 92% and specificity of 31%, and the area under the receiver-operating characteristic curve was 0.622. After multivariate logistic regression analysis, ASPECTS-DWI ≥7 was independently predictive of an independent outcome at 3 months (odds ratio (OR) 2.78, 95% confidence interval (CI) 1.45-5.49). ASPECTS-DWI before rt-PA therapy is useful to predict patients' chronic functional outcome. (author)

  8. High-functioning autism patients share similar but more severe impairments in verbal theory of mind than schizophrenia patients.

    Science.gov (United States)

    Tin, L N W; Lui, S S Y; Ho, K K Y; Hung, K S Y; Wang, Y; Yeung, H K H; Wong, T Y; Lam, S M; Chan, R C K; Cheung, E F C

    2017-09-18

    Evidence suggests that autism and schizophrenia share similarities in genetic, neuropsychological and behavioural aspects. Although both disorders are associated with theory of mind (ToM) impairments, a few studies have directly compared ToM between autism patients and schizophrenia patients. This study aimed to investigate to what extent high-functioning autism patients and schizophrenia patients share and differ in ToM performance. Thirty high-functioning autism patients, 30 schizophrenia patients and 30 healthy individuals were recruited. Participants were matched in age, gender and estimated intelligence quotient. The verbal-based Faux Pas Task and the visual-based Yoni Task were utilised to examine first- and higher-order, affective and cognitive ToM. The task/item difficulty of two paradigms was examined using mixed model analyses of variance (ANOVAs). Multiple ANOVAs and mixed model ANOVAs were used to examine group differences in ToM. The Faux Pas Task was more difficult than the Yoni Task. High-functioning autism patients showed more severely impaired verbal-based ToM in the Faux Pas Task, but shared similar visual-based ToM impairments in the Yoni Task with schizophrenia patients. The findings that individuals with high-functioning autism shared similar but more severe impairments in verbal ToM than individuals with schizophrenia support the autism-schizophrenia continuum. The finding that verbal-based but not visual-based ToM was more impaired in high-functioning autism patients than schizophrenia patients could be attributable to the varied task/item difficulty between the two paradigms.

  9. Recovery of renal function after radical nephrectomy and risk factors for postoperative severe renal impairment: A Japanese multicenter longitudinal study.

    Science.gov (United States)

    Kawamura, Naoko; Yokoyama, Minato; Fujii, Yasuhisa; Ishioka, Junichiro; Numao, Noboru; Matsuoka, Yoh; Saito, Kazutaka; Arisawa, Chizuru; Okuno, Tetsuo; Noro, Akira; Morimoto, Shinji; Kihara, Kazunori

    2016-03-01

    To investigate longitudinal changes in renal function after radical nephrectomy, and to explore risk factors of postoperative severe renal impairment in a Japanese multicenter cohort. The present retrospective study included 701 patients who had no metastasis, end-stage kidney disease or bilateral kidney cancer, who underwent radical nephrectomy and who were followed up for at least 1 year. The longitudinal change in postoperative renal function during a 10-year follow-up period was evaluated according to the presence or absence of potential risk factors including greater age, chronic kidney disease, hypertension, diabetes mellitus and cardiovascular disease. A slope of annual change in estimated glomerular filtration rate was analyzed using a linear mixed model. Associations between the potential risk factors and a >50% estimated glomerular filtration rate decrease were evaluated using a multivariate Cox regression model. Overall, the postoperative estimated glomerular filtration rate recovered over time with a significant positive slope of 0.34 mL/min/1.73 m(2)/year. Renal function did not tend to recover in patients with chronic kidney disease, hypertension, diabetes mellitus or cardiovascular disease. The multivariate analysis showed that greater age and diabetes mellitus were independent risk factors for severe renal impairment. Overall, patients who had deteriorated renal function immediately after radical nephrectomy recovered over time. However, patients with chronic kidney disease, hypertension, diabetes mellitus and cardiovascular disease did not tend to recover renal function postoperatively. Greater age and diabetes mellitus were independent risk factors for a >50% decrease in estimated glomerular filtration rate. © 2015 The Japanese Urological Association.

  10. Neonatal functional intestinal obstruction and the presence of severely immature ganglion cells on rectal biopsy: 6 year experience.

    Science.gov (United States)

    Burki, Tariq; Kiho, Liina; Scheimberg, Irene; Phelps, Simon; Misra, Devesh; Ward, Harry; Colmenero, Isabel

    2011-05-01

    We report our experience of managing eight babies who presented with neonatal intestinal obstruction and whose rectal biopsies showed severely immature ganglion cells. Neonatal unit records were reviewed to detect patients with suspected Hirschsprung's disease or functional intestinal obstruction. Those with intestinal atresia, anorectal malformation, malrotation, cystic fibrosis and prematurity were excluded. We identified 73 patients born at term. Twenty-seven did not need a rectal biopsy. Twenty-one had biopsy proven Hirschsprung's disease, while 17 had a normal rectal biopsy. Eight patients, all of whom presented with severe abdominal distension, showed immature ganglion cells. Seven had failed to pass meconium after birth. X-rays in all patients showed distended loops of bowel. Two neonates underwent an emergency laparotomy and a stoma. A repeat biopsy at 3 months showed maturation of ganglion cells and the stoma was reversed. Rectal biopsy was repeated in two other patients 2-9 months after the first biopsy and showed mature ganglion cells. At follow-up, one patient still suffers from severe constipation. Seven are asymptomatic now, including the two patients who needed a stoma. Immature ganglion cells on rectal biopsy may be an indicator of transient functional immaturity of the intestine.

  11. The Effect of Different Intensities of Treadmill Exercise on Cognitive Function Deficit Following a Severe Controlled Cortical Impact in Rats

    Directory of Open Access Journals (Sweden)

    Xiafeng Shen

    2013-10-01

    Full Text Available Exercise has been proposed for the treatment of traumatic brain injury (TBI. However, the proper intensity of exercise in the early phase following a severe TBI is largely unknown. To compare two different treadmill exercise intensities on the cognitive function following a severe TBI in its early phase, rats experienced a controlled cortical impact (CCI and were forced to treadmill exercise for 14 days. The results revealed that the rats in the low intensity exercise group had a shorter latency to locate a platform and a significantly better improvement in spatial memory in the Morris water maze (MWM compared to the control group (p 0.05. The brain-derived neurotrophic factor (BDNF and p-CREB protein levels in the contralateral hippocampus were increased significantly in the low intensity exercise group. Our results suggest that 2 weeks of low intensity of treadmill exercise is beneficial for improving cognitive function and increasing hippocampal BDNF expression after a severe TBI in its early phase.

  12. C-Speak Aphasia alternative communication program for people with severe aphasia: importance of executive functioning and semantic knowledge.

    Science.gov (United States)

    Nicholas, Marjorie; Sinotte, Michele P; Helm-Estabrooks, Nancy

    2011-06-01

    Learning how to use a computer-based communication system can be challenging for people with severe aphasia even if the system is not word-based. This study explored cognitive and linguistic factors relative to how they affected individual patients' ability to communicate expressively using C-Speak Aphasia (CSA), an alternative communication computer program that is primarily picture-based. Ten individuals with severe non-fluent aphasia received at least six months of training with CSA. To assess carryover of training, untrained functional communication tasks (i.e., answering autobiographical questions, describing pictures, making telephone calls, describing a short video, and two writing tasks) were repeatedly probed in two conditions: (1) using CSA in addition to natural forms of communication, and (2) using only natural forms of communication, e.g., speaking, writing, gesturing, drawing. Four of the 10 participants communicated more information on selected probe tasks using CSA than they did without the computer. Response to treatment was also examined in relation to baseline measures of non-linguistic executive function skills, pictorial semantic abilities, and auditory comprehension. Only nonlinguistic executive function skills were significantly correlated with treatment response.

  13. C-Speak Aphasia Alternative Communication Program for People with Severe Aphasia: Importance of Executive Functioning and Semantic Knowledge

    Science.gov (United States)

    Nicholas, Marjorie; Sinotte, Michele P.; Helm-Estabrooks, Nancy

    2011-01-01

    Learning how to use a computer-based communication system can be challenging for people with severe aphasia even if the system is not word-based. This study explored cognitive and linguistic factors relative to how they affected individual patients’ ability to communicate expressively using C-Speak Aphasia, (CSA), an alternative communication computer program that is primarily picture-based. Ten individuals with severe non-fluent aphasia received at least six months of training with CSA. To assess carryover of training, untrained functional communication tasks (i.e., answering autobiographical questions, describing pictures, making telephone calls, describing a short video, and two writing tasks) were repeatedly probed in two conditions: 1) using CSA in addition to natural forms of communication, and 2) using only natural forms of communication, e.g., speaking, writing, gesturing, drawing. Four of the ten participants communicated more information on selected probe tasks using CSA than they did without the computer. Response to treatment also was examined in relation to baseline measures of non-linguistic executive function skills, pictorial semantic abilities, and auditory comprehension. Only nonlinguistic executive function skills were significantly correlated with treatment response. PMID:21506045

  14. Symptomatic Diverticular Disease in Patients With Severely Reduced Kidney Function: Higher Rates of Complications and Transfusion Requirement

    Science.gov (United States)

    Dirweesh, Ahmed; Amodu, Afolarin; Khan, Muhammad; Zijoo, Ritika; Ambreen, Bushra; Ibrahim, Mohammad; Ijaz, Muhammad; Nawwar, Abdelhameed; Genena, Kareem; Tahir, Muhammad; Kumar, Naresh; Debari, Vincent A.; Wallach, Sara

    2017-01-01

    Background The prevalence of diverticulosis is increasing with 5-10% of patients developing diverticulitis and 5-15% developing symptomatic bleeding. Diverticulitis can result in abscess, perforation, fistula, or obstruction. Bleeding has combined morbidity and mortality rates of 10-20%. The purpose of this study was to compare diverticulitis-related complications and transfusion requirements for diverticular bleeding in patients with normal to moderately reduced kidney function (glomerular filtration rate (GFR) ≥ 30 mL/min/1.73 m2) and patients with severe renal impairment (GFR diverticular bleeding treated at our hospital from January 1, 2011 to July 31, 2016. Patients were evaluated for baseline characteristics, GFR, baseline hemoglobin, medications, comorbidities, length of stay (LOS), presence of perforations or abscesses and the need for transfusion. Results Of the 291 patients included, males were 167 (58%). Perforations and abscesses complicating diverticulitis developed in 31/136 (23%) of patients with GFR ≥ 30 mL/min/1.73 m2, and in 13/26 (50%) of patients with GFR diverticular bleeding occurred in 11/78 (14%) of patients with GFR ≥ 30 mL/min/1.73 m2 and in 22/51 (43%) of patients with GFR diverticular bleeding and LOS in patients with severely reduced kidney function compared to patients with normal-moderately reduced renal function. PMID:28270872

  15. Effect of Microwave Pretreatment on Extraction Yield and Quality of Catfish Oil in Northern Thailand

    Directory of Open Access Journals (Sweden)

    Chimsook Thitiphan

    2015-01-01

    Full Text Available The effect of microwave pretreatment of catfish processing waste on oil recovery and quality was investigated. Fish oil was extracted using the enzymatic hydrolysis using alcalase enzyme after the microwave pretreatment. The effect of microwave power and microwave pretreatment times was evaluated. The results revealed that a highest yield of 9.25% when catfish waste was treated at 110 W for 60 s. This condition was found as the most appropriate condition of microwave pretreatment since it decreased the extraction time from 150 min to up to 30 min. Analysis of oil quality indices (e.g. acid value, p-anisidine value, peroxide value extracted by microwave pretreatment and non-pretreatment indicated that catfish oil from both processes has comparatively similar fatty acids composition. In addition, catfish oil was extracted by microwave pretreatment and enzymatic hydrolysis had lower lipid oxidation compared to several standards.

  16. Carbohydrate degradation mechanisms and compounds from pretreated biomass

    DEFF Research Database (Denmark)

    Rasmussen, Helena

    The formation of inhibitors during pretreatment of lignocellulosic feedstocks is a persistent problem, and notably the compounds that retard enzymatic cellulose conversion represent an obstacle for achieving optimal enzymatic productivity and high glucose yields. Compounds with many chemical......, reduced the level of oligophenolic compounds with 73 % compared to the original pretreatment and 41 % compared to the control. When pretreatment severity was increased the amount of xylooligosaccharides decreased whereas the amount of oligophenolic compounds increased. No new degradation compounds were...... pretreated wheat straw after enzymatic treatment. It was found that formation of the oligophenolic degradation compounds were common across biomass sources as sugar cane bagasse and oil palm empty fruit bunches. These findings were in line with that the oligophenolic compounds arise from reactions involving...

  17. Green liquor pretreatment for improving enzymatic hydrolysis of corn stover.

    Science.gov (United States)

    Gu, Feng; Yang, Linfeng; Jin, Yongcan; Han, Qiang; Chang, Hou-min; Jameel, Hasan; Phillips, Richard

    2012-11-01

    Green liquor consists of sodium carbonate and sodium sulfide and is readily available in any kraft mills. The green liquor pretreatment process for bioethanol production was developed for wood chips. This process uses only proven technology and equipment currently used in a kraft pulp mill and has several additional advantages such as high sugar recovery and concentration, no inhibitive substances produced, as compared to acid-based pretreatment methods. The liquor was used to pretreat corn stover for enhancing enzymatic hydrolysis in bioethanol production. Pulp yield of 70% with 45% lignin removal was achieved under optimized conditions (8% total titratable alkali, 40% sulfidity and 140°C). About 70% of the original polysaccharides were converted into fermentable sugars, using 20 FPU/g-pulp of enzyme in the subsequent enzymatic hydrolysis. The result indicates that green liquor is a feasible pretreatment to improve the enzymatic saccharification of corn stover for bioethanol production. Copyright © 2012 Elsevier Ltd. All rights reserved.

  18. Executive function after severe childhood traumatic brain injury - Age-at-injury vulnerability periods: The TGE prospective longitudinal study.

    Science.gov (United States)

    Krasny-Pacini, Agata; Chevignard, Mathilde; Lancien, Sabine; Escolano, Sylvie; Laurent-Vannier, Anne; De Agostini, Maria; Meyer, Philippe

    2017-04-01

    Executive function (EF) impairment is a major predictor of overall outcome after traumatic brain injury (TBI). TBI severity is a factor of poor outcome, but most studies include a majority of children with mild and moderate TBI. The aims of this study were to estimate EF impairment after severe childhood TBI and to explore factors predicting EF outcome. The secondary aim was to compare recovery trajectories by age-at-injury groups. This was a prospective longitudinal study of children with severe TBI who were tested for EFs by performance-based tests and questionnaires at 3, 12 and 24 months. Children with TBI (n=65) showed significant impairment in working memory, inhibition, attention and global EF, with little or no recovery at 24 months. For flexibility and performance-based EF score, children were impaired at 3 months only and showed normal scores by 12 months. No impairment was found in planning. At 3 and 24 months, Glasgow Coma Scale score and parental education predicted global EF. Coma length was not a significant predictor of outcome. Age at injury predicted progress in EF, but the relationship was not linear; children 10-12 years old at injury showed better outcome than older and younger children. EFs are impaired after severe TBI in childhood. The relationship between age at injury and outcome is not linear. Relying on only performance-based EF tests can underestimate EF impairment. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  19. Frequency of worsening liver function in severe dengue hepatitis patients receiving paracetamol: A retrospective analysis of hospital data

    International Nuclear Information System (INIS)

    Syed, A.A.; Aslam, F.; Hakeem, H.; Siddiqui, F.; Nasir, N.

    2017-01-01

    To determine the frequency of worsening liver function among hospital in-patients with severe dengue hepatitis receiving paracetamol. Methods: This retrospective study was conducted at the Department of Medicine, Aga Khan University Hospital, Karachi, and comprised records of dengue patients with severe hepatitis who received paracetamol for control of fever between June 2007 and December 2014. Alanine aminotransferase at baseline and following paracetamol administration was noted, as well as dosage and duration of paracetamol, along with participants' demographic details. Frequency of patients who developed worsening or improvement of alanine aminotransferase was also noted. SPSS 19 was used for data analysis. Results: Of the 113 subjects, 73(64.6%) were male and 40(35.4%) were female. Overall improvement was observed in subsequent alanine aminotransferase levels (491 units per litre, IQR 356.5 TO 775 vs 151 units per litre, IQR 49.5 to 299.5). Most commonly prescribed dose of paracetamol was 2g (IQR 1 to 5 grams), which was taken for a median duration of 1 day (IQR 1 to 3 days). Moreover, 100(88.5 %) patients showed improvement in alanine aminotransferase. Only 13(11.5 %) patients developed worsening of alanine aminotransferase. Of those with worsening liver function, 8(61.5 %) were discharged home with no clinical deterioration and 5(38.5 %) deaths were observed. However, causes of deaths were unrelated to liver dysfunction. Conclusion: The frequency of worsening liver function following paracetamol administration in patients with severe dengue hepatitis was relatively low. (author)

  20. Loss-of-function mutations in SCN4A cause severe foetal hypokinesia or ‘classical’ congenital myopathy

    Science.gov (United States)

    Zaharieva, Irina T.; Thor, Michael G.; Oates, Emily C.; van Karnebeek, Clara; Hendson, Glenda; Blom, Eveline; Witting, Nanna; Rasmussen, Magnhild; Gabbett, Michael T.; Ravenscroft, Gianina; Sframeli, Maria; Suetterlin, Karen; Sarkozy, Anna; D’Argenzio, Luigi; Hartley, Louise; Matthews, Emma; Pitt, Matthew; Vissing, John; Ballegaard, Martin; Krarup, Christian; Slørdahl, Andreas; Halvorsen, Hanne; Ye, Xin Cynthia; Zhang, Lin-Hua; Løkken, Nicoline; Werlauff, Ulla; Abdelsayed, Mena; Davis, Mark R.; Feng, Lucy; Phadke, Rahul; Sewry, Caroline A.; Morgan, Jennifer E.; Laing, Nigel G.; Vallance, Hilary; Ruben, Peter; Hanna, Michael G.; Lewis, Suzanne; Kamsteeg, Erik-Jan; Männikkö, Roope

    2016-01-01

    See Cannon (doi:10.1093/brain/awv400) for a scientific commentary on this article. Congenital myopathies are a clinically and genetically heterogeneous group of muscle disorders characterized by congenital or early-onset hypotonia and muscle weakness, and specific pathological features on muscle biopsy. The phenotype ranges from foetal akinesia resulting in in utero or neonatal mortality, to milder disorders that are not life-limiting. Over the past decade, more than 20 new congenital myopathy genes have been identified. Most encode proteins involved in muscle contraction; however, mutations in ion channel-encoding genes are increasingly being recognized as a cause of this group of disorders. SCN4A encodes the α-subunit of the skeletal muscle voltage-gated sodium channel (Nav1.4). This channel is essential for the generation and propagation of the muscle action potential crucial to muscle contraction. Dominant SCN4A gain-of-function mutations are a well-established cause of myotonia and periodic paralysis. Using whole exome sequencing, we identified homozygous or compound heterozygous SCN4A mutations in a cohort of 11 individuals from six unrelated kindreds with congenital myopathy. Affected members developed in utero- or neonatal-onset muscle weakness of variable severity. In seven cases, severe muscle weakness resulted in death during the third trimester or shortly after birth. The remaining four cases had marked congenital or neonatal-onset hypotonia and weakness associated with mild-to-moderate facial and neck weakness, significant neonatal-onset respiratory and swallowing difficulties and childhood-onset spinal deformities. All four surviving cohort members experienced clinical improvement in the first decade of life. Muscle biopsies showed myopathic features including fibre size variability, presence of fibrofatty tissue of varying severity, without specific structural abnormalities. Electrophysiology suggested a myopathic process, without myotonia. In vitro

  1. Loss-of-function mutations in SCN4A cause severe foetal hypokinesia or 'classical' congenital myopathy.

    Science.gov (United States)

    Zaharieva, Irina T; Thor, Michael G; Oates, Emily C; van Karnebeek, Clara; Hendson, Glenda; Blom, Eveline; Witting, Nanna; Rasmussen, Magnhild; Gabbett, Michael T; Ravenscroft, Gianina; Sframeli, Maria; Suetterlin, Karen; Sarkozy, Anna; D'Argenzio, Luigi; Hartley, Louise; Matthews, Emma; Pitt, Matthew; Vissing, John; Ballegaard, Martin; Krarup, Christian; Slørdahl, Andreas; Halvorsen, Hanne; Ye, Xin Cynthia; Zhang, Lin-Hua; Løkken, Nicoline; Werlauff, Ulla; Abdelsayed, Mena; Davis, Mark R; Feng, Lucy; Phadke, Rahul; Sewry, Caroline A; Morgan, Jennifer E; Laing, Nigel G; Vallance, Hilary; Ruben, Peter; Hanna, Michael G; Lewis, Suzanne; Kamsteeg, Erik-Jan; Männikkö, Roope; Muntoni, Francesco

    2016-03-01

    Congenital myopathies are a clinically and genetically heterogeneous group of muscle disorders characterized by congenital or early-onset hypotonia and muscle weakness, and specific pathological features on muscle biopsy. The phenotype ranges from foetal akinesia resulting in in utero or neonatal mortality, to milder disorders that are not life-limiting. Over the past decade, more than 20 new congenital myopathy genes have been identified. Most encode proteins involved in muscle contraction; however, mutations in ion channel-encoding genes are increasingly being recognized as a cause of this group of disorders. SCN4A encodes the α-subunit of the skeletal muscle voltage-gated sodium channel (Nav1.4). This channel is essential for the generation and propagation of the muscle action potential crucial to muscle contraction. Dominant SCN4A gain-of-function mutations are a well-established cause of myotonia and periodic paralysis. Using whole exome sequencing, we identified homozygous or compound heterozygous SCN4A mutations in a cohort of 11 individuals from six unrelated kindreds with congenital myopathy. Affected members developed in utero- or neonatal-onset muscle weakness of variable severity. In seven cases, severe muscle weakness resulted in death during the third trimester or shortly after birth. The remaining four cases had marked congenital or neonatal-onset hypotonia and weakness associated with mild-to-moderate facial and neck weakness, significant neonatal-onset respiratory and swallowing difficulties and childhood-onset spinal deformities. All four surviving cohort members experienced clinical improvement in the first decade of life. Muscle biopsies showed myopathic features including fibre size variability, presence of fibrofatty tissue of varying severity, without specific structural abnormalities. Electrophysiology suggested a myopathic process, without myotonia. In vitro functional assessment in HEK293 cells of the impact of the identified SCN4A

  2. Effects of Pretreatments in Convective Dehydration of Rosehip (Rosa eglanteria

    Directory of Open Access Journals (Sweden)

    Alejandra Mabellini

    2012-04-01

    Full Text Available The aim of this work was to experimentally determine drying curves for thin layer and bed drying of rosehip fruits, with and without pretreatments, to reduce processing times as a function of drying air operating variables, to propose dehydration kinetics of fruits and to determine its kinetic parameters for further use within drying simulation software. Fruits were pre-treated both chemically and mechanically, which included dipping the fruits in NaOH and ethyl oleate solutions; and cutting or perforating the fruit cuticle, respectively. Simulation models were then adopted to fit the kinetics drying data considering fruit volume shrinkage. These simple models minimized the calculation time during the simulation of deep-bed driers. Results show that pre-treatments reduced processing times up to 57%, and evaluated models satisfactorily predicted the drying of rosehip fruit. Effective mass diffusion coefficients were up to 4-fold greater when fruit was submitted to mechanical pretreatments.

  3. Using a combined hydrolysis factor to optimize high titer ethanol production from sulfite-pretreated poplar without detoxification

    Science.gov (United States)

    Jingzhi Zhang; Feng Gu; J.Y. Zhu; Ronald S. Zalesny Jr.

    2015-01-01

    Sulfite pretreatment to overcome the recalcitrance of lignocelluloses (SPORL) was applied to poplar NE222 chips in a range of chemical loadings, temperatures, and times. The combined hydrolysis factor (CHF) as a pretreatment severity accurately predicted xylan dissolution by SPORL. Good correlations between CHF and pretreated...

  4. Exendin-4 pretreated adipose derived stem cells are resistant to oxidative stress and improve cardiac performance via enhanced adhesion in the infarcted heart.

    Directory of Open Access Journals (Sweden)

    Jianfeng Liu

    Full Text Available Reactive oxygen species (ROS, which were largely generated after myocardial ischemia, severely impaired the adhesion and survival of transplanted stem cells. In this study, we aimed to determine whether Exendin-4 pretreatment could improve the adhesion and therapeutic efficacy of transplanted adipose derived stem cells (ADSCs in ischemic myocardium. In vitro, H2O2 was used to provide ROS environments, in which ADSCs pretreated with Exendin-4 were incubated. ADSCs without pretreatment were used as control. Then, cell adhesion and viability were analyzed with time. Compared with control ADSCs, Exendin-4 treatment significantly increased the adhesion of ADSCs in ROS environment, while reduced intracellular ROS and cell injury as determined by dihydroethidium (DHE staining live/Dead staining, lactate dehydrogenase-release assay and MTT assay. Western Blotting demonstrated that ROS significantly decreased the expression of adhesion-related integrins and integrin-related focal adhesion proteins, which were significantly reversed by Exendin-4 pretreatment and followed by decreases in caspase-3, indicating that Exendin-4 may facilitate cell survival through enhanced adhesion. In vivo, myocardial infarction (MI was induced by the left anterior descending artery ligation in SD rats. Autologous ADSCs with or without Exendin-4 pretreatment were injected into the border area of infarcted hearts, respectively. Multi-techniques were used to assess the beneficial effects after transplantation. Longitudinal bioluminescence imaging and histological staining revealed that Exendin-4 pretreatment enhanced the survival and differentiation of engrafted ADSCs in ischemic myocardium, accompanied with significant benefits in cardiac function, matrix remodeling, and angiogenesis compared with non-pretreated ADSCs 4 weeks post-transplantation. In conclusion, transplantation of Exendin-4 pretreated ADSCs significantly improved cardiac performance and can be an innovative

  5. WWER-440/V-230 Confinement modernization to upgrade the critical safety function 'Containment integrity' in case of severe accident

    International Nuclear Information System (INIS)

    Sartmadjiev, A.

    1999-01-01

    In this lecture the WWER-440/V-230 confinement modernization to upgrade the critical safety function 'Containment integrity' in case of severe accident is presented. There are discussed: design limitations of the location system; consequence from these design limitations; a few confinement reconstruction concepts of this type of units worldwide; and purpose of the confinement reconstruction - to improve significantly the original design, ensuring (1) localization for all possible primary breaks and (2) limitation of the radiological consequences for the personnel, the population and the environment below the regulatory requirements

  6. Relationships Between Varus–Valgus Laxity of the Severely Osteoarthritic Knee and Gait, Instability, Clinical Performance, and Function

    Science.gov (United States)

    Freisinger, Gregory M.; Hutter, Erin E.; Lewis, Jacqueline; Granger, Jeffrey F.; Glassman, Andrew H.; Beal, Matthew D.; Pan, Xueliang; Schmitt, Laura C.; Siston, Robert A.; Chaudhari, Ajit M.W.

    2017-01-01

    Increased varus–valgus laxity has been reported in individuals with knee osteoarthritis (OA) compared to controls. However, the majority of previous investigations may not report truly passive joint laxity, as their tests have been performed on conscious participants who could be guarding against motion with muscle contraction during laxity evaluation. The purpose of this study was to investigate how a measure of passive knee laxity, recorded when the participant is under anesthesia, is related to varus–valgus excursion during gait, clinical measures of performance, perceived instability, and self-reported function in participants with severe knee OA. We assessed passive varus–valgus knee laxity in 29 participants (30 knees) with severe OA, as they underwent total knee arthroplasty (TKA). Participants also completed gait analysis, clinical assessment of performance (6-min walk (6 MW), stair climbing test (SCT), isometric knee strength), and self-reported measures of function (perceived instability, Knee injury, and Osteoarthritis Outcome Score (KOOS) a median of 18 days before the TKA procedure. We observed that greater passive varus–valgus laxity was associated with greater varus–valgus excursion during gait (R2 =0.34, p =0.002). Significant associations were also observed between greater laxity and greater isometric knee extension strength (p =0.014), farther 6 MW distance (p =0.033) and shorter SCT time (p =0.046). No relationship was observed between passive varus–valgus laxity and isometric knee flexion strength, perceived instability, or any KOOS subscale. The conflicting associations between laxity, frontal excursion during gait, and functional performance suggest a complex relationship between laxity and knee cartilage health, clinical performance, and self-reported function that merits further study. PMID:27664972

  7. Relationships between varus-valgus laxity of the severely osteoarthritic knee and gait, instability, clinical performance, and function.

    Science.gov (United States)

    Freisinger, Gregory M; Hutter, Erin E; Lewis, Jacqueline; Granger, Jeffrey F; Glassman, Andrew H; Beal, Matthew D; Pan, Xueliang; Schmitt, Laura C; Siston, Robert A; Chaudhari, Ajit M W

    2017-08-01

    Increased varus-valgus laxity has been reported in individuals with knee osteoarthritis (OA) compared to controls. However, the majority of previous investigations may not report truly passive joint laxity, as their tests have been performed on conscious participants who could be guarding against motion with muscle contraction during laxity evaluation. The purpose of this study was to investigate how a measure of passive knee laxity, recorded when the participant is under anesthesia, is related to varus-valgus excursion during gait, clinical measures of performance, perceived instability, and self-reported function in participants with severe knee OA. We assessed passive varus-valgus knee laxity in 29 participants (30 knees) with severe OA, as they underwent total knee arthroplasty (TKA). Participants also completed gait analysis, clinical assessment of performance (6-min walk (6 MW), stair climbing test (SCT), isometric knee strength), and self-reported measures of function (perceived instability, Knee injury, and Osteoarthritis Outcome Score (KOOS) a median of 18 days before the TKA procedure. We observed that greater passive varus-valgus laxity was associated with greater varus-valgus excursion during gait (R 2  = 0.34, p = 0.002). Significant associations were also observed between greater laxity and greater isometric knee extension strength (p = 0.014), farther 6 MW distance (p = 0.033) and shorter SCT time (p = 0.046). No relationship was observed between passive varus-valgus laxity and isometric knee flexion strength, perceived instability, or any KOOS subscale. The conflicting associations between laxity, frontal excursion during gait, and functional performance suggest a complex relationship between laxity and knee cartilage health, clinical performance, and self-reported function that merits further study. © 2016 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 35:1644-1652, 2017. © 2016 Orthopaedic

  8. THE EYE — MIRROR OF CARDIOVASCULAR DISORDER. RELATIONSHIP OF THE RETINA FUNCTIONAL STATE AND THE HYPERTENSION SEVERITY

    Directory of Open Access Journals (Sweden)

    V. S. Zadionchenko

    2011-01-01

    Full Text Available Aim. To study the retina state by functional methods in patients with arterial hypertension (HT of various degrees. Material and methods. Patients with uncomplicated HT of 1-3 degrees (n=81 and healthy subjects (n=20 of control group were examined. Routine (direct ophthalmoscopy and functional (evaluation of contrast and color sensitivity of the retina, electroretinography methods were used. Results. Functional retinal changes (reduction in color and contrast sensitivity progressed with increasing HT degree. These changes were located in the area of central retinal artery (paramacular area and area of choroidal blood flow (macular region. Retinal bioelectrical activity disturbance was also found by the electroretinography. Conclusion. The identified functional disorders suggest the retina involvement in the pathological process even in the early HT and may be associated with its severity. It confirms a relationship of HT with disorders of eye as a target organ in HT. Published data and results of our studies can refute the point of view about impossibility of changes assessment on the eye fundus in patients with uncomplicated HT, and indicates that it was premature exclusion of the eye from the list of target organs in HT.

  9. Processes for pretreating lignocellulosic biomass: A review

    Energy Technology Data Exchange (ETDEWEB)

    McMillan, J.D.

    1992-11-01

    This paper reviews existing and proposed pretreatment processes for biomass. The focus is on the mechanisms by which the various pretreatments act and the influence of biomass structure and composition on the efficacy of particular pretreatment techniques. This analysis is used to identify pretreatment technologies and issues that warrant further research.

  10. Mechanism of waste biomass pyrolysis: Effect of physical and chemical pre-treatments

    Energy Technology Data Exchange (ETDEWEB)

    Das, Oisik [Department of Biological Systems Engineering, Washington State University, Pullman 99164-6120, WA (United States); Department of Civil and Environmental Engineering, University of Auckland, Auckland 1142 (New Zealand); Sarmah, Ajit K., E-mail: a.sarmah@auckland.ac.nz [Department of Civil and Environmental Engineering, University of Auckland, Auckland 1142 (New Zealand)

    2015-12-15

    To impart usability in waste based biomass through thermo-chemical reactions, several physical and chemical pre-treatments were conducted to gain an insight on their mode of action, effect on the chemistry and the change in thermal degradation profiles. Two different waste biomasses (Douglas fir, a softwood and hybrid poplar, a hardwood) were subjected to four different pre-treatments, namely, hot water pre-treatment, torrefaction, acid (sulphuric acid) and salt (ammonium phosphate) doping. Post pre-treatments, the changes in the biomass structure, chemistry, and thermal makeup were studied through electron microscopy, atomic absorption/ultra violet spectroscopy, ion exchange chromatography, and thermogravimetry. The pre-treatments significantly reduced the amounts of inorganic ash, extractives, metals, and hemicellulose from both the biomass samples. Furthermore, hot water and torrefaction pre-treatment caused mechanical disruption in biomass fibres leading to smaller particle sizes. Torrefaction of Douglas fir wood yielded more solid product than hybrid poplar. Finally, the salt pre-treatment increased the activation energies of the biomass samples (especially Douglas fir) to a great extent. Thus, salt pre-treatment was found to bestow thermal stability in the biomass. - Highlights: • Pre-treatments reduce ash, extractives, alkalines and hemicellulose from biomass. • Torrefaction of Douglas fir yields more solid product than hybrid poplar. • Salt pretreatment significantly increases the activation energy of biomass. • Acid and salt pretreatment bestows thermal stability in biomass.

  11. Mechanism of waste biomass pyrolysis: Effect of physical and chemical pre-treatments

    International Nuclear Information System (INIS)

    Das, Oisik; Sarmah, Ajit K.

    2015-01-01

    To impart usability in waste based biomass through thermo-chemical reactions, several physical and chemical pre-treatments were conducted to gain an insight on their mode of action, effect on the chemistry and the change in thermal degradation profiles. Two different waste biomasses (Douglas fir, a softwood and hybrid poplar, a hardwood) were subjected to four different pre-treatments, namely, hot water pre-treatment, torrefaction, acid (sulphuric acid) and salt (ammonium phosphate) doping. Post pre-treatments, the changes in the biomass structure, chemistry, and thermal makeup were studied through electron microscopy, atomic absorption/ultra violet spectroscopy, ion exchange chromatography, and thermogravimetry. The pre-treatments significantly reduced the amounts of inorganic ash, extractives, metals, and hemicellulose from both the biomass samples. Furthermore, hot water and torrefaction pre-treatment caused mechanical disruption in biomass fibres leading to smaller particle sizes. Torrefaction of Douglas fir wood yielded more solid product than hybrid poplar. Finally, the salt pre-treatment increased the activation energies of the biomass samples (especially Douglas fir) to a great extent. Thus, salt pre-treatment was found to bestow thermal stability in the biomass. - Highlights: • Pre-treatments reduce ash, extractives, alkalines and hemicellulose from biomass. • Torrefaction of Douglas fir yields more solid product than hybrid poplar. • Salt pretreatment significantly increases the activation energy of biomass. • Acid and salt pretreatment bestows thermal stability in biomass.

  12. Frequency and severity of visual sensory and motor deficits in children with cerebral palsy: gross motor function classification scale.

    Science.gov (United States)

    Ghasia, Fatema; Brunstrom, Janice; Gordon, Mae; Tychsen, Lawrence

    2008-02-01

    Cerebral palsy (CP) is a permanent, nonprogressive disorder of movement and posture due to a lesion of the fetal or infant brain. The goal was to determine whether children with different severities of CP, as defined using the Gross Motor Function Classification System (GMFCS), had different degrees or types of visual dysfunction. An observational, cross-sectional-design study was conducted by using neurologic and masked ophthalmic measurements on a representative cohort of 50 children with CP. Mean age was 5.6 years (range, 2-19.5 years); mean gestational age was 31 weeks. The likelihood of debilitating visual deficits was greater in children with higher GMFCS scores, independent of gestational age. Children with level 5 disease (most severe) were at greatest risk for high myopia, absence of binocular fusion, dyskinetic strabismus, severe gaze dysfunction, and optic neuropathy or cerebral visual impairment (CVI). These deficits were rare or absent in children with the mildest disease, level 1. When categorized by anatomic or physiologic CP subtype, diplegic and spastic children were more often hyperopic and esotropic, but had the highest prevalence of fusion and stereopsis. In contrast, children with quadriplegic and mixed CP (dyskinetic, athetoid, hypotonic, and ataxic) more often had high myopia, CVI, dyskinetic strabismus, and gaze dysfunction. Visual deficits differ in children who have mild versus severe CP. Children with GMFCS level 1 to 2 have sensorimotor deficits resembling those of neurologically normal children with strabismus and amblyopia; children at level 3 to 5 have more severe deficits, not observed in neurologically normal children.

  13. Rib cage deformities alter respiratory muscle action and chest wall function in patients with severe osteogenesis imperfecta.

    Science.gov (United States)

    LoMauro, Antonella; Pochintesta, Simona; Romei, Marianna; D'Angelo, Maria Grazia; Pedotti, Antonio; Turconi, Anna Carla; Aliverti, Andrea

    2012-01-01

    Osteogenesis imperfecta (OI) is an inherited connective tissue disorder characterized by bone fragility, multiple fractures and significant chest wall deformities. Cardiopulmonary insufficiency is the leading cause of death in these patients. Seven patients with severe OI type III, 15 with moderate OI type IV and 26 healthy subjects were studied. In addition to standard spirometry, rib cage geometry, breathing pattern and regional chest wall volume changes at rest in seated and supine position were assessed by opto-electronic plethysmography to investigate if structural modifications of the rib cage in OI have consequences on ventilatory pattern. One-way or two-way analysis of variance was performed to compare the results between the three groups and the two postures. Both OI type III and IV patients showed reduced FVC and FEV(1) compared to predicted values, on condition that updated reference equations are considered. In both positions, ventilation was lower in OI patients than control because of lower tidal volume (pfunction was normal, OI type III patients were characterized by reduced (prespiratory pattern of Osteogenesis Imperfecta is closely related to the severity of the disease and to the sternal deformities. Pectus carinatum characterizes OI type III patients and alters respiratory muscles coordination, leading to chest wall and rib cage distortions and an inefficient ventilator pattern. OI type IV is characterized by lower alterations in the respiratory function. These findings suggest that functional assessment and treatment of OI should be differentiated in these two forms of the disease.

  14. Population profiles associated with severe functioning difficulties and disability among two to four years old children in Mexico

    Directory of Open Access Journals (Sweden)

    Rosalba Rojas-Martínez

    2017-07-01

    Full Text Available Objective. To describe the prevalence and factors associated with severe child functioning difficulties and disability (CFD among two to four year old children in Mexico, and estimates the probability of presenting CFD based on specific population profiles. Materials and methods. The sample consists of 5 104 children who participated in the National Survey of Children and Women 2015 (ENIM. We used postestimation exploration by computing predicted values of CFD to interpret the logistic models for discrete combinations of the independent variables. Results. CFD prevalence is 2%,which means at least 130 000 two to four year-old children are at risk of experiencing severely limited participation in an unaccommodating environment. The probability of presenting CFD is dramatically higher in specific sub-groups of the population, in particular, male children of women with low education, who live in the poorest households. Conclusions. A significant proportion of Mexican children face important challenges due to functioning difficulties and disability. Public policies must be developed to accommodate the needs of these children and provide a proper environment for their development.

  15. Wide-Field Landers Temporary Keratoprosthesis in Severe Ocular Trauma: Functional and Anatomical Results after One Year

    Directory of Open Access Journals (Sweden)

    Katarzyna Nowomiejska

    2015-01-01

    Full Text Available Purpose. To evaluate longitudinal functional and anatomical results after combined pars plana vitrectomy (PPV and penetrating keratoplasty (PKP using a wide-field Landers intraoperative temporary keratoprosthesis (TKP in patients with vitreoretinal pathology and corneal opacity due to severe ocular trauma. Material and Methods. Medical records of 12 patients who had undergone PPV/PKP/KP due to severe eye trauma were analyzed. Functional (best-corrected visual acuity and anatomic outcomes (clarity of the corneal graft, retinal attachment, and intraocular pressure were assessed during the follow-up (mean 16 months. Results. Final visual acuities varied from NLP to CF to 2 m. Visual acuity improved in 7 cases, was unchanged in 4 eyes, and worsened in 1 eye. The corneal graft was transparent during the follow-up in 3 cases and graft failure was observed in 9 eyes. Silicone oil was used as a tamponade in all cases and retina was reattached in 92% of cases. Conclusions. Combined PPV and PKP with the use of wide-field Landers TKP allowed for surgical intervention in patients with vitreoretinal pathology coexisting with corneal wound. Although retina was attached in most of the cases, corneal graft survived only in one-fourth of patients and final visual acuities were poor.

  16. Measurements of the proton light output function of the organic liquid scintillator NE213 in several detectors

    CERN Document Server

    Hawkes, N P; Bond, D S; Croft, S; Jarvis, O N; Watkins, N

    2002-01-01

    When using an organic liquid scintillator such as NE213 for neutron spectrometry, the light output as a function of proton energy is needed in order to unfold the neutron spectrum from the scintillator's pulse height distribution. We have measured this function for several detectors over the range 1.5-16 MeV approximately, using monoenergetic neutrons from the Harwell 5 MV Van de Graaff accelerator. Results were obtained for a wide variety of sizes and shapes of the scintillator cell, and were found to be essentially in agreement within errors. The results were also compared with those of several other workers (amongst whom there is considerable disagreement). Below 10 MeV, there is excellent agreement with one worker and moderate or poor agreement with others; above 10 MeV, agreement is moderate in all cases. We conclude that workers wishing to unfold neutron spectra from NE213 pulse height distributions would be advised to make measurements with their own particular detector configuration, rather than use p...

  17. Differences between suicide attempters and nonattempters in depressed older patients: depression severity, white-matter lesions, and cognitive functioning.

    Science.gov (United States)

    Sachs-Ericsson, Natalie; Hames, Jennifer L; Joiner, Thomas E; Corsentino, Elizabeth; Rushing, Nicole C; Palmer, Emily; Gotlib, Ian H; Selby, Edward A; Zarit, Steven; Steffens, David C

    2014-01-01

    The population of older adults with major depressive disorder (MDD) has the highest rate of suicide. White-matter brain lesions (WML) are a potential biologic marker for suicidality in young and middle-aged adults and are correlated with cognitive impairment in older adults. In this study of older patients with MDD, we examined 1) if a history of suicide attempts was associated with a more severe course of MDD; 2) if WML are a biologic marker for suicide; and 3) if suicide attempt history is associated with cognitive impairment mediated by WML. Data from the Neurocognitive Outcomes of Depression in the Elderly study. Depressed patients (60+) who had ever attempted suicide (n = 23) were compared with depressed patients (60+) who had not attempted suicide (n = 223). Baseline and follow-up assessments were obtained for depressive symptoms (every 3 months) and cognitive functioning (every 6 months) over 2 years. Three magnetic resonance imaging scans were conducted. At baseline, suicide attempters reported more severe past and present symptoms (e.g., depressive symptoms, current suicidal thoughts, psychotic symptoms, earlier age of onset, and more lifetime episodes) than nonattempters. Suicide attempters had more left WML at baseline, and suicide attempt history predicted a greater growth in both left and right WML. WML predicted cognitive decline; nonetheless, a history of suicide attempt was unrelated to cognitive functioning. Severity of depressive symptoms and WML are associated with suicide attempts in geriatric depressed patients. Suicide attempts predicted neurologic changes, which may contribute to poorer long-term outcomes in elder attempters. Copyright © 2014 American Association for Geriatric Psychiatry. Published by Elsevier Inc. All rights reserved.

  18. Impact of anaemia on lung function and exercise capacity in patients with stable severe chronic obstructive pulmonary disease.

    Science.gov (United States)

    Guo, Jian; Zheng, Cong; Xiao, Qiang; Gong, Sugang; Zhao, Qinhua; Wang, Lan; He, Jing; Yang, Wenlan; Shi, Xue; Sun, Xingguo; Liu, Jinming

    2015-10-08

    This study intended to search for potential correlations between anaemia in patients with severe chronic obstructive pulmonary disease (COPD; GOLD stage III) and pulmonary function at rest, exercise capacity as well as ventilatory efficiency, using pulmonary function test (PFT) and cardiopulmonary exercise testing (CPET). The study was undertaken at Shanghai Pulmonary Hospital, a tertiary-level centre affiliated to Tongji University. It caters to a large population base within Shanghai and referrals from centres in other cities as well. 157 Chinese patients with stable severe COPD were divided into 2 groups: the anaemia group (haemoglobin (Hb) patients. (1) Diffusing capacity for carbon monoxide (DLCO) corrected by Hb was significantly lower in the anaemia group ((15.3±1.9) mL/min/mm Hg) than in the non-anaemia group ((17.1±2.1) mL/min/mm Hg) (p0.05). (2) Peak Load, Peak oxygen uptake (VO2), Peak VO2%pred, Peak VO2/kg, Peak O2 pulse and the ratio of VO2 increase to WR increase (ΔVO2/ΔWR) were significantly lower in the anaemia group (p0.05). (3) A strong positive correlation was found between Hb concentration and Peak VO2 in patients with anaemia (r=0.702, pexercise tolerance during exercise in patients with severe COPD. The decrease in amplitude of Hb levels is related to the quantity of oxygen uptake. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  19. Cardiorespiratory demand of acute voluntary cycling with functional electrical stimulation in individuals with multiple sclerosis with severe mobility impairment.

    Science.gov (United States)

    Edwards, Thomas; Motl, Robert W; Pilutti, Lara A

    2018-01-01

    Exercise training is one strategy for improving cardiorespiratory fitness (CRF) in multiple sclerosis (MS); however, few modalities are accessible for those with severe mobility impairment. Functional electrical stimulation (FES) cycling is an adapted exercise modality with the potential for improving CRF in people with severe MS. The objective of this study was to characterize the cardiorespiratory response of acute voluntary cycling with FES in people with MS with severe mobility impairment, and to compare this response to passive leg cycling. Eleven participants with MS that required assistance for ambulation completed a single bout of voluntary cycling with FES or passive leg cycling. Oxygen consumption, heart rate (HR), work rate (WR), and ratings of perceived exertion (RPE) were recorded throughout the session. For the FES group, mean exercising oxygen consumption was 8.7 ± 1.8 mL/(kg·min) -1 , or 63.5% of peak oxygen consumption. Mean HR was 102 ± 9.7 bpm, approximately 76.4% of peak HR. Mean WR was 27.0 ± 9.2 W, or 57.3% of peak WR, and median RPE was 13.5 (interquartile range = 5.5). Active cycling with FES was significantly (p cycling based on oxygen consumption, HR, WR, and RPE during exercise. In conclusion, voluntary cycling with FES elicited an acute response that corresponded with moderate-to vigorous-intensity activity, suggesting that active cycling with FES can elicit a sufficient stimulus for improving CRF.

  20. Adolescent–Adult Discrepancies on the Eating Disorder Examination: A Function of Developmental Stage or Severity of Illness?

    Science.gov (United States)

    Loeb, Katharine L.; Jones, Jennifer; Roberto, Christina A.; Gugga, S. Sonia; Marcus, Sue M.; Attia, Evelyn; Walsh, B. Timothy

    2014-01-01

    Objective Across studies, adolescents score lower on measures of eating disorder pathology than adults, but it is unclear whether such findings reflect discrepancies inherent to site/study or true developmental differences. The aim of this study was to determine whether age predicts subscale and diagnostic scores of the Eating Disorder Examination (EDE) in adolescents and adults with anorexia nervosa (AN) admitted to a single research center within the same period of time. Method The sample consisted of 16 adolescent and 20 adult consecutive admissions to parallel, age-specific, research-based AN treatment programs. Participants completed a baseline evaluation at admission that included the EDE, depression measures, and global assessment of functioning scales. Results Age significantly predicted EDE scores in univariate regression analyses. However, in multivariate models that included severity indices of general and specific psychopathology as covariates, age was no longer a significant predictor of severity of eating disorder symptoms. Discussion This study adds to the growing body of data showing lower scores on the EDE for adolescents with AN relative to their adult counterparts, while eliminating potential site confounds. Results indicate that the higher adult scores may be carried in part by a more overall severe and chronic general clinical profile. PMID:21823141

  1. Rib cage deformities alter respiratory muscle action and chest wall function in patients with severe osteogenesis imperfecta.

    Directory of Open Access Journals (Sweden)

    Antonella LoMauro

    Full Text Available BACKGROUND: Osteogenesis imperfecta (OI is an inherited connective tissue disorder characterized by bone fragility, multiple fractures and significant chest wall deformities. Cardiopulmonary insufficiency is the leading cause of death in these patients. METHODS: Seven patients with severe OI type III, 15 with moderate OI type IV and 26 healthy subjects were studied. In addition to standard spirometry, rib cage geometry, breathing pattern and regional chest wall volume changes at rest in seated and supine position were assessed by opto-electronic plethysmography to investigate if structural modifications of the rib cage in OI have consequences on ventilatory pattern. One-way or two-way analysis of variance was performed to compare the results between the three groups and the two postures. RESULTS: Both OI type III and IV patients showed reduced FVC and FEV(1 compared to predicted values, on condition that updated reference equations are considered. In both positions, ventilation was lower in OI patients than control because of lower tidal volume (p<0.01. In contrast to OI type IV patients, whose chest wall geometry and function was normal, OI type III patients were characterized by reduced (p<0.01 angle at the sternum (pectus carinatum, paradoxical inspiratory inward motion of the pulmonary rib cage, significant thoraco-abdominal asynchronies and rib cage distortions in supine position (p<0.001. CONCLUSIONS: In conclusion, the restrictive respiratory pattern of Osteogenesis Imperfecta is closely related to the severity of the disease and to the sternal deformities. Pectus carinatum characterizes OI type III patients and alters respiratory muscles coordination, leading to chest wall and rib cage distortions and an inefficient ventilator pattern. OI type IV is characterized by lower alterations in the respiratory function. These findings suggest that functional assessment and treatment of OI should be differentiated in these two forms of the

  2. Prenatal exposure to maternal very severe obesity is associated with impaired neurodevelopment and executive functioning in children.

    Science.gov (United States)

    Mina, Theresia H; Lahti, Marius; Drake, Amanda J; Denison, Fiona C; Räikkönen, Katri; Norman, Jane E; Reynolds, Rebecca M

    2017-07-01

    BackgroundPrenatal maternal obesity has been associated with an increased risk of neurocognitive problems in childhood, but there are fewer studies on executive functioning.MethodsTests and questionnaires to assess neurodevelopment, executive functioning, and the ability to delay gratification were conducted in 113 children (mean (SD)=4.24 (0.63) years of age) born to mothers with very severe obesity (SO, body mass index (BMI)⩾40 kg/m 2 , n=51) or to lean mothers (BMI⩽25 kg/m 2 , n=62).ResultsPrenatal maternal SO predicted poorer neurodevelopment (unstandardized regression coefficient (B)=-0.42, 95% confidence interval (CI) (-0.82; -0.02)), worse problem-solving (odd ratio (OR)=0.60, 95% CI (1.13; 0.07)), and fine motor skills (OR=4.91, 95% CI (1.27; 19.04)), poorer executive functioning in areas of attention, inhibitory control, and working memory (standardized B=3.75, 95% CI (1.01; 13.93)) but not in self-gratification delay. The effects were independent of maternal concurrent psychological well-being and child's BMI, but not independent of maternal education.ConclusionFuture studies should investigate whether perinatal management of maternal obesity could prevent adverse outcomes in child neurodevelopment.

  3. Coagulation pretreatment of highly concentrated acrylonitrile wastewater from petrochemical plants.

    Science.gov (United States)

    Zheng, Dongju; Qin, Lin; Wang, Tao; Ren, Xiaojing; Zhang, Zhongguo; Li, Jiding

    2014-01-01

    Acrylonitrile (AN) wastewater is a heavily polluted and a likely hazardous liquid that is generated during the production of AN. Several chemical methods for the pretreatment of AN wastewater are available in laboratory scale. However, the harsh reaction conditions and high operational cost make these methods undesirable. Until now, four-effect evaporation is the only pretreatment method used for AN wastewater in industry despite its huge energy consumption and high cost. It is difficult to find an energy-saving pretreatment technique from the perspective of industrial application. In this study, a safe and low-cost coagulation technique was developed for the pretreatment of AN wastewater. Three types of inorganic coagulant and three types of polymer coagulant were investigated for the coagulation treatment of highly concentrated AN wastewater from petrochemical plants. The effects of coagulant type, dosage, and coagulation conditions on the pretreatment efficiency of AN wastewater were investigated. The results show that a combination of inorganic and polymer coagulants is effective for the pretreatment of AN wastewater.

  4. Dilute sulfuric acid pretreatment of sunflower stalks for sugar production.

    Science.gov (United States)

    Ruiz, Encarnación; Romero, Inmaculada; Moya, Manuel; Cara, Cristóbal; Vidal, Juan D; Castro, Eulogio

    2013-07-01

    In this work the pretreatment of sunflower stalks by dilute sulfuric acid is studied. Pretreatment temperature and the concentration of acid solution were selected as operation variables and modified according to a central rotatable composite experimental design. Based on previous studies pretreatment time was kept constant (5 min) while the variation range for temperature and acid concentration was centered at 175°C and 1.25% (w/v) respectively. Following pretreatment the insoluble solids were separated by filtration and further submitted to enzymatic hydrolysis, while liquid fractions were analyzed for sugars and inhibitors. Response surface methodology was applied to analyze results based on the combined severity of pretreatment experiments. Optimized results show that up to 33 g of glucose and xylose per 100g raw material (65% of the glucose and xylose present in the raw material) may be available for fermentation after pretreatment at 167°C and 1.3% sulfuric acid concentration. Copyright © 2013 Elsevier Ltd. All rights reserved.

  5. Tomographic and functional findings in severe COPD: comparison between the wood smoke-related and smoking-related disease

    Energy Technology Data Exchange (ETDEWEB)

    Gonzalez-Garcia, Mauricio; Maldonado Gomez, Dario; Torres-Duque, Carlos A.; Barrero, Margarita; Jaramillo Villegas, Claudia; Perez, Juan Manuel; Varon, Humberto, E-mail: mgonzalez@neumologica.org [Colombian Pulmonology Foundation, Bogota (Colombia); Department of Radiology and Diagnostic Imaging, Children' s Cardiology Foundation, Cardiology Institute, Bogota (Colombia)

    2013-11-01

    Objective: Wood smoke exposure is a risk factor for COPD. For a given degree of airway obstruction, the reduction in DLCO is smaller in individuals with wood smoke-related COPD than in those with smoking-related COPD, suggesting that there is less emphysema in the former. The objective of this study was to compare HRCT findings between women with wood smoke-related COPD and women with smoking-related COPD. Methods: Twenty-two women with severe COPD (FEV1/FVC ratio < 70% and FEV1 < 50%) were divided into two groups: those with wood smoke-related COPD (n = 12) and those with smoking-related COPD (n = 10). The two groups were compared regarding emphysema scores and airway involvement (as determined by HRCT); and functional abnormalities-spirometry results, DLCO, alveolar volume (VA), the DLCO/VA ratio, lung volumes, and specific airway resistance (sRaw). Results: There were no significant differences between the two groups in terms of FEV1, sRaw, or lung hyperinflation. Decreases in DLCO and in the DLCO/VA ratio were greater in the smoking-related COPD group subjects, who also had higher emphysema scores, in comparison with the wood smoke-related COPD group subjects. In the wood smoke-related COPD group, HRCT scans showed no significant emphysema, the main findings being peribronchial thickening, bronchial dilation, and subsegmental atelectasis. Conclusions: Female patients with severe wood smoke-related COPD do not appear to develop emphysema, although they do show severe airway involvement. The reduction in DLCO and VA, with a normal DLCO/VA ratio, is probably due to severe bronchial obstruction and incomplete mixing of inspired gas during the determination of single-breath DLCO. (author)

  6. Tomographic and functional findings in severe COPD: comparison between the wood smoke-related and smoking-related disease

    International Nuclear Information System (INIS)

    Gonzalez-Garcia, Mauricio; Maldonado Gomez, Dario; Torres-Duque, Carlos A.; Barrero, Margarita; Jaramillo Villegas, Claudia; Perez, Juan Manuel; Varon, Humberto

    2013-01-01

    Objective: Wood smoke exposure is a risk factor for COPD. For a given degree of airway obstruction, the reduction in DLCO is smaller in individuals with wood smoke-related COPD than in those with smoking-related COPD, suggesting that there is less emphysema in the former. The objective of this study was to compare HRCT findings between women with wood smoke-related COPD and women with smoking-related COPD. Methods: Twenty-two women with severe COPD (FEV1/FVC ratio < 70% and FEV1 < 50%) were divided into two groups: those with wood smoke-related COPD (n = 12) and those with smoking-related COPD (n = 10). The two groups were compared regarding emphysema scores and airway involvement (as determined by HRCT); and functional abnormalities—spirometry results, DLCO, alveolar volume (VA), the DLCO/VA ratio, lung volumes, and specific airway resistance (sRaw). Results: There were no significant differences between the two groups in terms of FEV1, sRaw, or lung hyperinflation. Decreases in DLCO and in the DLCO/VA ratio were greater in the smoking-related COPD group subjects, who also had higher emphysema scores, in comparison with the wood smoke-related COPD group subjects. In the wood smoke-related COPD group, HRCT scans showed no significant emphysema, the main findings being peribronchial thickening, bronchial dilation, and subsegmental atelectasis. Conclusions: Female patients with severe wood smoke-related COPD do not appear to develop emphysema, although they do show severe airway involvement. The reduction in DLCO and VA, with a normal DLCO/VA ratio, is probably due to severe bronchial obstruction and incomplete mixing of inspired gas during the determination of single-breath DLCO. (author)

  7. Ultrasonic sludge pretreatment under pressure.

    Science.gov (United States)

    Le, Ngoc Tuan; Julcour-Lebigue, Carine; Delmas, Henri

    2013-09-01

    The objective of this work was to optimize the ultrasound (US) pretreatment of sludge. Three types of sewage sludge were examined: mixed, secondary and secondary after partial methanisation ("digested" sludge). Thereby, several main process parameters were varied separately or simultaneously: stirrer speed, total solid content of sludge (TS), thermal operating conditions (adiabatic vs. isothermal), ultrasonic power input (PUS), specific energy input (ES), and for the first time external pressure. This parametric study was mainly performed for the mixed sludge. Five different TS concentrations of sludge (12-36 g/L) were tested for different values of ES (7000-75,000 kJ/kgTS) and 28 g/L was found as the optimum value according to the solubilized chemical oxygen demand in the liquid phase (SCOD). PUS of 75-150 W was investigated under controlled temperature and the "high power input - short duration" procedure was the most effective at a given ES. The temperature increase in adiabatic US application significantly improved SCOD compared to isothermal conditions. With PUS of 150 W, the effect of external pressure was investigated in the range of 1-16 bar under isothermal and adiabatic conditions for two types of sludge: an optimum pressure of about 2 bar was found regardless of temperature conditions and ES values. Under isothermal conditions, the resulting improvement of sludge disintegration efficacy as compared to atmospheric pressure was by 22-67% and 26-37% for mixed and secondary sludge, respectively. Besides, mean particle diameter (D[4,3]) of the three sludge types decreased respectively from 408, 117, and 110 μm to about 94-97, 37-42, and 36-40 μm regardless of sonication conditions, and the size reduction process was much faster than COD extraction. Copyright © 2013 Elsevier B.V. All rights reserved.

  8. Enzymatic pre-treatment increases the protein bioaccessibility and extractability in dulse (Palmaria palmata)

    OpenAIRE

    Mæhre, Hanne K; Jensen, Ida-Johanne; Eilertsen, Karl-Erik

    2016-01-01

    Several common protein extraction protocols have been applied on seaweeds, but extraction yields have been limited. The aims of this study were to further develop and optimize existing extraction protocols and to examine the effect of enzymatic pre-treatment on bioaccessibility and extractability of seaweed proteins. Enzymatic pre-treatment of seaweed samples resulted in a three-fold increase in amino acids available for extraction. Combining enzymatic pre-treatment with a...

  9. Functionality and Outcome in Older Patients with Severe Aortic Stenosis (FOOPAS: an interdisciplinary study concept for a prospective trial

    Directory of Open Access Journals (Sweden)

    Vogt F

    2018-02-01

    Full Text Available Ferdinand Vogt,1 Susanne Wicklein,2 Markus Gosch,2 Jürgen Jessl,3 Wolfgang Hitzl,4 Theodor Fischlein,1 Matthias Pauschinger,3 Steffen Pfeiffer,1 Dennis Eckner3 1Department of Cardiac Surgery, Paracelsus Medical University, Nuremberg, Germany; 2Department of Geriatric Medicine, Paracelsus Medical University, Nuremberg, Germany; 3Department of Cardiology, Paracelsus Medical University, Nuremberg, Germany; 4Research Office – Biostatistics, Paracelsus Medical University, Salzburg, Austria Background: Frailty is a geriatric syndrome that can influence mortality and functional recovery after treatment of severe aortic stenosis (AS. The integration of standardized geriatric assessment (GA in clinical practice is limited by a lack of consensus on how to measure it. Objectives: This study aims to compare the incremental predictive value of different frailty scales to predict the outcomes following surgical aortic valve replacement, transcatheter aortic valve implantation, and conservative treatment of severe AS. Methods: A prospective cohort of 300 older adults with severe AS will be assembled after standard clinical examinations and a comprehensive GA, including 18 different tests and values. Primary outcome parameters are overall mortality, cardiovascular mortality, quality of life, and functionality. Secondary parameters are overall complications, cardiovascular complications, and costs. Results: Expected results will contribute to the growing body of evidence on frailty based on parameters that influence clinical and functional outcome in elderly patients independent of the method of treatment. The pre-procedural assessment is expected to be valuable in discriminating new post-procedural complications from simple exacerbations of pre-existing conditions. Therefore, a new frailty test which is simple and feasible for application in a clinical routine by most medical professionals, may help in identifying patients for whom further GA should be

  10. DNM1L Variant Alters Baseline Mitochondrial Function and Response to Stress in a Patient with Severe Neurological Dysfunction.

    Science.gov (United States)

    Hogarth, Kaley A; Costford, Sheila R; Yoon, Grace; Sondheimer, Neal; Maynes, Jason T

    2018-04-01

    Mitochondria play vital roles in brain development and neuronal activity, and mitochondrial dynamics (fission and fusion) maintain organelle function through the removal of damaged components. Dynamin-like protein-1 (DRP-1), encoded by DNM1L, is an evolutionarily conserved GTPase that mediates mitochondrial fission by surrounding the scission site in concentric ring-like structures via self-oligomerization, followed by GTPase-dependant constriction. Here, we describe the clinical characteristics and cellular phenotype of a patient with severe neurological dysfunction, possessing a homozygous DNM1L variant c.305C>T (p.T115M) in the GTPase domain. For comparative analysis, we also describe a previously identified heterozygous variant demonstrating a rapidly fatal neurocognitive phenotype (c.261dup/c.385:386del, p.W88M*9/E129K*6). Using patient-generated fibroblasts, we demonstrated both DNM1L variants undergo adverse alterations to mitochondrial structure and function, including impaired mitochondrial fission, reduced membrane potential, and lower oxidative capacity including an increased cellular level of reactive oxygen species (ROS) and dsDNA breaks. Mutation of DNM1L was also associated with impaired responses to oxidative stress, as treatment with hydrogen peroxide dramatically increased cellular ROS, with minimal exacerbation of already impaired mitochondrial function. Taken together, our observations indicate that homozygous p.T115M variant of DNM1L produces a neurological and neurodevelopmental phenotype, consistent with impaired mitochondrial architecture and function, through a diminished ability to oligomerize, which was most prevalent under oxidative stress.

  11. Estradiol improves right ventricular function in rats with severe angioproliferative pulmonary hypertension: effects of endogenous and exogenous sex hormones

    Science.gov (United States)

    Frump, Andrea L.; Goss, Kara N.; Vayl, Alexandra; Albrecht, Marjorie; Fisher, Amanda; Tursunova, Roziya; Fierst, John; Whitson, Jordan; Cucci, Anthony R.; Brown, M. Beth

    2015-01-01

    Estrogens are disease modifiers in PAH. Even though female patients exhibit better right ventricular (RV) function than men, estrogen effects on RV function (a major determinant of survival in PAH) are incompletely characterized. We sought to determine whether sex differences exist in RV function in the SuHx model of PAH, whether hormone depletion in females worsens RV function, and whether E2 repletion improves RV adaptation. Furthermore, we studied the contribution of ERs in mediating E2’s RV effects. SuHx-induced pulmonary hypertension (SuHx-PH) was induced in male and female Sprague-Dawley rats as well as OVX females with or without concomitant E2 repletion (75 μg·kg−1·day−1). Female SuHx rats exhibited superior CI than SuHx males. OVX worsened SuHx-induced decreases in CI and SuHx-induced increases in RVH and inflammation (MCP-1 and IL-6). E2 repletion in OVX rats attenuated SuHx-induced increases in RV systolic pressure (RVSP), RVH, and pulmonary artery remodeling and improved CI and exercise capacity (V̇o2max). Furthermore, E2 repletion ameliorated SuHx-induced alterations in RV glutathione activation, proapoptotic signaling, cytoplasmic glycolysis, and proinflammatory cytokine expression. Expression of ERα in RV was decreased in SuHx-OVX but was restored upon E2 repletion. RV ERα expression was inversely correlated with RVSP and RVH and positively correlated with CO and apelin RNA levels. RV-protective E2 effects observed in females were recapitulated in male SuHx rats treated with E2 or with pharmacological ERα or ERβ agonists. Our data suggest significant RV-protective ER-mediated effects of E2 in a model of severe PH. PMID:25713318

  12. Intrathymic injection of hematopoietic progenitor cells establishes functional T cell development in a mouse model of severe combined immunodeficiency.

    Science.gov (United States)

    Tuckett, Andrea Z; Thornton, Raymond H; O'Reilly, Richard J; van den Brink, Marcel R M; Zakrzewski, Johannes L

    2017-05-16

    Even though hematopoietic stem cell transplantation can be curative in patients with severe combined immunodeficiency, there is a need for additional strategies boosting T cell immunity in individuals suffering from genetic disorders of lymphoid development. Here we show that image-guided intrathymic injection of hematopoietic stem and progenitor cells in NOD-scid IL2rγ null mice is feasible and facilitates the generation of functional T cells conferring protective immunity. Hematopoietic stem and progenitor cells were isolated from the bone marrow of healthy C57BL/6 mice (wild-type, Luciferase + , CD45.1 + ) and injected intravenously or intrathymically into both male and female, young or aged NOD-scid IL2rγ null recipients. The in vivo fate of injected cells was analyzed by bioluminescence imaging and flow cytometry of thymus- and spleen-derived T cell populations. In addition to T cell reconstitution, we evaluated mice for evidence of immune dysregulation based on diabetes development and graft-versus-host disease. T cell immunity following intrathymic injection of hematopoietic stem and progenitor cells in NOD-scid IL2rγ null mice was assessed in a B cell lymphoma model. Despite the small size of the thymic remnant in NOD-scid IL2rγ null mice, we were able to accomplish precise intrathymic delivery of hematopoietic stem and progenitor cells by ultrasound-guided injection. Thymic reconstitution following intrathymic injection of healthy allogeneic hematopoietic cells was most effective in young male recipients, indicating that even in the setting of severe immunodeficiency, sex and age are important variables for thymic function. Allogeneic T cells generated in intrathymically injected NOD-scid IL2rγ null mice displayed anti-lymphoma activity in vivo, but we found no evidence for severe auto/alloreactivity in T cell-producing NOD-scid IL2rγ null mice, suggesting that immune dysregulation is not a major concern. Our findings suggest that intrathymic

  13. The immediate effect of soft tissue manual therapy intervention on lung function in severe chronic obstructive pulmonary disease

    Directory of Open Access Journals (Sweden)

    Cruz-Montecinos C

    2017-02-01

    Full Text Available Carlos Cruz-Montecinos,1–3 Diego Godoy-Olave,4 Felipe A Contreras-Briceño,5 Paulina Gutiérrez,4 Rodrigo Torres-Castro,2 Leandro Miret-Venegas,3 Roger M Engel6 1Laboratory of Biomechanics and Kinesiology, San José Hospital, Santiago, Chile; 2Department of Physical Therapy, Faculty of Medicine, University of Chile, Santiago, Chile; 3Unit of Kinesiology and Physical Therapy, San José Hospital, Santiago, Chile; 4Departamento de Kinesiología, Universidad Metropolitana de Ciencias de la Educación, Santiago, Chile; 5Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile; 6Department of Chiropractic, Macquarie University, Sydney, Australia Background and objective: In chronic obstructive pulmonary disease (COPD, accessory respiratory muscles are recruited as a compensatory adaptation to changes in respiratory mechanics. This results in shortening and overactivation of these and other muscles. Manual therapy is increasingly being investigated as a way to alleviate these changes. The aim of this study was to measure the immediate effect on lung function of a soft tissue manual therapy protocol (STMTP designed to address changes in the accessory respiratory muscles and their associated structures in patients with severe COPD.Methods: Twelve medically stable patients (n=12 with an existing diagnosis of severe COPD (ten: GOLD Stage III and two: GOLD Stage IV were included. Residual volume, inspiratory capacity and oxygen saturation (SpO2 were recorded immediately before and after administration of the STMTP. A Student’s t-test was used to determine the effect of the manual therapy intervention (P<0.05.Results: The mean age of the patients was 62.4 years (range 46–77. Nine were male. Residual volume decreased from 4.5 to 3.9 L (P=0.002, inspiratory capacity increased from 2.0 to 2.1 L (P=0.039 and SpO2 increased from 93% to 96% (P=0.001.Conclusion: A single application of an STMTP appears to have the potential to produce

  14. Bioelectrical impedance phase angle relates to function, disease severity and prognosis in stable chronic obstructive pulmonary disease.

    Science.gov (United States)

    Maddocks, Matthew; Kon, Samantha S C; Jones, Sarah E; Canavan, Jane L; Nolan, Claire M; Higginson, Irene J; Gao, Wei; Polkey, Michael I; Man, William D-C

    2015-12-01

    Bioelectrical impedance analysis (BIA) provides a simple method to assess changes in body composition. Raw BIA variables such as phase angle provide direct information on cellular mass and integrity, without the assumptions inherent in estimating body compartments, e.g. fat-free mass (FFM). Phase angle is a strong functional and prognostic marker in many disease states, but data in COPD are lacking. Our aims were to describe the measurement of phase angle in patients with stable COPD and determine the construct and discriminate validity of phase angle by assessing its relationship with established markers of function, disease severity and prognosis. 502 outpatients with stable COPD were studied. Phase angle and FFM by BIA, quadriceps strength (QMVC), 4-m gait speed (4MGS), 5 sit-to-stand time (5STS), incremental shuttle walk (ISW), and composite prognostic indices (ADO, iBODE) were measured. Patients were stratified into normal and low phase angle and FFM index. Phase angle correlated positively with FFM and functional outcomes (r = 0.35-0.66, p < 0.001) and negatively with prognostic indices (r = -0.35 to -0.48, p < 0.001). In regression models, phase angle was independently associated with ISW, ADO and iBODE whereas FFM was removed. One hundred and seventy patients (33.9% [95% CI, 29.9-38.1]) had a low phase angle. Phenotypic characteristics included lower QMVC, ISW, and 4MGS, higher 5STS, ADO and iBODE scores, and more exacerbations and hospital days in past year. The proportion of patients to have died was significantly higher in patients with low phase angle compared to those with normal phase angle (8.2% versus 3.6%, p = 0.02). Phase angle relates to markers of function, disease severity and prognosis in patients with COPD. As a directly measured variable, phase angle offers more useful information than fat-free mass indices. Copyright © 2015 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.

  15. SHARED, NOT UNIQUE, COMPONENTS OF PERSONALITY AND PSYCHOSOCIAL FUNCTIONING PREDICT DEPRESSION SEVERITY AFTER ACUTE-PHASE COGNITIVE THERAPY

    Science.gov (United States)

    Clark, Lee Anna; Vittengl, Jeffrey R.; Kraft, Dolores; Jarrett, Robin B.

    2005-01-01

    In a sample of 100 patients with recurrent major depression, we collected depression severity data early and late in acute-phase cognitive therapy, plus a wide range of psychosocial variables that have been studied extensively in depression research, including measures of interpersonal, cognitive, and social functioning, and personality traits using an inventory that is linked with the Big-Three tradition in personality assessment theory. By assessing this broad range of variables in a single study, we could examine the extent to which relations of these variables with depression were due to (a) a common factor shared across this diverse set of constructs, (b) factors shared among each type of construct (personality vs. psychosocial measures), or (c) specific aspects of the individual measures. Only the most general factor shared across the personality and psychosocial variables predicted later depression. PMID:14632375

  16. Tank Focus Area pretreatment activities

    International Nuclear Information System (INIS)

    McGinnis, C.P.; Welch, T.D.; Manke, K.L.

    1997-01-01

    Plans call for the high-level wastes to be retrieved from the tanks and immobilized in a stable waste form suitable for long-term isolation. Chemistry and chemical engineering operations are required to retrieve the wastes, to condition the wastes for subsequent steps, and to reduce the costs of the waste management enterprise. Pretreatment includes those processes between retrieval and immobilization, and includes preparation of suitable feed material for immobilization and separations to partition the waste into streams that yield lower life-cycle costs. Some of the technologies being developed by the Tank Focus Area (TFA) to process these wastes are described. These technologies fall roughly into three areas: (1) solid/liquid separation (SLS), (2) sludge pretreatment, and (3) supernate pretreatment

  17. A novel thyroid stimulating immunoglobulin bioassay is a functional indicator of activity and severity of Graves' orbitopathy.

    Science.gov (United States)

    Lytton, S D; Ponto, K A; Kanitz, M; Matheis, N; Kohn, L D; Kahaly, G J

    2010-05-01

    Immunoglobulins stimulating the TSH receptor (TSI) influence thyroid function and likely mediate extrathyroidal manifestations of Graves' disease (GD). The aim of this study was to assess the clinical relevance of TSI in GD patients with or without Graves' orbitopathy (GO), to correlate the TSI levels with activity/severity of GO, and to compare the sensitivity/specificity of a novel TSI bioassay with TSH receptor (TSH-R) binding methods (TRAb). TSI were tested in two reporter cell lines designed to measure Igs binding the TSH-R and transmitting signals for cAMP/CREB/cAMP regulatory element complex-dependent activation of luciferase gene expression. Responsiveness to TSI of the novel chimeric (Mc4) TSH-R (amino acid residues 262-335 of human TSH-R replaced by rat LH-R) was compared with the wild-type (wt) TSH-R. All hyperthyroid GD/GO patients were TSI-positive. TSI were detected in 150 of 155 (97%, Mc4) and 148 of 155 (95%, wt) GO patients, in six of 45 (13%, Mc4) and 20 of 45 (44%, wt) mostly treated GD subjects, and in 0 of 40 (Mc4) and one of 40 (wt) controls. Serum TSI titers were 3- and 8-fold higher in GO vs. GD and control, respectively. All patients with diplopia and optic neuropathy and smokers were TSI-positive. TSI strongly correlated with GO activity (r = 0.87 and r = 0.7; both P TSI were greater than TRAb in GO. All 11 of 200 (5.5%) TSI-positive/TRAb-negative patients had GO, whereas all seven of 200 (3.5%) TSI-negative/TRAb-positive subjects had GD only. The novel Mc4/TSI is a functional indicator of GO activity and severity.

  18. Urine pretreatment for waste water processing systems. [for space station

    Science.gov (United States)

    Winkler, H. E.; Verostko, C. E.; Dehner, G. F.

    1983-01-01

    Recovery of high quality water from urine is an essential part of life support on a Space Station to avoid costly launch and resupply penalties. Water can be effectively recovered from urine by distillation following pretreatment by a chemical agent to inhibit microorganism contamination and fix volatile ammonia constituents. This paper presents the results of laboratory investigations of several pretreatment chemicals which were tested at several concentration levels in combination with sulfuric acid in urine. The optimum pretreatment formulation was then evaluated with urine in the Hamilton Standard Thermoelectric Integrated Membrane Evaporation Subsystem (TIMES). Over 2600 hours of test time was accumulated. Results of these laboratory and system tests are presented in this paper.

  19. Severe Urban Outdoor Air Pollution and Children's Structural and Functional Brain Development, From Evidence to Precautionary Strategic Action.

    Science.gov (United States)

    D'Angiulli, Amedeo

    2018-01-01

    According to the latest estimates, about 2 billion children around the world are exposed to severe urban outdoor air pollution. Transdisciplinary, multi-method findings from epidemiology, developmental neuroscience, psychology, and pediatrics, show detrimental outcomes associated with pre- and postnatal exposure are found at all ages. Affected brain-related functions include perceptual and sensory information processing, intellectual and cognitive development, memory and executive functions, emotion and self-regulation, and academic achievement. Correspondingly, with the breakdown of natural barriers against entry and translocation of toxic particles in the brain, the most common structural changes are responses promoting neuroinflammation and indicating early neurodegenerative processes. In spite of the gaps in current scientific knowledge and the challenges posed by non-scientific issues that influence policy, the evidence invites the conclusion that urban outdoor air pollution is a serious threat to healthy brain development which may set the conditions for neurodegenerative diseases. Such evidence supports the perspective that urgent strategic precautionary actions, minimizing exposure and attenuating its effects, are needed to protect children and their brain development.

  20. Severe Urban Outdoor Air Pollution and Children’s Structural and Functional Brain Development, From Evidence to Precautionary Strategic Action

    Directory of Open Access Journals (Sweden)

    Amedeo D’Angiulli

    2018-04-01

    Full Text Available According to the latest estimates, about 2 billion children around the world are exposed to severe urban outdoor air pollution. Transdisciplinary, multi-method findings from epidemiology, developmental neuroscience, psychology, and pediatrics, show detrimental outcomes associated with pre- and postnatal exposure are found at all ages. Affected brain-related functions include perceptual and sensory information processing, intellectual and cognitive development, memory and executive functions, emotion and self-regulation, and academic achievement. Correspondingly, with the breakdown of natural barriers against entry and translocation of toxic particles in the brain, the most common structural changes are responses promoting neuroinflammation and indicating early neurodegenerative processes. In spite of the gaps in current scientific knowledge and the challenges posed by non-scientific issues that influence policy, the evidence invites the conclusion that urban outdoor air pollution is a serious threat to healthy brain development which may set the conditions for neurodegenerative diseases. Such evidence supports the perspective that urgent strategic precautionary actions, minimizing exposure and attenuating its effects, are needed to protect children and their brain development.

  1. Pharmacoresistant Severe Mental Health Disorders in Children and Adolescents: Functional Abnormalities of Cytochrome P450 2D6

    Directory of Open Access Journals (Sweden)

    Susanne Thümmler

    2018-01-01

    Full Text Available BackgroundSevere mental health disorders in children and adolescents represent a major public health problem. Despite adequate drug treatment, some patients develop pharmacoresistant disease. As a consequence, physicians are confronted with prescribing challenges, prolonged hospitalization and increased risk of adverse events, thus aggravating short-, medium-, and long-term prognosis. The majority of psychotropic treatments, particularly antipsychotics and antidepressants, are metabolized at hepatic level by cytochrome P450 (CYP, particularly by CYP3A4 and CYP2D6. Several CYP2D6 genetic polymorphisms are described to be associated with ultrarapid (UM or poor drug metabolism (PM, inducing clinical resistance and/or adverse events, and might therefore be related to pharmacoresistant severe mental health disease.Case presentationA total of nine pharmacoresistant patients (four females, five males aged 11–16 (mean 14.1 years have been genotyped for CYP2D6 between January, 2015 and April, 2016. Patients were diagnosed with schizophrenia (n = 5, autism spectrum disorders (n = 2, intellectual disability with challenging behavior (n = 2, oppositional defiant disorder (n = 1, and post-traumatic stress and borderline personality disorders (n = 1. They had a treatment history with on average 6.1 (3–9 psychotropic, 5 (3–7 antipsychotic, and 3.4 (2–5 CYP2D6-metabolized antipsychotic and antidepressant molecules. Five patients (56% presented functional anomalies of the CYP2D6 gene: three patients were UM metabolizers with gene duplication and two patients were PM with *4/*41 and *3/*4 polymorphisms.ConclusionFunctional anomalies of CYP2D6 concerned more than half of our pediatric inpatient sample with pharmacoresistant disease. However, our case reports are limited by the low sample size. Nevertheless, knowledge of individual metabolism and in particular CYP2D6 genotyping should be considered for clinical workup and therapy

  2. The Italian National Registry of severe acquired brain injury: epidemiological, clinical and functional data of 1469 patients.

    Science.gov (United States)

    Avesani, R; Roncari, L; Khansefid, M; Formisano, R; Boldrini, P; Zampolini, M; Ferro, S; De Tanti, A; Dambruoso, F

    2013-10-01

    The lack of knowledge about epidemiological and clinical data of patients with Acquired Brain Injury (ABI) admitted to Rehabilitation facilities in Italy led to the creation, in June 2008, of a data collection on-line registry. To collect epidemiological and clinical data and to evaluate functional outcome of patients with severe traumatic and non-traumatic ABI admitted to Rehabilitation facilities in Italy between June 2008 and December 2011 and to compare data of patients with ABI of different aetiologies. Observational retrospective study. The study involved 29 Italian Rehabilitation facilities. The study enrolled 1469 patients with severe traumatic (TBI) and non-traumatic ABI (NTBI). Data collected included demographic (number of patients with TBI and NTBI, gender, age) and clinical characteristics (provenience, number of days elapsed between onset and rehabilitation admission, rehabilitation length of stay, discharge destination, death and vegetative state diagnosis, presence of percutaneous endoscopic gastrostomy, tracheostomy, pressure sores and paraosteoarthropathies). Functional outcome was evaluated using the Disability Rating Scale. Of the whole population studied, 44.31% and 55.69% patients had suffered a TBI and a NTBI, respectively. In the NTBI group 40.09% had a cerebrovascular injury, 12.04% an anoxic brain damage, 3.6% had a brain injury of other causes. The mean age was 43.67 and 56.68 for subjects with TBI and NTBI, respectively. Patients with TBI showed a lower onset-admission interval (OAI), compared with NTBI group; no difference in rehabilitation length of stay (LOS) was recorded between groups. Patients with TBI presented a lower DRS score at admission and discharge and returned home more frequently than NTBI group. The creation of a National registry allows the collection of data about patients with ABI in order to study the clinical course, the functional outcome and to establish a basis for comparison with other data sources. Clinical

  3. Association of rs1285933 single nucleotide polymorphism in CLEC5A gene with dengue severity and its functional effects.

    Science.gov (United States)

    Xavier-Carvalho, Caroline; Cezar, Renata Duarte da Silva; Freire, Naishe Matos; Vasconcelos, Carla Maria Mola de; Solorzano, Victor Edgar Fiestas; de Toledo-Pinto, Thiago Gomes; Fialho, Luciana Gomes; do Carmo, Rodrigo Feliciano; Vasconcelos, Luydson Richardson Silva; Cordeiro, Marli Tenório; Baptista, Paulo; de Azeredo, Elzinandes Leal; da Cunha, Rivaldo Venâncio; de Souza, Luiz José; Pacheco, Antonio Guilherme; Kubelka, Claire Fernandes; Moura, Patrícia Muniz Mendes Freire de; Moraes, Milton Ozorio

    2017-10-01

    Outbreaks of the Zika, dengue, and chikungunya viruses, especially in the Americas, pose a global threat due to their rapid spread and difficulty controlling the vector. Extreme phenotypes are often observed, from asymptomatic to severe clinical manifestations, which are well-studied in dengue. Host variations are also important contributors to disease outcomes, and many case-control studies have associated single nucleotide polymorphisms (SNPs) with severe dengue. Here, we found that the TC genotype and T-carriers for SNP rs1285933 in the C-type lectin superfamily member 5 (CLEC5A) gene was associated with severe dengue in a Northern Brazilian population (OR=2.75 and p-value=0.01, OR=2.11 and p-value=0.04, respectively). We also tested the functional effect of the CLEC5A protein and found that it is upregulated on the surface of human monocytes after in vitro dengue infection. CLEC5A was correlated with viral load inside the monocytes (Spearman r=0.55, p=0.008) and TNF production in culture supernatants (Spearman r=0.72, p=0.03). Analysis of mRNA in blood samples from DENV4-infected patients exhibiting mild symptoms showed that CLEC5A mRNA expression is correlated with TNF (r=0.67, p=0.0001) and other immune mediators. Monocytes from rs1285933 TT/TC individuals showed lower CLEC5A expression compared to CC genotypes. However, in these cells, CLEC5A was not correlated with TNF production. In summary, we confirmed that CLEC5A is genetically associated with dengue severity outcome, playing a central role during the immune response triggered by a dengue viral infection, and rs1285933 is a relevant SNP that is able to regulate signaling pathways after interactions between the dengue virus and CLEC5A receptors. Copyright © 2017 American Society for Histocompatibility and Immunogenetics. Published by Elsevier Inc. All rights reserved.

  4. Severity and extent of coronary artery disease and their relationship to left ventricular functional reserve in the chronic disease state

    International Nuclear Information System (INIS)

    Tsuiki, Kai; Kanaya, Tohru; Hayasaka, Makio

    1985-01-01

    This study evaluated the usefulness of EF, MPD and the first-third filling fraction (FF, divided by the volume accrued throughout diastole) at rest and during stress, using ergometer and first-pass radionuclide angiocardiography (RNA), to determine the severity of CAD, and to evaluate any abnormalities in the systolic and diastolic coupling in left ventricular function during stress. Seventy-four patients with significant CAD, including 41 with previous transmural MI (MI group) and 33 without MI (angina group) were the subjects of this study. EF at rest and during stress inversely correlated, and MPD on stress linearly correlated with PS in angina group with PS > 10, while no such correlations were found in MI group. A normal EF response (ΔEF ≥ 5 %) was accompanied by a greater-than-normal response in FF (ΔFF) in both groups. A lower EF response was accompanied by a smaller ΔFF in angina group, but by a larger ΔFF in MI group. The difference was statistically significant (p < 0.03), without significant differences by age, PS, peak heart rate, systolic blood pressure, and ischemia on ECG during stress. Resting EF and FF by the RNA method correlated with those by left ventriculography (LVG), respectively. It was suggested that RNA is an accurate method for determining EF and FF, while phase analysis may provide some additional information different from that provided by LVG. We concluded that EF and MPD during stress are as useful as ΔMPD with the exception of a few cases in predicting the severity of CAD, and that scar tissue within the ventricular wall in MI may play an important role in determining the ventricular diastolic mechanical property during stress. (J.P.N.)

  5. Resting-state functional connectivity of the amygdala and longitudinal changes in depression severity in adolescent depression.

    Science.gov (United States)

    Connolly, Colm G; Ho, Tiffany C; Blom, Eva Henje; LeWinn, Kaja Z; Sacchet, Matthew D; Tymofiyeva, Olga; Simmons, Alan N; Yang, Tony T

    2017-01-01

    The incidence of major depressive disorder (MDD) rises during adolescence, yet the neural mechanisms of MDD during this key developmental period are unclear. Altered amygdala resting-state functional connectivity (RSFC) has been associated with both adolescent and adult MDD, as well as symptom improvement in response to treatment in adults. However, no study to date has examined whether amygdala RSFC is associated with changes in depressive symptom severity in adolescents. We examined group differences in amygdala RSFC between medication-naïve depressed adolescents (N=48) and well-matched healthy controls (N=53) cross-sectionally. We then longitudinally examined whether baseline amygdala RSFC was associated with change in depression symptoms three months later in a subset of the MDD group (N=24). Compared to healthy controls, depressed adolescents showed reduced amygdala-based RSFC with the dorsolateral prefrontal cortex (DLPFC)and the ventromedial prefrontal cortex (VMPFC). Within the depressed group, more positive baseline RSFC between the amygdala and insulae was associated with greater reduction in depression symptoms three months later. Only a subset of depressed participants was assessed at follow-up and treatment type and delivery were not standardized. Adolescent depression may be characterized by dysfunction of frontolimbic circuits (amygdala-DLPFC, amygdala-VMPFC) underpinning emotional regulation, whereas those circuits (amygdala-insula) subserving affective integration may index changes in depression symptom severity and may therefore potentially serve as a candidate biomarker for treatment response. Furthermore, these results suggest that the biomarkers of MDD presence are distinct from those associated with change in depression symptoms over time. Copyright © 2016 Elsevier B.V. All rights reserved.

  6. Picroside II Shows Protective Functions for Severe Acute Pancreatitis in Rats by Preventing NF-κB-Dependent Autophagy

    Directory of Open Access Journals (Sweden)

    Xuehua Piao

    2017-01-01

    Full Text Available Picroside II, from the herb Picrorhiza scrophulariiflora Pennell, has antioxidant and anti-inflammatory activities. However, its function on severe acute pancreatitis (SAP and molecular mechanism remains unknown. The effects of picroside II on the SAP induced by cerulean were investigated. SAP rats were treated with picroside II (25 mg/kg. The severity of SAP was evaluated by using biochemical and histological analyses. Pancreatic cancer cell PANC-1 was transfected with ptfLC3 (an indicator of autophagic activity, pcDNA3.1-NF-κB (nuclear factor kappa B, and pTZU6+1-NF-κB-shRNA and then treated with picroside II. Relative molecules related with NF-κB-dependent autophagy were detected by using Western blot. Autophagic activities were observed by phase-contrast and fluorescent microscopes. Acetylated LC3 was detected by immunoprecipitation. The results showed that picroside II treatment reduced the level of ALT, AST, NF-κB, IL-1β, IL-6, TNF-α, and SIRT1 (NAD+-dependent deacetylase and increased the level of SOD and GSH. The autophagic activity was reduced when NF-κB was silenced, and the levels of TNF-α and SIRT1 were reduced. In contrast, the overexpression of NF-κB increased autophagic activity and the level of TNF-α, which activated SIRT1. SIRT1 deacetylated LC3 and increased autophagic activities. Picroside II ameliorates SAP by improving antioxidant and anti-inflammtory activities of SAP models via NF-κB-dependent autophagy.

  7. Italian Bipolar II vs I patients have better individual functioning, in spite of overall similar illness severity.

    Science.gov (United States)

    Dell'Osso, Bernardo; Dobrea, Cristina; Cremaschi, Laura; Buoli, Massimiliano; Miller, Shefali; Ketter, Terence A; Altamura, A Carlo

    2017-08-01

    Introduction Bipolar disorders (BDs) comprise different variants of chronic, comorbid, and disabling conditions, with relevant suicide and suicide attempt rates. The hypothesis that BD types I (BDI) and II (BDII) represent more and less severe forms of illness, respectively, has been increasingly questioned over recent years, justifying additional investigation to better characterize related sociodemographic and clinical profiles. A sample of 217 outpatients with Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR)-described BD (141 BDI, 76 BDII), without a current syndromal mood episode, was recruited, and sociodemographic and clinical characteristics of BDI and II patients were compared. BDII patients had significantly more favorable sociodemographics, in relation to occupational stability, cohabitation, and marital status. However, BDII compared with BDI patients had significantly longer duration of untreated illness, more frequent lifetime anxiety disorders comorbidity, longer most recent episode duration, higher rate of depressive first/most recent episode, and more current antidepressant use. In contrast, BDI compared with BDII patients had significantly more severe illness in terms of earlier age at onset; higher rate of elevated first/most recent episode, lifetime hospitalizations, and involuntary commitments; lower Global Assessment of Functioning score; and more current antipsychotic use. BDI and II patients had similar duration of illness, psychiatric family history, lifetime number of suicide attempts, current subthreshold symptoms, history of stressful life events, and overall psychiatric/medical comorbidity. BDII compared with BDI patients had more favorable sociodemographic features, but a mixture of specific unfavorable illness characteristics, confirming that BDII is not just a milder form of BD and requires further investigation in the field.

  8. Functional result of the surgical treatment of the fractures opened up in the severely traumatised hind foot

    International Nuclear Information System (INIS)

    Ramos Tovar, William Domingo; Arroyo Sanchez, Carlos Augusto

    2006-01-01

    Present study plans to carry out an evaluation of the functional result of the surgical treatment of the open fractures of the severely traumatised hind foot, in the Hospital Militar Central during 1998 to 2002 for the above-mentioned we plane a descriptive retrospective study type: series of cases. We also think about specific objectives in relation to demographic aspects, aspects of the treatment and of the complications that are presented in these patients. For the functional evaluation we used the AOFAS (American Orthopaedic Foot and Ankle Society Scale) scale for the hind foot. 60 patients were included. 95% was men. The age average was of 26 years. The mechanism in 51% of the cases was trauma due to high-speed firearm (rifle), 27% trauma for mine, 12% fall of height, 7% has an accident of traffic, and 3% of firearm of low speed (gun). The presentation frequency according to the classification of Gustilo was type ll 12%, type lllA 63% and type IIIB 25%. In all the cases the initial care was begin with surgical debridement and take of cultures and I. V. antibiotics. The interval of time between the lesion and the definitive surgery was of 6 months (1 month to 24 months). The initial handling was orthopedic in 23 cases, open reduction and internal fixation in 16 cases, external fixation in 19 cases, and external fixation plus internal fixation in 2 cases. Additional surgeries were required in 48 cases, 8 of these were tibiotalar arthrodesis, 26 subtalar arthrodesis, 5 tibiocalcaneal arthrodesis, 5 panarthrodesis, 4 arthrodesis of the mid foot. The final average score according to the AOFAS scale for the hind foot was 81 points

  9. The influence of isolated thoracoplasty on the evolution of pulmonary function after treatment of severe thoracic scoliosis.

    Science.gov (United States)

    Koller, Heiko; Schulte, Tobias L; Meier, Oliver; Koller, Juliane; Bullmann, Viola; Hitzl, Wolfgang; Mayer, Michael; Lange, Tobias; Schmücker, Jens

    2017-06-01

    Isolated thoracoplasty (iTP) on the convex side is performed long time after scoliosis surgery has been performed. ITP is thought to cause a further decline in pulmonary function (PF); however, the amount of decline is ill defined. The objectives of this study were to examine the influence of iTP on the postoperative evolution of PF and rib hump reduction in patients that previously undergone scoliosis surgery. Over an 11-year period, 75 patients underwent iTP. The authors performed a retrospective case series review. Patients with data from PF tests performed preoperatively and at the last follow-up were included. Minimum follow-up was 12 months. The PF value reported was predicted FVC (FVC%). According to the American Thoracic Society, pulmonary impairment was classified as no impairment (FVC: >80-100%), mild (FVC: >65 ≤80%), moderate (FVC: >50 ≤65), and severe (FVC ≤50%). The outcome was studied using validated measures (SRS-24 score, COMI, and the COPD Assessment Test (CAT)). The CAT is stratified into mild impairment (20-30 pts), and disabled (>30 pts). Twenty-six patients fulfilled the inclusion criteria. The patients' average age was 28 years at surgery with iTP, and 22 were females; the average BMI was 23, and the average follow-up was 76 months. Twenty of the patients had AIS, and six had congenital scoliosis. The time between scoliosis correction and iTP averaged 39 months. The mean number of resected rib segments was 7, and the mean blood loss was 834 ml. FVC% was 66% preoperatively and 57% at follow-up, with a significant change of 9% (p 10. Two patients had a major complication. A comparison of patients with pulmonary impairment preoperation vs. follow-up found 4 vs. 1 patients had no PF impairment, 8 vs. 4 patients had mild impairment, 10 vs. 13 patients had moderate impairment, and 4 vs. 8 patients had severe impairment. Isolated TP was shown an effective technique for rib hump resection. Six years after iTP, the FVC% declined by an

  10. How preschool executive functioning predicts several aspects of math achievement in Grades 1 and 3: A longitudinal study.

    Science.gov (United States)

    Viterbori, Paola; Usai, M Carmen; Traverso, Laura; De Franchis, Valentina

    2015-12-01

    This longitudinal study analyzes whether selected components of executive function (EF) measured during the preschool period predict several indices of math achievement in primary school. Six EF measures were assessed in a sample of 5-year-old children (N = 175). The math achievement of the same children was then tested in Grades 1 and 3 using both a composite math score and three single indices of written calculation, arithmetical facts, and problem solving. Using previous results obtained from the same sample of children, a confirmatory factor analysis examining the latent EF structure in kindergarten indicated that a two-factor model provided the best fit for the data. In this model, inhibition and working memory (WM)-flexibility were separate dimensions. A full structural equation model was then used to test the hypothesis that math achievement (the composite math score and single math scores) in Grades 1 and 3 could be explained by the two EF components comprising the kindergarten model. The results indicate that the WM-flexibility component measured during the preschool period substantially predicts mathematical achievement, especially in Grade 3. The math composite scores were predicted by the WM-flexibility factor at both grade levels. In Grade 3, both problem solving and arithmetical facts were predicted by the WM-flexibility component. The results empirically support interventions that target EF as an important component of early childhood mathematics education. Copyright © 2015 Elsevier Inc. All rights reserved.

  11. Quality of life and psychiatric work impairment in compulsive buying: increased symptom severity as a function of acquisition behaviors.

    Science.gov (United States)

    Williams, Alishia D

    2012-08-01

    The aims of the current study were to determine if compulsive acquisition behaviors are meaningfully related to quality of life and psychiatric work impairment and to determine if compulsive buyers who engage in 2 forms of acquisition (buying and excessive acquisition of free items) are more impaired than individuals who only engage in 1 form of acquisition. In a community-recruited sample, analysis of covariance conducted between groups identified as noncompulsive buyers (NCB) (n = 30), compulsive buyers who did not acquire free items (CBB) (n = 30), and compulsive buyers who also acquired free items (CBF) (n = 35) revealed that both acquisition groups reported higher levels of depression and stress and lower quality of psychological well-being than the NCB group, despite a comparable number of individuals self-reporting a current mental health disorder in each group. The CBF group reported higher levels of anxiety and general distress as well as greater work inefficiency days compared with the NCB and CBB groups. Furthermore, regression analyses supported the unique contribution of acquisition of free items to the prediction of psychiatric work impairment. Taken together, the findings highlight the serious impact of compulsive buying on work functioning, general quality of life, and psychological well-being and provide avenues for future research to investigate the role of acquisition of free items in symptom severity. Limitations and future directions are discussed. Copyright © 2012 Elsevier Inc. All rights reserved.

  12. Intelligence quotient and cognitive functions in severe restricting-type anorexia nervosa before and after weight gain.

    Science.gov (United States)

    Koyama, Ken Ichiro; Asakawa, Akihiro; Nakahara, Toshihiro; Amitani, Haruka; Amitani, Marie; Saito, Masaki; Taruno, Yuka; Zoshiki, Takahiro; Cheng, Kai-Chun; Yasuhara, Daisuke; Inui, Akio

    2012-01-01

    Restricting-type anorexia nervosa (AN-R), characterized by severe emaciation with long-term food restriction, is often difficult to treat. The present study investigated the overall intelligence quotient (IQ) scores and cognitive functions of patients with AN-R. Fourteen female inpatients with AN-R (body mass index 12.84 ± 0.41 kg/m²) and 10 healthy female participants participated in this study from 2007 through 2010. The Wechsler Adult Intelligence Scale, Third Edition and the Eating Disorder Inventory-II were administered. This research was performed at Kagoshima University Hospital. In the AN-R group, overall IQ scores showed borderline intelligence (e.g., full-scale IQ 75.86 ± 1.79, P cognitive scores were unchanged. These lower IQ scores could be connected to the psychological and behavioral traits in patients with AN-R. These problems should be considered by medical staff members who seek to treat patients with AN-R successfully. Copyright © 2012 Elsevier Inc. All rights reserved.

  13. [Clinical study of Pentraxin 3 in diagnosing the severity and cardiovascular function of the children with sepsis].

    Science.gov (United States)

    Kang, Xiayan; Zhu, Yimin; Zhang, Xinping

    2015-08-01

    To study the value of Pentraxin 3 (PTX3) in diagnosing the severity and cardiovascular function of the critically ill children. Method A total of 178 patients who were older than 28 days, with acute infection of respiratory or neurological system, excluding chronic or special disease, and admitted to the pediatric intensive care unit (PICU) of Hunan Children's Hospital from October 1, 2013 to April 30, 2014 were enrolled, including 102 male cases and 76 female cases. The ages ranged from 1 month to 13 years and 1 month, 78 of them were less than 1 year old ; 58 cases were between 1 to 3 years old; 42 cases were above 3 years old; 101 cases were diagnosed as respiratory system diseases, 77 cases had nervous system diseases. PTX3 was detected with enzyme-linked immunosorbent assay (ELISA) within 1 d after enrollment, at 3 days and 7 days, meanwhile, troponin, myocardial enzyme, brain-type natriuretic peptide (BNP), C-reactive protein (CRP), plasma calcitonin (PCT) and WBC etc. Were measured. According to the plasma PTX3 value which were measured within 24 h after enrollment the patients were divided into three groups: mildly elevated group (prognosis for the patient. The continuous variables were analyzed with t-test, F-test, H-test, the categorical variables were analyzed with Chi-square test, and the correlation analysis was performed to calculate Pearson coefficients. The PTX3 value measured within 24 h after enrollment increased with the degree of infection (50. 4(35. 2,70. 4) µg/L; 175. 8 (99. 6, 309. 9) µg/L;419. 9 (168. 3, 468. 6) µg/L; H = 88. 345, P = 0. 000). PTX3 level gradually declined, while in severe sepsis group decreased slowly (P prognosis for these three groups were different (33 (80.5%) and 8 (19. 5%), 35 (53%) and 31 (47%), 28 (39.4%) and 43 (60.6%), χ = 17. 663, P = 0. 000). The K-M curve for these three groups had statistically significant difference (χ2 = 7. 086, P = 0. 029). Those with heart failure had higher PTX3 value than those in

  14. Synergistic Effect of Trehalose and Saccharose Pretreatment on ...

    African Journals Online (AJOL)

    2). Osmotic fragility is an important factor in the maintenance of RBC integrity and normal functions [23]. Trehalose and saccharose pretreatment synergistically decreased lyophilization-rehydration-induced damage on. RBC osmotic fragility by reducing the osmotic fragility (Fig. 3). PS is only distributed in the internal side of ...

  15. Autohydrolysis pretreatment assessment in ethanol production from agave bagasse.

    Science.gov (United States)

    Rios-González, Leopoldo J; Morales-Martínez, Thelma K; Rodríguez-Flores, María F; Rodríguez-De la Garza, José A; Castillo-Quiroz, David; Castro-Montoya, Agustín J; Martinez, Alfredo

    2017-10-01

    The aim of the present work was to assess the autohydrolysis pretreatment of Agave tequilana bagasse for ethanol production. The pretreatment was conducted using a one-liter high pressure Parr reactor under different severity factors (SF) at a 1:6w/v ratio (solid:liquid) and 200rpm. The solids obtained under the selected autohydrolysis conditions were subjected to enzymatic hydrolysis with a commercial cellulase cocktail, and the enzymatic hydrolysate was fermented using Saccharomyces cerevisiae. The results obtained from the pretreatment process showed that the glucan content in the pretreated solid was mostly preserved, and an increase in the digestibility was observed for the case with a SF of 4.13 (190°C, 30min). Enzymatic hydrolysis of the pretreated solids showed a yield of 74.3%, with a glucose concentration of 126g/L, resulting in 65.26g/L of ethanol after 10h of fermentation, which represent a 98.4% conversion according to the theoretical ethanol yield value. Copyright © 2017 Elsevier Ltd. All rights reserved.

  16. Comparison of the effect of high-dose inhaled budesonide and fluticasone on adrenal function in patients with severe chronic obstructive pulmonary disease

    Directory of Open Access Journals (Sweden)

    Ahmed Fahim

    2012-01-01

    Conclusion: Inhaled budesonide and fluticasone have no significantly different effect on adrenal function in moderate to severe COPD. The adverse event profile of high-dose inhaled steroids should not influence the choice of medication.

  17. The Impact of Carotid Artery Stenting on Cerebral Perfusion, Functional Connectivity, and Cognition in Severe Asymptomatic Carotid Stenosis Patients

    Directory of Open Access Journals (Sweden)

    Tao Wang

    2017-08-01

    Full Text Available Background and purposeAsymptomatic carotid artery stenosis can lead to not only stroke but also cognition impairment. Although it has been proven that carotid artery stenting (CAS can reduce the risk of future strokes, the effect of CAS on cognition is conflicting. In recent years, pulsed arterial spin labeling (pASL MRI and resting-state functional MRI (R-fMRI have been employed in cognitive impairment studies. For the present study, cognition is evaluated in severe asymptomatic carotid artery stenosis patients undergoing CAS, and the mechanisms underlying the cognitive change are explored by pASL MRI and R-fMRI.Materials and methodsWe prospectively enrolled 24 asymptomatic, severe (≥70%, unilateral internal carotid artery stenosis patients, who were expecting the intervention of CAS. Cognition assessment (including the Montreal Cognitive Assessment Beijing Version, the Minimum Mental State Examination, the Digit Symbol Test, the Rey Auditory Verbal Learning Test, and the Verbal Memory Test and an integrated MRI program (pASL MRI, and R-fMRI were administered 7 days before and 3 months after CAS.Results16 subjects completed the follow-up study. After stenting, significant improvement in the scores of the MMSE, the Verbal Memory test, and the delayed recall was found. No significant difference was found in the scores of the Montreal Cognitive Assessment Beijing Version, the Digit Symbol Test, and the immediate recall. After CAS treatment, asymptomatic carotid artery stenosis patients showed increased perfusion in the left frontal gyrus, increased amplitude of low-frequency fluctuation (ALFF in the right precentral gyrus, and increased connectivity to the posterior cingulate cortex (PCC in the right supra frontal gyrus. However, no significant correlations were found between these imaging changes and cognition assessments.ConclusionSuccessful CAS can partly improve cognition in asymptomatic carotid artery stenosis patients. The cognition

  18. ALA Pretreatment Improves Waterlogging Tolerance of Fig Plants.

    Directory of Open Access Journals (Sweden)

    Yuyan An

    Full Text Available 5-aminolevulinic acid (ALA, a natural and environmentally friendly plant growth regulator, can improve plant tolerance to various environmental stresses. However, whether ALA can improve plant waterlogging tolerance is unknown. Here, we investigated the effects of ALA pretreatment on the waterlogging-induced damage of fig (Ficus carica Linn. plants, which often suffer from waterlogging stress. ALA pretreatment significantly alleviated stress-induced morphological damage, increased leaf relative water content (RWC, and reduced leaf superoxide anion ([Formula: see text] production rate and malonaldehyde (MDA content in fig leaves, indicating ALA mitigates waterlogging stress of fig plants. We further demonstrated that ALA pretreatment largely promoted leaf chlorophyll content, photosynthetic electron transfer ability, and photosynthetic performance index, indicating ALA significantly improves plant photosynthetic efficiency under waterlogging stress. Moreover, ALA pretreatment significantly increased activities of leaf superoxide dismutase (SOD and peroxidase (POD, root vigor, and activities of root alcohol dehydrogenase (ADH, and lactate dehydrogenase (LDH, indicating ALA also significantly improves antioxidant ability and root function of fig plants under waterlogging stress. Taken together, ALA pretreatment improves waterlogging tolerance of fig plants significantly, and the promoted root respiration, leaf photosynthesis, and antioxidant ability may contribute greatly to this improvement. Our data firstly shows that ALA can improve plant waterlogging tolerance.

  19. Health/functioning characteristics, gambling behaviors and gambling-related motivations in adolescents stratified by gambling problem severity: Findings from a high-school survey

    OpenAIRE

    Yip, Sarah W.; Desai, Rani A.; Steinberg, Marvin A.; Rugle, Loreen; Cavallo, Dana A.; Krishnan-Sarin, Suchitra; Potenza, Marc N.

    2011-01-01

    In adults, different levels of gambling problem severity are differentially associated with measures of health and general functioning, gambling behaviors and gambling-related motivations. Here we present data from a survey of 2,484 Connecticut high school students, and investigate the data stratifying by gambling problem severity based on DSM-IV criteria for pathological gambling. Problem/pathological gambling was associated with a range of negative functions; e.g., poor academic performance...

  20. Oxygen-enhanced MRI for patients with connective tissue diseases: Comparison with thin-section CT of capability for pulmonary functional and disease severity assessment

    Energy Technology Data Exchange (ETDEWEB)

    Ohno, Yoshiharu, E-mail: yosirad@kobe-u.ac.jp [Advanced Biomedical Imaging Research Center, Kobe University Graduate School of Medicine, Kobe, Hyogo (Japan); Division of Functional and Diagnostic Imaging Research, Department of Radiology, Kobe University Graduate School of Medicine, Kobe, Hyogo (Japan); Nishio, Mizuho [Advanced Biomedical Imaging Research Center, Kobe University Graduate School of Medicine, Kobe, Hyogo (Japan); Division of Functional and Diagnostic Imaging Research, Department of Radiology, Kobe University Graduate School of Medicine, Kobe, Hyogo (Japan); Koyama, Hisanobu [Division of Radiology, Department of Radiology, Kobe University Graduate School of Medicine, Kobe, Hyogo (Japan); Yoshikawa, Takeshi; Matsumoto, Sumiaki [Advanced Biomedical Imaging Research Center, Kobe University Graduate School of Medicine, Kobe, Hyogo (Japan); Division of Functional and Diagnostic Imaging Research, Department of Radiology, Kobe University Graduate School of Medicine, Kobe, Hyogo (Japan); Seki, Shinichiro [Division of Radiology, Department of Radiology, Kobe University Graduate School of Medicine, Kobe, Hyogo (Japan); Tsubakimoto, Maho [Division of Radiology, Department of Radiology, Kobe University Graduate School of Medicine, Kobe, Hyogo (Japan); Department of Radiology, Graduate School of Medical Science, University of the Ryukyus, Nakagami-Gun, Okinawa (Japan); Sugimura, Kazuro [Division of Radiology, Department of Radiology, Kobe University Graduate School of Medicine, Kobe, Hyogo (Japan)

    2014-02-15

    Purpose: To prospectively and directly compare oxygen-enhanced (O{sub 2}-enhanced) MRI with thin-section CT for pulmonary functional loss and disease severity assessment in connective tissue disease (CTD) patients with interstitial lung disease (ILD). Materials and methods: Thin-section CT, O{sub 2}-enhanced MRI, pulmonary function test and serum KL-6 were administered to 36 CTD patients with ILD (23 men, 13 women; mean age: 63.9 years) and nine CTD patients without ILD (six men, and three women; mean age: 62.0 years). A relative-enhancement ratio (RER) map was generated from O{sub 2}-enhanced MRI and mean relative enhancement ratio (MRER) for each subject was calculated from all ROI measurements. CT-assessed disease severity was evaluated with a visual scoring system from each of the thin-section CT data. MRER and CT-assessed disease severities of CTD patients with and without ILD were then statistically compared. To assess capability for pulmonary functional loss and disease severity assessment in CTD patients, correlations of MRER and CT-assessed disease severity with pulmonary functional parameters and serum KL-6 in all subjects were statistically determined. Results: MRER and CT-assessed disease severity showed significant differences between CTD patients with (MRER: 0.15 ± 0.08, CT-assessed disease severity: 13.0 ± 7.4%) and without ILD (MRER: 0.25 ± 0.06, p = 0.0011; CT-assessed disease severity: 1.6 ± 1.6%, p < 0.0001). MRER and CT-assessed disease severity correlated significantly with pulmonary functional parameters and serum KL-6 in all subjects (0.61 ≤ r ≤ 0.79, p < 0.05). Conclusion: O{sub 2}-enhanced MRI was found to be as useful as thin-section CT for pulmonary functional loss and disease severity assessment of CTD patients with ILD.

  1. Oxygen-enhanced MRI for patients with connective tissue diseases: Comparison with thin-section CT of capability for pulmonary functional and disease severity assessment

    International Nuclear Information System (INIS)

    Ohno, Yoshiharu; Nishio, Mizuho; Koyama, Hisanobu; Yoshikawa, Takeshi; Matsumoto, Sumiaki; Seki, Shinichiro; Tsubakimoto, Maho; Sugimura, Kazuro

    2014-01-01

    Purpose: To prospectively and directly compare oxygen-enhanced (O 2 -enhanced) MRI with thin-section CT for pulmonary functional loss and disease severity assessment in connective tissue disease (CTD) patients with interstitial lung disease (ILD). Materials and methods: Thin-section CT, O 2 -enhanced MRI, pulmonary function test and serum KL-6 were administered to 36 CTD patients with ILD (23 men, 13 women; mean age: 63.9 years) and nine CTD patients without ILD (six men, and three women; mean age: 62.0 years). A relative-enhancement ratio (RER) map was generated from O 2 -enhanced MRI and mean relative enhancement ratio (MRER) for each subject was calculated from all ROI measurements. CT-assessed disease severity was evaluated with a visual scoring system from each of the thin-section CT data. MRER and CT-assessed disease severities of CTD patients with and without ILD were then statistically compared. To assess capability for pulmonary functional loss and disease severity assessment in CTD patients, correlations of MRER and CT-assessed disease severity with pulmonary functional parameters and serum KL-6 in all subjects were statistically determined. Results: MRER and CT-assessed disease severity showed significant differences between CTD patients with (MRER: 0.15 ± 0.08, CT-assessed disease severity: 13.0 ± 7.4%) and without ILD (MRER: 0.25 ± 0.06, p = 0.0011; CT-assessed disease severity: 1.6 ± 1.6%, p < 0.0001). MRER and CT-assessed disease severity correlated significantly with pulmonary functional parameters and serum KL-6 in all subjects (0.61 ≤ r ≤ 0.79, p < 0.05). Conclusion: O 2 -enhanced MRI was found to be as useful as thin-section CT for pulmonary functional loss and disease severity assessment of CTD patients with ILD

  2. Recovery of right heart function with temporary right ventricular assist using a centrifugal pump in patients with severe biventricular failure.

    Science.gov (United States)

    Saito, Shunsuke; Sakaguchi, Taichi; Miyagawa, Shigeru; Nishi, Hiroyuki; Yoshikawa, Yasushi; Fukushima, Satsuki; Daimon, Takashi; Sawa, Yoshiki

    2012-08-01

    Long-term outcomes of a biventricular assist device (BiVAD) support are worse than those of an isolated left ventricular assist device (LVAD) support. This study evaluated our strategy for right heart failure using a temporary right VAD (RVAD) with an extracorporeal centrifugal pump. From January 2001 to December 2010, 108 patients underwent LVAD implantation at our institution and their clinical outcomes were studied. A temporary centrifugal RVAD was implanted in 26 patients. Multivariate logistic regression revealed pre-operative extracorporeal life support (odds ratio [OR], 37.0), central venous pressure (OR, 1.2), mean pulmonary artery pressure (OR, 0.9), and serum total bilirubin (OR, 1.4) were the risk factors for RVAD requirement. RVAD-off test was conducted, and 11 of the 26 patients showed significant recovery of right heart function and were eventually removed from RVAD support. The survival of patients with isolated LVAD was significantly better than those with a paracorporeal pulsatile BiVAD (80% vs 11% at 1 year, p < 0.001). However, there was no significant difference between the survival of patients who underwent isolated LVAD support and those who were initially implanted with temporary BiVAD but underwent the RVAD removal (80% vs 73% at 1 year, p = 0.827). Our strategy with temporary RVAD for severe acute right heart failure was effective in selecting the patients who could be weaned from RVAD support. Patient survival was improved by avoiding the long-term support with a paracorporeal pulsatile BiVAD. Copyright © 2012 International Society for Heart and Lung Transplantation. Published by Elsevier Inc. All rights reserved.

  3. Differential Item Functioning Comparisons on a Performance-Based Alternate Assessment for Students with Severe Cognitive Impairments, Autism and Orthopedic Impairments

    Science.gov (United States)

    Laitusis, Cara Cahalan; Maneckshana, Behroz; Monfils, Lora; Ahlgrim-Delzell, Lynn

    2009-01-01

    The purpose of this study was to examine Differential Item Functioning (DIF) by disability groups on an on-demand performance assessment for students with severe cognitive impairments. Researchers examined the presence of DIF for two comparisons. One comparison involved students with severe cognitive impairments who served as the reference group…

  4. Adaptive Behaviors in High-Functioning Taiwanese Children with Autism Spectrum Disorders: An Investigation of the Mediating Roles of Symptom Severity and Cognitive Ability

    Science.gov (United States)

    Chang, Chen-Lin; Lung, For-Wey; Yen, Cheng-Fang; Yang, Pinchen

    2013-01-01

    We investigated the relationship among cognitive level, autistic severity and adaptive function in a Taiwanese sample of 94 high-functioning children with autism spectrum disorders (ASD) (mean full scale intelligent quotients FSIQ = 84.8). Parents and teachers both completed the Adaptive Behavior Assessment System-II and the Social Responsiveness…

  5. Pretreatment Solution for Water Recovery Systems

    Science.gov (United States)

    Muirhead, Dean (Inventor)

    2018-01-01

    Chemical pretreatments are used to produce usable water by treating a water source with a chemical pretreatment that contains a hexavalent chromium and an acid to generate a treated water source, wherein the concentration of sulfate compounds in the acid is negligible, and wherein the treated water source remains substantially free of precipitates after the addition of the chemical pretreatment. Other methods include reducing the pH in urine to be distilled for potable water extraction by pretreating the urine before distillation with a pretreatment solution comprising one or more acid sources selected from a group consisting of phosphoric acid, hydrochloric acid, and nitric acid, wherein the urine remains substantially precipitate free after the addition of the pretreatment solution. Another method described comprises a process for reducing precipitation in urine to be processed for water extraction by mixing the urine with a pretreatment solution comprising hexavalent chromium compound and phosphoric acid.

  6. Catheter-based intervention for symptomatic patient with severe mitral regurgitation and very poor left ventricular systolic function

    DEFF Research Database (Denmark)

    Loh, Poay Huan; Bourantas, Christos V; Chan, Pak Hei

    2015-01-01

    Many patients with left ventricular systolic dysfunction have concomitant mitral regurgitation (MR). Their symptoms and prognosis worsen with increasing severity of MR. Percutaneous MitraClip(®) can be used safely to reduce the severity of MR even in patients with advanced heart failure and is as......Many patients with left ventricular systolic dysfunction have concomitant mitral regurgitation (MR). Their symptoms and prognosis worsen with increasing severity of MR. Percutaneous MitraClip(®) can be used safely to reduce the severity of MR even in patients with advanced heart failure...

  7. Optimisation of dilute acid pre-treatment of artisan rice hulls for ethanol production

    International Nuclear Information System (INIS)

    Lopez, Yoney; Martin, Carlos; Gullon, Beatriz; Parajo, Juan Carlos

    2011-01-01

    Rice hulls are potential low-cost feedstocks for fuel ethanol production in many countries. In this work, the dilute-acid pre-treatment of artisan rice hulls was investigated using a central composite rotatable experimental design. The experimental variables were temperature (140-210 C), biomass load (5-20%) and sulphuric acid concentration (0.5-1.5 g per 100 g of reaction mixture). A total of 16 experimental runs, including a 23-plan, two replicates at the central point and six star points, were carried out. Low temperatures were found to be favourable for the hydrolysis of xylan and of the easily hydrolyzable glucan fraction. High glucose formation (up to 15.3 g/100 g), attributable to starch hydrolysis, was detected in the hydrolysates obtained under the least severe pre-treatment conditions. Using the experimental results, several models for predicting the effect of the operational conditions on the yield of pretreated solids, xylan and glucan conversion upon pre-treatment, and on enzymatic convertibility of cellulose were developed. Optimum results were predicted for the conversion of easily-hydrolyzable glucan in the material pretreated at 140.7 C, and for the enzymatic saccharification of cellulose in the material pretreated at 169 C. These results suggested the use of two-step acid hydrolysis as future pre-treatment strategy for artisan rice hulls. Key words: Dilute acid hydrolysis, enzymatic hydrolysis, pre-treatment, rice hulls. (author)

  8. Is there correlation between cognition and functionality in severe dementia? The value of a performance-based ecological assessment for Alzheimer’s disease

    Directory of Open Access Journals (Sweden)

    José R. Wajman

    2014-11-01

    Full Text Available Objective Besides significant cognitive decline, patients in later stages of Alzheimer's disease (AD also present global functional impairment, usually reported by their caregivers. This study searched for preserved activities of daily living by investigating correlations among specific instruments for severe dementia with a performance-based functional scale. Method A sample of 95 moderate to severe AD patients and their caregivers underwent a neuropsychological battery consisting of screening tools, the Functional Assessment Staging Test (FAST, the Severe Mini-Mental State Examination (MMSEsev and a performance-based ecological scale, the Performance Test of Activities of Daily Living (PADL. Results Consistent findings emerged from the comparisons among tests. PADL showed significant statistical correlation with MMSEsev (ρ<0.001, according to FAST subdivisions. Conclusion Upon suspicion of unreliable caregiver reports, ecological scales may be useful for disease staging. Variable degrees of functionality and cognition may be present even in later stages of AD, requiring proper assessment.

  9. Pedestrian injury risk functions based on contour lines of equal injury severity using real world pedestrian/passenger-car accident data.

    Science.gov (United States)

    Niebuhr, Tobias; Junge, Mirko; Achmus, Stefanie

    2013-01-01

    Injury risk assessment plays a pivotal role in the assessment of the effectiveness of Advanced Driver Assistance Systems (ADAS) as they specify the injury reduction potential of the system. The usual way to describe injury risks is by use of injury risk functions, i.e. specifying the probability of an injury of a given severity occurring at a specific technical accident severity (collision speed). A method for the generation of a family of risk functions for different levels of injury severity is developed. The injury severity levels are determined by use of a rescaled version of the Injury Severity Score (ISS) namely the ISSx. The injury risk curves for each collision speed is then obtained by fixing the boundary conditions and use of a case-by-case validated GIDAS subset of pedestrian-car accidents (N=852). The resultant functions are of exponential form as opposed to the frequently used logistic regression form. The exponential approach in combination with the critical speed value creates a new injury risk pattern better fitting for high speed/high energy crashes. Presented is a family of pedestrian injury risk functions for an arbitrary injury severity. Thus, the effectiveness of an ADAS can be assessed for mitigation of different injury severities using the same injury risk function and relying on the internal soundness of the risk function with regard to different injury severity levels. For the assessment of emergency braking ADAS, a Zone of Effective Endangerment Increase (ZEEI), the speed interval in which a one percent speed increase results at least in a one percent of injury risk increase, is defined. The methodology presented is kept in such general terms that a direct adaption to other accident configurations is easily done.

  10. Surface properties correlate to the digestibility of hydrothermally pretreated lignocellulosic Poaceae biomass feedstocks

    DEFF Research Database (Denmark)

    Tristan Djajadi, Demi; Hansen, Aleksander R.; Jensen, Anders

    2017-01-01

    in response to hydrothermal pretreatment at different severities are still not sufficiently understood. Results: Potentially important lignocellulosic feedstocks for biorefining, corn stover (Zea mays subsp. mays L.), stalks of Miscanthus × giganteus, and wheat straw (Triticum aestivum L.) were systematically...

  11. Does anterior knee pain severity and function relate to the frontal plane projection angle and trunk and hip strength in women with patellofemoral pain?

    Science.gov (United States)

    Almeida, Gabriel Peixoto Leão; Carvalho E Silva, Ana Paula de Moura Campos; França, Fábio Jorge Renovato; Magalhães, Maurício Oliveira; Burke, Thomaz Nogueira; Marques, Amélia Pasqual

    2015-07-01

    The aim of the present study was to determine the relationship between knee pain severity and function with the frontal plane projection angle (FPPA) and trunk and hip peak torque (PT) in women with patellofemoral pain (PFPS). Twenty-two women with PFPS were assessed. Knee pain severity (KPS) was assessed with an 11-point visual analog scale and function with an Anterior Knee Pain Scale. The FPPA was recorded with a digital camera. PT of extensors, abductors, and the lateral rotators of hip and lateral core stability were measured with a handheld dynamometer. FPPA was the only predictor for the KPS. Regarding predictors of function, PT of lateral core stability and the extensor and abductor of the hip explained 41.4% of the function. Increase in FPPA was associated with greater KPS, and the lowest PT of lateral core stability, hip abductors, and extensors was associated with lower function in women with PFPS. Copyright © 2015 Elsevier Ltd. All rights reserved.

  12. Methods for assessing diabetic polyneuropathy : validity and reproducibility of the measurement of sensory symptom severity and nerve function tests

    NARCIS (Netherlands)

    Valk, G D; Grootenhuis, P A; van Eijk, J T; Bouter, L M; Bertelsmann, F W

    The usefulness of sensory symptoms in the assessment of diabetic polyneuropathy is unclear. In the present study, we studied the hypothesis that pain is associated with small nerve fibre function, and that sensory alteration is associated with large nerve fibre function. In addition, we assessed the

  13. Methods for assessing diabetic polyneuropathy: validity and reproducibility of the measurement of sensory symptom severity and nerve function tests.

    NARCIS (Netherlands)

    Valk, G.D.; Grootenhuis, P.A.; van Eijk, J.T.M.; Bouter, L.M.; Bertelsmann, F.W.

    2000-01-01

    The usefulness of sensory symptoms in the assessment of diabetic polyneuropathy is unclear. In the present study, we studied the hypothesis that pain is associated with small nerve fibre function, and that sensory alteration is associated with large nerve fibre function. In addition, we assessed the

  14. Behavioral Compliance and Devaluation of the Forbidden Object as a Function of Probability of Detection and Severity of Threat

    Science.gov (United States)

    Biaggio, Angela; Rodrigues, Aroldo

    1971-01-01

    Thirty-nine second grade children were subjects of an experiment devised to test the prediction derived from cognitive dissonance theory that mild threats are more effective than severe threats in obtaining internalization of prohibitions. (Author/NH)

  15. Method for pretreating lignocellulosic biomass

    Science.gov (United States)

    Kuzhiyil, Najeeb M.; Brown, Robert C.; Dalluge, Dustin Lee

    2015-08-18

    The present invention relates to a method for pretreating lignocellulosic biomass containing alkali and/or alkaline earth metal (AAEM). The method comprises providing a lignocellulosic biomass containing AAEM; determining the amount of the AAEM present in the lignocellulosic biomass; identifying, based on said determining, the amount of a mineral acid sufficient to completely convert the AAEM in the lignocellulosic biomass to thermally-stable, catalytically-inert salts; and treating the lignocellulosic biomass with the identified amount of the mineral acid, wherein the treated lignocellulosic biomass contains thermally-stable, catalytically inert AAEM salts.

  16. Steam explosion pretreatment for enhancing biogas production of late harvested hay.

    Science.gov (United States)

    Bauer, Alexander; Lizasoain, Javier; Theuretzbacher, Franz; Agger, Jane W; Rincón, María; Menardo, Simona; Saylor, Molly K; Enguídanos, Ramón; Nielsen, Paal J; Potthast, Antje; Zweckmair, Thomas; Gronauer, Andreas; Horn, Svein J

    2014-08-01

    Grasslands are often abandoned due to lack of profitability. Extensively cultivating grassland for utilization in a biogas-based biorefinery concept could mend this problem. Efficient bioconversion of this lignocellulosic biomass requires a pretreatment step. In this study the effect of different steam explosion conditions on hay digestibility have been investigated. Increasing severity in the pretreatment induced degradation of the hemicellulose, which at the same time led to the production of inhibitors and formation of pseudo-lignin. Enzymatic hydrolysis showed that the maximum glucose yields were obtained under pretreatment at 220 °C for 15 min, while higher xylose yields were obtained at 175 °C for 10 min. Pretreatment of hay by steam explosion enhanced 15.9% the methane yield in comparison to the untreated hay. Results indicate that hay can be effectively converted to methane after steam explosion pretreatment. Copyright © 2014 Elsevier Ltd. All rights reserved.

  17. The use of injectable calcium hydroxylapatite in the surgically pretreated larynx with glottal insufficiency.

    Science.gov (United States)

    Caffier, Philipp P; I Nasr, Ahmed; Weikert, Sebastian; Rummich, Julius; Gross, Manfred; Nawka, Tadeus

    2017-05-01

    To evaluate the efficacy of vocal fold (VF) augmentation with calcium hydroxylapatite (CaHA) microspheres in the surgically pretreated larynx with glottal insufficiency. Prospective clinical pilot study. After several prior reconstructive attempts (following tumor resection, VF paralysis, in sulcus vocalis, and VF scarring), CaHA was injected under general anaesthesia using a transoral microlaryngoscopic approach in 10 patients with residual glottal insufficiency ≤1.5 mm. The postinterventional result was assessed after 1 day, and 1 and 3 months. Evaluation of augmentation comprised intraoperative video/photo documentation, pre-/postoperative videolaryngostroboscopy, as well as established subjective and objective voice function diagnostics (Grade, Roughness, Breathiness [GRB] Scale; Voice Handicap Index; voice range profile; and acoustic-aerodynamic analysis). In the pretreated VF with no or minimal lamina propria remaining, the exact placement of CaHA was not possible due to unpredictable propagation into the scarred tissue. The results showed an insufficient postoperative augmentation. Accordingly, the voice function did not improve. However, a significant increase of the vocal range from 6.2 ± 3.2 to 8.7 ± 3.9 semitones was observed in the speaking voice profile (P =.02). All other acoustic and aerodynamic parameters remained on the whole unchanged; the slight differences between pre- and postoperative findings were not significant. The application of CaHA in the surgically pretreated scarred larynx is not reliable to achieve a sufficient glottal closure and a satisfactory improvement of voice. Though CaHA is a welcome addition to our armamentarium against glottal insufficiency, the suitability for augmentation of scar tissue in the larynx must be considered carefully in each individual case. 4 Laryngoscope, 127:1125-1130, 2017. © 2016 The American Laryngological, Rhinological and Otological Society, Inc.

  18. Subthreshold depression based on functional impairment better defined by symptom severity than by number of DSM-IV symptoms

    OpenAIRE

    Karsten, J.; Hartman, C. A.; Ormel, J.; Nolen, W. A.; Penninx, B. W. J. H.

    2010-01-01

    Background: Depression with fewer symptoms than required for a DSM-IV diagnosis of Major Depressive Disorder (MDD) has consistently been found to be associated with functional impairment. In this study, we aim to define clinically significant depression below the DSM-IV threshold for Major Depressive Disorder (MOD) by means of functional impairment. Methods: Data used are from 2157 respondents of the Netherlands Study of Depression and Anxiety (NESDA). The Composite International Diagnostic I...

  19. Validation of the efficiency of a robotic rehabilitation training system for recovery of severe plegie hand motor function after a stroke.

    Science.gov (United States)

    Tanabe, Hirofumi; Ikuta, Munehiro; Morita, Yoshifumi

    2017-07-01

    We have developed a rehabilitation training system called the Useful and Ultimate Rehabilitation System PARKO (UR System PARKO) to promote the recovery of motor function of the severe chronic plegic hand of stroke patients. This system was equipped with two functions to realize two conditions: (1) fixing of all fingers to a hyperextended position and (2) extending the elbow joint while applying resistance load to the fingertips. A clinical test was conducted with two patients to determine the therapeutic effect of the UR System PARKO for severe plegic hand. In both patients, the active ranges of motion of finger extension improved after training with the UR System PARKO. Moreover, the Modified Ashworth scale scores of finger extension increased. Thus, training reduced the spastic paralysis. These results suggest the effectiveness of training with the UR System PARKO for recovery of motor function as reflected in the finger extension of the severe plegic hand.

  20. The impacts of deacetylation prior to dilute acid pretreatment on the bioethanol process.

    Science.gov (United States)

    Chen, Xiaowen; Shekiro, Joseph; Franden, Mary Ann; Wang, Wei; Zhang, Min; Kuhn, Erik; Johnson, David K; Tucker, Melvin P

    2012-02-27

    Dilute acid pretreatment is a promising pretreatment technology for the biochemical production of ethanol from lignocellulosic biomass. During dilute acid pretreatment, xylan depolymerizes to form soluble xylose monomers and oligomers. Because the xylan found in nature is highly acetylated, the formation of xylose monomers requires two steps: 1) cleavage of the xylosidic bonds, and 2) cleavage of covalently bonded acetyl ester groups. In this study, we show that the latter may be the rate limiting step for xylose monomer formation. Furthermore, acetyl groups are also found to be a cause of biomass recalcitrance and hydrolyzate toxicity. While the removal of acetyl groups from native corn stover by alkaline de-esterification prior to pretreatment improves overall process yields, the exact impact is highly dependent on the corn stover variety in use. Xylose monomer yields in pretreatment generally increases by greater than 10%. Compared to pretreated corn stover controls, the deacetylated corn stover feedstock is approximately 20% more digestible after pretreatment. Finally, by lowering hydrolyzate toxicity, xylose utilization and ethanol yields are further improved during fermentation by roughly 10% and 7%, respectively. In this study, several varieties of corn stover lots were investigated to test the robustness of the deacetylation-pretreatment-saccharification-fermentation process. Deacetylation shows significant improvement on glucose and xylose yields during pretreatment and enzymatic hydrolysis, but it also reduces hydrolyzate toxicity during fermentation, thereby improving ethanol yields and titer. The magnitude of effect is dependent on the selected corn stover variety, with several varieties achieving improvements of greater than 10% xylose yield in pretreatment, 20% glucose yield in low solids enzymatic hydrolysis and 7% overall ethanol yield.

  1. The impacts of deacetylation prior to dilute acid pretreatment on the bioethanol process

    Directory of Open Access Journals (Sweden)

    Chen Xiaowen

    2012-02-01

    Full Text Available Abstract Background Dilute acid pretreatment is a promising pretreatment technology for the biochemical production of ethanol from lignocellulosic biomass. During dilute acid pretreatment, xylan depolymerizes to form soluble xylose monomers and oligomers. Because the xylan found in nature is highly acetylated, the formation of xylose monomers requires two steps: 1 cleavage of the xylosidic bonds, and 2 cleavage of covalently bonded acetyl ester groups. Results In this study, we show that the latter may be the rate limiting step for xylose monomer formation. Furthermore, acetyl groups are also found to be a cause of biomass recalcitrance and hydrolyzate toxicity. While the removal of acetyl groups from native corn stover by alkaline de-esterification prior to pretreatment improves overall process yields, the exact impact is highly dependent on the corn stover variety in use. Xylose monomer yields in pretreatment generally increases by greater than 10%. Compared to pretreated corn stover controls, the deacetylated corn stover feedstock is approximately 20% more digestible after pretreatment. Finally, by lowering hydrolyzate toxicity, xylose utilization and ethanol yields are further improved during fermentation by roughly 10% and 7%, respectively. In this study, several varieties of corn stover lots were investigated to test the robustness of the deacetylation-pretreatment-saccharification-fermentation process. Conclusions Deacetylation shows significant improvement on glucose and xylose yields during pretreatment and enzymatic hydrolysis, but it also reduces hydrolyzate toxicity during fermentation, thereby improving ethanol yields and titer. The magnitude of effect is dependent on the selected corn stover variety, with several varieties achieving improvements of greater than 10% xylose yield in pretreatment, 20% glucose yield in low solids enzymatic hydrolysis and 7% overall ethanol yield.

  2. The joint association of depression and cognitive function with severe disability among community-dwelling older adults in Finland, Poland and Spain.

    Science.gov (United States)

    Olaya, Beatriz; Moneta, Maria Victoria; Koyanagi, Ai; Lara, Elvira; Miret, Marta; Ayuso-Mateos, José Luis; Chatterji, Somnath; Leonardi, Matilde; Koskinen, Seppo; Tobiasz-Adamczyk, Beata; Lobo, Antonio; Haro, Josep Maria

    2016-04-01

    To explore the joint association of depression and cognitive function with severe disability in nationally-representative samples of community-dwelling adults aged 50 years and older from Finland, Poland and Spain. Cross-sectional. Community-based. Population-based sample of 7987 non-institutionalized adults aged 50 and older. The outcome was severe disability, defined as ≥ 90th percentile of the 12-item version of the World Health Organization Disability Assessment Schedule (WHODAS 2.0). Past 12-month DSM-IV major depressive disorder was assessed with the depression module of the WHO Composite International Diagnostic Interview (CIDI). A global cognitive function score was obtained through neuropsychological tests. Product terms between depression and cognition were introduced in multivariable logistic regression models to test for interaction. Lower cognitive function and depression were both significantly associated with severe disability in all countries. A significant interaction was only found in Finland where the ORs (95% CIs) of depression for severe disability at the 25th (worse), 50th, and 75th (better) percentiles of cognitive function were 7.26 (4.28-12.32), 11.1 (6.7-18.38), and 17.56 (9.29-33.2), respectively. People with depression and cognitive decline are likely to benefit from the usual evidence-based treatments to reduce the burden of disability. However, in Finland, those with better cognitive function may benefit from more aggressive depression treatment. Future research is warranted to assess whether our results may be replicated.

  3. Stuttering Severity and Educational Attainment

    Science.gov (United States)

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

    2011-01-01

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

  4. A functional brain-derived neurotrophic factor (BDNF) gene variant increases the risk of moderate-to-severe allergic rhinitis

    NARCIS (Netherlands)

    Jin, Peng; Andiappan, Anand Kumar; Quek, Jia Min; Lee, Bernett; Au, Bijin; Sio, Yang Yie; Irwanto, Astrid; Schurmann, Claudia; Grabe, Hans Joergen; Suri, Bani Kaur; Matta, Sri Anusha; Westra, Harm-Jan; Franke, Lude; Esko, Tonu; Sun, Liangdan; Zhang, Xuejun; Liu, Hong; Zhang, Furen; Larbi, Anis; Xu, Xin; Poidinger, Michael; Liu, Jianjun; Chew, Fook Tim; Rotzschke, Olaf; Shi, Li; Wang, De Yun

    Background: Brain-derived neurotrophic factor (BDNF) is a secretory protein that has been implicated in the pathogenesis of allergic rhinitis (AR), atopic asthma, and eczema, but it is currently unknown whether BDNF polymorphisms influence susceptibility to moderate-to-severe AR. Objective: We

  5. NK cells are intrinsically functional in pigs with Severe Combined Immunodeficiency (SCID) caused by spontaneous mutations in the Artemis gene

    Science.gov (United States)

    We have identified Severe Combined Immunodeficiency (SCID) in a line of Yorkshire pigs at Iowa State University. These SCID pigs lack B-cells and T-cells, but possess Natural Killer (NK) cells. This SCID phenotype is caused by recessive mutations in the Artemis gene. Interestingly, two human tumor c...

  6. Effects of MISC Intervention on Cognition, Autonomy, and Behavioral Functioning of Adult Consumers with Severe Intellectual Disability

    Science.gov (United States)

    Lifshitz, Hefziba; Klein, Pnina S.; Cohen, Sara Fridel

    2010-01-01

    This study examined the effects of a yearlong Mediational Intervention for Sensitizing Caregivers (MISC; Klein, 1992) on: (a) the quality of interactions between rehabilitation day center paraprofessional staff (n=10) and their adult consumers (n=19) with severe intellectual disability (ID) and (b) the consumers' cognition, autonomy, and…

  7. The Relationship between Cultural Background and Parental Perceptions of Functional Educational Programming for Students with Severe Handicaps.

    Science.gov (United States)

    Rivers, Eileen

    The study examined whether a relationship exists between cultural background (Caucasian, Hispanic, or Black) and families' attitudes toward educational programming for a family member with severe disabilities. Useable surveys were returned by 91 respondents out of the 103 of 337 families (31%) to whom surveys had been distributed. The 40-item…

  8. [Severe diarrhea after the original well-functioning percutaneous endoscopic gastrostomy tube was replaced by a Mic-Key button].

    Science.gov (United States)

    Jensen, Susanne Wigh; Eriksen, Jan; Kristensen, Kurt

    2006-03-06

    We report two cases of colocutaneous fistula as a complication of percutaneous endoscopic gastrostomy (PEG) in small children. Both children developed severe osmotic diarrhoea immediately after the original PEG tube was replaced by a Mic-Key button which subsequently migrated to the colon.

  9. Survey of Lignin-Structure Changes and Depolymerization during Ionic Liquid Pretreatment

    Energy Technology Data Exchange (ETDEWEB)

    Dutta, Tanmoy; Isern, Nancy G.; Sun, Jian; Wang, Eileen; Hull, Sarah; Cort, John R.; Simmons, Blake A.; Singh, Seema

    2017-09-26

    A detailed study of chemical changes in lignin structure during the ionic liquid (IL) pretreatment process is not only pivotal for understanding and overcoming biomass recalcitrance during IL pretreatment, but also is necessary for designing new routes for lignin valorization. Chemical changes in lignin were systematically studied as a function of pretreatment temperature, time and type of IL used. Kraft lignin was used as the lignin source and common pretreatment conditions were employed using three different ILs of varying chemical structure in terms of acidic or basic character. The chemical changes in the lignin structure due to IL pretreatment processes were monitored using 1H-13C HSQC NMR, 31P NMR, elemental analysis, GPC, FT-IR, and the depolymerized products were analyzed using GC-MS. Although pretreatment in acidic IL, triethylammonium hydrogensulfate ([TEA][HSO4]) results in maximum decrease in β-aryl ether bond, maximum dehydration and recondensation pathways were also evident, with the net process showing a minimum decrease in the molecular weight of regenerated lignin. However, 1-ethyl-3-methylimidazolium acetate ([C2C1Im][OAc]) pretreatment yields a smaller decrease in the β-aryl ether content along with minimum evidence of recondensation, resulting in the maximum decrease in the molecular weight. Cholinium lysinate ([Ch][Lys]) pretreatment shows an intermediate result, with moderate depolymerization, dehydration and recondensation observed. The depolymerization products after IL pretreatment are found to be a function of the pretreatment temperature and the specific chemical nature of the IL used. At higher pretreatment temperature, [Ch][Lys] pretreatment yields guaiacol, [TEA][HSO4] yields guaiacylacetone, and [C2C1Im][OAc] yields both guaiacol and guaiacylacetone as major products. These results clearly indicate that the changes in lignin structure as well as the depolymerized product profile depend on the pretreatment conditions and the nature

  10. The Use of Clay-Polymer Nanocomposites in Wastewater Pretreatment

    Science.gov (United States)

    Rytwo, Giora

    2012-01-01

    Some agricultural effluents are unsuitable for discharge into standard sewage-treatment plants: their pretreatment is necessary to avoid clogging of the filtering devices by colloidal matter. The colloidal stability of the effluents is mainly due to mutual repulsive forces that keep charged particles in suspension. Pretreatment processes are based on two separate stages: (a) neutralization of the charges (“coagulation”) and (b) bridging between several small particles to form larger aggregates that sink, leaving clarified effluent (“flocculation”). The consequent destabilization of the colloidal suspension lowers total suspended solids (TSSs), turbidity, and other environmental quality parameters, making the treatments that follow more efficient. Clay-based materials have been widely used for effluent pretreatment and pollutant removal. This study presents the use of nanocomposites, comprised of an anchoring particle and a polymer, as “coagoflocculants” for the efficient and rapid reduction of TSS and turbidity in wastewater with a high organic load. The use of such particles combines the advantages of coagulant and flocculant by neutralizing the charge of the suspended particles while bridging between them and anchoring them to a denser particle (the clay mineral), enhancing their precipitation. Very rapid and efficient pretreatment is achieved in one single treatment step. PMID:22454607

  11. The Use of Clay-Polymer Nanocomposites in Wastewater Pretreatment

    Directory of Open Access Journals (Sweden)

    Giora Rytwo

    2012-01-01

    Full Text Available Some agricultural effluents are unsuitable for discharge into standard sewage-treatment plants: their pretreatment is necessary to avoid clogging of the filtering devices by colloidal matter. The colloidal stability of the effluents is mainly due to mutual repulsive forces that keep charged particles in suspension. Pretreatment processes are based on two separate stages: (a neutralization of the charges (“coagulation” and (b bridging between several small particles to form larger aggregates that sink, leaving clarified effluent (“flocculation”. The consequent destabilization of the colloidal suspension lowers total suspended solids (TSSs, turbidity, and other environmental quality parameters, making the treatments that follow more efficient. Clay-based materials have been widely used for effluent pretreatment and pollutant removal. This study presents the use of nanocomposites, comprised of an anchoring particle and a polymer, as “coagoflocculants” for the efficient and rapid reduction of TSS and turbidity in wastewater with a high organic load. The use of such particles combines the advantages of coagulant and flocculant by neutralizing the charge of the suspended particles while bridging between them and anchoring them to a denser particle (the clay mineral, enhancing their precipitation. Very rapid and efficient pretreatment is achieved in one single treatment step.

  12. Effects of neuromuscular training (NEMEX-TJR) on patient-reported outcomes and physical function in severe primary hip or knee osteoarthritis

    DEFF Research Database (Denmark)

    Ageberg, Eva; Nilsdotter, Anna; Kosek, Eva

    2013-01-01

    The benefits of exercise in mild and moderate knee or hip osteoarthritis (OA) are apparent, but the evidence in severe OA is less clear. We recently reported that neuromuscular training was well tolerated and feasible in patients with severe primary hip or knee OA. The aims of this controlled...... before-and-after study were to compare baseline status to an age-matched population-based reference group and to examine the effects of neuromuscular training on patient-reported outcomes and physical function in patients with severe primary OA of the hip or knee....

  13. Functional platelet defects in children with severe chronic ITP as tested with 2 novel assays applicable for low platelet counts

    NARCIS (Netherlands)

    van Bladel, Esther R.; Laarhoven, Annemieke G.; van der Heijden, Laila B.; Heitink-Pollé, Katja M.; Porcelijn, Leendert; van der Schoot, C. Ellen; de Haas, Masja; Roest, Mark; Vidarsson, Gestur; de Groot, Philip G.; Bruin, Marrie C. A.

    2014-01-01

    Immune thrombocytopenia (ITP) is an autoimmune disease with a complex heterogeneous pathogenesis and a bleeding phenotype that is not necessarily correlated to platelet count. In this study, the platelet function was assessed in a well-defined cohort of 33 pediatric chronic ITP patients. Because

  14. Pre-hospital electrocardiographic severity and acuteness scores predict left ventricular function in patients with ST elevation myocardial infarction

    DEFF Research Database (Denmark)

    Fakhri, Yama; Ersbøll, Mads; Køber, Lars

    2016-01-01

    OBJECTIVES: System delay (time from first medical contact to primary percutaneous coronary intervention) is associated with heart failure and mortality in patients with ST segment elevation myocardial infarction (STEMI). We evaluated the impact of system delay on left ventricular function (LVF) a...

  15. A Banach algebra of functions of several variables of finite total variation and Lipschitzian superposition operators. I

    NARCIS (Netherlands)

    Chistyakov, VV

    2005-01-01

    It is shown that the space of functions of n real variables with finite total variation in the sense of Vitali, Hardy and Krause, defined on a rectangle I-a(b) C R-n, is a Banach algebra under the pointwise operations and Hildebrandt-Leonov's norm. This result generalizes the classical case of

  16. A Banach algebra of functions of several variables of finite total variation and Lipschitzian superposition operators. II

    NARCIS (Netherlands)

    Chistyakov, VV

    2005-01-01

    We characterize superposition Nemytskii operators, which map the Banach algebra of functions of n real variables with finite total variation in the sense of Vitali, Hardy and Krause into itself and satisfy the global Lipschitz condition. Our results extend previous results in this direction by

  17. The functional effect of segmental trunk and head control training in moderate-to-severe cerebral palsy

    DEFF Research Database (Denmark)

    Curtis, Derek John; Woollacott, Marjorie; Bencke, Jesper

    2018-01-01

    . Outcomes were Gross Motor Function Measure (GMFM), Pediatric Evaluation of Disability Inventory (PEDI), Segmental Assessment of Trunk Control (SATCo), and postural sway at baseline, at primary endpoint (6 months), and at follow-up (12 months). RESULTS: There were no significant differences in either GMFM...

  18. Reduced Expression of FOXP3 and Regulatory T-Cell Function in Severe Forms of Early-onset Autoimmune Enteropathy

    NARCIS (Netherlands)

    Moes, Nicolette; Rieux-Laucat, Frederic; Begue, Bernadette; Verdier, Julien; Neven, Benedicte; Patey, Natacha; Torgerson, Troy T.; Picard, Capucine; Stolzenberg, Marie-Claude; Ruemmele, Corinne; Rings, Edmond Hhm; Casanova, Jean-Laurent; Piloquet, Hugues; Biver, Armand; Breton, Anne; Ochs, Hans D.; Hermine, Olivier; Fischer, Alain; Goulet, Olivier; Cerf-Bensussan, Nadine; Ruemmele, Frank M.

    BACKGROUND & AIMS: Little is known about the pathophysiology of early onset forms of autoimmune enteropathy (AIE). AIE has been associated with mutations in FOXP3-a transcription factor that controls regulatory T-cell development and function. We analyzed the molecular basis of neonatal or early

  19. A real explosion: the requirement of steam explosion pretreatment.

    Science.gov (United States)

    Yu, Zhengdao; Zhang, Bailiang; Yu, Fuqiang; Xu, Guizhuan; Song, Andong

    2012-10-01

    The severity factor is a common term used in steam explosion (SE) pretreatment that describes the combined effects of the temperature and duration of the pretreatment. However, it ignores the duration of the explosion process. This paper describes a new parameter, the explosion power density (EPD), which is independent of the severity factor. Furthermore, we present the adoption of a 5m(3) SE model for a catapult explosion mode, which completes the explosion within 0.0875 s. The explosion duration ratio of this model to a conventional model of the same volume is 1:123. The comparison between the two modes revealed a qualitative change by explosion speed, demonstrating that this real explosion satisfied the two requirements of consistency, and suggested a guiding mechanism for the design of SE devices. Copyright © 2012 Elsevier Ltd. All rights reserved.

  20. Severity of structural and functional right ventricular remodeling depends on training load in an experimental model of endurance exercise.

    Science.gov (United States)

    Sanz-de la Garza, Maria; Rubies, Cira; Batlle, Montserrat; Bijnens, Bart H; Mont, Lluis; Sitges, Marta; Guasch, Eduard

    2017-09-01

    Arrhythmogenic right ventricular (RV) remodeling has been reported in response to regular training, but it remains unclear how exercise intensity affects the presence and extent of such remodeling. We aimed to assess the relationship between RV remodeling and exercise load in a long-term endurance training model. Wistar rats were conditioned to run at moderate (MOD; 45 min, 30 cm/s) or intense (INT; 60 min, 60 cm/s) workloads for 16 wk; sedentary rats served as controls. Cardiac remodeling was assessed with standard echocardiographic and tissue Doppler techniques, sensor-tip pressure catheters, and pressure-volume loop analyses. After MOD training, both ventricles similarly dilated (~16%); the RV apical segment deformation, but not the basal segment deformation, was increased [apical strain rate (SR): -2.9 ± 0.5 vs. -3.3 ± 0.6 s -1 , SED vs. MOD]. INT training prompted marked RV dilatation (~26%) but did not further dilate the left ventricle (LV). A reduction in both RV segments' deformation in INT rats (apical SR: -3.3 ± 0.6 vs. -3.0 ± 0.4 s -1 and basal SR: -3.3 ± 0.7 vs. -2.7 ± 0.6 s -1 , MOD vs. INT) led to decreased global contractile function (maximal rate of rise of LV pressure: 2.53 ± 0.15 vs. 2.17 ± 0.116 mmHg/ms, MOD vs. INT). Echocardiography and hemodynamics consistently pointed to impaired RV diastolic function in INT rats. LV systolic and diastolic functions remained unchanged in all groups. In conclusion, we showed a biphasic, unbalanced RV remodeling response with increasing doses of exercise: physiological adaptation after MOD training turns adverse with INT training, involving disproportionate RV dilatation, decreased contractility, and impaired diastolic function. Our findings support the existence of an exercise load threshold beyond which cardiac remodeling becomes maladaptive. NEW & NOTEWORTHY Exercise promotes left ventricular eccentric hypertrophy with no changes in systolic or diastolic function in healthy rats. Conversely, right

  1. Tank Focus Area Pretreatment Program. FY 1995 Program Management Plan

    International Nuclear Information System (INIS)

    Morrison, M.I.; McGinnis, C.P.; Wilkenson, W.T.; Hunt, R.D.

    1995-02-01

    This program management plan (PMP) describes the FY 1995 project plans for the Pretreatment Program of the Tank Focus Area. The Tank Focus Area is one of five areas of environmental concerns originally identified by the Deputy Assistant Secretary for Technology Development (EM-50). Projects in the Tank Focus Area relate to the remediation of liquid waste stored in underground storage tanks at various US Department of Energy sites. The Pretreatment Program is an organizational unit performing work within the Tank Focus Area. The function of the Pretreatment Program is to develop, test, evaluate, and demonstrate new technologies, with emphasis on separations. The 11 Pretreatment Program projects for FY 1995 are (1) Cesium Extraction Testing, (2) Comprehensive Supernate Treatment, (3) Hot Cell Studies, (4) Cesium Removal Demonstration, (5) Out-of-Tank Evaporator Demonstration, (6) Crossflow Filtration, (7) Technical Interchange with CEA, (8) TRUEX Applications, (9) NAC/NAG Process Studies (conducted at Oak Ridge National Laboratory), (10) NAC/NAG Process and Waste Form Studies (conducted at Florida International University), and (11) Program Management. Section 2 of this PMP contains a separate subsection for each FY 1995 project. A brief description of the project, a schedule of major milestones, and a breakdown of costs are provided for each project. The PMP also contains sections that describe the project controls that are in place. Quality assurance, document control, the project management system, and the management organization are described in these sections

  2. Effect of Kaempferol Pretreatment on Myocardial Injury in Rats.

    Science.gov (United States)

    Vishwakarma, Anamika; Singh, Thakur Uttam; Rungsung, Soya; Kumar, Tarun; Kandasamy, Arunvikram; Parida, Subhashree; Lingaraju, Madhu Cholenahalli; Kumar, Ajay; Kumar, Asok; Kumar, Dinesh

    2018-01-20

    The present study was undertaken to evaluate the effect of kaempferol in isoprenaline (ISP)-induced myocardial injury in rats. ISP was administered subcutaneously for two subsequent days to induce myocardial injury. Assessment of myocardial injury was done by estimation of hemodynamic functions, myocardial infarcted area, cardiac injury markers, lipid profile, oxidative stress, pro-inflammatory cytokines and histopathology of heart and liver. Rats pretreated with kaempferol showed reduction in the myocardial infarcted area and heart rate. However, no improvement was observed in change in body weight, mean arterial, systolic and diastolic blood pressure. Kaempferol showed significant decrease in serum LDH, CK-MB, troponin-I and lipid profile. However, highest dose of kaempferol did not reduce the serum triglyceride level. Further, antioxidant enzymes, SOD and catalase, were also higher. However, reduced glutathione, serum SGOT and creatinine did not show any improvement. Kaempferol showed reduction in MDA level. Kaempferol at highest dose showed reduction in pro-MMP-2 expression and MMP-9 level. mRNA expression level of TNF-α was not different in kaempferol-pretreated myocardial injured rats with ISP-alone group. Pretreatment with kaempferol at highest dose showed mild mononuclear infiltration and degenerative changes in heart tissue section of myocardial injured rats. Rats pretreated with kaempferol at higher concentration showed normal cordlike arrangement of hepatocytes with moderate swelling of hepatocytes (vacuolar degeneration) around the central vein. Study suggests that kaempferol attenuated lipid profile, infarcted area and oxidative stress in ISP-induced myocardial injury in rats.

  3. Immediate effects of lumacaftor/ivacaftor administration on lung function in patients with severe cystic fibrosis lung disease.

    Science.gov (United States)

    Popowicz, Natalia; Wood, Jamie; Tai, Anna; Morey, Sue; Mulrennan, Siobhain

    2017-05-01

    Safety-data for lumacaftor/ivacaftor (LUM/IVA) combination therapy in patients with severe lung disease (percent predicted forced expiratory volume in 1s [ppFEV 1 ] cystic fibrosis (CF) lung disease (median [IQR] ppFEV 1 : 34 [31-36]) prescribed LUM/IVA. All patients experienced a decline in ppFEV 1 from baseline at 2-hours (median [IQR] relative change: -19 [-21 to -11]%, p<0.001) that persisted at 24-hours but recovered in most patients at 1-month. No pre- and post-differences in bronchodilator response were observed. Ten (83.3%) patients reported non-severe respiratory-related adverse events within 24-hours of LUM/IVA initiation. At 1-month, eight (67%) patients had persistent symptoms and six (50%) were treated for a pulmonary exacerbation. Our results highlight that LUM/IVA respiratory-related adverse events are common in patients with a ppFEV 1 <40. We recommend close assessment of adverse events. Further studies are required to evaluate the efficacy of LUM/IVA in patients with severe lung disease. Crown Copyright © 2017. Published by Elsevier B.V. All rights reserved.

  4. The effect of the introduction of the Amsterdam Trauma Workflow Concept on mortality and functional outcome of patients with severe traumatic brain injury

    NARCIS (Netherlands)

    Jin, P. H. Ping Fung Kon; Penning, Niels; Joosse, Pieter; Hijdra, Albert H. J.; Bouma, Gert Joan; Ponsen, Kees Jan; Goslings, J. Carel

    2008-01-01

    The purpose of this study was to analyze the effect of the introduction of an all-in workflow concept that included direct computed tomography (CT) scanning in the trauma room on mortality and functional outcome of trauma patients with severe traumatic brain injury (TBI) admitted to a level-1 trauma

  5. Exploring the Phenotype of Phonological Reading Disability as a Function of the Phonological Deficit Severity: Evidence from the Error Analysis Paradigm in Arabic

    Science.gov (United States)

    Taha, Haitham; Ibrahim, Raphiq; Khateb, Asaid

    2014-01-01

    The dominant error types were investigated as a function of phonological processing (PP) deficit severity in four groups of impaired readers. For this aim, an error analysis paradigm distinguishing between four error types was used. The findings revealed that the different types of impaired readers were characterized by differing predominant error…

  6. Relationships between World Health Organization "International Classification of Functioning, Disability and Health" Constructs and Participation in Adults with Severe Mental Illness

    Science.gov (United States)

    Sánchez, Jennifer; Rosenthal, David A.; Chan, Fong; Brooks, Jessica; Bezyak, Jill L.

    2016-01-01

    Purpose: To examine the World Health Organization "International Classification of Functioning, Disability and Health" (ICF) constructs as correlates of community participation of people with severe mental illnesses (SMI). Methods: Quantitative descriptive research design using multiple regression and correlational techniques was used to…

  7. Complexation of trivalent lanthanides and actinides with several novel diglycolamide-functionalized calix[4]arenes: solvent extraction, luminescence and theoretical studies

    NARCIS (Netherlands)

    Raut, Dhaval R.; Mohapatra, Prasanta K.; Ansari, Seraj A.; Godbole, Shrikant V.; Iqbal, M.; Manna, Debashree; Ghanty, Tapan K.; Huskens, Jurriaan; Verboom, Willem

    2013-01-01

    Several diglycolamide-functionalized calix[4]arenes (DGA–Calix) were evaluated for actinide extraction from acidic feeds. The ligands with four diglycolamide (DGA) pendent arms are significantly more effective extractants than those with two DGA pendent arms. The ligands have a preference for the

  8. Rates of post-fire vegetation recovery and fuel accumulation as a function of burn severity and time-since-burn in four western U.S. ecosystems

    Science.gov (United States)

    Vegetation recovery and fuel accumulation rates following wildfire are useful measures of ecosystem resilience, yet few studies have quantified these variables over 10 years post-fire. Conventional wisdom is that recovery time to pre-fire condition will be slower as a function of burn severity, as i...

  9. Adaptive seating systems in children with severe cerebral palsy across International Classification of Functioning, Disability and Health for Children and Youth version domains : a systematic review

    NARCIS (Netherlands)

    Angsupaisal, Mattana; Maathuis, Carel G. B.; Hadders-Algra, Mijna

    2015-01-01

    AimThe aim of this study was to systematically review the effect of adaptive seating systems (AdSSs) in young people less than 19years of age with severe cerebral palsy (CP), with particular focus on child-related outcomes across all components of the functioning and disability domains of the

  10. A Comparison of Functional and Impairment-Based Robotic Training in Severe to Moderate Chronic Stroke: A Pilot Study

    Science.gov (United States)

    Krebs, Hermano Igo; Mernoff, Stephen; Fasoli, Susan E.; Hughes, Richard; Stein, Joel; Hogan, Neville

    2015-01-01

    Objective To compare the outcome of training the functional movement of transport of the arm and grasping an object with the alternative of training the transport of the arm in isolation. Design Pretest-posttest comparison. Setting Rehabilitation hospitals, outpatient care. Participants Volunteer sample of forty-seven persons with persistent hemiparesis from a single, unilateral stroke within the past one to five years. Intervention Robotic therapy 3×/week for 6 weeks for the paretic upper limb consisted of either a) sensorimotor, active-assistive impairment-based exercise during repetitive planar reaching tasks, or b) a “free-hand” approach, in which the robot assisted subjects employing the sensorimotor active-assistive exercise to transport the hand to a series of targets, where it stopped to allow the person to interact with actual objects (functional approach 1), or c) transport and manipulation, in which the robot assisted subjects employing active-assistive exercise during repetitive planar reaching tasks while grasping a simulated object and releasing it at the target or followed by grasp and release of a simulated object (functional approach 2). Primary Outcome Measure Fugl-Meyer Assessment Results All three groups improved from pre- to post-treatment with the sensorimotor impairment based approach demonstrating the best outcome of the three approaches. Conclusions Short-term, goal-directed robotic therapy can significantly improve motor abilities of the exercised limb segments in persons with chronic stroke, but contrary to expectation, training both the transport of the arm and manipulation of an object (functionally-based approaches) did not confer any advantage over training solely transport of the arm (impairment-based approach). PMID:18356591

  11. Frequent mild cognitive deficits in several functional domains in elderly patients with heart failure without known cognitive disorders.

    Science.gov (United States)

    Nordlund, Arto; Berggren, Jens; Holmström, Alexandra; Fu, Michael; Wallin, Anders

    2015-09-01

    The objective of the present study was to investigate whether mild cognitive deficits are present in patients with heart failure (HF) despite absence of any known cognitive disorder. A well defined group of patients (n = 40) with heart failure completed a cognitive screening check list, a depression screening questionnaire, and a battery consisting of neuropsychological tests assessing 5 different cognitive domains: speed/attention, episodic memory, visuospatial functions, language, and executive functions. The neuropsychological results were compared with those from a group of healthy control subjects (n = 41). The patients with HF displayed cognitive impairment compared with the control group within the domains speed and attention, episodic memory, visuospatial functions, and language. Among them, 34 HF patients (85%) could be classified with mild cognitive impairment (MCI), the majority as nonamnestic MCI, ie, with no memory impairment. Considering the high occurrence of mild cognitive deficits among HF patients without known cognitive disorders, closer attention should be paid to their self-care and compliance. Inadequate self-care and compliance could lead to more frequent hospitalizations. Furthermore, the HF patients may be at increased risk of dementia. Copyright © 2015 Elsevier Inc. All rights reserved.

  12. Wash water waste pretreatment system

    Science.gov (United States)

    1977-01-01

    Investigations were completed on wash waters based on each candidate personal cleansing agent. Evaluations of coagulants, antifoam agents, and the effect of promising antifoams on the chemical precipitation were included. Based on these evaluations two candidate soaps as well as their companion antifoam agents were selected for further work. Operating parameters included the effect of soap concentration, ferric chloride concentration, duration of mixing, and pore size of depth filters on the degree of soap removal. The effect of pressure on water flow through filter cartridges and on the rate of decline of water flow was also investigated. The culmination of the program was the recommendation of a pretreatment concept based on chemical precipitation followed by pressure filtration.

  13. Language and communication skills in preschool children with autism spectrum disorders: contribution of cognition, severity of autism symptoms, and adaptive functioning to the variability.

    Science.gov (United States)

    Kjellmer, Liselotte; Hedvall, Åsa; Fernell, Elisabeth; Gillberg, Christopher; Norrelgen, Fritjof

    2012-01-01

    This study examined the contribution of cognitive function, severity of autism, and adaptive functioning to the variability in language and communication skills in 129 preschool children (aged 24-63 months) with autism spectrum disorder (ASD). Participants were selected from a representative research cohort of 208 preschool children on the basis of caregiver completion of the MacArthur-Bates Communicative Development Inventories (CDI). The children were classified into three cognitive groups: (a) Normal intelligence; (b) Developmental delay; and (c) Intellectual disability. Autism symptom severity was measured by the Autistic Behavior Checklist (ABC), and adaptive functioning by the Daily Living Skills (DLS) and Socialization (Soc) subscales from the Vineland Adaptive Behavior Scales. For each of five CDI variables (Phrases understood, Words understood, Words produced, Gestures and actions, and Language use), the contribution of cognition, severity of autism symptoms, and adaptive functioning to the variability was examined. Cognition and age explained about half or more of the variance in the four verbal language CDI variables, but only about one fourth of the variance in the non-verbal communication variable Gestures and actions. Severity of autism symptoms and the two adaptive measures (DLS and Soc) each only accounted for a few percent more of the variance in the four CDI language variables; however, for Gestures and actions, an additional 11-21% of the variance was accounted for. In conclusion, for children with ASD, receptive and expressive language is mainly related to cognitive level, whereas non-verbal communication skills seem to also be related to severity of autism symptoms and adaptive functioning. Copyright © 2011 Elsevier Ltd. All rights reserved.

  14. Pretreatment factors significantly influence quality of life in cancer patients: A Radiation Therapy Oncology Group (RTOG) analysis

    International Nuclear Information System (INIS)

    Movsas, Benjamin; Scott, Charles; Watkins-Bruner, Deborah

    2006-01-01

    Purpose The purpose of this analysis was to assess the impact of pretreatment factors on quality of life (QOL) in cancer patients. Methods and Materials Pretreatment QOL (via Functional Assessment of Cancer Therapy [FACT], version 2) was obtained in 1,428 patients in several prospective Radiation Therapy Oncology Group (RTOG) trials including nonmetastatic head-and-neck (n = 1139), esophageal (n = 174), lung (n = 51), rectal (n = 47), and prostate (n = 17) cancer patients. Clinically meaningful differences between groups were defined as a difference of 1 standard error of measurement (SEM). Results The mean FACT score for all patients was 86 (20.7-112) with SEM of 5.3. Statistically significant differences in QOL were observed based on age, race, Karnofsky Performance Status, marital status, education level, income level, and employment status, but not by gender or primary site. Using the SEM, there were clinically meaningful differences between patients ≤50 years vs. ≥65 years. Hispanics had worse QOL than whites. FACT increased linearly with higher Karnofsky Performance Status and income levels. Married patients (or live-in relationships) had a better QOL than single, divorced, or widowed patients. College graduates had better QOL than those with less education. Conclusion Most pretreatment factors meaningfully influenced baseline QOL. The potentially devastating impact of a cancer diagnosis, particularly in young and minority patients, must be addressed

  15. Unusual long survival despite severe lung disease of a child with biallelic loss of function mutations in ABCA-3

    Directory of Open Access Journals (Sweden)

    P. El Boustany

    Full Text Available Homozygous or compound heterozygous for frameshift or nonsense mutations in the ATP–binding cassette transporter A3 (ABCA3 is associated with neonatal respiratory failure and death within the first year of life without lung transplantation. We report the case of a newborn baby girl who developed severe respiratory distress soon after birth. She was diagnosed with compound heterozygous frameshift mutation of the ABCA3 gene. Despite extensive treatment (intravenous corticosteroids pulse therapy, oral corticosteroids, azithromycin, and hydroxychloroquine, she developed chronic respiratory failure. As the parents refused cardio-pulmonary transplantation and couldn't resolve to an accompaniment of end of life, a tracheostomy was performed resulting in continuous mechanical ventilation. A neurodevelopmental delay and an overall muscular dystrophy were noted. At the age of 5 years, after 2 episodes of pneumothorax, the patient died from severe respiratory failure. To our knowledge, this was the first case of a child with compound heterozygous frameshift mutation who posed such an ethical dilemma with a patient surviving till the age of five years. Keywords: ABCA3 deficiency, Compound heterozygous frameshift mutation, Neonatal respiratory failure, Tracheostomy, Mechanical ventilation, Ethical dilemma

  16. Stress adversely affects efficacy of physostigmine-scopolamine pretreatment against soman in guinea pigs.

    Science.gov (United States)

    Philippens, Ingrid H C H M; Joosen, Marloes J A; Vanwersch, Raymond A P

    2005-09-01

    During military operations, soldiers may be exposed to mixtures of chemicals and to physical, emotional and psychological stress factors, which all may influence efficacy of any treatment, including the nerve agent pretreatment regimen. The purpose of this study was therefore to investigate the influence of chronic intermittent, variable, unpredictable and uncontrollable stress conditions on the side effects and therapeutic efficacy of the combination of physostigmine (0.025 mg/kg/h) and scopolamine (0.018 mg/kg/h) as a pretreatment against 2 x LD50 soman intoxication in guinea pigs. Stress during pretreatment led to an increase of motor activity and an increase of power in the EEG delta2 frequency band. After chronic stress, exposure of pretreated animals to 2 x LD50 soman resulted in more severe intoxication symptoms, a more persistent effect on the startle response, and considerable more severe and persistent effects on the EEG power-spectrum, indicating irreversible brain damage.

  17. Autohydrolysis Pretreatment of Lignocellulosic Biomass for Bioethanol Production

    Science.gov (United States)

    Han, Qiang

    Autohydrolysis, a simple and environmental friendly process, has long been studied but often abandoned as a financially viable pretreatment for bioethanol production due to the low yields of fermentable sugars at economic enzyme dosages. The introduction of mechanical refining can generate substantial improvements for autohydrolysis process, making it an attractive pretreatment technology for bioethanol commercialization. In this study, several lignocellulosic biomass including wheat straw, switchgrass, corn stover, waste wheat straw have been subjected to autohydrolysis pretreatment followed by mechanical refining to evaluate the total sugar recovery at affordable enzyme dosages. Encouraging results have been found that using autohydrolysis plus refining strategy, the total sugar recovery of most feedstock can be as high as 76% at 4 FPU/g enzymes dosages. The mechanical refining contributed to the improvement of enzymatic sugar yield by as much as 30%. Three non-woody biomass (sugarcane bagasse, wheat straw, and switchgrass) and three woody biomass (maple, sweet gum, and nitens) have been subjected to autohydrolysis pretreatment to acquire a fundamental understanding of biomass characteristics that affect the autohydrolysis and the following enzymatic hydrolysis. It is of interest to note that the nonwoody biomass went through substantial delignification during autohydrolysis compared to woody biomass due to a significant amount of p-coumaric acid and ferulic acid. It has been found that hardwood which has a higher S/V ratio in the lignin structure tends to have a higher total sugar recovery from autohydrolysis pretreatment. The economics of bioethanol production from autohydrolysis of different feedstocks have been investigated. Regardless of different feedstocks, in the conventional design, producing bioethanol and co-producing steam and power, the minimum ethanol revenues (MER) required to generate a 12% internal rate of return (IRR) are high enough to

  18. One-electron properties of several small molecules calculated using the local density approximation within density functional theory

    Science.gov (United States)

    Duffy, Patrick; Chong, Delano P.; Dupuis, Michel

    1995-02-01

    Density functional theory (DFT) is a field enjoying a tremendous recent surge in popularity among theoretical and practical chemists alike because of its ability to more easily handle larger molecular systems than conventional ab initio methods. Until recently, however, assessment of the quality of the properties predicted (and therefore the charge density) from DFT had been limited mainly to dipole moments and their nuclear coordinate and electric field derivatives. This paper presents the calculated results for some of the one-electron properties of the eight small molecules (NH3, PH3, H2O, H2S, HF, HCl, CO, and N2). The properties chosen weight different regions of the charge density, from either very close in or at the nucleus (e.g., δ, the electron density at the nucleus) to regions farther out from the nucleus (e.g., the diamagnetic susceptibility ). It is found that properties which depend on an accurate knowledge of the electron density near to the nucleus are predicted poorly by the local density approximation (LDA), while others more dependent on the charge density farther out from the nucleus are predicted much more accurately, possibly due to cancellation of errors. Use of the LDA is therefore not recommended for ``tight'' properties; use of a functional employing gradient corrections would be more suitable for this purpose.

  19. Pretreatment of the macroalgae Chaetomorpha linum for the production of bioethanol - Comparison of five pretreatment technologies

    DEFF Research Database (Denmark)

    Schultz-Jensen, Nadja; Thygesen, Anders; Thomsen, Sune Tjalfe

    2013-01-01

    -assisted pretreatment (PAP) and ball milling (BM), to determine effects of the pretreatment methods on the conversion of C. linum into ethanol by simultaneous saccharification and fermentation (SSF). WO and BM showed the highest ethanol yield of 44. g ethanol/100. g glucan, which was close to the theoretical ethanol......A qualified estimate for pretreatment of the macroalgae Chaetomorpha linum for ethanol production was given, based on the experience of pretreatment of land-based biomass. C. linum was subjected to hydrothermal pretreatment (HTT), wet oxidation (WO), steam explosion (STEX), plasma...... yield of 57. g ethanol/100. g glucan. A 64% higher ethanol yield, based on raw material, was reached after pretreatment with WO and BM compared with unpretreated C. linum, however 50% of the biomass was lost during WO. Results indicated that the right combination of pretreatment and marine macroalgae...

  20. Esthetic and function rehabilitation of severely worn dentition with prosthetic-restorative approach and VDO increase. Case report.

    Science.gov (United States)

    Gargari, M; Lorè, B; Ceruso, F M

    2014-01-01

    The aim of this study is to report a case of restorative treatment of severely worn dentition. In this case report, the erosive/abrasive worn dentition have been reconstructed with metal ceramic crown on the posterior teeth and with ceramic veneers on the anterior teeth 1.3 - 2.3 and 3.4 - 4.3. A prosthetic treatment was proposed to a male patient of 58 years old having a clinically significant tooth wear. After clinical exam, impressions of maxillary and mandible arches were taken with alginate to obtain preliminary casts for diagnostic waxing to all maxillary and mandibular teeth and fabrication of all provisional crowns in acrylic resin for posterior teeth, and from the diagnostic wax-up were fabricated a silicone guide masks for anterior teeth. An increase in VDO should be determined on the basis of a need to accomplish satisfactory and aesthetically pleasing restorations; it was proposed to increase the incisal lenght of the maxillary anterior incisors, together with alteration of the VDO 3 mm anteriorly. The posterior teeth 1.6 - 1.5 - 1.4 - 2.4 - 2.6 - 3.5 - 3.6 - 3.7 - 4.4 - 4.7, where the amount of tissue lost was greater, were recontructed with metal ceramic crowns. Two implants (Nobel replace 4.3x10) was placed. The implant were located in the area 4.5 - 4.6. The anterior teeth were restored with veneers. The prosthetic challenge with restoring severely worn dentitions is to preserve as much of the already diminished tooth structure as possible for retention while also providing enough interocclusal space for the restorative material.

  1. The role of temporary biventricular pacing in the cardiac surgical patient with severely reduced left ventricular systolic function.

    Science.gov (United States)

    Evonich, Rudolph F; Stephens, John C; Merhi, William; Dukkipati, Srinivas; Tepe, Nicholas; Shannon, Francis; Altshuler, Jeffrey; Sakwa, Marc; Bassett, Joseph; Hanson, Eric; Boura, Judy; O'Neill, William W; Haines, David E

    2008-10-01

    The objective was to evaluate the effects of atrial synchronous biventricular pacing in postoperative patients with severe cardiomyopathy. Atrial synchronous biventricular pacing epicardial leads were placed during cardiac surgery in patients with an ejection fraction of 30% or less. Patients were randomized to usual care pacing, the mode determined by the surgeon (excluding atrial synchronous biventricular pacing) with a preference for no pacing or atrial pacing (atrial inhibited pacing); atrial synchronous right ventricular pacing; or atrial synchronous biventricular pacing. Pacing was continued until cessation of hemodynamic support. At 12 hours postoperatively, patients were randomly tested in each mode (atrial inhibited, atrial synchronous right ventricular, and atrial synchronous biventricular pacing), and thermodilution outputs were measured. Forty subjects were randomized. Groups were similar in age (66 +/- 11 years), gender (85% were male), ejection fraction (23% +/- 6%), QRS duration (111 +/- 30 ms), and surgical indication. There was no difference in stroke index or cardiac index at 12 hours, duration of inotropic or intra-aortic balloon pump support, intensive care unit, or hospital length of stay. On comparative crossover testing, stroke volume was similar with atrial inhibited pacing and atrial synchronous biventricular pacing (59.3 +/- 13.4 vs 57 +/- 12.1, respectively, P = not significant); however, atrial synchronous right ventricular pacing was inferior (56 +/- 12.9, P or= 5%), whereas 41% had a 5% or greater decrease in stroke volume. Pacing mode affects stroke volume in patients with severe cardiomyopathy. Atrial synchronous biventricular pacing was helpful in a minority, but in 41% it compromised stroke volume.

  2. Confounding by Pre-Morbid Functional Status in Studies of Apparent Sex Differences in Severity and Outcome of Stroke.

    Science.gov (United States)

    Renoux, Christel; Coulombe, Janie; Li, Linxin; Ganesh, Aravind; Silver, Louise; Rothwell, Peter M

    2017-10-01

    Several studies have reported unexplained worse outcomes after stroke in women but none included the full spectrum of symptomatic ischemic cerebrovascular events while adjusting for prior handicap. Using a prospective population-based incident cohort of all transient ischemic attack/stroke (OXVASC [Oxford Vascular Study]) recruited between April 2002 and March 2014, we compared pre-morbid and post-event modified Rankin Scale score (mRS) in women and men and change in mRS score 1 month, 6 months, 1 year, and 5 years after stroke. Baseline stroke-related neurological impairment was measured with the National Institutes of Health Stroke Scale. Among 2553 patients (50.6% women) with a first transient ischemic attack/ischemic stroke, women had a worse handicap 1 month after ischemic stroke (age-adjusted odds ratio for mRS score, 1.35; 95% confidence interval, 1.12-1.63). However, women also had a higher pre-morbid mRS score compared with men (age-adjusted odds ratio, 1.58; 95% confidence interval, 1.36-1.84). There was no difference in stroke severity when adjusting for age and pre-morbid mRS (odds ratio, 1.10; 95% confidence interval, 0.90-1.35) and no difference in the pre-/poststroke change in mRS at 1 month (age-adjusted odds ratio, 1.00; 95% confidence interval, 0.82-1.21), 6 months, 1 year, and 5 years. Women had a lower mortality rate, and there was no sex difference in risk of recurrent stroke. We found no evidence of a worse outcome of stroke in women when adjusting for age and pre-morbid mRS. Failure to account for sex differences in pre-morbid handicap could explain contradictory findings in previous studies. Properties of the mRS may also contribute to these inconsistencies. Copyright © 2017 The Author(s).

  3. Functional and Structural Consequences of Nine CYP21A2 Mutations Ranging from Very Mild to Severe Effects

    Directory of Open Access Journals (Sweden)

    Débora de Paula Michelatto

    2016-01-01

    Full Text Available We present the functional and structural effects of seven novel (p.Leu12Met, p.Arg16Cys, p.Ser101Asn, p.Ser202Gly, p.Pro267Leu, p.Gln389_Ala391del, and p.Thr450Met and two previously reported but not studied (p.Ser113Phe and p.Thr450Pro CYP21A2 mutations. Functional analyses were complemented with in silico prediction of mutation pathogenicity based on the recently crystallized human CYP21A2 structure. Mutated proteins were transiently expressed in COS-1 cells and enzyme activities towards 17-hydroxyprogesterone and progesterone were determined. Residual enzyme activities between 43% and 97% were obtained for p.Arg16Cys, p.Ser101Asn, p.Ser202Gly, p.Pro267Leu, and p.Thr450Met, similar to the activities of the well-known nonclassic mutations p.Pro453Ser and p.Pro482Ser, whereas the p.Leu12Met variant showed an activity of 100%. Conversely, the novel p.Ser113Phe, p.Gln389_Ala391del, and p.Thr450Pro mutations drastically reduced the enzyme function below 4%. The Km values for all novel variants were in the same order of magnitude as for the wild-type protein except for p.The450Met. The maximum velocity was decreased for all mutants except for p.Leu12Met. We conclude that p.Leu12Met is a normal variant; the mutations p.Arg16Cys, p.Ser101Asn, p.Ser202Gly, p.Pro267Leu, and p.Thr450Met could be associated with very mild nonclassic CAH, and the mutations p.Ser113Phe, p.Gln389_Ala391del, and p.Thr450Pro are associated with classic CAH. The obtained residual activities indicated a good genotype-phenotype correlation.

  4. Functional Recovery and Life Satisfaction in the First Year After Severe Traumatic Brain Injury: A Prospective Multicenter Study of a Norwegian National Cohort.

    Science.gov (United States)

    Anke, Audny; Andelic, Nada; Skandsen, Toril; Knoph, Rein; Ader, Tiina; Manskow, Unn; Sigurdardottir, Solrun; Røe, Cecilie

    2015-01-01

    (1) To examine the impact of demographic and acute injury-related variables on functional recovery and life satisfaction after severe traumatic brain injury (sTBI) and (2) to test whether postinjury functioning, postconcussive symptoms, emotional state, and functional improvement are related to life satisfaction. Prospective national multicenter study. Level 1 trauma centers in Norway. 163 adults with sTBI. Functional recovery between 3 and 12 months postinjury measured with Glasgow Outcome Scale Extended, Rivermead Postconcussion Symptoms Questionnaire, Hospital Anxiety and Depression Scale, and satisfaction with life situation. 60% of cases experienced functional improvement from 3 to 12 months postinjury. Multivariate logistic regression analysis revealed that discharge to a rehabilitation department from acute care (odds ratio [OR] = 2.14; P life situation. Regression analysis revealed that older age (>65 years), low education, better functional outcome, and the absence of depressive and postconcussion symptoms were significant (P life satisfaction. Functional improvement was significantly associated with emotional state but not to life satisfaction. Following sTBI, approximately two-thirds of survivors improve between 3 and 12 months postinjury and are satisfied with their life. Direct discharge from acute care to specialized rehabilitation appears to increase functional recovery.

  5. Effects of different types of moderate severity disturbance on forest structural complexity and ecosystem functioning: A story of ice and fire

    Science.gov (United States)

    Fahey, R. T.; Atkins, J.; Gough, C. M.; Hardiman, B. S.; Haber, L.; Stuart-Haentjens, E.; David, O.; Campbell, J. L.; Rustad, L.; Duffy, M.

    2017-12-01

    Disturbances that alter the structure and function of forest ecosystems occur along a continuum of severity. In contrast to the extremes of the disturbance gradient (i.e., stand-replacing disturbance and small gap formation), moderate severity disturbances are poorly understood, even though they make up the majority of the gradient and their spatial extent (and likely overall importance to regional disturbance regimes) often exceeds that of more severe disturbances. Moderate severity disturbances originate from a variety of causes, such as fires, ice storms, or pest and pathogen outbreaks, and each of these could reshape structure and function in different ways. Observational data from a limited number of sites shows that moderate disturbance can increase ecosystem complexity, but the generality of this effect has not been tested across a broad range of disturbance types and severities. Here, we utilize data from a set of five case studies of experimental or natural moderate disturbance to assess the effects of different types and severities of disturbance on forest canopy structural complexity (CSC) and the relationship of canopy structure with ecosystem functioning. Using pre- and post-disturbance measures of CSC derived from aerial and terrestrial LiDAR, UAV imagery, and Landsat data we quantified changes in CSC following an experimental ice storm, a low-severity surface fire, Beech Bark Disease and Hemlock Wooly Adelgid outbreaks, and experimental accelerated succession. Our initial findings indicate that different disturbance types have highly variable effects on CSC, and also that progressive increases in disturbance severity alter CSC differently among disturbance types. Differential effects of variable disturbance types on CSC has implications for the carbon cycle, as forest structure is strongly linked with both growth-limiting resource (e.g., nutrients and light) acquisition and net primary productivity. Understanding how different types and severities of

  6. Recovery of post stroke proximal arm function, driven by complex neuroplastic bilateral brain activation patterns and predicted by baseline motor dysfunction severity

    Directory of Open Access Journals (Sweden)

    Svetlana ePundik

    2015-07-01

    Full Text Available Objectives: Neuroplastic changes that drive recovery of shoulder/elbow function after stoke have been poorly understood. The purpose of this study was to determine the relationship between neuroplastic brain changes related to shoulder/elbow movement control in response to treatment and recovery of arm motor function in chronic stroke survivors. Methods: Twenty-three chronic stroke survivors were treated with 12 weeks of arm rehabilitation. Outcome measures included functional Magnetic Resonance Imaging (fMRI for the shoulder/elbow components of reach and a skilled motor function test (Arm Motor Abilities Test (AMAT, collected before and after treatment.Results: We observed two patterns of neuroplastic changes that were associated with gains in motor function: decreased or increased task-related brain activation. Those with significantly better motor function at baseline exhibited a decrease in brain activation in response to treatment, evident in the ipsilesional primary motor and contralesional supplementary motor regions; in contrast, those with greater baseline motor impairment, exhibited increased brain activation in response to treatment. There was an linear relationship between greater functional gain (AMAT and increased activation in bilateral primary motor, contralesional primary and secondary sensory regions, and contralesional lateral premotor area, after adjusting for baseline AMAT, age, and time since stroke. Conclusions: Recovery of functional reach involves recruitment of several contralesional and bilateral primary motor regions. In response to intensive therapy, the direction of functional brain change (i.e. increase or decrease in task-related brain recruitment for shoulder/elbow reach components depends on baseline level of motor function and may represent either different phases or different strategies of neuroplasticity that drive functional recovery.

  7. Changes in human dendritic cell number and function in severe obesity may contribute to increased susceptibility to viral infection.

    LENUS (Irish Health Repository)

    O'Shea, D

    2013-02-26

    Dendritic cells (DCs) are key immune sentinels linking the innate and adaptive immune systems. DCs recognise danger signals and initiate T-cell tolerance, memory and polarisation. They are critical cells in responding to a viral illness. Obese individuals have been shown to have an impaired response to vaccinations against virally mediated conditions and to have an increased susceptibility to multi-organ failure in response to viral illness. We investigated if DCs are altered in an obese cohort (mean body mass index 51.7±7.3 kg m(-2)), ultimately resulting in differential T-cell responses. Circulating DCs were found to be significantly decreased in the obese compared with the lean cohort (0.82% vs 2.53%). Following Toll-like receptor stimulation, compared with lean controls, DCs generated from the obese cohort upregulated significantly less CD83 (40% vs 17% mean fluorescence intensity), a molecule implicated in the elicitation of T-cell responses, particularly viral responses. Obese DCs produced twofold more of the immunosuppressive cytokine interleukin (IL)-10 than lean controls, and in turn stimulated fourfold more IL-4-production from allogenic naive T cells. We conclude that obesity negatively impacts the ability of DCs to mature and elicit appropriate T-cell responses to a general stimulus. This may contribute to the increased susceptibility to viral infection observed in severe obesity.International Journal of Obesity advance online publication, 26 February 2013; doi:10.1038\\/ijo.2013.16.

  8. Effects of timing and severity of salinity stress on rice (Oryza sativa L.) yield, grain composition, and starch functionality.

    Science.gov (United States)

    Thitisaksakul, Maysaya; Tananuwong, Kanitha; Shoemaker, Charles F; Chun, Areum; Tanadul, Orn-u-ma; Labavitch, John M; Beckles, Diane M

    2015-03-04

    The aim of this work was to examine agronomic, compositional, and functional changes in rice (Oryza sativa L. cv. Nipponbare) grains from plants grown under low-to-moderate salinity stress in the greenhouse. Plants were grown in sodium chloride-containing soil (2 or 4 dS/m(2) electrical conductivity), which was imposed 4-weeks after transplant (called Seedling EC2 and EC4) or after the appearance of the anthers (called Anthesis EC2 and EC4). The former simulates field conditions while the latter permits observation of the isolated effect of salt on grain filling processes. Key findings of this study are the following: (i) Plants showed adaptive responses to prolonged salt treatment with no negative effects on grain weight or fertility. Seedling EC2 plants had more panicles and enhanced caryopsis dimensions, while surprisingly, Seedling EC4 plants did not differ from the control group in the agronomic parameters measured. (ii) Grain starch increased in Seedling EC4 (32.6%) and Anthesis EC2 (39%), respectively, suggesting a stimulatory effect of salt on starch accumulation. (iii) The salinity treatment of 2 dS/m(2) was better tolerated at anthesis than the 4 dS/m(2) treatment as the latter led to reduced grain weight (28.8%) and seed fertility (19.4%) and compensatory increases in protein (20.1%) and nitrogen (19.8%) contents. (iv) Although some salinity treatments led to changes in starch content, these did not alter starch fine structure, morphology, or composition. We observed no differences in reducing sugar and amylose content or starch granule size distribution among any of the treatments. The only alterations in starch were limited to small changes in thermal properties and glucan chain distribution, which were only seen in the Anthesis EC4 treatment. This similarity of compositional and functional features was supported by multivariate analysis of all variables measured, which suggested that differences due to treatments were minimal. Overall, this study

  9. Theory of mind, emotional and social functioning, and motor severity in children and adolescents with dystonic cerebral palsy.

    Science.gov (United States)

    Adegboye, Dolapo; Sterr, Annette; Lin, Jean-Pierre; Owen, Tamsin J

    2017-05-01

    This cross-sectional study aimed to investigate whether children and adolescents with dystonic cerebral palsy (CP) present with emotional and social difficulties along side motor limitations. Twenty-two verbal and nonverbal children and adolescents with dystonic CP were compared with a normative sample of twenty children and adolescents on measures of theory of mind (ToM), emotion regulation (ER), and social difficulties (SD). Higher social and emotional difficulties were found in the dystonic CP group compared to the control group. Nonverbal participants with dystonic CP were found to present with greater social impairment and lower ToM ability than their verbal counterparts. Emotional regulation and hyperactivity and attentional difficulties (HAD) significantly predicted ToM ability and social difficulties. Lower Gross Motor Function Classification System (GMFCS) level and IQ also contributed to differences in ToM ability. Findings support the need for greater attention to the emotional health and social development of children/adolescents with dystonic CP, along with assessments of motor difficulties in the planning and implementation of interventions and individual care plans. Further research is needed to explore links between motor disorder and mental state understanding in this clinical group. Copyright © 2017 European Paediatric Neurology Society. Published by Elsevier Ltd. All rights reserved.

  10. Decreased cerebellar-orbitofrontal connectivity correlates with stuttering severity: Whole-brain functional and structural connectivity associations with persistent developmental stuttering

    Directory of Open Access Journals (Sweden)

    Kevin Richard Sitek

    2016-05-01

    Full Text Available Persistent developmental stuttering is characterized by speech production disfluency and affects 1% of adults. The degree of impairment varies widely across individuals and the neural mechanisms underlying the disorder and this variability remain poorly understood. Here, we elucidate compensatory mechanisms related to this variability in impairment using whole-brain functional and white matter connectivity analyses in persistent developmental stuttering. We found that people who stutter had stronger functional connectivity between cerebellum and thalamus than people with fluent speech, while stutterers with the least severe symptoms had greater functional connectivity between left cerebellum and left orbitofrontal cortex. Additionally, people who stutter had decreased functional and white matter connectivity among the perisylvian auditory, motor, and speech planning regions compared to typical speakers, but greater functional connectivity between the right basal ganglia and bilateral temporal auditory regions. Structurally, disfluency ratings were negatively correlated with white matter connections to left perisylvian regions and to the brain stem. Overall, we found increased connectivity among subcortical and reward network structures in people who stutter compared to controls. These connections were negatively correlated with stuttering severity, suggesting the involvement of cerebellum and orbitofrontal cortex may underlie successful compensatory mechanisms by more fluent stutterers.

  11. Does Apolipoprotein e4 Status Moderate the Association of Family Environment with Long-Term Child Functioning following Early Moderate to Severe Traumatic Brain Injury? A Preliminary Study.

    Science.gov (United States)

    Treble-Barna, Amery; Zang, Huaiyu; Zhang, Nanhua; Martin, Lisa J; Yeates, Keith Owen; Taylor, H Gerry; Wade, Shari L; Kurowski, Brad G

    2016-09-01

    To examine whether apolipoprotein e4 (APOE) status moderates the association of family environment with child functioning following early traumatic brain injury (TBI). Sixty-five children with moderate to severe TBI and 70 children with orthopedic injury (OI) completed assessments 6, 12, 18 months, and 3.5 and 6.8 years post injury. DNA was extracted from saliva samples and genotyped for APOE e4 status. Linear mixed models examined moderating effects of APOE e4 status on associations between two family environment factors (parenting style, home environment) and three child outcomes (executive functioning, behavioral adjustment, adaptive functioning). Children with TBI who were carriers of the e4 allele showed poorer adaptive functioning relative to non-carriers with TBI and children with OI in the context of low authoritarianism. At high levels of authoritarianism, non-carriers with TBI showed the poorest adaptive functioning among groups. There were no main effects or interactions involving APOE and executive functioning or behavioral adjustment. The APOE e4 allele was detrimental for long-term adaptive functioning in the context of positive parenting, whereas in less optimal parenting contexts, being a non-carrier was detrimental. We provide preliminary evidence for an interaction of APOE e4 status and parenting style in predicting long-term outcomes following early TBI. (JINS, 2016, 22, 859-864).

  12. Enzymatic Saccharification and Ethanol Fermentation of Reed Pretreated with Liquid Hot Water

    Directory of Open Access Journals (Sweden)

    Jie Lu

    2012-01-01

    Full Text Available Reed is a widespread-growing, inexpensive, and readily available lignocellulosic material source in northeast China. The objective of this study is to evaluate the liquid hot water (LHW pretreatment efficiency of reed based on the enzymatic digestibility and ethanol fermentability of water-insoluble solids (WISs from reed after the LHW pretreatment. Several variables in the LHW pretreatment and enzymatic hydrolysis process were optimized. The conversion of glucan to glucose and glucose concentrations are considered as response variables in different conditions. The optimum conditions for the LHW pretreatment of reed area temperature of 180°C for 20min and a solid-to-liquid ratio of 1 : 10. These optimum conditions for the LHW pretreatment of reed resulted in a cellulose conversion rate of 82.59% in the subsequent enzymatic hydrolysis at 50°C for 72 h with a cellulase loading of 30 filter paper unit per gram of oven-dried WIS. Increasing the pretreatment temperature resulted in a higher enzymatic digestibility of the WIS from reed. Separate hydrolysis and fermentation of WIS showed that the conversion of glucan to ethanol reached 99.5% of the theoretical yield. The LHW pretreatment of reed is a suitable method to acquire a high recovery of fermentable sugars and high ethanol conversion yield.

  13. Feasibilities of consolidated bioprocessing microbes: from pretreatment to biofuel production.

    Science.gov (United States)

    Parisutham, Vinuselvi; Kim, Tae Hyun; Lee, Sung Kuk

    2014-06-01

    Lignocelluloses are rich sugar treasures, which can be converted to useful commodities such as biofuel with the help of efficient combination of enzymes and microbes. Although several bioprocessing approaches have been proposed, biofuel production from lignocelluloses is limited because of economically infeasible technologies for pretreatment, saccharification and fermentation. Use of consolidated bioprocessing (CBP) microbes is the most promising method for the cost-effective production of biofuels. However, lignocelluloses are obtained from highly diverse environment and hence are heterogeneous in nature. Therefore, it is necessary to develop and integrate tailor-designed pretreatment processes and efficient microbes that can thrive on many different kinds of biomass. In this review, the progress towards the construction of consolidated bioprocessing microbes, which can efficiently convert heterogeneous lignocellulosic biomass to bioenergy, has been discussed; in addition, the potential and constraints of current bioprocessing technologies for cellulosic biofuel production have been discussed. Copyright © 2014 Elsevier Ltd. All rights reserved.

  14. [Modern esophageal surgery and late functional results as equations with several unknowns--Hungarian Academy of Sciences Doctoral Thesis].

    Science.gov (United States)

    Altorjay, Aron

    2008-10-01

    Using the same surgical method and anatomically ideal primary healing, the functional results could even be different later. Trying to identify various factors being responsible for the above differences, 637 patient's data, who underwent previous oesophago-gastric surgery between 1985-2005, were analyzed. Biochemical, histological and electrophysiological examinations had been evaluated. Developing hypertrophy-like metabolic changes and enteric ganglionitis as morphological alternations of LES muscles induced by GERD may be reasons for complaints after antireflux surgery. The marking of Z-line with endoscopic clips followed by an immediately upright contrast study and substractional evaluation is appropriate for detecting true short esophagus. Open surgical procedures are justified even in the new millennium in cases when the patient already underwent previous upper abdominal operations - due to an increased risk of injury because of adhesions - in cases of primarily recurrent paraesophageal hernias after an unsuccessful open and/or laparoscopic reconstruction, as well as in cases of reflux with complications. When adenocarcinomas of the gastro-oesophageal junction are examined preoperatively, the ratio of the performed catabolic - AMAN, CB, and DPP I - enzymatic activity of the tissue sample from the tumour and adjacent intact mucosa within 2 cm of the tumour may have a prognostic value even in the preoperative examination period, and neo-adjuvant treatment should be considered in these group of patients. The patients' post-operative complaints and symptoms change during the post-operative period and correlate with the parameters of the myoelectric and contractile activities of the "Akiyama stomach". Tachygastria seems to be the major pathogenetic factor involved in the contractile dysfunction. Gastro-jejuno-duodenal interposition represents an adequate 'second-best' method of choice if technical difficulties emerge with jejunal or colon interposition following

  15. Severe Early-Onset Combined Immunodeficiency due to Heterozygous Gain-of-Function Mutations in STAT1.

    Science.gov (United States)

    Baris, Safa; Alroqi, Fayhan; Kiykim, Ayca; Karakoc-Aydiner, Elif; Ogulur, Ismail; Ozen, Ahmet; Charbonnier, Louis-Marie; Bakır, Mustafa; Boztug, Kaan; Chatila, Talal A; Barlan, Isil B

    2016-10-01

    Loss and gain-of-function (GOF) mutations in human signal transducer and activator of transcription 1 (STAT1) lead to distinct phenotypes. Although recurrent infections are common to both types of STAT1 mutations, GOF mutations are distinguished by chronic mucocutaneous candidiasis and autoimmunity. However, the clinical spectra of STAT1 GOF mutations continue to expand. We here describe two patients with STAT1 GOF mutations presenting early in life with combined immunodeficiency (CID). Clinical data and laboratory findings including immunophenotyping, level of interferon (IFN)-γ/IL-17(+) T cells, interferon-induced STAT1 phosphorylation, and JAK inhibitor assays were evaluated. Sequencing of STAT1 gene was performed by Sanger sequencer. Patient 1 (P1) had persistent oral candidiasis and cytomegalovirus (CMV) infection since 2 months of age and later developed cavitary lung lesions due to Mycobacterium tuberculosis. Patient 2 (P2) presented with oral candidiasis and recurrent pneumonia at 4 months of age and subsequently developed CMV pneumonitis. Both patients suffered heterozygous missense mutations in STAT1, leading to deleterious amino acid substitutions in the DNA binding domain (P1: c.1154C > T; p.T385M; P2. c.971G > T; p.C324F). Circulating CD4(+) T cells of both patients exhibited increased interferon-γ and decreased IL-17 expression as compared to controls. They also exhibited increased IFN-β and -γ-induced STAT1 phosphorylation that was reversed upon treatment with the JAK kinase inhibitor ruxolitinib. STAT1 GOF mutations may present early in life with CID, consistent with the clinical heterogeneity of the disease. JAK kinase inhibitors may potentially be useful in some patients as adjunct therapy pending definitive treatment with bone marrow transplantation.

  16. Changes in physico-chemical characteristics of leukocyte membranes as late effects of low doses of radioactivity and their correlation with several functions of the immune system

    International Nuclear Information System (INIS)

    Kalnina, I.; Meirovics, I.; Bruvere, R.; Heisele, O.; Volrate, A.; Feldmane, G.; Zvagule, T.; Klimkane, L.

    1998-01-01

    Membrane damage is considered to play key role in cell killing by ionising radiation and also in the loss of many different membrane functional properties induced by ionising radiation. The aim of this work was to characterize structural changes of peripheral blood mononuclear cells' (PBMC) membranes and their relationship to several functions of the immune system in Latvia' s residents who have been doing the clean-up work in Chernobyl in 1986. The correlative relationships between the fluorescence intensity and the fluorescence maxima wavelength of ABM in PBMC suspension, and several parameters of the immune state as well as the total anti oxidative activity of serum were determined in 97 clean-up workers. Conclusions: Obtained patterns of spectra suggest that specific and qualitatively different changes of membrane properties are evident in Chernobyl clean-up worker's PBMC. The revealed changes correlates with changes of the immune state of the individuals

  17. Health/functioning characteristics, gambling behaviors and gambling-related motivations in adolescents stratified by gambling problem severity: Findings from a high-school survey

    Science.gov (United States)

    Yip, Sarah W.; Desai, Rani A.; Steinberg, Marvin A.; Rugle, Loreen; Cavallo, Dana A.; Krishnan-Sarin, Suchitra; Potenza, Marc N.

    2013-01-01

    In adults, different levels of gambling problem severity are differentially associated with measures of health and general functioning, gambling behaviors and gambling-related motivations. Here we present data from a survey of 2,484 Connecticut high school students, and investigate the data stratifying by gambling problem severity based on DSM-IV criteria for pathological gambling. Problem/pathological gambling was associated with a range of negative functions; e.g., poor academic performance, substance use, dysphoria/depression, and aggression. These findings suggest a need for improved interventions related to adolescent gambling and a need for additional research into the relationship (e.g., mediating factors) between gambling and risk and protective behaviors. PMID:21999494

  18. Amnésia retrógrada funcional grave: relato de caso Severe functional retrograde amnesia: case report

    Directory of Open Access Journals (Sweden)

    Maila de Castro L. Neves

    2008-01-01

    Full Text Available CONTEXTO: Uma síndrome amnésica clássica caracteriza-se por evidente prejuízo da memória anterógrada, variável e temporária amnésia retrógrada, sendo as formas não-declarativas da memória poupadas. Entretanto, publicações recentes relataram casos de prejuízo desproporcional da memória retrógrada em relação à anterógrada. OBJETIVOS: Relatar o caso de um paciente de 26 anos de idade com um quadro grave de amnésia retrógrada, aparentemente sem fatores desencadeantes. MÉTODOS: Entrevista psiquiátrica e avaliação neuropsicológica. RESULTADOS: A perda de memória do paciente se estendia por toda sua vida, mas ele era capaz de adquirir e reter novas informações. Ele também apresentava prejuízos na produção e na compreensão de palavras, assim como no reconhecimento e no uso de objetos. CONCLUSÃO: A formulação diagnóstica final do caso é difícil, apontando possivelmente o contínuo existente entre a amnésia retrógrada psicogênica e a orgânica.BACKGROUND: A classic amnestic syndrome is characterized by a significant impairment of the anterograde memory, a variable and transitory retrograde amnesia with preserved non-declarative memory. However, case reports of patients with disproportionate compromise of the retrograde memory have been described in the recent literature. OBJECTIVES: To report a 26-year-old patient with a severe global retrograde amnesia with no evident triggering factor. METHODS: Psychiatric interview and neuropsychological evaluation. RESULTS: His memory loss compromised all domains of his life, although he could acquire and retain new information. He also exhibited prominent deficits in production and comprehension of common words as well as in recognition and use of objects. DISCUSSION: The final diagnostic formulation of the present case is difficult possibly indicating a continuum between psychogenic and organic retrograde amnesia.

  19. Effect of Intravenous Cyclophosphamide Pulse Therapy on Renal Functions and Histopathology in Patients with Severe Lupus Nephritis

    Directory of Open Access Journals (Sweden)

    Huraib Sameer

    2000-01-01

    chronic renal failure showed initial high serum creatinine to be a powerful predictor of renal failure. In conclusion, IC pulse therapy is effective in improving or stabilizing renal function in patients with class IV or V LN. The only poor prognostic determinant observed was higher initial serum creatinine value.

  20. INFLUENCE OF SEASON PATTERN ON PREVALENCE AND SEVERITY OF ACUTE MYOCARDIAL INFARCTION, FUNCTION OF HEMOSTASIS IN PATIENTS WITH ISCHEMIC HEART DESEASE OF CLIMATE AREA OF MIDDLE VOLGA REGION

    Directory of Open Access Journals (Sweden)

    O.K. Rybak

    2007-09-01

    Full Text Available The aim of this study is to evaluate season pattern, severity and outcome of acute myocardial infarction in dependence of yearly patterns of function of hemostasis in middle Volga Region. Season pattern of prevalence myocardial infarction with winter peak was discovered, be accompanied of increase platelet aggregation, deterioration of blood viscosity, fibrinolysis depression. Most serious clinical course of summer myocardial infarction was observed with prosperity of hemostasis.

  1. Severity of pediatric pain in relation to school-related functioning and teacher support: an epidemiological study among school-aged children and adolescents.

    Science.gov (United States)

    Vervoort, Tine; Logan, Deirdre E; Goubert, Liesbet; De Clercq, Bart; Hublet, Anne

    2014-06-01

    The current cross-sectional study examined child and adolescent pain severity in relation to various domains of school functioning and, in line with self-determination theory, the potentially protective role of perceived teacher support of child/adolescent autonomy and competence. Data from a large representative sample of Flemish school children and adolescents (N=10650; 50.8% boys; age range 10-21years; mean age=14.33) was collected as part of the World Health Organization (WHO) collaborative Health Behaviour in School-Aged Children (HBSC) survey. Child/adolescent pain severity was graded based on a pediatric pain classification system adapted from that of Von Korff et al. The current study thus provided insight regarding the prevalence of pain among Flemish children/adolescents and, extending the limitations of existing literature, examined the specific role of pain severity across various domains of school functioning. Findings indicated that a sizeable proportion of children reported moderate to severe pain problems (ie, about 14% of children and adolescents were classified in the highest pain grades: ie, grade III or IV). Furthermore, higher pain grades were associated with poorer outcomes across all indices of school functioning (ie, school absenteeism, school-related pressure and satisfaction, and bullying experiences), with the exception of academic performance. However, the association between pain grade and school absenteeism was less pronounced when children perceived their teachers to be highly supportive of competence and autonomy. Furthermore, teacher support of competence appeared to buffer against the harmful effects of severe pain upon instances of bullying experiences at school. Future research directions and implications for school-based interventions are discussed. Copyright © 2014 International Association for the Study of Pain. Published by Elsevier B.V. All rights reserved.

  2. Enhanced enzymatic saccharification of pretreated biomass using glycerol thermal processing (GTP).

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    Zhang, Wei; Sathitsuksanoh, Noppadon; Barone, Justin R; Renneckar, Scott

    2016-01-01

    Biomass was heated (200-240°C) in the presence of glycerol, for 4-12 min, under shear to disrupt the native cell wall architecture. The impact of this method, named glycerol thermal processing (GTP), on saccharification efficiency of the hardwood Liquidambar styraciflua, and a control cellulose sample was studied as a function of treatment severity. Furthermore, the enzymatic conversion of samples with varying compositions was studied after extraction of the structural polymers. Interestingly, the sweet gum processed materials crystallinity index increased by 10% of the initial value. The experiments revealed that the residual lignin was not a barrier to limiting the digestibility of cellulose after pretreatment yielding up to 70% glucose based on the starting wood material. Further xylan removal greatly improved the cellulose hydrolysis rate, converting nearly 70% of the cellulose into glucose within 24h, and reaching 78% of ultimate glucan digestibility after 72 h. Copyright © 2015 Elsevier Ltd. All rights reserved.

  3. Does improvement of cognitive functioning by cognitive remediation therapy effect work outcomes in severe mental illness? A secondary analysis of a randomized controlled trial.

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    Ikebuchi, Emi; Sato, Sayaka; Yamaguchi, Sosei; Shimodaira, Michiyo; Taneda, Ayano; Hatsuse, Norifumi; Watanabe, Yukako; Sakata, Masuhiro; Satake, Naoko; Nishio, Masaaki; Ito, Jun-Ichiro

    2017-05-01

    The aim of this study was to clarify whether improvement of cognitive functioning by cognitive remediation therapy can improve work outcome in schizophrenia and other severe mental illnesses when combined with supported employment. The subjects of this study were persons with severe mental illness diagnosed with schizophrenia, major depression, or bipolar disorder (ICD-10) and cognitive dysfunction who participated in both cognitive remediation using the Thinking Skills for Work program and a supported employment program in a multisite, randomized controlled study. Logistic and multiple linear regression analyses were performed to clarify the influence of cognitive functioning on vocational outcomes, adjusting for demographic and clinical variables. Improvement of cognitive functioning with cognitive remediation significantly contributed to the total days employed and total earnings of competitive employment in supported employment service during the study period. Any baseline demographic and clinical variables did not significantly contribute to the work-related outcomes. A cognitive remediation program transferring learning skills into the real world is useful to increase the quality of working life in supported employment services for persons with severe mental illness and cognitive dysfunction who want to work competitively. © 2016 The Authors. Psychiatry and Clinical Neurosciences © 2016 Japanese Society of Psychiatry and Neurology.

  4. Self-Efficacy and Hemoglobin A1C Among Adults With Serious Mental Illness and Type 2 Diabetes: The Roles of Cognitive Functioning and Psychiatric Symptom Severity.

    Science.gov (United States)

    Wykes, Thomas L; Lee, Aaron A; McKibbin, Christine L; Laurent, Sean M

    2016-04-01

    Self-efficacy is a core element of diabetes self-care and a primary target of diabetes interventions. Adults with serious mental illness (SMI) are twice as likely as adults among the general population to have Type 2 diabetes. This population faces substantial barriers (i.e., cognitive impairment, psychiatric symptoms) to optimal diabetes self-care, but the relationship of these barriers to both self-efficacy and glycemic control (hemoglobin A1C [A1C]) is not clearly understood. Data collected from adult participants with SMI (i.e., schizophrenia, schizoaffective disorder, bipolar disorder) and Type 2 diabetes (n = 92) were used to examine the moderating effects of cognitive functioning and psychiatric symptoms (i.e., positive and negative symptoms) on the association between self-efficacy and A1C. The relationship between self-efficacy and A1C was moderated by cognitive functioning (B = -4.03, standard error = 1.54, p = .011). Greater self-efficacy was associated with better glycemic control when cognitive functioning was high, but worse control when functioning was low. The relationship between self-efficacy and A1C was moderated by negative symptom severity (B = 6.88, standard error = 3.34, p = .043). Higher self-efficacy was associated with poorer glycemic control only when negative symptom severity was high. Positive symptoms did not interact with self-efficacy to predict A1C. These results suggest that adults with SMI and low cognitive function or high negative symptom severity may misperceive their ability to manage their diabetes. They may benefit from efforts, including care management and monitoring, cognitive remediation, and skill training, to identify and correct inaccurate diabetes self-efficacy.

  5. [Relationship between tic symptom severity and amplitude of low frequency fluctuation of resting-state functional magnetic resonance imaging of Tourette syndrome].

    Science.gov (United States)

    Cui, Yong-hua; Zheng, Yi; Jin, Zhen; He, Yong; Chen, Xu; Yu, Li-ping

    2013-06-01

    To examine the relationship between tic symptom severity and amplitude of low frequency fluctuation (ALFF) brain functioning of the first-episode Tourette syndrome through resting-state functional magnetic resonance imaging (fMRI). Sixteen subjects were all recruited from the outpatient department of pediatrics, Beijing Anding Hospital, Capital Medical University and were all first-episode Tourette syndrome patients [male: 13, female: 3; age: 6-16 years; mean age: (11.00 ± 2.92) years]; mean education time: (5.06 ± 2.86) years; course: 14-104 months; mean (48.44 ± 25.00) months; scores of YGTSS at baseline: tic severity score: 37.88 ± 5.39; global damage score: 25.63 ± 12.63. All the subjects experienced resting-state fMRI scans and ALFF were calculated in three frequency ranges: 0.01-0.1 Hz, 0.01-0.027 Hz and 0.027-0.073 Hz. First-episode Tourette syndrome patients and 16 gender, age, and education-matched normal controls experienced resting-state fMRI scans. Correlation analysis was performed in between the amplitude of low frequency fluctuation (ALFF) and the severity of tic symptom. P tic symptom patients, tic severity (total tic scores of YGTSS) was positively correlated with the ALFF values in the orbital part of left superior frontal gyrus (0.01-0.1 Hz:r = 0.83,0.027-0.073 Hz:r = 0.91, P Tic severity was negatively correlated with the ALFF values in the right calcarine fissure and surrounding cortex (0.01-0.1 Hz:r = -0.65,0.01-0.027 Hz:r = -0.69, P Tic symptom severity of the first-episode Tourette syndrome is associated with abnormal brain activity patterns of specific brain areas.

  6. Burke-Fahn-Marsden dystonia severity, Gross Motor, Manual Ability, and Communication Function Classification scales in childhood hyperkinetic movement disorders including cerebral palsy: a 'Rosetta Stone' study.

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    Elze, Markus C; Gimeno, Hortensia; Tustin, Kylee; Baker, Lesley; Lumsden, Daniel E; Hutton, Jane L; Lin, Jean-Pierre S-M

    2016-02-01

    Hyperkinetic movement disorders (HMDs) can be assessed using impairment-based scales or functional classifications. The Burke-Fahn-Marsden Dystonia Rating Scale-movement (BFM-M) evaluates dystonia impairment, but may not reflect functional ability. The Gross Motor Function Classification System (GMFCS), Manual Ability Classification System (MACS), and Communication Function Classification System (CFCS) are widely used in the literature on cerebral palsy to classify functional ability, but not in childhood movement disorders. We explore the concordance of these three functional scales in a large sample of paediatric HMDs and the impact of dystonia severity on these scales. Children with HMDs (n=161; median age 10y 3mo, range 2y 6mo-21y) were assessed using the BFM-M, GMFCS, MACS, and CFCS from 2007 to 2013. This cross-sectional study contrasts the information provided by these scales. All four scales were strongly associated (all Spearman's rank correlation coefficient rs >0.72, pdisorders including cerebral palsy can be effectively evaluated using these scales. © 2015 Mac Keith Press.

  7. Associations among depression severity, painful physical symptoms, and social and occupational functioning impairment in patients with major depressive disorder: a 3-month, prospective, observational study.

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    Harada, Eiji; Satoi, Yoichi; Kuga, Atsushi; Tokuoka, Hirofumi; Kikuchi, Toshiaki; Watanabe, Koichiro; Alev, Levent; Mimura, Masaru

    2017-01-01

    To investigate associations among depression severity, painful physical symptoms (PPS), and social and occupational functioning impairment in patients with major depressive disorder (MDD) who had achieved complete remission (CR) or partial remission (PR) after acute treatment. This was a 12-week, multicenter, prospective, observational study. Patients with MDD treated with an antidepressant medication for the previous 12 weeks (±3 weeks) who had achieved CR (defined as a 17-item Hamilton Rating Scale for Depression [HAM-D17] score ≤7) or PR (HAM-D17 score ≥8 and ≤18) were enrolled. Depression severity, PPS, and impairment in social and occupational functioning were assessed using the HAM-D17, the Brief Pain Inventory (Short Form) (BPI-SF), and the Social and Occupational Functioning Assessment Scale (SOFAS), respectively, at enrollment (Week 12) and after 12 weeks (Week 24). Overall, 323 Japanese patients with MDD were enrolled (CR n=158, PR n=165) and 288 patients completed the study (CR n=139, PR n=149). HAM-D17 and SOFAS scores were strongly and negatively correlated at enrollment (Week 12; P depressive symptoms and PPS is important for achieving a normal level of functioning on a long-term basis in patients with MDD.

  8. Schizophrenia patients with a history of severe violence differ from nonviolent schizophrenia patients in perception of emotions but not cognitive function.

    Science.gov (United States)

    Silver, Henry; Goodman, Craig; Knoll, Gabriella; Isakov, Victoria; Modai, Ilan

    2005-03-01

    Impaired processing of emotions may relate to violent behavior in schizophrenia patients. We compared emotional function in schizophrenia patients with and without a history of severe violent behavior. Tests of identification and differentiation of facial emotions were performed to compare 35 patients with chronic schizophrenia or schizoaffective disorder (DSM-IV criteria) and a history of severe violent behavior with 35 non-violent schizophrenia patients and 46 healthy controls. Tests of executive function, attention, visual orientation, working memory, memory for faces and objects, and motor function were also administered. Violent and nonviolent schizophrenia patients showed impaired emotional and cognitive function compared with controls. Violent patients showed a significantly better ability to identify facial emotional expressions but a poorer ability to discriminate between intensity of emotions than nonviolent schizophrenia patients. There was no difference in cognitive performance between the 2 patient groups. Violent schizophrenia patients may have a better ability to identify facial emotional cues than nonviolent schizophrenia patients but may be less able to assess the intensity of these cues. This trait may contribute to conflict generation and failure to recognize resolution signals, leading to conflict escalation and violence in violence-prone schizophrenia patients.

  9. Effect of tiotropium bromide combined with salmeterol fluticasone inhalation on airway function and airway inflammation in patients with moderate-severe stable COPD

    Directory of Open Access Journals (Sweden)

    Min Xiang

    2016-12-01

    Full Text Available Objective: To analyze the effect of tiotropium bromide combined with salmeterol fluticasone inhalation on airway function and airway inflammation in patients with moderate-severe stable COPD. Methods: A total of 118 patients with moderate-severe stable COPD were randomly divided into observation group and control group (n=59, control group accepted routine treatment, observation group received tiotropium bromide combined with salmeterol fluticasone inhalation treatment, and then differences in the levels of small airway function and airway wall parameters, the content of inflammatory factors and chemokines in serum and so on were compared between two groups of patients after 2 weeks of treatment. Results: After 2 weeks of treatment, small airway function parameters FEF25, FEF25-75 and FEF75 levels of observation group were significantly higher than those of control group, airway wall parameters WT, WA and T/D levels were significantly lower than those of control group, and AI level was significantly higher than that of control group; MIP-1α, PCT, NF-κ B, IL-6, CRP, Eotaxin, CCL18, Lymphotactin, sFKN and MCP-1 content in serum of observation group were significantly lower than those of control group while sTNFR content was significantly higher than that of control group. Conclusions: Tiotropium bromide combined with salmeterol fluticasone inhalation therapy can optimize the overall condition in patients with moderatesevere stable COPD, which is specifically reflected on the control of the airway function and the degree of inflammation.

  10. Elucidating the role of ferrous ion cocatalyst in enhancing dilute acid pretreatment of lignocellulosic biomass

    Directory of Open Access Journals (Sweden)

    Wei Hui

    2011-11-01

    Full Text Available Abstract Background Recently developed iron cocatalyst enhancement of dilute acid pretreatment of biomass is a promising approach for enhancing sugar release from recalcitrant lignocellulosic biomass. However, very little is known about the underlying mechanisms of this enhancement. In the current study, our aim was to identify several essential factors that contribute to ferrous ion-enhanced efficiency during dilute acid pretreatment of biomass and to initiate the investigation of the mechanisms that result in this enhancement. Results During dilute acid and ferrous ion cocatalyst pretreatments, we observed concomitant increases in solubilized sugars in the hydrolysate and reducing sugars in the (insoluble biomass residues. We also observed enhancements in sugar release during subsequent enzymatic saccharification of iron cocatalyst-pretreated biomass. Fourier transform Raman spectroscopy showed that major peaks representing the C-O-C and C-H bonds in cellulose are significantly attenuated by iron cocatalyst pretreatment. Imaging using Prussian blue staining indicated that Fe2+ ions associate with both cellulose/xylan and lignin in untreated as well as dilute acid/Fe2+ ion-pretreated corn s