Sample records for prolonged initial empirical

  1. An empirical review of potential mediators and mechanisms of prolonged exposure therapy.

    Cooper, Andrew A; Clifton, Erin G; Feeny, Norah C


    Prolonged exposure (PE) is an empirically-supported treatment for posttraumatic stress disorder (PTSD), but the precise mechanism(s) by which PE promotes symptom change are not well established. Understanding how PE works is critical to improving clinical outcomes, advancing dissemination efforts, and enhancing transdiagnostic models of psychopathology. However, mechanisms research conducted in clinical treatment settings is complex, and findings may be difficult to interpret without appropriate context. This is the first review of potential mechanisms of PE to provide such context, by rigorously evaluating empirical findings in line with essential criteria for effective research on mechanisms (or mediators). We begin by describing six putative mechanisms identified by emotional processing theory and contemporary models of fear extinction, before thoroughly reviewing empirical findings from clinical research on PE and similar PTSD treatments. We provide a detailed description of each study and mechanism test, as well as ratings of strength of evidence and quality of evaluation based on a novel rating scheme. We highlight variables with strong evidence (belief change and between-session habituation), intermediate evidence (inhibitory learning and emotional engagement), and minimal support (narrative organization and within-session habituation). After discussing limitations of the extant literature and this review, we summarize specific challenges for research on PE mechanisms and highlight directions for future study based on clinical and research implications. Copyright © 2017 Elsevier Ltd. All rights reserved.

  2. Empirical initialization of the trait estimator in adaptive testing

    Linden, van der Wim J.


    A procedure for empirical initialization of the trait. estimator in adaptive testing is proposed that is based on the statistical relation between and background variables known prior to test administration. The relation is modeled using a two-parameter version of a logistic item response theory m

  3. Rationale for hedging initiatives: Empirical evidence from the energy industry

    Dhanarajata, Srirajata

    Theory offers different rationales for hedging including (i) financial distress and bankruptcy cost, (ii) capacity to capture attractive investment opportunities, (iii) information asymmetry, (iv) economy of scale, (v) substitution for hedging, (vi) managerial risk aversion, and (vii) convexity of tax schedule. The purpose of this dissertation is to empirically test the explanatory power of the first five theoretical rationales on hedging done by oil and gas exploration and production (E&P) companies. The level of hedging is measured by the percentage of production effectively hedged, calculated based on the concept of delta and delta-gamma hedging. I employ Tobit regression, principal components, and panel data analysis on dependent and raw independent variables. Tobit regression is applied due to the fact that the dependent variable used in the analysis is non-negative. Principal component analysis helps to reduce the dimension of explanatory variables while panel data analysis combines/pools the data that is a combination of time-series and cross-sectional. Based on the empirical results, leverage level is consistently found to be a significant factor on hedging activities, either due to an attempt to avoid financial distress by the firm, or an attempt to control agency cost by debtholders, or both. The effect of capital expenditures and discretionary cash flows are both indeterminable due possibly to a potential mismatch in timing of realized cash flow items and hedging decision. Firm size is found to be positively related to hedging supporting economy of scale hypothesis, which is introduced in past literature, as well as the argument that large firm usually are more sophisticated and should be more willing and more comfortable to use hedge instruments than smaller firms.

  4. An Empirical Case Study of a Child Sexual Abuse Prevention Initiative in Georgia

    Schober, Daniel J.; Fawcett, Stephen B.; Thigpen, Sally; Curtis, Anna; Wright, Renee


    Objective: This empirical case study describes Prevent Child Abuse Georgia's effort to prevent child sexual abuse (CSA) by educating communities throughout the state on supporting preventive behaviour. The initiative consisted of three major components: (1) dissemination of CSA prevention messages and materials; (2) a statewide helpline that…

  5. An Empirical Case Study of a Child Sexual Abuse Prevention Initiative in Georgia

    Schober, Daniel J.; Fawcett, Stephen B.; Thigpen, Sally; Curtis, Anna; Wright, Renee


    Objective: This empirical case study describes Prevent Child Abuse Georgia's effort to prevent child sexual abuse (CSA) by educating communities throughout the state on supporting preventive behaviour. The initiative consisted of three major components: (1) dissemination of CSA prevention messages and materials; (2) a statewide helpline that…

  6. Impact of three empirical anti-tuberculosis treatment strategies for people initiating antiretroviral therapy.

    Van Rie, A; Westreich, D; Sanne, I


    Early mortality in people initiating antiretroviral treatment (ART) remains high. Empirical anti-tuberculosis treatment strategies aim to reduce early mortality by initiating anti-tuberculosis treatment in individuals at high risk of death from undiagnosed TB. Using data from 16 913 individuals starting ART under program conditions, we simulated the impact of three empirical treatment strategies (two clinical trials and a pragmatic approach), assuming that 50% of early deaths and 100% of incident TB are averted in those eligible. Compared to starting anti-tuberculosis treatment on clinical or mycobacteriological grounds, 4.4-31.4% more individuals were eligible for anti-tuberculosis treatment, 5.5-25.4% of deaths were averted and 10.9-57.3% of incident TB cases were prevented under empirical anti-tuberculosis treatment strategies. The proportion receiving any anti-tuberculosis treatment during the first 6 months of ART increased from the observed 24.0% to an estimated 27.5%, 40.4% and 51.3%, under the PrOMPT, REMEMBER and pragmatic approach, respectively. The impact of empirical anti-tuberculosis treatment strategies depends greatly on the eligibility criteria chosen. The additional strain placed on anti-tuberculosis treatment facilities and the relatively limited impact of some empirical TB strategies raise the question as to whether the benefits will outweigh the risks at population level.

  7. Department of pharmacy-initiated program for streamlining empirical antibiotic therapy.

    Pastel, D A; Chang, S; Nessim, S; Shane, R; Morgan, M A


    The outcome of a department of pharmacy-initiated "streamlining" study designed to promote cost-conscious modifications of empirically selected antibiotic therapy is described. Two hundred forty-one evaluable adult patients started on restricted-use antibiotics at this university-affiliated community private teaching hospital were enrolled in a 9-week prospective streamlining study. Patients were alternately assigned to a Control (i.e., no pharmacist-initiated streamlining recommendations offered based on culture and susceptibility reports) or a Pharmacist Intervention group (i.e., pharmacist offers recommendations to streamline therapy). A statistically significant greater number of patients had their empiric antibiotic treatment courses modified to more appropriate antibiotic choices after receipt of culture and susceptibility reports among private prescribers in the Pharmacist Intervention group (83%) than in the Control group (38%) (p = .006). Additionally, pharmacists were overall successful in gaining prescriber acceptance for 64% of recommended changes of empiric antibiotic treatment courses before the receipt of culture and susceptibility reports (e.g., dose and/or frequency changes). There was no program effect observed with respect to improved physician response to microbiologic data that would allow streamlining empirical antibiotic choices in the Housestaff (i.e., medical or surgical residents), or infectious disease consultant prescriber groups. Projected overall annual cost savings that would be achieved as a result of continued efforts by pharmacists directed at streamlining empirical "restricted" antibiotic regimens is approximately +40,000.

  8. [Breastfeeding (part one): Frequency, benefits and drawbacks, optimal duration and factors influencing its initiation and prolongation. Clinical guidelines for practice].

    Chantry, A A; Monier, I; Marcellin, L


    The objectives were to on assess the frequency and the duration of breastfeeding in France. On the other hand, the objectives were to identify its benefits and drawbacks, and to study the factors influencing its initiation and its extension. Bibliographic research in Medline, Google Scholar and in the Cochrane Library. Breastfeeding concerns in France about 70% of children at birth (EL2). Its median duration is about 15 weeks and 3 weeks ½ for exclusive breastfeeding. At three months, only one third of children breastfed at birth are still being breastfed (EL2). Whether this is due to the composition of breast milk or the behavior of mothers with their children or their socio-cultural level, or even by all these components at once, breastfeeding is associated with better cognitive development children (EL2). This effect is even more reinforced that mothers breastfeed exclusively and prolonged (EL2). As part of the prevention of many diseases (ear infections, gastrointestinal infections, atopic diseases, obesity and cardiovascular diseases…), exclusive and prolonged breastfeeding (grade B) between 4 to 6 months is recommended (professional consensus). Breastfeeding is not a means of preventing postpartum depression (professional consensus). To reduce the incidence of breast cancer, prolonged breastfeeding is recommended (grade B). In order to increase the rate of initiation of breastfeeding as well as its duration, it is recommended that health professionals work closely with mothers in their project (grade A), the breastfeeding promotion messages include message to husbands (grade B), and to promote breastfeeding on demand without fixed interval between feedings (grade B). However, there is not enough data to recommend the use of a specific position during breastfeeding, or the use of one or two breast or to early start breastfeeding or not (professional consensus). Exclusive and extended breastfeeding is recommended (grade B) between 4 to 6 months (professional

  9. Network structure implied by initial axon outgrowth in rodent cortex: empirical measurement and models.

    Cahalane, Diarmuid J; Clancy, Barbara; Kingsbury, Marcy A; Graf, Ethan; Sporns, Olaf; Finlay, Barbara L


    The developmental mechanisms by which the network organization of the adult cortex is established are incompletely understood. Here we report on empirical data on the development of connections in hamster isocortex and use these data to parameterize a network model of early cortical connectivity. Using anterograde tracers at a series of postnatal ages, we investigate the growth of connections in the early cortical sheet and systematically map initial axon extension from sites in anterior (motor), middle (somatosensory) and posterior (visual) cortex. As a general rule, developing axons extend from all sites to cover relatively large portions of the cortical field that include multiple cortical areas. From all sites, outgrowth is anisotropic, covering a greater distance along the medial/lateral axis than along the anterior/posterior axis. These observations are summarized as 2-dimensional probability distributions of axon terminal sites over the cortical sheet. Our network model consists of nodes, representing parcels of cortex, embedded in 2-dimensional space. Network nodes are connected via directed edges, representing axons, drawn according to the empirically derived anisotropic probability distribution. The networks generated are described by a number of graph theoretic measurements including graph efficiency, node betweenness centrality and average shortest path length. To determine if connectional anisotropy helps reduce the total volume occupied by axons, we define and measure a simple metric for the extra volume required by axons crossing. We investigate the impact of different levels of anisotropy on network structure and volume. The empirically observed level of anisotropy suggests a good trade-off between volume reduction and maintenance of both network efficiency and robustness. Future work will test the model's predictions for connectivity in larger cortices to gain insight into how the regulation of axonal outgrowth may have evolved to achieve efficient


    Pavel STANCIU


    Full Text Available The villages of Bucovina possess a particular charm, mainly through the orthodox churches with heritage value, the deep spiritual character sent both to local communities and tourists, the architecture based on wood handicraft, the manner in which traditions, local customs and crafts are still preserved, the multicultural character, and, not least, the outstanding hospitality of the hosts.Continuous improvement of performance in rural tourism refers to an integrated approach of specific elements in the destination Bucovina, online marketing becoming more present in everyday practice of small entrepreneurs in local tourism. From an empirical point of view, promotion of rural tourism on Facebook and YouTube represents an easy initiative accessible to the general public, which has the ability to create the foundation of a competitive tourism.

  11. Evaluating acellular versus cellular perfusate composition during prolonged ex vivo lung perfusion after initial cold ischaemia for 24 hours.

    Becker, Simon; Steinmeyer, Jasmin; Avsar, Murat; Höffler, Klaus; Salman, Jawad; Haverich, Axel; Warnecke, Gregor; Ochs, Matthias; Schnapper, Anke


    Normothermic ex vivo lung perfusion (EVLP) has developed as a powerful technique to evaluate particularly marginal donor lungs prior to transplantation. In this study, acellular and cellular perfusate compositions were compared in an identical experimental setting as no consensus has been reached on a preferred technique yet. Porcine lungs underwent EVLP for 12 h on the basis of an acellular or a cellular perfusate composition after 24 h of cold ischaemia as defined organ stress. During perfusion, haemodynamic and respiratory parameters were monitored. After EVLP, the lung condition was assessed by light and transmission electron microscopy. Aerodynamic parameters did not show significant differences between groups and remained within the in vivo range during EVLP. Mean oxygenation indices were 491 ± 39 in the acellular group and 513 ± 53 in the cellular group. Groups only differed significantly in terms of higher pulmonary artery pressure and vascular resistance in the cellular group. Lung histology and ultrastructure were largely well preserved after prolonged EVLP and showed only minor structural alterations which were similarly present in both groups. Prolonged acellular and cellular EVLP for 12 h are both feasible with lungs prechallenged by ischaemic organ stress. Physiological and ultrastructural analysis showed no superiority of either acellular or cellular perfusate composition.

  12. A discrete-time analysis of the effects of more prolonged exposure to neighborhood poverty on the risk of smoking initiation by age 25.

    Kravitz-Wirtz, Nicole


    Evidence suggests that individuals who initiate smoking at younger ages are at increased risk for future tobacco dependence and continued use as well as for numerous smoking-attributable health problems. Identifying individual, household, and to a far lesser extent, contextual factors that predict early cigarette use has garnered considerable attention over the last several decades. However, the majority of scholarship in this area has been cross-sectional or conducted over relatively short windows of observation. Few studies have investigated the effects of more prolonged exposure to smoking-related risk factors, particularly neighborhood characteristics, from childhood through early adulthood. Using the 1970-2011 waves of the Panel Study of Income Dynamics merged with census data on respondents' neighborhoods, this study estimates a series of race-specific discrete-time marginal structural logit models for the risk of smoking initiation as a function of neighborhood poverty, as well as individual and household characteristics, from ages four through 25. Neighborhood selection bias is addressed using inverse-probability-of-treatment weights. Results indicate that more prolonged exposure to high (>20%) as opposed to low (smoking onset by age 25, although consistent with prior literature, this effect is only evident among white and not nonwhite youth and young adults.

  13. A Multivariate Empirical Orthogonal Function-Based Scheme for the Balanced Initial Ensemble Generation of an Ensemble Kalman Filter

    ZHENG Fei; ZHU Jiang


    The initial ensemble perturbations for an ensemble data assimilation system are expected to reasonably sample model uncertainty at the time of analysis to further reduce analysis uncertainty.Therefore,the careful choice of an initial ensemble perturbation method that dynamically cycles ensemble perturbations is required for the optimal performance of the system.Based on the multivariate empirical onhogonal function(MEOF)method,a new ensemble initialization scheme is developed to generate balanced initial perturbations for the ensemble Kalman filter(EnKF)data assimilation,with a reasonable consideration of the physical relationships between different model variables.The scheme is applied in assimilation experiments with a global spectral atmospheric model and with real observations.The proposed perturbation method is compared to the commonly used method of spatially-correlated random perturbations.The comparisons show that the model uncertainties prior to the first analysis time,which are forecasted from the balanced ensemble initial fields,maintain a much more reasonable spread and a more accurate forecast error covariance than those from the randomly perturbed initial fields.The analysis results are further improved by the balanced ensemble initialization scheme due to more accurate background information.Also,a 20-day continuous assimilation experiment shows that the ensemble spreads for each model variable are still retained in reasonable ranges without considering additional perturbations or inflations during the assimilation cycles,while the ensemble spreads from the randomly perturbed initialization scheme decrease and collapse rapidly.

  14. Large Deviations for Empirical Measures of Not Necessarily Irreducible Countable Markov Chains with Arbitrary Initial Measures

    Yi Wen JIANG; Li Ming WU


    All known results on large deviations of occupation measures of Markov processes are based on the assumption of (essential) irreducibility. In this paper we establish the weak* large deviation principle of occupation measures for any countable Markov chain with arbitrary initial measures. The new rate function that we obtain is not convex and depends on the initial measure, contrary to the (essentially) irreducible case.

  15. Using Empirical Data to Estimate Potential Functions in Commodity Markets: Some Initial Results

    Shen, C.; Haven, E.


    This paper focuses on estimating real and quantum potentials from financial commodities. The log returns of six common commodities are considered. We find that some phenomena, such as the vertical potential walls and the time scale issue of the variation on returns, also exists in commodity markets. By comparing the quantum and classical potentials, we attempt to demonstrate that the information within these two types of potentials is different. We believe this empirical result is consistent with the theoretical assumption that quantum potentials (when embedded into social science contexts) may contain some social cognitive or market psychological information, while classical potentials mainly reflect `hard' market conditions. We also compare the two potential forces and explore their relationship by simply estimating the Pearson correlation between them. The Medium or weak interaction effect may indicate that the cognitive system among traders may be affected by those `hard' market conditions.

  16. Development of empirical relationship between P wave initial slopes and epicentral distance for early warning in South Korea

    Jung, S.; Sheen, D. H.


    Earthquake early warning aims to rapidly provide the information of an earthquake to minimize earthquake damage. The location accuracy of an earthquake is crucial for the accurate estimation of the source property. While standard location procedure can take the advantages of using combined P-wave and S-wave information, early warning information should be given before arriving S-wave. Odaka et al. (2003) found that P-wave initial slopes decrease almost linearly with increasing epicentral distance and proposed a method for estimating epicentral distance from P-wave initial slope. The early warning system in the Japan Meteorological Agency uses this method for locating an earthquake when only one station triggers. For developing the empirical relationship for earthquake early warning in South Korea, we investigate the relationship from 585 local earthquakes with magnitude larger than 2.0 and 147 regional earthquakes over magnitude 6.0 that occurred in and around the Korean Peninsula from 2005 to 2015.

  17. How do underwriters value initial public offerings? An empirical analysis of the french IPO market

    P.G.J. Roosenboom (Peter)


    textabstractThis paper investigates how French underwriters value the stocks of companies they bring public. Underwriters often use several valuation methods to determine their fair value estimate of the initial public offering (IPO) firm's equity. We investigate five of these valuation methods: pee

  18. How do underwriters value initial public offerings? An empirical analysis of the french IPO market

    P.G.J. Roosenboom (Peter)


    textabstractThis paper investigates how French underwriters value the stocks of companies they bring public. Underwriters often use several valuation methods to determine their fair value estimate of the initial public offering (IPO) firm's equity. We investigate five of these valuation methods:

  19. The Depression Inventory Development Workgroup: A Collaborative, Empirically Driven Initiative to Develop a New Assessment Tool for Major Depressive Disorder.

    Vaccarino, Anthony L; Evans, Kenneth R; Kalali, Amir H; Kennedy, Sidney H; Engelhardt, Nina; Frey, Benicio N; Greist, John H; Kobak, Kenneth A; Lam, Raymond W; MacQueen, Glenda; Milev, Roumen; Placenza, Franca M; Ravindran, Arun V; Sheehan, David V; Sills, Terrence; Williams, Janet B W


    The Depression Inventory Development project is an initiative of the International Society for CNS Drug Development whose goal is to develop a comprehensive and psychometrically sound measurement tool to be utilized as a primary endpoint in clinical trials for major depressive disorder. Using an iterative process between field testing and psychometric analysis and drawing upon expertise of international researchers in depression, the Depression Inventory Development team has established an empirically driven and collaborative protocol for the creation of items to assess symptoms in major depressive disorder. Depression-relevant symptom clusters were identified based on expert clinical and patient input. In addition, as an aid for symptom identification and item construction, the psychometric properties of existing clinical scales (assessing depression and related indications) were evaluated using blinded datasets from pharmaceutical antidepressant drug trials. A series of field tests in patients with major depressive disorder provided the team with data to inform the iterative process of scale development. We report here an overview of the Depression Inventory Development initiative, including results of the third iteration of items assessing symptoms related to anhedonia, cognition, fatigue, general malaise, motivation, anxiety, negative thinking, pain and appetite. The strategies adopted from the Depression Inventory Development program, as an empirically driven and collaborative process for scale development, have provided the foundation to develop and validate measurement tools in other therapeutic areas as well.

  20. [Amoxicillin and clavulanic acid versus amoxicillin plus gentamicin in the empirical initial treatment of urinary tract infections in hospitalized patients].

    Verzasconi, R; Rodoni, P; Monotti, R; Marone, C; Mombelli, G


    We compared the fixed combination amoxicillin plus clavulanic acid with that of amoxicillin plus gentamicin in the empirical initial treatment of severe urinary tract infections. The study included 87 hospitalized patients (51 women and 36 men, mean age 58 +/- 22 years) with acute uncomplicated pyelonephritis (n = 48) or with complicated urinary tract infections (n = 39). 80 patients (92%) had fever and 31 patients (36%) positive blood cultures. 45 patients were randomly assigned to amoxicillin plus clavulanic acid and 42 to amoxicillin plus gentamicin. Overall, 18 patients (21%) were infected with organisms resistant in vitro to amoxicillin plus clavulanic acid, whereas no pathogen was isolated with resistance to amoxicillin plus gentamicin (p amoxicillin plus gentamicin (p amoxicillin plus gentamicin group. Although the in-vitro resistance did not result in a lower clinical efficacy of amoxicillin plus clavulanic acid compared to amoxicillin plus gentamicin in our relatively small sample of patients, the data indicate that the antimicrobial activity of amoxicillin plus clavulanic acid is inadequate to cover the spectrum of causative agents in hospitalized patients with pyelonephritis or complicated urinary tract infections. Amoxicillin plus clavulanic acid should therefore not be used in the initial empirical treatment of these infections.

  1. Initial estimation of hydrate formation temperature of sweet natural gases based on new empirical correlation

    Mohammad Mahdi Ghiasi


    Production,processing and transportation of natural gases can be significantly affected by clathrate hydrates.Knowing the gas analysis is crucial to predict the right conditions for hydrate formation.Nevertheless,Katz gas gravity method can be used for initial estimation of hydrate formation temperature (HFT) under the circumstances of indeterminate gas composition.So far several correlations have been proposed for gas gravity method,in which the most accurate and reliable one has belonged to Bahadori and Vuthaluru.The main objective of this study is to present a simple and yet accurate correlation for fast prediction of sweet natural gases HFT based on the fit to Katz gravity chart.By reviewing the error analysis results,one can discover that the new proposed correlation has the best estimation capability among the widely accepted existing correlations within the investigated range.

  2. miR-125b can enhance skin tumor initiation and promote malignant progression by repressing differentiation and prolonging cell survival.

    Zhang, Liang; Ge, Yejing; Fuchs, Elaine


    Previously, we identified miR-125b as a key regulator of the undifferentiated state of hair follicle stem cells. Here, we show that in both mice and humans, miR-125b is abundantly expressed, particularly at early stages of malignant progression to squamous cell carcinoma (SCC), the second most prevalent cancer worldwide. Moreover, when elevated in normal murine epidermis, miR-125b promotes tumor initiation and contributes to malignant progression. We further show that miR-125b can confer "oncomiR addiction" in early stage malignant progenitors by delaying their differentiation and favoring an SCC cancer stem cell (CSC)-like transcriptional program. To understand how, we systematically identified and validated miR125b targets that are specifically associated with tumors that are dependent on miR-125b. Through molecular and genetic analysis of these targets, we uncovered new insights underlying miR-125b's oncogenic function. Specifically, we show that, on the one hand, mir-125b directly represses stress-responsive MAP kinase genes and associated signaling. On the other hand, it indirectly prolongs activated (phosphorylated) EGFR signaling by repressing Vps4b (vacuolar protein-sorting 4 homolog B), encoding a protein implicated in negatively regulating the endosomal sorting complexes that are necessary for the recycling of active EGFR. Together, these findings illuminate miR-125b as an important microRNA regulator that is shared between normal skin progenitors and their early malignant counterparts.

  3. Empiric Tuberculosis Therapy versus Isoniazid in Advanced HIV-infected Adult Outpatients Initiating Antiretroviral Therapy: a Multi-Country Randomized Controlled Trial

    Hosseinipour, Mina C.; Bisson, Gregory P.; Miyahara, Sachiko; Sun, Xin; Moses, Agnes; Riviere, Cynthia; Kirui, F.K.; Badal-Faesen, Sharla; Lagat, David; Nyirenda, Mulinda; Naidoo, K; Hakim, James; Mugyenyi, Peter; Henostroza, German; Leger, P.D; Lama, Javier.R; Mohapi, Lerato; Alave, Jorge; Mave, V; Veloso, Valdilea.G; Pillay, Sandy; Kumarasamy, N.; Bao, Jing; Hogg, Evelyn; Jones, Lynne; Zolopa, Andrew; Kumwenda, Johnstone; Gupta, Amita


    Summary Background Mortality within the first 6 months after initiating antiretroviral therapy (ART) is common in resource-limited settings and is often due to tuberculosis (TB) among patients with advanced HIV disease. Isoniazid preventive therapy (IPT) is recommended in HIV-infected adults, but sub-clinical TB can be difficult to diagnose. We hypothesized that empiric TB treatment would reduce early mortality compared to IPT in high-burden settings. Methods We conducted a multi-country randomized clinical trial comparing empiric TB therapy (Empiric) vs. isoniazid preventive therapy (IPT) in HIV-infected outpatients initiating ART with CD4 counts <50 cells/mm3. Individuals were screened for TB using a symptom screen, locally available diagnostics, and the GeneXpert MTB/RIF assay when available. The primary endpoint was survival (death or unknown status) at 24 weeks post randomization. Kaplan Meier estimates of the endpoint rates across arms were compared by the z-test. Registered at (NCT01380080). Findings From October 31, 2011 until June 9, 2014, we randomized 850 participants (424 in Empiric arm and 426 in IPT arm); the median CD4 count at baseline was 18 cells/mm3 (IQR: 9, 32). At week 24, each arm had 22 primary endpoints, for rates of 5.2% in each arm (95% CI: 3.5% to 7.8% for Empiric and 3.4% to 7.8% for IPT; absolute risk difference of -0.06% (95% CI: −3.05% to 2.94%). Grade 3 or 4 signs or symptoms occurred in 50 (12%) in the Empiric arm and 46 (11%) in the IPT arm. Grade 3 or 4 laboratory abnormalities occurred in 99 (23%) in the Empiric arm and 97 (23%) in the IPT arm. Incident TB was more common in the Empiric arm (31 vs. 18 events, p=0.01). Interpretation Empiric TB therapy did not reduce mortality at 24 weeks in outpatient adults initiating ART with advanced HIV disease. The low mortality rate of the trial supports implementation of systematic TB screening and IPT in outpatients with advanced HIV disease. PMID:27025337

  4. Empirical tuberculosis therapy versus isoniazid in adult outpatients with advanced HIV initiating antiretroviral therapy (REMEMBER): a multicountry open-label randomised controlled trial.

    Hosseinipour, Mina C; Bisson, Gregory P; Miyahara, Sachiko; Sun, Xin; Moses, Agnes; Riviere, Cynthia; Kirui, Fredrick K; Badal-Faesen, Sharlaa; Lagat, David; Nyirenda, Mulinda; Naidoo, Kogieleum; Hakim, James; Mugyenyi, Peter; Henostroza, German; Leger, Paul D; Lama, Javier R; Mohapi, Lerato; Alave, Jorge; Mave, Vidya; Veloso, Valdilea G; Pillay, Sandy; Kumarasamy, Nagalingeswaran; Bao, Jing; Hogg, Evelyn; Jones, Lynne; Zolopa, Andrew; Kumwenda, Johnstone; Gupta, Amita


    Mortality within the first 6 months after initiating antiretroviral therapy is common in resource-limited settings and is often due to tuberculosis in patients with advanced HIV disease. Isoniazid preventive therapy is recommended in HIV-positive adults, but subclinical tuberculosis can be difficult to diagnose. We aimed to assess whether empirical tuberculosis treatment would reduce early mortality compared with isoniazid preventive therapy in high-burden settings. We did a multicountry open-label randomised clinical trial comparing empirical tuberculosis therapy with isoniazid preventive therapy in HIV-positive outpatients initiating antiretroviral therapy with CD4 cell counts of less than 50 cells per μL. Participants were recruited from 18 outpatient research clinics in ten countries (Malawi, South Africa, Haiti, Kenya, Zambia, India, Brazil, Zimbabwe, Peru, and Uganda). Individuals were screened for tuberculosis using a symptom screen, locally available diagnostics, and the GeneXpert MTB/RIF assay when available before inclusion. Study candidates with confirmed or suspected tuberculosis were excluded. Inclusion criteria were liver function tests 2·5 times the upper limit of normal or less, a creatinine clearance of at least 30 mL/min, and a Karnofsky score of at least 30. Participants were randomly assigned (1:1) to either the empirical group (antiretroviral therapy and empirical tuberculosis therapy) or the isoniazid preventive therapy group (antiretroviral therapy and isoniazid preventive therapy). The primary endpoint was survival (death or unknown status) at 24 weeks after randomisation assessed in the intention-to-treat population. Kaplan-Meier estimates of the primary endpoint across groups were compared by the z-test. All participants were included in the safety analysis of antiretroviral therapy and tuberculosis treatment. This trial is registered with, number NCT01380080. Between Oct 31, 2011, and June 9, 2014, we enrolled 850

  5. Does the initiation of urate-lowering treatment during an acute gout attack prolong the current episode and precipitate recurrent attacks: a systematic literature review.

    Eminaga, Fatma; La-Crette, Jonathan; Jones, Adrian; Abhishek, A


    The aim of this study was to systematically review the literature on effect of initiating urate-lowering treatment (ULT) during an acute attack of gout on duration of index attack and persistence on ULT. OVID (Medline), EMBASE and AMED were searched to identify randomized controlled trials (RCTs) of ULT initiation during acute gout attack published in English language. Two reviewers appraised the study quality and extracted data independently. Standardized mean difference (SMD) and relative risk (RR) were used to pool continuous and categorical data. Meta-analysis was carried out using STATA version 14. A total of 537 studies were selected. A total of 487 titles and abstracts were reviewed after removing duplicates. Three RCTs were identified. There was evidence from two high-quality studies that early initiation of allopurinol did not increase pain severity at days 10-15 [SMDpooled (95 % CI) 0.18 (-0.58, 0.93)]. Data from three studies suggested that initiation of ULT during an acute attack of gout did not associate with dropouts [RRpooled (95 % CI) 1.16 (0.58, 2.31)]. There is moderate-quality evidence that the initiation of ULT during an acute attack of gout does not increase pain severity and risk of ULT discontinuation. Larger studies are required to confirm these findings so that patients with acute gout can be initiated on ULT with confidence.

  6. Tos prolongada como manifestación inicial de la arteritis de la temporal Prolonged cough as initial symptom of temporal arteritis

    María E Galván


    Full Text Available La tos prolongada puede ser un desafío diagnóstico y terapéutico. Presentamos el caso de un enfermo de 62 años con tos seca y quebrantamiento del estado general durante cuatro semanas, seguido de un síndrome febril prolongado cuyo diagnóstico final fue arteritis de la temporal, con confirmación por anatomía patológica. El dolor en los pabellones auriculares al adoptar el decúbito lateral fue otro síntoma interesante. La tos prolongada puede ser una manifestación inicial de la arteritis temporal en adultos mayores.Prolonged cough could be a diagnostic and therapeutic dilemma. We present here the case of an elder man who suffered from a dry cough and malaise during four weeks, followed by a fever of unknown origin. After many studies and review of symptoms, a biopsy of the temporal artery confirmed a giant cell arteritis. Cough and malaise could be an early symptom of temporal arteritis in elderly patients. Pain in the outer ear on the lateral decubitus could be another interesting symptom in this disease.

  7. A hip abduction exercise prior to prolonged standing increased movement while reducing cocontraction and low back pain perception in those initially reporting low back pain.

    Viggiani, Daniel; Callaghan, Jack P


    Persons who develop low back pain from prolonged standing exhibit increased muscle cocontraction, decreased movement and increased spine extension. However, it is unclear how these factors relate to pain development. The purpose of this study was to use hip abductor fatigue to manipulate muscle activity patterns and determine its effects on standing behaviours and pain development. Forty participants stood for two hours twice, once following a hip abductor fatigue exercise (fatigue), and once without exercise beforehand (control). Trunk and gluteal muscle activity were measured to determine cocontraction. Lumbo-pelvic angles and force plates were used to assess posture and movement strategies. Visual analog scales differentiated pain (PDs) and non-pain developers (NPDs). PDs reported less low back pain during the fatigue session, with females having earlier reductions of similar scale than males. The fatigue session reduced gluteal and trunk cocontraction and increased centre of pressure movement; male and female PDs had opposing spine posture compensations. Muscle fatigue prior to standing reduced cocontraction, increased movement during standing and reduced the low back pain developed by PDs; the timing of pain reductions depended on spine postures adopted during standing. Copyright © 2016 Elsevier Ltd. All rights reserved.

  8. Semi-empirical white dwarf initial-final mass relationships: a thorough analysis of systematic uncertainties due to stellar evolution models

    Salaris, Maurizio; Weiss, Achim; Bertolami, Marcelo Miller


    Using the most recent results about white dwarfs in 10 open clusters, we revisit semi-empirical estimates of the initial-final mass relation in star clusters, with emphasis on the use of stellar evolution models. We discuss the influence of these models on each step of the derivation. One intention of our work is to use consistent sets of calculations both for the isochrones and the white dwarf cooling tracks. The second one is to derive the range of systematic errors arising from stellar evolution theory. This is achieved by using different sources for the stellar models and by varying physical assumptions and input data. We find that systematic errors, including the determination of the cluster age, are dominating the initial mass values, while observational uncertainties influence the final mass primarily. After having determined the systematic errors, the initial-final mass relation allows us finally to draw conclusions about the physics of the stellar models, in particular about convective overshooting.

  9. Ursolic acid inhibits the initiation, progression of prostate cancer and prolongs the survival of TRAMP mice by modulating pro-inflammatory pathways.

    Muthu K Shanmugam

    Full Text Available Prostate cancer is one of the leading causes of cancer death among men worldwide. In this study, using transgenic adenocarcinoma of mouse prostate (TRAMP mice, the effect of diet enriched with 1% w/w ursolic acid (UA was investigated to evaluate the stage specific chemopreventive activity against prostate cancer. We found that TRAMP mice fed with UA diet for 8 weeks (weeks 4 to 12 delayed formation of prostate intraepithelial neoplasia (PIN. Similarly, mice fed with UA diet for 6 weeks (weeks 12 to 18 inhibited progression of PIN to adenocarcinoma as determined by hematoxylin and eosin staining. Finally, TRAMP mice fed with UA diet for 12 weeks (weeks 24 to 36 demonstrated markedly reduced tumor growth without any significant effects on total body weight and prolonged overall survival. With respect to the molecular mechanism, we found that UA down-regulated activation of various pro-inflammatory mediators including, NF-κB, STAT3, AKT and IKKα/β phosphorylation in the dorsolateral prostate (DLP tissues that correlated with the reduction in serum levels of TNF-α and IL-6. In addition, UA significantly down-regulated the expression levels of cyclin D1 and COX-2 but up-regulated the levels of caspase-3 as revealed by immunohistochemical analysis of tumor tissue sections. Finally, UA was detected in serum samples obtained from various mice groups fed with enriched diet in nanogram quantity indicating that it is well absorbed in the GI tract. Overall, our findings provide strong evidence that UA can be an excellent agent for both the prevention and treatment of prostate cancer.

  10. Fear of falling is associated with prolonged anticipatory postural adjustment during gait initiation under dual-task conditions in older adults.

    Uemura, Kazuki; Yamada, Minoru; Nagai, Koutatsu; Tanaka, Buichi; Mori, Shuhei; Ichihashi, Noriaki


    Little is known about dynamic balance control under dual-task conditions in older adults with fear of falling (FoF). The purpose of this study was to examine the effect of FoF on anticipatory postural adjustment (APA) during gait initiation under dual-task conditions in older adults. Fifty-seven elderly volunteers (age, 79.2 [6.8] years) from the community participated in this study. Each participant was categorised into either the Fear (n=24) or No-fear (n=33) group on the basis of the presence or absence of FoF. Under single- and dual-task conditions, centre of pressure (COP) data were collected while the participants performed gait initiation trials from a starting position on a force platform. We also performed a 10-m walking test (WT), a timed up & go test (TUG), and a functional reach test (FR). The reaction and APA phases were measured from the COP data. The results showed that under the dual-task condition, the Fear group had significantly longer APA phases than the No-fear group, although no significant differences were observed between the 2 groups in the reaction and APA phases under the single-task condition and in any clinical measurements (WT, TUG, and FR). Our findings suggest that specific deficits in balance control occur in subjects with FoF during gait initiation while dual tasking, even if their physical functions are comparable to subjects without FoF.

  11. Unique cellular events occurring during the initial interaction of macrophages with matrix-retained or methylated aggregated low density lipoprotein (LDL). Prolonged cell-surface contact during which ldl-cholesteryl ester hydrolysis exceeds ldl protein degradation.

    Buton, X; Mamdouh, Z; Ghosh, R; Du, H; Kuriakose, G; Beatini, N; Grabowski, G A; Maxfield, F R; Tabas, I


    A critical event in atherogenesis is the interaction of arterial wall macrophages with subendothelial lipoproteins. Although most studies have investigated this interaction by incubating cultured macrophages with monomeric lipoproteins dissolved in media, arterial wall macrophages encounter lipoproteins that are mostly bound to subendothelial extracellular matrix, and these lipoproteins are often aggregated or fused. Herein, we utilize a specialized cell-culture system to study the initial interaction of macrophages with aggregated low density lipoprotein (LDL) bound to extracellular matrix. The aggregated LDL remains extracellular for a relatively prolonged period of time and becomes lodged in invaginations in the surface of the macrophages. As expected, the degradation of the protein moiety of the LDL was very slow. Remarkably, however, hydrolysis of the cholesteryl ester (CE) moiety of the LDL was 3-7-fold higher than that of the protein moiety, in stark contrast to the situation with receptor-mediated endocytosis of acetyl-LDL. Similar results were obtained using another experimental system in which the degradation of aggregated LDL protein was delayed by LDL methylation rather than by retention on matrix. Additional experiments indicated the following properties of this interaction: (a) LDL-CE hydrolysis is catalyzed by lysosomal acid lipase; (b) neither scavenger receptors nor the LDL receptor appear necessary for the excess LDL-CE hydrolysis; and (c) LDL-CE hydrolysis in this system is resistant to cellular potassium depletion, which further distinguishes this process from receptor-mediated endocytosis. In summary, experimental systems specifically designed to mimic the in vivo interaction of arterial wall macrophages with subendothelial lipoproteins have demonstrated an initial period of prolonged cell-surface contact in which CE hydrolysis exceeds protein degradation.


    Zaritsky, Dennis [Steward Observatory, University of Arizona, 933 North Cherry Avenue, Tucson, AZ 85721 (United States); Gil de Paz, Armando; Bouquin, Alexandre Y. K., E-mail: [Departamento de Astrofísica y CC. de la Atmósfera, Facultad de CC. Físicas, Universidad Complutense de Madrid, Avda. de la Complutense s/n, Madrid E-28040 (Spain)


    Using new UV magnitudes for a sample of early-type galaxies (ETGs) with published stellar mass-to-light ratios, Y{sub *}, we find a correlation between UV color and Y{sub *} that is tighter than those previously identified between Y{sub *} and either the central stellar velocity dispersion, metallicity, or alpha enhancement. The sense of the correlation is that galaxies with larger Y{sub *} are bluer in the UV. We conjecture that differences in the lower mass end of the stellar initial mass function (IMF) are related to the nature of the extreme horizontal branch populations that are generally responsible for the UV flux in ETGs. If so, then UV color can be used to identify ETGs with particular IMF properties and to estimate Y{sub *}.

  13. An Empirical Study on Employees Provident Fund (EPF Response towards the Initiative of Hajj Registration through Account 1

    Siti Aminah Mainal


    Full Text Available The study intends to measure the contributors’ response from the initiative launched by EPF that permits the hajj registration through savings in EPF. The study incorporates questionnaire 5 Likert scale format which distributed to 350 EPF contributors within the Klang Valley region of which 174 were filled and returned. It is consistent with Roscoe (1975 who suggests to have a sample sizes of larger than 30 and less than 500 to minimize committing Type II errors. Klang Valley was chosen due to availability of significant white collar workers which displays a significant presence of middle and high income families which associates with private sector workers since they are the main contributors’ for EPF. All variables display meaningful relationship with each other but as shown in the regression analysis, the main variable that really influences one’s attitude towards the hajj withdrawal scheme is the perceived convenience of the program itself. The contradictory issue in this study is on the permission of hajj registration itself; whereby the permission is only for registration and not to the extent of withdrawal the money for the hajj except if the contributor has reached the age of 55. In other word, the authors view it as a non holistic approach. The findings are useful for the EPF to enhance its initiative by allowing physical withdrawal of money from the account 1 once the depositor gets the hajj call-up even though the person has not meet the age of 55. The limitation of the study can arise from the demographic influence pertinent to other areas in the country. It is recommended to expand the pool of respondents and covering other nation’s region as well; Southern part, Northern part, the East Coast etc. Better representation of the findings is expected by incorporating the EPF management in future research.

  14. An empirical investigation of quality improvement initiatives in for-profit and not-for-profit hospitals: environmental, competitive and outcome concerns.

    Miller, Phillip; Yasin, Mahmoud M; Zimmerer, Thomas W


    The objective of this study is to shed some light on quality improvement practices of for-profit and not-for-profit hospitals The scope and effectiveness of several quality improvement efforts are studied for a sample of 110 hospitals. Factor analysis was utilized to analyze the data collected. The results of this study tended to suggest that for-profit and not-for-profit hospitals were more similar than different with the regard to the effective utilization of quality improvement initiatives, thus underscoring the utility of quality improvement efforts despite differences in operating characteristics, strategies and operating constraints. The sample used in this study is limited. Thus, the results should be interpreted accordingly. This study offers decision-makers in healthcare operational settings empirical evidence of the operational and strategic effectiveness of different quality improvement efforts, thus justifying investments related to the initiation and implementation of such quality improvement efforts. This study represents an important step toward understanding the effective implementation of quality improvement initiatives in different operational settings.

  15. An Empirical Study on Mobile Payment Initial Adoption%移动支付服务初始采纳模型及其实证研究

    杨水清; 鲁耀斌; 曹玉枝


    This paper empirically examines the determinants of mobile payment adoption from a holistic perspective including social influences, individual characteristics and technical features in the China's mobile commerce context. The results indicate that; i) from technical features view, relative advantage and compatibility both have a positive influence on mobile payment initial adoption, while perceived risk and perceived cost both have a negative impact on mobile payment initial adoption; ii) from individual characteristics perspective, personal innovativeness has direct and indirect and positive influence on mobile payment initial adoptions iii) from social influences perspective, social influences also have direct and indirect and positive influence on the initial adoption. This study advances the understanding of determinants of mobile payment initial adoption. The theoretical and practical implications are also discussed.%基于中国移动商务情景,从社会影响、个体特征和技术属性的整体视角对移动支付用户初始采纳行为进行了实证研究.采用结构方程模型对收集的240份初始采纳样本进行分析发现,技术属性视角的2个正效用(相对优势和兼容性)对采纳意愿存在正向影响,2个负效用(感知风险和感知成本)对采纳意愿存在负向影响;个体特征视角的个体创新对初始采纳意愿施加了直接和间接的双重正向影响;社会影响视角的主观规范和形象对初始采纳意愿存在直接和间接的双重正向影响.

  16. Improving performance of long-term care networks at their initial stage: an empirical study of factors affecting results.

    Angiola, Nunzio; Bianchi, Piervito


    Until now very little research has been carried out on the performance of health and human services networks in evolution. In particular, previous studies mainly referred to "centrally governed services networks" in the US context. According to Provan and Kenis (2008), these networks are "lead organization-governed", and are different from the "participant-governed" model or the "network administrative organization (NAO)" solution. We focused our attention on the Apulia region care services networks (Italy). In the last few years, the governance of these networks has passed from the "participant-governed" model to the NAO approach. We examined how the integration mechanisms work in this type of networks, and if there were challenges to tackle in order to improve their overall performance. These networks were examined at their initial stage, exactly when their governance model moved to a more integrated solution. We collected survey data from 17 health and human services networks out of 45 (38%). The research is carried out by means of statistical methods (OLS). The analysis is cross sectional. The implementation of "rational/technocratic" factors is important but not sufficient to enhance collaboration. The integration at the "professional level" should be kept in mind. In particular, the role of network (case) managers is paramount. Copyright © 2016 John Wiley & Sons, Ltd.

  17. [Dopplerometry at prolonged pregnancy].

    Salii-Prenichi, L; Milchev, N; Markova, D; Apiosjan, Zh


    Prolonged pregnancy, associated with low amniotic fluid is a reason for the increase of fetal mortality and morbidity. There is no a define test at prolonged pregnancy which can determine which pregnancy are at a risk for adverse outcome and complications. Dopplerometry as a noninvasive method for examination of blood circulation, and especially a. cerebri media and a. umbilicalis can be used for the prediction of the outcome of prolonged pregnancy.

  18. The Comparison Of The Efficacy Of Cefriaxon Monotherapy With Ceftazidim Plus Amikacin As Initial Empiric Antibiotic Therapy In Febrile Neutropenic Patients Emam Hospital (2000-2001

    Mohammadi S M


    Full Text Available Neutropenic state with fever is exactly regarded as a medical emergency, with high mortality and morbidity rate, unless treated urgently and correctly. Every attempt should be made to find and establish the offending organism, but postponing treatment until obtaining culture results is not advised. Controversy exist on which antibiotic regimen to be used while waiting for culture results. Many antibiotic regiments both monotherapy or combination treatments have been used with varying result. The objective of this study is to compare the efficacy of cefriaxon monothenapy with ceftazidim. Plus Amikacin as initial empiric antibiotic therapy in febrile neutropenic patients."nMaterials and Methods: We performed a randomized, single blind clinical trial in 57 adult (age>12 years, neutropenic (PMN<1000 patients with fever (Temperature, oral >38.5c in Hematology ward, Imam khomeini hospital. After careful physical exam and obtaining blood & urine samples for culture, the patients were randomized to each of the two arms: Cefriaxon 2 grams daily, intravenously (arm A and; Ceftazidim 2g thrice daily plus amikacin 500 mg twice daily (arm B. Patients with shock, organ failure or previous antibiotic intake (during 48 hour before fever were excluded. If needed, dose adjustment of drugs were allowed. Effervescence in 3 days following initiation of treatment, lasting 48 hours or more, were regarded as effective (positive result."nResults: During a twelve months period of study, a total of 57 patients (17female, 40male were included. They were randomly selected to each arm of empirical treatment. Of 28 pts in arm A, 19 (67 percent, the treatment was effective, compared to 15 of 29 (51.7 percent in groups B. The duration of fever after initiation of treatment was 37.9 ± 17 hours in arm A and 40. 1 ± 20 h in arm B. Blood and / or urine culture was equally positive in two arms (25 percent in arm A and 27.6 percent in arm B."nConclusion: Cefriaxon monotherapy is at

  19. Exhaustion from prolonged gambling

    Fatimah Lateef


    Full Text Available Complaints of fatigue and physical exhaustion are frequently seen in the acute medical setting, especially amongst athletes, army recruits and persons involved in strenuous and exertional physical activities. Stress-induced exhaustion, on the other hand, is less often seen, but can present with very similar symptoms to physical exhaustion. Recently, three patients were seen at the Department of Emergency Medicine, presenting with exhaustion from prolonged involvement in gambling activities. The cases serve to highlight some of the physical consequences of prolonged gambling.

  20. Exhaustion from prolonged gambling

    Fatimah Lateef


    Complaints of fatigue and physical exhaustion are frequently seen in the acute medical setting, especially amongst athletes, army recruits and persons involved in strenuous and exertional physical activities.Stress-induced exhaustion, on the other hand, is less often seen, but can present with very similar symptoms to physical exhaustion.Recently, three patients were seen at theDepartment ofEmergencyMedicine, presenting with exhaustion from prolonged involvement in gambling activities.The cases serve to highlight some of the physical consequences of prolonged gambling.

  1. Deciding about treatments that prolong life

    Palliative care - treatments that prolong life; Palliative care - life support; End-of-life-treatments that prolong life; Ventilator - treatments that prolong life; Respirator - treatments that prolong life; ...

  2. Prolonged labour : women's experiences

    Nystedt, Astrid


    Aim: The overall aim of this thesis was to illuminate, describe, and promote understanding of women’s experiences of prolonged labour. The thesis compromises four studies. Methods: Paper I describes a case-referent study that recruited women (n = 255) giving singleton live birth to their first child by spontaneous labour after more than 37 completed weeks’ pregnancy. Participants completed a questionnaire that investigated childbirth experiences, previous family relationships, and childhood e...

  3. Prolonged acute hepatitis A mimicking autoimmune hepatitis

    Rintaro Mikata; Osamu Yokosuka; Fumio Imazeki; Kenichi Fukai; Tatsuo Kanda; Hiromitsu Saisho


    AIM: We report a case with a prolonged course of hepatitisA, with alanine aminotransferase (ALT) higher than 500 IU/Lfor more than 2 mo.METHODS: A middle-aged woman had an elevated IgG level of more than 2 000 mg/dL, positive arti-nudear antibodies (ANA) and anti-smooth muscle antibodies (ASMA), but no evidence of persistent hepatitis A virus (HAV) infection. Liver biopsy findings were compatible with prolonged acute hepatitis, although acute onset of autoimmune hepatitis could not be ruled out.RESULTS: It was assumed that she developed a course of hepatitis similar to autoimmune hepatitis triggered by HAV infection. Ursodeoxycholic acid (UDCA) treatment was initiated and a favorable outcome was obtained. CONCLUSION: We describe a case of a middle-aged woman who showed a prolonged course of acute hepatitis A mimicking autoimmune hepatitis. Treatment with UDCAproved to be effective.

  4. Examining potential contraindications for prolonged exposure therapy for PTSD

    Minnen, A. van; Harned, M.S.; Zöllner, L.; Mills, K.


    Although prolonged exposure (PE) has received the most empirical support of any treatment for posttraumatic stress disorder (PTSD), clinicians are often hesitant to use PE due to beliefs that it is contraindicated for many patients with PTSD. This is especially true for PTSD patients with comorbid p

  5. 腹膜透析相关性腹膜炎经验用药分析%Empiric initial therapy in peritoneal dialysis-related peritonitis

    晏焕青; 李芸; 保永军; 唐粼; 黄鑫; 周国秀; 朱彤莹


    Objective To investigate the pathogens,drug resistance and outcomes of continuous ambulatory peritoneal dialysis (CAPD) patients with peritoneal dialysis-related peritonitis in our peritoneal dialysis (PD) centers. Method Data including clinical manifestations,pathogens,treatment,outcome of 93 CAPD cases with peritoneal dialysis-related peritonitis in our peritoneal dialysis (PD) centers were retrospectively analyzed. Results Dialysate culture of 75cases was positive with a positive rate of 80.2%,including 45 cases of gram-positive cocci,21cases of gram-negative bacilli,2 cases of fungi and 5 cases of mixed infection.Coagulase-negative staphylococci were the most common gram-positive cocci.All the gram-positive cocci were sensitive to vancomycin,but the resistance rate to cefazolin was 60.0% with an increasing tendence year by year.Resistance rate of gram-negative bacilli to ceftazidime was 46.1%.All the gram-negative bacilli were sensitive to imipenem.The withdraw rate of CAPD was 17.2%(16/93) because of peritonitis. No obvious side-effect of peritoneal administration of vancomycin was found.Conclusions Gram-positive cocci are major pathogens in CAPD-related peritonitis.Now cefasolin is not suitable for the empiric initial treatment.Peritoneal administration of vancomycin should be recommended for peritonitis caused by gram-positive cocci.%目的 研究华山医院及宝山分院腹膜透析(腹透)相关性腹膜炎的致病菌、耐药性及患者转归,为临床经验用药提供依据.方法 回顾性分析2007年1月至2010年1月上述两医院腹透中心收治的93例腹透相关性腹膜炎的临床表现、致病菌、耐药性及转归.结果 75例腹透液培养阳性,阳性率为80.2%,其中革兰阳性球菌45例,革兰阴性杆菌21例,真菌2例,革兰阳性杆菌1例,革兰阴性球菌1例,多种菌混合感染5例.革兰阳性球菌主要以凝固酶阴性的葡萄球菌为主,所有革兰阳性球菌对万古霉素均敏感,但

  6. The Empirical Ties between Religious Motivation and Altruism in Foster Parents: Implications for Faith-Based Initiatives in Foster Care and Adoption

    Michael Howell-Moroney


    Full Text Available Amidst a crisis shortage of foster homes in the child welfare system, a number of innovative faith-based collaborations aimed at recruiting foster parents have recently emerged. It has been suggested that these collaborations offer a unique opportunity to recruit committed and altruistic parents as caregivers, providing much needed capacity to an overloaded child welfare system. This paper uses data from the National Survey of Current and Former Foster Parents to examine the associations between religious motivations for fostering, altruism and various measures of foster home utilization and longevity. The empirical results demonstrate that religiously motivated foster parents are more likely to have altruistic reasons for fostering, and scored higher than the non-religiously motivated group on an index of altruism. A separate empirical analysis shows that the interaction of high levels of altruism and religious motivation is associated with higher foster home utilization. No association was found between religious altruism and the parent’s expressed intent to continue providing foster care. The implications of these findings for current faith-based collaboration in the child welfare arena are discussed.

  7. Partisan Politics or Public-Health Need? An empirical analysis of state choice during initial implementation of the Affordable Care Act.

    Mayer, Martin; Kenter, Robert; Morris, John C


    States' policy decisions regarding the Affordable Care Act (ACA) of 2010 have often been explained as predominantly, if not solely, partisan. Might rival explanations also apply? Using a cross-sectional 50-state regression model, we studied standard political variables coupled with public-health indicators. This work differs from existing research by employing a dependent variable of five additive measures of ACA support, examining the impact of both political and socioeconomic indicators on state policy decisions. Expanding on recent empirical studies with our more nuanced additive index of support measures, we found that same-party control of a state's executive and legislative branches was indeed by far the single best predictor of policy decisions. Public-health indicators, overwhelmed by partisan effect, did not sufficiently explain state policy choice. This result does not allay the concerns that health policy has become synonymous with health politics and that health politics now has little to do with health itself.

  8. Empirical likelihood

    Owen, Art B


    Empirical likelihood provides inferences whose validity does not depend on specifying a parametric model for the data. Because it uses a likelihood, the method has certain inherent advantages over resampling methods: it uses the data to determine the shape of the confidence regions, and it makes it easy to combined data from multiple sources. It also facilitates incorporating side information, and it simplifies accounting for censored, truncated, or biased sampling.One of the first books published on the subject, Empirical Likelihood offers an in-depth treatment of this method for constructing confidence regions and testing hypotheses. The author applies empirical likelihood to a range of problems, from those as simple as setting a confidence region for a univariate mean under IID sampling, to problems defined through smooth functions of means, regression models, generalized linear models, estimating equations, or kernel smooths, and to sampling with non-identically distributed data. Abundant figures offer vi...

  9. Severe bradycardia and prolonged hypotension in ciguatera.

    Chan, Thomas Yan Keung


    Ciguatera results when ciguatoxin-contaminated coral reef fish from tropical or subtropical waters are consumed. The clinical features that present in affected persons are mainly gastrointestinal, neurological, general, and much less commonly, cardiovascular. We report the case of a 50-year-old man who developed the characteristic combination of acute gastrointestinal and neurological symptoms after the consumption of an unidentified coral reef fish head. In addition to those symptoms, he developed dizziness, severe bradycardia (46 bpm) and prolonged hypotension, which required the administration of intravenous atropine and over three days of intravenous fluid replacement with dopamine infusion. Patients with ciguatera can develop severe bradycardia and prolonged hypotension. Physicians should recognise the possible cardiovascular complications of ciguatera and promptly initiate treatment with intravenous atropine, intravenous fluid replacement and inotropic therapy if such complications are observed.

  10. Empire Redux

    Mercau, Ezequiel

    The Falklands War was shrouded in symbolism and permeated with imperial rhetoric, imagery and memories, bringing to the fore divergent conceptions of Britishness, kinship and belonging. The current dispute, moreover, is frequently framed in terms of national identity, and accusations of imperialism...... and neo-colonialism persist. Thus in dealing with the conflict, historians and commentators alike have often made references to imperial legacies, yet this has rarely been afforded much careful analysis. Views on this matter continue to be entrenched, either presenting the war as a throwback to nineteenth...... from the legacies of empire. Taking decolonization as a starting point, this thesis demonstrates how the idea of a ‘British world’ gained a new lease of life vis-à-vis the Falklands, as the Islanders adopted the rhetorical mantle of ‘abandoned Britons’. Yet this new momentum was partial and fractured...

  11. Empire Redux

    Mercau, Ezequiel

    from the legacies of empire. Taking decolonization as a starting point, this thesis demonstrates how the idea of a ‘British world’ gained a new lease of life vis-à-vis the Falklands, as the Islanders adopted the rhetorical mantle of ‘abandoned Britons’. Yet this new momentum was partial and fractured......The Falklands War was shrouded in symbolism and permeated with imperial rhetoric, imagery and memories, bringing to the fore divergent conceptions of Britishness, kinship and belonging. The current dispute, moreover, is frequently framed in terms of national identity, and accusations of imperialism......, as evinced by the developments triggered by the Argentine invasion in 1982. Despite the apparent firmness of the British government’s commitment to the Islands, cracks and fissures over the meaning of Britishness were simultaneously magnified. The perceived temporal dislocation of defending loyal Britons...

  12. Prolonged unexplained fatigue in paediatrics

    Bakker, R.J.


    Prolonged Unexplained Fatigue in Paediatrics. Fatigue, as the result of mental or physical exertion, will disappear after rest, drinks and food. Fatigue as a symptom of illness will recover with the recovering of the illness. But when fatigue is ongoing for a long time, and not the result of exertio

  13. Prolongation structures for supersymmetric equations

    Roelofs, G.H.M.; Hijligenberg, van den N.W.


    The well known prolongation technique of Wahlquist and Estabrook (1975) for nonlinear evolution equations is generalized for supersymmetric equations and applied to the supersymmetric extension of the KdV equation of Manin-Radul. Using the theory of Kac-Moody Lie superalgebras, the explicit form of

  14. Prolonged fever after Infliximab infusion

    Jennifer; Katz; Michael; Frank


    Pharmacologic management for ulcerative colitis (UC) has recently been expanded to include antitumor necrosis factor (TNF) therapy for severe disease. Infliximab, a chimeric monoclonal antibody directed again TNF α was first tested in patients with Crohn’s disease. In addition to serious infections, malignancy, drug induced lupus and other autoimmune diseases, serum sickness-like reactions, neurological disease, and infusion reactions further complicate the use of Infliximab. We report a case of prolonged fever after Infliximab infusion to treat steroid refractory UC.

  15. Prolonged Exposure Therapy For Post Traumatic Stress Disorder

    Levent SÜTÇİGİL


    Full Text Available Post-traumatic Stress Disorder (PTSD is a psychiatric illness that usually develops after an event that threatens one’s life and body integrity and it affects quality of life and impairs social functioning significantly. Many studies have shown therapeutic effect of cognitive behavioral therapies on posttraumatic stress disorder, so that these therapies take part in the first step of treatment guides. Exposure is a practice that is generally used to reduce pathological fear and related emotions common in posttraumatic stress disorder (PTSD and other anxiety disorders. During exposure, patients intentionally confront with feared objects, situations, thoughts and similar stimuli in order to reduce anxiety level. Exposure can be divided into two main techniques as in vivo exposure and imaginal exposure. Prolonged exposure therapy is a specialized treatment program configured for the treatment of posttraumatic stress disorder and it is based on emotional processing theory. Program is comprised of four main components: (a Psycho-education about trauma and posttraumatic disorders, (b Training for breathing exercises, (c repeated facing with objects, persons, situations and thoughts which causes re-experience about trauma, (d Patient are instructed for telling repeatedly and loudly about traumatic experiences . Prolonged exposure usually involves 9 to 12 sessions, each lasting about 60-90 minutes, administered once or twice a week. Prolonged exposure therapy was started to be implemented since the 1980s, during this period the effectiveness of the therapy has been shown in various empirical studies.

  16. Prolonged QT interval in Rett syndrome


    Rett syndrome is a severe neurodevelopmental disorder of unknown aetiology. A prolonged QT interval has been described previously in patients with Rett syndrome. To investigate QT prolongation and the presence of cardiac tachyarrhythmias in Rett syndrome electrocardiography and 24 hour Holter monitoring were performed prospectively in a cohort of 34 girls with Rett syndrome. The corrected QT value was prolonged in nine patients. Compared with a group of healthy controls of a...

  17. Prolonged Pregnancy: Methods, Causal Determinants and Outcome

    Olesen, Annette Wind

    Summary Prolonged pregnancy, defined as a pregnancy with a gestational length of 294 days or more, is a frequent condition. It is associated with an increased risk of fetal and maternal complications. Little is known about the aetiology of prolonged pregnancy. The aims of the thesis were 1...

  18. Prenatal risk indicators of a prolonged pregnancy

    Olesen, Annette Wind; Westergaard, Jes Grabow; Olsen, Jørn


    BACKGROUND: Few prenatal risk factors of prolonged pregnancy, a pregnancy of 42 weeks or more, are known. The objective was to examine whether sociodemographic, reproductive, toxicologic, or medical health conditions were associated with the risk of prolonged pregnancy. METHODS: Data from the Dan...

  19. Effect of prolonged chemical challenges on selected properties of silorane

    de Jesus, Vivian CBR; Martinelli, Natan Luiz; Pascotto, Renata Corrêa

    Objectives: The purpose of this study was to investigate the effect of prolonged chemical challenges on water sorption, solubility, and roughness of a silorane-based material when compared to methacrylate-based composites. Methods: Initial roughness and mass were registered for specimens (n=24...... phosphoric acid, 75% ethanol or distilled water for 7, 14, 21, and 180 days, when new measurements were performed. Subsequently, specimens were dehydrated until a constant mass was obtained. Water sorption and solubility were calculated after 180 days of immersion in the different solutions. Data were...... differences in water sorption and solubility were detected amongst the investigated composites (pwater sorption (with similar values to Filtek Z250 and Filtek Z350XT) and low solubility (with similar values to Filtek Z250) after prolonged immersion...

  20. Empirical Test Case Specification

    Kalyanova, Olena; Heiselberg, Per

    This document includes the empirical specification on the IEA task of evaluation building energy simulation computer programs for the Double Skin Facades (DSF) constructions. There are two approaches involved into this procedure, one is the comparative approach and another is the empirical one. I....... In the comparative approach the outcomes of different software tools are compared, while in the empirical approach the modelling results are compared with the results of experimental test cases....

  1. QT Prolongation due to Graves’ Disease

    Zain Kulairi


    Full Text Available Hyperthyroidism is a highly prevalent disease affecting over 4 million people in the US. The disease is associated with many cardiac complications including atrial fibrillation and also less commonly with ventricular tachycardia and fibrillation. Many cardiac pathologies have been extensively studied; however, the relationship between hyperthyroidism and rate of ventricular repolarization manifesting as a prolonged QTc interval is not well known. Prolonged QTc interval regardless of thyroid status is a risk factor for cardiovascular mortality and life-threatening ventricular arrhythmia. The mechanism regarding the prolongation of the QT interval in a hyperthyroid patient has not been extensively investigated although its clinical implications are relevant. Herein, we describe a case of prolonged QTc in a patient who presented with signs of hyperthyroidism that was corrected with return to euthyroid status.

  2. Hippocampal Abnormalities in Prolonged Febrile Seizures

    J Gordon Millichap


    Full Text Available Apparent diffusion coefficient (ADC measurements were used to characterize hippocampal edema within 5 days of a prolonged febrile seizure (PFS in a study at Great Ormond Street Hospital, London, UK.

  3. MRI Abnormalities After Prolonged Febrile Seizures

    J Gordon Millichap


    Full Text Available The clinical, radiologic, and laboratory findings of 17 Asian patients with encephalopathy following a prolonged febrile seizure were reviewed retrospectively at Kameda Medical Center, and other centers in Japan and San Francisco, USA.

  4. QT Prolongation due to Graves' Disease

    Deol, Nisha; Tolly, Renee; Manocha, Rohan; Naseer, Maliha


    Hyperthyroidism is a highly prevalent disease affecting over 4 million people in the US. The disease is associated with many cardiac complications including atrial fibrillation and also less commonly with ventricular tachycardia and fibrillation. Many cardiac pathologies have been extensively studied; however, the relationship between hyperthyroidism and rate of ventricular repolarization manifesting as a prolonged QTc interval is not well known. Prolonged QTc interval regardless of thyroid status is a risk factor for cardiovascular mortality and life-threatening ventricular arrhythmia. The mechanism regarding the prolongation of the QT interval in a hyperthyroid patient has not been extensively investigated although its clinical implications are relevant. Herein, we describe a case of prolonged QTc in a patient who presented with signs of hyperthyroidism that was corrected with return to euthyroid status. PMID:28154763

  5. 企业职工延长退休年龄影响因素实证研究--以W市为例%Empirical Study on the Influence Factors of Enterprise Employees’ Prolonging the Retirement Age:Take the City of W as an Example



    Enterprise employees as an important social component element and the recipient of policy, the development and implementation of policies that prolonging the retirement age need to be widely consulted by them. This study take the city of W as the base of investigation, and get the conclusions by using the method of Literature Research, Social Investigation and In-depth In-terview and use the tool of SPSS, one of the conclusions is the sort of influence factors of raising the enterprise employees’ age, the order from strong to the weak is:health, income, job satis-faction, the time that a week work,work nature, raising children, spouse status, age, unit wel-fare, unit nature, gender, education level, company position, support for the elderly, marriage status. the other one is the relationship between influence factors and raising the retirement age,:(1) individual factors, male workers can accept the delay retirement more than female work-ers. The relationship between age and delayed retirement is opposite. Married or unmarried em-ployees are not wil ing to accept the delay retirement. The degree of education in the non wil ing to delay retirement is positively related to the maximum delay retirement age. (2) enterprise fac-tors, the nature of the enterprise is a state-owned, col ective or holding company with foreign in-vestment enterprises more wil ing to accept the delay retirement. There is no direct stimulation to the delayed retirement wil of employees in the enterprise, but the more benefits for the delay re-tirement, the more positive correlation between the number of welfare and the maximum delay re-tirement age. There is no strict correlation between the position of the company and the delay re-tirement. (3) burden factors, the burden of raising children and supporting the elderly is nega-tively related to the delay retirement. (4) economic factors, low income and high income individu-als and families are more reluctant to delay retirement. Health

  6. Autobiography After Empire

    Rasch, Astrid

    metropole, political legitimacy at the end of empire and settler family innocence, I argue that the writers engage with collective memories about empire in their personal recollections. Such collective narratives pattern autobiographies so that the same concerns and rhetoric recur in widely different...

  7. Empirical Philosophy of Science

    Mansnerus, Erika; Wagenknecht, Susann


    knowledge takes place through the integration of the empirical or historical research into the philosophical studies, as Chang, Nersessian, Thagard and Schickore argue in their work. Building upon their contributions we will develop a blueprint for an Empirical Philosophy of Science that draws upon......Empirical insights are proven fruitful for the advancement of Philosophy of Science, but the integration of philosophical concepts and empirical data poses considerable methodological challenges. Debates in Integrated History and Philosophy of Science suggest that the advancement of philosophical...... qualitative methods from the social sciences in order to advance our philosophical understanding of science in practice. We will regard the relationship between philosophical conceptualization and empirical data as an iterative dialogue between theory and data, which is guided by a particular ‘feeling with...

  8. Quality of drug label information on QT interval prolongation

    Warnier, Miriam J; Holtkamp, Frank A; Rutten, Frans H;


    characteristics (SPC) of recently approved medicinal products. METHODS: Drug labels of products centrally approved in Europe between 2006 and 2012 were screened. Of drugs including the term 'QT' in the SPC, the message on QT-prolongation ('no prolongation'/'unclear drug-QT association'/'possibly QT......-prolongation'/'QT-prolongation') and the advice on cautionary measures pertaining to QT-prolongation in the label were examined, as well as their association. RESULTS: Of the 175 screened products, 44 contained information on QT in the SPC ('no QT-prolongation': 23%, 'unclear drug-QT association': 43%, 'possibly QT-prolongation': 16%, 'QT......-prolongation': 18%). 62% contained advices to act with caution in patients with additional risk factors for QT-prolongation. Products that more likely to have QT-prolonging properties according to the SPC provided more information on QT-prolongation in the SPC ('no prolongation': 10% and for the category 'QT...

  9. Left Ventricular Function After Prolonged Exercise in Equine Endurance Athletes

    Flethøj, M.; Schwarzwald, C. C.; Haugaard, M. M.;


    Background: Prolonged exercise in human athletes is associated with transient impairment of left ventricular (LV) function, known as cardiac fatigue. Cardiac effects of prolonged exercise in horses remain unknown. Objectives :To investigate the effects of prolonged exercise on LV systolic...

  10. Theological reflections on empire

    Allan A. Boesak


    Full Text Available Since the meeting of the World Alliance of Reformed Churches in Accra, Ghana (2004, and the adoption of the Accra Declaration, a debate has been raging in the churches about globalisation, socio-economic justice, ecological responsibility, political and cultural domination and globalised war. Central to this debate is the concept of empire and the way the United States is increasingly becoming its embodiment. Is the United States a global empire? This article argues that the United States has indeed become the expression of a modern empire and that this reality has considerable consequences, not just for global economics and politics but for theological refl ection as well.

  11. Empirical entropy in context

    Gagie, Travis


    We trace the history of empirical entropy, touching briefly on its relation to Markov processes, normal numbers, Shannon entropy, the Chomsky hierarchy, Kolmogorov complexity, Ziv-Lempel compression, de Bruijn sequences and stochastic complexity.

  12. Safety information on QT-interval prolongation

    Warnier, Miriam J; Holtkamp, Frank A; Rutten, Frans H;


    Prolongation of the QT interval can predispose to fatal ventricular arrhythmias. Differences in QT-labeling language can result in miscommunication and suboptimal risk mitigation. We systematically compared the phraseology used to communicate on QT-prolonging properties of 144 drugs newly approve......) was moderate (kappa 0.434). However, the agreement in expected clinical decisions based on the product labels was much higher (kappa 0.673). The US drug label tends to be more explicit, especially when it considers absence of QT effects....

  13. The effect of ethanol on the release of opioids from oral prolonged-release preparations.

    Walden, Malcolm; Nicholls, Fiona A; Smith, Kevin J; Tucker, Geoffrey T


    Recent experience has prompted the US FDA to consider whether ethanol ingestion may modify the release characteristics of prolonged-release formulations, where dose dumping may be an issue for patient safety. The influence of ethanol on the in vitro release of opioid drugs from some prolonged-release formulations utilizing different release technologies was examined. Results indicated that the prolonged-release mechanisms remained intact under the testing conditions, although one product showed initial sensitivity to ethanol in its release characteristics. Nevertheless, in this case, extrapolation of the findings to likely outcome in vivo indicated no risk of dose-dumping. It is proposed that prolonged-release medicinal products should be tested during development to ensure robustness to the effects of ethanol on drug release.

  14. Subsidiary Initiative Taking in Multinational Corporations

    Dörrenbacher, Christoph; Gammelgaard, Jens


    This paper investigates the political maneuvering that accompanies subsidiary initiative taking in multinational corporations. On the basis of an explorative empirical investigation of subsidiary initiative taking in the French subsidiaries of six German MNCs, the paper explores the activities...

  15. Is preemptive antifungal therapy a good alternative to empirical treatment in prolonged febrile neutropenia?

    Erica Koch


    Full Text Available La neutropenia febril prolongada conlleva un alto riesgo de desarrollar infecciones fúngicas invasoras, por lo que habitualmente se administra terapia antifúngica empírica en estos casos. Sin embargo, esta se asocia a importantes efectos adversos, por lo que se ha propuesto como alternativa la estrategia "preemptive" o anticipada, es decir, la indicación de antifúngicos sólo ante la evidencia indirecta de infección fúngica invasora. Utilizando la base de datos Epistemonikos, la cual es mantenida mediante búsquedas en 30 bases de datos, identificamos tres revisiones sistemáticas que en conjunto incluyen doce estudios. Cuatro estudios aleatorizados evaluaron la pregunta abordada en este artículo. Realizamos un metanálisis y tablas de resumen de los resultados utilizando el método GRADE. Concluimos que no está claro si la estrategia "preemptive" tiene algún efecto sobre la mortalidad porque la certeza de la evidencia es muy baja, pero podría disminuir levemente el uso de antifúngicos en pacientes con neutropenia febril prolongada.


    Suzanne Schneider


    Full Text Available Prolonged exercise may compromise immunity through a reduction of salivary antimicrobial proteins (AMPs. Salivary IgA (IgA has been extensively studied, but little is known about the effect of acute, prolonged exercise on AMPs including lysozyme (Lys and lactoferrin (Lac. Objective: To determine the effect of a 50-km trail race on salivary cortisol (Cort, IgA, Lys, and Lac. Methods: 14 subjects: (6 females, 8 males completed a 50km ultramarathon. Saliva was collected pre, immediately after (post and 1.5 hrs post race ( 1.5. Results: Lac concentration was higher at 1.5 hrs post race compared to post exercise (p0.05. IgA concentration, secretion rate, and IgA/Osm were lower 1.5 hrs post compared to pre race (p<0.05. Cort concentration was higher at post compared to 1.5 (p<0.05, but was unaltered from pre race levels. Subjects finished in 7.81 ± 1.2 hrs. Saliva flow rate did not differ between time points. Saliva Osm increased at post (p<0.05 compared to pre race. Conclusions: The intensity could have been too low to alter Lys and Lac secretion rates and thus, may not be as sensitive as IgA to changes in response to prolonged running. Results expand our understanding of the mucosal immune system and may have implications for predicting illness after prolonged running.

  17. Carotid Baroreflex Function During Prolonged Exercise

    Raven, P. B.


    Astronauts are often required to work (exercise) at moderate to high intensities for extended periods while performing extra-vehicular activities (EVA). Although the physiologic responses associated with prolonged exercise have been documented, the mechanisms involved in blood pressure regulation under these conditions have not yet been fully elucidated. An understanding of this issue is pertinent to the ability of humans to perform work in microgravity and complies with the emphasis of NASA's Space Physiology and Countermeasures Program. Prolonged exercise at a constant workload is know to result in a progressive decrease in mean arterial pressure (MAP) concomitant with a decrease in stroke volume and a compensatory increase in heart rate. The continuous decrease in MAP during the exercise, which is related to the thermoregulatory redistribution of circulating blood volume to the cutaneous circulation, raises the question as to whether there is a loss of baroreflex regulation of arterial blood pressure. We propose that with prolongation of the exercise to 60 minutes, progressive increases on central command reflect a progressive upward resetting of the carotid baroreflex (CBR) such that the operating point of the CBR is shifted to a pressure below the threshold of the reflex rendering it ineffectual in correcting the downward drift in MAP. In order to test this hypothesis, experiments have been designed to uncouple the global hemodynamic response to prolonged exercise from the central command mediated response via: (1) continuous maintenance of cardiac filling volume by intravenous infusion of a dextran solution; and (2) whole body surface cooling to counteract thermoregulatory cutaneous vasodialation. As the type of work (exercise) performed by astronauts is inherently arm and upper body dependent, we will also examine the physiologic responses to prolonged leg cycling and arm ergometry exercise in the supine positions with and without level lower body negative

  18. An Empirical Analysis of Investor Sentiment on Initial Return of IPO in China%投资者情绪对中国 IPO首日收益率影响的实证分析

    蒋先玲; 张斯琪


    以2009年1月~2014年3月上证交易数据为样本,利用主成分分析法构建基于中国国情的投资者情绪综合指数( CICSI ),并采用VAR模型、格兰杰因果关系检验和脉冲响应等方法考查投资者情绪综合指数与中国IPO首日收益率之间的动态关系。结果表明,投资者情绪对IPO首日收益率有显著的正向影响;同时,IPO首日收益率的波动也会对投资者情绪波动有显著的冲击,但产生的影响在时间上会相对滞后。实证分析结果有助于了解投资者的行为特征、决策的过程及影响机制,对于投资者的管理与引导、定价效率的提高、相关机制的完善具有现实意义。%The paper selects transaction data in Shanghai Stock Exchange from January 2009 to March 2014 and builds the investor composite sentiment index in Chinese stock market ( CICSI) by the method of principal compo-nent analysis.Then the paper establishes VAR model to analyze the dynamic relation ship between composite index of investor sentiment and the initial return of IPO by means of Granger causality test and impulse response function analysis.The results show that investor sentiment can produces a significant positive impact on the initial return of IPO.At the same time,the fluctuations of initial return of IPO can also have a great effect on investor sentiment, though this impact will be lagging behind.The results can contribute to a better comprehension of investor behavior characteristics, decision making process and influencing mechanism.It can also have the practical significance in government guidance, the advancement of pricing efficiency as well as the perfection of mechanism in Chinese stock market.

  19. Utilizing Monte Carlo Simulations to Optimize Institutional Empiric Antipseudomonal Therapy

    Sarah J. Tennant


    Full Text Available Pseudomonas aeruginosa is a common pathogen implicated in nosocomial infections with increasing resistance to a limited arsenal of antibiotics. Monte Carlo simulation provides antimicrobial stewardship teams with an additional tool to guide empiric therapy. We modeled empiric therapies with antipseudomonal β-lactam antibiotic regimens to determine which were most likely to achieve probability of target attainment (PTA of ≥90%. Microbiological data for P. aeruginosa was reviewed for 2012. Antibiotics modeled for intermittent and prolonged infusion were aztreonam, cefepime, meropenem, and piperacillin/tazobactam. Using minimum inhibitory concentrations (MICs from institution-specific isolates, and pharmacokinetic and pharmacodynamic parameters from previously published studies, a 10,000-subject Monte Carlo simulation was performed for each regimen to determine PTA. MICs from 272 isolates were included in this analysis. No intermittent infusion regimens achieved PTA ≥90%. Prolonged infusions of cefepime 2000 mg Q8 h, meropenem 1000 mg Q8 h, and meropenem 2000 mg Q8 h demonstrated PTA of 93%, 92%, and 100%, respectively. Prolonged infusions of piperacillin/tazobactam 4.5 g Q6 h and aztreonam 2 g Q8 h failed to achieved PTA ≥90% but demonstrated PTA of 81% and 73%, respectively. Standard doses of β-lactam antibiotics as intermittent infusion did not achieve 90% PTA against P. aeruginosa isolated at our institution; however, some prolonged infusions were able to achieve these targets.

  20. Life Writing After Empire

    A watershed moment of the twentieth century, the end of empire saw upheavals to global power structures and national identities. However, decolonisation profoundly affected individual subjectivities too. Life Writing After Empire examines how people around the globe have made sense of the post......-imperial condition through the practice of life writing in its multifarious expressions, from auto/biography through travel writing to oral history and photography. Through interdisciplinary approaches that draw on literature and history alike, the contributors explore how we might approach these genres differently...... in order to understand how individual life writing reflects broader societal changes. From far-flung corners of the former British Empire, people have turned to life writing to manage painful or nostalgic memories, as well as to think about the past and future of the nation anew through the personal...

  1. Empirical philosophy of science


    A growing number of philosophers of science make use of qualitative empirical data, a development that may reconfigure the relations between philosophy and sociology of science and that is reminiscent of efforts to integrate history and philosophy of science. Therefore, the first part...... of this introduction to the volume Empirical Philosophy of Science outlines the history of relations between philosophy and sociology of science on the one hand, and philosophy and history of science on the other. The second part of this introduction offers an overview of the papers in the volume, each of which...... is giving its own answer to questions such as: Why does the use of qualitative empirical methods benefit philosophical accounts of science? And how should these methods be used by the philosopher?...

  2. [Prolonged pregnancy--prostaglandins as the cause of labor onset].

    Rath, W


    The causes of prolonged pregnancy are still largely unknown and their investigation requires a detailed observation of potential birth-initiating stimuli on the endocrine and biomolecular level. A large number of clinical and biochemical studies point to the central importance of prostaglandins for the beginning of human birth. The main places of origin of the intensified prostaglandin formation and release are the amnion and the decidua which has "macrophage-like" properties and functions. The superordinate regulation and trigger mechanisms for intensified uterine prostaglandin production has not been sufficiently investigated either. Possible factors currently being debated include local changes in estrogen and progesterone biosynthesis in fetal membranes and decidua, subclinical inflammatory reactions with the activation of macrophages and the consecutive release of cytokines, and a loss of maternal immune tolerance with a time-determined rejection reaction. In addition, the substances inhibiting and stimulating prostaglandin synthesis have been detected in the amniotic fluid, fetal membranes and decidua. The fetus itself also plays an important part in the initiation of labor. Prolongation may be due to anatomic functional disturbances of the one hand which prevent the activation of the fetal hypothalamic-hypophyseal-adrenal axis and the release of the birth-initiating stimuli originating in the fetus; on the other hand, an elevated immune tolerance with a delayed rejection reaction or the lack of "bacterial stimulus" may inhibit the activation of the macrophages and hence the formation of cytokines. The consequences would be the development and release of a quantity of prostaglandins from the fetal membranes and decidua insufficient to overcome the pregnancy-maintaining safety systems.(ABSTRACT TRUNCATED AT 250 WORDS)

  3. [Prolonged pain in neonates: retrospective analysis].

    Lilla, Michèle; Stadelman-Diaw, Corinne; Ramelet, Anne-Sylvie


    Infants hospitalised in neonatology are inevitably exposed to pain repeatedly. Premature infants are particularly vulnerable, because they are hypersensitive to pain and demonstrate diminished behavioural responses to pain. They are therefore at risk of developing short and long-term complications if pain remains untreated. Compared to acute pain, there is limited evidence in the literature on prolonged pain in infants. However, the prevalence is reported between 20 and 40 %. This single case study aimed to identify the bio-contextual characteristics of neonates who experienced prolonged pain. This study was carried out in the neonatal unit of a tertiary referral centre in Western Switzerland. A retrospective data analysis of seven infants' profile, who experienced prolonged pain ,was performed using five different data sources. The mean gestational age of the seven infants was 32weeks. The main diagnosis included prematurity and respiratory distress syndrome. The total observations (N=55) showed that the participants had in average 21.8 (SD 6.9) painful procedures that were estimated to be of moderate to severe intensity each day. Out of the 164 recorded pain scores (2.9 pain assessment/day/infant), 14.6 % confirmed acute pain. Out of those experiencing acute pain, analgesia was given in 16.6 % of them and 79.1 % received no analgesia. This study highlighted the difficulty in managing pain in neonates who are exposed to numerous painful procedures. Pain in this population remains underevaluated and as a result undertreated.Results of this study showed that nursing documentation related to pain assessment is not systematic.Regular assessment and documentation of acute and prolonged pain are recommended. This could be achieved with clear guidelines on the Assessment Intervention Reassessment (AIR) cyclewith validated measures adapted to neonates. The adequacy of pain assessment is a pre-requisite for appropriate pain relief in neonates.

  4. Napping and Human Functioning during Prolonged Work


    alternative to napping is prolonged wakefulness. Polyphasic sleep , with frequent naps rather than a single sleep period per 24 hours, is natural for both the...very young and for the aged. It is not practiced by most adults, perhaps because of societal demands. Possibly a polyphasic sleep schedule could be...Functioning 1.2 Scope of this Chapter 2. REVIEW OF LITERATURE 2.1 Partial Sleep Deprivation Studies 2.2 Nap Studies: Four Nap Factors Affecting Performance

  5. Prolonged grief: setting the research agenda

    Rita Rosner


    Full Text Available Background: Prolonged grief disorder is proposed for the International Classification of Diseases (ICD-11, though it was rejected as a diagnosis for DSM-5. Objective: This review outlines findings and defines important areas for future research viewed from a lifespan perspective. Results: The development and psychometric evaluation of measures for the new diagnosis is paramount, specifically for children and adolescents. Treatments need to be adapted for specific subgroups and research findings have to be disseminated into various professional settings.

  6. Prolonged ulcerative laryngitis: a new disease entity.

    Hsiao, Tzu-Yu


    Over the last decade, a new disease entity, prolonged ulcerative laryngitis (PUL), with unique clinical presentation and prolonged disease course, has been recognized. Until now, very few studies dealing with this disease have been reported in the literature. From 1999 to 2008, we analyzed clinical data from a series of 39 PUL patients who were treated with an observational approach without implementing specific treatments. This disease affects adults, predominantly females. The age of patients in our series ranged from 26 to 76 years with a median of 49.5 years. This disease is characterized by ulcers and signs of acute inflammation on the membranous portion of the vocal folds with a prolonged clinical course. The recovery times of patients ranged from 4 to 20 weeks with an average of 9.4 weeks. The data in this study may reflect a natural history of this disease. PUL seems to be a self-limited disease, but the etiology of this disease is unknown. Specific infections or systemic inflammatory processes involving the larynx must be ruled out before diagnosis, and conservative treatments are suggested.

  7. High platelet reactivity--the challenge of prolonged anticoagulation therapy after ACS

    Brouwer, M.A.; Jaspers Focks, J.; Verheugt, F.W.A.


    Despite dual antiplatelet therapy (DAPT), one-year event rates after acute coronary syndrome (ACS) vary from 9-12%. The development of novel oral anticoagulants (NOAC) without a need for monitoring has initiated renewed interest for prolonged adjunctive anticoagulation. Importantly, the cornerstone

  8. Prolonged survival of a cat diagnosed with feline infectious peritonitis by immunohistochemistry.

    Hugo, Timothy B; Heading, Kathryn L


    A 4-year-old, neutered male, British shorthair cat was presented with inappetence, vomiting, hyperproteinemia, and hyperglobulinemia. An exploratory celiotomy identified enlarged mesenteric lymph nodes. Immunohistochemistry of lymph node biopsies confirmed feline infectious peritonitis. This patient had a prolonged survival of 787 d after initial presentation.

  9. An Empirical Kaiser Criterion.

    Braeken, Johan; van Assen, Marcel A L M


    In exploratory factor analysis (EFA), most popular methods for dimensionality assessment such as the screeplot, the Kaiser criterion, or-the current gold standard-parallel analysis, are based on eigenvalues of the correlation matrix. To further understanding and development of factor retention methods, results on population and sample eigenvalue distributions are introduced based on random matrix theory and Monte Carlo simulations. These results are used to develop a new factor retention method, the Empirical Kaiser Criterion. The performance of the Empirical Kaiser Criterion and parallel analysis is examined in typical research settings, with multiple scales that are desired to be relatively short, but still reliable. Theoretical and simulation results illustrate that the new Empirical Kaiser Criterion performs as well as parallel analysis in typical research settings with uncorrelated scales, but much better when scales are both correlated and short. We conclude that the Empirical Kaiser Criterion is a powerful and promising factor retention method, because it is based on distribution theory of eigenvalues, shows good performance, is easily visualized and computed, and is useful for power analysis and sample size planning for EFA. (PsycINFO Database Record

  10. Empirical Music Aesthetics

    Grund, Cynthia M.

    musical performance and reception is inspired by traditional approaches within aesthetics, but it also challenges some of the presuppositions inherent in them. As an example of such work I present a research project in empirical music aesthetics begun last year and of which I am a team member....

  11. Trade and Empire

    Bang, Peter Fibiger


    This articles seeks to establish a new set of organizing concepts for the analysis of the Roman imperial economy from Republic to late antiquity: tributary empire, port-folio capitalism and protection costs. Together these concepts explain better economic developments in the Roman world than the...

  12. Empirical Discovery in Linguistics

    Pericliev, V


    A discovery system for detecting correspondences in data is described, based on the familiar induction methods of J. S. Mill. Given a set of observations, the system induces the ``causally'' related facts in these observations. Its application to empirical linguistic discovery is described.

  13. Essays in empirical banking

    Bai, Y.


    This dissertation consists of three essays on empirical banking. They study how do information and political activeness affect banks’ lending behavior, as well as the effect of lending relationship with banks on firms’ stock performance during interbank liquidity crunch. The first essay looks at a t

  14. Trade and Empire

    Bang, Peter Fibiger


    This articles seeks to establish a new set of organizing concepts for the analysis of the Roman imperial economy from Republic to late antiquity: tributary empire, port-folio capitalism and protection costs. Together these concepts explain better economic developments in the Roman world than the ...

  15. Empirical Music Aesthetics

    Grund, Cynthia M.

    musical performance and reception is inspired by traditional approaches within aesthetics, but it also challenges some of the presuppositions inherent in them. As an example of such work I present a research project in empirical music aesthetics begun last year and of which I am a team member....

  16. Empirical social choice

    Kurrild-Klitgaard, Peter


    applications. Special attention is given to three phenomena and their possible empirical manifestations: The instability of social choice in the form of (1) the possibility of majority cycles, (2) the non-robustness of social choices given alternative voting methods, and (3) the possibility of various forms...

  17. Auditory Imagery: Empirical Findings

    Hubbard, Timothy L.


    The empirical literature on auditory imagery is reviewed. Data on (a) imagery for auditory features (pitch, timbre, loudness), (b) imagery for complex nonverbal auditory stimuli (musical contour, melody, harmony, tempo, notational audiation, environmental sounds), (c) imagery for verbal stimuli (speech, text, in dreams, interior monologue), (d)…

  18. Prolonged morphine administration alters protein expression in the rat myocardium

    Drastichova Zdenka


    Full Text Available Abstract Background Morphine is used in clinical practice as a highly effective painkiller as well as the drug of choice for treatment of certain heart diseases. However, there is lack of information about its effect on protein expression in the heart. Therefore, here we aimed to identify the presumed alterations in rat myocardial protein levels after prolonged morphine treatment. Methods Morphine was administered to adult male Wistar rats in high doses (10 mg/kg per day for 10 days. Proteins from the plasma membrane- and mitochondria-enriched fractions or cytosolic proteins isolated from left ventricles were run on 2D gel electrophoresis, scanned and quantified with specific software to reveal differentially expressed proteins. Results Nine proteins were found to show markedly altered expression levels in samples from morphine-treaded rats and these proteins were identified by mass spectrometric analysis. They belong to different cell pathways including signaling, cytoprotective, and structural elements. Conclusions The present identification of several important myocardial proteins altered by prolonged morphine treatment points to global effects of this drug on heart tissue. These findings represent an initial step toward a more complex view on the action of morphine on the heart.

  19. Examining potential contraindications for prolonged exposure therapy for PTSD

    Agnes van Minnen


    Full Text Available Although prolonged exposure (PE has received the most empirical support of any treatment for post-traumatic stress disorder (PTSD, clinicians are often hesitant to use PE due to beliefs that it is contraindicated for many patients with PTSD. This is especially true for PTSD patients with comorbid problems. Because PTSD has high rates of comorbidity, it is important to consider whether PE is indeed contraindicated for patients with various comorbid problems. Therefore, in this study, we examine the evidence for or against the use of PE with patients with problems that often co-occur with PTSD, including dissociation, borderline personality disorder, psychosis, suicidal behavior and non-suicidal self-injury, substance use disorders, and major depression. It is concluded that PE can be safely and effectively used with patients with these comorbidities, and is often associated with a decrease in PTSD as well as the comorbid problem. In cases with severe comorbidity, however, it is recommended to treat PTSD with PE while providing integrated or concurrent treatment to monitor and address the comorbid problems.

  20. Mast cell leukemia with prolonged survival on PKC412/midostaurin.

    Xu, Xiangdong; Kreisel, Friederike H; Frater, John L; Hassan, Anjum


    Mast cell leukemia (MCL) is a rare and aggressive form of systemic mastocytosis. There are approximately 50 reported cases since 1950s. MCL is refractory to cytoreduction chemotherapy and the average survival is only six months. We report a MCL case in a 71 year-old woman with high tumor load at the initial presentation in 2005, who did not respond to either interleukin-2 or dasatinib therapy. After enrolled in a clinical trial of PKC412 (or Midostaurin) with a daily dose of 100 mg, the patient responded well to PKC412 and became transfusion independent in three months. Since then, her disease had been stably controlled. This is the first report of a high-tumor-load MCL case which achieved prolonged survival (101 months) by PKC 412. The 101-month overall survival is the longest among reported MCL cases in the English literature.

  1. Prolonged reorganization of thiol-capped Au nanoparticles layered structures

    Sarathi Kundu


    Full Text Available Prolonged reorganization behaviour of mono-, di-, tri- and multi-layer films of Au nanoparticles prepared by Langmuir-Blodgett method on hydrophobic Si(001 substrates have been studied by using X-ray scattering techniques. Out-of-plane study shows that although at the initial stage the reorganization occurs through the compaction of the films keeping the layered structure unchanged but finally all layered structures modify to monolayer structure. Due to this reorganization the Au density increases within the nanometer thick films. In-plane study shows that inside the reorganized films Au nanoparticles are distributed randomly and the particle size modifies as the metallic core of Au nanoparticles coalesces.

  2. Prolonged labour as indication for emergency caesarean section

    Maaløe, Nanna; Sorensen, B L; Onesmo, R


    To audit the quality of obstetric management preceding emergency caesarean sections for prolonged labour.......To audit the quality of obstetric management preceding emergency caesarean sections for prolonged labour....

  3. Symptôme, sublimation, sexuation: les prolongements du symptôme

    Geneviève More


    Full Text Available à partir du commentaire de Lacan sur Joyce, j'ai développé une thèse lacanienne fondamentale pour penser la transmission entre les générations avec un autre concept que celui de l'identification : le prolongement du symptôme. De plus, l'accent mis sur le sinthome par Lacan, n'empêche pas de situer la sublimation comme l'un des autres prolongements possibles du symptôme initial de Joyce.

  4. Laryngotracheal Injury following Prolonged Endotracheal Intubation

    J. Mehdizadeh


    Full Text Available Background: Prolonged endotracheal intubation is a growing method for supporting ventilation in patients who require intensive care. Despite considerable advancement in endotracheal intubation, this method still has some complications; the most important is laryngo-tracheal injuries. Methods: Over a 2-year period, this retrospective study was conducted on 57 patients with history of prolonged intubation who were referred to the ENT Department of Amir Alam Hospital. For each patient, a complete evaluation including history, physical examination, and direct laryngoscopy and bronchoscopy was done under general anesthesia. Results: Fifty-seven patients (44 male; mean age, 23.014.7 years were studied. Mean intubation period was 15.88 days. The most common presenting symptom was dyspnea (62%. Head trauma was responsible for most cases of intubation (72.4%. The most common types of tracheal and laryngeal lesions were tracheal (56.9% and subglottic (55.2% stenosis, respectively. Mean length of tracheal stenosis was 0.810.83 cm. There was a statistically significant relationship between length of tracheal stenosis and intubation period (P=0.0001 but no relation was observed between tracheal stenosis and age, sex, and etiology of intubation (All P=NS. Among the glottic lesions, inter- arytenoids adhesion was the most common lesion (25.9%. No statistically significant relation was found between glottic and subglottic lesions and age, sex and intubation period (all P=NS. Length of stenosis and intubation period was significantly greater in tracheal/ subglottic lesions than those in glottic/ supraglottic lesions (all P=NS. Conclusion: After prolonged endotracheal intubation, laryngo-tracheal lesions had no relation with patient’s age, sex, and cause of intubation.There was direct relation between length of tracheal stenosis and intubation period. Glottic lesions were more commonly observed in head trauma patients. Lesion length and intubation

  5. Empirical codon substitution matrix

    Gonnet Gaston H


    Full Text Available Abstract Background Codon substitution probabilities are used in many types of molecular evolution studies such as determining Ka/Ks ratios, creating ancestral DNA sequences or aligning coding DNA. Until the recent dramatic increase in genomic data enabled construction of empirical matrices, researchers relied on parameterized models of codon evolution. Here we present the first empirical codon substitution matrix entirely built from alignments of coding sequences from vertebrate DNA and thus provide an alternative to parameterized models of codon evolution. Results A set of 17,502 alignments of orthologous sequences from five vertebrate genomes yielded 8.3 million aligned codons from which the number of substitutions between codons were counted. From this data, both a probability matrix and a matrix of similarity scores were computed. They are 64 × 64 matrices describing the substitutions between all codons. Substitutions from sense codons to stop codons are not considered, resulting in block diagonal matrices consisting of 61 × 61 entries for the sense codons and 3 × 3 entries for the stop codons. Conclusion The amount of genomic data currently available allowed for the construction of an empirical codon substitution matrix. However, more sequence data is still needed to construct matrices from different subsets of DNA, specific to kingdoms, evolutionary distance or different amount of synonymous change. Codon mutation matrices have advantages for alignments up to medium evolutionary distances and for usages that require DNA such as ancestral reconstruction of DNA sequences and the calculation of Ka/Ks ratios.

  6. [Prolonged acute pancreatitis after bone marrow transplantation].

    De Singly, B; Simon, M; Bennani, J; Wittnebel, S; Zagadanski, A-M; Pacault, V; Gornet, J-M; Allez, M; Lémann, M


    Acute pancreatitis is not infrequent after allogenic marrow transplantation. Several causes can predispose to pancreatitis, including Graft-Versus-Host Disease (GVHD), a condition which is probably underestimated. In the literature, few description of pancreatic GVHD can be found. Pancreatic GVHD diagnosis can be difficult if pancreatic involvement occurs without other typical manifestations of GVHD. We report the case of a woman, 54 years old, suffering from prolonged, painful pancreatitis two months after allogenic bone marrow transplantation for acute myeloid leucemia. Pancreatic GVHD diagnosis was performed after five weeks on duodenal biopsies despite the absence of diarrheoa. The patient dramatically improved within few days on corticosteroids.

  7. Prolonged parenteral nutrition after neonatal gastrointestinal surgery

    Estmann, Anne; Qvist, Niels; Husby, Steffen


    INTRODUCTION: Long-term treatment with parenteral nutrition (PN) may be essential for survival in infants after neonatal gastrointestinal surgery. It seemed well indicated in a population-based study to estimate the need for long-term PN and to characterize the infants that received TPN with regard...... to diagnosis and clinical course. METHODOLOGY: This study reviews the clinical course of infants with gastrointestinal disease (gastroschisis, intestinal atresia, omphalocele, volvulus, Hirschsprung's disease and necrotizing enterocolitis) with a prolonged need for parenteral nutrition in the Western part...

  8. Survival of soil bacteria during prolonged desiccation.

    Chen, M.; Alexander, M.


    A determination was made of the kinds and numbers of bacteria surviving when two soils were maintained in the laboratory under dry conditions for more than half a year. Certain non-spore-forming bacteria were found to survive in the dry condition for long periods. A higher percentage of drought-tolerant than drought-sensitive bacteria was able to grow at low water activities. When they were grown in media with high salt concentrations, bacteria generally became more tolerant of prolonged drought and they persisted longer. The percent of cells in a bacterial population that remained viable when exposed to drought stress varied with the stage of growth.

  9. Prolonged parenteral nutrition after neonatal gastrointestinal surgery

    Estmann, Anne; Qvist, Niels; Husby, Steffen


    INTRODUCTION: Long-term treatment with parenteral nutrition (PN) may be essential for survival in infants after neonatal gastrointestinal surgery. It seemed well indicated in a population-based study to estimate the need for long-term PN and to characterize the infants that received TPN with regard...... to diagnosis and clinical course. METHODOLOGY: This study reviews the clinical course of infants with gastrointestinal disease (gastroschisis, intestinal atresia, omphalocele, volvulus, Hirschsprung's disease and necrotizing enterocolitis) with a prolonged need for parenteral nutrition in the Western part...

  10. Lifetime Prolonging Algorithms for Underwater Sensor Networks

    GUO Zhong-wen; LI Zhi-wei; YU Lei


    Underwater acoustic modem technology has attained a level of maturity to support underwater acoustic sensor networks (UASNs) which are generally formed by acoustically connected sensor nodes and a surface station providing a link to an on-shore control center. While many applications require long-term monitoring of the deployment area, the battery-powered network nodes limit the lifetime of UASNs. Therefore, designing a UASN that minimizes the power consumption while maximizing lifetime becomes a very difficult task. In this paper, a method is proposed to determine the optimum number of clusters through combining an application-specific protocol architecture and underwater acoustic communication model so as to reduce the energy dissipation of UASNs. Deploying more sensor nodes which work alternately is another way to prolong the lifetime of UASNs. An algorithm is presented for selecting sensor nodes and putting them into operation in each round, ensuring the monitoring to the whole given area. The present results show that the algorithm can help prolong system lifetime remarkably when it is applied to other conventional approaches for sensor networks under the condition that the sensor node density is high.

  11. Prolonged energy harvesting for ingestible devices.

    Nadeau, Phillip; El-Damak, Dina; Glettig, Dean; Kong, Yong Lin; Mo, Stacy; Cleveland, Cody; Booth, Lucas; Roxhed, Niclas; Langer, Robert; Chandrakasan, Anantha P; Traverso, Giovanni


    Ingestible electronics have revolutionized the standard of care for a variety of health conditions. Extending the capacity and safety of these devices, and reducing the costs of powering them, could enable broad deployment of prolonged monitoring systems for patients. Although prior biocompatible power harvesting systems for in vivo use have demonstrated short minute-long bursts of power from the stomach, not much is known about the capacity to power electronics in the longer term and throughout the gastrointestinal tract. Here, we report the design and operation of an energy-harvesting galvanic cell for continuous in vivo temperature sensing and wireless communication. The device delivered an average power of 0.23 μW per mm(2) of electrode area for an average of 6.1 days of temperature measurements in the gastrointestinal tract of pigs. This power-harvesting cell has the capacity to provide power for prolonged periods of time to the next generation of ingestible electronic devices located in the gastrointestinal tract.

  12. Delayed effects of environmentally relevant concentrations of 3,3',4,4'-tetrachlorobiphenyl (PCB-77) and non-polar sediment extracts detected in the prolonged-FETAX

    Gutleb, A.C.; Mossink, L.; Schriks, M.; Berg, van den J.H.J.; Murk, A.J.


    In the prolonged-FETAX (prolonged-Frog Embryo Teratogenic Assay-Xenopus) tadpoles are allowed to develop until metamorphosis after an initial 4 day early life-stage exposure (FETAX). PCB 77 (3,4,3¿,4¿-tetrachlorobiphenyl) and sediment extracts were used in the presented experiments. Concentrations o

  13. An Automatic Prolongation Detection Approach in Continuous Speech With Robustness Against Speaking Rate Variations

    Esmaili, Iman; Dabanloo, Nader Jafarnia; Vali, Mansour


    In recent years, many methods have been introduced for supporting the diagnosis of stuttering for automatic detection of prolongation in the speech of people who stutter. However, less attention has been paid to treatment processes in which clients learn to speak more slowly. The aim of this study was to develop a method to help speech-language pathologists (SLPs) during diagnosis and treatment sessions. To this end, speech signals were initially parameterized to perceptual linear predictive (PLP) features. To detect the prolonged segments, the similarities between successive frames of speech signals were calculated based on correlation similarity measures. The segments were labeled as prolongation when the duration of highly similar successive frames exceeded a threshold specified by the speaking rate. The proposed method was evaluated by UCLASS and self-recorded Persian speech databases. The results were also compared with three high-performance studies in automatic prolongation detection. The best accuracies of prolongation detection were 99 and 97.1% for UCLASS and Persian databases, respectively. The proposed method also indicated promising robustness against artificial variation of speaking rate from 70 to 130% of normal speaking rate. PMID:28487827

  14. Epistemology and Empirical Investigation

    Ahlström, Kristoffer


    Recently, Hilary Kornblith has argued that epistemological investigation is substantially empirical. In the present paper, I will ¿rst show that his claim is not contingent upon the further and, admittedly, controversial assumption that all objects of epistemological investigation are natural kinds....... Then, I will argue that, contrary to what Kornblith seems to assume, this methodological contention does not imply that there is no need for attending to our epistemic concepts in epistemology. Understanding the make-up of our concepts and, in particular, the purposes they ¿ll, is necessary...... for a proper acknowledgment of epistemology’s role in conceptual improvement...

  15. Realism And Empirical Evidence

    Schmelzer, I


    We define realism using a slightly modified version of the EPR criterion of reality. This version is strong enough to show that relativity is incomplete. We show that this definition of realism is nonetheless compatible with the general principles of causality and canonical quantum theory as well as with experimental evidence in the (special and general) relativistic domain. We show that the realistic theories we present here, compared with the standard relativistic theories, have higher empirical content in the strong sense defined by Popper's methodology.

  16. What 'empirical turn in bioethics'?

    Hurst, Samia


    Uncertainty as to how we should articulate empirical data and normative reasoning seems to underlie most difficulties regarding the 'empirical turn' in bioethics. This article examines three different ways in which we could understand 'empirical turn'. Using real facts in normative reasoning is trivial and would not represent a 'turn'. Becoming an empirical discipline through a shift to the social and neurosciences would be a turn away from normative thinking, which we should not take. Conducting empirical research to inform normative reasoning is the usual meaning given to the term 'empirical turn'. In this sense, however, the turn is incomplete. Bioethics has imported methodological tools from empirical disciplines, but too often it has not imported the standards to which researchers in these disciplines are held. Integrating empirical and normative approaches also represents true added difficulties. Addressing these issues from the standpoint of debates on the fact-value distinction can cloud very real methodological concerns by displacing the debate to a level of abstraction where they need not be apparent. Ideally, empirical research in bioethics should meet standards for empirical and normative validity similar to those used in the source disciplines for these methods, and articulate these aspects clearly and appropriately. More modestly, criteria to ensure that none of these standards are completely left aside would improve the quality of empirical bioethics research and partly clear the air of critiques addressing its theoretical justification, when its rigour in the particularly difficult context of interdisciplinarity is what should be at stake.

  17. [Sideroblastic anemia after prolonged linezolid therapy].

    Kakimoto, Tsunayuki; Nakazato, Tomonori; Miura, Reiko; Kurai, Hanako; Yamashita, Daisuke; Sagara, Yuko; Ishida, Akaru


    Linezolid is an effective and well-tolerated antibiotic for the treatment of infections caused by Gram-positive pathogens. Some reports have shown that linezolid treatment for more than 2 weeks has been associated with reversible bone marrow suppression, especially thrombocytopenia and anemia. We encountered a case of sideroblastic anemia following prolonged linezolid therapy in a laryngeal cancer patient. He received linezolid therapy for multiple abscesses due to MRSA. Before treatment, the Hb level was 12.5 g/dl and then slowly decreased to 5.9 g/dl for 2 months during treatment. Ringed sideroblasts were detected in the bone marrow. Linezolid was discontinued and the Hb level was slowly increased. This case was considered to reflect a rare complication of linezolid therapy.

  18. Multifactorial QT Interval Prolongation and Takotsubo Cardiomyopathy

    Michael Gysel


    Full Text Available A 71-year-old woman collapsed while working as a grocery store cashier. CPR was performed and an AED revealed torsades de pointes (TdP. She was subsequently defibrillated resulting in restoration of sinus rhythm with a QTc interval of 544 msec. Further evaluation revealed a diagnosis of Takotsubo Cardiomyopathy (TCM contributing to the development of a multifactorial acquired long QT syndrome (LQTS. The case highlights the role of TCM as a cause of LQTS in the setting of multiple risk factors including old age, female gender, hypokalemia, and treatment with QT prolonging medications. It also highlights the multifactorial nature of acquired LQTS and lends support to growing evidence of an association with TCM.

  19. Neurohumoral responses during prolonged exercise in humans

    Nybo, Lars; Nielsen, Bodil; Blomstrand, Eva


    in the hyperthermic trial, with a concomitant increase in perceived exertion (P brain had a small release of tryptophan (arteriovenous difference of -1.2 +/- 0.3 micromol/l), whereas a net balance was obtained during the two exercise trials. Both the arterial and jugular venous dopamine levels...... became elevated during the hyperthermic trial, but the net release from the brain was unchanged. During exercise, the O2/CHO was similar across trials, but, during recovery from the hyperthermic trial, the ratio decreased to 3.8 +/- 0.3 (P ...This study examined neurohumoral alterations during prolonged exercise with and without hyperthermia. The cerebral oxygen-to-carbohydrate uptake ratio (O2/CHO = arteriovenous oxygen difference divided by arteriovenous glucose difference plus one-half lactate), the cerebral balances of dopamine...

  20. Empirical microeconomics action functionals

    Baaquie, Belal E.; Du, Xin; Tanputraman, Winson


    A statistical generalization of microeconomics has been made in Baaquie (2013), where the market price of every traded commodity, at each instant of time, is considered to be an independent random variable. The dynamics of commodity market prices is modeled by an action functional-and the focus of this paper is to empirically determine the action functionals for different commodities. The correlation functions of the model are defined using a Feynman path integral. The model is calibrated using the unequal time correlation of the market commodity prices as well as their cubic and quartic moments using a perturbation expansion. The consistency of the perturbation expansion is verified by a numerical evaluation of the path integral. Nine commodities drawn from the energy, metal and grain sectors are studied and their market behavior is described by the model to an accuracy of over 90% using only six parameters. The paper empirically establishes the existence of the action functional for commodity prices that was postulated to exist in Baaquie (2013).

  1. Prolonged pain and disability are common after rib fractures.

    Fabricant, Loic; Ham, Bruce; Mullins, Richard; Mayberry, John


    The contribution of rib fractures to prolonged pain and disability may be underappreciated and undertreated. Clinicians are traditionally taught that the pain and disability of rib fractures resolves in 6 to 8 weeks. This study was a prospective observation of 203 patients with rib fractures at a level 1 trauma center. Chest wall pain was evaluated by the McGill Pain Questionnaire (MPQ) pain rating index (PRI) and present pain intensity (PPI). Prolonged pain was defined as a PRI of 8 or more at 2 months after injury. Prolonged disability was defined as a decrease in 1 or more levels of work or functional status at 2 months after injury. Predictors of prolonged pain and disability were determined by multivariate analysis. One hundred forty-five male patients and 58 female patients with a mean injury severity score (ISS) of 20 (range, 1 to 59) had a mean of 5.4 rib fractures (range, 1 to 29). Forty-four (22%) patients had bilateral fractures, 15 (7%) had flail chest, and 92 (45%) had associated injury. One hundred eighty-seven patients were followed 2 months or more. One hundred ten (59%) patients had prolonged chest wall pain and 142 (76%) had prolonged disability. Among 111 patients with isolated rib fractures, 67 (64%) had prolonged chest wall pain and 69 (66%) had prolonged disability. MPQ PPI was predictive of prolonged pain (odds ratio [OR], 1.8; 95% confidence interval [CI], 1.4 to 2.5), and prolonged disability (OR, 2.2; 95% CI, 1.5 to 3.4). The presence of significant associated injuries was predictive of prolonged disability (OR, 5.9; 95% CI, 1.4 to 29). Prolonged chest wall pain is common, and the contribution of rib fractures to disability is greater than traditionally expected. Further investigation into more effective therapies that prevent prolonged pain and disability after rib fractures is needed. Copyright © 2013 Elsevier Inc. All rights reserved.

  2. Prolonged exposure therapy for combat- and terror-related posttraumatic stress disorder: a randomized control comparison with treatment as usual.

    Nacasch, Nitzah; Foa, Edna B; Huppert, Jonathan D; Tzur, Dana; Fostick, Leah; Dinstein, Yula; Polliack, Michael; Zohar, Joseph


    Empirically based studies have demonstrated that prolonged exposure therapy effectively reduces posttraumatic stress disorder (PTSD) symptoms in a vast range of traumas, yet reports of the efficacy of such therapies in combat- and terror-related PTSD are scarce. In this article, we examine the efficacy of prolonged exposure therapy in combat- and terror-related PTSD in comparison to treatment as usual (TAU). Between July 2002 and October 2005, 30 patients of a trauma unit within a psychiatric outpatient clinic were recruited and randomized into prolonged exposure versus TAU therapies. Patients were diagnosed with chronic PTSD (Mini-International Neuropsychiatric Interview criteria) related to combat- (n = 19) or terror-related (n = 11) trauma. Main outcome measures included symptoms of PTSD and depression, as measured by the PTSD Symptom Scale-Interview Version and the Beck Depression Inventory. Posttraumatic stress disorder symptom severity was significantly lower in patients who received prolonged exposure therapy in comparison to patients who received TAU (F(1,24) = 35.3, P terror-related PTSD symptoms. In addition, prolonged exposure was superior to TAU in the short- and long-term reduction of PTSD and depression symptoms. Identifier: NCT00229372. © Copyright 2011 Physicians Postgraduate Press, Inc.

  3. Clinical neurophysiology of prolonged disorders of consciousness: From diagnostic stimulation to therapeutic neuromodulation.

    Ragazzoni, Aldo; Cincotta, Massimo; Giovannelli, Fabio; Cruse, Damian; Young, G Bryan; Miniussi, Carlo; Rossi, Simone


    The identification of signs of awareness in patients with prolonged disorders of consciousness (DoC) after severe brain injury is a challenging task for clinicians. Differentiating on behavioural examination the vegetative state (VS) from the minimally conscious state (MCS) can lead to a high misdiagnosis rate. Advanced neuroimaging and neurophysiological techniques can supplement clinical evaluation by providing physiological evidence of brain activity. However, an open issue remains whether these empirical results are directly or indirectly associated with covert consciousness and limitations emerge for their diagnostic application at the single-patient level. On the therapeutic side, the efficacy of both non-invasive and invasive brain stimulation/modulation trials is matter of debate. The present review provides an updated analysis of the diagnostic and prognostic impact that the different neurophysiological techniques of stimulation [including short-latency evoked potentials, long-latency event related potentials (ERPs), transcranial magnetic stimulation (TMS), TMS-EEG co-registration] offer in prolonged DoC. The results of the therapeutic stimulation techniques are also evaluated. It is concluded that TMS-EEG emerges as the most promising tool for differentiating VS from MCS whereas ERPs allow neurophysiologists to probe covert cognitive capacities of each patient. Significant behavioural improvements in prolonged DoC with brain stimulation techniques are still anecdotical and further treatment options are awaited. Copyright © 2017 International Federation of Clinical Neurophysiology. Published by Elsevier B.V. All rights reserved.

  4. Late recovery of awareness in prolonged disorders of consciousness -a cross-sectional cohort study.

    Yelden, Kudret; Duport, Sophie; James, Leon M; Kempny, Agnieszka; Farmer, Simon F; Leff, Alex P; Playford, E Diane


    To detect any improvement of awareness in prolonged disorders of consciousness in the long term. A total of 34 patients with prolonged disorders of consciousness (27 vegetative state and seven minimally conscious state; 16 males; aged 21-73) were included in the study. All patients were initially diagnosed with vegetative/minimally conscious state on admission to our specialist neurological rehabilitation unit. Re-assessment was performed 2-16 years later using Coma Recovery Scale-Revised. Although remaining severely disabled, 32% of the patients showed late improvement of awareness evidenced with development of non-reflexive responses such as reproducible command following and localization behaviors. Most of the late recoveries occurred in patients with subarachnoid hemorrhage (5/11, 45.5%). The ages of patients within the late recovery group (Mean = 45, SD = 11.4) and non-recovery group (Mean = 43, SD = 15.5) were not statistically different (p = 0.76). This study shows that late improvements in awareness are not exceptional in non-traumatic prolonged disorders of consciousness cases. It highlights the importance of long-term follow up of patients with prolonged disorders of consciousness, regardless of the etiology, age, and time passed since the brain injury. Long-term follow up will help clinicians to identify patients who may benefit from further assessment and rehabilitation. Although only one patient achieved recovery of function, recovery of awareness may have important ethical implications especially where withdrawal of artificial nutrition and hydration is considered. Implications for rehabilitation Long-term regular follow-up of people with prolonged disorders of consciousness is important. Albeit with poor functional outcomes late recovery of awareness is possible in both traumatic and non-traumatic prolonged disorders of consciousness cases. Recovery of awareness has significant clinical and ethical implications especially where

  5. Empiric Antibiotic Therapy of Nosocomial Bacterial Infections.

    Reddy, Pramod


    Broad-spectrum antibiotics are commonly used by physicians to treat various infections. The source of infection and causative organisms are not always apparent during the initial evaluation of the patient, and antibiotics are often given empirically to patients with suspected sepsis. Fear of attempting cephalosporins and carbapenems in penicillin-allergic septic patients may result in significant decrease in the spectrum of antimicrobial coverage. Empiric antibiotic therapy should sufficiently cover all the suspected pathogens, guided by the bacteriologic susceptibilities of the medical center. It is important to understand the major pharmacokinetic properties of antibacterial agents for proper use and to minimize the development of resistance. In several septic patients, negative cultures do not exclude active infection and positive cultures may not represent the actual infection. This article will review the important differences in the spectrum of commonly used antibiotics for nosocomial bacterial infections with a particular emphasis on culture-negative sepsis and colonization.

  6. Rub epilepsy: a somatosensory evoked reflex epilepsy induced by prolonged cutaneous stimulation


    TO DELINEATE RUB EPILEPSY—a type of reflex epilepsy induced by prolonged or repetitive cutaneous stimulation in a circumscribed area of the body—three cases are presented, as well as one of tooth brushing epilepsy for comparison. In all three cases of rub epilepsy, cutaneous stimuli in a particular body area on the left side initially induced a sensory jacksonian march in the middle of, or in close vicinity to, the trigger zone, which led to subsequent unilateral tonic contr...

  7. Prolonged cholestasis and ductopenia associated with tenoxicam.

    Trak-Smayra, Viviane; Cazals-Hatem, Dominique; Asselah, Tarik; Duchatelle, Veronique; Degott, Claude


    Cholestatic liver diseases leading to progressive destruction of intra-hepatic bile ducts and ductopenia encompass multiple etiologies. Pathophysiology and natural history of drug-induced cholangiopathies remain unclear. We report a case of prolonged ductopenia attributed to Tenoxicam (Tilcotil o--a non-steroidal anti-inflammatory drug of the oxicam family) ingested at therapeutic dose. A 36 year-old male patient was admitted for jaundice and Lyell syndrome starting 1 week after the ingestion of Tenoxicam. Liver biopsy showed cholestasis, non-suppurative cholangitis and polymorphous inflammatory infiltrate of the portal tracts (round cells, macrophages an eosinophils). Treatment with ursodesoxycholic acid and cholestyramine was instituted and the patient was asymptomatic 1 year after. Three years later mild biological cholestasis persisted and ductopenia was evidenced on liver biopsy. In this report we found that: (1) The toxicity of tenoxicam was probably mediated by an immunoallergic mechanism (Lyell syndrome and eosinophils on histology); (2) ductopenia was secondary to inflammatory cholangitis. Factors responsible for this chronic evolution are still unknown (genetic predisposition, vascular factors, etc.); and (3) the presence of ductopenia contrasted with the "clinical recovery" of the disease suggesting accessory bile drainage by cholangioles or partial reconstruction of the biliary tree.

  8. Prolonging sensor networks lifetime using convex clusters

    Payam Salehi


    Full Text Available Reducing the energy consumption of nodes in sensor networks and prolonging the network life time has been proposed as one of the most important challenges facing researchers in the field of sensor networks. Therefore, designing an energy-aware protocol to gather data from network level and transmitting it to sink is placed on the agenda at this paper. After presenting an analysis of the processes of clustering in sensory networks and investigating the effect of sending interval on the amount of energy consumption, We have shown that if the use of convex static casters be done such as all the communications within the cluster with the sending distance less than the optimal threshold, it Will help to increase the lifetime of nodes. also have shown that if we create a virtual backbone between cluster heads to transfer far cluster heads data from sink to sink , will has a significant impact on increasing the network lifetime. For this reason, a detailed discussion on how to determine the size of clusters and partitioning of the network environment to them is presented in Chapter 4.Simulation results show considerable improvement of the proposed algorithm.

  9. Persistent telomere cohesion triggers a prolonged anaphase.

    Kim, Mi Kyung; Smith, Susan


    Telomeres use distinct mechanisms (not used by arms or centromeres) to mediate cohesion between sister chromatids. However, the motivation for a specialized mechanism at telomeres is not well understood. Here we show, using fluorescence in situ hybridization and live-cell imaging, that persistent sister chromatid cohesion at telomeres triggers a prolonged anaphase in normal human cells and cancer cells. Excess cohesion at telomeres can be induced by inhibition of tankyrase 1, a poly(ADP-ribose) polymerase that is required for resolution of telomere cohesion, or by overexpression of proteins required to establish telomere cohesion, the shelterin subunit TIN2 and the cohesin subunit SA1. Regardless of the method of induction, excess cohesion at telomeres in mitosis prevents a robust and efficient anaphase. SA1- or TIN2-induced excess cohesion and anaphase delay can be rescued by overexpression of tankyrase 1. Moreover, we show that primary fibroblasts, which accumulate excess telomere cohesion at mitosis naturally during replicative aging, undergo a similar delay in anaphase progression that can also be rescued by overexpression of tankyrase 1. Our study demonstrates that there are opposing forces that regulate telomere cohesion. The observation that cells respond to unresolved telomere cohesion by delaying (but not completely disrupting) anaphase progression suggests a mechanism for tolerating excess cohesion and maintaining telomere integrity. This attempt to deal with telomere damage may be ultimately futile for aging fibroblasts but useful for cancer cells.

  10. [Prospective study of patients with prolonged fever].

    Calderón, E; Legorreta, J; Sztabinski, G; Hernández, M; Wilkins, A; Gómez, D; Dávila, A


    A prospective study was made in 283 patients who attended IMAN's Children's Hospital, with fever the main symptom. A clinical and paraclinical procedure was designed for the study of each patient. 112 patients were eliminated because they did not follow the established criteria. All patients had acute infectious diseases considered trivial; 85% were 3 weeks to 2 years of age. They all had an antibacterial treatment without precise diagnosis. It was considered that on admission the patients showed a normal course in the natural history of the basic disease. The study group included 171 patients 2 months to 13 years of age; 62.5% had fever due to infection, 12.2% to collagenopathies, 7% to neoplasias 5.2% to miscellaneous causes and 12.8% were not diagnosed. The most common infectious causes for prolonged fever were tuberculosis, upper respiratory infections, amoebic liver abscess, typhoid fever and malaria. Careful questioning and clinical examination were enough to enlighten diagnosis in more than 80% of the patients.


    Ah. Yusuf


    Full Text Available Introduction: Decision for cesarean section may lead to the stress for women in delivery. Stress response requires longer recovery time in post cesarean section patients. Most of patients who experience stress before and after surgical is associated with wound healing delay. When this condition continues, the wound will have a higher risk of infection. The objective of this study was to analyze correlation between stress and wound healing phase in post cesarean section patients. Method: A cross sectional design was used in this study. The population were women with cesarean section, both elective or emergency, in Delivery Room I RSU Dr. Soetomo Surabaya. Samples were recruited by using purposive sampling, with 28 samples who met to the inclusion criterias. The observed variables were stress and wound healing phase in post cesarean section patient. Stress data were collected by interview and wound healing measurement done by observation on the 3rd day post cesarean section. Result: The result showed that women with stress experience wound healing delay. The characteristic of wound healing delay was prolonged on inflammation phase, nevertheless there was presence of granulation tissue. Spearman’s rho correlation showed that correlation value r=0.675 with p=0.000. Discussion: It can be concluded that there was strong significant correlation between stress and wound healing phase in post cesarean section patients. It is important to give this information to the patients with cesarean section in order to prevent stress and delay in wound healing phase.

  12. Gluteal Compartment Syndrome After Prolonged Immobilisation

    H.L. Liu


    Full Text Available Muscles in the gluteal region are confined by distinct fascial attachments which can potentially result in compartment syndrome. A 74-year-old chronic drinker was admitted to the medical ward after being found drunk on the street. He noticed acute painful swelling of the right side of his buttock the following morning and recalled a slip and fall prior to his blackout. The whole right half of the buttock was tense with erythematous overlying skin. Examination revealed sciatic nerve palsy and myoglobinuria. Emergency fasciotomy and debridement were performed. Intra-operative pressure measurement confirmed a grossly elevated intra-compartmental pressure. Gluteal compartment syndrome is an extremely rare condition and has only been scantily documented previously in case reports. Early diagnosis is crucial but delay recognition is common from lack of knowledge of the condition and readily results in permanent sciatic nerve injury and acute renal shutdown from myoglobinuria. Awareness of the condition, early diagnosis and prompt exploration provide the only chance of avoiding these devastating consequences. Acute swelling diffusely affecting the whole or one side of the buttock, a history of trauma and prolonged local pressure impingement associated with pain out of proportion to the clinical signs should raise a suspicion of this rare condition.

  13. 网络零售中的新客户与老客户购买行为差异基于淘宝网的实证对比研究%The Initial Buyers and Repeat Buyers in Online Retailing: an Empirical Study based on TaoBao. com

    秦二娃; 卢向华


    traditional markets in terms of shopping environment, transaction process, consumer decision making process et al. It is rea sonable to doubt if we can simply copy the method of traditional market to manage the initial buyers and repeat buy ers to online. As the best of our knowledge, there is very few research differentiates the initial buyer and repeat buyers in the online retailing customer relationship management. With the rapid development and maturing of the online retailing market in China, it is necessary to study the differenceservice requirements between initial buyers and repeat buyers in the online retailing context. In the prior researches, many researchers studied online service quality focused on the perceptions of all cus tomers. Furthermore, some researchers focused on the different needs of the online retailers' service quality between the loyal customers and information searchers from Internet users' perceptions. Unfortunately, the role of customers experience is always not been taken seriously in online retailing. In this paper, we focus on the perspective of on line retailers to investigate the influence of customers' direct experience in online purchase intention, which is help ful for online retailers to promote differently when they try to retain repeat customers or attract initial customers. Based on the theoretical framework of "anchoring and adjustment", this paper analyzes the different services re quirements between initial buyers and repeat buyer by combining the characteristics of online shopping. The serv ices we examined in this paper include information retrieval services, product comparison services, reputation sys tems services and postpurchase services obtained according to buyers' purchase process. Four pairs of hypothesis are put forward based on the theoretical analysis and comprehensive literature review. Our empirical test is followed with the data from Taobao. com. We collect 2384 online retailers' information from Nov

  14. Empirical techniques in finance

    Bhar, Ramaprasad


    This book offers the opportunity to study and experience advanced empi- cal techniques in finance and in general financial economics. It is not only suitable for students with an interest in the field, it is also highly rec- mended for academic researchers as well as the researchers in the industry. The book focuses on the contemporary empirical techniques used in the analysis of financial markets and how these are implemented using actual market data. With an emphasis on Implementation, this book helps foc- ing on strategies for rigorously combing finance theory and modeling technology to extend extant considerations in the literature. The main aim of this book is to equip the readers with an array of tools and techniques that will allow them to explore financial market problems with a fresh perspective. In this sense it is not another volume in eco- metrics. Of course, the traditional econometric methods are still valid and important; the contents of this book will bring in other related modeling topics tha...

  15. Auditory imagery: empirical findings.

    Hubbard, Timothy L


    The empirical literature on auditory imagery is reviewed. Data on (a) imagery for auditory features (pitch, timbre, loudness), (b) imagery for complex nonverbal auditory stimuli (musical contour, melody, harmony, tempo, notational audiation, environmental sounds), (c) imagery for verbal stimuli (speech, text, in dreams, interior monologue), (d) auditory imagery's relationship to perception and memory (detection, encoding, recall, mnemonic properties, phonological loop), and (e) individual differences in auditory imagery (in vividness, musical ability and experience, synesthesia, musical hallucinosis, schizophrenia, amusia) are considered. It is concluded that auditory imagery (a) preserves many structural and temporal properties of auditory stimuli, (b) can facilitate auditory discrimination but interfere with auditory detection, (c) involves many of the same brain areas as auditory perception, (d) is often but not necessarily influenced by subvocalization, (e) involves semantically interpreted information and expectancies, (f) involves depictive components and descriptive components, (g) can function as a mnemonic but is distinct from rehearsal, and (h) is related to musical ability and experience (although the mechanisms of that relationship are not clear).

  16. Stakeholder Pressures, Environmental Impact and Managerial Initiatives of SMEs

    Madsen, Henning; Ulhøi, John Parm


    impact was available in Denmark. Consequently, a longitudinal research project was initiated to enlighten the situation. This study investigates environmentally related initiatives taken in response to the perception of stakeholder pressures and the perceived corporate environmental impact. The empirical...

  17. Final Empirical Test Case Specification

    Kalyanova, Olena; Heiselberg, Per

    This document includes the empirical specification on the IEA task of evaluation building energy simulation computer programs for the Double Skin Facades (DSF) constructions. There are two approaches involved into this procedure, one is the comparative approach and another is the empirical one....

  18. Encephalitis with Prolonged but Reversible Splenial Lesion

    Alena Meleková


    Full Text Available Introduction: The splenium of the corpus callosum has a specific structure of blood supply with a tendency towards blood-brain barrier breakdown, intramyelinic edema, and damage due to hypoxia or toxins. Signs and symptoms of reversible syndrome of the splenium of the corpus callosum typically include disorientation, confusion, impaired consciousness, and epileptic seizures. Case report: A previously healthy 32-year-old man suffered from weakness, headache, and fever. Subsequently, he developed apathy, ataxia, and inability to walk, and therefore was admitted to the hospital. Cerebrospinal fluid showed protein elevation (0.9 g/l and pleocytosis (232/1 ul. A brain MRI showed hyperintense lesions in the middle of the corpus callosum. The patient was treated with antibiotics, and subsequently, in combination with steroids. Two months later, the hyperintense lesions in the splenium and the basal ganglia had disappeared. Almost seven months since his hospitalization in the Department of Neurology, the patient has returned to his previous employment. He now does not exhibit any mental changes, an optic edema and urological problems have improved. In addition, he is now actively engaged in sports. Conclusion: We have described a case of a 32-year-old man with confusion, ataxia, and inability to stand and walk. The man developed a febrile meningeal syndrome and a hyperintense lesion of the splenium, which lasted for two months. Neurological changes, optic nerve edema, and urinary retention have resolved over the course of seven months. We think that the prolonged but transient lesion of the splenium may have been caused by encephalitis of viral origin.

  19. Diaphragmatic energetics during prolonged exhaustive exercise.

    Manohar, M; Hassan, A S


    The present study was carried out to examine diaphragmatic O2 extraction and lactate and ammonia production during prolonged exhaustive exercise. Experiments were performed on nine healthy exercise-conditioned ponies in which catheters had been implanted in the phrenic vein previously. Blood-gas variables and lactate and ammonia concentrations were determined on simultaneously obtained arterial and phrenic-venous blood samples at rest and during 30 min of exertion at 15 mph + 7% grade (heart rate, 200 beats/min; approximately 90% of maximum). Arterial O2 tension and saturation were maintained near resting value but CO2 tension decreased markedly with exercise, and because of increased hemoglobin concentration, arterial O2 content rose. Concomitantly, phrenic venous O2 tension, saturation and content decreased markedly (23.6 +/- 1 mm Hg, 24.5 +/- 2%, 5.2 +/- 0.3 ml/dl at 3 min of exertion) and significant fluctuations did not occur as exercise duration progressed to 30 min. Diaphragmatic arteriovenous O2 content difference and O2 extraction rose from 4 +/- 0.3 to 16 +/- 0.5 ml/dl and from 30 +/- 3 to 75 +/- 1% at 3 min of exercise, and significant deviations did not occur as exercise duration progressed. Arterial lactate and ammonia levels increased during exercise, indicating their release from working limb muscles. Phrenic-venous values of lactate and ammonia did not exceed arterial values. Ponies sweated profusely and were unable to keep up with the belt speed in the last 4 to 5 min of exercise. Constancy of phrenic arteriovenous O2 content difference in exercise indicated ability to adjust perfusion in diaphragm so as to adequately meet its O2 needs.(ABSTRACT TRUNCATED AT 250 WORDS)

  20. Exceptionally prolonged tooth formation in elasmosaurid plesiosaurians

    Kear, Benjamin P.; Larsson, Dennis; Lindgren, Johan; Kundrát, Martin


    Elasmosaurid plesiosaurians were globally prolific marine reptiles that dominated the Mesozoic seas for over 70 million years. Their iconic body-plan incorporated an exceedingly long neck and small skull equipped with prominent intermeshing ‘fangs’. How this bizarre dental apparatus was employed in feeding is uncertain, but fossilized gut contents indicate a diverse diet of small pelagic vertebrates, cephalopods and epifaunal benthos. Here we report the first plesiosaurian tooth formation rates as a mechanism for servicing the functional dentition. Multiple dentine thin sections were taken through isolated elasmosaurid teeth from the Upper Cretaceous of Sweden. These specimens revealed an average of 950 daily incremental lines of von Ebner, and infer a remarkably protracted tooth formation cycle of about 2–3 years–other polyphyodont amniotes normally take ~1–2 years to form their teeth. Such delayed odontogenesis might reflect differences in crown length and function within an originally uneven tooth array. Indeed, slower replacement periodicity has been found to distinguish larger caniniform teeth in macrophagous pliosaurid plesiosaurians. However, the archetypal sauropterygian dental replacement system likely also imposed constraints via segregation of the developing tooth germs within discrete bony crypts; these partly resorbed to allow maturation of the replacement teeth within the primary alveoli after displacement of the functional crowns. Prolonged dental formation has otherwise been linked to tooth robustness and adaption for vigorous food processing. Conversely, elasmosaurids possessed narrow crowns with an elongate profile that denotes structural fragility. Their apparent predilection for easily subdued prey could thus have minimized this potential for damage, and was perhaps coupled with selective feeding strategies that ecologically optimized elasmosaurids towards more delicate middle trophic level aquatic predation. PMID:28241059

  1. Fatigue associated with prolonged graded running.

    Giandolini, Marlene; Vernillo, Gianluca; Samozino, Pierre; Horvais, Nicolas; Edwards, W Brent; Morin, Jean-Benoît; Millet, Guillaume Y


    Scientific experiments on running mainly consider level running. However, the magnitude and etiology of fatigue depend on the exercise under consideration, particularly the predominant type of contraction, which differs between level, uphill, and downhill running. The purpose of this review is to comprehensively summarize the neurophysiological and biomechanical changes due to fatigue in graded running. When comparing prolonged hilly running (i.e., a combination of uphill and downhill running) to level running, it is found that (1) the general shape of the neuromuscular fatigue-exercise duration curve as well as the etiology of fatigue in knee extensor and plantar flexor muscles are similar and (2) the biomechanical consequences are also relatively comparable, suggesting that duration rather than elevation changes affects neuromuscular function and running patterns. However, 'pure' uphill or downhill running has several fatigue-related intrinsic features compared with the level running. Downhill running induces severe lower limb tissue damage, indirectly evidenced by massive increases in plasma creatine kinase/myoglobin concentration or inflammatory markers. In addition, low-frequency fatigue (i.e., excitation-contraction coupling failure) is systematically observed after downhill running, although it has also been found in high-intensity uphill running for different reasons. Indeed, low-frequency fatigue in downhill running is attributed to mechanical stress at the interface sarcoplasmic reticulum/T-tubule, while the inorganic phosphate accumulation probably plays a central role in intense uphill running. Other fatigue-related specificities of graded running such as strategies to minimize the deleterious effects of downhill running on muscle function, the difference of energy cost versus heat storage or muscle activity changes in downhill, level, and uphill running are also discussed.

  2. Characterization of renal response to prolonged immersion in normal man

    Epstein, M.; Denunzio, A. G.; Ramachandran, M.


    ?jDuring the initial phase of space flight, there is a translocation of fluid from the lower parts of the body to the central vascular compartment with a resultant natriuresis, diuresis, and weight loss. Because water immersion is regarded as an appropriate model for studying the redistribution of fluid that occurs in weightlessness, an immersion study of relatively prolonged duration was carried out in order to characterize the temporal profile of the renal adaptation to central hypervolemia. Twelve normal male subjects underwent an immersion study of 8-h duration in the sodium-replete state. Immersion resulted in marked natriuresis and diuresis which were sustained throughout the immersion period. The failure of that natriuresis and diuresis of immersion to abate or cease despite marked extracellular fluid volume contraction as evidenced by a mean weight loss of -2.2 + or - 0.3 kg suggests that central blood volume was not restored to normal and that some degree of central hypervolemia probably persisted.

  3. Color stability and staining of silorane after prolonged chemical challenges

    de Jesus, Vivian CBR; Martinelli, Nata Luiz; Poli-Frederico, Regina Célia;

    Objectives: The purpose of this study was to investigate the effect of prolonged chemical challenges on color stability and staining susceptibility of a silorane-based composite material when compared to methacrylate-based composites. Methods: Cylindrical specimens (n=24) were fabricated from...... methacrylate (Filtek Z250, 3M ESPE; Filtek Z350XT, 3M ESPE; Master Fill, Biodinâmica) or silorane-based (Filtek P90, 3M ESPE) composite materials. Initial color was registered in a spectrophotometer. Specimens were divided in four groups and individually stored at 37°C in 0.02N citric acid, 0.02N phosphoric...... acid, 75% ethanol or distilled water (control) for 7, 14, 21, and 180 days, when new measurements were performed. A staining test was performed (n=12) after 21 days of chemical challenge by immersion in coffee during 3 weeks at 37°C. Color changes (¿E) were characterized using the CIEL*a*b* color...

  4. Effect of prolonged chemical challenges on selected properties of silorane

    de Jesus, Vivian CBR; Martinelli, Natan Luiz; Pascotto, Renata Corrêa;

    Objectives: The purpose of this study was to investigate the effect of prolonged chemical challenges on water sorption, solubility, and roughness of a silorane-based material when compared to methacrylate-based composites. Methods: Initial roughness and mass were registered for specimens (n=24......) fabricated from methacrylate (Filtek Z250, 3M ESPE; Filtek Z350XT, 3M ESPE; Master Fill, Biodinâmica) or silorane-based (Filtek P90, 3M ESPE) composites. The volume of all specimens was also calculated. Specimens were divided in four groups (n=6) and individually stored at 37°C in 0.02N citric acid, 0.02N...... submitted to two-way analysis of variance or analysis of variance for repeated measures, and Tukey’s multiple comparison test (a=0.05). Results: The silorane-based composite was the roughest (pcomposite (Ra=0.06±0.01) when compared to the other investigated materials (Ra=0.05±0.01). Significant...

  5. Depth perception after prolonged usage of night vision goggles.

    Sheehy, J B; Wilkinson, M


    The present study was initiated following a report that a few helicopter pilots had failed a test of stereoscopic depth perception after a prolonged training flight employing night vision goggles (NVGs). In order to determine the cause of the loss, 12 helicopter pilots/copilots were assessed for depth perception, lateral and vertical phoria, and contrast sensitivity before and after training flights requiring the pilots to wear night vision goggles for the duration of the flight. Pilots flew one to three missions while wearing either PVS-5A or AN/AVS-6 goggles. Mission duration ranged from 1 to 4 h. The results indicate that contrast sensitivity and depth perception when monocular cues are present did not degrade over the course of the mission. Lateral phoria, however, did demonstrate an average exophoric shift of 1.5 prism diopters for 12 out of the 24 missions. The results indicate that the original report of a loss of depth perception based on a test of depth requiring stereopsis might have been caused by a shift in lateral phoria. It would be expected that as additional fusional effort is required, the minimum resolvable disparity degrades due to the increase in accommodation brought about through vergence accommodation. Possible causes for the phoria shift and future testing are discussed.

  6. Extraordinarily Prolonged Disease Recurrence in a Granulosa Cell Tumor Patient

    Lisa N. Abaid


    Full Text Available Background: Granulosa cell tumors are rare sex cord stromal lesions that comprise approximately 3% of all ovarian neoplasms. The vast majority of granulosa cell tumors are considered indolent but in spite of aggressive management, delayed recurrence is of significant concern. Case Report: We describe a case involving a 67-year-old woman who presented with abdominal pain, bloody stools, and mild nausea. Following a CT scan of the abdomen and pelvis, a 19-cm pelvic mass was identified. Her prior medical history included a hysterectomy for uterine fibroids 40 years ago and a bilateral salpingo-oophorectomy for a presumed granulosa cell tumor 20 years ago. Final pathology revealed granulosa cell tumor with small bowel mesentery involvement. The patient underwent surgical resection and adjuvant chemotherapy; she is currently doing well. Conclusion: Granulosa cell tumors are considered to be of low malignant potential but they have the capacity to recur, even several years following initial patient management. This case exemplifies the disease’s capacity for prolonged recurrence and further accentuates the significance of long-term follow-up in these patients.

  7. Empire as a Geopolitical Figure

    Parker, Noel


    This article analyses the ingredients of empire as a pattern of order with geopolitical effects. Noting the imperial form's proclivity for expansion from a critical reading of historical sociology, the article argues that the principal manifestation of earlier geopolitics lay not in the nation...... but in empire. That in turn has been driven by a view of the world as disorderly and open to the ordering will of empires (emanating, at the time of geopolitics' inception, from Europe). One implication is that empires are likely to figure in the geopolitical ordering of the globe at all times, in particular...... after all that has happened in the late twentieth century to undermine nationalism and the national state. Empire is indeed a probable, even for some an attractive form of regime for extending order over the disorder produced by globalisation. Geopolitics articulated in imperial expansion is likely...

  8. QT interval prolongation after Premature Ventricular Contractions (PVCs

    Mohammed Haroon Rashid


    Full Text Available Long QT syndrome (LQTS is an inherited ion channelopathy resulting in abnormal ventricular repolarization and abnormal prolongation of QT interval on the ECG. Syncope, fainting, cardiac arrest, and sudden death are common manifestations of LQTS. We present a case report that describes a patient with prolonged QT interval after extrasystoles and a family history of sudden cardiac deaths.

  9. Remembrances of Empires Past

    Robert Aldrich


    Full Text Available This paper argues that the colonial legacy is ever present in contemporary Europe. For a generation, most Europeans largely tried, publicly, to forget the colonial past, or remembered it only through the rose-coloured lenses of nostalgia; now the pendulum has swung to memory of that past – even perhaps, in the views of some, to a surfeit of memory, where each group agitates for its own version of history, its own recognition in laws and ceremonies, its own commemoration in museums and monuments, the valorization or repatriation of its own art and artefacts. Word such as ‘invasion,’ ‘racism’ and ‘genocide’ are emotional terms that provoke emotional reactions. Whether leaders should apologize for wrongs of the past – and which wrongs – remains a highly sensitive issue. The ‘return of the colonial’ thus has to do with ethics and politics as well as with history, and can link to statements of apology or recognition, legislation about certain views of history, monetary compensation, repatriation of objects, and—perhaps most importantly—redefinition of national identity and policy. The colonial flags may have been lowered, but many barricades seem to have been raised. Private memories—of loss of land, of unacknowledged service, of political, economic, social and cultural disenfranchisement, but also on the other side of defeat, national castigation and self-flagellation—have been increasingly public. Monuments and museums act not only as sites of history but as venues for political agitation and forums for academic debate – differences of opinion that have spread to the streets. Empire has a long after-life.

  10. Empirically Driven Software Engineering Research

    Rombach, Dieter

    Software engineering is a design discipline. As such, its engineering methods are based on cognitive instead of physical laws, and their effectiveness depends highly on context. Empirical methods can be used to observe the effects of software engineering methods in vivo and in vitro, to identify improvement potentials, and to validate new research results. This paper summarizes both the current body of knowledge and further challenges wrt. empirical methods in software engineering as well as empirically derived evidence regarding software typical engineering methods. Finally, future challenges wrt. education, research, and technology transfer will be outlined.

  11. Birds of the Mongol Empire

    Eugene N. Anderson


    Full Text Available The Mongol Empire, the largest contiguous empire the world has ever known, had, among other things, a goodly number of falconers, poultry raisers, birdcatchers, cooks, and other experts on various aspects of birding. We have records of this, largely in the Yinshan Zhengyao, the court nutrition manual of the Mongol empire in China (the Yuan Dynasty. It discusses in some detail 22 bird taxa, from swans to chickens. The Huihui Yaofang, a medical encyclopedia, lists ten taxa used medicinally. Marco Polo also made notes on Mongol bird use. There are a few other records. This allows us to draw conclusions about Mongol ornithology, which apparently was sophisticated and detailed.

  12. Drug-Induced QT Prolongation as a Result of an Escitalopram Overdose in a Patient with Previously Undiagnosed Congenital Long QT Syndrome

    Paul Singh


    Full Text Available We present a case of drug-induced QT prolongation caused by an escitalopram overdose in a patient with previously undiagnosed congenital LQTS. A 15-year-old Caucasian female presented following a suicide attempt via an escitalopram overdose. The patient was found to have a prolonged QT interval with episodes of torsades de pointes. The patient was admitted to the telemetry unit and treated. Despite the resolution of the torsades de pointes, she continued to demonstrate a persistently prolonged QT interval. She was seen by the cardiology service and diagnosed with congenital long QT syndrome. This case illustrates the potential for an escitalopram overdose to cause an acute QT prolongation in a patient with congenital LQTS and suggests the importance of a screening electrocardiogram prior to the initiation of SSRIs, especially in patients at high risk for QT prolongation.

  13. The impact of prolonged violent video-gaming on adolescent sleep: an experimental study.

    King, Daniel L; Gradisar, Michael; Drummond, Aaron; Lovato, Nicole; Wessel, Jason; Micic, Gorica; Douglas, Paul; Delfabbro, Paul


    Video-gaming is an increasingly prevalent activity among children and adolescents that is known to influence several areas of emotional, cognitive and behavioural functioning. Currently there is insufficient experimental evidence about how extended video-game play may affect adolescents' sleep. The aim of this study was to investigate the short-term impact of adolescents' prolonged exposure to violent video-gaming on sleep. Seventeen male adolescents (mean age = 16 ± 1 years) with no current sleep difficulties played a novel, fast-paced, violent video-game (50 or 150 min) before their usual bedtime on two different testing nights in a sleep laboratory. Objective (polysomnography-measured sleep and heart rate) and subjective (single-night sleep diary) measures were obtained to assess the arousing effects of prolonged gaming. Compared with regular gaming, prolonged gaming produced decreases in objective sleep efficiency (by 7 ± 2%, falling below 85%) and total sleep time (by 27 ± 12 min) that was contributed by a near-moderate reduction in rapid eye movement sleep (Cohen's d = 0.48). Subjective sleep-onset latency significantly increased by 17 ± 8 min, and there was a moderate reduction in self-reported sleep quality after prolonged gaming (Cohen's d = 0.53). Heart rate did not differ significantly between video-gaming conditions during pre-sleep game-play or the sleep-onset phase. Results provide evidence that prolonged video-gaming may cause clinically significant disruption to adolescent sleep, even when sleep after video-gaming is initiated at normal bedtime. However, physiological arousal may not necessarily be the mechanism by which technology use affects sleep.

  14. Prolonged chewing at lunch decreases later snack intake.

    Higgs, Suzanne; Jones, Alison


    Prolonged chewing of food can reduce meal intake. However, whether prolonged chewing influences intake at a subsequent eating occasion is unknown. We hypothesised that chewing each mouthful for 30s would reduce afternoon snack intake more than (a) an habitual chewing control condition, and (b) an habitual chewing condition with a pauses in between each mouthful to equate the meal durations. We further hypothesised that this effect may be related to effects of prolonged chewing on lunch memory. Forty three participants ate a fixed lunch of sandwiches in the laboratory. They were randomly allocated to one of the three experimental groups according to a between-subjects design. Appetite, mood and lunch enjoyment ratings were taken before and after lunch and before snacking. Snack intake of candies at a taste test 2h after lunch was measured as well as rated vividness of lunch memory. Participants in the prolonged chewing group ate significantly fewer candies than participants in the habitual chewing group. Snack intake by the pauses group did not differ from either the prolonged or habitual chewing groups. Participants in the prolonged chewing group were less happy and enjoyed their lunch significantly less than participants in other conditions. Appetite ratings were not different across groups. Rated vividness of lunch memory was negatively correlated with intake but there was no correlation with rated lunch enjoyment. Prolonged chewing of a meal can reduce later snack intake and further investigation of this technique for appetite control is warranted.

  15. [Prolonged release of chlorambucil and etoposide from poly-3-oxybutyrate-based microspheres].

    Filatova, E V; Iakovlev, S G; Bonartsev, A P; Makhina, T K; Myshkina, V L; Bonartseva, G A


    Microspheres were obtained on the basis of poly(3-oxibutyrate) (POB) with the inclusion of the Chlorambucil and Etoposide cytostatic drugs in a polymer matrix, and the morphology, kinetics of drug release from microspheres, and the interaction between microspheres and tumor cells in vitro were studied. Data on the kinetics of drug release suggests that a prolonged release occurs by drug diffusion from the polymer matrix at the initial stage and at the expense of hydrolytic degradation of the polymer at a later stage. A study of the biocompatibility and biological activity of biopolymeric microspheres showed that chlorambucil operates actively and strongly inhibits the growth of cultured cells for a short time (24 h). Etoposide acts weaker (the percentage of cell growth suppression during 48 h does not exceed 50%), but subsequently it has a basis for the creation of new dosage forms with prolonged action of Etoposide and chlorambucil for cancer therapy.

  16. Perfusion and pH MRI in familial hemiplegic migraine with prolonged aura.

    Blicher, Jakob Udby; Tietze, Anna; Donahue, Manus J; Smith, Seth A; Østergaard, Leif


    To investigate tissue flow disturbance and hypoxia during migraine aura, we studied a case of familial hemiplegic migraine (FHM) using novel magnetic resonance imaging (MRI) techniques. A 44-year-old male was admitted with suspected stroke because of confusion and aphasia. Initial gadolinium-based perfusion MRI showed a decrease in cerebral blood flow and an increase in capillary flow disturbances within the left hemisphere. Later during the prolonged aura phase, chemical exchange saturation transfer MRI indicated a drop in pH in the affected area. The patient was diagnosed with an R908Q mutation in the ATP1A2 gene causing FHM type 2. During prolonged aura in FHM, MRI shows reduced CBF, capillary flow disturbances and a possible pH drop that could indicate tissue hypoxia. © International Headache Society 2015.

  17. Empirical Legality and Effective Reality

    Hernán Pringe


    Full Text Available The conditions that Kant’s doctrine establishes are examined for the predication of the effective reality of certain empirical objects. It is maintained that a for such a predication, it is necessary to have not only perception but also a certain homogeneity of sensible data, and b the knowledge of the existence of certain empirical objects depends on the application of regulative principles of experience.

  18. Differentiating Computer Experience and Attitudes toward Computers: An Empirical Investigation.

    Smith, B.; Caputi, P.; Rawstorne, P.


    Describes a study that defined and provided initial empirical support for differentiating the concepts of computer attitude, subjective computer experience, and objective computer experience. Discusses results of a principal component factor analysis and presents a conceptual analysis of the relation between subjective computer experience and…

  19. Children Who Witness Domestic Violence: A Review of Empirical Literature.

    Kolbo, Jerome R.; And Others


    Presents a review of the empirical literature examining the initial effects of witnessing domestic violence on children's functioning. Although results are somewhat inconclusive regarding children's social, cognitive, and physical development, findings of recently conducted investigations, when combined and compared with the previously reviewed…

  20. Empirical model for mineralisation of manure nitrogen in soil

    Sørensen, Peter; Thomsen, Ingrid Kaag; Schröder, Jaap


    A simple empirical model was developed for estimation of net mineralisation of pig and cattle slurry nitrogen (N) in arable soils under cool and moist climate conditions during the initial 5 years after spring application. The model is based on a Danish 3-year field experiment with measurements...

  1. Supplementation of Ascorbic Acid in Weanling Horses Following Prolonged Transportation

    Michelle Stives


    Full Text Available Though horses synthesize ascorbic acid in their liver in amounts that meet their needs under normal circumstances, prolonged stress results in low plasma concentrations due to enhanced utilization and renal excretion and can reduce immune function. It was hypothesized that plasma ascorbic acid could be maintained in weanling horses by oral supplementation following prolonged transportation. Weanlings were supplemented with no ascorbic acid (Tx 0: n = 4, 5 grams ascorbic acid twice daily for 5 days (Tx 1: n = 4 or for 10 days (Tx 2: n = 4 following >50 hours of transportation. Supplementation caused slight (P < 0.2 increases in plasma ascorbic acid concentrations. Both supplemented groups had decreased (P < 0.05 plasma concentrations for 1 to 3 weeks following cessation of supplementation, possibly due to increased renal excretion or suppressed hepatic synthesis. Supplementation of ascorbic acid following prolonged stress will increase plasma concentrations, but prolonged supplementation should be avoided.

  2. Prolonged sedentary time and physical activity in workplace and non-work contexts: a cross-sectional study of office, customer service and call centre employees.

    Thorp, Alicia A; Healy, Genevieve N; Winkler, Elisabeth; Clark, Bronwyn K; Gardiner, Paul A; Owen, Neville; Dunstan, David W


    To examine sedentary time, prolonged sedentary bouts and physical activity in Australian employees from different workplace settings, within work and non-work contexts. A convenience sample of 193 employees working in offices (131), call centres (36) and customer service (26) was recruited. Actigraph GT1M accelerometers were used to derive percentages of time spent sedentary (customer service workers were typically the least sedentary and the most active at work. The workplace is a key setting for prolonged sedentary time, especially for some occupational groups, and the potential health risk burden attached requires investigation. Future workplace regulations and health promotion initiatives for sedentary occupations to reduce prolonged sitting time should be considered.

  3. Prolonged cannabis withdrawal in young adults with lifetime psychiatric illness.

    Schuster, Randi Melissa; Fontaine, Madeleine; Nip, Emily; Zhang, Haiyue; Hanly, Ailish; Eden Evins, A


    Young adults with psychiatric illnesses are more likely to use cannabis and experience problems from use. It is not known whether those with a lifetime psychiatric illness experience a prolonged cannabis withdrawal syndrome with abstinence. Participants were fifty young adults, aged 18-25, recruited from the Boston-area in 2015-2016, who used cannabis at least weekly, completed the Structured Clinical Interview for DSM-IV to identify Axis I psychiatric diagnoses (PD+ vs PD-), and attained cannabis abstinence with a four-week contingency management protocol. Withdrawal symptom severity was assessed at baseline and at four weekly abstinent visits using the Cannabis Withdrawal Scale. Cannabis dependence, age of initiation, and rate of abstinence were similar in PD+ and PD- groups. There was a diagnostic group by abstinent week interaction, suggesting a difference in time course for resolution of withdrawal symptoms by group, F(4,46)=3.8, p=0.009, controlling for sex, baseline depressive and anxiety symptoms, and frequency of cannabis use in the prior 90days. In post hoc analyses, there was a difference in time-course of cannabis withdrawal. PD- had significantly reduced withdrawal symptom severity in abstinent week one [t(46)=-2.2, p=0.03], while PD+ did not report improved withdrawal symptoms until the second abstinent week [t(46)=-4.1, p=0.0002]. Cannabis withdrawal symptoms improved over four weeks in young people with and without a lifetime psychiatric diagnosis. However, those with a psychiatric illness reported one week delayed improvement in withdrawal symptom severity. Longer duration of cannabis withdrawal may be a risk factor for cannabis dependence and difficulty quitting. Copyright © 2017 Elsevier Inc. All rights reserved.

  4. Prolongation structure of the Landau–Lifshitz equation

    Roelofs, G.H.M.; Martini, R.


    The prolongation method of Wahlquist and Estabrook is applied to the Landau–Lifshitz equation. The resulting prolongation algebra is shown to be isomorphic to a subalgebra of the tensor product of the Lie algebra so(3) with the elliptic curve v α 2−v β 2=j β−j α (α,β=1,2,3), which is essentially a s

  5. Prolonged febrile illness and fever of unknown origin in adults.

    Hersch, Elizabeth C; Oh, Robert C


    Fever of unknown origin has been described as a febrile illness (temperature of 101°F [38.3°C] or higher) for three weeks or longer without an etiology despite a one-week inpatient evaluation. A more recent qualitative definition requires only a reasonable diagnostic evaluation. Although there are more than 200 diseases in the differential diagnosis, most cases in adults are limited to several dozen possible causes. Fever of unknown origin is more often an atypical presentation of a common disease rather than an unusual disease. The most common subgroups in the differential are infection, malignancy, noninfectious inflammatory diseases, and miscellaneous. Clinicians should perform a comprehensive history and examination to look for potentially diagnostic clues to guide the initial evaluation. If there are no potentially diagnostic clues, the patient should undergo a minimum diagnostic workup, including a complete blood count, chest radiography, urinalysis and culture, electrolyte panel, liver enzymes, erythrocyte sedimentation rate, and C-reactive protein level testing. Further testing should include blood cultures, lactate dehydrogenase, creatine kinase, rheumatoid factor, and antinuclear antibodies. Human immunodeficiency virus and appropriate region-specific serologic testing (e.g., cytomegalovirus, Epstein-Barr virus, tuberculosis) and abdominal and pelvic ultrasonography or computed tomography are commonly performed. If the diagnosis remains elusive, 18F fluorodeoxyglucose positron emission tomography plus computed tomography may help guide the clinician toward tissue biopsy. Empiric antibiotics or steroids are generally discouraged in patients with fever of unknown origin.

  6. Outcome of Induction of Labour in Prolonged Pregnancy.

    Nasrin, S; Islam, S; Shahida, S M; Begum, R A; Haque, N


    This was a hospital based prospective clinical study conducted among women having prolonged pregnancy to assess the outcome of induction of labour in prolonged pregnancy cases. One hundred and thirty nine women having uncomplicated prolonged pregnancy were studied. The study was carried out in Sir Salimullah Medical College & Mitford Hospital, Dhaka from 01 July 2010 to 30 March 2011. In this study 66% of the respondents had vaginal delivery on routine induction of labour and in 34% cases induction failed. Ninety three percent (93%) of the multigravida had vaginal delivery and in primigravida their vaginal delivery rate was 47.5%. Regarding cervical condition for delivery, 75% of the respondents having favourable cervix had vaginal delivery and in case of unfavourable cervix respondents, they had 55% cases of vaginal delivery. About the foetal outcome it was evidenced from this study that the perinatal adverse outcome increases with the increasing age of gestation beyond 40 completed weeks of gestation. This study showed that the use of prostaglandins for cervical ripening and by confirming the diagnosis of prolonged pregnancy, the delivery outcome in prolonged pregnancy can be improved. The study also showed that induction of labour is not associated with any major complications and the routine induction of labour in prolonged pregnancy is beneficial for both mother and the baby.

  7. Diagnosis, antenatal surveillance and management of prolonged pregnancy: current perspectives.

    Vitale, S G; Marilli, I; Rapisarda, A M; Iapichino, V; Stancanelli, F; Cianci, A


    Prolonged pregnancy is defined as a pregnancy that extends beyond 42 weeks of gestation (294 days) from the first day of the last normal menstrual period. An accurate estimation of the 'natural' incidence of prolonged pregnancy would require meticulous early pregnancy dating. The use of ultrasound to establish gestational age reduces the number of pregnancies that are classified as prolonged. Prolonged pregnancy is associated with an increased perinatal mortality and morbidity in pregnancies which appear to be otherwise low risk. Postterm births are easily preventable by intervening to deliver with the use of induction of labor. Thus, this potentially problematic condition deserves further attention and careful consideration. The focus of this article is to review and challenge some current concepts surrounding the diagnosis and management of prolonged pregnancy. We outline how to identify those women with prolonged pregnancy and which is the appropriate moment to start monitoring the fetal wellbeing. Finally we address the question of benefits and hazards of induction of labor strategies.

  8. Impact of Azithromycin on Pregnancy Prolongation in Women at Risk of Preterm Labor: A Time-to-Event Analysis.

    Goyer, Isabelle; Ferland, Gabrielle; Ruo, Ni; Morin, Caroline; Brochet, Marie-Sophie; Morin, Lucie; Ferreira, Ema


    Since 2006, the empiric use of azithromycin in women at risk of premature birth has become prevalent in our institution without any evidence of its efficacy. Although antibiotics can prolong pregnancy in preterm prolonged rupture of membranes, no published data are available for women with intact membranes. To describe the purpose of adding azithromycin to the usual treatments (cerclage, tocolysis, rest, etc.) to prolong pregnancy in women with intact membranes who are at risk of or already in preterm labour. A retrospective observational cohort study was done at a Mother-Child University Hospital Centre. Patients admitted to obstetric ward who received azithromycin between January 1(st), 2006 and August 1(st), 2010 were included. A total of 127 exposed women were matched to 127 controls through medical records and pharmacy software. A time-to-event analysis was done to compare gestational age at the time of the recorded composite event (delivery, or rupture of membranes, or second intervention to prolong pregnancy). To compare proportions of composite event at different time points, χ(2) tests were used. Patients who received azithromycin had a more severe condition at presentation. Once adjusted for confounding factors, prolongation of pregnancy (HR =1.049; CI 95%: 0.774-1.421 [p=0.758]) and gestational age at the event (HR=1.200; CI 95%: 0.894-1.609 [p=0.225]) did not differ between the groups. The proportions of women with an event ≥7 days post-diagnosis or ≥37 gestational weeks were similar. Azithromycin was added to medical therapy in a more at-risk population and no clear benefit was measured.

  9. Empirical Research In Engineering Design

    Ahmed, Saeema


    Increasingly engineering design research involves the use of empirical studies that are conducted within an industrial environment [Ahmed, 2001; Court 1995; Hales 1987]. Research into the use of information by designers or understanding how engineers build up experience are examples of research...... of research issues. This paper describes case studies of empirical research carried out within industry in engineering design focusing upon information, knowledge and experience in engineering design. The paper describes the research methods employed, their suitability for the particular research aims......, the advantages and disadvantages of the methods and describes two case studies in detail. The paper draws conclusions from the studies reviewed about the use of empirical research methods in industry....

  10. Empirical Research In Engineering Design

    Ahmed, Saeema


    Increasingly engineering design research involves the use of empirical studies that are conducted within an industrial environment [Ahmed, 2001; Court 1995; Hales 1987]. Research into the use of information by designers or understanding how engineers build up experience are examples of research...... of research issues. This paper describes case studies of empirical research carried out within industry in engineering design focusing upon information, knowledge and experience in engineering design. The paper describes the research methods employed, their suitability for the particular research aims......, the advantages and disadvantages of the methods and describes two case studies in detail. The paper draws conclusions from the studies reviewed about the use of empirical research methods in industry....

  11. Autologous Dendritic Cells Prolong Allograft Survival Through Tmem176b-Dependent Antigen Cross-Presentation

    Charnet, P.; Savina, A.; Tilly, G.; Gautreau, L.; Carretero-Iglesia, L.; Beriou, G.; Cebrian, I.; Cens, T.; Hepburn, L.; Chiffoleau, E.; Floto, R. A.; Anegon, I.; Amigorena, S.; Hill, M.; Cuturi, M. C.


    The administration of autologous (recipient-derived) tolerogenic dendritic cells (ATDCs) is under clinical evaluation. However, the molecular mechanisms by which these cells prolong graft survival in a donor-specific manner is unknown. Here, we tested mouse ATDCs for their therapeutic potential in a skin transplantation model. ATDC injection in combination with anti-CD3 treatment induced the accumulation of CD8+CD11c+ T cells and significantly prolonged allograft survival. TMEM176B is an intracellular protein expressed in ATDCs and initially identified in allograft tolerance. We show that Tmem176b−/− ATDCs completely failed to trigger both phenomena but recovered their effect when loaded with donor peptides before injection. These results strongly suggested that ATDCs require TMEM176B to cross-present antigens in a tolerogenic fashion. In agreement with this, Tmem176b−/− ATDCs specifically failed to cross-present male antigens or ovalbumin to CD8+ T cells. Finally, we observed that a Tmem176b-dependent cation current controls phagosomal pH, a critical parameter in cross-presentation. Thus, ATDCs require TMEM176B to cross-present donor antigens to induce donor-specific CD8+CD11c+ T cells with regulatory properties and prolong graft survival. PMID:24731243

  12. Ageing is associated with a prolonged fever response in human endotoxemia

    Krabbe, Karen S.; Kemp, Helle Bruunsgaard; Hansen, Christian Muff


    The purpose of this study was to investigate whether an age-associated impaired acute-phase response exists. Nine healthy elderly volunteers (median, 66 years; range, 61 to 69 years) and eight young controls (median, 24 years; range, 20 to 27 years) were given an intravenous bolus of endotoxin (2...... levels than did the young group. In conclusion, ageing is associated with an altered acute-phase response including initial hyperreactivity, prolonged inflammatory activity, and prolonged fever response.......The purpose of this study was to investigate whether an age-associated impaired acute-phase response exists. Nine healthy elderly volunteers (median, 66 years; range, 61 to 69 years) and eight young controls (median, 24 years; range, 20 to 27 years) were given an intravenous bolus of endotoxin (2...... ng/kg). The rectal temperature was monitored continuously, and blood samples for cytokine measurements were obtained before endotoxin administration as well as 0.5, 1, 1.5, 2, 3, 4, 8, 12, and 24 h after the injection. The elderly subjects showed a more prolonged fever response compared to the young...

  13. Adverse metabolic consequences in humans of prolonged sleep restriction combined with circadian disruption.

    Buxton, Orfeu M; Cain, Sean W; O'Connor, Shawn P; Porter, James H; Duffy, Jeanne F; Wang, Wei; Czeisler, Charles A; Shea, Steven A


    Epidemiological studies link short sleep duration and circadian disruption with higher risk of metabolic syndrome and diabetes. We tested the hypotheses that prolonged sleep restriction with concurrent circadian disruption, as can occur in people performing shift work, impairs glucose regulation and metabolism. Healthy adults spent >5 weeks under controlled laboratory conditions in which they experienced an initial baseline segment of optimal sleep, 3 weeks of sleep restriction (5.6 hours of sleep per 24 hours) combined with circadian disruption (recurring 28-hour "days"), followed by 9 days of recovery sleep with circadian re-entrainment. Exposure to prolonged sleep restriction with concurrent circadian disruption, with measurements taken at the same circadian phase, decreased the participants' resting metabolic rate and increased plasma glucose concentrations after a meal, an effect resulting from inadequate pancreatic insulin secretion. These parameters normalized during the 9 days of recovery sleep and stable circadian re-entrainment. Thus, in humans, prolonged sleep restriction with concurrent circadian disruption alters metabolism and could increase the risk of obesity and diabetes.

  14. Prolonged shedding of rhinovirus and re-infection in adults with respiratory tract illness.

    Zlateva, Kalina T; de Vries, Jutte J C; Coenjaerts, Frank E J; van Loon, Anton M; Verheij, Theo; Little, Paul; Butler, Christopher C; Goossens, Herman; Ieven, Margareta; Claas, Eric C J


    Rhinovirus infections occur frequently throughout life and have been reported in about one-third of asymptomatic cases. The clinical significance of sequential rhinovirus infections remains unclear. To determine the incidence and clinical relevance of sequential rhinovirus detections, nasopharyngeal samples from 2485 adults with acute cough/lower respiratory illness were analysed. Patients were enrolled prospectively by general practitioners from 12 European Union countries during three consecutive years (2007-2010). Nasopharyngeal samples were collected at the initial general practitioner consultation and 28 days thereafter and symptom scores were recorded by patients over that period. Rhinovirus RNA was detected in 444 (18%) out of 2485 visit one samples and in 110 (4.4%) out of 2485 visit two respiratory samples. 21 (5%) of the 444 patients had both samples positive for rhinovirus. Genotyping of both virus detections was successful for 17 (81%) out of 21 of these patients. Prolonged rhinovirus shedding occurred in six (35%) out of 21 and re-infection with a different rhinovirus in 11 (65%) out of 21. Rhinovirus re-infections were significantly associated with chronic obstructive pulmonary disease (p=0.04) and asthma (p=0.02) and appeared to be more severe than prolonged infections. Our findings indicate that in immunocompetent adults rhinovirus re-infections are more common than prolonged infections, and chronic airway comorbidities might predispose to more frequent rhinovirus re-infections.

  15. Empire: An Analytical Category for Educational Research

    Coloma, Roland Sintos


    In this article Roland Sintos Coloma argues for the relevance of empire as an analytical category in educational research. He points out the silence in mainstream studies of education on the subject of empire, the various interpretive approaches to deploying empire as an analytic, and the importance of indigeneity in research on empire and…

  16. Healing results of prolonged acute frontal sinusitis treated with endoscopic sinus surgery.

    Wide, Kristina; Antila, Jukka; Sipilä, Jukka; Suonpää, Jouko; Parkkola, Riitta


    In a marked part of patients suffering from acute frontal sinusitis, the symptoms do not resolve after initial therapy (antibiotics and/or trephination). The prolongation of the healing or recurrences may be caused by persistent inflammation or by structural abnormalities at the nasofrontal connection. During the last decade endoscopic surgery (FES) has become a very useful method to restore the frontonasal drainage although long term results of this kind of population are rare. We evaluated the results of endoscopic surgery in two patient groups (total number of 50) both operated after prolongation (persistent symptoms after 4 weeks) of the initial acute phase of the frontal sinusitis. The first group (A, 15 patients, first trephined) was followed-up 4 years, the number of recurrences after the first FES was 60% and in the other group (B, no initial trephination) with over 6 months follow-up, 91% of patients had recurrences. In group A pre- and postoperative CT-scanning was used to determine the possible anatomical variations that could be causing the failures. All but 3 patients showed some kind of abnormal anatomical variation. In group B only preoperative CT was done. In most cases the reasons for recurrences of frontal sinusitis were polyps and/or chronic inflammation at the ethmoidal region.

  17. Student initiative: A conceptual analysis

    Polovina Nada


    Full Text Available In the description and scientific consideration of the attitude of children and youth towards their education and development, the concept of student initiative has been gaining ground lately, and it is hence the subject of analysis in this paper. The analysis is important because of the discrepancy between the increased efforts of the key educational policy holders to promote the idea about the importance of the development of student initiative and rare acceptance of this idea among theoreticians, researchers and practitioners dealing with the education and development of children and youth. By concretising the features of initiative student behaviour, our aim was, on the one hand, to observe the structural determinants and scientific status of the very concept of an initiative student, and, on the other, to contribute to the understanding of the initiative behaviour in practice. In the first part of the paper we deal with different notions and concretisations of the features of initiative behaviour of children and youth, which includes the consideration of: basic student initiative, academic student initiative, individual student initiative, the capacity for initiative and personal development initiative. In the second part of the paper, we discuss the relations of the concept of student initiative with the similar general concepts (activity/passivity, proactivity, agency and the concepts immediately related to school environment (student involvement, student participation. The results of our analysis indicate that the concept of student initiative has: particular features that differentiate it from similar concepts; the potential to reach the status of a scientific concept, bearing in mind the initial empirical specifications and general empirical verifiability of the yet unverified determinants of the concept. In the concluding part of the paper, we discuss the implications of the conceptual analysis for further research, as well as for

  18. Circulating levels of pegvisomant and endogenous growth hormone during prolonged pegvisomant therapy in patients with acromegaly

    Madsen, Michael; Fisker, Sanne; Feldt-Rasmussen, Ulla;


    OBJECTIVE: To investigate whether pegvisomant treatment in acromegaly induces gradual elevations in endogenous serum growth hormone (GH) levels and whether serum pegvisomant levels predict the therapeutic outcome. PATIENTS AND METHODS: Seventeen patients (6 women), mean age 46·3 years (range: 23...... correlated with baseline growth hormone levels, whereas no associations between serum pegvisomant and either dose, gender, age or body weight were found. CONCLUSIONS: (1) Serum GH levels increased initially, but remained stable during prolonged pegvisomant treatment in patients with acromegaly, (2) serum...

  19. Initial Study

    Torp, Kristian


    Congestion is a major problem in most cities and the problem is growing (Quiroga, 2000) (Faghri & Hamad, 2002). When the congestion level is increased the drivers notice this as delays in the traffic (Taylor, Woolley, & Zito, 2000), i.e., the travel time for the individual driver is simply...... increased. In the initial study presented here, the time it takes to pass an intersection is studied in details. Two major signal-controlled four-way intersections in the center of the city Aalborg are studied in details to estimate the congestion levels in these intersections, based on the time it takes...

  20. Empirical ethics as dialogical practice

    Widdershoven, G.A.M.; Abma, T.A.; Molewijk, A.C.


    In this article, we present a dialogical approach to empirical ethics, based upon hermeneutic ethics and responsive evaluation. Hermeneutic ethics regards experience as the concrete source of moral wisdom. In order to gain a good understanding of moral issues, concrete detailed experiences and persp

  1. Empirical Evidence for Narrative Structure.

    Gee, James Paul; Grosjean, Francois


    Used experimental tasks--spontaneous telling of a story, reading, and parsing--to determine whether empirical data reflect narrative structure of stories. It was concluded that spontaneous pausing reflects the narrative structure and can be used as a guide to constructing theories of narrative structure and deciding between competing theories.…

  2. Empirical analysis of consumer behavior

    Huang, Yufeng


    This thesis consists of three essays in quantitative marketing, focusing on structural empirical analysis of consumer behavior. In the first essay, he investigates the role of a consumer's skill of product usage, and its imperfect transferability across brands, in her product choice. It shows that

  3. Empirical analysis of consumer behavior

    Huang, Yufeng


    This thesis consists of three essays in quantitative marketing, focusing on structural empirical analysis of consumer behavior. In the first essay, he investigates the role of a consumer's skill of product usage, and its imperfect transferability across brands, in her product choice. It shows that e

  4. Suicide in the Byzantine Empire.

    Tsoukalas, G; Laios, K; Kontaxaki, M-I; Karamanou, M; Androutsos, G


    Studying the suicide in the Byzantine Empire is difficult due to the limited number of references to it. Their number is greater in the early years of the Empire, mainly because of the persecution of Christians and gradually decreases. The attitude of the Church also gradually hardens, as well as the law. The law was strictly followed to the West, but as far as the Eastern Empire is concerned there are no references of punishment, confiscation of property or vandalism of dead bodies mentioned. Avoiding public humiliation after a public crime or a military defeat, religious redemption, emotional disturbance and debts, are the main cause of suicide. There are some references of mass suicides, while women suicides are relatively fewer, if the early Christian years are excluded. Suicide is more acceptable to the pagans because of their lifestyle. The therapeutic approach comes mainly through the treatment of depression. Aretaeus and Galen cite some ways to deal with the disturbance in the internal balance of black bile. Their view echoes through the centuries and the subsequent doctors embrace it. At least after the 9th century, more importance is given to the patient's bliss. Gemistus Pletho tried to revive the Platonic view of suicide shortly before the end of the Empire. The Church forbids Christian burial and troubled soul hovers in an intangible journey.

  5. Empirical analysis of consumer behavior

    Huang, Yufeng


    This thesis consists of three essays in quantitative marketing, focusing on structural empirical analysis of consumer behavior. In the first essay, he investigates the role of a consumer's skill of product usage, and its imperfect transferability across brands, in her product choice. It shows that e

  6. Empirical estimates of the NAIRU

    Madsen, Jakob Brøchner


    Empirical studies have found that the non-accelerating inflation rate of unemployment (NAIRU) has been fluctuating in OECD countries around a constant mean of several percentage points over the past decades. This mean is calculated from the constant terms carried over from the wage and price grow...

  7. Nucleic acid therapy for lifespan prolongation: Present and future

    Wing-Fu Lai


    Lifespan prolongation is a common desire of the human race. With advances in biotechnology, the mechanism of aging has been gradually unraveled, laying the theoretical basis of nucleic acid therapy for lifespan prolongation. Regretfully, clinically applicable interventions do not exist without the efforts of converting theory into action, and it is the latter that has been far from adequately addressed at the moment. This was demonstrated by a database search on PubMed and Web of Science, from which only seven studies published between 2000 and 2010 were found to directly touch on the development of nucleic acid therapy for anti-aging and/or longevity enhancing purposes. In light of this, the objective of this article is to overview the current understanding of the intimate association between genes and longevity, and to bring the prospect of nucleic acid therapy for lifespan prolongation to light.

  8. Severe postpartum sepsis with prolonged myocardial dysfunction: a case report

    Chen Katherine T


    Full Text Available Abstract Introduction Severe sepsis during pregnancy or in the postpartum period is a rare clinical event. In non obstetric surviving patients, the cardiovascular changes seen in sepsis and septic shock are fully reversible five to ten days after their onset. We report a case of septic myocardial dysfunction lasting longer than ten days. To the best of our knowledge, this is the first report of prolonged septic myocardial dysfunction in a parturient. Case presentation A 24 year old Hispanic woman with no previous medical history developed pyelonephritis and severe sepsis with prolonged myocardial dysfunction after a normal spontaneous vaginal delivery. Conclusions Septic myocardial dysfunction may be prolonged in parturients requiring longer term follow up and pharmacologic treatment.

  9. QT prolongation in a child with thyroid storm

    Albert, Benjamin B; Eckersley, Luke Gerard; Skinner, Jonathan Robert; Jefferies, Craig


    Summary A 12-year-old girl presented with an acute confusional state and a 2-year history of weight loss, anxiety, agitation and recurrent fever. Thyroid function tests confirmed severe hyperthyroidism, and a diagnosis of thyroid storm was made (Burch and Wartofsky score=75). ECG showed a prolonged QTc interval of 506 ms. Acute treatment for thyroid storm consisted of Lugol's iodine, prednisolone, carbimazole and propranolol. She made a steady recovery and by 3 months her thyroid function had normalised; a repeat ECG showed a QTc within the normal range (430 ms). There was no relevant family history. This is a case of QTc prolongation with hyperthyroidism and normalisation with euthyroidism. It is not commonly recognised that hyperthyroidism in children may be associated with QTc prolongation. QTc measurement should be incorporated into management protocols for hyperthyroidism. PMID:24729112

  10. Visual Semiotics & Uncertainty Visualization: An Empirical Study.

    MacEachren, A M; Roth, R E; O'Brien, J; Li, B; Swingley, D; Gahegan, M


    This paper presents two linked empirical studies focused on uncertainty visualization. The experiments are framed from two conceptual perspectives. First, a typology of uncertainty is used to delineate kinds of uncertainty matched with space, time, and attribute components of data. Second, concepts from visual semiotics are applied to characterize the kind of visual signification that is appropriate for representing those different categories of uncertainty. This framework guided the two experiments reported here. The first addresses representation intuitiveness, considering both visual variables and iconicity of representation. The second addresses relative performance of the most intuitive abstract and iconic representations of uncertainty on a map reading task. Combined results suggest initial guidelines for representing uncertainty and discussion focuses on practical applicability of results.

  11. Bartonella henselae Infective Endocarditis Detected by a Prolonged Blood Culture

    Mito, Tsutomu; Hirota, Yusuke; Suzuki, Shingo; Noda, Kazutaka; Uehara, Takanori; Ohira, Yoshiyuki; Ikusaka, Masatomi


    A 65-year-old Japanese man was admitted with a 4-month history of fatigue and exertional dyspnea. Transthoracic echocardiography revealed a vegetation on the aortic valve and severe aortic regurgitation. Accordingly, infective endocarditis and heart failure were diagnosed. Although a blood culture was negative on day 7 after admission, a prolonged blood culture with subculture was performed according to the patient's history of contact with cats. Consequently, Bartonella henselae was isolated. Bartonella species are fastidious bacteria that cause blood culture-negative infective endocarditis. This case demonstrates that B. henselae may be detected by prolonged incubation of blood cultures. PMID:27746451

  12. Sponsored parachute jumps--can they cause prolonged pain?

    Straiton, N; Sterland, J


    A survey of parachute injuries sustained in 1984 at a local parachute club was made using hospital notes and a questionnaire. The overall injury rate was 0.2%. The injury rate in first time jumpers was 1.1%. The injuries often resulted in a prolonged hospital stay, time off work and residual pain and disability. Injury rates may be reduced by more prolonged and intensive training preceding the first jumps. Those people not interested in parachuting as a regular sport and who jump once only in...

  13. Sponsored parachute jumps--can they cause prolonged pain?

    Straiton, N; Sterland, J


    A survey of parachute injuries sustained in 1984 at a local parachute club was made using hospital notes and a questionnaire. The overall injury rate was 0.2%. The injury rate in first time jumpers was 1.1%. The injuries often resulted in a prolonged hospital stay, time off work and residual pain and disability. Injury rates may be reduced by more prolonged and intensive training preceding the first jumps. Those people not interested in parachuting as a regular sport and who jump once only in order to raise money for charity are at risk of serious injury and perhaps should consider less dangerous alternatives.

  14. Prolonged nerve blockade in a patient treated with lithium

    Lehavi A


    Full Text Available Amit Lehavi, Boris Shenderey, Yeshayahu (Shai KatzDepartment of Anesthesiology, Rambam Health Care Campus, Haifa, IsraelAbstract: We report a case of a patient, chronically treated with oral lithium, who presented with an extremely prolonged (42-hour duration of sensory and motor paralysis following an uneventful infraclavicular block for hand surgery that was performed under ultrasound guidance using bupivacaine and lidocaine. Due to its direct effect on nerve conduction of action potential, we propose that lithium may have had a role in the unusually prolonged duration of a peripheral nerve block.Keywords: nerve blockade, lithium, duration, anesthesia

  15. Changes in the human blood coagulating system during prolonged hypokinesia

    Filatova, L. M.; Anashkin, O. D.


    Changes in the coagulating system of the blood were studied in six subjects during prolonged hypokinesia. Thrombogenic properties of the blood rose in all cases on the 8th day. These changes are explained by stress reaction due to unusual conditions for a healthy person. Changes in the blood coagulating system in the group subjected to physical exercise and without it ran a practically parallel course. Apparently physical exercise is insufficient to prevent such changes that appear in the coagulating system of the blood during prolonged hypokinesia.

  16. Hypoglycaemia and QT interval prolongation in type 1 diabetes

    Christensen, Toke Folke; Cichosz, Simon Lebech; Tarnow, L.


    hypoglycaemia varies greatly between studies. METHODS: We studied ten adults with type 1 diabetes (age 41±15years) without cardiovascular disease or neuropathy. Single-blinded hypoglycaemia was induced by a subcutaneous insulin bolus followed by a control episode on two occasions separated by 4weeks. QT....... CONCLUSIONS: Hypoglycaemia as experienced after a subcutaneous injection of insulin may cause QTc prolongation in type 1 diabetes. However, the magnitude of prolongation is less than typically reported during glucose clamp studies, possible because of the study design with focus on minimizing unwanted study...

  17. Design of novel injectable cationic microspheres based on aminated gelatin for prolonged insulin action.

    Morimoto, Kazuhiro; Chono, Sumio; Kosai, Tadashi; Seki, Toshinobu; Tabata, Yasuhiko


    The aim of this study was to prepare two types of injectable cationized microspheres based on a native gelatin (NGMS) and aminated gelatin with ethylenediamine (CGMS) to prolong the action of insulin. Release of rhodamin B isothiocyanate insulin from CGMS was compared with that from NGMS under in-vitro and in-vivo conditions. Lower release of insulin from CGMS compared with that from NGMS was caused by the suppression of initial release. The disappearance of 125I-insulin from the injection site after intramuscular administration by NGMS and CGMS had a biphasic profile in mice. Almost all the 125I-insulin had disappeared from the injection site one day after administration by NGMS. The remaining insulin at the injection site after administration by CGMS was prolonged, with approximately 59% remaining after one day and 16% after 14 days. The disappearance of CGMS from the injection site was lower than that of NGMS. However, the difference in these disappearance rates was not great compared with those of 125I-insulin from the injection site by NGMS and CGMS. The time course of disappearance of 125I-CGMS from the injection site was similar to that of 125I-insulin by CGMS. The initial hypoglycaemic effect was observed 1 h after administration of insulin by NGMS, thereafter its effect rapidly disappeared. The hypoglycaemic effect was observed 2-4 h after administration by CGMS and continued to be exhibited for 7 days. The prolonged hypoglycaemic action by CGMS depended on the time profiles of the disappearance of insulin from muscular tissues, which occurs due to the enzymatic degradation of CGMS.

  18. Prolonged sedentary time and physical activity in workplace and non-work contexts: a cross-sectional study of office, customer service and call centre employees

    Thorp Alicia A


    Full Text Available Abstract Background To examine sedentary time, prolonged sedentary bouts and physical activity in Australian employees from different workplace settings, within work and non-work contexts. Methods A convenience sample of 193 employees working in offices (131, call centres (36 and customer service (26 was recruited. Actigraph GT1M accelerometers were used to derive percentages of time spent sedentary ( Results Working hours were mostly spent sedentary (77.0%, 95%CI: 76.3, 77.6, with approximately half of this time accumulated in prolonged bouts of 20 minutes or more. There were significant (p Conclusion The workplace is a key setting for prolonged sedentary time, especially for some occupational groups, and the potential health risk burden attached requires investigation. Future workplace regulations and health promotion initiatives for sedentary occupations to reduce prolonged sitting time should be considered.

  19. Empirical likelihood method in survival analysis

    Zhou, Mai


    Add the Empirical Likelihood to Your Nonparametric ToolboxEmpirical Likelihood Method in Survival Analysis explains how to use the empirical likelihood method for right censored survival data. The author uses R for calculating empirical likelihood and includes many worked out examples with the associated R code. The datasets and code are available for download on his website and CRAN.The book focuses on all the standard survival analysis topics treated with empirical likelihood, including hazard functions, cumulative distribution functions, analysis of the Cox model, and computation of empiric

  20. Prolonged fasting of children before anaesthesia is common in private practice.

    Buller, Y; Sims, C


    Fasting guidelines for children are well established. Despite these guidelines, previous studies have shown children are often fasted for prolonged periods before anaesthesia, potentially causing discomfort and distress. Moreover, recent publications indicate shorter fasting times for oral clear fluids in children may be safe. We audited fasting times of children having elective surgery at a local large private hospital that provides care for both adults and children. We gave feedback and education to our caregivers, then repeated the audit. Data were collected from 307 children (age 6.0 ± 4.1 years) in an initial eight-week audit, and from 153 children (age 6.7 ± 4.5 years) in a follow-up four-week audit. We found fasting durations were excessive in many children. Sixty-two percent of children in each audit fasted longer than four hours for clear fluids. Children on morning lists fasted longer than children on afternoon lists. Fasting from solids was also excessively long. In the initial audit, 30% fasted more than 12 hours for solids, including 18 who last ate more than 16 hours before surgery. Data from the follow-up audit were similar. We conclude that fasting of children at our hospital is excessive, despite our efforts to shorten the duration. We suspect that our hospital is not the only one with a high incidence of prolonged fasting for children and suggest possible solutions.

  1. Are ECG monitoring recommendations before prescription of QT-prolonging drugs applied in daily practice?

    Warnier, Miriam Jacoba; Rutten, Frans Hendrik; Souverein, Patrick Cyriel


    PURPOSE: Monitoring of the QT duration by electrocardiography (ECG) prior to treatment is frequently recommended in the label of QT-prolonging drugs. It is, however, unknown how often general practitioners in daily clinical practice are adhering to these risk-minimization measures. We assessed...... the frequency of ECG measurements in patients where haloperidol was initiated in primary care. METHODS: Patients (≥18 years) with a first prescription of haloperidol in the UK Clinical Practice Research Datalink (2009-2013) were included. The proportion of ECGs made was determined in two blocks of 4 weeks......: during the exposure period when haloperidol was initiated, and during the control period, 1 year before. Conditional logistic regression analysis was applied to calculate the relative risk of having an ECG in the exposure period compared with the control period. Subgroup analyses were performed to assess...

  2. Empirical determinants of relationship lending

    Sahar Loukil


    Full Text Available We study the determinants of the incidence of relationship lending. For our study, we combine established insights from the study of Elsas with empirical banking relationship lending literature. We relate loan contract and borrower characteristics to self-assessments of Tunisian banks with respect to the existence of close relationship. Using detailed loan contract information from Tunisian banks and a questionnaire addressed to loan officers, we report the first comprehensive evidence on the development of relationship lending. We find that access to information, the ability to influence the manager, and the solvency of the company are relevant factors. While the exclusivity and the duration of the relationship, classic measures of the existence of close ties with the bank, are not determining factors. So these proxy measures should be used with caution in future empirical works.

  3. Empirically Testing Thematic Analysis (ETTA)

    Alkier Gildberg, Frederik; Bradley, Stephen; Tingleff, Ellen Boldrup


    Text analysis is not a question of a right or wrong way to go about it, but a question of different traditions. These tend to not only give answers to how to conduct an analysis, but also to provide the answer as to why it is conducted in the way that it is. The problem however may be that the link...... between tradition and tool is unclear. The main objective of this article is therefore to present Empirical Testing Thematic Analysis, a step by step approach to thematic text analysis; discussing strengths and weaknesses, so that others might assess its potential as an approach that they might utilize....../develop for themselves. The advantage of utilizing the presented analytic approach is argued to be the integral empirical testing, which should assure systematic development, interpretation and analysis of the source textual material....

  4. Concept Convergence in Empirical Domains

    Ontañón, Santiago; Plaza, Enric

    How to achieve shared meaning is a significant issue when more than one intelligent agent is involved in the same domain. We define the task of concept convergence, by which intelligent agents can achieve a shared, agreed-upon meaning of a concept (restricted to empirical domains). For this purpose we present a framework that, integrating computational argumentation and inductive concept learning, allows a pair of agents to (1) learn a concept in an empirical domain, (2) argue about the concept's meaning, and (3) reach a shared agreed-upon concept definition. We apply this framework to marine sponges, a biological domain where the actual definitions of concepts such as orders, families and species are currently open to discussion. An experimental evaluation on marine sponges shows that concept convergence is achieved, within a reasonable number of interchanged arguments, and reaching short and accurate definitions (with respect to precision and recall).

  5. The Myth of Global Empire

    Fernando Mires


    Full Text Available This essay openly questions the new phantom that is going all around the world, called the Marxism-Globalism. The critiques are exposed through the reading of one of the most discussed book in these last years: Empire, written by Richard Hardt y Toni Negri. According to the author of current essay, the difference between Marxism-Leninism and the Marxism-Globalism, is that the first of them brought with it the promise of total security (no properties, no State, no social classes, and the second one brought the dammed promise of total globality (Capitalism Empire, in which we find, in the right hand, the world market spirit, and, in the left hand, the globalities of postmodernism.

  6. [Prolonged weaning: S2k-guideline published by the German Respiratory Society].

    Schönhofer, B; Geiseler, J; Dellweg, D; Moerer, O; Barchfeld, T; Fuchs, H; Karg, O; Rosseau, S; Sitter, H; Weber-Carstens, S; Westhoff, M; Windisch, W


    Mechanical ventilation (MV) is an essential part of modern intensive care medicine. MV is performed in patients with severe respiratory failure caused by insufficiency of the respiratory muscles and/or lung parenchymal disease when/after other treatments, i. e. oxygen, body position, secretion management, medication or non invasive ventilation have failed.In the majority of ICU patients weaning is routine and does not present any problems. Nevertheless 40-50 % of the time during mechanical ventilation is spent on weaning. About 20 % of patients need continued MV despite resolution of the conditions which originally precipitated the need for MV.There maybe a combination of reasons; chronic lung disease, comorbidities, age and conditions acquired in ICU (critical care neuromyopathy, psychological problems). According to an International Consensus Conference the criteria for "prolonged weaning" are fulfilled if patients fail at least three weaning attempts or require more than 7 days of weaning after the first spontaneous breathing trial. Prolonged weaning is a challenge. An inter- and multi-disciplinary approach is essential for weaning success. Complex, difficult to wean patients who fulfill the criteria for "prolonged weaning" can still be successfully weaned in specialised weaning units in about 50% of cases.In patients with unsuccessful weaning, invasive mechanical ventilation has to be arranged either at home or in a long term care facility.This S2-guideline was developed because of the growing number of patients requiring prolonged weaning. It is an initiative of the German Respiratory Society (Deutsche Gesellschaft für Pneumologie und Beatmungsmedizin e. V., DGP) in cooperation with other societies engaged in the field.The guideline is based on a systematic literature review of other guidelines, the Cochrane Library and PubMed.The consensus project was chaired by the Association of Scientific Medical Societies in Germany (Arbeitsgemeinschaft der

  7. Openness initiative

    Duncan, S.S. [Los Alamos National Lab., NM (United States)


    Although antinuclear campaigns seem to be effective, public communication and education efforts on low-level radioactive waste have mixed results. Attempts at public information programs on low-level radioactive waste still focus on influencing public opinion. A question then is: {open_quotes}Is it preferable to have a program focus on public education that will empower individuals to make informed decisions rather than trying to influence them in their decisions?{close_quotes} To address this question, a case study with both quantitative and qualitative data will be used. The Ohio Low-Level Radioactive Waste Education Program has a goal to provide people with information they want/need to make their own decisions. The program initiated its efforts by conducting a statewide survey to determine information needed by people and where they turned for that information. This presentation reports data from the survey and then explores the program development process in which programs were designed and presented using the information. Pre and post data from the programs reveal attitude and knowledge shifts.

  8. Repeated Prolonged Exercise Decreases Maximal Fat Oxidation in Older Men

    Morville, Thomas; Rosenkilde, Mads; Munch-Andersen, Thor


    INTRODUCTION/PURPOSE: Fat metabolism and muscle adaptation was investigated in 6 older trained men (age: 61 ± 4 years; VO2max: 48 ± 2 mL kg min) following repeated prolonged exercise). METHODS: 2706 km (1,681 miles) cycling was performed over 14 days and a blood sample and a muscle biopsy were...

  9. Prolonged unassisted survival in an infant with anencephaly.

    Dickman, Holly; Fletke, Kyle; Redfern, Roberta E


    Anencephaly is one of the most lethal congenital defects. This case report is of an anencephalic infant who lived to 28 months of life and defies current literature. She is the longest surviving anencephalic infant who did not require life-sustaining interventions. This case presents the obstacles that arose from this infant's prolonged life and recommendations based on these findings.

  10. Single Prolonged Stress Disrupts Retention of Extinguished Fear in Rats

    Knox, Dayan; George, Sophie A.; Fitzpatrick, Christopher J.; Rabinak, Christine A.; Maren, Stephen; Liberzon, Israel


    Clinical research has linked post-traumatic stress disorder (PTSD) with deficits in fear extinction. However, it is not clear whether these deficits result from stress-related changes in the acquisition or retention of extinction or in the regulation of extinction memories by context, for example. In this study, we used the single prolonged stress…

  11. Intrinsic motivation and amotivation in first episode and prolonged psychosis.

    Luther, Lauren; Lysaker, Paul H; Firmin, Ruth L; Breier, Alan; Vohs, Jenifer L


    The deleterious functional implications of motivation deficits in psychosis have generated interest in examining dimensions of the construct. However, there remains a paucity of data regarding whether dimensions of motivation differ over the course of psychosis. Therefore, this study examined two motivation dimensions, trait-like intrinsic motivation, and the negative symptom of amotivation, and tested the impact of illness phase on the 1) levels of these dimensions and 2) relationship between these dimensions. Participants with first episode psychosis (FEP; n=40) and prolonged psychosis (n=66) completed clinician-rated measures of intrinsic motivation and amotivation. Analyses revealed that when controlling for group differences in gender and education, the FEP group had significantly more intrinsic motivation and lower amotivation than the prolonged psychosis group. Moreover, intrinsic motivation was negatively correlated with amotivation in both FEP and prolonged psychosis, but the magnitude of the relationship did not statistically differ between groups. These findings suggest that motivation deficits are more severe later in the course of psychosis and that low intrinsic motivation may be partially independent of amotivation in both first episode and prolonged psychosis. Clinically, these results highlight the importance of targeting motivation in early intervention services.

  12. Single Prolonged Stress Disrupts Retention of Extinguished Fear in Rats

    Knox, Dayan; George, Sophie A.; Fitzpatrick, Christopher J.; Rabinak, Christine A.; Maren, Stephen; Liberzon, Israel


    Clinical research has linked post-traumatic stress disorder (PTSD) with deficits in fear extinction. However, it is not clear whether these deficits result from stress-related changes in the acquisition or retention of extinction or in the regulation of extinction memories by context, for example. In this study, we used the single prolonged stress…

  13. The impact of obesity on physiological responses during prolonged exercise

    Eijsvogels, T.M.H.; Veltmeijer, M.T.; Schreuder, T.H.A.; Poelkens, F.; Thijssen, D.H.J.; Hopman, M.T.E.


    Background:Prolonged, moderate-intensity exercise training is routinely prescribed to subjects with obesity. In the general population, this type of exercise can lead to fluid and sodium imbalance. However, little is known whether obesity alters the risk of fluid and sodium imbalances.Objective:This

  14. Cerebral ammonia uptake and accumulation during prolonged exercise in humans

    Nybo, Lars; Dalsgaard, Mads K.; Steensberg, Adam


    We evaluated whether peripheral ammonia production during prolonged exercise enhances the uptake and subsequent accumulation of ammonia within the brain. Two studies determined the cerebral uptake of ammonia (arterial and jugular venous blood sampling combined with Kety-Schmidt-determined cerebra...

  15. Prolonged drought results in starvation of African elephant (Loxodonta africana)

    Wato, Yussuf A.; Heitkonig, Ignas; Wieren, van Sipke E.; Wahungu, Geoffrey; Prins, Herbert H.T.; Langevelde, van Frank


    Elephant inhabiting arid and semi-arid savannas often experience periods of drought, which, if prolonged, may cause mortality. During dry periods, elephant aggregate around water sources and deplete local forage availability. However, the relationships between adult elephant mortality and both hi

  16. The carotid baroreflex is reset following prolonged exercise in humans

    Hart, E. C.; Rasmussen, P.; Secher, N. H.


    Alterations in the carotid baroreflex (CBR) control of arterial pressure may explain the reduction in arterial pressure and left ventricular (LV) function after prolonged exercise. We examined the CBR control of heart rate (HR) and mean arterial pressure (MAP), in addition to changes in LV function......, pre- to post-exercise....

  17. Economic viability of beef cattle grazing systems under prolonged drought

    Prolonged drought in the Southern Great Plains of the USA in recent years has raised concerns about vulnerability of beef cattle grazing systems under adverse climate change. To help address the economic viability of beef grazing operations in the Southern Great Plains, this paper provides an econom...

  18. Recognition Memory Is Impaired in Children after Prolonged Febrile Seizures

    Martinos, Marina M.; Yoong, Michael; Patil, Shekhar; Chin, Richard F. M.; Neville, Brian G.; Scott, Rod C.; de Haan, Michelle


    Children with a history of a prolonged febrile seizure show signs of acute hippocampal injury on magnetic resonance imaging. In addition, animal studies have shown that adult rats who suffered febrile seizures during development reveal memory impairments. Together, these lines of evidence suggest that memory impairments related to hippocampal…

  19. The Prolonged Neonatal Admission: Implications for our National Children's Hospital

    McGlacken-Byrne, SM


    A significant number of neonates are admitted to tertiary paediatric units for prolonged stays annually, despite limited availability of neonatal beds. As the three Dublin paediatric hospitals merge, this pressure will be transferred to our new National Children’s Hospital.\\r\

  20. Prolongation Structure of Semi-discrete Nonlinear Evolution Equations


    Based on noncommutative differential calculus, we present a theory of prolongation structure for semi-discrete nonlinear evolution equations. As an illustrative example, a semi-discrete model of the nonlinear Schr(o)dinger equation is discussed in terms of this theory and the corresponding Lax pairs are also given.

  1. Prolonged drought results in starvation of African elephant (Loxodonta africana)

    Wato, Yussuf A.; Heitkonig, Ignas; Wieren, van Sipke E.; Wahungu, Geoffrey; Prins, Herbert H.T.; Langevelde, van Frank


    Elephant inhabiting arid and semi-arid savannas often experience periods of drought, which, if prolonged, may cause mortality. During dry periods, elephant aggregate around water sources and deplete local forage availability. However, the relationships between adult elephant mortality and both

  2. Assessing QT Interval Prolongation and its Associated Risks with Antipsychotics

    Nielsen, Jimmi; Graff, Claus; Kanters, Jørgen K.


    markers for TdP have been developed but none of them is clinically implemented yet and QT interval prolongation is still considered the most valid surrogate marker. Although automated QT interval determination may offer some assistance, QT interval determination is best performed by a cardiologist skilled...

  3. Assessing QT interval prolongation and its associated risks with antipsychotics

    Nielsen, Jimmi; Graff, Claus; Kanters, Jørgen K.


    markers for TdP have been developed but none of them is clinically implemented yet and QT interval prolongation is still considered the most valid surrogate marker. Although automated QT interval determination may offer some assistance, QT interval determination is best performed by a cardiologist skilled...

  4. Effect of prolonged bed rest on the anterior hip muscles.

    Dilani Mendis, M; Hides, Julie A; Wilson, Stephen J; Grimaldi, Alison; Belavý, Daniel L; Stanton, Warren; Felsenberg, Dieter; Rittweger, Joern; Richardson, Carolyn


    Prolonged bed rest and inactivity is known to cause muscular atrophy with previous research indicating that muscles involved in joint stabilisation are more susceptible. The anterior hip muscles are important for hip joint function and stability but little is known about the effects of prolonged inactivity on their function. This study investigated the effect of prolonged bed rest on the size of the anterior hip muscles and their pattern of recovery. The effect of resistive vibration exercise (RVE) as a countermeasure to muscle atrophy was also investigated. 12 male participants, randomly assigned to either a control or an exercise group, underwent 8 weeks of bed rest with 6 months follow-up. Changes in muscle cross-sectional area (CSA) of the iliacus, psoas, iliopsoas, sartorius and rectus femoris muscles were measured by magnetic resonance imaging at regular intervals during bed rest and recovery phases. CSAs of iliopsoas and sartorius decreased at the hip joint (piliacus, psoas, and rectus femoris CSAs were unchanged (p>0.05). No significant difference was found between the two groups for all muscles (all p>0.1), suggesting inefficacy of the countermeasure in this sample. These findings suggest that prolonged bed rest can result in the atrophy of specific muscles across the hip joint which may affect its stability and function.

  5. Prolonged idiopathic gastric dilatation following revascularization for chronic mesenteric ischemia.

    Gauci, Julia L; Stoven, Samantha; Szarka, Lawrence; Papadakis, Konstantinos A


    A 71-year-old female presented with nausea, emesis, early satiety, and abdominal distension following revascularization for chronic mesenteric ischemia. Computed tomography angiogram showed gastric dilatation. Esophagogastroduodenoscopy, small bowel follow through, and paraneoplastic panel were negative. Gastric emptying was delayed. Despite conservative management, she required a percutaneous endoscopic jejunostomy. The development of a prolonged gastroparetic state has not been previously described.

  6. Delirium in Prolonged Hospitalized Patients in the Intensive Care Unit

    Vahedian Azimi


    Full Text Available Background Prolonged hospitalization in the intensive care unit (ICU can impose long-term psychological effects on patients. One of the most significant psychological effects from prolonged hospitalization is delirium. Objectives The aim of this study was to assess the effect of prolonged hospitalization of patients and subsequent delirium in the intensive care unit. Patients and Methods This conventional content analysis study was conducted in the General Intensive Care Unit of the Shariati Hospital of Tehran University of Medical Sciences, from the beginning of 2013 to 2014. All prolonged hospitalized patients and their families were eligible participants. From the 34 eligible patients and 63 family members, the final numbers of actual patients and family members were 9 and 16, respectively. Several semi-structured interviews were conducted face-to-face with patients and their families in a private room and data were gathered. Results Two main themes from two different perspectives emerged, 'patients' perspectives' (experiences during ICU hospitalization and 'family members' perspectives' (supportive-communicational experiences. The main results of this study focused on delirium, Patients' findings were described as pleasant and unpleasant, factual and delusional experiences. Conclusions Family members are valuable components in the therapeutic process of delirium. Effective use of family members in the delirium caring process can be considered to be one of the key non-medical nursing components in the therapeutic process.

  7. Roman Empire and Central Asia

    Ubaldo Lugli


    Full Text Available This article is aimed at retracing the interrelations of ancient Roman and Asian civilizations; a key focus is made on Asian cultural heritage. The commercial and trade commercial relations are considered, which led the way to development of both as well as military clashes and claiming territories by both civilizations. A due attention is paid to the influence of different ancient establishments on the Asian territory, converting thereafter Rome into a truly multicultural and cosmopolitan empire.

  8. The empirical war on drugs.

    Vitellone, Nicole


    In a special issue of the journal Addictions (1995) academics, researchers and health care professionals debated the status of the empirical in socially orientated drugs research. A number of researchers noted that our knowledge and understanding of drugs and drug users has changed significantly since the 1990s. Post AIDS this shift is identified as a consequence of the development of qualitative research methods. The qualitative turn in drugs research has involved a shift away form traditional epidemiological approaches and the pursuit of more socially focused methods. Whilst qualitative research has yielded important empirical data on risk behavior the pursuit of these methods has not been without controversy. In addressing the debate on methods in the drugs field this article investigates the effects of social science methods for research on injecting drug use. In so doing I examine what counts and what gets left out of research on injecting beaviour. Drawing on Actor Network Theory (ANT) I suggest Bruno Latour's methodological approach offers critical insights for addressing the empirical objects of injecting drug use. Copyright © 2013 Elsevier B.V. All rights reserved.

  9. Empirical and Computational Tsunami Probability

    Geist, E. L.; Parsons, T.; ten Brink, U. S.; Lee, H. J.


    A key component in assessing the hazard posed by tsunamis is quantification of tsunami likelihood or probability. To determine tsunami probability, one needs to know the distribution of tsunami sizes and the distribution of inter-event times. Both empirical and computational methods can be used to determine these distributions. Empirical methods rely on an extensive tsunami catalog and hence, the historical data must be carefully analyzed to determine whether the catalog is complete for a given runup or wave height range. Where site-specific historical records are sparse, spatial binning techniques can be used to perform a regional, empirical analysis. Global and site-specific tsunami catalogs suggest that tsunami sizes are distributed according to a truncated or tapered power law and inter-event times are distributed according to an exponential distribution modified to account for clustering of events in time. Computational methods closely follow Probabilistic Seismic Hazard Analysis (PSHA), where size and inter-event distributions are determined for tsunami sources, rather than tsunamis themselves as with empirical analysis. In comparison to PSHA, a critical difference in the computational approach to tsunami probabilities is the need to account for far-field sources. The three basic steps in computational analysis are (1) determination of parameter space for all potential sources (earthquakes, landslides, etc.), including size and inter-event distributions; (2) calculation of wave heights or runup at coastal locations, typically performed using numerical propagation models; and (3) aggregation of probabilities from all sources and incorporation of uncertainty. It is convenient to classify two different types of uncertainty: epistemic (or knowledge-based) and aleatory (or natural variability). Correspondingly, different methods have been traditionally used to incorporate uncertainty during aggregation, including logic trees and direct integration. Critical

  10. Trends in the Publication of Empirical Economics

    David Figlio


    This paper documents recent trends in the publication of empirical articles in general-interest economics journals. Three measures of journal quality are estimated. The author finds substantial differences in publication rates of empirical articles among top tier and second-tier journals, and shows that the empirical percentages among general-interest journals has been converging of late. He offers potential explanations for the negative relationship between measured journal quality and empir...

  11. AIDS, empire, and public health behaviorism.

    Basu, Sanjay


    Much of the current health approach to designing HIV/AIDS interventions in resource-poor settings involves behavior-change initiatives, particularly those adopting education-based and "culturally competent" frameworks for the reduction of HIV-associated "risk behaviors." This article reviews the evidence and social assumptions behind this approach to preventing HIV transmission, and argues that these approaches are often inadequate or misguided, particularly in their conflation of the concept of "culture" with social circumstances. By analyzing the socioeconomic circumstances that constrain individual agency, and by combining data from prevention literature with analyses of international trade agreements and the controversies over antiretroviral drug distribution, the author argues that the movement of capital and the maintenance of inequality are central to the problems associated with behavior-change initiatives and must be addressed through new paradigms in order to respond appropriately to the global AIDS pandemic. Hardt and Negri's paradigm of "Empire"--that is, examining the system through which social inequalities are maintained not only between countries but also within them--offers prospects for the design of new interventions and targets for public health workers and social movements.

  12. Teaching Empirical Software Engineering Using Expert Teams

    Kuhrmann, Marco


    is crucial, software engineering is considered hard to teach. Yet, empirical software engineering increases this difficulty by adding the scientific method as extra dimension. In this paper, we present a Master-level course on empirical software engineering in which different empirical instruments...

  13. Comparison between amniotomy, oxytocin or both for augmentation of labor in prolonged latent phase: a randomized controlled trial.

    Nachum, Zohar; Garmi, Gali; Kadan, Yfat; Zafran, Noah; Shalev, Eliezer; Salim, Raed


    A prolonged latent phase is independently associated with an increased incidence of subsequent labor abnormalities. We aimed to compare between oxytocin augmentation, amniotomy and a combination of both on the duration of labor among women with a prolonged latent phase. Women with a singleton fetus in cephalic presentation who have a prolonged latent phase, were randomly allocated to amniotomy (group 1), oxytocin (group 2) or both (group 3). A group of women who progressed spontaneously without intervention composed the control group (group 4). The primary outcome was the duration of time from initiation of augmentation until delivery. A total of 213 women were consented and randomized to group 1 (70 women), group 2 (72 women) and group 3 (71 women). Group 4 was composed from additional 70 women. A mean reduction of 120 minutes in labor duration was observed among group 3 compared to group 1 (p = 0.08) and 180 minutes compared to group 2 and 4 (p = 0.001). Women in group 3 had a shorter length of time from augmentation until the beginning of the active phase and a shorter first stage of labor than group 1 (p = 0.03), group 2 (p = 0.001) and group 4 (p = 0.001). Satisfaction was greater among group 3 and 4. Mode of delivery and neonatal outcome were comparable between the groups. Labor augmentation by combined amniotomy and oxytocin among women with a prolonged latent phase at term seems superior compared to either of them alone.

  14. Empirical isotropic chemical shift surfaces

    Czinki, Eszter; Csaszar, Attila G. [Eoetvoes University, Laboratory of Molecular Spectroscopy, Institute of Chemistry (Hungary)], E-mail:


    A list of proteins is given for which spatial structures, with a resolution better than 2.5 A, are known from entries in the Protein Data Bank (PDB) and isotropic chemical shift (ICS) values are known from the RefDB database related to the Biological Magnetic Resonance Bank (BMRB) database. The structures chosen provide, with unknown uncertainties, dihedral angles {phi} and {psi} characterizing the backbone structure of the residues. The joint use of experimental ICSs of the same residues within the proteins, again with mostly unknown uncertainties, and ab initio ICS({phi},{psi}) surfaces obtained for the model peptides For-(l-Ala){sub n}-NH{sub 2}, with n = 1, 3, and 5, resulted in so-called empirical ICS({phi},{psi}) surfaces for all major nuclei of the 20 naturally occurring {alpha}-amino acids. Out of the many empirical surfaces determined, it is the 13C{sup {alpha}} ICS({phi},{psi}) surface which seems to be most promising for identifying major secondary structure types, {alpha}-helix, {beta}-strand, left-handed helix ({alpha}{sub D}), and polyproline-II. Detailed tests suggest that Ala is a good model for many naturally occurring {alpha}-amino acids. Two-dimensional empirical 13C{sup {alpha}}-{sup 1}H{sup {alpha}} ICS({phi},{psi}) correlation plots, obtained so far only from computations on small peptide models, suggest the utility of the experimental information contained therein and thus they should provide useful constraints for structure determinations of proteins.


    Christopher Ikechukwu Asogwa


    Man has ever sought knowledge (science), and in different forms. And, empirical knowledge is one of these forms, which is always hoisted as having stood the test of time. Hence, the problem was to see if empirical knowledge has yet overcome the age long problem of fallibilism. The purpose here was to show that empirical knowledge is still fallible. HIV/AIDS as a form of empirical science investigation was used to show case this. This was seen as important because if empirical knowledge has fa...

  16. Prolonged hyperpolarizing potentials precede spindle oscillations in the thalamic reticular nucleus

    Fuentealba, Pablo; Timofeev, Igor; Steriade, Mircea


    The thalamic reticular (RE) nucleus is a key structure in the generation of spindles, a hallmark bioelectrical oscillation during early stages of sleep. Intracellular recordings of RE neurons in vivo revealed the presence of prolonged hyperpolarizing potentials preceding spindles in a subgroup (30%) of neurons. These hyperpolarizations (6-10 mV) lasted for 200-300 ms and were present just before the onset of spontaneously occurring spindle waves. Corticothalamic volleys also were effective in generating such hyperpolarizations followed by spindles in RE neurons. A drop of up to 40% in the apparent input resistance (Rin) was associated with these hyperpolarizing potentials, suggesting an active process rather than disfacilitation. Accordingly, the reversal potential was approximately -100 mV for both spontaneous and cortically elicited hyperpolarizations, consistent with the activation of slow K+ conductances. QX-314 in the recording pipettes decreased both the amplitude and incidence of prolonged hyperpolarizations, suggesting the participation of G protein-dependent K+ currents in the generation of hyperpolarizations. Simultaneous extracellular and intracellular recordings in the RE nucleus demonstrated that some RE neurons discharged during the hyperpolarizations and, thus, may be implicated in their generation. The prolonged hyperpolarizations preceding spindles may play a role in the transition from tonic to bursting firing of RE neurons within a range of membrane potential (-60 to -65 mV) at which they set favorable conditions for the generation of low-threshold spike bursts that initiate spindle sequences. These data are further arguments for the generation of spindles within the thalamic RE nucleus. PMID:15210981

  17. Effects of fasting on plasma glucose and prolonged tracer measurement of hepatic glucose output in NIDDM

    Glauber, H.; Wallace, P.; Brechtel, G.


    We studied the measurement of hepatic glucose output (HGO) with prolonged (3-/sup 3/H)glucose infusion in 14 patients with non-insulin-dependent diabetes mellitus (NIDDM). Over the course of 10.5 h, plasma glucose concentration fell with fasting by one-third, from 234 +/- 21 to 152 +/- 12 mg/dl, and HGO fell from 2.35 +/- 0.18 to 1.36 +/- 0.07 mg . kg-1 . min-1 (P less than .001). In the basal state, HGO and glucose were significantly correlated (r = 0.68, P = .03), and in individual patients, HGO and glucose were closely correlated as both fell with fasting (mean r = 0.79, P less than .01). Plasma (3-/sup 3/H)glucose radioactivity approached a steady state only 5-6 h after initiation of the primed continuous infusion, and a 20% overestimate of HGO was demonstrated by not allowing sufficient time for tracer labeling of the glucose pool. Assumption of steady-state instead of non-steady-state kinetics in using Steele's equations to calculate glucose turnover resulted in a 9-24% overestimate of HGO. Stimulation of glycogenolysis by glucagon injection demonstrated no incorporation of (3-/sup 3/H)glucose in hepatic glycogen during the prolonged tracer infusion. In a separate study, plasma glucose was maintained at fasting levels (207 +/- 17 mg/dl) for 8 h with the glucose-clamp technique. Total glucose turnover rates remained constant during this prolonged tracer infusion. However, HGO fell to 30% of the basal value simply by maintaining fasting hyperglycemia in the presence of basal insulin levels.

  18. Deep, prolonged torpor by pregnant, free-ranging bats

    Willis, Craig K. R.; Brigham, R. Mark; Geiser, Fritz


    Many mammals save energy during food shortage or harsh weather using controlled reductions in body temperature and metabolism called torpor. However, torpor slows offspring growth, and reproductive individuals are thought to avoid using it because of reduced fitness resulting from delayed offspring development. We tested this hypothesis by investigating torpor during reproduction in hoary bats ( Lasiurus cinereus, Vespertilionidae) in southern Canada. We recorded deep, prolonged torpor bouts, which meet the definition for hibernation, by pregnant females. Prolonged torpor occurred during spring storms. When conditions improved females aroused and gave birth within several days. Our observations imply a fitness advantage of torpor in addition to energy conservation because reduced foetal growth rate could delay parturition until conditions are more favourable for lactation and neonatal survival.

  19. Diagnostic and clinical considerations in prolonged grief disorder.

    Maercker, Andreas; Lalor, John


    This review focuses on the similarities and differences between prolonged grief disorder (PGD) and post-traumatic stress disorder (PTSD). It highlights how a PTSD-related understanding aids the investigation and clinical management of PGD. Grief has long been understood as a natural response to bereavement, as serious psychological and physiological stress has been regarded as a potential outcome of extreme or traumatic stress. PTSD was first included in DSM-III in 1980. In the mid-1980s, the first systematic investigation began into whether there is an extreme or pathological form of mourning. Meanwhile, there is much research literature on complicated, traumatic, or prolonged grief This literature is reviewed in this article, with the following questions: Is it possible to distinguish normal from non-normal grief? Which clinical presentation does PGD have-and how does this compare with PTSD? Finally, diagnostic, preventive, and therapeutic approaches and existing tools are presented.

  20. QTc-prolonging drugs and hospitalizations for cardiac arrhythmias

    De Bruin, Marie L; Hoes, Arno W; Leufkens, Hubert G M


    Cardiac arrhythmia as an adverse effect of noncardiac drugs has been an issue of growing importance during the past few years. In this population-based study, we evaluated the risk for serious cardiac arrhythmias during the use of several noncardiac QTc-prolonging drugs in day-to-day practice......, and subsequently focused on several specific groups of patients who could be extremely vulnerable for drug-induced arrhythmias. We performed a case-control study in which patients (cases), hospitalized for nonatrial cardiac arrhythmias from 1987 to 1998, were compared with their matched controls regarding current...... use of QTc-prolonging drugs. Odds ratios (OR) and 95% confidence intervals (CI) were calculated using multivariate conditional logistic regression, adjusting for potential confounding factors. Data were obtained from the PHARMO record linkage system. We identified 501 cases, 39 of whom used QTc...

  1. Smoking prolongs the infectivity of patients with tuberculosis.

    Siddiqui, U A


    We sought to establish if smokers on anti-tuberculosis treatment are more likely to have a prolonged period of infectivity, compared to non-smoking tuberculosis patients, in a low tuberculosis prevalence country. We conducted a cross-sectional, retrospective study in Ireland that recruited 53 microbiologically confirmed cases of pulmonary tuberculosis (PTB). The age-sex adjusted odds ratios (AOR) suggest that the infectivity status of PTB on treatment was four times more likely to be prolonged beyond 6-8 weeks, if the cases had a smoking history (AOR: 4.42; 95% CI: 1.23; 15.9). Smoking was associated with delayed sputum smear conversion in PTB patients on treatment.

  2. Infection prevention and control during prolonged human space travel.

    Mermel, Leonard A


    Prolonged human spaceflight to another planet or an asteroid will introduce unique challenges of mitigating the risk of infection. During space travel, exposure to microgravity, radiation, and stress alter human immunoregulatory responses, which can in turn impact an astronaut's ability to prevent acquisition of infectious agents or reactivation of latent infection. In addition, microgravity affects virulence, growth kinetics, and biofilm formation of potential microbial pathogens. These interactions occur in a confined space in microgravity, providing ample opportunity for heavy microbial contamination of the environment. In addition, there is the persistence of aerosolized, microbe-containing particles. Any mission involving prolonged human spaceflight must be carefully planned to minimize vulnerabilities and maximize the likelihood of success.

  3. Prolonged Remission in Neuromyelitis Optica Following Cessation of Rituximab Treatment.

    Weinfurtner, Kelley; Graves, Jennifer; Ness, Jayne; Krupp, Lauren; Milazzo, Maria; Waubant, Emmanuelle


    Neuromyelitis optica is an autoimmune disease characterized by acute episodes of transverse myelitis and optic neuritis. Several small, open-label studies suggest rituximab, a monoclonal antibody against CD20, prevents relapses in neuromyelitis optica; however, there is little consensus on timing or duration of treatment. Here we report four patients with severe relapsing neuromyelitis optica who were stabilized on rituximab and, after discontinuing treatment, continued to experience prolonged remission of their disease. Remission ranged from 4.5 to 10.5 years total, including 3 to 9 years off all therapies. The patients had sustained clinical responses despite normal B-lymphocyte levels and, in at least 2 patients, continued seropositivity for aquaporin-4 antibodies. These cases suggest that rituximab may induce prolonged remission in certain neuromyelitis optica patients, and they highlight the need for further elucidation of rituximab's mechanism in neuromyelitis optica.

  4. Reversal of prolonged isoniazid-induced coma by pyridoxine.

    Brent, J; Vo, N; Kulig, K; Rumack, B H


    Isoniazid overdose is known to result in the rapid onset of seizures, metabolic acidosis, and prolonged obtundation. Pyridoxine has been reported to be effective in treating isoniazid-induced seizures. We report three cases of obtundation secondary to isoniazid overdose that was immediately reversed by intravenous pyridoxine. In two of these cases, status seizures were stopped by intravenous pyridoxine administration, but the patients remained comatose for prolonged periods. The comas were immediately reversed by the administration of additional pyridoxine. In the third case, the patient's lethargy was treated by intravenous pyridoxine on presentation and was followed by immediate awakening. Pyridoxine is effective in treating not only isoniazid-induced seizures, but also the mental status changes associated with this overdose. The dose required to induce awakening may be higher than that required to control seizures.

  5. Atraumatic femoral neck fracture secondary to prolonged lactation induced osteomalacia

    Dhammapal Sahebrao Bhamare


    Full Text Available Presenting a case of atraumatic fracture neck femur secondary to 2 years of prolonged lactation. A 26-year-old lactating mother presented with pain in left hip from last 12 months. She was apparently alright before and during pregnancy. Plain radiograph showed a complete undisplaced fracture of femoral neck. Osteomalacia was diagnosed by radiological and serological investigations. The fracture was fixed using AO type cannulated cancellous screws. The fracture showed good clinical and radiological union at 3 months. Literature review shows that this is a first case of atraumatic fracture of neck femur due to prolonged lactational osteomalacia. It showed that even apparently healthy Indians are susceptible to osteomalacia, more so during pregnancy and lactation and can be presented as atraumatic fracture. Although considered relatively stable, a compression type incomplete fracture neck femur may progress to a complete fracture if not treated in time.

  6. Prolonged apnea following modified electroconvulsive therapy with suxamethonium

    T M Omprakash


    Full Text Available A 36-year-old male from an urban middleclass family with strained relationship among family members was referred from a corporate hospital for further management of psychological problem. As he was attempting suicide repeatedly, Electroconvulsive Therapy (ECT was planned. After preoperative assessment and preparation, modified ECT was done with thiopentone and 0.5 mg/kg of suxamethonium. Apnea following suxamethonium was prolonged for 2 hours. Subsequent enquiry revealed that patient was treated for organophosphate poisoning and was on ventilator support for 15 days. This was concealed by the relatives. On searching patient previous records, Butyrylcholinesterase levels were very low, i.e., 350 u/l (normal reference range is 5 500 - 12 500 u/l. Prolonged suxamethonium apnea should be anticipated in patients with recent history of organophosphate poisoning; it is advisable to estimate the levels of butyrylcholinesterase and avoid suxamethonium in patients with low enzyme levels.

  7. MRI findings of prolonged post-traumatic sternal pain

    Grosse, Alexandra; Grosse, Claudia; Anderson, Suzanne [University Hospital of Berne, Department of Diagnostic, Pediatric and Interventional Radiology, Berne (Switzerland); Steinbach, Lynne [University of California San Francisco, Department of Radiology, San Francisco, CA (United States)


    The objective of this study was to characterize the different causes of prolonged sternal pain following thoracic trauma with involvement of the sternum and to define criteria for sternal nonunion diagnosis using MRI. Five patients with abnormalities of the sternum were evaluated for prolonged sternal pain following thoracic trauma using MRI. MR images were evaluated by two radiologists in consensus. The patients were selected from the radiology database, which included 8 patients with post-traumatic prolonged sternal pain. Two patients (n = 2) revealed a sternal nonunion after sternal fracture. One patient had a sternal fracture with delayed union and minor displacement of the sternal halves. Abnormal signal intensity alterations adjacent to and within the manubrio-sternal joint were evident in 2 patients and considered due to trauma-related changes in the manubrio-sternal joint. The 3 patients who were not included in the study had no abnormalities of the sternum: 1 of them proved to have a well-healed sternal fracture and nonunion of a rib fracture, 1 had subtle Tietze's syndrome, and 1 patient revealed no pathological findings on imaging. Various factors may be responsible for prolonged sternal pain following thoracic trauma, and these can be viewed with MRI. In cases of sternal nonunion there was common fluid-like signal in the fracture interspace between the bony edges, and the bone marrow adjacent to the nonunion showed altered signal intensity. MRI identified sternal nonunion and other trauma-related abnormalities of the sternum following chest trauma. (orig.)

  8. Disseminated Mycobacterium celatum disease with prolonged pulmonary involvement

    Patsche, Cecilie Blenstrup; Svensson, Erik; Wejse, Christian


    Mycobacterium celatum is a rare cause of human infection, causing disseminated disease in immunosuppressed individuals. Infections localized to the lungs and the lymph nodes have also been reported in immunocompetent individuals. The existing literature on the subject is limited as are experience....... The treatment regimen was changed to azithromycin, ciprofloxacin, and pyrazinamide and the treatment duration was prolonged to a total of 24 months, with good effect....

  9. Tetrodotoxin-Bupivacaine-Epinephrine Combinations for Prolonged Local Anesthesia

    Christina Bognet


    Full Text Available Currently available local anesthetics have analgesic durations in humans generally less than 12 hours. Prolonged-duration local anesthetics will be useful for postoperative analgesia. Previous studies showed that in rats, combinations of tetrodotoxin (TTX with bupivacaine had supra-additive effects on sciatic block durations. In those studies, epinephrine combined with TTX prolonged blocks more than 10-fold, while reducing systemic toxicity. TTX, formulated as Tectin, is in phase III clinical trials as an injectable systemic analgesic for chronic cancer pain. Here, we examine dose-duration relationships and sciatic nerve histology following local nerve blocks with combinations of Tectin with bupivacaine 0.25% (2.5 mg/mL solutions, with or without epinephrine 5 µg/mL (1:200,000 in rats. Percutaneous sciatic blockade was performed in Sprague-Dawley rats, and intensity and duration of sensory blockade was tested blindly with different Tectin-bupivacaine-epinephrine combinations. Between-group comparisons were analyzed using ANOVA and post-hoc Sidak tests. Nerves were examined blindly for signs of injury. Blocks containing bupivacaine 0.25% with Tectin 10 µM and epinephrine 5 µg/mL were prolonged by roughly 3-fold compared to blocks with bupivacaine 0.25% plain (P < 0.001 or bupivacaine 0.25% with epinephrine 5 µg/mL (P < 0.001. Nerve histology was benign for all groups. Combinations of Tectin in bupivacaine 0.25% with epinephrine 5 µg/mL appear promising for prolonged duration of local anesthesia.

  10. Prolonged morphine administration alters protein expression in the rat myocardium

    Drastichova Zdenka; Skrabalova Jitka; Neckar Jan; Kolar Frantisek; Novotny Jiri


    Abstract Background Morphine is used in clinical practice as a highly effective painkiller as well as the drug of choice for treatment of certain heart diseases. However, there is lack of information about its effect on protein expression in the heart. Therefore, here we aimed to identify the presumed alterations in rat myocardial protein levels after prolonged morphine treatment. Methods Morphine was administered to adult male Wistar rats in high doses (10 mg/kg per day) for 10 days. Protein...

  11. Amphiphilic vinyl polymers effectively prolong liposome circulation time in vivo.

    Torchilin, V P; Shtilman, M I; Trubetskoy, V S; Whiteman, K; Milstein, A M


    Newly synthesized amphiphilic polyacrylamide and poly(vinyl pyrrolidone), single terminus-modified with long-chain fatty acyl groups, are able to incorporate into the liposomal membrane, and similar to poly(ethylene glycol) prolong liposome circulation in vivo and decrease liposome accumulation in the liver. Protective efficacy of modified polymers increases with the increase in the length of acyl moiety and decreases for higher molecular weight polymers. The data on amphiphilic polymer-modified liposome biodistribution are presented.

  12. Risk Factors of Prolonged Hospitalization in Patients with Hyperemesis Gravidarum

    Hasan Onur Topcu


    Conclusion: Number of vomiting per day and maternal serum TSH levels could help physicians to estimate the risk of prolonged hospitalization; however further investigations are needed in large population studies. Identifying the high risk patients is important both for prevention of HEG and beginning appropriate antiemetic treatment to avoid complications to reduce the economic costs. [Cukurova Med J 2015; 40(1.000: 113-118

  13. Neural compensation within the human triceps surae during prolonged walking.

    Cronin, Neil J; Peltonen, Jussi; Sinkjaer, Thomas; Avela, Janne


    During human walking, muscle activation strategies are approximately constant across consecutive steps over a short time, but it is unknown whether they are maintained over a longer duration. Prolonged walking may increase tendinous tissue (TT) compliance, which can influence neural activation, but the neural responses of individual muscles have not been investigated. This study investigated the hypothesis that muscle activity is up- or down-regulated in individual triceps surae muscles during prolonged walking. Thirteen healthy subjects walked on a treadmill for 60 min at 4.5 km/h, while triceps surae muscle activity, maximal muscle compound action potentials, and kinematics were recorded every 5 min, and fascicle lengths were estimated at the beginning and end of the protocol using ultrasound. After 1 h of walking, soleus activity increased by 9.3 ± 0.2% (P triceps surae muscles and that changes in muscle activation are generally mirrored by changes in muscle fascicle length. These findings also support the notion of muscle-specific changes in TT compliance after prolonged walking and highlight the ability of the CNS to maintain relatively constant movement patterns in spite of neuromechanical changes in individual muscles.

  14. Prolonged symptoms in sporadic hemiplegic migraine: aura or migrainous infarction?

    Lai, Tzu-Hsien; Hong, Chien-Tai


    Sporadic hemiplegic migraine is a rare form of migraine associated with motor weakness during the aura phase. While the aura usually lasts less than 1 hour, patients with sporadic hemiplegic migraine frequently have prolonged weakness. A 60-year-old male had sporadic hemiplegic migraine after a head injury at the age of 14. He presented to our emergency department with a typical migraine attack except prolonged right limbs weakness and numbness (>1 day). Brain magnetic resonance imaging showed an acute infarction in the left posterior medial pons. He recovered completely from motor weakness but still complained of residual numbness in his right limbs three months later. We report the first adult case of sporadic hemiplegic migraine with migrainous infarction located in the pons. Since patients with hemiplegic migraine often have prolonged aura, it is easy to be confused with a migrainous infarction. The case report highlights that migrainous infarction is a complication difficult to diagnose and treat early, especially in patients with hemiplegic migraine.

  15. Secondary bacteraemia in adult patients with prolonged dengue fever.

    Premaratna, R; Dissanayake, D; Silva, F H D S; Dassanayake, M; de Silva, H J


    Although dengue management guidelines do not advice on use of antibiotics in dengue shock syndrome, unrecognised bactraemia is likely to contribute to morbidity and mortality. To assess the occurance of secondary bacteraemia in adult patients with prolonged dengue fever. A prospective study was conducted recruiting patients with confirmed acute dengue infection who had prolonged fever (>5 days). Two sets of blood cultures were taken in such patients prior to institution of antibiotic therapy. Demographic, clinical, haematological and biochemical parameters were recorded. Development of ascites and pleural effusions were detected using ultrasonography. Fourty patients (52.5% males) with a mean age of 29.8 years (SD 13.6) were studied. The average duration of fever was 7.9 days (SD 1.8). Ten patients (25%) had bacterial isolates in their blood cultures; Staphylococcus aureus (n=2), coliforms (n=3), pseudomonas (n=1) and 4 had mixed growths. The culture positive group had severe body aches at admission and higher fever, third space fluid accumulation, a significant drop in platelets and a higher CRP. A quarter of dengue patients with prolonged fever had a bacterial isolate. Culture positive patients appeared more ill with body aches and had higher degrees of fever during the latter part of the illness. Increased vascular permeability may predispose to bacterial seepage into blood. Although white cell count is not helpful in detecting bacteraemia, low platelet count and elevation of CRP seem to be helpful.

  16. A centrally mediated prolonged hypotension produced by oxotremorine or pilocarpine

    Dage, R.C.


    1 Oxotremorine, methyloxotremorine, pilocarpine or arecoline were given intravenously to anaesthetized cats, dogs or rats, and intraperitoneally to conscious normotensive and spontaneously hypertensive rats, pretreated with doses of methylatropine that completely blocked peripheral muscarinic receptors, to ascertain their effects on blood pressure and heart rate. 2 Oxotremorine but not methyloxotremorine produced a prolonged hypotension in cats and dogs but not in rats. Heart rate was not changed. Pilocarpine, although less potent, produced an identical effect, whereas the effect of arecoline was short by comparison. The hypotensive effect of these drugs was reversed by atropine. 3 In dogs, oxotremorine produced a prolonged hypotension with no change in heart rate or cardiac output. 4 A decrease in spontaneous sympathetic nerve activity accompanied the hypotension in cats. Both effects were reversed by atropine but could be reinvoked by large doses of oxotremorine. 5 The oxotremorine-induced hypotension in cats was not altered by decerebration but was abolished by high cervical spinal section. 6 The results indicate that the prolonged hypotension elicited by oxotremorine is mediated by an action at muscarinic receptors in the brain stem resulting in a decrease in sympathetic nerve activity and peripheral resistance but not heart rate or cardiac output. PMID:760887

  17. Prolonged job strain and subsequent risk of cancer in women

    Vesterlund, Gitte K.; Høeg, Beverley L.; Johansen, Christoffer


    Background: The role of psychological stress in cancer risk is continuously debated. Stress at work is the most common form of stress and previous studies have shown inconsistent results regarding cancer risk. In this longitudinal study, we examined the association between prolonged job strain ac....... Since a large proportion of cancer patients perceive psychological stress as a possible cause of their cancer disease, it is of importance to communicate these findings to the public.......Background: The role of psychological stress in cancer risk is continuously debated. Stress at work is the most common form of stress and previous studies have shown inconsistent results regarding cancer risk. In this longitudinal study, we examined the association between prolonged job strain...... across six years and subsequent cancer risk. Methods and materials: We used data from 6571 cancer-free women from the Danish Nurse Cohort aged 45–70 years at inclusion, and self-reported questionnaires on job strain at baseline in 1993 and again in 1999. Prolonged job strain was defined as high job...

  18. Treatment of postcatheterization femoral arteriovenous fistulas with simple prolonged bandaging

    ZHOU Tao; LIU Zhen-jiang; ZHOU Sheng-hua; SHEN Xiang-qian; LIU Qi-ming; FANG Zhen-fei; HU Xin-qun; LI Jiang; L(U) Xiao-lin


    Background The methods for the treatment of postcatheterization femoral arteriovenous fistulas (AVF-s) - simple observation, ultrasound guided compression, covered stents implantation and coil embolization have poor outcome.Surgery is the standard method for treatment of femoral AVFs, but it is a traumatic operation. In this study, we report the results of the treatment of postcatheterization femoral AVFs by simple prolonged compressing bandage.Methods To treat iatrogenic femoral AVFs caused by transfemoral catheterization, prolonged binding with elastic or common bandage was applied in 16 cases. Catheterization was performed in 7 cases for radiofrequency current catheter ablation, in 4 for occlusion of congenital heart disease, in 3 for percutaneous coronary intervention, in 1 for coronary angiography and in 1 for right heart catheterization.Results All iatrogenic femoral AVFs were healed after simple binding with elastic or common bandage for 4-46 days (mean (15±10) days). During the period of binding, local skins ulceration occurred at puncture site in two cases and femoral vein thrombus was found in one patient. During 6-24 months (mean (11.8±3.6) months) followup with colour Doppler ultrasonography, no recurrent arteriovenous shunting or other complications were observed.Conclusion The results suggest that simple prolonged bandaging for postcatheterization femoral AVFs is an effective and economical procedure.

  19. Opioid/naloxone prolonged release combinations for opioid induced constipation

    Shailendra Kapoor


    I read with great interest the recent article by Chen et a/in a recent issue of your esteemed journal.The article is highly thought provoking.One emerging therapeutic alternative for opioid induced constipation is the emergence of opioid/naloxone prolonged release combinations.For instance,naloxone when administered in a 1∶2 ratio with oxycodone reverses the inhibitory effect of oxycodone on the gastrointestinal tract.The advantage of oxycodone/naloxone prolonged release (OXN) is that while its anti-nociceptive efficacy is equivalent to that of oxycodone prolonged release (OXC),it significantly decreases the "Bowel Function Index" thereby ameliorating symptoms of opioid induced constipation to a large extent.Schutter et al in a recent study have reported a decrease in the bowel function index from 38.2 to 15.1.Similarly,L(o)wenstein et al in another recent study have reported that following a month of therapy,complete spontaneous bowel movements per week is increased from one in OXC therapy to three in OXN therapy.

  20. Respiratory virus infection as a cause of prolonged symptoms in acute otitis media.

    Arola, M; Ziegler, T; Ruuskanen, O


    We studied respiratory viruses in 22 children with acute otitis media who had failed to improve after at least 48 hours of antimicrobial therapy. The mean duration of preenrollment antimicrobial therapy was 4.8 days. For comparison we studied 66 children with newly diagnosed acute otitis media. Respiratory viruses were isolated from middle ear fluid or from the nasopharynx, or both, significantly more often in the patients unresponsive to initial antimicrobial therapy than in the comparison patients (68% vs 41%, p less than 0.05). Viruses were recovered from the middle ear fluid in 32% of the study patients and from 15% of the comparison group. Bacteria were isolated from the middle ear fluid of four (18%) children in the study group; one child had an isolate resistant to initial antimicrobial therapy. All four children with bacteria in the middle ear fluid had evidence of concomitant respiratory virus infection. Our results indicate that respiratory virus infection is often present in patients with acute otitis media unresponsive to initial antimicrobial therapy, and may explain the prolongation of symptoms of infection. Resistant bacteria seem to be a less common cause of failure of the initial treatment.

  1. The Type II Aachen-Keratoprosthesis in humans: case report of the first prolonged application.

    Kompa, S; Redbrake, C; Langefeld, S; Brenman, K; Schrage, N


    To improve the prognosis of corneal grafts in silicone-oil filled eyes of patients with severe ocular trauma by a prolonged application of the Type II Aachen-Keratoprosthesis (KPro). This application endeavors to improve post-keratoplasty prognosis by avoiding corneal endothelial dystrophy in the aphakic eye due to contact with silicone oil. PATIENT AND PROCEDURES: The Aachen-Keratoprosthesis' haptic was modified to allow tight contact with cells. The Type II Aachen-Keratoprosthesis was then implanted in an 18-year-old male, with previous management of bilateral corneal rupture. Rather than utilize the device as a temporary intraoperative tool, we extended the device's lifespan in the eye. Following implantation, the patient could see hand movements up to 0.1 with best correction. After 8 weeks, vision decreased and a retroprosthetic membrane proliferated. Upon conjunctival retraction, 3 months after the initial surgery, we excised the prosthesis and performed a re-vitrectomy and corneal grafting. The silicone oil was removed. After eighteen postoperative months, the graft remained clear, the retina was completely attached, and the vision was stable: 0.1 best corrected. This case reports the prolonged implantation and prospect of the Type II Aachen-Keratoprosthesis to be utilized as a permanent device to restore vision in the near future.

  2. Successful Prolonged Mechanical CPR in a Severely Poisoned Hypothermic Patient: A Case Report

    Alberto Piacentini


    Full Text Available Mechanical cardiopulmonary resuscitation (m-CPR devices are an alternative to manual CPR, but their efficacy has been subject to debate. We present a case of a patient with full-neurologic recovery after prolonged m-CPR. The patient presented with severe hypothermia (internal temperature 24°C and poisoning (sedatives/hypnotics. Hepatic perfusion and metabolism are considered keys to restore spontaneous circulation. During this period no problems related to the device or patient positioning were encountered. Delivery of high-quality CPR and prolonged resuscitation were achieved. We confirm that ventilations asynchronous with chest compressions can be a problem. Reduction in chest measurements can hamper lung ventilation. A synchronous mode of manual ventilation (30 : 2 seems to be the best solution. The patient had an initial period of manual CPR. No damage to any organ or structure was noted. This case is of further interest because our EMS helicopters can fly 24 hours a day and m-CPR devices could play an important role as a “bridge” in patients when active rewarming by cardiopulmonary bypass is indicated (CPB.

  3. Insights into prolonged solution criticality incidents, using the coupled radiation/multiphase code FETCH

    Pain, C.C.; Oliveira, C.R.E. de; Goddard, A.J.H. [T.H. Huxley School of the Environment, Earth Sciences and Engineering, Imperial College, London (United Kingdom)


    The development of the FETCH transient code has been supported by the UK regulator, the Nuclear Installations Inspectorate, as a generic reference method for modelling fissile solution criticality. The fundamental basis of the method means that it can be applied to situations somewhat beyond the range of available experiment. General geometry finite-element modelling is used for the two linked modules: neutron transport and multiphase computational fluid dynamics. Multiphase modelling includes bubble dynamics, free surface motion (sloshing) and the ability to calculate pressure waves and their interaction with bubble formation. FETCH has been benchmarked against transient power and pressure results from the SILENE experiments and is being tested against published TRACY measurements. Research is being performed in order to use data from the incident at the JCO Company on 30-31 September 1999 to: (a) gain an understanding of the mechanism of criticality to improve the future safety designs of the fuel cycle facilities; and (b) to understand the mechanisms of this accident itself, for example its prolonged nature. The full published geometry of the 'sedimentation tank' has been modelled focusing on, firstly, the role of the assumed initial conditions, such as filling rate. The influence of heat removal rate upon the power during prolonged criticality phase is demonstrated. The paper comments on the role that pressure might have in influencing the consequences of criticality accidents. (author)

  4. Hybrid-Empirical Ground Motion Estimations for Georgia

    Tsereteli Nino


    Full Text Available Ground motion prediction equations are essential for several purposes ranging from seismic design and analysis to probabilistic seismic hazard assessment. In seismically active regions without sufficiently strong ground motion data to build empirical models, hybrid models become vital. Georgia does not have sufficiently strong ground motion data to build empirical models. In this study, we have applied the host-to-target method in two regions in Georgia with different source mechanisms. According to the tectonic regime of the target areas, two different regions are chosen as host regions. One of them is in Turkey with the dominant strike-slip source mechanism, while the other is in Iran with the prevalence of reverse-mechanism events. We performed stochastic finite-fault simulations in both host and target areas and employed the hybrid-empirical method as introduced in Campbell (2003. An initial set of hybrid empirical ground motion estimates is obtained for PGA and SA at selected periods for Georgia.

  5. Prolonged storage of packed red blood cells for blood transfusion.

    Martí-Carvajal, Arturo J; Simancas-Racines, Daniel; Peña-González, Barbra S


    A blood transfusion is an acute intervention, used to address life- and health-threatening conditions on a short-term basis. Packed red blood cells are most often used for blood transfusion. Sometimes blood is transfused after prolonged storage but there is continuing debate as to whether transfusion of 'older' blood is as beneficial as transfusion of 'fresher' blood. To assess the clinical benefits and harms of prolonged storage of packed red blood cells, in comparison with fresh, on recipients of blood transfusion. We ran the search on 1st May 2014. We searched the Cochrane Injuries Group Specialized Register, Cochrane Central Register of Controlled Trials (CENTRAL, The Cochrane Library), MEDLINE (OvidSP), Embase (OvidSP), CINAHL (EBSCO Host) and two other databases. We also searched clinical trials registers and screened reference lists of the retrieved publications and reviews. We updated this search in June 2015 but these results have not yet been incorporated. Randomised clinical trials including participants assessed as requiring red blood cell transfusion were eligible for inclusion. Prolonged storage was defined as red blood cells stored for ≥ 21 days in a blood bank. We did not apply limits regarding the duration of follow-up, or country where the study took place. We excluded trials where patients received a combination of short- and long-stored blood products, and also trials without a clear definition of prolonged storage. We independently performed study selection, risk of bias assessment and data extraction by at least two review authors. The major outcomes were death from any cause, transfusion-related acute lung injury, and adverse events. We estimated relative risk for dichotomous outcomes. We measured statistical heterogeneity using I(2). We used a random-effects model to synthesise the findings. We identified three randomised clinical trials, involving a total of 120 participants, comparing packed red blood cells with ≥ 21 days storage

  6. Needle Thoracostomy for Patients with Prolonged Transport Times: A Case-control Study.

    Weichenthal, Lori; Crane, Desiree Hansen; Rond, Luke; Roche, Conal


    Introduction The use of prehospital needle thoracostomy (NT) is controversial. Some studies support its use; however, concerns exist regarding misplacement, inappropriate patient selection, and iatrogenic injury. Even less is known about its efficacy in situations where there is a delay to definitive care. Hypothesis/Aim To determine any differences in survival of patients who underwent NT in the setting of prolonged versus short transport times, and to describe differences in mechanisms and complications between the two groups. This was a retrospective, matched, case-control study of trauma patients in a four county Emergency Medical Service (EMS) system from April 1, 2007 through April 1, 2013. This system serves an urban, rural, and wilderness catchment area. A prehospital database was queried for all patients in whom NT was performed, identifying 182 patients. When these calls were limited to those with prolonged transport times, the search was narrowed to 32 cases. A matched control group, based on age and gender, with short transport times was then created as a comparison. Data collected from prehospital and hospital records included: demographics; mechanism of injury; call status; response to NT; and final outcome. Univariate and multivariate analyses were conducted, as appropriate, to assess the primary outcome of survival and to further elucidate the descriptive data. There was no difference in survival between the case and control groups, either when evaluated with univariate (34% vs 25%; P=.41) or multivariate (odds ratio=0.99; 95% CI, 0.96-1.02; P=.57) analyses. Blunt trauma was the most common mechanism in both groups, but penetrating trauma was more common in the control group (30% vs 9%; P=.003). Patients in the control group were also more likely to have no vital signs on initial assessment (62% vs 31%; P=.003). More patients in the case group were described as having clinical improvement after NT (34% vs 19%; P=.03). No complications of NT were

  7. Feasibility and Efficacy of Prolonged Exposure for PTSD among Individuals with a Psychotic Spectrum Disorder

    Anouk L. Grubaugh


    Full Text Available Objective: Few empirical studies have examined the feasibility of trauma-focused treatment among individuals with schizophrenia. This lack of research is important given the substantial overlap of trauma exposure and subsequent PTSD with psychotic spectrum disorders, and the potential for PTSD to complicate the course and prognosis of schizophrenia and other variants of severe mental illness.Method: As part of a larger study, 14 veterans with a psychotic spectrum disorder were enrolled to receive prolonged exposure (PE for PTSD within a single arm open trial study design. Patient reactions and responses to PE were examined using feasibility indices such as attrition, survey reactions, and treatment expectancy; pre and post-changes in PTSD severity and diagnostic status; and thematic interviews conducted post-intervention.Results: Quantitative and qualitative data indicate that implementation of PE is feasible, subjectively well-tolerated, and may result in clinically significant reductions in PTSD symptoms in patients with psychotic spectrum disorders.Conclusion: Consistent with treatment outcome data in clinical populations with a broader range of severe mental illnesses, the current results support the use of PTSD exposure-based interventions, such as PE, for individuals with psychotic spectrum disorders.

  8. Ambulatory assessment of skin conductivity during first thesis presentation: lower self-confidence predicts prolonged stress response.

    Elfering, Achim; Grebner, Simone


    In this field study self-confidence was tested to predict the course of galvanic electrodermal stress response prior, during and after public speaking. Ten graduate students initially rated their self-confidence and afterwards presented their thesis proposals orally in a 10-min presentation to their supervisor and peers. Galvanic skin response level was measured throughout and analysed for 10 min prior to, during, and 10 min after the presentation. Two major galvanic electrodermal stress response types were observed. Five students showed a 'healthy response', i.e. an anticipatory increase in electrodermal conductance, followed by a decrease after termination of the presentation. The other five students showed a steady increase of skin conductance during and after their presentation ('prolonged response'). In line with the allostatic load model the 'prolonged response' group reported significantly lower self-confidence before presentation than the 'healthy response' group (p Self-confidence is a resource in novices facing an unfamiliar stressor.

  9. A successful case of anti-NMDAR encephalitis without tumor treated with a prolonged regimen of plasmapheresis

    Mateus Mistieri Simabukuro

    Full Text Available ABSTRACT Anti-NMDA receptor encephalitis is a severe but treatable autoimmune disease of the CNS. However, the use of immunotherapy and long-term outcomes have yet to be defined for this disease. We describe a case of an 18-year-old male diagnosed with anti-NMDAR encephalitis not associated with tumor, which did not respond to initial treatment with immunoglobulin, followed by corticosteroids, cyclophosphamide and evolved with significant clinical improvement after a prolonged course of plasmapheresis. Although it is not possible to affirm the good outcome was due solely to the prolonged plasmapheresis regimen, recently published data shows that improvement may take weeks or months to occur. This case discloses another therapeutic possibility for patients with refractory disease who fail to respond to recommended first-line and second-line therapy.

  10. Expert opinion vs. empirical evidence

    Herman, Rod A; Raybould, Alan


    Expert opinion is often sought by government regulatory agencies when there is insufficient empirical evidence to judge the safety implications of a course of action. However, it can be reckless to continue following expert opinion when a preponderance of evidence is amassed that conflicts with this opinion. Factual evidence should always trump opinion in prioritizing the information that is used to guide regulatory policy. Evidence-based medicine has seen a dramatic upturn in recent years spurred by examples where evidence indicated that certain treatments recommended by expert opinions increased death rates. We suggest that scientific evidence should also take priority over expert opinion in the regulation of genetically modified crops (GM). Examples of regulatory data requirements that are not justified based on the mass of evidence are described, and it is suggested that expertise in risk assessment should guide evidence-based regulation of GM crops. PMID:24637724

  11. Empirical Adequacy and Scientific Discovery

    Samuel Simon


    Full Text Available This paper aims to show that Bas van Fraassen’s constructive empiricism, such as it is expounded in The Scientific Image, ends up in considerable difficulties in the philosophy of science. The main problem would be the exclusion of mathematics from the conception of science, given its clear absence of empirical adequacy, which is the most important requirement of his formulation. In this sense, it is suggested a more inclusive formulation of scientific theory, aroused from the notion of Da Costa’s (1999 simple structure, considering the notion of scientific discovery in a strict sense, and the validity limit of a theory and the formalism used in a temporal context.

  12. Sparse Empirical Bayes Analysis (SEBA)

    Bochkina, Natalia


    We consider a joint processing of $n$ independent sparse regression problems. Each is based on a sample $(y_{i1},x_{i1})...,(y_{im},x_{im})$ of $m$ \\iid observations from $y_{i1}=x_{i1}\\t\\beta_i+\\eps_{i1}$, $y_{i1}\\in \\R$, $x_{i 1}\\in\\R^p$, $i=1,...,n$, and $\\eps_{i1}\\dist N(0,\\sig^2)$, say. $p$ is large enough so that the empirical risk minimizer is not consistent. We consider three possible extensions of the lasso estimator to deal with this problem, the lassoes, the group lasso and the RING lasso, each utilizing a different assumption how these problems are related. For each estimator we give a Bayesian interpretation, and we present both persistency analysis and non-asymptotic error bounds based on restricted eigenvalue - type assumptions.

  13. Characteristics and implications of prolonged fusicoccin-induced growth of Avena coleoptile sections

    Cleland, R. E.


    A study has been made of the prolonged growth of Avena coleoptile sections in response to fusicoccin (FC), a phytotoxin that promotes apoplastic acidification. The final amount of FC-induced growth is a function of the FC concentration. Removal of the epidermis speeds up the initial rate of elongation and shortens the duration of the response, without affecting the total amount of extension. A suboptimal FC concentration (7 x 10(-8) M) which induces the same rate of proton excretion as does optimal indoleacetic acid (IAA) (1 x 10(-5) M), causes elongation which is 60-75% of that induced by IAA in 4 h or 50-65% in 7 h. This suggests that acid-induced extension could make a major contribution to auxin-induced growth for at least 7 h.

  14. Evaluation of ligand-binding affinity using polynomial empirical scoring functions.

    de Azevedo, Walter Filgueira; Dias, Raquel


    Assessing protein-ligand interaction is of great importance for virtual screening initiatives in order to discover new drugs. The present work describes a set of empirical scoring functions to assess the binding affinity, involving terms for intermolecular hydrogen bonds and contact surface. The results show that our methodology works better to predict protein-ligand affinity when compared with XSCORE, a popular empirical scoring function.

  15. Empirical Optimization of Undulator Tapering at FLASH2 and Comparison with Numerical Simulations

    Mak, Alan; Faatz, Bart; Werin, Sverker


    In a free-electron laser equipped with variable-gap undulator modules, the technique of undulator tapering opens up the possibility to increase the radiation power beyond the initial saturation point, thus enhancing the efficiency of the laser. The effectiveness of the enhancement relies on the proper optimization of the taper profile. In this work, a multidimensional optimization approach is implemented empirically in the x-ray free-electron laser FLASH2. The empirical results are compared with numerical simulations.

  16. Empirical optimization of undulator tapering at FLASH2 and comparison with numerical simulations

    Mak, Alan; Curbis, Francesca; Werin, Sverker [Lund Univ. (Sweden). MAX IV Laboratory; Faatz, Bart [Deutsches Elektronen-Synchrotron (DESY), Hamburg (Germany)


    In a free-electron laser equipped with variable-gap undulator modules, the technique of undulator tapering opens up the possibility to increase the radiation power beyond the initial saturation point, thus enhancing the efficiency of the laser. The effectiveness of the enhancement relies on the proper optimization of the taper profile. In this work, a multidimensional optimization approach is implemented empirically in the X-ray free-electron laser FLASH2. The empirical results are compared with numerical simulations.

  17. An empirical model of tropical ocean dynamics

    Newman, Matthew; Scott, James D. [University of Colorado, CIRES Climate Diagnostics Center, Boulder, CO (United States); NOAA Earth System Research Laboratory, Physical Sciences Division, Boulder, CO (United States); Alexander, Michael A. [NOAA Earth System Research Laboratory, Physical Sciences Division, Boulder, CO (United States)


    To extend the linear stochastically forced paradigm of tropical sea surface temperature (SST) variability to the subsurface ocean, a linear inverse model (LIM) is constructed from the simultaneous and 3-month lag covariances of observed 3-month running mean anomalies of SST, thermocline depth, and zonal wind stress. This LIM is then used to identify the empirically-determined linear dynamics with physical processes to gauge their relative importance to ENSO evolution. Optimal growth of SST anomalies over several months is triggered by both an initial SST anomaly and a central equatorial Pacific thermocline anomaly that propagates slowly eastward while leading the amplifying SST anomaly. The initial SST and thermocline anomalies each produce roughly half the SST amplification. If interactions between the sea surface and the thermocline are removed in the linear dynamical operator, the SST anomaly undergoes less optimal growth but is also more persistent, and its location shifts from the eastern to central Pacific. Optimal growth is also found to be essentially the result of two stable eigenmodes with similar structure but differing 2- and 4-year periods evolving from initial destructive to constructive interference. Variations among ENSO events could then be a consequence not of changing stability characteristics but of random excitation of these two eigenmodes, which represent different balances between surface and subsurface coupled dynamics. As found in previous studies, the impact of the additional variables on LIM SST forecasts is relatively small for short time scales. Over time intervals greater than about 9 months, however, the additional variables both significantly enhance forecast skill and predict lag covariances and associated power spectra whose closer agreement with observations enhances the validation of the linear model. Moreover, a secondary type of optimal growth exists that is not present in a LIM constructed from SST alone, in which initial SST

  18. Empirically Based, Agent-based models

    Elinor Ostrom


    Full Text Available There is an increasing drive to combine agent-based models with empirical methods. An overview is provided of the various empirical methods that are used for different kinds of questions. Four categories of empirical approaches are identified in which agent-based models have been empirically tested: case studies, stylized facts, role-playing games, and laboratory experiments. We discuss how these different types of empirical studies can be combined. The various ways empirical techniques are used illustrate the main challenges of contemporary social sciences: (1 how to develop models that are generalizable and still applicable in specific cases, and (2 how to scale up the processes of interactions of a few agents to interactions among many agents.

  19. Bayes and empirical Bayes: do they merge?

    Petrone, Sonia; Scricciolo, Catia


    Bayesian inference is attractive for its coherence and good frequentist properties. However, it is a common experience that eliciting a honest prior may be difficult and, in practice, people often take an {\\em empirical Bayes} approach, plugging empirical estimates of the prior hyperparameters into the posterior distribution. Even if not rigorously justified, the underlying idea is that, when the sample size is large, empirical Bayes leads to "similar" inferential answers. Yet, precise mathematical results seem to be missing. In this work, we give a more rigorous justification in terms of merging of Bayes and empirical Bayes posterior distributions. We consider two notions of merging: Bayesian weak merging and frequentist merging in total variation. Since weak merging is related to consistency, we provide sufficient conditions for consistency of empirical Bayes posteriors. Also, we show that, under regularity conditions, the empirical Bayes procedure asymptotically selects the value of the hyperparameter for ...

  20. Regional Financial Development,Relationship-Specific Transaction and IPO’s Abnormal Initial Return--Empirical Evidence from the Supplier/Customer Relationship Based on the A-shareIPO Prospectus%地区金融发展、关系型交易与IPO首日超额收益--基于A股招股说明书供应商/客户关系的经验证据

    林钟高; 林夜


    Different from previous papers which focus on IPO’s abnormal initial return only from financial indicators, issuing mechanism and investors’ or underwriters’ behavior choice, this paper uses A shares as the research sample in Shanghai and Shenzhen Stock Exchange from 2004 to 2014, and the supplier/customer relationship transactions’ data which provided by the IPO corporations’ prospectus as a starting point to investigate how the relationship-specific transaction, regional financial development and their interaction affect IPO’s abnormal initial return.The empirical results show that IPO corporations with larger proportion of relationship-specific transactions will have higher IPO’s abnormal initial returns. Further, we find that the improvement of regional financial development level can effectively inhibit the incremental effect of relationship-specific transaction on IPO’s abnormal initial return, and this effect is more significant with institutional investors’ governance effect. This research suggests that relationship contract has an impact on IPO’s abnormal initial returns, and the regional heterogeneity of financial development and institutional investors’ heterogeneity has resulted in the difference of the degree of the impact. This shows us, in China, we should not only pay attention to the important role of“relationship trust”, but also pay more attention to the financial development and the improvement of corporate governance.%与以往从财务指标、发行机制以及投资者、承销商行为选择等方面出发研究IPO首日超额收益不同,本文以2004~2014年沪深A股为研究样本,从拟上市公司招股说明书中提供的供应商/客户关系交易数据出发,考察关系型交易对IPO首日超额收益的影响及其地区金融发展水平对这种影响的调节作用。研究发现,关系型交易比重越大的企业能够在IPO首日获得越高的超额收益,进一步检验发现,

  1. Why Psychology Cannot be an Empirical Science.

    Smedslund, Jan


    The current empirical paradigm for psychological research is criticized because it ignores the irreversibility of psychological processes, the infinite number of influential factors, the pseudo-empirical nature of many hypotheses, and the methodological implications of social interactivity. An additional point is that the differences and correlations usually found are much too small to be useful in psychological practice and in daily life. Together, these criticisms imply that an objective, accumulative, empirical and theoretical science of psychology is an impossible project.

  2. Energy efficiency initiatives: Indian experience

    Dey, Dipankar [ICFAI Business School, Kolkata, (IBS-K) (India)


    India, with a population of over 1.10 billion is one of the fastest growing economies of the world. As domestic sources of different conventional commercial energy are drying up, dependence on foreign energy sources is increasing. There exists a huge potential for saving energy in India. After the first 'oil shock' (1973), the government of India realized the need for conservation of energy and a 'Petroleum Conservation Action Group' was formed in 1976. Since then many initiatives aiming at energy conservation and improving energy efficiency, have been undertaken (the establishment of Petroleum Conservation Research Association in 1978; the notification of Eco labelling scheme in 1991; the formation of Bureau of Energy Efficiency in 2002). But no such initiative was successful. In this paper an attempt has been made to analyze the changing importance of energy conservation/efficiency measures which have been initiated in India between 1970 and 2005.The present study tries to analyze the limitations and the reasons of failure of those initiatives. The probable reasons are: fuel pricing mechanism (including subsidies), political factors, corruption and unethical practices, influence of oil and related industry lobbies - both internal and external, the economic situation and the prolonged protection of domestic industries. Further, as India is opening its economy, the study explores the opportunities that the globally competitive market would offer to improve the overall energy efficiency of the economy. The study suggests that the Bureau of Energy Efficiency (BEE) - the newly formed nodal agency for improving energy efficiency of the economy may be made an autonomous institution where intervention from the politicians would be very low. For proper implementation of different initiatives to improve energy efficiency, BEE should involve more the civil societies (NGO) from the inception to the implementation stage of the programs. The paper also

  3. The impact of obesity on physiological responses during prolonged exercise.

    Eijsvogels, T M H; Veltmeijer, M T W; Schreuder, T H A; Poelkens, F; Thijssen, D H J; Hopman, M T E


    Prolonged, moderate-intensity exercise training is routinely prescribed to subjects with obesity. In the general population, this type of exercise can lead to fluid and sodium imbalance. However, little is known whether obesity alters the risk of fluid and sodium imbalances. This study examined physiological responses, such as core body temperature, fluid and sodium balance, in lean (BMIobese (BMI>30) subjects during prolonged moderate-intensity exercise. A total of 93 volunteers (24-80 years), stratified for BMI, participated in the Nijmegen Marches and walked 30-50 km at a self-selected pace. Heart rate and core body temperature were recorded every 5 km. Subjects reported fluid intake, while urine output was measured and sweat rate was calculated. Baseline and post-exercise plasma sodium levels were determined, and urinary specific gravity levels were assessed before and after exercise. BMI groups did not differ in training status preceding the experiment. Exercise duration (8 h 41 ± 1 h 36 min) and intensity (72 ± 9% HR(max)) were comparable across groups, whereas obese subjects tended to have a higher maximum core body temperature than lean controls (P=0.06). Obese subjects demonstrated a significantly higher fluid intake (Pobese versus lean subjects after exercise (Pexercise, whereas plasma-sodium levels increased significantly (Pobese subjects. Also, overweight and obese subjects demonstrated a significantly larger decrease in body mass after exercise than lean controls (PObese subjects demonstrate a larger deviation in markers of fluid and sodium balance than their lean counterparts during prolonged moderate-intensity exercise. These findings suggest that overweight and obese subjects, especially under strenuous environmental conditions, have an increased risk to develop fluid and sodium imbalances.

  4. Prevention of neutropenia during chemotherapy by prolonged myelostimulatory preparations

    V. V. Ptushkin


    Full Text Available Neutropenia and associated infection, resulting in hospitalization and use of antibiotics, has a negative effect on chemotherapy. The need to reduce the dose of cytotoxic drugs during neutropenia leads to lower survival rates in patients with hematological malignancies and solid tumors. Since 1990s myelocytokines – proteins that accelerate neutrophil recovery after cytostatic chemotherapy and reduce the risk of infection – is widely used in the clinical practice. The use of these drugs can support the planned dose intensity of chemotherapy and improves the treatment efficacy. The disadvantages of these drugs include the need for their daily parenteral administration for 7–10 days. The development of long-acting forms (pegfilgrastim and lipegfilgrastim has solved this problem. Self-regulating clearance of prolonged forms allowed to use them only once on a chemotherapy course. Results of pegfilgrastim administration in 25 patients with hematological malignancies (8 patients and solid tumors (17 patients included in our analysis. Prolonged preparation showed high efficacy in secondary prophylaxis of neutropenia and infection decreasing the risk by 82 %. The single administration of pegfilgrastim allowed safe dose intensity chemotherapy with shorter intervals between courses (AC-14 in 8 patients with breast cancer. Tolerability was good; cases of hyperleukocytosis have notbeen reported. Recently in Europe and the Russian Federation a new drug from prolonged myelocytokine group – lipegfilgrastim – has been registered. The results of two controlled trials in patients with breast cancer (n = 410 receiving doxorubicin/docetaxel showed high efficacy of the drug as the pegfilgrastim with comparable tolerability.

  5. Fetal brain hypometabolism during prolonged hypoxaemia in the llama.

    Ebensperger, Germán; Ebensperger, Renato; Herrera, Emilio A; Riquelme, Raquel A; Sanhueza, Emilia M; Lesage, Florian; Marengo, Juan J; Tejo, Rodrigo I; Llanos, Aníbal J; Reyes, Roberto V


    In this study we looked for additional evidence to support the hypothesis that fetal llama reacts to hypoxaemia with adaptive brain hypometabolism. We determined fetal llama brain temperature, Na(+) and K(+) channel density and Na(+)-K(+)-ATPase activity. Additionally, we looked to see whether there were signs of cell death in the brain cortex of llama fetuses submitted to prolonged hypoxaemia. Ten fetal llamas were instrumented under general anaesthesia to measure pH, arterial blood gases, mean arterial pressure, heart rate, and brain and core temperatures. Measurements were made 1 h before and every hour during 24 h of hypoxaemia (n = 5), which was imposed by reducing maternal inspired oxygen fraction to reach a fetal arterial partial pressure of oxygen (P(a,O(2))) of about 12 mmHg. A normoxaemic group was the control (n = 5). After 24 h of hypoxaemia, we determined brain cortex Na(+)-K(+)-ATPase activity, ouabain binding, and the expression of NaV1.1, NaV1.2, NaV1.3, NaV1.6, TREK1, TRAAK and K(ATP) channels. The lack of brain cortex damage was assessed as poly ADP-ribose polymerase (PARP) proteolysis. We found a mean decrease of 0.56 degrees C in brain cortex temperature during prolonged hypoxaemia, which was accompanied by a 51% decrease in brain cortex Na(+)-K(+)-ATPase activity, and by a 44% decrease in protein content of NaV1.1, a voltage-gated Na(+) channel. These changes occurred in absence of changes in PARP protein degradation, suggesting that the cell death of the brain was not enhanced in the fetal llama during hypoxaemia. Taken together, these results provide further evidence to support the hypothesis that the fetal llama responds to prolonged hypoxaemia with adaptive brain hypometabolism, partly mediated by decreases in Na(+)-K(+)-ATPase activity and expression of NaV channels.

  6. Abnormal vascular function in PR-interval prolongation.

    Chan, Yap-Hang; Siu, Chung-Wah; Yiu, Kai-Hang; Li, Sheung-Wai; Lau, Kui-Kai; Lam, Tai-Hing; Lau, Chu-Pak; Tse, Hung-Fat


    Underlying mechanisms of PR-interval prolongation leading to increased risk of adverse cardiovascular outcomes, including atrial fibrillation, are unclear. This study aims to investigate the relation between PR interval and changes in vascular function. We hypothesize that there exists an intermediate pathological stage between electrocardiographic PR prolongation and adverse cardiovascular outcomes, which could be reflected by changes in surrogate measurements of vascular function. We recruited 88 healthy subjects (mean age 57.5 ± 9.8 y, 46% male) from a community-based health screening program who had no history of cardiovascular disease or diabetes mellitus. PR interval was determined from a resting 12-lead electrocardiogram. Vascular function was noninvasively assessed by flow-mediated dilation (FMD) using high-resolution ultrasound and brachial-ankle pulse wave velocity (PWV) using a vascular profiling system. Only 3 subjects had a PR-interval length longer than the conventional cutoff of 200 ms. The PR-interval length was associated inversely with FMD (Pearson r = -0.30, P = 0.004) and positively with PWV (r = 0.40, P PR-interval length by each 25 ms was independently associated with reduced FMD by -1 unit (absolute %, B = -0.04 [95% confidence interval: -0.080 to -0.002, P = 0.040)] and increased PWV by +103 cm/second (B = +4.1 [95% confidence interval: 0.6-7.6, P = 0.023]). This study shows that PR-interval length, even in the conventionally normal range, is independently associated with endothelial dysfunction and increased arterial stiffness in healthy subjects free of atherosclerotic disease. This suggests the presence of a systemic, intermediate pathologic stage of the vasculature in PR prolongation before clinically manifest cardiovascular events, and could represent a mediating mechanism. © 2011 Wiley Periodicals, Inc.

  7. Teaching Empirical Software Engineering Using Expert Teams

    Kuhrmann, Marco

    Empirical software engineering aims at making software engineering claims measurable, i.e., to analyze and understand phenomena in software engineering and to evaluate software engineering approaches and solutions. Due to the involvement of humans and the multitude of fields for which software...... is crucial, software engineering is considered hard to teach. Yet, empirical software engineering increases this difficulty by adding the scientific method as extra dimension. In this paper, we present a Master-level course on empirical software engineering in which different empirical instruments...

  8. Visual impact in the digital press: a Spanish empirical research

    Joan Francesc Fondevila Gascón


    Full Text Available Visual resource (photography and video inclusion in digital journalism is obtaining importance in the multimedia area. The principal resources of digital press are multimedia, hypertext and interactivity. Multimedia is in an initial process of evolution. The objective of this research is to observe empirically the use of visual resources by the digital pure player press. These media try to take advantage of the new multimedia possibilities in the development and presentation of the contents. We have analyzed empirically video and photography inclusion in the multimedia framework (text, photography, video, audio, infograph and animation programs in four digital newspapers (Libertad Digital and El Plural, in Spanish, and and e-Noticies, in Catalan analyzed according to journalistic genres.

  9. VISUAL IMPACT IN THE DIGITAL PRESS: a spanish empirical research

    Joan Francesc Fondevila Gascón


    Full Text Available Visual resource (photography and video inclusion in digitaljournalism is obtaining importance in the multimedia area. Theprincipal resources of digital press are multimedia, hypertextand interactivity. Multimedia is in an initial process of evolution.The objective of this research is to observe empirically the useof visual resources by the digital pure player press. Thesemedia try to take advantage of the new multimedia possibilitiesin the development and presentation of the contents. We haveanalyzed empirically video and photography inclusion inthe multimedia framework (text, photography, video, audio,infograph and animation programs in four digital newspapers(Libertad Digital and El Plural, in Spanish, and ande-Noticies, in Catalan analyzed according to journalistic genres.

  10. Responsible research and innovation: A manifesto for empirical ethics?

    Gardner, John; Williams, Clare


    In 2013 the Nuffield Council on Bioethics launched their report Novel Neurotechnologies: Intervening in the Brain. The report, which adopts the European Commission's notion of Responsible Research and Innovation, puts forward a set of priorities to guide ethical research into, and the development of, new therapeutic neurotechnologies. In this paper, we critically engage with these priorities. We argue that the Nuffield Council's priorities, and the Responsible Research and Innovation initiative as a whole, are laudable and should guide research and innovation in all areas of healthcare. However, we argue that operationalising Responsible Research and Innovation requires an in-depth understanding of the research and clinical contexts. Providing such an understanding is an important task for empirical ethics. Drawing on examples from sociology, science and technology studies, and related disciplines, we propose four avenues of social science research which can provide such an understanding. We suggest that these avenues can provide a manifesto for empirical ethics.

  11. Interleukin-6 release from the human brain during prolonged exercise

    Nybo, Lars; Nielsen, Bodil; Pedersen, Bente Klarlund


    Interleukin (IL)-6 is a pleiotropic cytokine, which has a variety of physiological roles including functions within the central nervous system. Circulating IL-6 increases markedly during exercise, partly due to the release of IL-6 from the contracting skeletal muscles, and exercise-induced IL-6 may...... influence of hyperthermia. In conclusion, IL-6 is released from the brain during prolonged exercise in humans and it appears that the duration of the exercise rather than the increase in body temperature dictates the cerebral IL-6 response....

  12. Nanomodified natural zeolite as a fertilizer of prolonged activity

    G. Tsintskaladze


    Full Text Available Natural zeolites of sedimentary origin are widely used in agriculture both as individual fertilizer and a mix of mineral and organic fertilizers. Natural zeolites are crystalline nanoporous hydrated aluminosilicates. Fertilizer of prolonged activity enriched with macro- and microelements is obtained by fusing zeolite with dehydrated ammonium using nanotechnological method of modification. The structure and some physical and chemical properties of a novel nanomaterial were studied by the methods of X-ray diffraction, IR-spectroscopy, absorption and thermal analysis. It was shown that the obtained fertilizer may be used in both protected and open grounds.

  13. Hemiplegic Migraine Presenting with Prolonged Somnolence: A Case Report.

    Saleh, Christian; Pierquin, Geneviève; Beyenburg, Stefan


    Hemiplegic migraine is a rare and complex disease, characterized by migraine with a reversible motor aura. Hemiplegic migraine can be easily misdiagnosed at its first presentation with an atypical severe form of migraine, a stroke, multiple sclerosis, metabolic disorders, conversion disorder or an epilepsy. We present the case of a young 24-year-old male patient, who since the age of 4 years had been having multiple episodes of migraine associated with hemiparesis, paraesthesia, prolonged somnolence, aphasia and confusion. We review the literature and discuss important diagnostic findings in hemiplegic migraine to help establishing a prompt diagnosis.

  14. Hemiplegic Migraine Presenting with Prolonged Somnolence: A Case Report

    Christian Saleh


    Full Text Available Hemiplegic migraine is a rare and complex disease, characterized by migraine with a reversible motor aura. Hemiplegic migraine can be easily misdiagnosed at its first presentation with an atypical severe form of migraine, a stroke, multiple sclerosis, metabolic disorders, conversion disorder or an epilepsy. We present the case of a young 24-year-old male patient, who since the age of 4 years had been having multiple episodes of migraine associated with hemiparesis, paraesthesia, prolonged somnolence, aphasia and confusion. We review the literature and discuss important diagnostic findings in hemiplegic migraine to help establishing a prompt diagnosis.

  15. Hemiplegic Migraine Presenting with Prolonged Somnolence: A Case Report

    Saleh, Christian; Pierquin, Geneviève; Beyenburg, Stefan


    Hemiplegic migraine is a rare and complex disease, characterized by migraine with a reversible motor aura. Hemiplegic migraine can be easily misdiagnosed at its first presentation with an atypical severe form of migraine, a stroke, multiple sclerosis, metabolic disorders, conversion disorder or an epilepsy. We present the case of a young 24-year-old male patient, who since the age of 4 years had been having multiple episodes of migraine associated with hemiparesis, paraesthesia, prolonged somnolence, aphasia and confusion. We review the literature and discuss important diagnostic findings in hemiplegic migraine to help establishing a prompt diagnosis. PMID:27790126

  16. How long would SDH/SONET be prolonged?

    Tao, Zhiyong; Mao, Qian


    As we all know, the increasing speed of data traffic is exceeding gradually from voice in today"s communication network. The main reason is the explosive of Internet. The controversy with IP over ATM/SDH/Optical becomes hotter and hotter, Many people in the telecommunication field are doubt: HOW LONG WOULD SDH/SONET BE PROLONGED? WHAT KIND OF SDH EQUIPMENTS COULD BE USED IN THE NETWORK? With the analysis from several aspects: services in the network, new development with SDH technology, market in transport equipment, This paper is considered that the SDH with some new features would be predominant transport technology in the recent years.

  17. Response of grassland ecosystems to prolonged soil moisture deficit

    Ross, Morgan A.; Ponce-Campos, Guillermo E.; Barnes, Mallory L.; Hottenstein, John D.; Moran, M. Susan


    Soil moisture is commonly used for predictions of plant response and productivity. Climate change is predicted to cause an increase in the frequency and duration of droughts over the next century, which will result in prolonged periods of below-normal soil moisture. This, in turn, is expected to impact regional plant production, erosion and air quality. In fact, the number of consecutive months of soil moisture content below the drought-period mean has recently been linked to regional tree and shrub mortality in the southwest United States. This study investigated the effects of extended periods of below average soil moisture on the response of grassland ANPP to precipitation. Grassland ecosystems were selected for this study because of their ecological sensitivity to precipitation patterns. It has been postulated that the quick ecological response of grasslands to droughts can provide insight to large scale functional responses of regions to predicted climate change. The study sites included 21 grassland biomes throughout arid-to-humid climates in the United States with continuous surface soil moisture records for 2-13 years during the drought period from 2000-2013. Annual net primary production (ANPP) was estimated from the 13-year record of NASA MODIS Enhanced Vegetation Index extracted for each site. Prolonged soil moisture deficit was defined as a period of at least 10 consecutive months during which soil moisture was below the drought-period mean. ANPP was monitored before, during and after prolonged soil moisture deficit to quantify shifts in the functional response of grasslands to precipitation, and in some cases, new species assemblages that included invasive species. Preliminary results indicated that when altered climatic conditions on grasslands led to an increase in the duration of soil water deficit, then the precipitation-to-ANPP relation became non-linear. Non-linearity was associated with extreme grassland dieback and changes in the historic

  18. Extracorporeal Free Flap Perfusion in Case of Prolonged Ischemia Time

    Taeger, C. D.; Präbst, K; Beier, J P; Meyer, A; Horch, R E


    Summary: In free flap surgery, a clinically established concept still has to be found for the reduction of ischemia-related cell damage in the case of prolonged ischemia. Although promising results using extracorporeal free flap perfusion in the laboratory have been published in the past, until now this concept has not yet paved its way into clinical routine. This might be due to the complexity of perfusion systems and a lack of standardized tools. Here, we want to present the results of the ...


    Bronfenbrenner, J; Favour, C B


    (1) Restriction of fluid intake to 1,500 cc and the salt intake to 3 gm a day doubles the penicillin blood level following interrupted intramuscular [See Figure in the PDF file] injections of penicillin. (2) The administration of benzoic acid to a patient on an unrestricted diet Ilay double the penicillin blood level during similar treatment. (3) The combination of these two procedures results in a four- to eight-fold increase in penicillin blood level with a prolonged effective blood concentration.

  20. Hospital Board Oversight of Quality and Patient Safety: A Narrative Review and Synthesis of Recent Empirical Research



    .... National directives and initiatives emphasize the importance of action by boards, but the empirical basis for informing effective hospital board oversight has yet to receive full and careful review. Methods...

  1. Influence of body temperature on the development of fatigue during prolonged exercise in the heat

    Hyldig, Tino Hoffmann


    We investigated whether fatigue during prolonged exercise in uncompensable hot environments occurred at the same critical level of hyperthermia when the initial value and the rate of increase in body temperature are altered. To examine the effect of initial body temperature [esophageal temperature...... (Tes) = 35.9 ± 0.2, 37.4 ± 0.1, or 38.2 ± 0.1 (SE) °C induced by 30 min of water immersion], seven cyclists (maximal O2 uptake = 5.1 ± 0.1 l/min) performed three randomly assigned bouts of cycle ergometer exercise (60% maximal O2 uptake) in the heat (40°C) until volitional exhaustion. To determine...... the influence of rate of heat storage (0.10 vs. 0.05°C/min induced by a water-perfused jacket), four cyclists performed two additional exercise bouts, starting with Tes of 37.0°C. Despite different initial temperatures, all subjects fatigued at an identical level of hyperthermia (Tes = 40.1-40.2°C, muscle...

  2. Transient impairments in single muscle fibre contractile function after prolonged cycling in elite endurance athletes

    Hvid, L G; Gejl, Kasper Degn; Bech, R D


    Prolonged muscle activity impairs whole-muscle performance and function. However, little is known about the effects of prolonged muscle activity on the contractile function of human single muscle fibres. The purpose of this study was to investigate the effects of prolonged exercise and subsequent...... recovery on the contractile function of single muscle fibres obtained from elite athletes....


    Galimberti R


    Full Text Available SUMMARYSecondary hyperparathyroidism is one of the main deragements caused by chronic renal failure, and parathyroid hormone is considered one of the toxins of the uremic syndrome. Prolonged fever due to primary hyperparathyroidism have already been described in the literature but not yet as induced by secondary hyperparathyroidism. In this case report a patient suffering from an erythema nodosum and prolonged fever associated to secondary hyperparathyroidism that disappeared through subtotal parathyroidectomy is presented.RESUMENEl hiperparatiroidismo secundario es uno de los principales disturbios causados por la insuficiencia renal crónica, y la paratohormona es considerada una de las toxinas del sindrome urémico. El sindrome febril prolongado secundario a hiperparatiroidismo primario ya ha sido descripto en la literatura, aunque no lo ha sido aun el inducido por hiperparatiroidismo secundario. En el presente reporte se presenta un caso de eritema nodoso y sindrome febril prolongado asociado a hiperparatiroidismo secundario y que resolvió luego de efectuada una paratiroidectomía subtotal.

  4. Prolonged fasting impairs neural reactivity to visual stimulation.

    Kohn, N; Wassenberg, A; Toygar, T; Kellermann, T; Weidenfeld, C; Berthold-Losleben, M; Chechko, N; Orfanos, S; Vocke, S; Laoutidis, Z G; Schneider, F; Karges, W; Habel, U


    Previous literature has shown that hypoglycemia influences the intensity of the BOLD signal. A similar but smaller effect may also be elicited by low normal blood glucose levels in healthy individuals. This may not only confound the BOLD signal measured in fMRI, but also more generally interact with cognitive processing, and thus indirectly influence fMRI results. Here we show in a placebo-controlled, crossover, double-blind study on 40 healthy subjects, that overnight fasting and low normal levels of glucose contrasted to an activated, elevated glucose condition have an impact on brain activation during basal visual stimulation. Additionally, functional connectivity of the visual cortex shows a strengthened association with higher-order attention-related brain areas in an elevated blood glucose condition compared to the fasting condition. In a fasting state visual brain areas show stronger coupling to the inferior temporal gyrus. Results demonstrate that prolonged overnight fasting leads to a diminished BOLD signal in higher-order occipital processing areas when compared to an elevated blood glucose condition. Additionally, functional connectivity patterns underscore the modulatory influence of fasting on visual brain networks. Patterns of brain activation and functional connectivity associated with a broad range of attentional processes are affected by maturation and aging and associated with psychiatric disease and intoxication. Thus, we conclude that prolonged fasting may decrease fMRI design sensitivity in any task involving attentional processes when fasting status or blood glucose is not controlled.

  5. Cellular mechanism of the QT prolongation induced by sulpiride.

    Lee, Hyang-Ae; Kim, Ki-Suk; Park, Sang-Joon; Kim, Eun-Joo


    In this study, the authors investigated the electrophysiological effect of sulpiride on cardiac repolarization using conventional microelectrode recording techniques in isolated canine Purkinje fibers and a whole-cell patch clamp technique in transiently transfected cells with the hERG, KCNQ1/KCNE1, KCNJ2, and SCN5A cDNA and in rat cardiac myocytes for I(Ca). In studies of action potential duration, 10 microM, 100 microM, 300 microM, and 1 mM sulpiride prolonged action potential duration in a concentration-dependent manner. In studies of cardiac ion channels, sulpiride did not significantly affect I(Na), I(Ca), I(Ks), I(K1), except for I(Kr). Sulpiride dose-dependently decreased the hERG tail current. It is considered that the prolonged action potential duration by sulpiride was mainly the result of inhibition of the hERG channel. The data suggest that the clinical use of sulpiride is reasonable within therapeutic plasma concentrations, but all patients taking this drug should be cautiously monitored for clinical signs of long-QT syndrome and severe arrhythmia.

  6. Moderate superficial hypothermia prolongs bleeding time in humans.

    Romlin, B; Petruson, K; Nilsson, K


    In vitro and in vivo studies have shown that mild systemic hypothermia influences platelet adhesion and aggregation and coagulation reactions. We wanted to test the hypothesis that mild local hypothermia in healthy volunteers with preserved core temperature increased bleeding time. A secondary aim was to evaluate if local cooling influenced whole blood coagulation measured by thrombelastograph (TEG) in the same setting. Bleeding time was measured at the left volar forearm at a baseline skin temperature of 32 degrees C and after cooling to 30 degrees C and 28 degrees C in a water bath. Skin temperature was continuously measured by contact thermistors. Measurements of coagulation by TEG were performed at baseline skin temperature before cooling and after cooling to 28 degrees C skin temperature. Tympanic membrane temperature was continuously measured. Compared with baseline, bleeding time was significantly prolonged at 30 degrees C skin temperature and further prolonged at 28 degrees C skin temperature. No significant differences were measured in any of the TEG parameters. During the procedure, tympanic membrane temperature did not change. Lowering the skin temperature from 32 degrees C to 30 degrees C and 28 degrees C with a preserved core temperature more than doubled the bleeding time. Whole blood coagulation measured by TEG was not influenced by the local cooling. In addition to core temperature, local temperature may offer information in understanding the surgical site of bleeding.

  7. High efficiency holographic Bragg grating with optically prolonged memory

    Khoo, Iam Choon; Chen, Chun-Wei; Ho, Tsung-Jui


    In this paper, we show that photosensitive azo-dye doped Blue-phase liquid crystals (BPLC) formed by natural molecular self-assembly are capable of high diffraction efficiency holographic recording with memory that can be prolonged from few seconds to several minutes by uniform illumination with the reference beam. Operating in the Bragg regime, we have observed 50 times improvement in the grating diffraction efficiency and shorter recording time compared to previous investigations. The enabling mechanism is BPLC’s lattice distortion and index modulation caused by the action of light on the azo-dopant; upon photo-excitation, the azo-molecules undergo transformation from the oblong-shaped Trans-state to the bent-shaped Cis-state, imparting disorder and also cause the surrounding BPLC molecules to undergo coupled flow & reorientation leading to lattice distortion and index modulation. We also showed that the same mechanism at work here that facilitates lattice distortion can be used to frustrate free relaxation of the lattice distortion, thereby prolonging the lifetime of the written grating, provided the reference beam is kept on after recording. Due to the ease in BPLC fabrication and the availability of azo-dopants with photosensitivity throughout the entire visible spectrum, one can optimize the controlling material and optical parameters to obtain even better performance.

  8. Effect of Multiparity and Prolonged Lactation on Bone Mineral Density

    Natung, Tanie; Barooah, Rituparna; Ahanthem, Santa Singh


    Objectives This study was done to determine the effect of multiparity and prolonged lactation on bone mineral density (BMD). Methods This cross-sectional study included 196 perimenopausal and postmenopausal women aged 40 to 60 years old. Age, body mass index (BMI), menopausal status, duration of menopause, parity and total duration of lactation, nutritional history were recorded. Lumbar spine (LS; L2-L4) and femur neck (FN) BMD were measured using dual energy X-ray absorptiometry. Correlation of parity and lactation with BMD were investigated using multiple regression analysis. Results Parity was inversely correlated to BMD for LS (β = −0.266, P = 0.001) and FN (β = −0.380, P = 0.000). This relation remained significant even after adjusting for age, BMI and duration of menopause. Duration of lactation was inversely correlated with BMD for LS (β = −0.271, P = 0.001) but no for FN (β = −0.124, P = 0.130). Conclusions Multiparity and prolonged lactation have negative impact on BMD especially with in a socioeconomic group whose nutritional intake is borderline. Our data support that parity and duration of lactation can be associated with future osteoporosis. PMID:28119896

  9. Prolongation Structure Analysis of a Coupled Dispersionless System

    Souleymanou Abbagari; Bouetou Bouetou Thomas; Kuetche Kamgang Victor; Mouna Ferdinand; Timoleon Crepin Kofane


    We address the problem of integrability of a coupled dispersionless system recently introduced by Zhaqilao, Zhao and Li [Chin. Phys. B 18 (2009) 1780] which physically describes the propagation of electromagnetic fields within an optical nonlinear medium, but also arrives in the physical description of a charged object dynamics in an external magnetic field. Following the prolongation structure analysis developed by Wahlquist and Estabrook, we derive a more general form of Lax pairs of the previous coupled dispersionless system and its concrete nonAbelian Lie algebra resorting to a hidden symmetry. Also, we construct the B(a)cklund transformation of the system using the Riccati form of the linear eigenvalue problem.%@@ We address the problem of integrability of a coupled dispersionless system recently introduced by Zhaqilao, Zhao and Li [Chin.Phys.B 18(2009) 1780] which physically describes the propagation of electromagnetic fields within an optical nonlinear medium, but also arrives in the physical description of a charged object dynamics in an external magnetic field.Following the prolongation structure analysis developed by Wahlquist and Estabrook, we derive a more general form of Lax pairs of the previous coupled dispersionless system and its concrete non-Abelian Lie algebra resorting to a hidden symmetry.Also, we construct the Backlund transformation of the system using the Riccati form of the linear eigenvalue problem.

  10. The effects of a prolonged running exercise on strength characteristics.

    Lepers, R; Pousson, M L; Maffiuletti, N A; Martin, A; Van Hoecke, J


    The aim of this study was to examine concentric, isometric, and eccentric strength reductions in the quadriceps muscle following a prolonged running exercise. Before and after a 2 h run (28.4+/-1.4 km) peak torque (PT) of the knee extensors at angular velocities of -120, -90, -60, 0, 60, 120, 180, 240 degrees x s(-1) using an isokinetic dynamometer, electromyographic (EMG) activity of the vastus lateralis (VL) and vastus medialis (VM) muscles and height of a counter movement jump were recorded in twelve well-trained triathletes. Counter movement jump performances decreased by 10% and PT values were all significantly lower (p run. The torque loss was significantly (p activity (RMS) was lower in both VL and VM muscles after the 2 h run but no difference existed in RMS losses between concentric and eccentric contractions. The present results demonstrate that 1) a prolonged running exercise more greatly affects eccentric force production in the quadriceps muscle, and 2) this specificity seems to be due to an impairment of the muscular contractile mechanism rather than a modification to the neural input.

  11. Prolonged Paroxysmal Sympathetic Storming Associated with Spontaneous Subarachnoid Hemorrhage

    Yan Liu


    Full Text Available Paroxysmal sympathetic storming (PSS is a rare disorder characterized by acute onset of nonstimulated tachycardia, hypertension, tachypnea, hyperthermia, external posturing, and diaphoresis. It is most frequently associated with severe traumatic brain injuries and has been reported in intracranial tumors, hydrocephalous, severe hypoxic brain injury, and intracerebral hemorrhage. Although excessive release of catecholamine and therefore increased sympathetic activities have been reported in subarachnoid hemorrhage (SAH, there is no descriptive report of PSS primarily caused by spontaneous SAH up to date. Here, we report a case of prolonged PSS in a patient with spontaneous subarachnoid hemorrhage and consequent vasospasm. The sympathetic storming started shortly after patient was rewarmed from hypothermia protocol and symptoms responded to Labetalol, but intermittent recurrence did not resolve until 3 weeks later with treatment involving Midazolam, Fentanyl, Dexmedetomidine, Propofol, Bromocriptine, and minimizing frequency of neurological and vital checks. In conclusion, prolonged sympathetic storming can also be caused by spontaneous SAH. In this case, vasospasm might be a precipitating factor. Paralytics and hypothermia could mask the manifestations of PSS. The treatment of the refractory case will need both timely adjustment of medications and minimization of exogenous stressors or stimuli.

  12. Influence of a Prolonged Tennis Match Play on Serve Biomechanics.

    Martin, Caroline; Bideau, Benoit; Delamarche, Paul; Kulpa, Richard


    The aim of this study was to quantify kinematic, kinetic and performance changes that occur in the serve throughout a prolonged tennis match play. Serves of eight male advanced tennis players were recorded with a motion capture system before, at mid-match, and after a 3-hour tennis match. Before and after each match, electromyographic data of 8 upper limb muscles obtained during isometric maximal voluntary contraction were compared to determine the presence of muscular fatigue. Vertical ground reaction forces, rating of perceived exertion, ball speed, and ball impact height were measured. Kinematic and upper limb kinetic variables were computed. The results show decrease in mean power frequency values for several upper limb muscles that is an indicator of local muscular fatigue. Decreases in serve ball speed, ball impact height, maximal angular velocities and an increase in rating of perceived exertion were also observed between the beginning and the end of the match. With fatigue, the majority of the upper limb joint kinetics decreases at the end of the match. No change in timing of maximal angular velocities was observed between the beginning and the end of the match. A prolonged tennis match play may induce fatigue in upper limb muscles, which decrease performance and cause changes in serve maximal angular velocities and joint kinetics. The consistency in timing of maximal angular velocities suggests that advanced tennis players are able to maintain the temporal pattern of their serve technique, in spite of the muscular fatigue development.

  13. Risk Factors for Prolonged Treatment of Whiplash-Associated Disorders.

    Hiroyuki Oka

    Full Text Available Whiplash-associated disorders (WAD are the most common injuries that are associated with car collisions in Japan and many Western countries. However, there is no clear evidence regarding the potential risk factors for poor recovery from WAD. Therefore, we used an online survey of the Japanese population to examine the association between potential risk factors and the persistence of symptoms in individuals with WAD.An online survey was completed by 127,956 participants, including 4,164 participants who had been involved in a traffic collision. A random sample of the collision participants (n = 1,698 were provided with a secondary questionnaire. From among the 974 (57.4% respondents to the secondary questionnaire, we selected 183 cases (intractable neck pain that was treated over a period of 6 months and 333 controls (minor neck pain that was treated within 3 months. Multivariable logistic regression analysis was used to evaluate the potential risk factors for prolonged treatment of WAD.Female sex, the severity of the collision, poor expectations of recovery, victim mentality, dizziness, numbness or pain in the arms, and lower back pain were associated with a poor recovery from WAD.In the present study, the baseline symptoms (dizziness, numbness or pain in the arms, and lower back pain had the strongest associations with prolonged treatment for WAD, although the psychological and behavioral factors were also important. These risk factors should be considered when evaluating patients who may have the potential for poor outcomes.

  14. Survival without sequelae after prolonged cardiopulmonary resuscitation after electric shock.

    Motawea, Mohamad; Al-Kenany, Al-Sayed; Hosny, Mostafa; Aglan, Omar; Samy, Mohamad; Al-Abd, Mohamed


    "Electrical shock is the physiological reaction or injury caused by electric current passing through the human body. It occurs upon contact of a human body part with any source of electricity that causes a sufficient current through the skin, muscles, or hair causing undesirable effects ranging from simple burns to death." Ventricular fibrillation is believed to be the most common cause of death after electrical shock. "The ideal duration of cardiac resuscitation is unknown. Typically prolonged cardiopulmonary resuscitation is associated with poor neurologic outcomes and reduced long term survival. No consensus statement has been made and traditionally efforts are usually terminated after 15-30 minutes." The case under discussion seems worthy of the somewhat detailed description given. It is for a young man who survived after 65 minutes after electrical shock (ES) after prolonged high-quality cardiopulmonary resuscitation (CPR), multiple defibrillations, and artificial ventilation without any sequelae. Early start of adequate chest compressions and close adherence to advanced cardiac life support protocols played a vital role in successful CPR.

  15. Cyclodextrin modified PLLA parietal reinforcement implant with prolonged antibacterial activity.

    Vermet, G; Degoutin, S; Chai, F; Maton, M; Flores, C; Neut, C; Danjou, P E; Martel, B; Blanchemain, N


    The use of textile meshes in hernia repair is widespread in visceral surgery. Though, mesh infection is a complication that may prolong the patient recovery period and consequently presents an impact on public health economy. Such concern can be avoided thanks to a local and extended antibiotic release on the operative site. In recent developments, poly-l-lactic acid (PLLA) has been used in complement of polyethyleneterephthalate (Dacron®) (PET) or polypropylene (PP) yarns in the manufacture of semi-resorbable parietal implants. The goal of the present study consisted in assigning drug reservoir properties and prolonged antibacterial effect to a 100% PLLA knit through its functionalization with a cyclodextrin polymer (polyCD) and activation with ciprofloxacin. The study focused i) on the control of degree of polyCD functionalization of the PLLA support and on its physical and biological characterization by Scanning Electron Microscopy (SEM), Differential Scanning Calorimetry (DSC) and cell viability, ii) on the understanding of drug/meshes interaction using mathematic model and iii) on the correlation between drug release studies in phosphate buffer saline (PBS) and microbiological evaluation of meshes and release medium against E. coli and S. aureus. All above mentioned tests highlighted the contribution of polyCD on the improved performances of the resulting antibacterial implantable material.

  16. [An encyclopedia for the empire].

    Stöltzner, Michael


    In the preface to the universal encyclopedia Die Kultur der Gegenwart (The Culture of the Present), the editor-in-chief Paul Hinneberg places his project--not openly but nevertheless unequivocally--in the tradition of the French Encyclopédie that Diderot and d'Alembert had organized from 1751 until 1765. The attempt to accomplish anew such a large-scale project and, in this way, to win the German Empire the kind of intellectual leadership which the Encyclopédie, in historical retrospect, had achieved for the epoch of Enlightenment, required to convince the leading scholars, scientists, and technicians of the nation to participate in the endeavor and to assemble their contributions under a common systematic agenda through which this universal encyclopedia would distinguish itself from all dictionaries and disciplinary encyclopedias. While the Encyclopédie followed to a large extent an empiricist philosophy, Hinneberg trusted in the integrative function of the concept of culture and the ability of his contributors to elucidate the history of their respective disciplines and to connect them with neighboring fields of culture. The present contributions argues that although, from a philosophical point of view, the historicist tack taken by Hinneberg makes the concept of culture quite blurry, it nevertheless provides enough cohesive structure such that the work, even though unfinished as a consequence of war and inflation, represents a faithful picture of its epoch that Hinneberg understands as an epoch of transition.

  17. The Problem of Empirical Redundancy of Constructs in Organizational Research: An Empirical Investigation

    Le, Huy; Schmidt, Frank L.; Harter, James K.; Lauver, Kristy J.


    Construct empirical redundancy may be a major problem in organizational research today. In this paper, we explain and empirically illustrate a method for investigating this potential problem. We applied the method to examine the empirical redundancy of job satisfaction (JS) and organizational commitment (OC), two well-established organizational…

  18. The Problem of Empirical Redundancy of Constructs in Organizational Research: An Empirical Investigation

    Le, Huy; Schmidt, Frank L.; Harter, James K.; Lauver, Kristy J.


    Construct empirical redundancy may be a major problem in organizational research today. In this paper, we explain and empirically illustrate a method for investigating this potential problem. We applied the method to examine the empirical redundancy of job satisfaction (JS) and organizational commitment (OC), two well-established organizational…

  19. Europe after Empire: Decolonization, Society, and Culture

    Buettner, E.


    Europe after Empire is a pioneering comparative history of European decolonization from the formal ending of empires to the postcolonial European present. Elizabeth Buettner charts the long-term development of post-war decolonization processes as well as the histories of inward and return migration

  20. Empirical Moral Philosophy and Teacher Education

    Schjetne, Espen; Afdal, Hilde Wågsås; Anker, Trine; Johannesen, Nina; Afdal, Geir


    In this paper, we explore the possible contributions of empirical moral philosophy to professional ethics in teacher education. We argue that it is both possible and desirable to connect knowledge of how teachers empirically do and understand professional ethics with normative theories of teachers' professional ethics. Our argument is made in…

  1. The dangers of non-empirical confirmation

    Rovelli, Carlo


    In the book "String Theory and the Scientific Method", Richard Dawid describes a few of the many non-empirical arguments that motivate theoretical physicists' confidence in a theory, taking string theory as case study. I argue that excessive reliance on non-empirical evidence compromises the reliability of science, and that precisely the case of string theory well illustrates this danger.

  2. Empirical Moral Philosophy and Teacher Education

    Schjetne, Espen; Afdal, Hilde Wågsås; Anker, Trine; Johannesen, Nina; Afdal, Geir


    In this paper, we explore the possible contributions of empirical moral philosophy to professional ethics in teacher education. We argue that it is both possible and desirable to connect knowledge of how teachers empirically do and understand professional ethics with normative theories of teachers' professional ethics. Our argument is made in…

  3. Rates and risks for prolonged grief disorder in a sample of orphaned and widowed genocide survivors

    Jacob Nadja


    Full Text Available Abstract Background The concept of Prolonged Grief Disorder (PGD has been defined in recent years by Prigerson and co-workers, who have developed and empirically tested consensus and diagnostic criteria for PGD. Using these most recent criteria defining PGD, the aim of this study was to determine rates of and risks for PGD in survivors of the 1994 Rwandan genocide who had lost a parent and/or the husband before, during or after the 1994 events. Methods The PG-13 was administered to 206 orphans or half orphans and to 194 widows. A regression analysis was carried out to examine risk factors of PGD. Results 8.0% (n = 32 of the sample met criteria for PGD with an average of 12 years post-loss. All but one person had faced multiple losses and the majority indicated that their grief-related loss was due to violent death (70%. Grief was predicted mainly by time since the loss, by the violent nature of the loss, the severity of symptoms of posttraumatic stress disorder (PTSD and the importance given to religious/spiritual beliefs. By contrast, gender, age at the time of bereavement, bereavement status (widow versus orphan, the number of different types of losses reported and participation in the funeral ceremony did not impact the severity of prolonged grief reactions. Conclusions A significant portion of the interviewed sample continues to experience grief over interpersonal losses and unresolved grief may endure over time if not addressed by clinical intervention. Severity of grief reactions may be associated with a set of distinct risk factors. Subjects who lose someone through violent death seem to be at special risk as they have to deal with the loss experience as such and the traumatic aspects of the loss. Symptoms of PTSD may hinder the completion of the mourning process. Religious beliefs may facilitate the mourning process and help to find meaning in the loss. These aspects need to be considered in the treatment of PGD.

  4. POET: Parameterized Optimization for Empirical Tuning

    Yi, Q; Seymour, K; You, H; Vuduc, R; Quinlan, D


    The excessive complexity of both machine architectures and applications have made it difficult for compilers to statically model and predict application behavior. This observation motivates the recent interest in performance tuning using empirical techniques. We present a new embedded scripting language, POET (Parameterized Optimization for Empirical Tuning), for parameterizing complex code transformations so that they can be empirically tuned. The POET language aims to significantly improve the generality, flexibility, and efficiency of existing empirical tuning systems. We have used the language to parameterize and to empirically tune three loop optimizations-interchange, blocking, and unrolling-for two linear algebra kernels. We show experimentally that the time required to tune these optimizations using POET, which does not require any program analysis, is significantly shorter than that when using a full compiler-based source-code optimizer which performs sophisticated program analysis and optimizations.

  5. Negative impact of prolonged cold storage time before machine perfusion preservation in donation after circulatory death kidney transplantation.

    Paloyo, Siegfredo; Sageshima, Junichiro; Gaynor, Jeffrey J; Chen, Linda; Ciancio, Gaetano; Burke, George W


    Kidney grafts are often preserved initially in static cold storage (CS) and subsequently on hypothermic machine perfusion (MP). However, the impact of CS/MP time on transplant outcome remains unclear. We evaluated the effect of prolonged CS/MP time in a single-center retrospective cohort of 59 donation after circulatory death (DCD) and 177 matched donation after brain death (DBD) kidney-alone transplant recipients. With mean overall CS/MP times of 6.0 h/30.0 h, overall incidence of delayed graft function (DGF) was higher in DCD transplants (30.5%) than DBD transplants (7.3%, P time (P = 0.0002), male recipient (P = 0.02), and longer MP time (P = 0.08) were associated with higher DGF incidence. In evaluating the joint effects of donor type (DBD vs. DCD), CS time (time (time ≥36 h (P = 0.003) across each donor type and CS time stratum, whereas the unfavorable effect of CS time ≥6 h (P = 0.01) is primarily seen among DCD recipients. Prolonged cold ischemia time had no unfavorable effect on renal function or graft survival at 12mo post-transplant. Long CS/MP time detrimentally affects early DCD/DBD kidney transplant outcome when grafts were mainly preserved by MP; prolonged CS time before MP has a particularly negative impact in DCD kidney transplantation.

  6. Aspects of Decision-Making for Risk Reduction during the Prolonged Earthquake Sequence in Canterbury, New Zealand

    Wein, A. M.; Potter, S.; Becker, J.; Ratliff, J. L.; Hudson-Doyle, E.


    An earthquake sequence is a prolonged natural hazard event. Scientists can dynamically forecast aftershock frequency within bounds of uncertainty. We examine how this capability can be used in decision-making to reduce risk during a period of heightened seismicity. We draw from experience of the Canterbury earthquake sequence initiated by a magnitude 7.1 mainshock on September 4, 2010 near the city of Christchurch, a population of 370,000. The sequence impacted the built, economic, social and natural environments of the Canterbury region. We study the use of aftershock forecasts in decision-making across the roles of policy makers, emergency managers and responders, critical infrastructure providers, insurers, communication officers, scientists, and the public. We held focus groups and interviews involving 53 participants using a semi-structured message centered approach in May and June of 2013. Transcripts from the focus groups and interviews were thematically coded using qualitative analysis. Responses to a pre-questionnaire suggested that aftershock information for decision-making increases slightly in importance throughout the four phases of a disaster - mitigation, preparedness, response and recovery. We summarize our findings from this research, including the use and barriers to the use of aftershock forecasts in decision-making across the disaster phases by roles conflicts of interest that arise in the decision-making hierarchy challenges with providing and using forecasts during a prolonged event. Finally, we reflect on implications for Operational Earthquake Forecasting and how our findings may be generalized to other prolonged hazards.

  7. Effectiveness of carbohydrate feeding in delaying fatigue during prolonged exercise.

    Coyle, E F; Coggan, A R


    Prolonged exercise in the fasted state frequently results in a lowering of blood glucose concentration, and when the intensity is moderate (i.e. 60-80% of VO2 max), muscle often becomes depleted of glycogen. The extent to which carbohydrate feedings contribute to energy production, and their effectiveness for improving endurance during prolonged exercise, are reviewed in this article. Prolonged exercise (i.e. greater than 2 hours) results in a failure of hepatic glucose output to keep pace with muscle glucose uptake. As a result, blood glucose concentration frequently declines below 2.5 mmol/L. Despite this hypoglycaemia, fewer than 25% of subjects display symptoms suggestive of central nervous system dysfunction. Since fatigue rarely results from hypoglycaemia alone, the effectiveness of carbohydrate feeding should be judged by its potential for muscle glycogen sparing. Carbohydrate feeding during moderate intensity exercise postpones the development of fatigue by approximately 15 to 30 minutes, yet it does not prevent fatigue. This observation agrees with data suggesting that carbohydrate supplementation reduces muscle glycogen depletion. It is not certain whether carbohydrate feeding increases muscle glucose uptake throughout moderate exercise or if glucose uptake is higher only during the latter stages of exercise. In contrast to moderate intensity exercise, carbohydrate feeding during low intensity exercise (i.e. less than 45% of VO2 max) results in hyperinsulinaemia. Consequently, muscle glucose uptake and total carbohydrate oxidation are increased by approximately the same amount. The amount of ingested glucose which is oxidised is greater than the increase in total carbohydrate oxidation and therefore endogenous carbohydrate is spared. The majority of sparing appears to occur in the liver, which is reasonable since muscle glycogen is not utilised to a large extent during mild exercise. Although carbohydrate feedings prevent hypoglycaemia and are readily

  8. Prolonged Temozolomide Maintenance Therapy in Newly Diagnosed Glioblastoma.

    Skardelly, Marco; Dangel, Elena; Gohde, Julia; Noell, Susan; Behling, Felix; Lepski, Guilherme; Borchers, Christian; Koch, Marilin; Schittenhelm, Jens; Bisdas, Sotirios; Naumann, Aline; Paulsen, Frank; Zips, Daniel; von Hehn, Ulrike; Ritz, Rainer; Tatagiba, Marcos Soares; Tabatabai, Ghazaleh


    The impact of prolonging temozolomide (TMZ) maintenance beyond six cycles in newly diagnosed glioblastoma (GBM) remains a topic of discussion. We investigated the effects of prolonged TMZ maintenance on progression-free survival (PFS) and overall survival (OS). In this retrospective single-center cohort study, we included patients with GBM who were treated with radiation therapy with concomitant and adjuvant TMZ. For analysis, patients were considered who either completed six TMZ maintenance cycles (group B), continued with TMZ therapy beyond six cycles (group C), or stopped TMZ maintenance therapy within the first six cycles (group A). Patients with progression during the first six TMZ maintenance cycles were excluded. Clinical data from 107 patients were included for Kaplan-Meier analyses and 102 for Cox regressions. Median PFS times were 8.1 months (95% confidence interval [CI] 6.1-12.4) in group A, 13.7 months (95% CI 10.6-17.5) in group B, and 20.9 months (95% CI 15.2-43.5) in group C. At first progression, response rates of TMZ/lomustine rechallenge were 47% in group B and 13% in group C. Median OS times were 12.7 months (95% CI 10.3-16.8) in group A, 25.2 months (95% CI 17.7-55.5) in group B, and 28.6 months (95% CI 24.4-open) in group C. Nevertheless, multivariate Cox regression for patients in group C compared with group B that accounted for imbalances of other risk factors showed no different relative risk (RR) for OS (RR 0.77, p = .46). Our data do not support a general extension of TMZ maintenance therapy beyond six cycles. The Oncologist 2017;22:570-575 IMPLICATIONS FOR PRACTICE: Radiation therapy with concomitant and adjuvant temozolomide (TMZ) maintenance therapy is still the standard of care in patients below the age of 65 years in newly diagnosed glioblastoma. However, in clinical practice, many centers continue TMZ maintenance therapy beyond six cycles. The impact of this continuation is controversial and has not yet been addressed in

  9. Leading and managing organizational change initiatives

    Peus, Claudia; Frey, Dieter; Gerkhardt, Marit; Fischer, Peter; Traut-Mattausch, Eva


    Although indispensable for long-term economic growth, organizational changes are usually met with resistance. This article draws on psychological theories and empirical evidence to highlight why and under what conditions changes lead to resistance and what likely consequences of resistance are. Furthermore, the article discusses the variables that have been identified as success factors for organizational change initiatives. These include individual difference variables and objective characte...

  10. Leading and managing organizational change initiatives

    Peus, Claudia; Frey, Dieter; Gerkhardt, Marit; Fischer, Peter; Traut-Mattausch, Eva


    Although indispensable for long-term economic growth, organizational changes are usually met with resistance. This article draws on psychological theories and empirical evidence to highlight why and under what conditions changes lead to resistance and what likely consequences of resistance are. Furthermore, the article discusses the variables that have been identified as success factors for organizational change initiatives. These include individual difference variables and objective characte...

  11. Empiric potassium supplementation and increased survival in users of loop diuretics.

    Charles E Leonard

    Full Text Available BACKGROUND: The effectiveness of the clinical strategy of empiric potassium supplementation in reducing the frequency of adverse clinical outcomes in patients receiving loop diuretics is unknown. We sought to examine the association between empiric potassium supplementation and 1 all-cause death and 2 outpatient-originating sudden cardiac death (SD and ventricular arrhythmia (VA among new starters of loop diuretics, stratified on initial loop diuretic dose. METHODS: We conducted a one-to-one propensity score-matched cohort study using 1999-2007 US Medicaid claims from five states. Empiric potassium supplementation was defined as a potassium prescription on the day of or the day after the initial loop diuretic prescription. Death, the primary outcome, was ascertained from the Social Security Administration Death Master File; SD/VA, the secondary outcome, from incident, first-listed emergency department or principal inpatient SD/VA discharge diagnoses (positive predictive value = 85%. RESULTS: We identified 654,060 persons who met eligibility criteria and initiated therapy with a loop diuretic, 27% of whom received empiric potassium supplementation (N = 179,436 and 73% of whom did not (N = 474,624. The matched hazard ratio for empiric potassium supplementation was 0.93 (95% confidence interval, 0.89-0.98, p = 0.003 for all-cause death. Stratifying on initial furosemide dose, hazard ratios for empiric potassium supplementation with furosemide < 40 and ≥ 40 milligrams/day were 0.93 (0.86-1.00, p = 0.050 and 0.84 (0.79-0.89, p < 0.0001. The matched hazard ratio for empiric potassium supplementation was 1.02 (0.83-1.24, p = 0.879 for SD/VA. CONCLUSIONS: Empiric potassium supplementation upon initiation of a loop diuretic appears to be associated with improved survival, with a greater apparent benefit seen with higher diuretic dose. If confirmed, these findings support the use of empiric potassium supplementation upon initiation of a loop diuretic.

  12. Empiric Potassium Supplementation and Increased Survival in Users of Loop Diuretics

    Leonard, Charles E.; Razzaghi, Hanieh; Freeman, Cristin P.; Roy, Jason A.; Newcomb, Craig W.; Hennessy, Sean


    Background The effectiveness of the clinical strategy of empiric potassium supplementation in reducing the frequency of adverse clinical outcomes in patients receiving loop diuretics is unknown. We sought to examine the association between empiric potassium supplementation and 1) all-cause death and 2) outpatient-originating sudden cardiac death (SD) and ventricular arrhythmia (VA) among new starters of loop diuretics, stratified on initial loop diuretic dose. Methods We conducted a one-to-one propensity score-matched cohort study using 1999–2007 US Medicaid claims from five states. Empiric potassium supplementation was defined as a potassium prescription on the day of or the day after the initial loop diuretic prescription. Death, the primary outcome, was ascertained from the Social Security Administration Death Master File; SD/VA, the secondary outcome, from incident, first-listed emergency department or principal inpatient SD/VA discharge diagnoses (positive predictive value = 85%). Results We identified 654,060 persons who met eligibility criteria and initiated therapy with a loop diuretic, 27% of whom received empiric potassium supplementation (N = 179,436) and 73% of whom did not (N = 474,624). The matched hazard ratio for empiric potassium supplementation was 0.93 (95% confidence interval, 0.89–0.98, p = 0.003) for all-cause death. Stratifying on initial furosemide dose, hazard ratios for empiric potassium supplementation with furosemide <40 and ≥40 milligrams/day were 0.93 (0.86–1.00, p = 0.050) and 0.84 (0.79–0.89, p<0.0001). The matched hazard ratio for empiric potassium supplementation was 1.02 (0.83–1.24, p = 0.879) for SD/VA. Conclusions Empiric potassium supplementation upon initiation of a loop diuretic appears to be associated with improved survival, with a greater apparent benefit seen with higher diuretic dose. If confirmed, these findings support the use of empiric potassium supplementation upon initiation of a

  13. Life Quality Index – an empirical or a normative concept?

    Ditlevsen, Ove Dalager; Friis-Hansen, Peter


    The Life Quality Index introduced by Nathwani, Lind and Pandey is a social indicator that by invariance serves the purpose of allocating a balanced and ethically reasonable part of the Gross Domestic Product of a country to life saving initiatives. In the attempts to understand the reasoning behind...... the construction of the LQI one may ask whether the LQI is built on empirical evidence of social behavior that implies the modeled balance between the free time and the work time. Even if so, one may ask whether the invariance principle is a fact of social life or a normative principle of ethical social behavior...

  14. Determinants of Economic Growth: Empirical Evidence from Russian Regions

    Svetlana Ledyaeva


    Full Text Available A modification of Barro and Sala-i-Martin empirical framework of growth model is specified to examine determinants of per capita growth in 74 Russian regions during period of 1996-2005. We utilize both panel and cross-sectional data. Results imply that in general regional growth in 1996-2005 is explained by the initial level of region's economic development, the 1998 financial crisis, domestic investments, and exports. Growth convergence between poor and rich regions in Russia was not found for the period studied.

  15. Comparison between amniotomy, oxytocin or both for augmentation of labor in prolonged latent phase: a randomized controlled trial

    Shalev Eliezer


    Full Text Available Abstract Background A prolonged latent phase is independently associated with an increased incidence of subsequent labor abnormalities. We aimed to compare between oxytocin augmentation, amniotomy and a combination of both on the duration of labor among women with a prolonged latent phase. Methods Women with a singleton fetus in cephalic presentation who have a prolonged latent phase, were randomly allocated to amniotomy (group 1, oxytocin (group 2 or both (group 3. A group of women who progressed spontaneously without intervention composed the control group (group 4. The primary outcome was the duration of time from initiation of augmentation until delivery. Results A total of 213 women were consented and randomized to group 1 (70 women, group 2 (72 women and group 3 (71 women. Group 4 was composed from additional 70 women. A mean reduction of 120 minutes in labor duration was observed among group 3 compared to group 1 (p = 0.08 and 180 minutes compared to group 2 and 4 (p = 0.001. Women in group 3 had a shorter length of time from augmentation until the beginning of the active phase and a shorter first stage of labor than group 1 (p = 0.03, group 2 (p = 0.001 and group 4 (p = 0.001. Satisfaction was greater among group 3 and 4. Mode of delivery and neonatal outcome were comparable between the groups. Conclusion Labor augmentation by combined amniotomy and oxytocin among women with a prolonged latent phase at term seems superior compared to either of them alone.

  16. Prolonged treatment of refractory status epilepticus in a child.

    Sahin, M; Riviello, J J


    Barbiturate anesthesia, which is commonly used for refractory status epilepticus, is an effective treatment, but with many significant complications. The relationship between the duration of this extreme therapy and the ultimate outcome of refractory status epilepticus has not been well studied. We report a 7-year-old girl who presented with refractory status epilepticus secondary to presumed encephalitis with a focal lesion on cranial magnetic resonance imaging. She was treated for 70 days with high-dose antiepileptic drugs and recovered with a residual seizure disorder. This case suggests that, if the status epilepticus is due to a reversible cause such as encephalitis, neurologic recovery may occur despite this very prolonged course of extreme therapy.

  17. Media Impacts on Women's Fertility Desires: A Prolonged Exposure Experiment.

    Knobloch-Westerwick, Silvia; Willis, Laura E; Kennard, Ashley R


    Media exposure may have implications for family planning, a public health issue of key importance. Drawing on social comparison theory and social identity theory, a prolonged exposure experiment examined whether media portrayals of women's social roles affect fertility desires among 166 American, nonstudent, never married, childless women ages 21-35 years old. After sign-up and baseline sessions, participants viewed magazine pages five days in a row. Stimuli presented women in either mother/homemaker roles, beauty ideal roles, or professional roles. Three days later, participants again indicated their number of desired children and time planned until first birth. Exposure to mother/homemaker and beauty ideal portrayals increased the number of desired children across time. Exposure to professional portrayals increased the time planned until 1st birth compared to beauty ideal portrayals-this impact was partially mediated by a shift toward more progressive gender norms (per social identity theory) and assimilation (per social comparison theory).

  18. Prolonged QT interval in a man with anorexia nervosa

    Macías-Robles, María Dolores; Perez-Clemente, Ana María; Maciá-Bobes, Carmen; Alvarez-Rueda, María Asunción; Pozo-Nuevo, Sergio


    Anorexia nervosa is an eating disorder characterized by the avoidance of food intake, which usually leads to a weight loss. Cardiac co-morbility is common and we can find sometimes a mass loss from the left ventricle, which can be seen by echocardiography. But the commonest complications are rhythm variations, typically bradycardia with a prolonged QT interval in up to a 40% of the cases, which altogether elevates ventricular tachycardia and sudden death risk. We present the case of a male who was diagnosed with anorexia nervosa and developed asthenia, a long QT interval and also a severe both hypokalaemia and hypomagnesaemia. We intend to discuss the pathogenic paths as well as prophylactic and therapeutic measures to this potentially-lethal pathology. PMID:19646241

  19. Prolonged intensive dominance behavior between gray wolves, Canis lupus

    Mech, L. David; Cluff, H. Dean


    Dominance is one of the most pervasive and important behaviors among wolves in a pack, yet its significance in free-ranging packs has been little studied. Insights into a behavior can often be gained by examining unusual examples of it. In the High Arctic near Eureka, Nunavut, Canada, we videotaped and described an unusually prolonged and intensive behavioral bout between an adult male Gray Wolf (Canis lupus) and a male member of his pack, thought to be a maturing son. With tail raised, the adult approached a male pack mate about 50 m from us and pinned and straddled this packmate repeatedly over 6.5 minutes, longer than we had ever seen in over 50 years of studying wolves. We interpreted this behavior as an extreme example of an adult wolf harassing a maturing offspring, perhaps in prelude to the offspring?s dispersal.

  20. Near wins prolong gambling on a video lottery terminal.

    Côté, Denis; Caron, Anne; Aubert, Jonathan; Desrochers, Véronique; Ladouceur, Robert


    The purpose of the present study was to evaluate whether near wins can prolong gambling activity on a video lottery terminal. In a three-reel game, near wins were operationally defined as two identical symbols followed by a third different symbol. Players in an experimental condition were exposed to 27% near wins in a series of continuous losses, whereas players in a control group were exposed to none. Participants played as long as they wished, and received real money for their wins. The results showed that players in the near win condition played 33% more games than did the control group. The results of this study suggest that near wins can be added to the list of factors that may motivate people to gamble despite the probability of monetary loss.

  1. Rat liver pathomorphology during prolonged sodium valproate administration.

    Sobaniec-Lotowska, M; Sobaniec, W; Kułak, W


    Prolonged administration (1, 3, 6, 9 and 12 months) to rats of an antiepileptic drug--sodium valproate (Vupral--"Polfa") in the dose of 200 mg/kg/day produced the first hepatic morphological lesions after 3 months of the experiment. These structural abnormalities progressively increased to achieve their peak within 12 months. The most prominent microscopic changes consisted of extensive microvesicular fatty change and vacuolar degeneration of periportal hepatocytes. Intralobular focal necrosis, infiltrations of lymphocytes, plasma cells, and phagocytes in the portal tracts, and centrilobular congestion were also present. The connective tissue did not proliferate either in periportal lobular zone or around the central veins. The described lesions seem thus to be reversible.

  2. Brain activity and fatigue during prolonged exercise in the heat

    Hyldig, Tino Hoffmann


    reflects suppressed arousal. In H, subjects fatigued after 34.4-1.4 min coinciding with an oesophageal temperature (Toes) of 39.8-0.1°C, an almost maximal heart rate (HR 192-3 beats·min-1), a rating of perceived exertion (RPE) of 19.0-0.8 and significantly elevated !/# index (188-71% of the value after 2...... min of exercise; PIncreases in the !/# index were strongly correlated to increases in Toes (r2=0.98; P=0.0001).......We hypothesized that fatigue due to hyperthermia during prolonged exercise in the heat is in part related to alterations in frontal cortical brain activity. The electroencephalographic activity (EEG) of the frontal cortex of the brain was measured in seven cyclists [maximal O2 uptake (VO2max) 4...

  3. New Heterogeneous Clustering Protocol for Prolonging Wireless Sensor Networks Lifetime

    Md. Golam Rashed


    Full Text Available Clustering in wireless sensor networks is one of the crucial methods for increasing of network lifetime. The network characteristics of existing classical clustering protocols for wireless sensor network are homogeneous. Clustering protocols fail to maintain the stability of the system, especially when nodes are heterogeneous. We have seen that the behavior of Heterogeneous-Hierarchical Energy Aware Routing Protocol (H-HEARP becomes very unstable once the first node dies, especially in the presence of node heterogeneity. In this paper we assume a new clustering protocol whose network characteristics is heterogeneous for prolonging of network lifetime. The computer simulation results demonstrate that the proposed clustering algorithm outperforms than other clustering algorithms in terms of the time interval before the death of the first node (we refer to as stability period. The simulation results also show the high performance of the proposed clustering algorithm for higher values of extra energy brought by more powerful nodes.

  4. CNS fatigue provoked by prolonged exercise in the heat

    Nybo, Lars


    to the brain. However, exercise with superimposed hyperthermia is not only a challenge to the brain it also provides an excellent model for studying factors of importance for central fatigue. Excessive heat storage within the brain appears to be the primary cause for the central fatigue during exercise...... to aggravate central fatigue and degrade exercise performance. Hyperthermia mediated central fatigue may include other cerebral perturbations such as reduced perfusion of the brain, accumulation of ammonia or depletion of neuronal energy stores, but further research is needed to elucidate their possible......Exercise-induced hyperthermia is associated with central fatigue as indicated by an impaired ability to sustain maximal motor activation during prolonged voluntary efforts. Therefore, exercise in hot environments challenges not only to the cardiorespiratory and locomotive systems but also...

  5. Prolonged remission of leukemia associated with polycythemia vera.

    Hazani, A; Tatarsky, I; Barzilai, D


    A patient with polycythemia vera (PV) received successive treatment by phlebotomies, radioactive phosphorus, myleran and cyclophosphamide. Sixteen years after the diagnosis, he developed acute myeloblastic leukemia. A complete remission was achieved following two courses of COAP (cyclophosphamide, vincristine, Cytosine Arabinoside, and prednisone) therapy. Four months later, while still in leukemic remission, he became mildly polycythemic again and the treatment with phlebotomies and cyclophosphamide was resume. The patient has subsequently been in complete remission of leukemia for over three years and his polycythemia is controlled by small doses of cyclophosphamide. This appears to be a unique case of such a prolonged remission of leukemia in the course of PV, with a return to a mild polycythemia state.

  6. Prolonging the postcomplex spike pause speeds eyeblink conditioning.

    Maiz, Jaione; Karakossian, Movses H; Pakaprot, Narawut; Robleto, Karla; Thompson, Richard F; Otis, Thomas S


    Climbing fiber input to the cerebellum is believed to serve as a teaching signal during associative, cerebellum-dependent forms of motor learning. However, it is not understood how this neural pathway coordinates changes in cerebellar circuitry during learning. Here, we use pharmacological manipulations to prolong the postcomplex spike pause, a component of the climbing fiber signal in Purkinje neurons, and show that these manipulations enhance the rate of learning in classical eyelid conditioning. Our findings elucidate an unappreciated aspect of the climbing fiber teaching signal, and are consistent with a model in which convergent postcomplex spike pauses drive learning-related plasticity in the deep cerebellar nucleus. They also suggest a physiological mechanism that could modulate motor learning rates.

  7. Prolonged weightlessness, reference frames and visual symmetry detection.

    Leone, G; de Schonen, S; Lipshits, M


    We evaluated the influence of prolonged weightlessness on the performance of three cosmonauts to bilateral symmetry detection in the course of a 15-day-long Russian-French mission CASSIOPEE 96 aboard the MIR station. We tested the influence of weightlessness on subjects' performance as a function of the retinal orientation of axis of symmetry. as a function of type of stimuli (closed versus multi-elements shapes) and as a function of visual field presentation (at fixation, left visual field. right visual field). The results indicate firstly a difference between presentation at fixation versus away of fixation. Away of fixation, no effect of microgravity on performance was shown. A hypothesis of hemispheric specialization for symmetry detection was not supported as well. At fixation, an effect of micro-gravity was shown and more interestingly, the effect was quite different as a function of type of shapes used. suggesting that symmetry detection is a multiple-stage process.

  8. Prolonged cholestasis and ductopenia following gold salt therapy.

    Basset, Céline; Vadrot, Jacqueline; Denis, Jacques; Poupon, Joël; Zafrani, Elie Serge


    Hepatotoxicity, predominantly cholestatic, is a rare adverse effect of gold salt therapy, which usually completely resolves within a few months. We report the case of a female patient treated for rheumatoid arthritis, who had gold salt overdose, and in whom acute cholestatic hepatitis occurred three weeks after beginning of therapy. Evolution of gold concentration was followed in plasma and urine, as well as in cutaneous and liver dry tissue. Liver biopsy showed marked inflammatory changes of interlobular bile ducts that evolved towards ductopenia, which was responsible for prolonged cholestasis still present 15 months later. In addition, sialadenitis with sicca syndrome was noted six months after onset of the disease. The mechanism of hepatotoxicity was probably immunoallergic since liver lesions were associated with hypersensitivity syndrome including dermatitis and blood and tissue eosinophilia. This is the first report of gold salt hepatotoxicity with histological demonstration of cholangitis followed by ductopenia.

  9. Tracheoesophageal fistula--a complication of prolonged tracheal intubation.

    Paraschiv, M


    Tracheoesophageal fistula most commonly occurs as a complication of prolonged tracheal intubation. The incidence decreased after the use of low pressure and high volume endotracheal cuffs, but the intensive care units continue to provide such cases. The abnormal tracheoesophageal communication causes pulmonary contamination (with severe suppuration) and impossibility to feed the patient. The prognosis is reserved, because most patients are debilitated and ventilator dependent, with severe neurological and cardiovascular diseases. The therapeutic options are elected based on respiratory, neurological and nutritional status. The aim of conservative treatment is to stop the contamination (drainage gastrostomy, feeding jejunostomy) and to treat the pulmonary infection and biological deficits. Endoscopic therapies can be tried in cases with surgical contraindication. Operation is addressed to selected cases and consists in the dissolution of the fistula, esophageal suture with or without segmental tracheal resection associated. Esophageal diversion is rarely required. The correct indication and timing of surgery, proper surgical technique and postoperative care are prerequisites for adequate results.


    Ceptureanu Sebastian Ion


    Full Text Available There are many studies linking entrepreneurship and economic development. For specialists and public decision makers, developing entrepreneurship seems to be an easy policy action, even though actions and results are rather debatable. Unfortunately the relevant literature is not so generous concerning youth entrepreneurship. Youth is one of the most vulnerable groups in society, especially in the current economic and demographic situation in European Union and worldwide. At the same time, youth is the period when most people engage in their first job, are gaining financial independence and are assuming new responsibilities and roles shaping their identity. With respect to this, starting their own business is a natural choice for many young people. When considering entrepreneurial potential of young Romanians, there is almost not any data available. This paper aims to disseminate the results of a survey focused on young entrepreneurs, designed to fill the gap in the literature about Romanian young entrepreneurs’ features. The empirical study was divided in five parts: A. Personality of young entrepreneurs, highlighting the main features of behaviour and personality of young entrepreneurs. B. Professional background, focusing on young entrepreneurs’ background and how it influences their interest and performance improvement. C. Risk and crisis acceptance, highlighting the ability of young entrepreneurs to deal with critical situations. D. Business and business environment, focusing on internal and environmental aspects of the business. E. Social - cultural attitude, highlighting the attitude of society (incentives and disincentives to entrepreneurial initiatives of young people. This are excerpts of results from the first part, regarding personality of Romanian young entrepreneurs, concerning issues like level of independence, capacity for innovation, self-confidence, decision making process, level of persistence flexibility of young

  11. Efficacy of the "baby-sitter" procedure after prolonged denervation.

    Mersa, B; Tiangco, D A; Terzis, J K


    This study was undertaken to evaluate whether 40 percent of the hypoglossal nerve, which showed optimal efficacy in restoring orbicularis oculi muscle (OOM) function after different percentages of partial neurectomy in a previous study would be effective after prolonged denervation time. Twenty Sprague-Dawley rats were divided into four groups. In first-stage surgery the left facial nerve of all animals was transected at the level of the stylomastoid foramen and main zygomatic branch. Group A (controls) consisted of animals with only left facial nerves transected (no repair). In Groups B, C, and D the facial nerve was transected and the facial musculature was denervated for a period of 4, 8, and 12 weeks respectively. During a second-stage procedure, a 40 percent neurectomy was performed on the hypoglossal nerve. Subsequently, a nerve transfer was performed by coaptations of a saphenous nerve graft to the neurectomized hypoglossal nerve and the main zygomatic branch of the facial nerve that innervated the OOM. Behavioral analysis of blink reflex, electrophysiology, and axon and motor end-plate counts in Groups B, C, and D showed superior results compared to Group A. There was no statistically significant difference observed among Groups B, C, and D (p > 0.05). Despite the diminished number of axons in the zygomatic branch and motor end-plates in the orbicularis oculi muscle after 12 weeks of denervation, there was still sufficient muscle target recovery to effect some eye closure in all groups except the controls. This study demonstrated in this model that the 40 percent partial neurectomy of the XII to VII component of the "baby-sitter" procedure was effective even after prolonged denervation.

  12. Joint contracture following prolonged stay in the intensive care unit

    Clavet, Heidi; Hébert, Paul C.; Fergusson, Dean; Doucette, Steve; Trudel, Guy


    Background Prolonged immobility during a critical illness may predispose patients to the development of joint contracture. We sought to document the incidence of, the risk factors for and the reversibility of joint contractures among patients who stayed in a tertiary intensive care unit (ICU) for 2 weeks or longer. Methods We conducted a chart review to collect data on the presence of and risk factors for joint contractures in the shoulders, elbows, hips, knees and ankles among patients admitted to the ICU between January 2003 and March 2005. Results At the time of transfer out of the ICU, at least 1 joint contracture was recorded in 61 (39%) of 155 patients; 52 (34%) of the patients had joint contractures of an extent documented to impair function. Time spent in the ICU was a significant risk factor for contracture: a stay of 8 weeks or longer was associated with a significantly greater risk of any joint contracture than a stay of 2 to 3 weeks (adjusted odds ratio [OR] 7.09, 95% confidence interval (CI) 1.29–38.9; p = 0.02). Among the variables tested, only the use of steroids conferred a protective effect against joint contractures (adjusted OR 0.35, 95% CI 0.14–0.83; p = 0.02). At the time of discharge to home, which occurred a median of 6.6 weeks after transfer out of intensive care, 50 (34%) of the 147 patients not lost to follow-up still had 1 or more joint contractures, and 34 (23%) of the patients had at least 1 functionally significant joint contracture. Interpretation Following a prolonged stay in the ICU, a functionally significant contracture of a major joint occurred in more than one-third of patients, and most of these contractures persisted until the time of discharge to home. PMID:18332384

  13. Candidemia in patients with prolonged fever in Kashan, Iran.

    Razzaghi, R; Momen-Heravi, M; Erami, M; Nazeri, M


    Candida species are considered a common cause of fungal blood stream infections, which are associated with considerable mortality and morbidity rates, especially in the admitted and immunocompromised patients. Despite the increase in new and available antifungal agents, the emergence of resistant strains is growing. Regarding this, the aim of the present study was to assess the fungal epide-miology of candidemia and the antifungal susceptibility patterns against five current antifungal agents among the patients with prolonged fever, who were admitted to Beheshti Educational Hospital, Kashan, Iran. This cross-sectional study was conducted on 253 hospitalized patients with prolonged fever despite receiving broad-spectrum antibiotic therapy. Blood samples were collected aseptically, and then cultured using an automated blood culture system and conventional broth culture bottle. Candida isolates were identified at species level using morphological and physiological properties and produced color on the CHROMagar Candida. Furthermore, the antifungal susceptibility testing was performed using (CLSI M27-A3 and CLSI M27-S4) broth microdilution methods. The most positive cultures were detected by the automated blood culture system. C.albicans (%50) was the most prevalent species, followed by C. glabrata (%40), and C. parapsilosis, (%10) respectively .The mortality rate was high (%60) and most patients with candidemia were admitted to the Intensive Care Unit and Neonatal Intensive Care Unit. All isolates were susceptible to amphotericin B, while the highest resistance belonged to caspofungin. In this study, high resistance was reported, especially for caspofungin, which can be regarded as the emergence of caspofungin-resistant strains. Regarding this, the establishment of a surveillance and prevention program for the reduction of the emergence of resistant species is necessary.

  14. Knee abduction angular impulses during prolonged running with wedged insoles.

    Lewinson, Ryan T; Worobets, Jay T; Stefanyshyn, Darren J


    Wedged insoles may produce immediate effects on knee abduction angular impulses during running; however, it is currently not known whether these knee abduction angular impulse magnitudes are maintained throughout a run when fatigue sets in. If changes occur, this could affect the clinical utility of wedged insoles in treating conditions such as patellofemoral pain. Thus, the purpose of this study was to determine whether knee abduction angular impulses are altered during a prolonged run with wedged insoles. It was hypothesized that knee abduction angular impulses would be reduced following a prolonged run with wedged insoles. Nine healthy runners participated. Runners were randomly assigned to either a 6-mm medial wedge condition or a 6-mm lateral wedge condition and then ran continuously overground for 30 min. Knee abduction angular impulses were quantified at 0 and 30 min using a gait analysis procedure. After 2 days, participants returned to perform the same test but with the other wedge type. Two-way repeated-measures analysis of variance was used to evaluate main effects of wedge condition and time and interactions between wedge condition and time (α = 0.05). Paired t-tests were used for post hoc analysis (α = 0.01). No interaction effects (p = 0.958) were found, and knee abduction angular impulses were not significantly different over time (p = 0.384). Lateral wedge conditions produced lesser knee abduction angular impulses than medial conditions at 0 min (difference of 2.79 N m s, p = 0.006) and at 30 min (difference of 2.76 N m s, p < 0.001). It is concluded that significant knee abduction angular impulse changes within wedge conditions do not occur during a 30-min run. Additionally, knee abduction angular impulse differences between wedge conditions are maintained during a 30-min run.

  15. Cesium-induced QT-interval prolongation in an adolescent.

    O'Brien, Catherine E; Harik, Nada; James, Laura P; Seib, Paul M; Stowe, Cindy D


    Alternative medicine is becoming increasingly popular, especially with terminally ill patients. Most alternative remedies have not been adequately studied or proven effective for the diseases for which they are promoted. In the worst cases, these therapies are harmful. We describe a 16-year-old girl with metastatic hepatocellular carcinoma who experienced cesium-induced QT-interval prolongation after the start of a cesium chloride-based alternative treatment regimen. She had received seven courses of chemotherapy, with a cumulative doxorubicin dose of 500 mg/m(2) over 5 months, resulting in minimal tumor regression. Against the advice of her oncologist, she abandoned traditional therapy and started an alternative regimen that included cesium chloride supplements. Two weeks later, the patient went to a local emergency department after experiencing two brief syncopal episodes. An electrocardiogram revealed occasional premature ventricular contractions, a QTc interval of 683 msec (normal range for females 450-460 msec), and R on T phenomenon. She was admitted to the hospital and later experienced monomorphic ventricular tachycardia, which resolved spontaneously. Lidocaine therapy was started, and the patient was transferred to a cardiac intensive care unit at our hospital. Her plasma cesium level was 2400 microg/dl (normal cesium level was 1800 microg/dl, and her QTc interval was 494 msec. According to the Naranjo adverse drug reaction probability scale, cesium was the probable cause of the patient's arrhythmia. In animal models, cesium chloride has induced cardiac arrhythmias, including torsade de pointes. It inhibits delayed rectifier potassium channels in the myocardium, causing delayed repolarization and QT-interval prolongation. Patients with cancer should be aware that alternative remedies may be harmful and ineffective. Because patients may be unlikely to self-report alternative remedies, health care providers should specifically ask their patients about any

  16. Lipid metabolism disturbances and AMPK activation in prolonged propofol-sedated rabbits under mechanical ventilation

    Wei JIANG; Zheng-bo YANG; Quan-hong ZHOU; Xiang HUAN; Li WANG


    To explore the mechanisms underlying the propofol infusion syndrome (PRIS),a potentially fatal complication during prolonged propofol infusion.Methods:Male rabbits urider mechanical ventilation through endotracheal intubation were divided into 3 groups (n=6 for each) that were sedated with 1% propofol (Group P),isoflurane (Group Ⅰ) or isoflurane while receiving 10% intralipid (Group Ⅱ),respectively.Blood biochemical parameters were collected at O,6,12,18,24,and 30-36 h after the initiation of treatments.The hearts were removed out immediately after the experiments,and the level of tumor necrosis factor (TNF)-α in the hearts were studied using immunohistochemistry.AMP-activated protein kinase (AMPK) and phospho-AMPK in the hearts were assessed using Western blotting.Results:The mortality rate was 50% in Group P,and 0% in Groups Ⅰ and Ⅱ.The serum lipids and liver function indices in Group P were significantly increased,but moderately increased in Group Ⅱ.Significant decreases in these indices were found in Groups Ⅰ.All the groups showed dramatically increased release of creatine kinase (CK).Intense positive staining of TNF-c was found in all the heart samples in Group P,but only weak and neglectful staining was found in the hearts from Group Ⅱ and Group Ⅰ,respectively.AMPK phosphorylation was significantly increased in the hearts of Group P.Conclusion:Continuous infusion of large dose of propofol in rabbits undergoing prolonged mechanical ventilation causes hyperlipidemia,liver dysfunction,increased CK levels,AMPK activation and myocardial injury.The imbalance between energy demand and utilization may contribute to PRIS.

  17. A special type of scald caused by prolonged exposure to slowly heated water.

    Pircher, R; Pollak, S; Vogt, S; Epting, T; Kramer, L; Geisenberger, D


    When skin is subjected to water temperatures gradually rising from moderate to critical ranges for a prolonged period of time, the resulting scalds will initially present as reddening, followed by blistering and at last by full-thickness burns. On changing from second- to third-degree burn, the blisters stop to become enlarged and solidify due to heat-induced coagulation necrosis. Such gradually intensifying tissue damage results in multiple firm skin blisters together with third-degree burn of the affected area. The initially serous blister fluid assumes a jelly-like consistency as the proteins undergo denaturation. Scalds of this special type may occur in persons taking a bath and becoming incapable to act so that the warm water tap remains turned on or a hairdryer continues to work after having been dropped into the bath water. On the basis of two relevant fatalities (suicidal electrocutions in bathtubs by means of hairdryers), the macroscopic and histological appearance of blisters which only secondarily turned into a full-thickness scald is compared with blisters in genuine second-degree scalds. The blister fluid of the latter ones was also investigated as to their protein composition and hemoglobin concentration. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  18. 消费者商场“手机钱包”初始信任影响因素的实证分析——基于长株潭试点区域%An Empirical Analysis of Factors Influencing Consumers' Initial Trust on Mobile Phone-Purse in Malls --Based on Changshan-Zhuzhou-Xiangtan Experimental Area

    郭新华; 吕鹏; 张军校


    消费者在商场移动支付情境中对"手机钱包"初始信任的影响因素众多,研究发现结构保证因素对处于推广初期的"手机钱包"业务的初始信任影响最显著,其他影响因素依次为感知手机钱包优点、风险因素、个人信任倾向、声誉因素。基于以上结论,企业应通过提高"手机钱包"优点认知、寻求政府支持、引入第三方认证、采取差异化营销策略等措施来构建安全和谐的消费环境。%There are many factors influencing the consumers' initial trust on "mobile phone-purse" in payment in shopping malls. The study finds that the most significant influence on consumers' initial trust on "mobile phone-purse" in the early promotion period comes from the structure security factors, while the other factors are perception about the purse advantages, risk factors, personal trust tendency, and reputation factors. Due to the above conclusions, the enterprise should enhance the recognition of "mobile phone-purse" advantages, seek the government's support, bring in the third party certification, take differentiation strategy of marketing measures, and construct a harmonious and safety consumption environment.

  19. Nosocomial pneumonia : rationalizing the approach to empirical therapy.

    Andriesse, Gunnar I; Verhoef, Jan


    Nosocomial pneumonia or hospital-acquired pneumonia (HAP) causes considerable morbidity and mortality. It is the second most common nosocomial infection and the leading cause of death from hospital-acquired infections. In 1996 the American Thoracic Society (ATS) published guidelines for empirical therapy of HAP. This review focuses on the literature that has appeared since the ATS statement. Early diagnosis of HAP and its etiology is crucial in guiding empirical therapy. Since 1996, it has become clear that differentiating mere colonization from etiologic pathogens infecting the lower respiratory tract is best achieved by employing bronchoalveolar lavage (BAL) or protected specimen brush (PSB) in combination with quantitative culture and detection of intracellular microorganisms. Endotracheal aspirate and non-bronchoscopic BAL/PSB in combination with quantitative culture provide a good alternative in patients suspected of ventilator-associated pneumonia. Since culture results take 2-3 days, initial therapy of HAP is by definition empirical. Epidemiologic studies have identified the most frequently involved pathogens: Enterobacteriaceae, Haemophilus influenzae, Streptococcus pneumoniae and Staphylococcus aureus ('core pathogens'). Empirical therapy covering only the 'core pathogens' will suffice in patients without risk factors for resistant microorganisms. Studies that have appeared since the ATS statement issued in 1996, demonstrate several new risk factors for HAP with multiresistant pathogens. In patients with risk factors, empirical therapy should consist of antibacterials with a broader spectrum. The most important risk factors for resistant microorganisms are late onset of HAP (>/=5 days after admission), recent use of antibacterial therapy, and mechanical ventilation. Multiresistant bacteria of specific interest are methicillin-resistant S. aureus (MRSA), Pseudomonas aeruginosa, Acinetobacter calcoaceticus-baumannii, Stenotrophomonas maltophilia and extended

  20. Body Fineness Ratio as a Predictor of Maximum Prolonged-Swimming Speed in Coral Reef Fishes

    Walker, Jeffrey A.; Alfaro, Michael E.; Noble, Mae M.; Fulton, Christopher J.


    The ability to sustain high swimming speeds is believed to be an important factor affecting resource acquisition in fishes. While we have gained insights into how fin morphology and motion influences swimming performance in coral reef fishes, the role of other traits, such as body shape, remains poorly understood. We explore the ability of two mechanistic models of the causal relationship between body fineness ratio and endurance swimming-performance to predict maximum prolonged-swimming speed (Umax) among 84 fish species from the Great Barrier Reef, Australia. A drag model, based on semi-empirical data on the drag of rigid, submerged bodies of revolution, was applied to species that employ pectoral-fin propulsion with a rigid body at Umax. An alternative model, based on the results of computer simulations of optimal shape in self-propelled undulating bodies, was applied to the species that swim by body-caudal-fin propulsion at Umax. For pectoral-fin swimmers, Umax increased with fineness, and the rate of increase decreased with fineness, as predicted by the drag model. While the mechanistic and statistical models of the relationship between fineness and Umax were very similar, the mechanistic (and statistical) model explained only a small fraction of the variance in Umax. For body-caudal-fin swimmers, we found a non-linear relationship between fineness and Umax, which was largely negative over most of the range of fineness. This pattern fails to support either predictions from the computational models or standard functional interpretations of body shape variation in fishes. Our results suggest that the widespread hypothesis that a more optimal fineness increases endurance-swimming performance via reduced drag should be limited to fishes that swim with rigid bodies. PMID:24204575

  1. Body fineness ratio as a predictor of maximum prolonged-swimming speed in coral reef fishes.

    Walker, Jeffrey A; Alfaro, Michael E; Noble, Mae M; Fulton, Christopher J


    The ability to sustain high swimming speeds is believed to be an important factor affecting resource acquisition in fishes. While we have gained insights into how fin morphology and motion influences swimming performance in coral reef fishes, the role of other traits, such as body shape, remains poorly understood. We explore the ability of two mechanistic models of the causal relationship between body fineness ratio and endurance swimming-performance to predict maximum prolonged-swimming speed (Umax ) among 84 fish species from the Great Barrier Reef, Australia. A drag model, based on semi-empirical data on the drag of rigid, submerged bodies of revolution, was applied to species that employ pectoral-fin propulsion with a rigid body at U max. An alternative model, based on the results of computer simulations of optimal shape in self-propelled undulating bodies, was applied to the species that swim by body-caudal-fin propulsion at Umax . For pectoral-fin swimmers, Umax increased with fineness, and the rate of increase decreased with fineness, as predicted by the drag model. While the mechanistic and statistical models of the relationship between fineness and Umax were very similar, the mechanistic (and statistical) model explained only a small fraction of the variance in Umax . For body-caudal-fin swimmers, we found a non-linear relationship between fineness and Umax , which was largely negative over most of the range of fineness. This pattern fails to support either predictions from the computational models or standard functional interpretations of body shape variation in fishes. Our results suggest that the widespread hypothesis that a more optimal fineness increases endurance-swimming performance via reduced drag should be limited to fishes that swim with rigid bodies.

  2. Recent Developments in Empirical Industrial Organization.

    Porter, Robert H.


    Presents an bibliographic essay of recent empirical research in industrial organization. Examines topics such as the econometrics of markets with imperfect competition, technology and industry structure, industry evolution, and industry studies of regulation. (CFR)

  3. Measuring Prevention More Broadly, An Empirical...

    U.S. Department of Health & Human Services — Measuring Prevention More Broadly, An Empirical Assessment of CHIPRA Core Measures Differences in CHIP design and structure, across states and over time, may limit...




    The EMPIRE code system is being extended to cover the resolved and unresolved resonance region employing proven methodology used for the production of new evaluations in the recent Atlas of Neutron Resonances. Another directions of Empire expansion are uncertainties and correlations among them. These include covariances for cross sections as well as for model parameters. In this presentation we concentrate on the KALMAN method that has been applied in EMPIRE to the fast neutron range as well as to the resonance region. We also summarize role of the EMPIRE code in the ENDF/B-VII.0 development. Finally, large scale calculations and their impact on nuclear model parameters are discussed along with the exciting perspectives offered by the parallel supercomputing.

  5. Empirical Investigation into Simultaneous Interpreting Skills.

    Schjoldager, Anne


    Presents data concerning the first stages of an ongoing empirical investigation into simultaneous interpreting skills and the best methods and strategies for teaching it. Discusses underlying premises, hypotheses, and objectives of the study as it is now planned. (HB)

  6. Empirically Supported Treatments for Panic Disorder

    McHugh, R.K.; Smits, J.A.J.; Otto, M.W.


    This article provides an empirical review of the elements and efficacy of both pharmacologic and psychosocial treatments for panic disorder. Both monotherapies and combination treatment strategies are considered. The available evidence suggests that both cognitive behavioral therapy (CBT) and

  7. Stakeholder Pressures, Environmental Impact and Managerial Initiatives of SMEs

    Madsen, Henning; Ulhøi, John Parm


    impact was available in Denmark. Consequently, a longitudinal research project was initiated to enlighten the situation. This study investigates environmentally related initiatives taken in response to the perception of stakeholder pressures and the perceived corporate environmental impact. The empirical......Environmental sustainability has become an issue of uttermost importance for business organisations. Therefore, the implementation of corporate environmental initiatives has been vigorously embraced by industry. Two decades ago, no clear picture of industry initiatives to reduce their environmental...... popularity of self-regulation, voluntary initiatives do not tend to be widely adopted by SMEs, stressing a need for a continuing regulation of industry’s behaviour in relation to environmental issues....

  8. Precision and accuracy of mechanistic-empirical pavement design

    Theyse, HL


    Full Text Available The availability of mechanistic-empirical pavement design methods is increasing internationally. Although mechanistic-empirical design does offer some insight into pavement behaviour and performance, at least more so than empirical design methods...

  9. Mathematical knowledge: a case study in empirical philosophy of mathematics

    Löwe, B.; Müller, T.; Wilhelmus, E.; Van Kerkhove, B.; De Vuyst, J.; Van Bendegem, J.P.


    In this paper, we present a paradigm for the philosopher of mathematics who takes mathematical practice seriously: Empirical Philosophy of Mathematics. In this philosophical paradigm, we use empirical methods (from sociology, psychology, cognitive science, didactics) to evaluate empirical questions

  10. Fitting the empirical distribution of intertrade durations

    Politi, Mauro; Scalas, Enrico


    Based on the analysis of a tick-by-tick data set used in the previous work by one of the authors (DJIA stocks traded at NYSE in October 1999), in this paper, we reject the hypothesis that tails of the empirical intertrade distribution are described by a power law. We further argue that the Tsallis q-exponentials are a viable tool for fitting and describing the unconditional distribution of empirical intertrade durations and they compare well to the Weibull distribution.

  11. Empirical direction in design and analysis

    Anderson, Norman H


    The goal of Norman H. Anderson's new book is to help students develop skills of scientific inference. To accomplish this he organized the book around the ""Experimental Pyramid""--six levels that represent a hierarchy of considerations in empirical investigation--conceptual framework, phenomena, behavior, measurement, design, and statistical inference. To facilitate conceptual and empirical understanding, Anderson de-emphasizes computational formulas and null hypothesis testing. Other features include: *emphasis on visual inspection as a basic skill in experimental analysis to help student

  12. Downside Risk And Empirical Asset Pricing

    Vliet, Pim


    textabstractCurrently, the Nobel prize winning Capital Asset Pricing Model (CAPM) celebrates its 40th birthday. Although widely applied in financial management, this model does not fully capture the empirical riskreturn relation of stocks; witness the beta, size, value and momentum effects. These problems may be caused by the use of variance as the relevant risk measure. This study analyzes if asset pricing models that use alternative risk measures better describe the empirical riskreturn tra...



    Headcut migration is studied by using empirical and numerical modeling approaches. Empirical formulas for the headcut migration are established using available measurement data, which consider not only the flow strength but also the properties of soil. Numerical model for the headcut migration is proposed. The influences of dynamic pressure gradient, downward flow, and bed slope on sediment entrainment are considered. The local erosion patterns and migration speeds of headcut calculated by the numerical model agree reasonably well with observed data.

  14. Prolonged (9 h) poikilocapnic hypoxia (12% O2) augments cutaneous thermal hyperaemia in healthy humans.

    Lawley, Justin S; Oliver, Samuel J; Mullins, Paul G; Macdonald, Jamie H; Moore, Jonathan P


    The primary aim of this study was to investigate the effect of systemic poikilocapnic hypoxia on forearm cutaneous thermal hyperaemia. A secondary aim was to examine the relationship between the individual susceptibility to oxygen desaturation and cutaneous vasodilator capacity. Twelve healthy participants (seven male) were exposed to 9 h of normoxia and 12% poikilocapnic hypoxia in a temperature- and humidity-controlled environmental chamber. Skin blood flow was assessed at the ventral forearm using laser Doppler flowmetry combined with rapid local heating. After 6 min at baseline (skin temperature clamped at 33°C), local skin temperature was elevated at a rate of 0.5°C every 5 s up to 42°C to elicit a sensory axon response and then held constant for 30 min to cause a plateau. Skin blood flow was calculated as cutaneous vascular conductance [CVC; in perfusion units/mean arterial blood pressure (APU mmHg(-1))] and expressed in raw format and relative to heating at 44°C in normoxia (%CVC44). During hypoxaemia, vasodilatation was greater during the initial peak (raw, Δ0.35 APU mmHg(-1), P = 0.09; %CVC44, Δ18%, P = 0.05) and the plateau phase (raw, Δ0.55 APU mmHg(-1), P = 0.03; %CVC44, Δ26%, P = 0.02). The rate of rise in cutaneous blood flow during the initial peak was significantly greater during poikilocapnic hypoxia (P < 0.01). We observed a negative relationship between oxygen saturation in poikilocapnic hypoxia and the change in baseline (P = 0.06), initial peak (P = 0.01) and plateau phase of thermal hyperaemia (P = 0.01). Prolonged poikilocapnic hypoxia causes robust increases in CVC during both phases of thermal hyperaemia that are dependent on the oxygen saturation of the individual.

  15. The Effect of Ethanol on the Release of Opioids from Oral Prolonged-Release Preparations

    Walden, Malcolm; Nicholls, Fiona A.; Smith, Kevin J.; Tucker, Geoffrey T


    Recent experience has prompted the US FDA to consider whether ethanol ingestion may modify the release characteristics of prolonged-release formulations, where dose dumping may be an issue for patient safety. The influence of ethanol on the in vitro release of opioid drugs from some prolonged-release formulations utilizing different release technologies was examined. Results indicated that the prolonged-release mechanisms remained intact under the testing conditions, although one product show...

  16. Diverse definitions of prolonged labour and its consequences with sometimes subsequent inappropriate treatment

    Nystedt, Astrid; Hildingsson, Ingegerd


    Background: Prolonged labour very often causes suffering from difficulties that may have lifelong implications. This study aimed to explore the prevalence and treatment of prolonged labour and to compare birth outcome and women's experiences of prolonged and normal labour. Method: Women with spontaneous onset of labour, living in a Swedish county, were recruited two months after birth, to a cross-sectional study. Women (n = 829) completed a questionnaire that investigated socio-demographic an...

  17. The Plus 50 Initiative Evaluation: Initiative Impact

    American Association of Community Colleges (NJ1), 2012


    The American Association of Community Colleges (AACC), with funding from The Atlantic Philanthropies, created the Plus 50 Initiative (2008-2012). This initiative was designed to build the capacity of community colleges nationwide to develop programming that engages the plus 50 learner. This report contains: (1) An overview of the Plus 50…

  18. Features of History, Anthropometric Data and Individual Functions of the Liver in Children with Prolonged Jaundice

    O.V. Tyajka


    Full Text Available Background. Neonatal jaundice is one of the urgent problems in neonatology. There is a tendency to increase the incidence of prolonged jaundice. The aim of our study was to explore the features of history, anthropometric data and some liver functions in children with prolonged jaundice. Materials and methods. The study involved 111 children with prolonged jaundice aged from 3 weeks to 3 months. In all children with prolonged jaundice, we have examined complete blood count, urinalysis, blood chemistry (determination of total bilirubin and fractions, total protein, albumin, glucose and used instrumental methods of examination — ultrasound of the abdominal cavity and cranial ultrasonography, electrocardiography. Most children with prolonged jaundice were breastfed and were term infants. Results. Indicators of physical development at birth (body weight, body length, head circumference, chest circumference in children with prolonged jaundice and in healthy children had not statistically significant differences. Neonatal jaundice was prolonged in children, who were born from the first pregnancy, — 60 children (54.1 %. A high level of total and indirect bilirubin was accompanied by a low level of albumin in the blood serum of children with prolonged jaundice. Protein-synthesis function of the liver was reduced in children with prolonged jaundice.

  19. Supporting prolonged COPD monitoring using an application for mobile devices.

    Haller, Andreas; Schuerg, Sebastian; Schudt, Florian; Koczulla, Andreas Rembert; Mursina, Ljudmila; Gross, Volker; Sohrabi, Keywan


    COPD (chronic obstructive pulmonary disease) is the most frequent form of chronic respiratory disease. During the progress of this disease, phases of aggravation of pulmonary function (exacerbations) can occur, which reduce the quality of life. Clinical experience shows that single investigations are insufficient. Therefore a prolonged monitoring is required to recognize an exacerbation early. This home monitoring will involve a quick respiratory test and a related application for Android, iOS and Windows phones. This rapid test transmits the relevant pulmonary parameters, converted in an Extensible Markup Language file to the smartphone. The application will analyze the incoming data to evaluate the current health status of the patient. Additionally the data will be transferred to the virtual control point (server) and stored in a database. If critical values are detected, the server will send a notification to prior defined relatives and doctors. A connection to a Hospital Information System will be possible through an included Health Level 7 interface. This offers an improved site-independent patient care. The project is planned to be in development until 2016.

  20. Mean arterial pressure following prolonged exercise in the heat

    Gagnon, D; Lynn, A G; Binder, K


    Prolonged exercise in the heat without fluid replacement represents a significant challenge to the regulation of mean arterial pressure (MAP). It is unknown, however, if MAP is equally challenged during the post-exercise period, and whether regular endurance exercise training can provide any...... benefit to its regulation. We examined MAP (Finometer) in eight trained (T) and eight untrained (UT) individuals prior to, and following, 120 min of cycling at 42 °C with (HYD) and without (DEHY) fluid replacement. Exercise during DEHY induced significant hyperthermia (T: 39.20 ± 0.52 °C vs UT: 38.70 ± 0.......36 °C, P = 0.941) and body weight losses (T: 3.4 ± 1.2% vs UT: 2.7 ± 0.9%, P = 0.332), which did not differ between groups. Although MAP was equally reduced 5 min into the post-exercise period of DEHY (T: -20 ± 11 mmHg vs UT: -22 ± 13 mmHg, P = 0.800), its subsequent recovery was significantly different...

  1. Recovery in skeletal muscle contractile function after prolonged hindlimb immobilization

    Fitts, R. H.; Brimmer, C. J.


    The effect of three-month hindlimb immobilization (IM) in rats on contractile properties of slow-twitch soleus (SOL), fast-twitch extensor digitorum longus, and fast-twitch superficial region of the vastus lateralis were measured after 0, 14, 28, 60, and 90 days of recovery on excized, horizontally suspended muscles stimulated electrically to maximal twitch tension. IM caused decreases in muscle-to-body weight ratios for all muscles, with no complete recovery even after 90 days. The contractile properties of the fast-twitch muscles were less affected by IM than those of the slow-twitch SOL. The SOL isometric twitch duration was shortened, due to reduced contraction and half-relaxation time, both of which returned to control levels after 14 days of recovery. The peak tetanic tension, P(O), g/sq cm,, decreased with IM by 46 percent in the SOL, but recovered by the 28th day. The maximum shortening velocity was not altered by IM in any of the muscles. Thus, normal contractile function could recover after prolonged limb IM.

  2. Rosuvastatin blocks hERG current and prolongs cardiac repolarization.

    Plante, Isabelle; Vigneault, Patrick; Drolet, Benoît; Turgeon, Jacques


    Blocking of the potassium current I(Kr) [human ether-a-go-go related gene (hERG)] is generally associated with an increased risk of long QT syndrome (LQTS). The 3-hydroxy-3-methyl-glutaryl-coenzyme A reductase inhibitor, rosuvastatin, is a methanesulfonamide derivative, which shows structural similarities with several I(Kr) blockers. Hence, we assessed the effects of rosuvastatin on cardiac repolarization by using in vitro, ex vivo, and in vivo models. Patch clamp experiments on hERG-transfected human embryonic kidney (HEK) 293 cells established the potency of rosuvastatin to block hERG [half maximal inhibitory concentration (IC(50) ) = 195 nM]. We showed in isolated guinea pig hearts that 195 nM rosuvastatin prolonged (basic cycle length of 250 ms; p cancer resistance protein (BCRP), multidrug resistance gene (MDR1)] and influx [organic anion transporting polypeptide (OATP) 2B1] transporters involved in the disposition and cardiac distribution of the drug. Genetic polymorphisms observed for BCRP, MDR1, and OATP2B1, and IC(50) determined for hERG blocking lead us to propose that some patients may be at risk of rosuvastatin-induced LQTS.

  3. Prolonged treatment with ursodeoxycholic acid for primary biliary cirrhosis.

    Crippa, G; Cagnoni, C; Castelli, A; Concesi, C; Girometta, S; Pancotti, D; Sverzellati, E; Tacchini, G; Pierfranceschi, M G; Carrara, G C


    Eighteen patients affected with biopsy-proved primary biliary cirrhosis (PBC) (histological stage III and IV) received ursodeoxicholic acid (UDCA) 600 mg for 1 year. Signs and symptoms and biochemical tests (glutamic and oxalcetic transaminase, glutamic and pyruvic transaminase, bilirubine, gamma-glutamyl transpeptidase, alkaline phosphatase, leucine aminopeptidase, bile acids, plasma proteins electrophoresis, immunoglubulins A, G and M) and antimitochondrial antibodies were evaluated before the treatment and every four months during the treatment. The results were compared with those obtained in 8 untreated patients affected PBC. The control group of patients were comparable (as far as age, histological stage, biochemical tests are concerned) to the group who received UDCA. Bilirubine, ALP, gamma-GT and LAP decreased during the treatment with UDCA and remained lower than baseline values until the end of the observation (12 months), while no changes occurred in the untreated patients. Both in the treated and untreated group plasma protein electrophoresis, serum immunoglubulins A, G and M remained unchanged, as well as anti-mitochondrial antibody. A moderate reduction of transaminases and bile acids was observed in the group of patients receiving UDCA but it did not reach statistical significance. In 16 out of the 18 treated patients pruritus disappeared and resulted diminished in the remaining 2 patients. No significant amelioration of pruritus was observed in the patients who did not receive UDCA. In conclusion, our data show that prolonged treatment with UDCA drastically reduces pruritus and improves cholestasis biochemical tests in patients affected with symptomatic PBC.(ABSTRACT TRUNCATED AT 250 WORDS)

  4. Epileptogenesis provoked by prolonged experimental febrile seizures: mechanisms and biomarkers

    Dubé, Celiné M.; Ravizza, Teresa; Hamamura, Mark; Zha, Qinqin; Keebaugh, Andrew; Fok, Kimberly; Andres, Adrienne M.; Nalcioglu, Orhan; Obenaus, Andre; Vezzani, Annamaria; Baram, Tallie Z.


    Whether long febrile seizures (FS) can cause epilepsy in the absence of genetic or acquired predisposing factors is unclear. Having established causality between long FS and limbic epilepsy in an animal model, we studied here if the duration of the inciting FS influenced the probability of developing subsequent epilepsy and the severity of the spontaneous seizures. We evaluated if interictal epileptifom activity and/or elevation of hippocampal T2 signal on MRI provided predictive biomarkers for epileptogenesis, and if the inflammatory mediator interleukin-1β (IL-1β), an intrinsic element of FS generation, contributed also to subsequent epileptogenesis. We found that febrile status epilepticus, lasting an average of 64 minutes, increased the severity and duration of subsequent spontaneous seizures compared with FS averaging 24 minutes. Interictal activity in rats sustaining febrile status epilepticus was also significantly longer and more robust, and correlated with the presence of hippocampal T2 changes in individual rats. Neither T2 changes nor interictal activity predicted epileptogenesis. Hippocampal levels of IL-1β were significantly higher for over 24 hours after prolonged FS. Chronically, IL-1β levels were elevated only in rats developing spontaneous limbic seizures after febrile status epilepticus, consistent with a role for this inflammatory mediator in epileptogenesis. Establishing seizure duration as an important determinant in epileptogenesis, and defining the predictive roles of interictal activity, MRI, and inflammatory processes are of paramount importance to the clinical understanding of the outcome of FS, the most common neurological insult in infants and children. PMID:20519523

  5. Prolonged sleep fragmentation of mice exacerbates febrile responses to lipopolysaccharide

    Ringgold, Kristyn M.; Barf, R. Paulien; George, Amrita; Sutton, Blair C.; Opp, Mark R.


    Background Sleep disruption is a frequent occurrence in modern society. Whereas many studies have focused on the consequences of total sleep deprivation, few have investigated the condition of sleep disruption. New Method We disrupted sleep of mice during the light period for 9 consecutive days using an intermittently-rotating disc. Results Electroencephalogram (EEG) data demonstrated that non-rapid eye movement (NREM) sleep was severely fragmented and REM sleep was essentially abolished during the 12 h light period. During the dark period, when sleep was not disrupted, neither NREM sleep nor REM sleep times differed from control values. Analysis of the EEG revealed a trend for increased power in the peak frequency of the NREM EEG spectra during the dark period. The fragmentation protocol was not overly stressful as body weights and water consumption remained unchanged, and plasma corticosterone did not differ between mice subjected to 3 or 9 days of sleep disruption and home cage controls. However, mice subjected to 9 days of sleep disruption by this method responded to lipopolysaccharide with an exacerbated febrile response. Comparison with existing methods Existing methods to disrupt sleep of laboratory rodents often subject the animal to excessive locomotion, vibration, or sudden movements. This method does not suffer from any of these confounds. Conclusions This study demonstrates that prolonged sleep disruption of mice exacerbates febrile responses to lipopolysaccharide. This device provides a method to determine mechanisms by which chronic insufficient sleep contributes to the etiology of many pathologies, particularly those with an inflammatory component. PMID:23872243

  6. Glucocorticoid augmentation of prolonged exposure therapy: rationale and case report

    Laura Pratchett


    Full Text Available Rationale: Prolonged exposure (PE therapy has been found to reduce symptoms of posttraumatic stress disorder (PTSD; however, it is difficult for many patients to engage fully in the obligatory retelling of their traumatic experiences. This problem is compounded by the fact that habituation and cognitive restructuring – the main mechanisms through which PE is hypothesized to work – are not instantaneous processes, and often require several weeks before the distress associated with imaginal exposure abates. Case reports: Two cases are described that respectively illustrate the use of hydrocortisone and placebo, in combination with PE, for the treatment of combat-related PTSD. Based on known effects of glucocorticoids on learning and memory performance, we hypothesized that augmentation with hydrocortisone would improve the therapeutic effects of PE by hastening “new” learning and facilitating decreases in the emotional impact of fear memories during the course of treatment. The veteran receiving hydrocortisone augmentation of PE displayed an accelerated and ultimately greater decline in PTSD symptoms than the veteran receiving placebo. Conclusions: While no general conclusion can be derived from comparison of two patients, the findings are consistent with the rationale for augmentation. These case reports support the potential for an appropriately designed and powered clinical trial to examine the efficacy of glucocorticoids in augmenting the effects of psychotherapy for PTSD.

  7. Quality assessment of palm products upon prolonged heat treatment.

    Tarmizi, Azmil Haizam Ahmad; Lin, Siew Wai


    Extending the frying-life of oils is of commercial and economic importance. Due to this fact, assessment on the thermal stability of frying oils could provide considerable savings to the food processors. In this study, the physico-chemical properties of five palm products mainly palm oil, single-fractionated palm olein, double-fractionated palm olein, red palm olein and palm-based shortening during 80 hours of heating at 180 degrees C were investigated. Heating properties of these products were then compared with that of high oleic sunflower oil, which was used as reference oil. The indices applied in evaluating the quality changes of oils were free fatty acid, smoke point, p-anisidine value, tocols, polar and polymer compounds. Three palm products i.e. palm oil, single-fractionated palm olein and double-fractionated palm olein were identified to be the most stable in terms of lower formation of free fatty acid, polar and polymer compounds as well as preserving higher smoke point and tocols content compared to the other three oils. The low intensity of hydrolytic and oxidative changes due to prolonged heating, suggests that these palm products are inherently suitable for frying purposes.

  8. Adhesive polydopamine coated avermectin microcapsules for prolonging foliar pesticide retention.

    Jia, Xin; Sheng, Wen-bo; Li, Wei; Tong, Yan-bin; Liu, Zhi-yong; Zhou, Feng


    In this work, we report a conceptual strategy for prolonging foliar pesticide retention by using an adhesive polydopamine (PDA) microcapsule to encapsulate avermectin, thereby minimizing its volatilization and improving its residence time on crop surfaces. Polydopamine coated avermectin (Av@PDA) microcapsules were prepared by emulsion interfacial-polymerization and characterized by Fourier transform infrared spectroscopy, energy dispersive X-ray spectroscopy, field-emission scanning electron microscope, and transmission electron microscopy. The in situ synthesis route confers Av@PDA microcapsules with remarkable avermectin loading ability of up to 66.5% (w/w). Kinetic study of avermectin release demonstrated that Av@PDA microcapsules exhibit sustained- and controlled-release properties. The adhesive property of Av@PDA microcapsules on different surfaces was verified by a comparative study between Av@PDA and passivated Av@SiO2 and Av@PDA@SiO2 capsules with silica shell. Moreover, PDA shell could effectively shield UV irradiation and so protect avermectin from photodegradation, making it more applicable for foliar spraying. Meanwhile, it is determinated that Av@PDA microcapsules have good mechanical stability property.

  9. Axial elongation following prolonged near work in myopes and emmetropes.

    Woodman, Emily C; Read, Scott A; Collins, Michael J; Hegarty, Katherine J; Priddle, Scott B; Smith, Josephine M; Perro, Judd V


    To investigate the influence of a period of sustained near work upon axial length in groups of emmetropes (EMM) and myopes. Forty young adult subjects (20 myopes and 20 emmetropes) were recruited for the study. Myopes were further classified as early onset (EOM), late onset (LOM), stable (SM) or progressing (PM) subgroups. Axial length was measured with the IOLMaster instrument before, immediately after and then again 10 min after a continuous 30 min near task of 5 D accommodation demand. Measures of distance objective refraction were also collected. Significant changes in axial length were observed immediately following the near task. EOM axial length elongated on average by 0.027±0.021 mm, LOM by 0.014±0.020 mm, EMM by 0.010±0.015 mm, PM by 0.031±0.022 mm and SM by 0.014±0.018 mm. At the conclusion of the 10 min regression period, axial length measures were not significantly different from baseline values. Axial elongation was observed following a prolonged near task. Both EOM and PM groups showed increases in axial length that were significantly greater than emmetropes.

  10. Can the rat donor liver tolerate prolonged warm ischemia ?

    Ji Qi Yan; Hong Wei Li; Wei Yao Cai; Ming Jun Zhang; Wei Ping Yang


    The last two decades of the twentieth century have witnessed increasingly successful rates of liver transplantation. The number of liver transplantations has increased steadily while the number of organ donors has remained relatively constant. Thus a great disparity has developed between the demand and supply of donor organs and remains a major limiting factor for further expansion of liver transplantation. Although many procedures, such as split liver[1] , living-related transplantation[2] , and xenotransplantation[3], have been attempted clinically to overcome the shortage, it is hoped that livers harvested from non-heart-beating donors (NHBDs) would alleviatethe problem of organ shortage, which again becomes the focus of attention[4-9]. However, sensitivity of the liver to warm ischemia remains a major worry for use of theNHBDs. The aim of this animal study was to assess if murine liver could tolerate prolonged period of warm ischemia and to determine the optimum timing of intervention in the cadaver donor in order to preserve liver viability.

  11. Heart rate variability analysis for newborn infants prolonged pain assessment.

    De Jonckheere, J; Rakza, T; Logier, R; Jeanne, M; Jounwaz, R; Storme, L


    Pain management is a general concern for healthcare quality. In the particular context of neonatal care, it's well known that an efficient pain management will decrease mortality and morbidity of newborn infants. Furthermore, the plasticity of developing brain is vulnerable to pain and/or stress, that in turn may cause long term neurodevelopmental changes, including altered pain sensitivity and neuroanatomic and behavioural abnormalities. During neonatal intensive care stay, large number of painful procedures are performed, the majority of which are not accompanied by adequate analgesia. Optimal management requires competent pain assessment which can be especially difficult to perform in this non verbal population. We have developed an instantaneous heart rate variability (HRV) analysis method, non intrusive and user-friendly, based on the ECG signal acquisition. This analysis method enabled us to design parameters related to the influence of pain on the Autonomic Nervous System (ANS) activity. This paper presents the application of this method, previously validated for adults under general anesthesia, to the domain of newborn infants prolonged pain assessment.

  12. Reflective equilibrium and empirical data: third person moral experiences in empirical medical ethics.

    De Vries, Martine; Van Leeuwen, Evert


    In ethics, the use of empirical data has become more and more popular, leading to a distinct form of applied ethics, namely empirical ethics. This 'empirical turn' is especially visible in bioethics. There are various ways of combining empirical research and ethical reflection. In this paper we discuss the use of empirical data in a special form of Reflective Equilibrium (RE), namely the Network Model with Third Person Moral Experiences. In this model, the empirical data consist of the moral experiences of people in a practice. Although inclusion of these moral experiences in this specific model of RE can be well defended, their use in the application of the model still raises important questions. What precisely are moral experiences? How to determine relevance of experiences, in other words: should there be a selection of the moral experiences that are eventually used in the RE? How much weight should the empirical data have in the RE? And the key question: can the use of RE by empirical ethicists really produce answers to practical moral questions? In this paper we start to answer the above questions by giving examples taken from our research project on understanding the norm of informed consent in the field of pediatric oncology. We especially emphasize that incorporation of empirical data in a network model can reduce the risk of self-justification and bias and can increase the credibility of the RE reached.

  13. Enhanced detection of paroxysmal atrial fibrillation by early and prolonged continuous holter monitoring in patients with cerebral ischemia presenting in sinus rhythm.

    Stahrenberg, Raoul; Weber-Krüger, Mark; Seegers, Joachim; Edelmann, Frank; Lahno, Rosine; Haase, Beatrice; Mende, Meinhard; Wohlfahrt, Janin; Kermer, Pawel; Vollmann, Dirk; Hasenfuss, Gerd; Gröschel, Klaus; Wachter, Rolf


    Diagnosis of paroxysmal atrial fibrillation is difficult but highly relevant in patients presenting with cerebral ischemia yet free from atrial fibrillation on admission. Early initiation and prolongation of continuous Holter monitoring may improve diagnostic yield compared with the standard of care including a 24-hour Holter recording. In the observational Find-AF trial (ISRCTN 46104198), consecutive patients presenting with symptoms of cerebral ischemia were included. Patients free from atrial fibrillation at presentation received 7-day Holter monitoring. Two hundred eighty-one patients were prospectively included. Forty-four (15.7%) had atrial fibrillation documented by routine electrocardiogram on admission. All remaining patients received Holter monitors at a median of 5.5 hours after presentation. In those 224 patients who received Holter monitors but had no previously known paroxysmal atrial fibrillation, the detection rate with early and prolonged (7 days) Holter monitoring (12.5%) was significantly higher than for any 24-hour (mean of 7 intervals: 4.8%, P = 0.015) or any 48-hour monitoring interval (mean of 6 intervals: 6.4%, P = 0.023). Of those 28 patients with new atrial fibrillation on Holter monitoring, 15 (6.7%) had been discharged without therapeutic anticoagulation after routine clinical care (ie, with data from 24-hour Holter monitoring only). Detection rates were 43.8% or 6.3% for short supraventricular runs of ≥ 10 beats or prolonged episodes (> 5 hours) of atrial fibrillation, respectively. Diagnostic yield appeared to be only slightly and not significantly increased during the first 3 days after the index event. Prolongation of Holter monitoring in patients with symptoms of cerebral ischemic events increases the rate of detection of paroxysmal atrial fibrillation up to Day 7, leading to a relevant change in therapy in a substantial number of patients. Early initiation of monitoring does not appear to be crucial. Hence, prolonged Holter

  14. Initialized Fractional Calculus

    Lorenzo, Carl F.; Hartley, Tom T.


    This paper demonstrates the need for a nonconstant initialization for the fractional calculus and establishes a basic definition set for the initialized fractional differintegral. This definition set allows the formalization of an initialized fractional calculus. Two basis calculi are considered; the Riemann-Liouville and the Grunwald fractional calculi. Two forms of initialization, terminal and side are developed.

  15. Integrated empirical ethics: loss of normativity?

    van der Scheer, Lieke; Widdershoven, Guy


    An important discussion in contemporary ethics concerns the relevance of empirical research for ethics. Specifically, two crucial questions pertain, respectively, to the possibility of inferring normative statements from descriptive statements, and to the danger of a loss of normativity if normative statements should be based on empirical research. Here we take part in the debate and defend integrated empirical ethical research: research in which normative guidelines are established on the basis of empirical research and in which the guidelines are empirically evaluated by focusing on observable consequences. We argue that in our concrete example normative statements are not derived from descriptive statements, but are developed within a process of reflection and dialogue that goes on within a specific praxis. Moreover, we show that the distinction in experience between the desirable and the undesirable precludes relativism. The normative guidelines so developed are both critical and normative: they help in choosing the right action and in evaluating that action. Finally, following Aristotle, we plead for a return to the view that morality and ethics are inherently related to one another, and for an acknowledgment of the fact that moral judgments have their origin in experience which is always related to historical and cultural circumstances.

  16. Central and regional hemodynamics in prolonged space flights

    Gazenko, O. G.; Shulzhenko, E. B.; Turchaninova, V. F.; Egorov, A. D.

    This paper presents the results of measuring central and regional (head, forearm, calf) hemodynamics at rest and during provocative tests by the method of tetrapolar rheography in the course of Salyut-6-Soyuz and Salyut-7-Soyuz missions. The measurements were carried out during short-term (19 man-flights of 7 days in duration) and long-term (21 man-flights of 65-237 days in duration) manned missions. At rest, stroke volume (SV) and cardiac output (CO) as well as heart rate (HR) decreased insignificantly (in short-term flights) or remained essentially unchanged (in long-term flights). In prolonged flights CO increased significantly in response to exercise tests due to an increase in HR and the lack of changes in SV. After exercise tests SV and CO decreased as compared to the preflight level. During lower body negative pressure (LBNP) tests HR and CO were slightly higher than preflight. Changes in regional hemodynamics included a distinct decrease of pulse blood filling (PBF) of the calf, a reduction of the tone of large vessels of the calf and small vessels of the forearm. Head examination (in the region of the internal carotid artery) showed a decrease of PBF of the left hemisphere (during flight months 2-8) and a distinct decline of the tone of small vessels, mainly, in the right hemisphere. During LBNP tests the tone of pre- and postcapillary vessels of the brain returned to normal while PBF of the right and left hemisphere vessels declined. It has been shown that regional circulation variations depend on the area examined and are induced by a rearrangement of total hemodynamics of the human body in microgravity. This paper reviews the data concerning changes in central and regional circulation of men in space flights of different duration.

  17. Does obesity prolong anesthesia in children undergoing common ENT surgery?

    Lee, Jennifer J; Sun, Lena S; Gu, Brian; Kim, Minjae; Wang, Shuang; Han, Sena


    To report the epidemiology of obesity in a pediatric surgical population and determine whether obesity is a risk factor for longer anesthesia duration. Childhood obesity is a significant public health problem in the United States. Epidemiologic studies on pediatric surgical populations have been limited to states with very high prevalence of adult obesity (Michigan, Texas). Data from other states and more recent data since 2006 are unavailable. We examined anesthesia records for surgical patients age 2-18 years at Columbia University Medical Center from January 2009 to December 2010. Patients undergoing bariatric surgery or those with records missing preoperative height or weight data were excluded. Body mass index (BMI) was calculated as weight (kg)/height (m(2) ). BMI ≥95th percentile according to national growth charts were considered obese. We reviewed 9522 patients of which 1639 were obese (17.2%). The sex-age category interaction on obesity was not significant using logistic regression (P = 0.11). Among surgical groups, the otolaryngology (ENT) cohort had the highest obesity rate (21.7%, 360/1656). Obese children who had tonsillectomy, adenoidectomy, or both did not have a prolonged anesthetic (P = 0.33) or surgical duration (P = 0.61) compared with nonobese children, adjusting for surgeon, season, surgical procedure code, and ASA status. Children presenting for surgery, particularly the ENT cohort, have a high prevalence of obesity. Obese and nonobese children who had tonsillectomy, adenoidectomy, or both had comparable durations of anesthesia. Therefore, obesity did not lead to longer anesthetic duration. © 2014 John Wiley & Sons Ltd.

  18. Intrasplenic transplantation of allogeneic hepatocytes prolongs survival in anhepatic rats.

    Arkadopoulos, N; Lilja, H; Suh, K S; Demetriou, A A; Rozga, J


    To examine whether hepatocytes transplanted in the spleen can function as an ectopic liver, we performed hepatocyte transplantation in rats that were rendered anhepatic. Total hepatectomy was performed by using a novel single-stage technique. Following hepatectomy, Group 1 rats (n = 16) were monitored until death to determine survival time without prior intervention. Group 2 anhepatic rats (n = 20) were sacrificed at various times to measure blood hepatocyte growth factor (HGF) and transforming growth factor beta1 (TGF-beta1) levels. Group 3 (n = 16) rats received intrasplenic injection of isolated hepatocytes (2.5 x 10(7) cells/rat) followed by total hepatectomy after 3 days. Group 4 (n = 12) sham-transplanted rats received intrasplenic saline infusion, and after 3 days they were rendered anhepatic. Group 2, 3, and 4 rats were maintained on daily Cyclosporine A (10 mg/kg; intramuscularly). Group 1 anhepatic rats survived for 22.4 +/- 5.2 hours (standard deviation). The anhepatic state was associated with a progressive and statistically significant rise in blood HGF and TGF-beta1 levels. Rats that received hepatocyte transplantation before total hepatectomy had a significantly longer survival time than sham-transplanted anhepatic controls (34.1 +/- 8.5 vs. 15.5 +/- 4.8 hrs, P ammonia, prothrombin time, international normalized ratio, and TGF-beta1 levels when compared with sham-transplanted controls. In conclusion, intrasplenic transplantation of allogeneic hepatocytes prolonged survival, improved blood chemistry, and lowered blood TGF-beta1 levels in rats rendered anhepatic.

  19. Neural effects of prolonged mental fatigue: a magnetoencephalography study.

    Ishii, Akira; Tanaka, Masaaki; Shigihara, Yoshihito; Kanai, Etsuko; Funakura, Masami; Watanabe, Yasuyoshi


    Mental fatigue, manifest as a reduced efficiency for mental work load, is prevalent in modern society. It is important to understand the neural mechanisms of mental fatigue and to develop appropriate methods for evaluating mental fatigue. In this study we quantified the effect of a long-duration mental fatigue-inducing task on neural activity. We used magnetoencephalography (MEG) to examine the time course change of neural activity over the long duration of the task trials. Nine healthy male volunteers participated in this study. They performed two mental fatigue-inducing tasks on separate days. The order of task presentation was randomized in a single-blinded, crossover fashion. Each task consisted of 25-min mental fatigue-inducing 0- or 2-back task session for three times. Subjective rating of mental fatigue sensation and electrocardiogram, and resting state MEG measurements were performed just before and after each task session. MEG data were analyzed using narrow-band adaptive spatial filtering methods. Alpha band (8-13 Hz) power in the visual cortex decreased after performing the mental fatigue-inducing tasks, and the decrease of alpha power was greater when they performed 2-back task trials. The decrease in alpha power was positively associated with the self-reported level of mental fatigue sensation and sympathetic nerve activity level. These results demonstrate that performing the prolonged mental fatigue-inducing task causes overactivation of the visual cortex, manifest as decreased alpha power in this brain region. Our results increase understanding of the neural mechanisms of mental fatigue and can be used to develop new quantitative methods to assess mental fatigue.

  20. Prolonged Cerebrospinal Fluid Neurofilament Light Chain Increase in Patients with Post-Traumatic Disorders of Consciousness.

    Bagnato, Sergio; Grimaldi, Luigi M E; Di Raimondo, Giorgio; Sant'Angelo, Antonino; Boccagni, Cristina; Virgilio, Vittorio; Andriolo, Maria


    The mechanisms involved in secondary brain injury after the acute phase of severe traumatic brain injury (TBI) are largely unknown. Ongoing axonal degeneration, consequent to the initial trauma, may lead to secondary brain injury. To test this hypothesis, we evaluated the cerebrospinal fluid (CSF) level of neurofilament light chain (NF-L), a proposed marker of axonal degeneration, in 10 patients who developed a severe disorder of consciousness after a TBI, including 7 in a minimally conscious state and 3 with unresponsive wakefulness syndrome (time since brain injury, 309 ± 169 days). CSF NF-L level was measured with a commercially available NF-L enzyme-linked immunosorbent assay. CSF NF-L level was very high in all 10 patients, ranging from 2.4- to 60.5-fold the upper normal limit (median value, 4458 pg/mL; range, 695-23,000). Moreover, NF-L level was significantly higher after a severe TBI than in a reference group of 9 patients with probable Alzheimer's disease, a population with elevated levels of CSF NF-L attributed to neuronal degeneration (median value, 1173 pg/mL; range, 670-3643; p < 0.01). CSF NF-L level was correlated with time post-TBI (p = 0.04). These results demonstrate prolonged secondary brain injury, suggesting that patients exhibit ongoing axonal degeneration up to 19 months after a severe TBI.

  1. Predictors of Recovery from Traumatic Brain Injury-Induced Prolonged Consciousness Disorder

    Hiroaki Abe


    Full Text Available We investigated the clinical predictors of the degree of recovery in patients with prolonged disorders of consciousness (PDC caused by traumatic brain injury. Fourteen patients with PDC underwent two diffusion tensor imaging (DTI studies; the first and second scans were performed at 345.6±192.6 and 689.1±272.2 days after the injury, respectively. In addition to the temporal changes in each of these diffusion parameters, fractional anisotropy (FA, mean diffusivity, axial diffusivity (AD, and radial diffusivity were assessed over a 1-year period. Relationship of clinical and DTI parameters with recovery from PDC (RPDC was evaluated using Spearman’s rank-correlation and stepwise multiple linear regression analysis. The mean FA and number of voxels with FA values > 0.4 (VsFA0.4 were significantly decreased at the second scan. A significant positive correlation was observed between the degree of RPDC and mean FA (r=0.60 and VsFA0.4 (r=0.68 as well as between the difference in VsFA0.4 (r=0.63 and AD (r=0.54 between the first and second scans. On multiple linear regression analysis, initial severity of PDC and the difference in AD remained significantly associated with the degree of RPDC. The microstructural white matter changes observed in this study indicate their potential relation with the degree of RPDC over the longer term.

  2. Development of buccal adhesive tablet with prolonged antifungal activity: Optimization and ex vivo deposition studies

    Madgulkar A


    Full Text Available The purpose of the present work was to prepare buccal adhesive tablets of miconazole nitrate. The simplex centroid experimental design was used to arrive at optimum ratio of carbopol 934P, hydroxypropylmethylcellulose K4M and polyvinylpyrollidone, which will provide desired drug release and mucoadhesion. Swelling index, mucoadhesive strength and in vitro drug release of the prepared tablet was determined. The drug release and bioadhesion was dependent on type and relative amounts of the polymers. The optimized combination was subjected to in vitro antifungal activity, transmucosal permeation, drug deposition in mucosa, residence time and bioadhesion studies. IR spectroscopy was used to investigate any interaction between drug and excipients. Dissolution of miconazole from tablets was sustained for 6 h. based on the results obtained, it can be concluded that the prepared slow release buccoadhesive tablets of miconazole would markedly prolong the duration of antifungal activity. Comparison of in vitro antifungal activity of tablet with marketed gel showed that drug concentrations above the minimum inhibitory concentration were achieved immediately from both formulations but release from tablet was sustained up to 6 h, while the gel showed initially fast drug release, which did not sustain later. Drug permeation across buccal mucosa was minimum from the tablet as well as marketed gel; the deposition of drug in mucosa was higher in case of tablet. In vitro residence time and bioadhesive strength of tablet was higher than gel. Thus the buccoadhesive tablet of miconazole nitrate may offer better control of antifungal activity as compared to the gel formulation.

  3. Genomic Variability of Serial Human Isolates of Salmonella enterica Serovar Typhimurium Associated with Prolonged Carriage.

    Octavia, Sophie; Wang, Qinning; Tanaka, Mark M; Sintchenko, Vitali; Lan, Ruiting


    Salmonella enterica serovar Typhimurium is an important foodborne human pathogen that often causes self-limiting but severe gastroenteritis. Prolonged excretion of S. Typhimurium after the infection can lead to secondary transmissions. However, little is known about within-host genomic variation in bacteria associated with asymptomatic shedding. Genomes of 35 longitudinal isolates of S. Typhimurium recovered from 11 patients (children and adults) with culture-confirmed gastroenteritis were sequenced. There were three or four isolates obtained from each patient. Single nucleotide polymorphisms (SNPs) were analyzed in these isolates, which were recovered between 1 and 279 days after the initial diagnosis. Limited genomic variation (5 SNPs or fewer) was associated with short- and long-term carriage of S. Typhimurium. None of the isolates was shown to be due to reinfection. SNPs occurred randomly, and the majority of the SNPs were nonsynonymous. Two nonsense mutations were observed. A nonsense mutation in flhC rendered the isolate nonmotile, whereas the significance of a nonsense mutation in yihV is unknown. The estimated mutation rate is 1.49 × 10(-6) substitution per site per year. S. Typhimurium isolates excreted in stools following acute gastroenteritis in children and adults demonstrated limited genomic variability over time, regardless of the duration of carriage. These findings have important implications for the detection of possible transmission events suspected by public health genomic surveillance of S. Typhimurium infections.

  4. The effects of prolonged exposure and sertraline on emotion regulation in individuals with posttraumatic stress disorder.

    Jerud, Alissa B; Pruitt, Larry D; Zoellner, Lori A; Feeny, Norah C


    The effects of current posttraumatic stress disorder (PTSD) interventions on emotion regulation are relatively unknown. Many conceptualize PTSD as a disorder of emotion dysregulation, and clinicians often fear that emotion regulation impairments will not change with stand-alone PTSD treatments, particularly for individuals with pre-existing emotion regulation difficulties. The present study examined changes in emotion regulation (expressive suppression, cognitive reappraisal, negative mood regulation) with prolonged exposure (PE) therapy or sertraline, specifically examining whether those with higher pre-existing emotion regulation difficulties improved over treatment on these indices. Individuals with chronic PTSD (N = 200) received 10 weeks of PE or sertraline and were followed through 6-month follow-up. Emotion regulation was assessed at pre- and post-treatment and at 3- and 6-month follow-up. Individuals with poorer initial emotion regulation showed greater improvement on all indices of emotion regulation, regardless of which treatment they received. Changes occurred during active treatment and were maintained over follow-up. These findings have both theoretical and clinical implications, arguing that emotion regulation is not impaired across all individuals with PTSD and that PE and sertraline effectively address emotion regulation difficulties.

  5. Utilization of squid pen for the efficient production of chitosanase and antioxidants through prolonged autoclave treatment.

    Wang, San-Lang; Wu, Pei-Chen; Liang, Tzu-Wen


    We have developed a culture system for efficient production of chitosanase by Bacillus sp. TKU004. TKU004 was cultivated by using squid pen powder as the sole carbon/nitrogen source. The effects of autoclave treatments of the medium on the production of chitosanase were investigated. Autoclave treatment of squid pen powder for 45 min remarkably promoted enzyme productivity. When the culture medium containing an initial squid pen powder concentration of 3% was autoclaved for 45 min, the chitosanase activity was optimal and reached 0.14-0.16 U/mL. In addition, extracellular surfactant-stable chitosanase was purified from the TKU004 culture supernatant. The antioxidant activity of TKU004 culture supernatant was determined through the scavenging ability of DPPH, with 70% per mL. With this method, we have shown that marine wastes can be utilized efficiently through prolonged autoclave treatments to generate a high value-added product, and have revealed its hidden potential in the production of functional foods.

  6. Spine Posture and Discomfort During Prolonged Simulated Driving With Self-Selected Lumbar Support Prominence.

    De Carvalho, Diana E; Callaghan, Jack P


    We examined magnitude preference, subjective discomfort, and spine posture during prolonged simulated driving with a self-selected amount of lumbar support. The general use of lumbar supports has been associated with decreased reports of low-back pain during driving exposures; however, minimal data exist regarding occupant magnitude preference. Participants chose between five discrete levels of lumbar support (0-4 cm). Time-varying postural and discomfort responses were then monitored throughout 2 hr of simulated driving. There were no significant effects of gender or time on posture. Women preferred larger amounts of support than men (3.25 cm ± 0.71 and 2.56 cm ± 0.88, respectively, p = .048). All participants exhibited significant increases (p = .003) in pelvic discomfort throughout the 2-hr trial regardless of the level of support chosen. Discomfort related to various aspects of the lumbar support increased significantly over time. Retrospectively, no participants desired a setting beyond 4 cm, and the majority of respondents indicate had they been able to change their initial selection, they would choose a setting between 2 and 3 cm. The results suggest that occupants would prefer increasing the excursion capability of automobile lumbar supports beyond 2 cm. Excursion capability and adjustability of automobile lumbar supports are important features to better meet end-user preference and to reducing lumbar flexion in sitting. © 2015, Human Factors and Ergonomics Society.

  7. Wireless and empire geopolitics radio industry and ionosphere in the British Empire 1918-1939

    Anduaga, Aitor


    Although the product of consensus politics, the British Empire was based on communications supremacy and the knowledge of the atmosphere. Focusing on science, industry, government, the military, and education, this book studies the relationship between wireless and Empire throughout the interwar period.

  8. Prolonged Culture of Aligned Skeletal Myotubes on Micromolded Gelatin Hydrogels

    Bettadapur, Archana; Suh, Gio C.; Geisse, Nicholas A.; Wang, Evelyn R.; Hua, Clara; Huber, Holly A.; Viscio, Alyssa A.; Kim, Joon Young; Strickland, Julie B.; McCain, Megan L.


    In vitro models of skeletal muscle are critically needed to elucidate disease mechanisms, identify therapeutic targets, and test drugs pre-clinically. However, culturing skeletal muscle has been challenging due to myotube delamination from synthetic culture substrates approximately one week after initiating differentiation from myoblasts. In this study, we successfully maintained aligned skeletal myotubes differentiated from C2C12 mouse skeletal myoblasts for three weeks by utilizing micromolded (μmolded) gelatin hydrogels as culture substrates, which we thoroughly characterized using atomic force microscopy (AFM). Compared to polydimethylsiloxane (PDMS) microcontact printed (μprinted) with fibronectin (FN), cell adhesion on gelatin hydrogel constructs was significantly higher one week and three weeks after initiating differentiation. Delamination from FN-μprinted PDMS precluded robust detection of myotubes. Compared to a softer blend of PDMS μprinted with FN, myogenic index, myotube width, and myotube length on μmolded gelatin hydrogels was similar one week after initiating differentiation. However, three weeks after initiating differentiation, these parameters were significantly higher on μmolded gelatin hydrogels compared to FN-μprinted soft PDMS constructs. Similar results were observed on isotropic versions of each substrate, suggesting that these findings are independent of substrate patterning. Our platform enables novel studies into skeletal muscle development and disease and chronic drug testing in vitro.

  9. Risk Factors of Prolonged Postoperative Pleural Effusion After Repair of Tetralogy of Fallot

    Chi-Ming Liang


    Conclusion: Prolonged PE is a significant morbidity after TOF repair. The risk factors for prolonged PE are gender, age at repair, body weight, bypass time, low oxygen saturation before surgery, wound infection after surgery, duration of endotracheal intubation, length of hospital stay, and Nakata index. Oxygen saturation before surgery and wound infection were major risk factors while age at repair was a confounder.

  10. Jobs encompassing prolonged sitting in cramped positions and risk of venous thromboembolism

    Suadicani, Poul; Hannerz, Harald; Bach, Elsa


    There is mounting evidence that prolonged cramped sitting in connection with long-lasting air travel increases the risk of deep vein thrombosis of the legs and pulmonary embolism, i.e. venous thromboembolism (VTE). Prolonged cramped sitting may occur even in various jobs unrelated to air travel...

  11. Prolonged treatment for acute symptomatic refractory status epilepticus: outcome in children.

    Sahin, Mustafa; Menache, Caroline C; Holmes, Gregory L; Riviello, James J


    High-dose suppressive therapy (HDST) is used to treat refractory status epilepticus (RSE). Prolonged therapy is required in some cases, and prognosis is important in making therapeutic decisions. The authors therefore studied the long-term outcome in previously normal children who survived prolonged HDST for acute symptomatic RSE. All have intractable epilepsy, and none returned to baseline.

  12. Hepatic scar in a case of healed candidiasis showing prolonged enhancement on CT

    Itai, Yuji; Yashiro, Naobumi


    A patient with acute myelocytic leukemia recovering from hepatic candidiasis after long-term administration of amphotericin B had large scar in the liver which showed prominent prolonged enhancement on postcontrast CT. Prolonged enhancement can occur in regions other than hepatic masses.

  13. Invariant prolongation of overdetermined PDE's in projective, conformal and Grassmannian geometry

    Hammerl, Matthias; Souček, Vladimír; Šilhan, Josef


    This is the second in a series of papers on natural modification of the normal tractor connection in a parabolic geometry, which naturally prolongs an underlying overdetermined system of invariant differential equations. We give a short review of the general procedure developed in [5] and then compute the prolongation covariant derivatives for a number of interesting examples in projective, conformal and Grassmannian geometries.

  14. Risk factors for a prolonged operative time in a single-incision laparoscopic cholecystectomy

    Sato, Norihiro; Yabuki, Kei; Shibao, Kazunori; Mori, Yasuhisa; Tamura, Toshihisa; Higure, Aiichiro; Yamaguchi, Koji


    Background: A prolonged operative time is associated with adverse post-operative outcomes in laparoscopic surgery. Although a single-incision laparoscopic cholecystectomy (SILC) requires a longer operative time as compared with a conventional laparoscopic cholecystectomy, risk factors for a prolonged operative time in SILC remain unknown.

  15. Clinically relevant QTc prolongation due to overridden drug-drug interaction alerts: A retrospective cohort study

    I.H. van der Sijs (Heleen); R. Kowlesar (Ravi); A.P.J. Klootwijk (Peter); S.P. Nelwan (Stefan); A.G. Vulto (Arnold); T. van Gelder (Teun)


    textabstractAIMS: To investigate whether, in patients in whom drug-drug interaction (DDI) alerts on QTc prolongation were overridden, the physician had requested an electrocardiogram (ECG), and if these ECGs showed clinically relevant QTc prolongation. METHODS: For all patients with overridden DDI a

  16. Generalized lymphadenopathy as a marker of ongoing inflammation in prolonged cholestatic hepatitis A.

    Mukhopadhya, Ashis; Chandy, George M


    Extrahepatic manifestations of hepatitis A are very unusual. We describe a case of prolonged cholestatic hepatitis A in a patient with generalized lymphadenopathy. With normalization of transaminases, there was an accompanying reduction in size of these lymph nodes. Lymphadenopathy reflects ongoing hepatic inflammation in prolonged cholestatic hepatitis A.

  17. Initial Distribution Spread: A density forecasting approach

    Machete, Reason L


    Ensemble forecasting of nonlinear systems involves the use of a model to run forward a discrete ensemble (or set) of initial states. Data assimilation techniques tend to focus on estimating the true state of the system, even though model error limits the value of such efforts. This paper argues for choosing the initial ensemble in order to optimise forecasting performance rather than estimate the true state of the system. Density forecasting and choosing the initial ensemble are treated as one problem. Forecasting performance can be quantified by some scoring rule. In the case of the logarithmic scoring rule, theoretical arguments and empirical results are presented. It turns out that, if the underlying noise dominates model error, we can diagnose the noise spread.

  18. Empires and the Sovereign State Order


    the totality of relations between independent sovereign states. So the ‘question of empires’ and international relations can be formulated as: what role might empires have in the context of international order that has been widely understood to comprise first and foremost autonomous states? Hence my title......For all the sustained discussion about the inclusion of bodies other than states (Ruggie 1993, 1998; Ferguson and Mansbach 1996, 2007; Nancy 2007; Walker 1993, 2010) the object of analysis of international politics, the ‘IR system as such’, remains largely focused (as the name suggests) upon....... Is it, for example, adequate to imagine a world of states with occasional interference from one or more empires to cover anomalies or exceptions where standard models of international order do not seem to work? That still leaves the idea of empires on the sidelines, an intrusion, a sticking plaster...

  19. ECG signal denoising via empirical wavelet transform.

    Singh, Omkar; Sunkaria, Ramesh Kumar


    This paper presents new methods for baseline wander correction and powerline interference reduction in electrocardiogram (ECG) signals using empirical wavelet transform (EWT). During data acquisition of ECG signal, various noise sources such as powerline interference, baseline wander and muscle artifacts contaminate the information bearing ECG signal. For better analysis and interpretation, the ECG signal must be free of noise. In the present work, a new approach is used to filter baseline wander and power line interference from the ECG signal. The technique utilized is the empirical wavelet transform, which is a new method used to compute the building modes of a given signal. Its performance as a filter is compared to the standard linear filters and empirical mode decomposition.The results show that EWT delivers a better performance.

  20. Empirical Bayes analysis of single nucleotide polymorphisms

    Ickstadt Katja


    Full Text Available Abstract Background An important goal of whole-genome studies concerned with single nucleotide polymorphisms (SNPs is the identification of SNPs associated with a covariate of interest such as the case-control status or the type of cancer. Since these studies often comprise the genotypes of hundreds of thousands of SNPs, methods are required that can cope with the corresponding multiple testing problem. For the analysis of gene expression data, approaches such as the empirical Bayes analysis of microarrays have been developed particularly for the detection of genes associated with the response. However, the empirical Bayes analysis of microarrays has only been suggested for binary responses when considering expression values, i.e. continuous predictors. Results In this paper, we propose a modification of this empirical Bayes analysis that can be used to analyze high-dimensional categorical SNP data. This approach along with a generalized version of the original empirical Bayes method are available in the R package siggenes version 1.10.0 and later that can be downloaded from Conclusion As applications to two subsets of the HapMap data show, the empirical Bayes analysis of microarrays cannot only be used to analyze continuous gene expression data, but also be applied to categorical SNP data, where the response is not restricted to be binary. In association studies in which typically several ten to a few hundred SNPs are considered, our approach can furthermore be employed to test interactions of SNPs. Moreover, the posterior probabilities resulting from the empirical Bayes analysis of (prespecified interactions/genotypes can also be used to quantify the importance of these interactions.

  1. Prolonged Grief in Palliative Family Caregivers: A Pilot Study in a Portuguese Sample.

    Coelho, Alexandra; Delalibera, Mayra; Barbosa, António; Lawlor, Peter


    Caregivers are particularly vulnerable to experience intense levels of distress following the loss. The aim of this prospective pilot study is to determine the incidence of prolonged grief disorder symptoms among caregivers. A total of 73 bereaved families responded to the Prolonged Grief Disorder Evaluation Instrument (PG-13) at 6 and 12 months following their loss. The incidence of prolonged grief disorder at the first assessment was 28.8%, and it decreased to 15.1% at the second assessment. The prevalence of prolonged grief disorder declined significantly over time (p = .041). In the second evaluation, six bereaved individuals continued to meet criteria for a diagnosis of prolonged grief disorder, 15 remitted, and 4 new (incident) cases emerged. The important differences in values that occur after 12 months suggest time is important in distinguishing between those at risk for persistent distress and those whose grief symptomatology will decrease with time.

  2. [Drug-induced QT interval prolongation: do we know the risks?].

    Villamañán, Elena; Armada, Eduardo; Ruano, Margarita


    Sudden cardiac death is an important cause of mortality in developed countries, most of them being consequence of acute ventricular arrhythmias. These arrhythmias, in some cases, owe to QT interval prolongation. A major risk factor for this condition is the use of drugs that prolong the QT interval. In fact, in recent years, one of the most common reasons for drug withdrawal or usage restrictions has been drug induced QT interval prolongation that involves both cardiovascular and non-cardiovascular drugs. Taking into account the severity that the occurrence of such an event may have, it is important for clinicians to know the risks of these drugs in certain patients. In this review we analyze the drugs that prolong the QT interval, the risk factors that can enhance QT prolongation and the drug interactions that can increase these risks. Copyright © 2013 Elsevier España, S.L.U. All rights reserved.

  3. Univariate Risk Factors for Prolonged Mechanical Ventilation in Patients Undergoing Prosthetic Heart Valves Replacement Surgery


    Data from 736 patients undergoing prosthetic heart valve replacement surgery and concomitant surgery (combined surgery) from January 1998 to January 2004 at Union Hospital were retrospectively reviewed. Univariate logistic regression analyses were conducted to identify risk factors for prolonged mechanical ventilation. The results showed that prolonged cardiopulmonary bypass duration, prolonged aortic cross clamp time and low ejection fraction less than 50 percent (50 %)were found to be independent predictors for prolonged mechanical ventilation. Meanwhile age,weight, and preoperative hospital stay (days) were not found to be associated with prolonged mechanical ventilation. It was concluded that, for age and weight, this might be due to the lower number of old age patients (70 years and above) included in our study and genetic body structure of majority Chinese population that favor them to be in normal weight, respectively.

  4. Empirical evaluation methods in computer vision

    Christensen, Henrik I


    This book provides comprehensive coverage of methods for the empirical evaluation of computer vision techniques. The practical use of computer vision requires empirical evaluation to ensure that the overall system has a guaranteed performance. The book contains articles that cover the design of experiments for evaluation, range image segmentation, the evaluation of face recognition and diffusion methods, image matching using correlation methods, and the performance of medical image processing algorithms. Sample Chapter(s). Foreword (228 KB). Chapter 1: Introduction (505 KB). Contents: Automate

  5. Evaluation of empirical atmospheric diffusion data

    Horst, T.W.; Doran, J.C.; Nickola, P.W.


    A study has been made of atmospheric diffusion over level, homogeneous terrain of contaminants released from non-buoyant point sources up to 100 m in height. Current theories of diffusion are compared to empirical diffusion data, and specific dispersion estimation techniques are recommended which can be implemented with the on-site meteorological instrumentation required by the Nuclear Regulatory Commission. A comparison of both the recommended diffusion model and the NRC diffusion model with the empirical data demonstrates that the predictions of the recommended model have both smaller scatter and less bias, particularly for ground-level sources.

  6. Empirical Model Building Data, Models, and Reality

    Thompson, James R


    Praise for the First Edition "This...novel and highly stimulating book, which emphasizes solving real problems...should be widely read. It will have a positive and lasting effect on the teaching of modeling and statistics in general." - Short Book Reviews This new edition features developments and real-world examples that showcase essential empirical modeling techniques Successful empirical model building is founded on the relationship between data and approximate representations of the real systems that generated that data. As a result, it is essential for researchers who construct these m

  7. Bottom-up Initiatives for Photovoltaic: Incentives and Barriers

    Kathrin Reinsberger


    Full Text Available When facing the challenge of restructuring the energy system, bottom-up initiatives can aid the diffusion of decentralized and clean energy technologies. We focused here on a bottom-up initiative of citizen-funded and citizen-operated photovoltaic power plants. The project follows a case study-based approach and examines two different community initiatives. The aim is to investigate the potential incentives and barriers relating to participation or non-participation in predefined community PV projects. Qualitative, as well as quantitative empirical research was used to examine the key factors in the further development of bottom-up initiatives as contributors to a general energy transition.

  8. Effects of prolonged lung inflation or deflation on pulmonary stretch receptor discharge in the alligator (Alligator mississippiensis).

    Marschand, Rachel E; Wilson, Jenna L; Burleson, Mark L; Crossley, Dane A; Hedrick, Michael S


    The American alligator (Alligator mississippiensis) is a semi-aquatic diving reptile that has a periodic breathing pattern. Previous work identified pulmonary stretch receptors, that are rapidly and slowly adapting, as well as intrapulmonary chemoreceptors (IPC), sensitive to CO2, that modulate breathing patterns in alligators. The purpose of the present study was to quantify the effects of prolonged lung inflation and deflation (simulated dives) on pulmonary stretch receptors (PSR) and/or IPC discharge characteristics. The effects of airway pressure (0-20 cm H2O), hypercapnia (7% CO2), and hypoxia (5% O2) on dynamic and static responses of PSR were studied in juvenile alligators (mean mass=246 g) at 24°C. Alligators were initially anesthetized with isoflurane, cranially pithed, tracheotomized and artificially ventilated. Vagal afferent tonic and phasic activity was recorded with platinum hook electrodes. Receptor activity was a mixture of slowly adapting PSR (SAR) and rapidly adapting PSR (RAR) with varying thresholds and degrees of adaptation, without CO2 sensitivity. Receptor activity before, during and after 1 min periods of lung inflation and deflation was quantified to examine the effect of simulated breath-hold dives. Some PSR showed a change in dynamic response, exhibiting inhibition for several breaths after prolonged lung inflation. Following 1 min deflation, RAR, but not SAR, exhibited a significant potentiation of burst frequency relative to control. For SAR, the post-inflation receptor inhibition was blocked by CO2 and hypoxia; for RAR, the post-inflation inhibition was potentiated by CO2 and blocked by hypoxia. These results suggest that changes in PSR firing following prolonged inflation and deflation may promote post-dive ventilation in alligators. We hypothesize that PSR in alligators may be involved in recovery of breathing patterns and lung volume during pre- and post-diving behavior and apneic periods in diving reptiles.

  9. An empirical test of Maslow's theory of need hierarchy using hologeistic comparison by statistical sampling.

    Davis-Sharts, J


    Maslow's hierarchy of basic human needs provides a major theoretical framework in nursing science. The purpose of this study was to empirically test Maslow's need theory, specifically at the levels of physiological and security needs, using a hologeistic comparative method. Thirty cultures taken from the 60 cultural units in the Health Relations Area Files (HRAF) Probability Sample were found to have data available for examining hypotheses about thermoregulatory (physiological) and protective (security) behaviors practiced prior to sleep onset. The findings demonstrate there is initial worldwide empirical evidence to support Maslow's need hierarchy.

  10. Experimental and Empirical Time to Corrosion of Reinforced Concrete Structures under Different Curing Conditions

    Ahmed A. Abouhussien


    Full Text Available Reinforced concrete structures, especially those in marine environments, are commonly subjected to high concentrations of chlorides, which eventually leads to corrosion of the embedded reinforcing steel. The total time to corrosion of such structures may be divided into three stages: corrosion initiation, cracking, and damage periods. This paper evaluates, both empirically and experimentally, the expected time to corrosion of reinforced concrete structures. The tested reinforced concrete samples were subjected to ten alternative curing techniques, including hot, cold, and normal temperatures, prior to testing. The corrosion initiation, cracking, and damage periods in this investigation were experimentally monitored by an accelerated corrosion test performed on reinforced concrete samples. Alternatively, the corrosion initiation time for counterpart samples was empirically predicted using Fick’s second law of diffusion for comparison. The results showed that the corrosion initiation periods obtained experimentally were comparable to those obtained empirically. The corrosion initiation was found to occur at the first jump of the current measurement in the accelerated corrosion test which matched the half-cell potential reading of around −350 mV.

  11. An empirical examination of the factor structure of compassion

    Gu, Jenny; Cavanagh, Kate; Baer, Ruth


    Compassion has long been regarded as a core part of our humanity by contemplative traditions, and in recent years, it has received growing research interest. Following a recent review of existing conceptualisations, compassion has been defined as consisting of the following five elements: 1) recognising suffering, 2) understanding the universality of suffering in human experience, 3) feeling moved by the person suffering and emotionally connecting with their distress, 4) tolerating uncomfortable feelings aroused (e.g., fear, distress) so that we remain open to and accepting of the person suffering, and 5) acting or being motivated to act to alleviate suffering. As a prerequisite to developing a high quality compassion measure and furthering research in this field, the current study empirically investigated the factor structure of the five-element definition using a combination of existing and newly generated self-report items. This study consisted of three stages: a systematic consultation with experts to review items from existing self-report measures of compassion and generate additional items (Stage 1), exploratory factor analysis of items gathered from Stage 1 to identify the underlying structure of compassion (Stage 2), and confirmatory factor analysis to validate the identified factor structure (Stage 3). Findings showed preliminary empirical support for a five-factor structure of compassion consistent with the five-element definition. However, findings indicated that the ‘tolerating’ factor may be problematic and not a core aspect of compassion. This possibility requires further empirical testing. Limitations with items from included measures lead us to recommend against using these items collectively to assess compassion. Instead, we call for the development of a new self-report measure of compassion, using the five-element definition to guide item generation. We recommend including newly generated ‘tolerating’ items in the initial item pool, to

  12. Comparison of blade-strike modeling results with empirical data

    Ploskey, Gene R. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Carlson, Thomas J. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States)


    This study is the initial stage of further investigation into the dynamics of injury to fish during passage through a turbine runner. As part of the study, Pacific Northwest National Laboratory (PNNL) estimated the probability of blade strike, and associated injury, as a function of fish length and turbine operating geometry at two adjacent turbines in Powerhouse 1 of Bonneville Dam. Units 5 and 6 had identical intakes, stay vanes, wicket gates, and draft tubes, but Unit 6 had a new runner and curved discharge ring to minimize gaps between the runner hub and blades and between the blade tips and discharge ring. We used a mathematical model to predict blade strike associated with two Kaplan turbines and compared results with empirical data from biological tests conducted in 1999 and 2000. Blade-strike models take into consideration the geometry of the turbine blades and discharges as well as fish length, orientation, and distribution along the runner. The first phase of this study included a sensitivity analysis to consider the effects of difference in geometry and operations between families of turbines on the strike probability response surface. The analysis revealed that the orientation of fish relative to the leading edge of a runner blade and the location that fish pass along the blade between the hub and blade tip are critical uncertainties in blade-strike models. Over a range of discharges, the average prediction of injury from blade strike was two to five times higher than average empirical estimates of visible injury from shear and mechanical devices. Empirical estimates of mortality may be better metrics for comparison to predicted injury rates than other injury measures for fish passing at mid-blade and blade-tip locations.

  13. Dioxin Exposure Initiative

    The Dioxin Exposure Initiative (DEI) is no longer active. This page contains a summary of the dioxin exposure initiative with illustrations, contact and background information.Originally supported by scientist Matthew Lorber, who retired in Mar 2017.

  14. Personal Initiative at Work and When Facing Unemployment

    Lantz, Annika; Andersson, Kin


    Purpose: Learning at work generalises through socialisation into behaviours away from the workplace. The aim of this study is to give empirical evidence of a positive relationship between job design, self-efficacy, competence efficacy and personal initiative at work, and proactive job search while under notice of redundancy and in unemployment.…

  15. Management and outcome of prolonged pregnancies in Shariati university hospital

    Eslamian L.


    Full Text Available Background: There is dearth of reports from Iran regarding the prevalence of postterm pregnancy and its complications. The present study was conducted to evaluate the prevalence, management and outcome of prolonged pregnancies.Methods: This cross-sectional study included data from the hospital records of all women referred to Shariati Hospital, Tehran, from 2001 to 2002 with pregnancies of more than 40 weeks in duration. Pregnancies ≥40-42 weeks were considered postdate and those more than 42 weeks postterm pregnancy. The data compiled from the hospital records were subjected to t, χ2 and Mann-Whitney U tests.Results: Of the 1500 deliveries in this hospital, 98 patients were included in this study, 66.3% of whom were nullipara and 33.7% multipara. The prevalence of postterm pregnancy was estimated to be 3.3%. Cervix dilation of 2 cm or less on admission occurred in 65 women (73.3%. The mean Bishop score was 4.31. Of the 62 fetuses that underwent assessment tests, 54 (87.1% were normal. The median time between the last test and induction of labor was 2.1 days, and 2.6 days for cesarean deliveries, which was not a significant difference (P=0.6. Cervical ripening with misoprostrol was performed in 36 cases (36.7% and was successful in 18 cases. In this group, the median time for cervical ripening in multiparas was significantly less than nulliparas (4 vs. 7 hrs, P=0.004. Women not subjected to cervical ripening had a higher cesarean rate than those who did undergo cervical ripening (74.7% vs. 66.1%, although this difference was not significant (P=0.9. Vaginal and cesarean delivery rates showed no significant difference between cases that underwent induction with oxytocin and those subjected to cervical ripening with misoprostol (P=0.9. The mean Apgar score was 9.5, with all scores above 6. There were no cases of neonatal hypoglycemia, hypocalcemia, NICU admission or prenatal death. The mean nursery stay was 1.84 days with a range of 1-8 days

  16. When "Other" Initiate Repair.

    Schegloff, Emanuel A.


    Elaborates on the locus of other-initiated repair, and reports on a number of environments in which others initiate repair turns later than the one directly following the trouble-source turn. Describes several ways that other initiation of repair, which occurs in next-turn position, may be delayed within that position. (Author/VWL)

  17. Evaluation of molecular docking using polynomial empirical scoring functions.

    Dias, Raquel; Timmers, Luis Fernando Saraiva Macedo; Caceres, Rafael Andrade; de Azevedo, Walter Filgueira


    Molecular docking simulations are of pivotal importance for analysis of protein-ligand interactions and also an essential resource for virtual-screening initiatives. In molecular docking simulations several possible docked structures are generated, which create an ensemble of structures representing binary complexes. Therefore, it is crucial to find the best solution for the simulation. One approach to this problem is to employ empirical scoring function to identify the best docked structure. It is expected that scoring functions show a descriptive funnel-shaped energy surface without many false minima to impair the efficiency of conformational sampling. We employed this methodology against a test set with 300 docked structures. Docking simulations of these ligands against enzyme binding pocket indicated a funnel-shaped behavior of the complexation for this system. This review compares a set of recently proposed polynomial empirical scoring functions, implemented in a program called POLSCORE, with two popular scoring function programs (XSCORE and DrugScore). Overall comparison indicated that POLSCORE works better to predict the correct docked position, for the ensemble of docked structures analyzed in the present work.

  18. Empirically Based Myths: Astrology, Biorhythms, and ATIs.

    Ragsdale, Ronald G.


    A myth may have an empirical basis through chance occurrence; perhaps Aptitude Treatment Interactions (ATIs) are in this category. While ATIs have great utility in describing, planning, and implementing instruction, few disordinal interactions have been found. Article suggests narrowing of ATI research with replications and estimates of effect…

  19. Developing Empirically Based Models of Practice.

    Blythe, Betty J.; Briar, Scott


    Over the last decade emphasis has shifted from theoretically based models of practice to empirically based models whose elements are derived from clinical research. These models are defined and a developing model of practice through the use of single-case methodology is examined. Potential impediments to this new role are identified. (Author/BL)

  20. Compassion: An Evolutionary Analysis and Empirical Review

    Goetz, Jennifer L.; Keltner, Dacher; Simon-Thomas, Emiliana


    What is compassion? And how did it evolve? In this review, we integrate 3 evolutionary arguments that converge on the hypothesis that compassion evolved as a distinct affective experience whose primary function is to facilitate cooperation and protection of the weak and those who suffer. Our empirical review reveals compassion to have distinct…

  1. Analyzing Teaching Commitment: Theoretical and Empirical Dimensions.

    Tyree, Alexander K., Jr.

    Classical commitment studies are either sociologically oriented or based in the psychological empirical research tradition. A review of the literature reveals agreement on the multidimensionality and the contextual complexity of commitment, two principles which guide the hypotheses of the present study. This study uses the Administrator and…

  2. The problem analysis for empirical studies

    Groenland, E.A.G.


    This article proposes a systematic methodology for the development of a problem analysis for cross-sectional, empirical research. This methodology is referred to as the 'Annabel approach'. It is suitable both for academic studies and applied (business) studies. In addition it can be used for both

  3. African American Homeschooling Practices: Empirical Evidence

    Mazama, Ama


    Despite a significant increase in scholarly interest for homeschooling, some of its most critical aspects, such as instructional daily practices, remain grossly understudied. This essay thus seeks to fill that void by presenting empirical evidence regarding the homeschooling practices of a specific group, African Americans. Most specifically, the…

  4. Empirical Progression of Lean Manufacturing: Literature Review

    Dilanthi M.G.S


    Full Text Available Lean manufacturing has evolved over time devising with thinking of waste reduction. Many researchers have studied in this field and have tried to define the concept and to evaluate its performance. Therefore the main purpose of this paper is to recognize the conceptual evolution and to comprehend such empirical work related to lean manufacturing.

  5. Empirical Rationality in the Stock Market

    Raahauge, Peter


    for this empiricalrationality on part of the agent, the resulting empirical model assignslikelihood to the data actually observed, unlike in the unmodified rational expectationscase. A Lucas (1978)-type asset pricing model which incorporatesempirical rationality is constructed and estimated using U.S. stock data...

  6. International Joint Venture Termination: An Empirical Investigation

    Nielsen, Ulrik B.; Rasmussen, Erik Stavnsager; Siersbæk, Nikolaj

    for the article stems from data from the project portfolio of a Danish Investment Fund for Developing Countries with a total of 773 investments. A number of hypotheses are established from the literature review and tested related to the empirical data. The result indicates that the most important factor...

  7. Transition States from Empirical Force Fields

    Jensen, Frank; Norrby, Per-Ola


    This is an overview of the use of empirical force fields in the study of reaction mechanisms. EVB-type methods (including RFF and MCMM) produce full reaction surfaces by mixing, in the simplest case, known force fields describing reactants and products. The SEAM method instead locates approximate...

  8. Alternative Approaches to Evaluation in Empirical Microeconomics

    Blundell, Richard; Dias, Monica Costa


    This paper reviews some of the most popular policy evaluation methods in empirical microeconomics: social experiments, natural experiments, matching, instrumental variables, discontinuity design, and control functions. It discusses identification of traditionally used average parameters and more complex distributional parameters. The adequacy,…

  9. An empirical-parametric gamma calibration algorithm

    Isohanni, Jani


    A method to determine the gamma correction curves for displays is presented. An empirical model is first constructed from exhaustive measurements of a few representative units. The model parameters for the remaining units are then fitted using only a few measurements. The method uses standard least-squares algorithms and is computationally light. Experimental results for a small sample of LCD displays are presented.

  10. Empirical progress and nomic truth approximation revisited

    Kuipers, Theodorus


    In my From Instrumentalism to Constructive Realism (2000) I have shown how an instrumentalist account of empirical progress can be related to nomic truth approximation. However, it was assumed that a strong notion of nomic theories was needed for that analysis. In this paper it is shown, in terms of

  11. Software Development Management: Empirical and Analytical Perspectives

    Kang, Keumseok


    Managing software development is a very complex activity because it must deal with people, organizations, technologies, and business processes. My dissertation consists of three studies that examine software development management from various perspectives. The first study empirically investigates the impacts of prior experience with similar…

  12. Downside Risk And Empirical Asset Pricing

    P. van Vliet (Pim)


    textabstractCurrently, the Nobel prize winning Capital Asset Pricing Model (CAPM) celebrates its 40th birthday. Although widely applied in financial management, this model does not fully capture the empirical riskreturn relation of stocks; witness the beta, size, value and momentum effects. These pr

  13. Empirical research in OM: three paradigms

    Steenhuis, Harm-Jan; Bruijn, de Erik J.


    Over the past 20 years, several articles have appeared in the operations management literature that have suggested that the link between operations management academics and operations management practitioners has been weakened. It has been suggested that to improve this link, more empirical research

  14. Bayesian photometric redshifts with empirical training sets

    Wolf, Christian


    We combine in a single framework the two complementary benefits of chi^2-template fits and empirical training sets used e.g. in neural nets: chi^2 is more reliable when its probability density functions (PDFs) are inspected for multiple peaks, while empirical training is more accurate when calibration and priors of query data and training set match. We present a chi^2-empirical method that derives PDFs from empirical models as a subclass of kernel regression methods, and apply it to the SDSS DR5 sample of >75,000 QSOs, which is full of ambiguities. Objects with single-peak PDFs show 2.5, these figures are 2x better. Outliers result purely from the discrete nature and limited size of the model, and rms errors are dominated by the instrinsic variety of object colours. PDFs classed as ambiguous provide accurate probabilities for alternative solutions and thus weights for using both solutions and avoiding needless outliers. E.g., the PDFs predict 78.0% of the stronger peaks to be correct, which is true for 77.9% ...

  15. Human Development, Inequality and Poverty: empirical findings

    Suman Seth; Antonio Villar


    This paper provides a discussion on the empirical findings surrounding the design of human development, inequality and poverty measures. We focus on the United Nations Development Program approach to those issues, in particular regarding the human development index and the multidimensional poverty index.

  16. Downside Risk And Empirical Asset Pricing

    P. van Vliet (Pim)


    textabstractCurrently, the Nobel prize winning Capital Asset Pricing Model (CAPM) celebrates its 40th birthday. Although widely applied in financial management, this model does not fully capture the empirical riskreturn relation of stocks; witness the beta, size, value and momentum effects. These

  17. The problem analysis for empirical studies

    Groenland, E.A.G.


    This article proposes a systematic methodology for the development of a problem analysis for cross-sectional, empirical research. This methodology is referred to as the 'Annabel approach'. It is suitable both for academic studies and applied (business) studies. In addition it can be used for both qu

  18. Optimality of Empirical Z-R Relations

    Haddad, Z. S.; Rosenfield, D.


    This paper attempts to justify mathematically the two empirical approaches to the problem of deriving Z-R relations from (Z,R) measurements, namely the power-law regression and the probability matching method (PMM). The basic mathematical assumptions that apply in each case are explicitly identified.

  19. The Linguistic Imperialism of Neoliberal Empire

    Phillipson, Robert


    The article explores the transition from the linguistic imperialism of the colonial and postcolonial ages to the increasingly dominant role of English as a neoimperial language. It analyzes "global" English as a key dimension of the U.S. empire. U.S. expansionism is a fundamental principle of the foreign policy of the United States that can be…

  20. Student Discipline: Legal, Empirical, and Educational Perspectives.

    Harris, J. John, III, Ed.; Bennett, Christine, Ed.

    This book presents four perspectives on student discipline: legal and historical, empirical, educational, and futuristic. Part I examines the legal history of student discipline in papers by J. John Harris III, Richard E. Fields, and A. Reynaldo Contreras (Chapter 1); Richard E. Fields (Chapter 2); and David G. Carter, Sr. and Cynthia L. Jackson…

  1. Trade costs in empirical New Economic Geography

    Bosker, E.M.; Garretsen, J.H.

    Trade costs are a crucial element of New Economic Geography (NEG) models. Without trade costs there is no role for geography. In empirical NEG studies the unavailability of direct trade cost data calls for the need to approximate these trade costs by introducing a trade cost function. In doing so,

  2. An Empirical Investigation into Programming Language Syntax

    Stefik, Andreas; Siebert, Susanna


    Recent studies in the literature have shown that syntax remains a significant barrier to novice computer science students in the field. While this syntax barrier is known to exist, whether and how it varies across programming languages has not been carefully investigated. For this article, we conducted four empirical studies on programming…

  3. Methods for Calculating Empires in Quasicrystals

    Fang Fang


    Full Text Available This paper reviews the empire problem for quasiperiodic tilings and the existing methods for generating the empires of the vertex configurations in quasicrystals, while introducing a new and more efficient method based on the cut-and-project technique. Using Penrose tiling as an example, this method finds the forced tiles with the restrictions in the high dimensional lattice (the mother lattice that can be cut-and-projected into the lower dimensional quasicrystal. We compare our method to the two existing methods, namely one method that uses the algorithm of the Fibonacci chain to force the Ammann bars in order to find the forced tiles of an empire and the method that follows the work of N.G. de Bruijn on constructing a Penrose tiling as the dual to a pentagrid. This new method is not only conceptually simple and clear, but it also allows us to calculate the empires of the vertex configurations in a defected quasicrystal by reversing the configuration of the quasicrystal to its higher dimensional lattice, where we then apply the restrictions. These advantages may provide a key guiding principle for phason dynamics and an important tool for self error-correction in quasicrystal growth.

  4. Quantitative analyses of empirical fitness landscapes

    Szendro, I.G.; Schenk, M.F.; Franke, J.; Krug, J.; Visser, de J.A.G.M.


    The concept of a fitness landscape is a powerful metaphor that offers insight into various aspects of evolutionary processes and guidance for the study of evolution. Until recently, empirical evidence on the ruggedness of these landscapes was lacking, but since it became feasible to construct all po

  5. Spitsbergen - Imperialists beyond the British Empire

    Kruse, Frigga; Hacquebord, Louwrens


    This paper looks at the relationship between Spitsbergen in the European High Arctic and the global British Empire in the first quarter of the twentieth century. Spitsbergen was an uninhabited no man's land and comprised an unknown quantity of natural resources. The concepts of geopolitics and New i

  6. Empirical research in OM: three paradigms

    Steenhuis, H.J.; de Bruijn, E.J.


    Over the past 20 years, several articles have appeared in the operations management literature that have suggested that the link between operations management academics and operations management practitioners has been weakened. It has been suggested that to improve this link, more empirical research

  7. An Empirical Examination of Lotka's Law.

    Pao, Miranda Lee


    Findings of empirical examination of author productivity data to determine conformity to Lotka's law indicate that: most data didn't fit inverse square function; two constants in Lotka's formulation (slope n, constant c) must be derived from observed distribution; inverse square law was special case of inverse exponential relationship. (37…

  8. Software Development Management: Empirical and Analytical Perspectives

    Kang, Keumseok


    Managing software development is a very complex activity because it must deal with people, organizations, technologies, and business processes. My dissertation consists of three studies that examine software development management from various perspectives. The first study empirically investigates the impacts of prior experience with similar…

  9. Measuring Poverty: Theoretical and Empirical Considerations

    Iceland, John


    This article discusses the theoretical underpinnings of different types of income poverty measures--absolute, relative, and a National Academy of Sciences (NAS) "quasi-relative" one--and empirically assesses them by tracking their performance over time and across demographic groups. Part of the assessment involves comparing these measures to…

  10. Framing the empirical findings on firm growth

    Capasso, M.; Cefis, E.; Sapio, S.


    This paper proposes a general framework to account for the divergent results in the empirical literature on the relation between firm sizes and growth rates, and on many results on growth autocorrelation. In particular, we provide an explanation for why traces of the LPE sometimes occur in condition

  11. Mobile Systems Development: An Empirical Study

    Hosbond, J. H.

    work patterns. This paper is about the development of mobile systems.Based on an on-going empirical study I present four case studies of companies each with different products or services to offer and diverging ways of establishing and sustaining a successful business in the mobile industry. From...

  12. Parent-Adolescent Conflict: An Empirical Review.

    Hall, James A.


    Compares psychoanalytic, systems, and social learning theories to determine the empirical support for each theoretical orientation in treating problematic conflict between parents and adolescents. Discusses parent-adolescent conflict, including developmental stage theory, parenting styles, peer pressures, communication skills, marital conflict,…

  13. Diffuse alveolar damage in a patient with rheumatoid arthritis under prolonged leflunomide treatment: A Case Report and Literature Review.

    Keng, Li-Ta; Lin, Mong-Wei; Huang, Hsien-Neng; Chung, Kuei-Pin


    Patients with rheumatoid arthritis (RA) often have pulmonary involvement, and interstitial lung disease (ILD) is the primary manifestation, in which diffuse alveolar damage (DAD) is a rare histopathologic pattern. Leflunomide (LEF) is a frequently prescribed disease-modifying antirheumatic drug for treating RA. LEF-related ILD in the form of DAD has been reported in patients with RA, with the duration of LEF treatment before symptom onset ranging from 6 to 1204 days.We present a case of elderly woman with RA under prolonged LEF treatment for >9 years (3291 days), who had acute respiratory failure with the initial presentation of exertional dyspnea, fever, chills, and productive cough for 2 days. The histopathologic result of surgical lung biopsy was compatible with DAD. She was diagnosed as having LEF-related ILD, based on correlated clinical history, compatible histopathologic examination and excluding possible infection after extensive survey.Although the causative role of LEF cannot be confirmed, this case still hints that LEF-related DAD may occur even if LEF has been prescribed for a prolonged period.

  14. Visual Loss, Retinal Hemorrhages, and Optic Disc Edema Resulting From Thiamine Deficiency Following Bariatric Surgery Complicated by Prolonged Vomiting

    Lawton, Andrew W.; Frisard, Nicholas E.


    Background: Vision loss resulting from thiamine deficiency is a recognized complication of bariatric surgery. Most patients with such vision loss have Wernicke encephalopathy with characteristic changes seen on neuroimaging. Other patients may have retinal hemorrhages, optic disc edema, and peripheral neuropathy without Wernicke encephalopathy. The risk for thiamine deficiency is potentiated by the presence of prolonged vomiting. Case Report: A 37-year-old female presented with abrupt onset of vision loss and peripheral neuropathy following bariatric surgery. She had a history of prolonged vomiting postoperatively. Examination of the posterior segment of the eye revealed optic disc edema and large retinal hemorrhages bilaterally. Metabolic workup demonstrated thiamine deficiency. She responded quickly to parenteral thiamine therapy with recovery of normal vision and resolution of ophthalmologic findings. Conclusion: Patients who undergo bariatric surgery and have a thiamine deficiency can present with visual symptoms and ophthalmologic findings only visible by fundoscopy prior to developing more severe and potentially irreversible complications from the vitamin deficiency. Early detection of intraocular changes resulting from thiamine deficiency and initiation of therapy could prevent more devastating neurologic manifestations. Our case supports the consideration of a prospective study aimed at determining the true incidence of ocular and visual changes such as retinal hemorrhage, optic disc edema, and peripapillary telangiectasia in patients following bariatric surgery.

  15. Pyridoxine-dependent epilepsy: normal outcome in a patient with late diagnosis after prolonged status epilepticus causing cortical blindness.

    Kluger, G; Blank, R; Paul, K; Paschke, E; Jansen, E; Jakobs, C; Wörle, H; Plecko, B


    We report on a male proband with pyridoxine-dependent epilepsy (PDE) and neonatal seizure onset. At the age of 31 months, a prolonged status epilepticus led to severe neurological regression with cortical blindness, loss of speech and muscular hypotonia with slow recovery over the following 3 months. At 33 months of age pyridoxine therapy was initiated with excellent response and the boy remained seizure-free on pyridoxine monotherapy, except for two occasions with seizure recurrence 10 days after accidental pyridoxine withdrawal. alpha-aminoadipic semialdehyde dehydrogenase (antiquitin) deficiency was indicated by elevated pipecolic acid concentrations in plasma and alpha-aminoadipic semialdehyde excretion in urine. Molecular analysis of the antiquitin gene revealed a novel missense mutation c.57insA, while the mutation of the other allele remained unidentified so far. Despite the delay in diagnosis and prolonged status epilepticus, neuropsychological evaluations at the ages of 11 and 18 years demonstrated full-scale IQ of 93 and 92, respectively, with better verbal IQ (103 and 101) than performance IQ (85 and 82).

  16. Anaerobic performance when rehydrating with water or commercially available sports drinks during prolonged exercise in the heat.

    Coso, Juan Del; Estevez, Emma; Baquero, Raúl Antonio; Mora-Rodriguez, Ricardo


    The effects that rehydrating drinks ingested during exercise may have on anaerobic exercise performance are unclear. This study aimed to determine which of four commercial rehydrating drinks better maintains leg power and force during prolonged cycling in the heat. Seven endurance-trained and heat-acclimatized cyclists pedaled for 120 min at 63% maximum oxygen consumption in a hot, dry environment (36 degrees C; 29% humidity, 1.9 m.s-1 airflow). In five randomized trials, during exercise, subjects drank 2.4 +/- 0.1 L of (i) mineral water (WAT; San Benedetto), (ii) 6% carbohydrate-electrolyte solution (Gatorade lemon), (iii) 8% carbohydrate-electrolyte solution (Powerade Citrus Charge), (iv) 8% carbohydrate-electrolyte solution with lower sodium concentration than other sports drinks (Aquarius orange), or (v) did not ingest any fluid (DEH). Fluid balance, rectal temperature (Trec), maximal cycling power (Pmax), and leg maximal voluntary isometric contraction (MVC) were measured. During DEH, subjects lost 3.7 +/- 0.2% of initial body mass, whereas subjects lost only 0.8% +/- 0.1% in the other trials (p rehydration with commercially available sports drinks during prolonged exercise in the heat preserves leg force, whereas rehydrating with water does not. However, low sodium concentration in a sports drink seems to preclude its ergogenic effects on force.

  17. New approaches in the management of insomnia: weighing the advantages of prolonged-release melatonin and synthetic melatoninergic agonists

    Rüdiger Hardeland


    Full Text Available Rüdiger HardelandJohann Friedrich Blumenbach Institute of Zoology and Anthropology, University of Göttingen, GermanyAbstract: Hypnotic effects of melatonin and melatoninergic drugs are mediated via MT1 and MT2 receptors, especially those in the circadian pacemaker, the suprachiasmatic nucleus, which acts on the hypothalamic sleep switch. Therefore, they differ fundamentally from GABAergic hypnotics. Melatoninergic agonists primarily favor sleep initiation and reset the circadian clock to phases allowing persistent sleep, as required in circadian rhythm sleep disorders. A major obstacle for the use of melatonin to support sleep maintenance in primary insomnia results from its short half-life in the circulation. Solutions to this problem have been sought by developing prolonged-release formulations of the natural hormone, or melatoninergic drugs of longer half-life, such as ramelteon, tasimelteon and agomelatine. With all these drugs, improvements of sleep are statistically demonstrable, but remain limited, especially in primary chronic insomnia, so that GABAergic drugs may be indicated. Melatoninergic agonists do not cause next-day hangover and withdrawal effects, or dependence. They do not induce behavioral changes, as sometimes observed with z-drugs. Despite otherwise good tolerability, the use of melatoninergic drugs in children, adolescents, and during pregnancy has been a matter of concern, and should be avoided in autoimmune diseases and Parkinsonism. Problems and limits of melatoninergic hypnotics are compared.Keywords: agomelatine, hypnotics, melatonin, prolonged-release, ramelteon, tasimelteon

  18. Linking Shared Organisational Context and Relational Capital through Unlearning: An Initial Empirical Investigation in SMEs

    Cegarra-Navarro, Juan G.; Dewhurst, Frank W.


    Purpose: The environment provided by an organisation to facilitate learning and create knowledge has been defined as the shared organisational context. The value to an organisation of knowledge created by the shared organisational context is called intellectual capital, of which one key component is relational capital. The purpose of this paper is…

  19. Multiscale empirical interpolation for solving nonlinear PDEs

    Calo, Victor M.


    In this paper, we propose a multiscale empirical interpolation method for solving nonlinear multiscale partial differential equations. The proposed method combines empirical interpolation techniques and local multiscale methods, such as the Generalized Multiscale Finite Element Method (GMsFEM). To solve nonlinear equations, the GMsFEM is used to represent the solution on a coarse grid with multiscale basis functions computed offline. Computing the GMsFEM solution involves calculating the system residuals and Jacobians on the fine grid. We use empirical interpolation concepts to evaluate these residuals and Jacobians of the multiscale system with a computational cost which is proportional to the size of the coarse-scale problem rather than the fully-resolved fine scale one. The empirical interpolation method uses basis functions which are built by sampling the nonlinear function we want to approximate a limited number of times. The coefficients needed for this approximation are computed in the offline stage by inverting an inexpensive linear system. The proposed multiscale empirical interpolation techniques: (1) divide computing the nonlinear function into coarse regions; (2) evaluate contributions of nonlinear functions in each coarse region taking advantage of a reduced-order representation of the solution; and (3) introduce multiscale proper-orthogonal-decomposition techniques to find appropriate interpolation vectors. We demonstrate the effectiveness of the proposed methods on several nonlinear multiscale PDEs that are solved with Newton\\'s methods and fully-implicit time marching schemes. Our numerical results show that the proposed methods provide a robust framework for solving nonlinear multiscale PDEs on a coarse grid with bounded error and significant computational cost reduction.

  20. Life Quality Index – an empirical or a normative concept?

    Ditlevsen, Ove Dalager; Friis-Hansen, Peter


    The Life Quality Index introduced by Nathwani, Lind and Pandey is a social indicator that by invariance serves the purpose of allocating a balanced and ethically reasonable part of the Gross Domestic Product of a country to life saving initiatives. In the attempts to understand the reasoning behind...... the construction of the LQI one may ask whether the LQI is built on empirical evidence of social behavior that implies the modeled balance between the free time and the work time. Even if so, one may ask whether the invariance principle is a fact of social life or a normative principle of ethical social behavior....... By using a dimensionless representation of the work time value production and the free time and an optimal balancing of the two against each other, it is demonstrated that there is a specific mathematical formula that connects work time and value productivity. Moreover, comparisons of the theory...

  1. Status and cockpit dynamics: a review and empirical study.

    Milanovich, D M; Driskell, J E; Stout, R J; Salas, E


    One of the most troublesome dynamics evident in the airplane cockpit is related to patterns of authority relations between the captain and the first officer: Too often, captains fail to listen and first officers fail to speak. The authors propose that many instances of superordinate and subordinate behavior in the cockpit--the captain's tendency to reject input from other team members and the first officer's hesitancy to question the captain--represent cases of status generalization. First, the authors describe the theory of status generalization and show support for the operation of the theory by presenring examples of flightcrew behavior that the theory predicts. Second, an initial empirical test was conducted to instantiate the claim that captain-first officer differences can be seen as status differences. Finally, the significance and implications of this perspective are discussed.

  2. Empirical study of sensor observation services server instances

    Tamayo, Alain; Granell, Carlos; Huerta, Joaquín; 10.1007/978-3-642-19789-5_10


    The number of Sensor Observation Service (SOS) instances available online has been increasing in the last few years. The SOS specification standardises interfaces and data formats for exchanging sensor-related in-formation between information providers and consumers. SOS in conjunction with other specifications in the Sensor Web Enablement initiative, at-tempts to realise the Sensor Web vision, a worldwide system where sensor networks of any kind are interconnected. In this paper we present an empirical study of actual instances of servers implementing SOS. The study focuses mostly in which parts of the specification are more frequently included in real implementations, and how exchanged messages follows the structure defined by XML Schema files. Our findings can be of practical use when implementing servers and clients based on the SOS specification, as they can be optimized for common scenarios.

  3. An Empirical Perspective on the Culture - Corporate Social Responsibility Relationship

    Dumitru ZAIȚ


    Full Text Available Business competition and pressure of European directives put Romanian company in a position to find answers to issues related to long-term survival and development. In this context we believe it is necessary to analyze some of the most important components that should be taken into consideration at the strategic level: national and organizational culture. The results indicate that corporate social responsibility is supported by learning and change-oriented organizational culture, but also by a favorable cultural and national economic framework. Based on these theoretical considerations we intent to emphasize the relationships between national culture / corporate culture and corporate social responsibility (CSR, elaborating an empirical argument by analyzing the results provided by Global 100, an annual project initiated by Corporate Knights Inc. (Davos. Starting with 2005, it has the largest database in the world and an appropriate evaluation methodology that provides a ranking of the top 100 most responsible companies in the world.

  4. Environmental management in Slovenian industrial enterprises - Empirical study

    Vesna Čančer


    Full Text Available timulated with the firm belief that environmental management helps enterprises to achieve business success, expressed by a majority of managers in the sample enterprises, we present the results of an empirical study in the Slovene processing industry. The purpose of our research work is to identify, analyse and present the importance of the environment in business decision-making, the role of environmental management in strategic decision-making and its distribution across the business functions; environmental performance in business processes; the use of the methods for environmentally oriented business decision-making and the developmental tendencies of environmental management in Slovene enterprises of the processing industry. We define the key drivers of environmental management and their effect on the environmental behaviour of these enterprises. We present and interpret data indicating that environmental management is caused not only by compliance and regulation, but also by competition and enterprises’ own initiative.

  5. Cultural Adaptations of Prolonged Exposure Therapy for Treatment and Prevention of Posttraumatic Stress Disorder in African Americans

    Monnica T. Williams


    Full Text Available Posttraumatic stress disorder (PTSD is a highly disabling disorder, afflicting African Americans at disproportionately higher rates than the general population. When receiving treatment, African Americans may feel differently towards a European American clinician due to cultural mistrust. Furthermore, racism and discrimination experienced before or during the traumatic event may compound posttrauma reactions, impacting the severity of symptoms. Failure to adapt treatment approaches to encompass cultural differences and racism-related traumas may decrease treatment success for African American clients. Cognitive behavioral treatment approaches are highly effective, and Prolonged Exposure (PE in particular has the most empirical support for the treatment of PTSD. This article discusses culturally-informed adaptations of PE that incorporates race-related trauma themes specific to the Black experience. These include adding more sessions at the front end to better establish rapport, asking directly about race-related themes during the assessment process, and deliberately bringing to the forefront race-related experiences and discrimination during treatment when indicated. Guidelines for assessment and the development of appropriate exposures are provided. Case examples are presented demonstrating adaptation of PE for a survivor of race-related trauma and for a woman who developed internalized racism following a sexual assault. Both individuals experienced improvement in their posttrauma reactions using culturally-informed adaptations to PE.

  6. The "PE coach" smartphone application: an innovative approach to improving implementation, fidelity, and homework adherence during prolonged exposure.

    Reger, Greg M; Hoffman, Julia; Riggs, David; Rothbaum, Barbara O; Ruzek, Josef; Holloway, Kevin M; Kuhn, Eric


    Prolonged exposure (PE) is an empirically supported treatment that is being disseminated broadly to providers in the Department of Veterans Affairs and Department of Defense. Innovative methods are needed to support the implementation, dissemination, and patient and provider adherence to PE. The PE Coach is a smartphone application (app) designed to mitigate barriers to PE implementation. PE Coach is installed on the patient's phone and includes a range of capabilities for use during the PE session and after each session to support the treatment. Functions include the ability to audio record treatment sessions onto the patient's device, to construct the in vivo hierarchy on the device, to record completed homework exercises, to review homework adherence, and to track symptom severity over time. The app also allows sessions and homework to be scheduled directly in the app, populating the device calendar with patient reminder notifications. In the final session, a visual display of symptom improvement and habituation to items on the in vivo hierarchy is presented. These capabilities may significantly improve convenience, provider implementation and adherence, and patient compliance with treatment. Future research is needed to test whether PE Coach is useful and effective.

  7. Development of a Search and Rescue Simulation to Study the Effects of Prolonged Isolation on Team Decision Making

    Entin, Elliot E.; Kerrigan, Caroline; Serfaty, Daniel; Young, Philip


    The goals of this project were to identify and investigate aspects of team and individual decision-making and risk-taking behaviors hypothesized to be most affected by prolonged isolation. A key premise driving our research approach is that effects of stressors that impact individual and team cognitive processes in an isolated, confined, and hazardous environment will be projected onto the performance of a simulation task. To elicit and investigate these team behaviors we developed a search and rescue task concept as a scenario domain that would be relevant for isolated crews. We modified the Distributed Dynamic Decision-making (DDD) simulator, a platform that has been extensively used for empirical research in team processes and taskwork performance, to portray the features of a search and rescue scenario and present the task components incorporated into that scenario. The resulting software is called DD-Search and Rescue (Version 1.0). To support the use of the DDD-Search and Rescue simulator in isolated experiment settings, we wrote a player's manual for teaching team members to operate the simulator and play the scenario. We then developed a research design and experiment plan that would allow quantitative measures of individual and team decision making skills using the DDD-Search and Rescue simulator as the experiment platform. A description of these activities and the associated materials that were produced under this contract are contained in this report.

  8. An imported case of severe falciparum malaria with prolonged hemolytic anemia clinically mimicking a coinfection with babesiosis.

    Na, Young Ju; Chai, Jong-Yil; Jung, Bong-Kwang; Lee, Hyun Jung; Song, Ji Young; Je, Ji Hye; Seo, Ji Hye; Park, Sung Hun; Choi, Ji Seon; Kim, Min Ja


    While imported falciparum malaria has been increasingly reported in recent years in Korea, clinicians have difficulties in making a clinical diagnosis as well as in having accessibility to effective anti-malarial agents. Here we describe an unusual case of imported falciparum malaria with severe hemolytic anemia lasting over 2 weeks, clinically mimicking a coinfection with babesiosis. A 48-year old Korean man was diagnosed with severe falciparum malaria in France after traveling to the Republic of Benin, West Africa. He received a 1-day course of intravenous artesunate and a 7-day course of Malarone (atovaquone/proguanil) with supportive hemodialysis. Coming back to Korea 5 days after discharge, he was readmitted due to recurrent fever, and further treated with Malarone for 3 days. Both the peripheral blood smears and PCR test were positive for Plasmodium falciparum. However, he had prolonged severe hemolytic anemia (Hb 5.6 g/dl). Therefore, 10 days after the hospitalization, Babesia was considered to be potentially coinfected. A 7-day course of Malarone and azithromycin was empirically started. He became afebrile within 3 days of this babesiosis treatment, and hemolytic anemia profiles began to improve at the completion of the treatment. He has remained stable since his discharge. Unexpectedly, the PCR assays failed to detect DNA of Babesia spp. from blood. In addition, during the retrospective review of the case, the artesunate-induced delayed hemolytic anemia was considered as an alternative cause of the unexplained hemolytic anemia.

  9. A New Environmentally Safe Formulation and of Low Cost for Prolonged Release System of Atrazine and Diuron

    Gracy karla da Rocha Cortes


    Full Text Available Diuron and atrazine were incorporated in new formulations developed with the purpose to improve herbicides action through release systems, as well as to reduce the environmental toxicity. A low cost formulation (ALG/ESC was obtained by combining sodium alginate (ALG with fish scales of the Piau fish (ESC from the Leporinus elongatus species. From the crosslinking of ALG/ESC with CaCl2, the formulation ALG/ESC-CaCl2 was obtained. For ALG/ESC-CaCl2, the results are successful, showing a prolonged release of 3.5 and 4.5 days for atrazine and diuron, respectively. Based on parameters of an empirical equation used to fit the herbicide release data, it appears that the release systems of diuron and atrazine from ALG/ESC-CaCl2 are by diffusion processes due to anomalous transport, which did not follow Fick’s laws of diffusion. DOI:

  10. The Significance of Prolonged and Saddleback Fever in Hospitalised Adult Dengue.

    Ng, Deborah Hl; Wong, Joshua Gx; Thein, Tun-Linn; Leo, Yee-Sin; Lye, David C


    Dengue fever is gaining importance in Singapore with an increase in the number of cases and mortality in recent years. Although prolonged and saddleback fever have been reported in dengue fever, there are no specific studies on their significance in dengue. This study aims to examine the prevalence of prolonged and saddleback fever in dengue as well as their associations with dengue severity. A total of 2843 polymerase-chain reaction (PCR) confirmed dengue patients admitted to Tan Tock Seng Hospital from 2004 to 2008 were included in the study. Sixty-nine percent of them were male with a median age of 34 years. Prolonged fever (fever > 7 days duration) was present in 572 (20.1%) of patients. Dengue hemorrhagic fever (DHF), dengue shock syndrome (DSS) and severe dengue (SD) were significantly more likely to occur in patients with prolonged fever. Mucosal bleeding, anorexia, diarrhea, abdominal pain, nausea or vomiting, lethargy, rash, clinical fluid accumulation, hepatomegaly, nosocomial infection, leukopenia, higher neutrophil count, higher hematocrit, higher alanine transaminase (ALT) and aspartate transaminase (AST), higher creatinine, lower protein and prolonged activated partial thromboplastin time (APTT) were significantly associated with prolonged fever but not platelet count or prothrombin time (PT). Saddleback fever was present in 165 (5.8%). Although DHF and SD were more likely to occur in patients in those with saddleback fever, DSS was not. Compared with prolonged fever, saddleback fever did not show many significant associations except for diarrhea, abdominal pain, clinical fluid accumulation, hematocrit and platelet change, and lower systolic blood pressure. This study demonstrates that prolonged fever may be associated with various warning signs and more severe forms of dengue (SD, DSS, DHF), while saddleback fever showed associations with DHF and SD but not DSS. The presence of prolonged or saddleback fever in dengue patients should therefore prompt

  11. Ventricular Cycle Length Characteristics Estimative of Prolonged RR Interval during Atrial Fibrillation



    Background When atrial fibrillation (AF) is incessant, imaging during a prolonged ventricular RR interval may improve image quality. It was hypothesized that long RR intervals could be predicted from preceding RR values. Methods From the PhysioNet database, electrocardiogram RR intervals were obtained from 74 persistent AF patients. An RR interval lengthened by at least 250 ms beyond the immediately preceding RR interval (termed T0 and T1, respectively) was considered prolonged. A two-parameter scatterplot was used to predict the occurrence of a prolonged interval T0. The scatterplot parameters were: (1) RR variability (RRv) estimated as the average second derivative from 10 previous pairs of RR differences, T13–T2, and (2) Tm–T1, the difference between Tm, the mean from T13 to T2, and T1. For each patient, scatterplots were constructed using preliminary data from the first hour. The ranges of parameters 1 and 2 were adjusted to maximize the proportion of prolonged RR intervals within range. These constraints were used for prediction of prolonged RR in test data collected during the second hour. Results The mean prolonged event was 1.0 seconds in duration. Actual prolonged events were identified with a mean positive predictive value (PPV) of 80% in the test set. PPV was >80% in 36 of 74 patients. An average of 10.8 prolonged RR intervals per 60 minutes was correctly identified. Conclusions A method was developed to predict prolonged RR intervals using two parameters and prior statistical sampling for each patient. This or similar methodology may help improve cardiac imaging in many longstanding persistent AF patients. PMID:23998759

  12. Prolonged bradycardia, asystole and outcome of high spinal cord injury patients: Risk factors and management

    Shaikh, Nissar; Rhaman, M. A.; Raza, Ali; Shabana, Adel; Malstrom, Mahommad Faisal; Al-Sulaiti, Ghanem


    Background: High spinal cord injury (HSCI) is one of the devastating traumatic injuries. 80% of these patients are young male, and 93% will have major neurological disabilities. There is a paucity of literature about prolonged bradycardia in HSCI patients. The aim of this study was to know the prevalence, risk factors, precipitating factors for prolonged bradycardia in the HSCI patients. Materials and Methods: All patients who were admitted to the Intensive Care Unit (ICU) of a tertiary hospital, with spinal cord injury above level of dorsal (D4) were enrolled in this study prospectively. Patient's demographic data, mechanism, level and type of spinal injury, associated injuries, injury severity score (ISS), spinal shock, vasopressors used, time of occurrence of bradycardia, treatment for bradycardia, precipitating as well as risk factors and outcome were recorded. Results: During the study period, a total of 138 patients were admitted to the ICU with HSCI. Majority of patients were male. The most frequently associated injury in these patients was skeletal fractures (38.4%). Most common complication was pneumonia 56 (41%). Forty-five (33%) of the total patients had prolonged bradycardia; 87% of these patients had pneumonia when bradycardia occurred. 53.4% had cardiac asystole. 29 (21%) patients had bradycardia at the time of endotracheal suctioning, whereas 27 (20%) patients developed bradycardia at the time of positioning. Majority of the patients were managed conservatively. Those HSCI patients who developed prolonged bradycardia, their ISS score was statistically higher, ICU and hospital stay was significantly higher compared with those HSCI patient who did not have prolonged bradycardia. Multivariate analysis revealed that hypotension on admission; pneumonia, and tracheostomy were risk factors for the development of prolonged bradycardia in HSCI patients. Conclusion: Prolonged bradycardia was associated with significantly higher incidence of asystole


    Ilkka Väänänen


    Full Text Available The purpose of this study was to describe the physiological responses to daily repeated acute but non-competitive prolonged exercise during a 4-day march and a 2-day cross-country ski event to the cardiorespiratory, autonomic nervous, musculoskeletal and endocrine systems. Mood states were also evaluated after these repeated exercises. The data of these short-term follow-up (reversal field trials was collected from healthy, 23 to 48 year old Finnish male soldiers in 1993 (n=6 and 1994 (n=15 during the "International Four-Day Long-Distance March" in Nijmegen, The Netherlands, and from ten healthy, 22 to 48 year old Finnish male participants in 1995 during a 2-day Finlandia Ski Race in Lahti, Finland. Acute cardiovascular responses were estimated by measuring the heart rate during exercise. The responses of the autonomic nervous system were estimated by measuring the heart rates during the orthostatic test. The musculoskeletal responses were estimated by measuring the perceived pains, flexibility, functional strength, use of elastic energy and oedemic changes of the lower extremities. Hormonal responses were estimated from the urinary excretion of catecholamines, and the concentrations of serum cortisol, testosterone, luteinizing (LH and follicle stimulating hormone (FSH. Mood states were assessed with the Profile of Mood States (POMS questionnaire. Daily walking time was 7-10 hours while the skiing time was 3 hours. Average heart rate during walking was 59% and skiing 87% of maximum heart rate. Morning heart rate in the supine position increased progressively through the marching period but not through the skiing experiment. After the first day, perceived pain increased significantly and remained at a similarly increased level until the end of the exercise period. Leg measurements showed no signs of oedema, decreases in flexibility, or functional strength. Catecholamine excretion rates during marches indicated cumulatively increased

  14. Empirical beam hardening correction (EBHC) for CT

    Kyriakou, Yiannis; Meyer, Esther; Prell, Daniel; Kachelriess, Marc [Institute of Medical Physics, University of Erlangen-Nuernberg, 91052 Erlangen (Germany)


    C-arm CT scanner (Axiom Artis dTA, Siemens Healthcare, Forchheim, Germany). A large variety of phantom, small animal, and patient data were used to demonstrate the data and system independence of EBHC. Results: Although no physics apart from the initial segmentation procedure enter the correction process, beam hardening artifacts were significantly reduced by EBHC. The image quality for clinical CT, micro-CT, and C-arm CT was highly improved. Only in the case of C-arm CT, where high scatter levels and calibration errors occur, the relative improvement was smaller. Conclusions: The empirical beam hardening correction is an interesting alternative to conventional iterative higher order beam hardening correction algorithms. It does not tend to over- or undercorrect the data. Apart from the segmentation step, EBHC does not require assumptions on the spectra or on the type of material involved. Potentially, it can therefore be applied to any CT image.

  15. Sequential thrombosis and bleeding in a woman with a prolonged activated partial thromboplastin time

    Pearce Michael I


    Full Text Available Abstract Simultaneous or sequential haemorrhage and thrombosis in the presence of a prolonged activated partial thromboplastin time (aPTT is a rare occurrence: we describe the case a 37 year old lady who developed post-delivery deep vein thrombosis treated with low molecular heparin and warfarin followed a week later by extensive bruising over legs and forearms, a significant drop in haemoglobin and a very prolonged aPTT. Further tests revealed an acquired factor VIII inhibitor at 35 Bethesda Units. We discuss the clinical and laboratory implications and provide a literature review of simultaneous thrombophilia and haemophilia in the presence of a prolonged aPTT.

  16. Sleep-prolonging effect of Coriandrum sativum hydro-alcoholic extract in mice.

    Rakhshandeh, Hassan; Sadeghnia, Hamid Reza; Ghorbani, Ahmad


    The present study was planned to investigate sleep-prolonging effect of C. sativum. The hydro-alcoholic extract (HAE) and its three fractions namely water (WF), ethyl acetate (EAF) and N-butanol (NBF) were prepared from C. sativum aerial parts and administrated to mice. Also, the possible cytotoxicity of the extracts was tested using cultured PC12 cells. The HAE, EAF and NBF significantly prolonged sleep duration. Only the NBF could significantly decrease sleep latency. No decrease in the neuronal surviving was observed either by HAE or by its fractions. The present data indicate that C. sativum exert sleep-prolonging action without major neurotoxic effect.

  17. Use of neuromuscular monitoring to detect prolonged effect of succinylcholine or mivacurium

    Cassel, J; Staehr-Rye, A K; Nielsen, C V


    effect of the neuromuscular blocking agent was not discovered until after extubation. In the third patient, the lack of response to nerve stimulation was interpreted as a technical failure and the prolonged effect of succinylcholine was discovered when general anaesthesia was terminated. Both patients...... allowed a prolonged neuromuscular blockade to be discovered prior to tracheal extubation of the patient. The patient was extubated after successful reversal of the neuromuscular blockade. On the contrary, neuromuscular monitoring was not used during anaesthesia in the second patient; hence, the prolonged...

  18. [Actinomycosis of the minor pelvis associated with prolonged use of intrauterine contraceptive devices (IUD)].

    Durdević, S; Vejnović, T; Novakov, A


    Pelvic actinomycosis is a rare disorder caused by Gram-positive anaerobic bacteria Actinomyces Israeli, and it is commonly associated with the prolonged use of IUD. The authors present two cases of pelvic actinomycosis in patients who used IUD for prolonged periods of time (eight and fourteen years). The diagnostic procedure in both cases lasted long and the definite diagnosis was made only after the pathohistological examination of the material taken during the surgical treatment. Actinomyces Israeli should be considered as one of the causes of the diagnosed pelvic inflammation especially when it is associated with the prolonged use of IUD.

  19. Sustainable Agricultural Marketing Initiatives

    Hakan Adanacıoğlu


    Sustainable marketing is a holistic approach that puts equal emphasis on environmental, social equity, and economic concerns in the development of marketing strategies. The purpose of the study is to examine and discuss the sustainable agricultural marketing initiatives practiced throughout the World and Turkey, and to put forth suggestions to further improve the performance of agricultural marketing initiatives in Turkey. Some of the sustainable agricultural marketing initiatives practiced a...

  20. Factors associated with suitability of empiric antibiotic therapy in hospitalized patients with bloodstream infections.

    Grossman, Chagai; Keller, Nathan; Bornstein, Gil; Ben-Zvi, Ilan; Koren-Morag, Nira; Rahav, Galia


    Bacteremia is associated with high morbidity and mortality rates. Initiation of inadequate empiric antibiotic therapy is associated with a worse outcome. The aim of this study was to establish the prevalence and the factors associated with inappropriate empiric antibiotic therapy in patients hospitalized with bacteremia. A cross-sectional study was conducted during January 2010-December 2011 at the medical wards of the Chaim Sheba Medical Center, Israel. The records of all patients with bacteremia were reviewed. Clinical and laboratory characteristics, bacteremic pathogens and antimicrobial agents were retrieved from the medical records. Factors associated with appropriateness of empiric antibiotic therapy were assessed. A total of 681 eligible adults were included in the study. Antibiotic therapy was found to be inappropriate in 138 (20.2%) patients (95% C.I. 17.2-23.2). The rate of appropriateness was not related to the type of antibiotic regimen and the type of bacteria. Patients with healthcare-associated infections were more likely to be administrated inappropriate antibiotic therapy. Patients with primary bloodstream infections were also more likely to be administrated inappropriate antibiotic therapy. Empiric combination therapy was more likely to be appropriate than monotherapy, except for an aminoglycosides-based combination. Combination empiric antibiotic therapy should be considered in patients with healthcare-associated infections and in those with primary bloodstream infections.