Monitoring of cerebral haemodynamics in newborn infants

DEFF Research Database (Denmark)

Liem, K Djien; Greisen, Gorm

2010-01-01

The most important cerebrovascular injuries in newborn infants, particularly in preterm infants, are cerebral haemorrhage and ischemic injury. The typical cerebral vascular anatomy and the disturbance of cerebral haemodynamics play important roles in the pathophysiology. The term 'cerebral haemod...

Significance of Haemodynamic and Haemostatic Factors in the Course of Different Manifestations of Cerebral Small Vessel Disease: The SHEF-CSVD Study—Study Rationale and Protocol

Directory of Open Access Journals (Sweden)

Jacek Staszewski

2013-01-01

Full Text Available Rationale. This paper describes the rationale and design of the SHEF-CSVD Study, which aims to determine the long-term clinical and radiological course of cerebral small vessel disease (CSVD and to evaluate haemostatic and haemodynamic prognostic factors of the condition. Design. This single-centre, prospective, non-interventional cohort study will follow 150 consecutive patients with different clinical manifestations of CSVD (lacunar ischaemic stroke, vascular dementia, vascular parkinsonism or spontaneous deep, intracerebral haemorrhage and 50 age- and sex-matched controls over a period of 24 months. The clinical and radiological course will be evaluated basing on a detailed neurological, neuropsychological and MRI examinations. Haemodynamic (cerebral vasoreactivity, 24 h blood pressure control and haemostatic factors (markers of endothelial and platelet dysfunction, brachial artery flow-mediated dilatation test will be determined. Discussion. The scheduled study will specifically address the issue of haemodynamic and haemostatic prognostic factors and their course over time in various clinical manifestations of CSVD. The findings may aid the development of prophylactic strategies and individualised treatment plans, which are critical during the early stages of the disease.

Bitter tastants alter gastric-phase postprandial haemodynamics.

Science.gov (United States)

McMullen, Michael K; Whitehouse, Julie M; Whitton, Peter A; Towell, Anthony

2014-07-03

Since Greco-Roman times bitter tastants have been used in Europe to treat digestive disorders, yet no pharmacological mechanism has been identified which can account for this practice. This study investigates whether the bitter tastants, gentian root (Gentian lutea L.) and wormwood herb (Artemisia absinthium L.), stimulate cephalic and/or gut receptors to alter postprandial haemodynamics during the gastric-phase of digestion. Normal participants ingested (1) 100 mL water plus capsules containing either cellulose (placebo-control) or 1000 mg of each tastant (n=14); or (2) 100mL of water flavoured with 500 or 1500 mg of each tastant (a) gentian (n=12) and (b) wormwood (n=12). A single beat-to-beat cardiovascular recording was obtained for the entire session. Pre/post-ingestion contrasts with the control were analysed for (1) the encapsulated tastants, in the "10 to 15" minute post-ingestion period, and (2) the flavoured water in the "5 to 10" minute post-ingestion period. Water, the placebo-control, increased cardiac contraction force and blood pressure notwithstanding heart rate decreases. Encapsulated tastants did not further alter postprandial haemodynamics. In contrast gentian (500 and 1500 mg) and wormwood (1500 mg) flavoured water elicited increased peripheral vascular resistance and decreased cardiac output, primarily by reducing stroke volume rather than heart rate. Drinking 100mL water elicits a pressor effect during the gastric-phase of digestion due to increased cardiac contraction force. The addition of bitter tastants to water elicits an additional and parallel pressor effect due to increased peripheral vascular resistance; yet the extent of the post-prandial blood pressure increases are unchanged, presumably due to baroreflex buffering. The vascular response elicited by bitter tastants can be categorised as a sympathetically-mediated cephalic-phase response. A possible mechanism by which bitter tastants could positively influence digestion is altering

Effects of treatment with β-blocker and aldosterone antagonist on central and peripheral haemodynamics and oxygenation in cirrhosis

DEFF Research Database (Denmark)

Winkler, Christine; Hobolth, Lise; Krag, Aleksander

2011-01-01

Patients with cirrhosis often exhibit abnormalities in cardiovascular regulation and oxygenation. Many of these patients are treated with β-blockers and aldosterone antagonists that may influence the regulation of systemic haemodynamics, but the specific effects on systemic haemodynamics and oxyg......Patients with cirrhosis often exhibit abnormalities in cardiovascular regulation and oxygenation. Many of these patients are treated with β-blockers and aldosterone antagonists that may influence the regulation of systemic haemodynamics, but the specific effects on systemic haemodynamics...

Haemodynamics of aerobic and resistance blood flow restriction exercise in young and older adults.

Science.gov (United States)

Staunton, Craig A; May, Anthony K; Brandner, Christopher R; Warmington, Stuart A

2015-11-01

Light-load blood flow restriction exercise (BFRE) may provide a novel training method to limit the effects of age-related muscle atrophy in older adults. Therefore, the purpose of this study was to compare the haemodynamic response to resistance and aerobic BFRE between young adults (YA; n = 11; 22 ± 1 years) and older adults (OA; n = 13; 69 ± 1 years). On two occasions, participants completed BFRE or control exercise (CON). One occasion was leg press (LP; 20 % 1-RM) and the other was treadmill walking (TM; 4 km h(-1)). Haemodynamic responses (HR, Q, SV and BP) were recorded during baseline and exercise. At baseline, YA and OA were different for some haemodynamic parameters (e.g. BP, SV). The relative responses to BFRE were similar between YA and OA. Blood pressures increased more with BFRE, and also for LP over TM. Q increased similarly for BFRE and CON (in both LP and TM), but with elevated HR and reduced SV (TM only). While BFR conferred slightly greater haemodynamic stress than CON, this was lower for walking than leg-press exercise. Given similar response magnitudes between YA and OA, these data support aerobic exercise being a more appropriate BFRE for prescription in older adults that may contribute to limiting the effects of age-related muscle atrophy.

Relationship between haemodynamic impairment and collateral blood flow in carotid artery disease

DEFF Research Database (Denmark)

Hartkamp, Nolan S; Petersen, Esben T; Chappell, Michael A

2018-01-01

Collateral blood flow plays a pivotal role in steno-occlusive internal carotid artery (ICA) disease to prevent irreversible ischaemic damage. Our aim was to investigate the effect of carotid artery disease upon cerebral perfusion and cerebrovascular reactivity and whether haemodynamic impairment...... is influenced at brain tissue level by the existence of primary and/or secondary collateral. Eighty-eight patients with steno-occlusive ICA disease and 29 healthy controls underwent MR examination. The presence of collaterals was determined with time-of-flight, two-dimensional phase contrast MRA and territorial....... In conclusion, both CBF and cerebrovascular reactivity were found to be reduced in symptomatic patients with steno-occlusive ICA disease. The presence of collateral flow is associated with further haemodynamic impairment. Recruitment of secondary collaterals is associated with severe haemodynamic impairment....

Influence of antenatal physical exercise on haemodynamics in pregnant women: a flexible randomisation approach.

Science.gov (United States)

Carpenter, Rhiannon Emma; Emery, Simon J; Uzun, Orhan; D'Silva, Lindsay A; Lewis, Michael J

2015-08-22

Normal pregnancy is associated with marked changes in haemodynamic function, however the influence and potential benefits of antenatal physical exercise at different stages of pregnancy and postpartum remain unclear. The aim of this study was therefore to characterise the influence of regular physical exercise on haemodynamic variables at different stages of pregnancy and also in the postpartum period. Fifty healthy pregnant women were recruited and randomly assigned (2 × 2 × 2 design) to a land or water-based exercise group or a control group. Exercising groups attended weekly classes from the 20th week of pregnancy onwards. Haemodynamic assessments (heart rate, cardiac output, stroke volume, total peripheral resistance, systolic and diastolic blood pressure and end diastolic index) were performed using the Task Force haemodynamic monitor at 12-16, 26-28, 34-36 and 12 weeks following birth, during a protocol including postural manoeurvres (supine and standing) and light exercise. In response to an acute bout of exercise in the postpartum period, stroke volume and end diastolic index were greater in the exercise group than the non-exercising control group (p = 0.041 and p = 0.028 respectively). Total peripheral resistance and diastolic blood pressure were also lower (p = 0.015 and p = 0.007, respectively) in the exercise group. Diastolic blood pressure was lower in the exercise group during the second trimester (p = 0.030). Antenatal exercise does not appear to substantially alter maternal physiology with advancing gestation, speculating that the already vast changes in maternal physiology mask the influences of antenatal exercise, however it does appear to result in an improvement in a woman's haemodynamic function (enhanced ventricular ejection performance and reduced blood pressure) following the end of pregnancy. ClinicalTrials.gov NCT02503995. Registered 20 July 2015.

The CGRP-antagonist, BIBN4096BS does not affect cerebral or systemic haemodynamics in healthy volunteers

DEFF Research Database (Denmark)

Petersen, K A; Birk, S; Lassen, L H

2005-01-01

CBF(MCA)) was measured by 133-Xenon inhalation SPECT. The diameter of the temporal and radial artery was measured by high-resolution ultrasound. Systemic haemodynamics and partial pressure of CO(2) (P(et)CO(2)), and adverse events were monitored regularly. BIBN4096BS had no influence on global or regional cerebral blood......BIBN4096BS is a CGRP-antagonist effective in the treatment of migraine. Blocking the receptor of a strong vasodilator involves a theoretical risk of causing cerebral vasoconstriction, a probability not previously investigated with BIBN4096BS. Seven healthy volunteers completed this double...... flow, or on the blood flow velocity in the middle cerebral artery. There was no effect on systemic haemodynamics and adverse events were minor. We conclude that there is no effect of CGRP-receptor blockade on the cerebral or systemic circulation in humans. Circulating CGRP is therefore not likely...

Evaluating the roles of detailed endocardial structures on right ventricular haemodynamics by means of CFD simulations.

Science.gov (United States)

Sacco, Federica; Paun, Bruno; Lehmkuhl, Oriol; Iles, Tinen L; Iaizzo, Paul A; Houzeaux, Guillaume; Vázquez, Mariano; Butakoff, Constantine; Aguado-Sierra, Jazmin

2018-06-11

Computational modelling plays an important role in right ventricular (RV) haemodynamic analysis. However, current approaches employ smoothed ventricular anatomies. The aim of this study is to characterise RV haemodynamics including detailed endocardial structures like trabeculae, moderator band and papillary muscles (PMs). Four paired detailed and smoothed RV endocardium models (two male and two female) were reconstructed from ex-vivo human hearts high-resolution magnetic resonance images (MRI). Detailed models include structures with ≥1 mm 2 cross-sectional area. Haemodynamic characterisation was done by computational fluid dynamics (CFD) simulations with steady and transient inflows, using high performance computing (HPC). The differences between the flows in smoothed and detailed models were assessed using Q-criterion for vorticity quantification, the pressure drop between inlet and outlet, and the wall shear stress (WSS). Results demonstrated that detailed endocardial structures increase the degree of intra-ventricular pressure drop, decrease the WSS and disrupt the dominant vortex creating secondary small vortices. Increasingly turbulent blood flow was observed in the detailed RVs. Female RVs were less trabeculated and presented lower pressure drops than the males. In conclusion, neglecting endocardial structures in RV haemodynamic models may lead to inaccurate conclusions about the pressures, stresses, and blood flow behaviour in the cavity. This article is protected by copyright. All rights reserved.

Freedom Solo® versus Trifecta® bioprostheses: clinical and haemodynamic evaluation after propensity score matching.

Science.gov (United States)

Cerqueira, Rui J; Raimundo, Renata; Moreira, Soraia; Saraiva, Francisca A; Andrade, Marta; Salgueiro, Elson; Almeida, Jorge; Amorim, Mário Jorge; Pinho, Paulo; Lourenço, André P; Leite-Moreira, Adelino

2018-01-16

The goal of this study was to compare the stentless Freedom Solo® (FS) and the stented Trifecta® (TF) aortic bioprostheses with regard to haemodynamic profile, left ventricular mass regression and early and late postoperative outcomes and survival. A longitudinal cohort study of consecutive patients undergoing aortic valve replacement (2009-16) with either the FS or TF at 1 centre was performed. Local databases and national records were queried. Prosthesis haemodynamics and left ventricular dimensions were obtained from postoperative echocardiograms. After propensity score matching (21 covariates), the Kaplan-Meier and competing risk analyses were performed for survival and the combined outcome of structural valve deterioration and endocarditis, respectively. Haemodynamics and mass regression were assessed by a mixed-effects model including propensity score as a covariate. From a total sample of 397 patients with the FS and 525 TF bioprostheses with a median follow-up time of 4.0 (2.2-6.0) and 2.4 (1.4-3.7) years, respectively, a matched sample of 329 pairs was obtained. Matched groups showed no differences in survival (hazard ratio = 1.04, 95% confidence interval = 0.69-1.56) or cumulative hazards of combined outcome (subdistribution hazard ratio = 0.54, 95% confidence interval = 0.21-1.39). Although the TF showed an improved haemodynamic profile, no difference was found in mass regression. Patients with TF bioprostheses had higher rates of prolonged mechanical ventilation, whereas patients with the FS bioprosthesis showed higher rates of thrombocytopenia. The TF showed an improved haemodynamic profile compared to the FS, but this did not translate into further reverse remodelling. Postoperative outcomes and survival rates were comparable for both bioprostheses. Long-term follow-up is needed for comparisons with classical bioprosthesis models. © The Author(s) 2018. Published by Oxford University Press on behalf of the European Association for

Haemodynamic preservation in cesarean sections by low dose 0.5% hyperbaric bupivacaine

International Nuclear Information System (INIS)

Ahmad, M.; Ahmad, M.

2017-01-01

Spinal anaesthesia is technique of choice for caesarean sections and hyperbaric bupivacaine is a recommended drug for this popular block. Although safe but few complications are haemodynamic changes, postdural puncture headache, cauda equina syndrome and radiculopathy. However, hypotension remains the common side effect which is believed to occur in 95% of patients resulting in reduction of uteroplacental perfusion causing foetal acid-base abnormalities. Various doses regimes are in safe anaesthesia practice for providing regional anaesthesia for such patients with least detrimental effects on foetal outcome. This study was carried out to find the effective dose of 0.5% hyperbaric bupivacaine in caesarean section patients by comparing two different doses. Methods: After enrolling two hundred patients of C section (Caesarean section) for this study, 90 patients were selected to compare the effects of 0.5% hyperbaric bupivacaine. Group A (n=45) received 10 mg of drug while group B (n=45) received 12 mg for spinal anaesthesia. Onset of block, sensory and motor level, haemodynamic changes, surgery time, maternal satisfaction, APGAR score and incidence of complications were compared in two groups. Results: Blood pressure decreases were less in Group A (p-0.074) but not statistically significant. Phenylephrine for hypotension was given to 17% vs 5% in group B. Maternal satisfaction was found to be better in group B 33 vs 17 but was statistically significant (p 0.034). 2% patients had bradycardia in group A which was treated by atropine. No complications were reported in either group. Conclusion: Doses of hyperbaric bupivacaine for spinal anaesthesia in caesarean sections must be at least 12 mg because it produces excellent anaesthesia and maternal satisfaction without complications. (author)

Alteration of cerebrovascular haemodynamic patterns due to atrial fibrillation: an in silico investigation.

Science.gov (United States)

Scarsoglio, S; Saglietto, A; Anselmino, M; Gaita, F; Ridolfi, L

2017-04-01

There has recently been growing evidence that atrial fibrillation (AF), the most common cardiac arrhythmia, is independently associated with the risk of dementia. This represents a very recent frontier with high social impact for the number of individuals involved and for the expected increase in AF incidence in the next 40 years. Although a number of potential haemodynamic processes, such as microembolisms, altered cerebral blood flow, hypoperfusion and microbleeds, arise as connecting links between the two pathologies, the causal mechanisms are far from clear. An in silico approach is proposed that combines in sequence two lumped-parameter schemes, for the cardiovascular system and the cerebral circulation. The systemic arterial pressure is obtained from the cardiovascular system and used as the input for the cerebral circulation, with the aim of studying the role of AF on the cerebral haemodynamics with respect to normal sinus rhythm (NSR), over a 5000 beat recording. In particular, the alteration of the haemodynamic (pressure and flow rate) patterns in the microcirculation during AF is analysed by means of different statistical tools, from correlation coefficients to autocorrelation functions, crossing times, extreme values analysis and multivariate linear regression models. A remarkable signal alteration, such as a reduction in signal correlation (NSR, about 3 s; AF, less than 1 s) and increased probability (up to three to four times higher in AF than in NSR) of extreme value events, emerges for the peripheral brain circulation. The described scenario offers a number of plausible cause-effect mechanisms that might explain the occurrence of critical events and the haemodynamic links relating to AF and dementia. © 2017 The Author(s).

Comparison of the Success Rates and Haemodynamic Changes of ...

African Journals Online (AJOL)

Comparison of the Success Rates and Haemodynamic Changes of Caudal Block .and Dorsal Penile Nerve Block in Paediatric Day-Case Circumcision. Panda U. Shehu, Abubakar S. Adamu, Samboy Tanimu, Mohammed Tela, Samuelwabada Saniadamu ...

Analysis of haemodynamic disturbance in the atherosclerotic carotid artery using computational fluid dynamics

International Nuclear Information System (INIS)

Birchall, Daniel; Zaman, Azfar; Hacker, Jacob; Davies, Gavin; Mendelow, David

2006-01-01

Computational fluid dynamics (CFD) provides a means for the quantitative analysis of haemodynamic disturbances in vivo, but most work has used phantoms or idealised geometry. Our purpose was to use CFD to analyse flow in carotid atherosclerosis using patient-specific geometry and flow data. Eight atherosclerotic carotid arteries and one healthy control artery were imaged with magnetic resonance angiography (MRA) and duplex ultrasound, and the data used to construct patient-specific computational models used for CFD and wall shear stress (WSS) analysis. There is a progressive change in three-dimensional (3-D) velocity profile and WSS profile with increasing severity of stenosis, characterised by increasing restriction of areas of low WSS, change in oscillation patterns, and progressive rise in WSS within stenoses and downstream jets. Areas of turbulent, retrograde flow and of low WSS are demonstrated in the lee of the stenoses. This study presents the largest CFD analysis of abnormal haemodynamics at the atheromatous carotid bifurcation using patient-specific data and provides the basis for further investigation of causal links between haemodynamic variables and atherogenesis and formation of unstable plaque. We propose that this provides a means for the prospective assessment of relative stroke risk in patients with carotid atherosclerosis. (orig.)

Haemodynamic changes following treatment of subclinical and overt hyperthyroidism

DEFF Research Database (Denmark)

Faber, J; Wiinberg, N; Schifter, S

2001-01-01

rate. Subclinical hyperthyroidism is characterised by reduced serum TSH levels despite free thyroxine (T4) and tri-iodothyronine (T3) estimates within the reference range, in subjects with no obvious symptoms of hyperthyroidism. We measured haemodynamic changes (using impedance cardiography...

Ocular Image and Haemodynamic Features Associated with Different Gradings of Ipsilateral Internal Carotid Artery Stenosis

Directory of Open Access Journals (Sweden)

Hui Wang

2017-01-01

Full Text Available Objectives. To analyse the changes of ocular haemodynamics and morphology in Chinese patients with internal carotid artery (ICA stenosis in the current study. Methods. A retrospective case-control study was conducted with 219 patients. The haemodynamic characteristics, the calibre of retinal vessels, and the subfoveal choroidal thickness (SFChT were compared. We analysed the correlations with the degree of ipsilateral ICA stenosis. Results. There were no significant differences among the groups in the central retinal artery equivalent (CRAE, central retinal vein equivalent (CRVE, and AVR (p=0.073, p=0.188, and p=0.738, resp.. The peak systolic velocity (PSV and end diastolic velocity (EDV in the central retinal artery (CRA and the posterior ciliary artery (PCA were significantly lower than normal eyes (p<0.001. The outer retinal layer thickness and SFChT values of the ICA stenosis groups were significantly lower than normal eyes (p=0.030 and p<0.001, resp.. Conclusion. The PSV and EDV in CRA and PCA and the SFChT and outer retinal layer thickness of ICA eyes were significantly lower than normal eyes. ICA stenosis may impact choroidal haemodynamics, and decreased choroidal circulation might affect the discordance of the SFChT and the outer retinal layer thickness.

[Effects of liensinine on haemodynamics in rats and the physiologic properties of isolated rabbit atria].

Science.gov (United States)

Wang, J L; Nong, Y; Jing, M X

1992-01-01

Liensinine(Lien), an alkaloid extracted from the green seed embryo of Nelumbo nucifera Gaertn, has been shown to have anti-arrhythmic action, its mechanism may be related to blockade of Ca2+, Na+ influx. Lien 3 mg/kg i.v. may temporarily inhibit all parameters of haemodynamics in anesthetized or pithed rats. The inhibitory effects on LVP, +dp/dtmax and SAP in anesthetized rats are slightly stronger than those of quinidine (Qui) 3 mg/kg. Lien 1-30 mg/kg dose-dependently produced these actions. Lien and Qui 12 mg/kg lowered LVP, +dp/dtmax and SAP by 33%, 37%, 29% and 9%, 12%, 9% respectively. While both of them inhibited the other parameters of haemodynamics with nearly equal degrees. The degrees of inhibitory effect of Lien 12 mg/kg on all haemodynamic parameters nearly corresponded to these of verapamil 1 mg/kg. Lien 1-100 mumol/L reduced the contractile force of isolated left atria and the spontaneously beating rate of isolated right atria of rabbits in concentration-dependent manner. These results indicate that the properties of the effect of Lien on haemodynamics may be similar to those of verapamil and different from those of Qui.

Haemodynamic patterns in ST-elevation myocardial infarction : incidence and correlates of elevated filling pressures

NARCIS (Netherlands)

Bergstra, A.; Svilaas, T.; van Veldhuisen, D. J.; van den Heuvel, A. F. M.; van der Horst, I. C. C.; Zijlstra, F.

Objectives. We sought to study the incidence and clinical correlates of elevated filling pressures in ST-elevation myocardial infarction (STEMI) patients, without physical signs of heart failure and treated with primary coronary angioplasty. Background. Haemodynamic data, as measured with a

Efficacy and haemodynamic effects of vacuum-assisted closure for post-sternotomy mediastinitis in children.

Science.gov (United States)

Takahara, Shingo; Sai, Sadahiro; Kagatani, Tomoaki; Konishi, Akinobu

2014-10-01

Post-sternotomy mediastinitis is a significant morbidity with controversial management. Vacuum-assisted closure (VAC) has been used to treat mediastinitis, with many reports documenting its efficacy and feasibility, particularly in adults. However, its use is not prevalent in the paediatric population because of concerns that it may deteriorate haemodynamics. This study aimed to evaluate outcomes and effects of VAC on the haemodynamics of paediatric patients with post-sternotomy mediastinitis. Six patients were treated with VAC between April 2005 and March 2013. We retrospectively investigated their profiles, clinical outcomes and haemodynamic changes, including mean blood pressure (MBP), mean heart rate (MHR), urinary output, amount of diuretics and vasoactive-inotropic score (VIS), before and after VAC initiation. The median age and body weight of patients were 6.4 months and 4.5 kg, respectively. Three patients (50%) had single ventricular physiology. The median VAC duration was 12 days. One patient died of pulmonary venous obstruction after mediastinitis was cured. The average MBPs in every 8-h period were examined, and there were no significant changes (P = 0.773); the average MHRs were examined in the same manner and they decreased significantly after initiation of VAC (P = 0.032). Only 2 patients required vasoactive agents. The VIS did not change in 1 patient and decreased in the other. The mean amount of diuretics administered and urinary output per body weight did not change significantly (P = 0.395 and 0.273, respectively). In conclusion, the haemodynamics of children were not significantly affected by the negative pressure of VAC, indicating that this therapy may be safe and effective for post-sternotomy mediastinitis, even in small children with complex cardiac anomalies. © The Author 2014. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

Genomic ancestry as a predictor of haemodynamic profile in heart failure.

Science.gov (United States)

Bernardez-Pereira, Sabrina; Gioli-Pereira, Luciana; Marcondes-Braga, Fabiana G; Santos, Paulo Caleb Junior Lima; Spina, Joceli Mabel Rocha; Horimoto, Andréa Roseli Vançan Russo; Santos, Hadassa Campos; Bacal, Fernando; Fernandes, Fábio; Mansur, Alfredo Jose; Pietrobon, Ricardo; Krieger, José Eduardo; Mesquita, Evandro Tinoco; Pereira, Alexandre Costa

2016-01-01

The aim of this study is to assess the association between genetic ancestry, self-declared race and haemodynamic parameters in patients with chronic heart failure (HF). Observational, cross-sectional study. Eligible participants were aged between 18 and 80 years; ejection fraction was ≤50%. Patients underwent genetic analysis of ancestry informative markers, echocardiography and impedance cardiography (ICG). Race was determined by self-classification into two groups: white and non-white. Genomic ancestry was estimated using a panel of 101 348 polymorphic markers and three continental reference populations (European, African and Native American). Our study included 362 patients with HF between August 2012 and August 2014. 123 patients with HF declared themselves as white and 234 patients declared themselves as non-white. No statistically significant differences were found regarding the ICG parameters according to self-declared race. The Amerindian ancestry was positively correlated with systolic time ratio (r=0.109, pancestry. In multiple linear regression, African ancestry remained associated with the E/e' ratio, even after adjustment to risk factors. The African genetic ancestry was associated with worse parameters of diastolic function; the Amerindian ancestry correlated with a worse pattern of ventricular contractility, while self-declared colour was not helpful to infer haemodynamic profiles in HF. NTC02043431.

Myocardial and haemodynamic responses to two fluid regimens in African children with severe malnutrition and hypovolaemic shock (AFRIM study)

NARCIS (Netherlands)

Obonyo, Nchafatso; Brent, Bernadette; Olupot-Olupot, Peter; Boele van Hensbroek, Michael; Kuipers, Irene; Wong, Sidney; Shiino, Kenji; Chan, Jonathan; Fraser, John; van Woensel, Job B. M.; Maitland, Kathryn

2017-01-01

Background: Fluid therapy in severely malnourished children is hypothesized to be deleterious owing to compromised cardiac function. We evaluated World Health Organization (WHO) fluid resuscitation guidelines for hypovolaemic shock using myocardial and haemodynamic function and safety endpoints.

Haemodynamic responses and changes of haemostatic risk factors in cold-adapted humans.

Science.gov (United States)

De Lorenzo, F; Kadziola, Z; Mukherjee, M; Saba, N; Kakkar, V V

1999-09-01

Epidemiological studies have shown an increase in acute myocardial infarctions or deaths due to myocardial infarction in colder weather; the mechanisms most likely involve increased blood levels of haemostatic risk factors, and increases in arterial blood pressure and heart rate. We studied the relationship between cold adaptation, haemostatic risk factors and haemodynamic variables. Cold adaptation was obtained by a programme of immersion of the whole body up to the neck in a water-filled bath, the temperature of which was gradually decreased from 22 degrees C to 14 degrees C, time of exposure being increased from 5 to 20 min over a period of 90 days. We studied 428 patients (44% men) and measured blood levels of fibrinogen, plasminogen activator inhibitor 1 (PAI-1), tissue plasminogen activator antigen (t-PA), plasma viscosity, von Willebrand factor, D-dimer and platelet count, both at baseline and after 90 days of daily immersion. There were significant reductions in von Willebrand factor (-3%; p cold adaptation (-310; p = 0.004). Cold adaptation, compared with exposure to cold weather, induces different haemodynamic responses and changes of blood levels of haemostatic risk factors.

Peripartum haemodynamic status of bitches with normal birth or dystocia.

Science.gov (United States)

Lúcio, C F; Silva, L C G; Rodrigues, J A; Veiga, G A L; Vannucchi, C I

2009-07-01

There has been limited investigation of parturition in the bitch and there is little information published on clinical and obstetrical examination other than opinion and anecdote. While there are substantial data on haemodynamic and vascular changes during normal parturition in humans, little is known about the physiological events in the dog. This study was aimed at maternal haemodynamic changes occurring during normal parturition and to investigate how these were modified in bitches with dystocia (DYST) treated either medically or via assisted delivery and caesarean operation. Three groups of 10 bitches were investigated; those with normal parturition, those with DYST corrected by manipulative assistance or caesarean operation and those with uterine inertia treated by oxytocin administration. Heart rate, systolic and diastolic blood pressure, electrocardiogram and blood glucose concentration were measured pre-partum, intra-partum, immediately after parturition and 1 h later. Heart rate was high at all times throughout the study and the majority of bitches had normal sinus rhythm. Blood pressure was generally within the normal range, and although systolic and diastolic blood pressure was highest during the intra-partum period and sometimes during the immediate post-partum period, there were no significant differences between groups. All bitches had blood glucose concentrations within the normal range throughout the study although pre-partum concentrations were statistically lower than many of the other time periods. The study provides useful physiological data that will facilitate monitoring and clinical management of bitches throughout normal parturition and DYST.

Correlation between maternal body composition and haemodynamic changes in pregnancy: different profiles for different hypertensive disorders.

Science.gov (United States)

Pisani, I; Tiralongo, G M; Lo Presti, D; Gagliardi, G; Farsetti, D; Vasapollo, B; Novelli, G P; Andreoli, A; Valensise, H

2017-10-01

To assess and correlate changes in body composition and haemodynamic function during pregnancy. To identify different haemodynamic profiles based on the onset of hypertensive diseases such as gestational hypertension and preeclampsia. We enrolled 265 healthy, normotensive pregnant women throughout pregnancy (from 6+0 to 36+0weeks). They were subjected to assessment of body composition and haemodynamic function using non-invasive methods. We divided our population in three groups: group A with physiological pregnancy, group B with gestational hypertension and group C with preeclamptic patients. In patients who developed gestational hypertension we found lower total body water (TBW) percentage, higher Fat Mass (FM), associated with lower Cardiac Output (CO) and higher Total Vascular Resistance (TVR) during the second trimester. In the third trimester we didn't find haemodynamic differences, but a significative increase in extracellular water (ECW) percentage. In patients who developed preeclampsia we found since the first trimester significative higher TVR and hypodynamic circulation, associated with lower FM percentage. Assessment of body composition and maternal cardiac function may help to identify earlier in pregnancy, patients with different (mal) adaptations to pregnancy. Women with high TVR, hypodynamic circulation and low fat mass during the first trimester, might be at higher risk to develop preeclampsia. Patients with higher BMI and FM percentage, and increased TVR in the second trimester, might be at risk of gestational hypertension and excessive fluid retention at the end of pregnancy. Copyright © 2017 International Society for the Study of Hypertension in Pregnancy. Published by Elsevier B.V. All rights reserved.

Continuous spinal anaesthesia with minimally invasive haemodynamic monitoring for surgical hip repair in two patients with severe aortic stenosis

Directory of Open Access Journals (Sweden)

María Mercedes López

2016-02-01

Full Text Available BACKGROUND AND OBJECTIVES: Aortic stenosis increases perioperative morbidity and mortality, perioperative invasive monitoring is advised for patients with an aortic valve area 30 mm Hg and it is important to avoid hypotension and arrhythmias. We report the anaesthetic management with continuous spinal anaesthesia and minimally invasive haemodynamic monitoring of two patients with severe aortic stenosis undergoing surgical hip repair. CASE REPORT: Two women with severe aortic stenosis were scheduled for hip fracture repair. Continuous spinal anaesthesia with minimally invasive haemodynamic monitoring was used for anaesthetic management of both. Surgery was performed successfully after two consecutive doses of 2 mg of isobaric bupivacaine 0.5% in one of them and four consecutive doses in the other. Haemodynamic conditions remained stable throughout the intervention. Vital signs and haemodynamic parameters remained stable throughout the two interventions. CONCLUSION: Our report illustrates the use of continuous spinal anaesthesia with minimally invasive haemodynamic monitoring as a valid alternative to general or epidural anaesthesia in two patients with severe aortic stenosis who are undergoing lower limb surgery. However, controlled clinical trials would be required to establish that this technique is safe and effective in these type or patients.

Onset time and haemodynamic response after thiopental vs. propofol in the elderly: a randomized trial

DEFF Research Database (Denmark)

Sørensen, Martin Kryspin; Dolven, T L; Rasmussen, L S

2011-01-01

The induction dose of hypnotic agents should be reduced in the elderly, but it is not well studied whether thiopental or propofol should be preferred in this group of patients. The aim of this study was to compare onset time, hypnosis level and the haemodynamic response after thiopental vs...

Lung congestion in chronic heart failure: haemodynamic, clinical, and prognostic implications

DEFF Research Database (Denmark)

Melenovsky, Vojtech; Andersen, Mads Jønsson; Andress, Krystof

2015-01-01

AIMS:The goal of the study was to examine the prognostic impact, haemodynamic and clinical features associated with lung congestion in patients with chronic heart failure (HF). METHODS AND RESULTS:HF patients (n = 186) and HF-free controls (n = 21) underwent right heart catheterization...... days (interquartile range 80-875), 59 patients (32%) died. Lung congestion was associated with reduced survival (P renal dysfunction. CONCLUSION:Interstitial lung oedema is associated with pulmonary vascular disease, RV overload...

Preconception and early pregnancy maternal haemodynamic changes in healthy women in relation to pregnancy viability.

Science.gov (United States)

Foo, F L; Collins, A; McEniery, C M; Bennett, P R; Wilkinson, I B; Lees, C C

2017-05-01

Are there differences in preconception cardiovascular function between women who have a viable pregnancy and those who have a first trimester miscarriage? Preconception cardiovascular function of central haemodynamics and arterial function are similar between women who have a viable pregnancy and those who have a first trimester miscarriage. Miscarriages have been associated with increased long-term cardiovascular disease risk, and arterial and cardiovascular dysfunction has been hypothesised as the common link. It is not known if these risks are present prior to pregnancy or are a reflection of poor arterial and haemodynamic adaptation to pregnancy. This prospective longitudinal preconception cohort study was conducted over 18 months. In total, 367 participants were recruited pre-pregnancy, from which 197 pregnancies were recorded; 39 of these pregnancies ended in first trimester miscarriage. Complete longitudinal data were available for 172 pregnancies (140 viable pregnancies, 32 first trimester miscarriages) from pre-pregnancy to 6 weeks gestation. This was a single site study based at a maternity hospital in London. Healthy women were recruited prior to natural conception and followed up once they became pregnant. All underwent haemodynamic [cardiac output (CO), peripheral vascular resistance (PVR)] and arterial function [aortic augmentation index (AIx) and pulse wave velocity (PWV)] testing prior to pregnancy and at 6 weeks gestation, using non-invasive devices (gas re-breathing method, Innocor® and an occilometric device, Vicorder®). Cross-sectional measurements at pre-pregnancy and 6 weeks gestation and a longitudinal analysis of changes were compared between women who had a subsequent viable pregnancy, and those who had a subsequent first trimester miscarriage. There were no differences between women destined to have a healthy ongoing pregnancy compared to those who miscarried, in terms of baseline cardiovascular function, assessed by CO, PVR, PWV or AIx

Cardiac autonomic and haemodynamic recovery after a single session of aerobic exercise with and without blood flow restriction in older adults.

Science.gov (United States)

Ferreira, Marina Lívia Venturini; Sardeli, Amanda Veiga; Souza, Giovana Vergínia De; Bonganha, Valéria; Santos, Lucas Do Carmo; Castro, Alex; Cavaglieri, Cláudia Regina; Chacon-Mikahil, Mara Patrícia Traina

2017-12-01

This study investigated the autonomic and haemodynamic responses to different aerobic exercise loads, with and without blood flow restriction (BFR). In a crossover study, 21 older adults (8 males and 13 females) completed different aerobic exercise sessions: low load without BFR (LL) (40% VO 2 max ), low load with BFR (LL-BFR) (40% VO 2 max + 50% BFR) and high load without BFR (HL) (70% VO 2 max ). Heart rate variability and haemodynamic responses were recorded during rest and throughout 30 min of recovery. HL reduced R-R interval, the root mean square of successive difference of R-R intervals and high frequency during 30 min of recovery at a greater magnitude compared with LL and LL-BFR. Sympathetic-vagal balance increased the values for HL during 30 min of recovery at a greater magnitude when compared with LL and LL-BFR. Post-exercise haemodynamic showed reduced values of double product at 30 min of recovery compared to rest in LL-BFR, while HL showed higher values compared to rest, LL-BFR and LL. Reduced systolic blood pressure was observed for LL-BFR (30 min) compared to rest. Autonomic and haemodynamic responses indicate lower cardiovascular stress after LL-BFR compared to HL, being this method, besides the functional adaptations, a potential choice to attenuate the cardiovascular stress after exercise in older adults.

Monitoring cardiac output during hyperbaric oxygen treatment of haemodynamically unstable patients

DEFF Research Database (Denmark)

Hansen, Marco Bo; Treschow, Frederik; Skielboe, Martin

2013-01-01

Patients suffering from necrotizing fasciitis (NF) are often haemodynamically unstable and require extended monitoring of cardiovascular parameters; yet this is limited during hyperbaric oxygen treatment (HBOT). We aimed to evaluate the use and safety of transoesophageal Doppler (TED) monitoring ...

Reliability of impedance cardiography in measuring central haemodynamics

DEFF Research Database (Denmark)

Mehlsen, J; Bonde, J; Stadeager, C

1991-01-01

The purpose of the study described here was to investigate the reliability of impedance cardiography (IC) in measuring cardiac output (CO) and central blood volume. Absolute values and changes in these variables obtained by impedance cardiography and by isotope- or thermodilution techniques were...... suitable for repeated measurements in studies on the haemodynamic effects of physiological or pharmacological intervention. Impedance cardiography is sufficiently reliable for comparison of absolute values of CO between different groups of patients. We cannot recommend impedance cardiography...... healthy subjects and in 25 unmedicated patients with ischaemic heart disease. We obtained significant correlations between absolute values (y = 0.68x + 1.48) and changes (y = 1.00x + 0.0003) in CO measured by IC and isotope- or thermodilution. IC significantly overestimated absolute values of CO (P less...

Metabolic and haemodynamic effects of oral glucose loading in young healthy men carrying the 825T-allele of the G protein β3 subunit

Directory of Open Access Journals (Sweden)

Wenzel Rene R

2003-06-01

Full Text Available Abstract Background A C825T polymorphism was recently identified in the gene encoding the β3 subunit of heterotrimeric G-proteins (GNB3. The T-allele is significantly associated with essential hypertension and obesity. In order to further explore a possible pathogenetic link between the T-allele and impaired glucose tolerance we studied metabolic and haemodynamic responses to oral glucose loading in young, healthy subjects with and without the 825T-allele. Methods Twelve subjects with and 10 without the 825T-allele were investigated at rest and following glucose ingestion (75 g. Blood glucose, serum insulin and haemodynamics were determined prior to and over 2 hours following glucose ingestion. We non-invasively measured stroke volume (SV, by impedance-cardiography, blood pressure (BP, heart rate (HR, and systolic-time-intervals. Cardiac output (CO was calculated from HR and SV. Total peripheral resistance was calculated from CO and BP. Metabolic and haemodynamic changes were quantified by maximal responses and by calculation of areas under the concentration time profile (AUC. Significances of differences between subjects with and without the T-allele were determined by unpaired two-tailed t-tests. A p Results Metabolic and haemodynamic parameters at baseline were very similar between both groups. The presence of the T-allele did not alter the response of any metabolic or haemodynamic parameter to glucose loading. Conclusions In conclusion, this study does not support the hypothesis that the C825T polymorphism may serve as a genetic marker of early impaired glucose tolerance.

Data-driven haemodynamic response function extraction using Fourier-wavelet regularised deconvolution

NARCIS (Netherlands)

Wink, Alle Meije; Hoogduin, Hans; Roerdink, Jos B.T.M.

2008-01-01

Background: We present a simple, data-driven method to extract haemodynamic response functions (HRF) from functional magnetic resonance imaging (fMRI) time series, based on the Fourier-wavelet regularised deconvolution (ForWaRD) technique. HRF data are required for many fMRI applications, such as

Data-driven haemodynamic response function extraction using Fourier-wavelet regularised deconvolution

NARCIS (Netherlands)

Wink, Alle Meije; Hoogduin, Hans; Roerdink, Jos B.T.M.

2010-01-01

Background: We present a simple, data-driven method to extract haemodynamic response functions (HRF) from functional magnetic resonance imaging (fMRI) time series, based on the Fourier-wavelet regularised deconvolution (ForWaRD) technique. HRF data are required for many fMRI applications, such as

Mesenchymal stem cells correct haemodynamic dysfunction associated with liver injury after extended resection in a pig model.

Science.gov (United States)

Tautenhahn, Hans-Michael; Brückner, Sandra; Uder, Christiane; Erler, Silvio; Hempel, Madlen; von Bergen, Martin; Brach, Janine; Winkler, Sandra; Pankow, Franziska; Gittel, Claudia; Baunack, Manja; Lange, Undine; Broschewitz, Johannes; Dollinger, Matthias; Bartels, Michael; Pietsch, Uta; Amann, Kerstin; Christ, Bruno

2017-06-01

In patients, acute kidney injury (AKI) is often due to haemodynamic impairment associated with hepatic decompensation following extended liver surgery. Mesenchymal stem cells (MSCs) supported tissue protection in a variety of acute and chronic diseases, and might hence ameliorate AKI induced by extended liver resection. Here, 70% liver resection was performed in male pigs. MSCs were infused through a central venous catheter and haemodynamic parameters as well as markers of acute kidney damage were monitored under intensive care conditions for 24 h post-surgery. Cytokine profiles were established to anticipate the MSCs' potential mode of action. After extended liver resection, hyperdynamic circulation, associated with hyponatraemia, hyperkalaemia, an increase in serum aldosterone and low urine production developed. These signs of hepatorenal dysfunction and haemodynamic impairment were corrected by MSC treatment. MSCs elevated PDGF levels in the serum, possibly contributing to circulatory homeostasis. Another 14 cytokines were increased in the kidney, most of which are known to support tissue regeneration. In conclusion, MSCs supported kidney and liver function after extended liver resection. They probably acted through paracrine mechanisms improving haemodynamics and tissue homeostasis. They might thus provide a promising strategy to prevent acute kidney injury in the context of post-surgery acute liver failure.

Central haemodynamics in patients with severe postural hypotension

DEFF Research Database (Denmark)

Mehlsen, J; Haedersdal, C; Trap-Jensen, J

1991-01-01

Central haemodynamics in the supine and head-up tilted positions were studied in 24 patients with severe postural hypotension with and without supine hypertension. Results were compared with those obtained in eight normotensive and eight untreated hypertensive controls. In the supine position...... the patients had higher vascular resistances, lower stroke volumes and longer left ventricular ejection time indexes compared to controls, whereas left ventricular ejection fractions did not differ significantly. The patients with supine hypertension had significantly higher vascular resistance compared...... to those with supine normotension. The highest supine blood pressure levels were found in patients with multiple system atrophy. During tilt, vascular resistance and heart rates were increased and stroke volumes and left ventricular ejection time indexes were decreased in the controls. The patients were...

Identification of causal relations between haemodynamic variables, auditory evoked potentials and isoflurane by means of fuzzy logic

DEFF Research Database (Denmark)

Jensen, E W; Nebot, A; Caminal, P

1999-01-01

The aim of this study was to identify a possible relationship between haemodynamic variables, auditory evoked potentials (AEP) and inspired fraction of isoflurane (ISOFl). Two different models (isoflurane and mean arterial pressure) were identified using the fuzzy inductive reasoning (FIR...

A COMPARATIVE CLINICAL STUDY BETWEEN IV ESMOLOL AND IV FENTANYL ON ATTENUATION OF HAEMODYNAMIC RESPONSES TO LARYNGOSCOPY AND INTUBATION

Directory of Open Access Journals (Sweden)

Abu Lais Mustaque

2016-04-01

Full Text Available INTRODUCTION Laryngoscopy and intubation is an integral part for providing general anaesthesia to patients undergoing various types of surgery. It also plays an important role in critical care units viz. for providing mechanical ventilation. It is a very essential tool in the hands of anaesthesiologist in maintaining airway. The present study is undertaken to determine and compare the efficacy of single bolus dose of IV esmolol 1 mg/kg and IV fentanyl 2 mcg/kg in attenuating the haemodynamic responses to laryngoscopy and tracheal intubation and to ascertain the effectiveness of esmolol hydrochloride and fentanyl citrate in suppressing sympathetic responses. MATERIAL & METHODS The study was conducted under the Department of Anaesthesiology and Critical Care, Assam Medical College and Hospital, Dibrugarh, during the period July 2013 to June 2014. For this purpose, 150 patients of either sex between 20-50 years of ASA I & II physical status were selected after obtaining informed and written consent and were divided into two groups namely, Group E receiving IV esmolol (1 mg/kg and Group F receiving IV fentanyl (2 mcg/kg. RESULTS Inj. fentanyl 2 mcg/kg IV administered 5 minutes before laryngoscopy and intubation was able to prevent adverse haemodynamic changes better than Inj. esmolol 1 mg/kg IV administered 3 minutes prior to laryngoscopy and intubation during elective surgeries under general anaesthesia. CONCLUSION Hence, from the findings of this study we can conclude that IV bolus dose of fentanyl 2 mcg/kg administered 5 minutes before laryngoscopy and intubation can attenuate the sympathetic response to laryngoscopy and intubation without any side effects of the drug in healthy patients undergoing elective surgeries under general anaesthesia.

[Digitalization for acute myocardial infarction: haemodynamic changes in patients with heart failure at rest (author's transl)].

Science.gov (United States)

Bachour, G; Hochrein, H

1975-11-21

Haemodynamic changes after intravenous administration of 0.4 mg beta-methyldigoxin or 0.4 mg digoxin daily were measured on the first to fourth day in 42 patients in heart failure after onset of transmural myocardial infarction. Regular reduction in filling pressure and increased stroke volume while arterial blood pressure remained unaltered pointed to improved contractility. Digitalization in the first few days after infarction achieved sustained tendency towards improved haemodynamics. It is concluded that early digitalization is indicated in patients with acute myocardial infarction if there are signs of heart failure.

Cerebral haemodynamics in female teenagers exposed to ionizing irradiation in low doses and living in 'clean' areas

International Nuclear Information System (INIS)

Naumova, G.I.; Naumov, A.D.

1999-01-01

Thirty seven girls living in various districts of the Mogilev Region and having received absorbed irradiation dose at thyroid gland owing to iodine 131 more than 1 Gy and 65 ones living in relatively free from radionuclide areas were examined. The results indicated changes in cerebral haemodynamics in the first group. Vegetative vessels dystonia syntrom had been revealed at 31 exposed to iodine 131 irradiation patients (83%) and at 16 patients (25%) from the control group. The changes tended to induce hypotonia of small cerebral peripheral blood vessels with indices asymmetry of left and right cerebral hemispheres

Clinical and angiographic predictors of haemodynamically significant angiographic lesions: development and validation of a risk score to predict positive fractional flow reserve.

Science.gov (United States)

Sareen, Nishtha; Baber, Usman; Kezbor, Safwan; Sayseng, Sonny; Aquino, Melissa; Mehran, Roxana; Sweeny, Joseph; Barman, Nitin; Kini, Annapoorna; Sharma, Samin K

2017-04-07

Coronary revascularisation based upon physiological evaluation of lesions improves clinical outcomes. Angiographic or visual stenosis assessment alone is insufficient in predicting haemodynamic stenosis severity by fractional flow reserve (FFR) and therefore cannot be used to guide revascularisation, particularly in the lesion subset system formulated. Of 1,023 consecutive lesions (883 patients), 314 (31%) were haemodynamically significant. Characteristics associated with FFR ≤0.8 include male gender, higher SYNTAX score, lesions ≥20 mm, stenosis >50%, bifurcation, calcification, absence of tortuosity and smaller reference diameter. A user-friendly integer score was developed with the five variables demonstrating the strongest association. On prospective validation (in 279 distinct lesions), the increasing value of the score correlated well with increasing haemodynamic significance (C-statistic 0.85). We identified several clinical and angiographic characteristics and formulated a scoring system to guide the approach to intermediate lesions. This may translate into cost savings. Larger studies with prospective validation are required to confirm our results.

Does domperidon influence the haemodynamics of oesophageal varices. Beeinflusst Domperidon die Haemodynamik von Oesophagusvarizen

Energy Technology Data Exchange (ETDEWEB)

Hoevels, J [Staedtische Krankenanstalten Bielefeld (Germany, F.R.). Klinik fuer Roentgendiagnostik und Nuklearmedizin

1989-04-01

In three patients with portal venous hypertension and oesophageal varices the effect of domperidon on the haemodynamics of the varices was studied. Following transhepatic catheterisation of the left gastric vein the perfusion of the oesophageal varices before and after the application of domperidon was evaluated angiographically. No decrease of the perfusion of the oesophageal varices secondary to domperidon was observed using this method. (orig.).

Resting Pd/Pa and haemodynamic relevance of coronary stenosis as evaluated by fractional flow reserve.

Science.gov (United States)

De Luca, Giuseppe; Verdoia, Monica; Barbieri, Lucia; Marino, Paolo; Suryapranata, Harry

2018-03-01

Fractional flow reserve (FFR) currently represents the gold standard in the evaluation of the haemodynamic relevance of coronary stenoses. However, both intracoronary and intravenous adenosine may be tolerated poorly by some patients. Therefore, considerable interest had been focused in the last few years on new adenosine-free indexes to define the haemodynamic relevance of coronary stenoses. So far, few data have been reported on resting Pd/Pa and its correlation with FFR as evaluated with high-dose intracoronary adenosine administration, which is the aim of the current study. FFR was assessed in 120 patients with 137 intermediate lesions during cardiac catheterization by a pressure-recording guidewire (PrimeWire). FFR was calculated as the ratio of the distal coronary pressure to the aortic pressure at hyperaemia. Intracoronary doses of adenosine were administered up to 720 μg as intracoronary boli. Exclusion criteria were as follows: (a) allergy to adenosine; (b) baseline bradycardia (heart rate values and increased the percentage of patients showing an FFR less than 0.80. Resting Pd/Pa showed good accuracy in the identification of patients with significant FFR values (value in the prediction of a positive FFR value. A value up to 0.88 was associated with a 100% positive predictive value, whereas a value of at least 0.95 was associated with a 95% negative predictive value. This study showed that in intermediate lesions, resting Pd/Pa was related linearly to FFR. We identified 0.93 as the best cut-off value in the prediction of haemodynamically significant coronary stenosis as evaluated by FFR. However, cut-off values of 0.88 and 0.95 could provide the maximal predictive positive and negative values, suggesting the additional use of FFR only in patients with resting values within this range.

The haemodynamic effects of iodinated water soluble radiographic contrast media: a review

International Nuclear Information System (INIS)

Morcos, S.K.; Dawson, P.; Pearson, J.D.; Jeremy, J.Y.; Davenport, A.P.; Yates, M.S.; Tirone, P.; Cipolla, P.; Haeen, C. de; Muschick, P.; Krause, W.; Refsum, H.; Emery, C.J.; Liss, Per; Nygren, A.; Haylor, J.; Pugh, N.D.; Karlsson, J.O.G.

1998-01-01

All classes of iodinated water-soluble radiographic contrast media (RCM) are vasoactive with the iso-osmolar dimers inducing the least changes in the vascular tone. The mechanisms responsible for RCM-induced changes in the vascular tone are not fully understood and could be multifactorial. A direct effect on the vascular smooth muscle cells causing alterations in the ion exchanges across the cell membrane is thought to be an important factor in RCM-induced vasodilatation. The release of the endogenous vasoactive mediators adenosine and endothelin may also play a crucial role in the haemodynamic effects of RCM particularly in the kidney. In addition, the effects of RCM on blood rheology can cause a reduction in the blood flow in the microcirculation. The purpose of this review is to discuss the pathophysiology of the haemodynamic effects of RCM and to offer some insight into the biology of the endothelium and vascular smooth muscle cells as well as the pharmacology of the important vasoactive mediators endothelin and adenosine

Randomised controlled trial examining the effect of an outpatient exercise training programme on haemodynamics and cardiac MR parameters of right ventricular function in patients with pulmonary arterial hypertension: the ExPAH study protocol.

Science.gov (United States)

Chia, Karen S W; Faux, Steven G; Wong, Peter K K; Holloway, Cameron; Assareh, Hassan; McLachlan, Craig S; Kotlyar, Eugene

2017-02-06

Pulmonary hypertension (PH) is a potentially life-threatening condition characterised by elevated pulmonary artery pressure. Early stage PH patients are often asymptomatic. Disease progression is associated with impairment of right ventricular function and progressive dyspnoea. Current guidelines recommend exercise training (grade IIa, level B). However, many questions remain regarding the mechanisms of improvement, intensity of supervision and optimal frequency, duration and intensity of exercise. This study will assess the effect of an outpatient rehabilitation programme on haemodynamics and cardiac right ventricular function in patients with pulmonary arterial hypertension (PAH), a subgroup of PH. This randomised controlled trial involves both a major urban tertiary and smaller regional hospital in New South Wales, Australia. The intervention will compare an outpatient rehabilitation programme with a control group (home exercise programme). Participants will be stable on oral PAH-specific therapy. The primary outcome measure will be right ventricular ejection fraction measured by cardiac MRI. Secondary outcomes will include haemodynamics measured by right heart catheterisation, endurance, functional capacity, health-related quality of life questionnaires and biomarkers of cardiac function and inflammation. Ethical approval has been granted by St Vincent's Hospital, Sydney (HREC/14/SVH/341). Results of this study will be disseminated through presentation at scientific conferences and in scientific journals. ACTRN12615001041549; pre-results. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Fibrinogen plasma concentration is an independent marker of haemodynamic impairment in chronic thromboembolic pulmonary hypertension

Science.gov (United States)

Hennigs, Jan K.; Baumann, Hans Jörg; Lüneburg, Nicole; Quast, Gesine; Harbaum, Lars; Heyckendorf, Jan; Sydow, Karsten; Schulte-Hubbert, Bernhard; Halank, Michael; Klose, Hans

2014-01-01

Fibrinogen has a crucial role in both inflammation and coagulation, two processes pivotal for the pathogenesis of pulmonary hypertension. We therefore aimed to investigate whether fibrinogen plasma concentrations a) are elevated in pulmonary arterial hypertension (PAH) and chronic thromboembolic pulmonary hypertension (CTEPH) and b) may serve as a novel biomarker for haemodynamic impairment. In a dual-centre, retrospective analysis including 112 patients with PAH (n = 52), CTEPH (n = 49) and a control cohort of patients with suspected PAH ruled out by right heart catheterisation (n = 11), we found fibrinogen plasma concentrations to be increased in patients with PAH (4.1 ± 1.4 g/l) and CTEPH (4.3 ± 1.2 g/l) compared to control patients (3.4 ± 0.5 g/l, p = 0.0035 and p = 0.0004, respectively). In CTEPH patients but not in PAH patients fibrinogen was associated with haemodynamics (p < 0.036) and functional parameters (p < 0.041). Furthermore, fibrinogen was linked to disease severity (WHO functional class, p = 0.017) and independently predicted haemodynamic impairment specifically in CTEPH (p < 0.016). Therefore, fibrinogen seems to represent an important factor in CTEPH pathophysiology and may have the potential to guide clinical diagnosis and therapy. PMID:24770447

Haemodynamic stability during anaesthesia induction with propofol – impact of phenylephrine. A double-blind, randomised clinical trial.

OpenAIRE

KAMENIK, MIRT; KOS, DARJAN; MÖLLER PETRUN, Andreja; GREEN, DAVID W; ZORKO, NUŠKA; MEKIŠ, DUŠAN

2018-01-01

Background. We studied the efects of a parallel phenylephrine infusion during bispectral index guided anaesthesia induction with propofol on haemodynamic parameters. We hypothesised that mean arterial pressure and cardiac index would be better maintained in the group of patients receiving the phenylephrine infusion during induction. Methods. We studied ASA I-III patients scheduled for oncological abdominal surgery. Forty patients randomly received either a ...

Reproducibility of haemodynamical simulations in a subject-specific stented aneurysm model--a report on the Virtual Intracranial Stenting Challenge 2007.

Science.gov (United States)

Radaelli, A G; Augsburger, L; Cebral, J R; Ohta, M; Rüfenacht, D A; Balossino, R; Benndorf, G; Hose, D R; Marzo, A; Metcalfe, R; Mortier, P; Mut, F; Reymond, P; Socci, L; Verhegghe, B; Frangi, A F

2008-07-19

This paper presents the results of the Virtual Intracranial Stenting Challenge (VISC) 2007, an international initiative whose aim was to establish the reproducibility of state-of-the-art haemodynamical simulation techniques in subject-specific stented models of intracranial aneurysms (IAs). IAs are pathological dilatations of the cerebral artery walls, which are associated with high mortality and morbidity rates due to subarachnoid haemorrhage following rupture. The deployment of a stent as flow diverter has recently been indicated as a promising treatment option, which has the potential to protect the aneurysm by reducing the action of haemodynamical forces and facilitating aneurysm thrombosis. The direct assessment of changes in aneurysm haemodynamics after stent deployment is hampered by limitations in existing imaging techniques and currently requires resorting to numerical simulations. Numerical simulations also have the potential to assist in the personalized selection of an optimal stent design prior to intervention. However, from the current literature it is difficult to assess the level of technological advancement and the reproducibility of haemodynamical predictions in stented patient-specific models. The VISC 2007 initiative engaged in the development of a multicentre-controlled benchmark to analyse differences induced by diverse grid generation and computational fluid dynamics (CFD) technologies. The challenge also represented an opportunity to provide a survey of available technologies currently adopted by international teams from both academic and industrial institutions for constructing computational models of stented aneurysms. The results demonstrate the ability of current strategies in consistently quantifying the performance of three commercial intracranial stents, and contribute to reinforce the confidence in haemodynamical simulation, thus taking a step forward towards the introduction of simulation tools to support diagnostics and

Does extubation result in haemodynamic instability in patients following coronary artery bypass grafts?

Science.gov (United States)

Walthall, H; Ray, S; Robson, D

2001-10-01

Coronary heart disease and its management continue to be at the centre of Government health policy. The present political climate demands clinical effectiveness and best practice should be established, while maintaining the philosophy of cost-effectiveness and resource management. These directives have led practitioners to question the care of patients following coronary artery bypass surgery, in particular the role of mechanical ventilation and the subsequent act of extubation. A retrospective study of 89 patients who had coronary artery bypass grafts (emergency and elective) was undertaken, to establish if extubation had a significant effect on the haemodynamic status of patients with variable degrees of left ventricular function (19% with poor left ventricular function). The study found that extubation was achieved within a mean time of 4.97 hours following return from surgery. Extubation resulted in a significant increase in heart rate (P = 0.001), as well as a respiratory acidosis (pCO2: P = 0.000; pH: P = 0.000). However, the stability of the patient was not compromised, with neither mean arterial blood pressure (P = 0.825) nor oxygenation levels (P = 0.267) being significantly altered by extubation. On multivariate analysis, the act of extubation had no significant effect on any of the dependent variables. These results suggest that it is not extubation alone that has an impact on the haemodynamic stability of patients following coronary artery bypass grafts, but that this is indeed multifactorial. Therefore extubation is 'safe' practice for patients with varying degrees of left ventricular function following coronary artery bypass grafts. Limitations of the study are acknowledged.

Data-driven haemodynamic response function extraction using Fourier-wavelet regularised deconvolution

Directory of Open Access Journals (Sweden)

Roerdink Jos BTM

2008-04-01

Full Text Available Abstract Background We present a simple, data-driven method to extract haemodynamic response functions (HRF from functional magnetic resonance imaging (fMRI time series, based on the Fourier-wavelet regularised deconvolution (ForWaRD technique. HRF data are required for many fMRI applications, such as defining region-specific HRFs, effciently representing a general HRF, or comparing subject-specific HRFs. Results ForWaRD is applied to fMRI time signals, after removing low-frequency trends by a wavelet-based method, and the output of ForWaRD is a time series of volumes, containing the HRF in each voxel. Compared to more complex methods, this extraction algorithm requires few assumptions (separability of signal and noise in the frequency and wavelet domains and the general linear model and it is fast (HRF extraction from a single fMRI data set takes about the same time as spatial resampling. The extraction method is tested on simulated event-related activation signals, contaminated with noise from a time series of real MRI images. An application for HRF data is demonstrated in a simple event-related experiment: data are extracted from a region with significant effects of interest in a first time series. A continuous-time HRF is obtained by fitting a nonlinear function to the discrete HRF coeffcients, and is then used to analyse a later time series. Conclusion With the parameters used in this paper, the extraction method presented here is very robust to changes in signal properties. Comparison of analyses with fitted HRFs and with a canonical HRF shows that a subject-specific, regional HRF significantly improves detection power. Sensitivity and specificity increase not only in the region from which the HRFs are extracted, but also in other regions of interest.

The particularities of vegetative regulation of central haemodynamic at children living in condition of chronic radiation and chemical influence in low doses

International Nuclear Information System (INIS)

Zherko, O.M.

2000-01-01

398 children 7-16 years old living in condition of environmental threats have been examined. The most essential changes of the vegetative regulation of central haemodynamic have been found at children 7-13 years old. The distortion of vegetative regulation of the central haemodynamic have been revealed: sympatcotonia in case of arterial hypotensia and deficiency of sympathetic regulation of arterial hypertensia. Level of hormones of the sympatoadrenality system was fall. (authors)

Assessment of haemodynamic changes and acid-base equilibrium during hypovolaemia and after infusion of plasma substitutes in dogs.

Science.gov (United States)

Filczewski, M; Oledzka, K; Szymańska-Kosmala, M; Bogucka, E

1980-01-01

The following haemodynamic values were determined in anaesthetized mongrel dogs: heart rate, systolic blood pressure in the ascending aorta, left ventricular pressure at the peak dp/dt, left ventricular end-diastolic pressure, time interval from Q in ECG to the onset of the systolic wave of dp/dt, time interval from Q in ECG to peak dp/dt, maximum rate of left ventricular pressure rise, femoral arterial flow, and certain indices of left ventricular contractility. It was concluded from the results of these experiments that infusion of a modified gelatin solution Fluigel prevented haemodynamic and metabolic changes produced by experimental hypovolaemia more effectively than infusion of Plasmagel.

Integrated SPECT/CT for assessment of haemodynamically significant coronary artery lesions in patients with acute coronary syndrome

Energy Technology Data Exchange (ETDEWEB)

Rispler, Shmuel [Technion - Israel Institute of Technology, Department of Cardiology, Rambam Health Care Campus and the B. Rappaport Faculty of Medicine, Haifa (Israel); Technion - Israel Institute of Technology, Department of Nuclear Medicine, Rambam Health Care Campus and the B. Rappaport Faculty of Medicine, Haifa (Israel); Aronson, Doron; Roguin, Ariel; Beyar, Rafael [Technion - Israel Institute of Technology, Department of Cardiology, Rambam Health Care Campus and the B. Rappaport Faculty of Medicine, Haifa (Israel); Abadi, Sobhi; Engel, Ahuva [Technion - Israel Institute of Technology, Department of Medical Imaging, Rambam Health Care Campus and the B. Rappaport Faculty of Medicine, Haifa (Israel); Israel, Ora; Keidar, Zohar [Technion - Israel Institute of Technology, Department of Nuclear Medicine, Rambam Health Care Campus and the B. Rappaport Faculty of Medicine, Haifa (Israel)

2011-10-15

Early risk stratification in patients with non-ST elevation acute coronary syndromes (NSTE-ACS) is important since the benefit from more aggressive and costly treatment strategies is proportional to the risk of adverse clinical events. In the present study we assessed whether hybrid single photon emission computed tomography (SPECT)/coronary computed tomography angiography (CCTA) technology could be an appropriate tool in stratifying patients with NSTE-ACS. SPECT/CCTA was performed in 90 consecutive patients with NSTE-ACS. The Thrombolysis in Myocardial Infarction risk score (TIMI-RS) was used to classify patients as low- or high-risk. Imaging was performed using SPECT/CCTA to identify haemodynamically significant lesions defined as >50% stenosis on CCTA with a reversible perfusion defect on SPECT in the corresponding territory. CCTA demonstrated at least one lesion with >50% stenosis in 35 of 40 high-risk patients (87%) as compared to 14 of 50 low-risk patients (35%; TIMI-RS <3; p <0.0001). Of the 40 high-risk and 50 (16%) low-risk TIMI-RS patients, 16 (40%) and 8 (16%), respectively, had haemodynamically significant lesions (p = 0.01). Patients defined as high-risk by a high TIMI-RS, a positive CCTA scan or both (n = 45) resulted in a sensitivity of 95%, specificity of 49%, PPV of 35% and NPV of 97% for having haemodynamically significant coronary lesions. Those with normal perfusion were spared revascularization procedures, regardless of their TIMI-RS. Noninvasive assessment of coronary artery disease by SPECT/CCTA may play an important role in risk stratification of patients with NSTE-ACS by better identifying the subgroup requiring intervention. (orig.)

Integrated SPECT/CT for assessment of haemodynamically significant coronary artery lesions in patients with acute coronary syndrome

International Nuclear Information System (INIS)

Rispler, Shmuel; Aronson, Doron; Roguin, Ariel; Beyar, Rafael; Abadi, Sobhi; Engel, Ahuva; Israel, Ora; Keidar, Zohar

2011-01-01

Early risk stratification in patients with non-ST elevation acute coronary syndromes (NSTE-ACS) is important since the benefit from more aggressive and costly treatment strategies is proportional to the risk of adverse clinical events. In the present study we assessed whether hybrid single photon emission computed tomography (SPECT)/coronary computed tomography angiography (CCTA) technology could be an appropriate tool in stratifying patients with NSTE-ACS. SPECT/CCTA was performed in 90 consecutive patients with NSTE-ACS. The Thrombolysis in Myocardial Infarction risk score (TIMI-RS) was used to classify patients as low- or high-risk. Imaging was performed using SPECT/CCTA to identify haemodynamically significant lesions defined as >50% stenosis on CCTA with a reversible perfusion defect on SPECT in the corresponding territory. CCTA demonstrated at least one lesion with >50% stenosis in 35 of 40 high-risk patients (87%) as compared to 14 of 50 low-risk patients (35%; TIMI-RS <3; p <0.0001). Of the 40 high-risk and 50 (16%) low-risk TIMI-RS patients, 16 (40%) and 8 (16%), respectively, had haemodynamically significant lesions (p = 0.01). Patients defined as high-risk by a high TIMI-RS, a positive CCTA scan or both (n = 45) resulted in a sensitivity of 95%, specificity of 49%, PPV of 35% and NPV of 97% for having haemodynamically significant coronary lesions. Those with normal perfusion were spared revascularization procedures, regardless of their TIMI-RS. Noninvasive assessment of coronary artery disease by SPECT/CCTA may play an important role in risk stratification of patients with NSTE-ACS by better identifying the subgroup requiring intervention. (orig.)

The effects of indomethacin on intracranial pressure and cerebral haemodynamics in patients undergoing craniotomy

DEFF Research Database (Denmark)

Rasmussen, Mads; Tankisi, A; Cold, G E

2004-01-01

We compared the effects of indomethacin (bolus of 0.2 mg.kg-1 followed by an infusion of 0.2 mg.kg-1.h-1) and placebo on intracranial pressure and cerebral haemodynamics in 30 patients undergoing craniotomy for supratentorial brain tumours under propofol and fentanyl anaesthesia. Indomethacin...

Systemic, pulmonary and renal haemodynamic and renal morphologic effects of intravenously infused iodixanol

International Nuclear Information System (INIS)

Sunnegaardh, O.; Hietala, S.O.; Holtz, E.; Nycomed A/S, Oslo

1990-01-01

The systemic, pulmonary and renal haemodynamic effects following an intravenous infusion (1 ml/s, 4 ml/kg) of a non-ionic isoosmolar contrast medium (iodixanol) were investigated in 8 pigs. Histopathologic changes occurring after infusion of iodixanol were studied by repeated renal biopsies. Iodixanol caused a significant increase of cardiac output, mean right atrial pressure, mean pulmonary arterial pressure, mean pulmonary arterial occlusion pressure and mean arterial pressure. There was a decrease of the systemic and pulmonary vascular resistances. Most renal biopsies showed no pathologic findings after infusion of iodixanol but in 3 specimens proteinaceous content was observed 15 min after infusion. (orig.)

Renal haemodynamic in essential hypertension assessed by 133Xe washout and selective renal angiography

International Nuclear Information System (INIS)

Gatta, A.; Merkel, C.; Pessina, A.C.; Milani, L.; Sacerdoti, D.; Zuin, R.

1982-01-01

The renal and intrarenal haemodynamic pattern in 17 patients with essential hypertension of different severity and duration was studied by means of the 133-Xenon washout technique and the selective renal angiography. The mean and the cortical renal blood flows were on average significantly decreased as compared to the controls. A good agreement was found between the reduction in renal perfusion and the degree of vascular abnormalities as shown by angiography; on the contrary no correlation was found between the impairment in renal blood flow and the degree and/or duration of hypertension

Renal haemodynamics, sodium and water reabsorption during continuous intravenous infusion of recombinant interleukin-2

DEFF Research Database (Denmark)

Geertsen, P F; von der Maase, H; Olsen, Niels Vidiendal

1998-01-01

1. Renal haemodynamics, lithium and sodium clearance were measured in 14 patients treated with recombinant interleukin-2 for metastatic renal cell carcinoma. 2. Patients were studied before and after 72 h of continuous intravenous infusion of recombinant interleukin-2 (18x10(6) i.u..24 h-1.m-2) a...... effect. Changes in renal prostaglandin synthesis may contribute to the decrease in renal blood flow. The lithium clearance data suggest that an increased proximal tubular reabsorption rate may contribute to the decreased sodium clearance during recombinant interleukin-2 treatment....

Effect of octreotide on systemic, central, and splanchnic haemodynamics in cirrhosis

DEFF Research Database (Denmark)

Møller, S; Brinch, K; Henriksen, Jens Henrik Sahl

1997-01-01

patients with cirrhosis underwent liver vein catheterisation. Portal and arterial blood pressures were determined at baseline and 10, 30, and 50 min after a bolus injection of octreotide 100 micrograms, followed by continuous infusion of octreotide 100 micrograms/ h for 1 h. Hepatic blood flow, cardiac...... output, central and arterial blood volume, and central circulation time were determined at baseline and 50 min after the start of the octreotide infusion. RESULTS: The mean arterial blood pressure increased during the first 10 min (p ... hypertension. However, reports on the splanchnic and systemic effects of octreotide are contradictory and therefore the aim of the present study was to assess the effects of continuous infusion of octreotide on central and systemic haemodynamics, portal pressures, and hepatic blood flow. METHODS: Thirteen...

Haemodynamic changes following treatment of subclinical and overt hyperthyroidism

DEFF Research Database (Denmark)

Faber, J; Wiinberg, N; Schifter, S

2001-01-01

Hyperthyroidism has profound effects on the cardiovascular system, including reduced systemic vascular resistance (SVR) due to relaxation of vascular smooth muscle cells, enhanced heart rate (HR) and cardiac output (CO) due to an increase in cardiac diastolic relaxation, contractility and heart...... rate. Subclinical hyperthyroidism is characterised by reduced serum TSH levels despite free thyroxine (T4) and tri-iodothyronine (T3) estimates within the reference range, in subjects with no obvious symptoms of hyperthyroidism. We measured haemodynamic changes (using impedance cardiography......) in subjects with endogenous subclinical hyperthyroidism in order to elucidate whether these patients had signs of excess thyroid hormone at the tissue level....

Comparison of haemodynamic responses following different concentrations of adrenaline with and without lignocaine for surgical field infiltration during cleft lip and cleft palate surgery in children.

Science.gov (United States)

Muthukumar, Marimuthu; Arya, Virendra K; Mathew, Preety J; Sharma, Ramesh K

2012-01-01

Surgical field infiltration with adrenaline is common practice for quality surgical field during cleft lip and palate repair in children. Intravascular absorption of adrenaline infiltration often leads to adverse haemodynamic responses. In this prospective, double-blinded, randomised study the haemodynamic effects, quality of surgical field and postoperative analgesia following surgical field infiltration with different concentrations of adrenaline with and without lignocaine were compared in 100 American Society of Anesthesiologists physical status I children aged six months to seven years undergoing cleft lip/palate surgery. A standard anaesthesia protocol was used and they were randomised into four groups based on solution for infiltration: adrenaline 1:400,000 (group A), adrenaline 1:200,000 (group B), lignocaine + adrenaline 1:400,000 (group C) and lignocaine + adrenaline 1:200,000 (group D). Statistically significant tachycardia and hypertension occurred only in group B as compared to other groups (P adrenaline with lignocaine 0.5 to 0.7% is most suitable for infiltration in terms of stable haemodynamics, quality of surgical field and good postoperative analgesia in children.

Echocardiographic estimation of acute haemodynamic response during optimization of multisite pace-maker using different pacing modalities and atrioventricular delays

Directory of Open Access Journals (Sweden)

Šalinger-Martinović Sonja

2009-01-01

Full Text Available Background/Aim. Cardiac resynchronization therapy (CRT improves ventricular dyssynchrony and is associated with an improvement in symptoms, quality of life and prognosis in patients with severe heart failure and intraventricular conduction delay. Different pacing modalities produce variable activation patterns and may be a cause of different haemodynamic changes. The aim of our study was to investigate acute haemodynamic changes with different CRT configurations during optimization procedure. Methods. This study included 30 patients with severe left ventricular systolic dysfunction and left bundle branch block with wide QRS (EF 24.33 ± 3.7%, QRS 159 ± 17.3 ms, New York Heart Association III/IV 25/5 with implanted CRT device. The whole group of patients had severe mitral regurgitation in order to measure dP/dt. After implantation and before discharge all the patients underwent optimization procedure guided by Doppler echocardiography. Left and right ventricular pre-ejection intervals (LVPEI and RVPEI, interventricular mechanical delay (IVD and the maximal rate of ventricular pressure rise during early systole (max dP/dt were measured during left and biventricular pacing with three different atrioventricular (AV delays. Results. After CRT device optimization, optimal AV delay and CRT mode were defined. Left ventricular pre-ejection intervals changed from 170.5 ± 24.6 to 145.9 ± 9.5 (p < 0.001, RVPEI from 102.4 ± 15.9 to 119.8 ± 10.9 (p < 0.001, IVD from 68.1 ± 18.3 to 26.5 ± 8.2 (p < 0.001 and dP/dt from 524.2 ± 67 to 678.2 ± 88.5 (p < 0.01. Conclusion. In patients receiving CRT echocardiographic assessment of the acute haemodynamic response to CRT is a useful tool in optimization procedure. The variability of Doppler parameters with different CRT modalities emphasizes the necessity of individualized approach in optimization procedure.

Stress-sensitive arterial hypertension, haemodynamic changes and brain metabolites in hypertensive ISIAH rats: MRI investigation.

Science.gov (United States)

Seryapina, A A; Shevelev, O B; Moshkin, M P; Markel, A L; Akulov, A E

2017-05-01

What is the central question of this study? Stress-sensitive arterial hypertension is considered to be controlled by changes in central and peripheral sympathetic regulating mechanisms, which eventually result in haemodynamic alterations and blood pressure elevation. Therefore, study of the early stages of development of hypertension is of particular interest, because it helps in understanding the aetiology of the disease. What is the main finding and its importance? Non-invasive in vivo investigation in ISIAH rats demonstrated that establishment of sustainable stress-sensitive hypertension is accompanied by a decrease in prefrontal cortex activity and mobilization of hypothalamic processes, with considerable correlations between haemodynamic parameters and individual metabolite ratios. The study of early development of arterial hypertension in association with emotional stress is of great importance for better understanding of the aetiology and pathogenesis of the hypertensive disease. Magnetic resonance imaging (MRI) was applied to evaluate the changes in haemodynamics and brain metabolites in 1- and 3-month-old inherited stress-induced arterial hypertension (ISIAH) rats (10 male rats) with stress-sensitive arterial hypertension and in control normotensive Wistar Albino Glaxo (WAG) rats (eight male rats). In the 3-month-old ISIAH rats, the age-dependent increase in blood pressure was associated with increased blood flow through the renal arteries and decreased blood flow in the lower part of the abdominal aorta. The renal vascular resistance in the ISIAH rats decreased during ageing, although at both ages it remained higher than the renal vascular resistance in WAG rats. An integral metabolome portrait demonstrated that development of hypertension in the ISIAH rats was associated with an attenuation of the excitatory and energetic activity in the prefrontal cortex, whereas in the WAG rats the opposite age-dependent changes were observed. In contrast, in the

Systolic blood pressure is superior to other haemodynamic predictors of outcome in community acquired pneumonia.

Science.gov (United States)

Chalmers, J D; Singanayagam, A; Hill, A T

2008-08-01

Admission blood pressure (BP) assessment is a central component of severity assessment for community acquired pneumonia. The aim of this study was to establish which readily available haemodynamic measure on admission is most useful for predicting severity in patients admitted with community acquired pneumonia. A prospective observational study of patients admitted with community acquired pneumonia was conducted in Edinburgh, UK. The measurements compared were systolic and diastolic BP, mean arterial pressure and pulse pressure. The outcomes of interest were 30 day mortality and the requirement for mechanical ventilation and/or inotropic support. Admission systolic BP pressure pressure AUC values for each predictor of 30 day mortality were as follows: systolic BP pressure pressure AUC values for each predictor of need for mechanical ventilation and/or inotropic support were as follows: systolic BP pressure pressure blood pressure AUC 0.76 vs 0.74) and to the standard CURB65 score (0.76 vs 0.76) for the prediction of 30 day mortality. The simplified CRB65 score was equivalent for prediction of mechanical ventilation and/or inotropic support to standard CRB65 (0.77 vs 0.77) and to CURB65 (0.77 vs 0.78). Systolic BP is superior to other haemodynamic predictors of 30 day mortality and need for mechanical ventilation and/or inotropic support in community acquired pneumonia. The CURB65 score can be simplified to a modified CRB65 score by omission of the diastolic BP criterion without compromising its accuracy.

A haemodynamic study of pulmonary hypertension in chronic hypersensitivity pneumonitis.

Science.gov (United States)

Oliveira, Rudolf K F; Pereira, Carlos A C; Ramos, Roberta P; Ferreira, Eloara V M; Messina, Carolina M S; Kuranishi, Lilian T; Gimenez, Andrea; Campos, Orlando; Silva, Célia M C; Ota-Arakaki, Jaquelina S

2014-08-01

Chronic hypersensitivity pneumonitis is a common fibrotic interstitial lung disease. The prevalence of pulmonary hypertension diagnosed by right heart catheterisation and its cardiopulmonary function findings in patients with chronic hypersensitivity pneumonitis are unknown. Consecutive symptomatic patients with chronic hypersensitivity pneumonitis were prospectively evaluated. All patients were submitted to right heart catheterisation, pulmonary function testing, a 6-min walk test, echocardiography, blood gas determination and N-terminal pro-brain natriuretic peptide analyses. Nonhypoxaemic patients also underwent incremental cardiopulmonary exercise testing. 50 patients underwent right heart catheterisation; 25 (50%) of these had pulmonary hypertension and 22 (44%) had a pre-capillary haemodynamic pattern. The patients with pre-capillary pulmonary hypertension had lower forced vital capacity (mean ± sd 50 ± 17% versus 69 ± 22% predicted, p<0.01), carbon monoxide diffusing capacity (37 ± 12% versus 47 ± 14% predicted, p<0.01), arterial oxygen tension (median (interquartile range) 59.0 (47.8-69.3) versus 73.0 (62.2-78.5) mmHg, p<0.01) and saturation after the 6-min walk test (78 ± 8% versus 86 ± 7%, p<0.01). In pre-capillary pulmonary hypertension, oxygen uptake was also lower at the anaerobic threshold (41 ± 11% versus 50 ± 8% predicted, p=0.04) and at peak exercise (12.8 ± 1.6 versus 15.0 ± 2.5 mL · kg(-1) · min(-1), p=0.02). Pre-capillary pulmonary hypertension is common in symptomatic chronic hypersensitivity pneumonitis and is related to interstitial lung disease severity. Additionally, pulmonary hypertension is more prevalent in hypoxaemic patients with impaired lung function and exercise capacity. ©ERS 2014.

Epidural anaesthesia with levobupivacaine and ropivacaine : effects of age on the pharmacokinetics, neural blockade and haemodynamics

NARCIS (Netherlands)

Simon, Mischa J.G.

2006-01-01

Epidural neural blockade results from processes after the administration of a local anaesthetic in the epidural space until the uptake in neural tissue. The pharmacokinetics, neural blockade and haemodynamics after epidural anaesthesia may be influenced by several factors, with age as the most

Arterial hypertension in cirrhosis: arterial compliance, volume distribution, and central haemodynamics

DEFF Research Database (Denmark)

Henriksen, Jens Henrik Sahl; Fuglsang, S; Bendtsen, F

2006-01-01

, was significantly better in hypertensive cirrhotics than in their normotensive counterparts (pportal pressure was similar (HVPG 13 v 15 mm Hg; NS). AC was significantly lower and normal in the arterial hypertensive cirrhotic group (1.07 v 1.39 mm Hg/ml; p...BACKGROUND AND AIMS: Arterial hypertension is a common disorder. Hyperkinetic circulation and reduced effective volaemia are central elements in the haemodynamic dysfunction in cirrhosis. The aim of the present study was to investigate whether cirrhotic patients with arterial hypertension...... are normokinetic and normovolaemic or whether they reveal the same circulatory dysfunction as their normotensive counterparts. MATERIAL AND METHODS: Thirty three patients with arterial hypertension were identified among 648 patients with cirrhosis: 14 in Child class A, 12 in class B, and seven in class C. Controls...

Facing emotions in narcolepsy with cataplexy: haemodynamic and behavioural responses during emotional stimulation.

Science.gov (United States)

de Zambotti, Massimiliano; Pizza, Fabio; Covassin, Naima; Vandi, Stefano; Cellini, Nicola; Stegagno, Luciano; Plazzi, Giuseppe

2014-08-01

Narcolepsy with cataplexy is a complex sleep disorder that affects the modulation of emotions: cataplexy, the key symptom of narcolepsy, is indeed strongly linked with emotions that usually trigger the episodes. Our study aimed to investigate haemodynamic and behavioural responses during emotional stimulation in narco-cataplexy. Twelve adult drug-naive narcoleptic patients (five males; age: 33.3 ± 9.4 years) and 12 healthy controls (five males; age: 30.9 ± 9.5 years) were exposed to emotional stimuli (pleasant, unpleasant and neutral pictures). Heart rate, arterial blood pressure and mean cerebral blood flow velocity of the middle cerebral arteries were continuously recorded using photoplethysmography and Doppler ultrasound. Ratings of valence and arousal and coping strategies were scored by the Self-Assessment Manikin and by questionnaires, respectively. Narcoleptic patients' haemodynamic responses to pictures overlapped with the data obtained from controls: decrease of heart rate and increase of mean cerebral blood flow velocity regardless of pictures' content, increase of systolic blood pressure during the pleasant condition, and relative reduction of heart rate during pleasant and unpleasant conditions. However, when compared with controls, narcoleptic patients reported lower arousal scores during the pleasant and neutral stimulation, and lower valence scores during the pleasant condition, respectively, and also a lower score at the 'focus on and venting of emotions' dimensions of coping. Our results suggested that adult narcoleptic patients, compared with healthy controls, inhibited their emotion-expressive behaviour to emotional stimulation, and that may be related to the development of adaptive cognitive strategies to face emotions avoiding cataplexy. © 2014 European Sleep Research Society.

Laparoscopic management of retroperitoneal injuries from penetrating abdominal trauma in haemodynamically stable patients.

Science.gov (United States)

Koto, Modise Zacharia; Matsevych, Oleh Y; Mosai, Fusi; Balabyeki, Moses; Aldous, Colleen

2018-02-27

Laparoscopy is increasingly utilised in the trauma setting. However, its safety and reliability in evaluating and managing retroperitoneal injuries are not known. The aim of this study was to analyse our experience with laparoscopic management of retroperitoneal injuries due to penetrating abdominal trauma (PAT) and to investigate its feasibility, safety and accuracy in haemodynamically stable patients. Over a 4-year period, patients approached laparoscopically with retroperitoneal injuries were analysed. Mechanism, location and severity of injuries were recorded. Surgical procedures, conversion rate and reasons for conversion and outcomes were described. Of the 284 patients with PAT, 56 patients had involvement of retroperitoneum. Stab wounds accounted 62.5% of patients. The mean Injury Severity Score was 7.4 (4-20). Among retroperitoneal injuries, the colon (27%) was the most commonly involved hollow viscera followed by duodenum (5%). The kidney (5%) and the pancreas (4%) were the injured solid organs. The conversion rate was 19.6% and was mainly due to active bleeding (73%). Significantly more patients with gunshot wound were converted to laparotomy (38% vs. 9%). Therapeutic laparoscopy was performed in 36% of patients. There were no recorded missed injuries or mortality. Five (9%) patients developed the Clavien-Dindo Grade 3 complications, three were managed with reoperation, one with drainage/debridement and one with endovascular technique. Laparoscopic management of retroperitoneal injuries is safe and feasible in haemodynamically stable patients with PAT. However, a high conversion rate indicates difficulties in managing these injuries. The requirements are the dexterity in laparoscopy and readiness to convert in the event of bleeding.

Validation of non-invasive haemodynamic methods in patients with liver disease

DEFF Research Database (Denmark)

Brittain, Jane M; Busk, Troels M; Møller, Søren

2018-01-01

Patients with advanced cirrhosis often present a hyperdynamic circulation characterized by a decrease in systolic and diastolic blood pressure (SBP and DBP), and an increase in heart rate (HR) and cardiac output (CO). Accurate assessment of the altered circulation can be performed invasively......; however, due to the disadvantages of this approach, non-invasive methods are warranted. The purpose of this study was to compare continuous non-invasive measurements of haemodynamic variables by the Finometer and the Task Force Monitor with simultaneous invasive measurements. In 25 patients with cirrhosis......, respectively; and CO: 0·1 ± 1·6 and -1·0 ± 2·0 L min(-1) , respectively. The study demonstrates that the overall performances of the Finometer and the Task Force Monitor in estimating absolute values of SBP, DBP, HR and CO in patients with cirrhosis are not equivalent to the gold standard, but may have...

Morphologic characteristics of central pulmonary thromboemboli predict haemodynamic response in massive pulmonary embolism.

Science.gov (United States)

Podbregar, Matej; Voga, Gorazd; Krivec, Bojan

2004-08-01

On hospital admission, the morphology of the central pulmonary artery thromboemboli is an independent predictor of 30-day mortality in patients with massive pulmonary embolism (MPE). This may be due to the differential susceptibility of thromboemboli to thrombolysis. The aim of this study was to assess haemodynamic response to treatment in patients with MPE and morphologically different thromboemboli. Prospective observational study. An 11-bed closed medical ICU at a 860-bed community general hospital. Twelve consecutive patients with shock or hypotension due to MPE and central pulmonary thromboemboli detected by transesophageal echocardiography who were treated with thrombolysis between January 2000 through April 2002. Patients were divided into two groups according to the characteristics of detected central pulmonary thromboemboli: group 1, thrombi with one or more long, mobile parts; and group 2, immobile thrombi. Urokinase infusion was terminated when mixed venous oxygen saturation was stabilized above 60% for 15 min. At 2 h, the total pulmonary vascular resistance index was reduced more in group 1 than group 2 [from 27+/-12 mmHg/(l.min.m(2)) to 14+/-6 mmHg/(l.min.m(2)) (-52%) vs 27+/-8 mmHg/(l.min.m(2)) to 23+/-10 mmHg/(l.min.m(2)) (-15%), respectively, P=0.04]. In group 1 thrombolysis was terminated earlier than group 2 (89+/-40 min vs 210+/-62 min, respectively, P= 0.0024). The cumulative dose of urokinase used in group 1 was lower than group 2 (1.7+/-0.3 M i.u. vs 2.7+/-0.5 M i.u., respectively, P= 0.023). Haemodynamic stabilization is achieved faster in patients with mobile central thromboemboli detected by transesophageal echocardiography during MPE.

Haemodynamic characterisation and heart catheterisation complications in children with pulmonary hypertension : Insights from the Global TOPP Registry (tracking outcomes and practice in paediatric pulmonary hypertension)

NARCIS (Netherlands)

Beghetti, M.; Schulze-Neick, I.; Berger, R. M. F.; Ivy, D. D.; Bonnet, D.; Weintraub, R. G.; Saji, T.; Yung, D.; Mallory, G. B.; Geiger, R.; Berger, J. T.; Barst, R. J.; Humpl, T.; Mattos, S.; Jing, Z. C.; Han, Z. Y.; Sondergaard, L.; Jensen, T.; Levy, M.; Mebus, S.; Apitz, Ch.; Szatmari, A.; Ablonczy, L.; Milanesi, O.; Favero, V.; Pulido, T.; De La Garza, P.; Douwes, J. M.; Brun, H.; Moll, L.; Michalak, K.; Kawalec, W.; Zuk, M.; Boillat, M. Fasnacht; Olgunturk, R.; Kula, S. Serdar; Alehan, D.; Day, R. W.; Austin, E.; Moore, D. J.; Atz, A. M.; Feinstein, J. A.

2016-01-01

Background: The TOPP Registry has been designed to provide epidemiologic, diagnostic, clinical, and outcome data on children with pulmonary hypertension (PH) confirmed by heart catheterisation (HC). This study aims to identify important characteristics of the haemodynamic profile at diagnosis and HC

Haemodynamic and end tidal CO2 changes state after inflation and deflation of pneumatic tourniquet on extremities.

Science.gov (United States)

Zaman, S M; Islam, M M; Chowdhury, K K; Rickta, D; Ireen, S T; Choudhury, M R; Alam, M

2010-10-01

The use of a tourniquet for obtaining a bloodless field is an essential and accepted tool for extremity surgery. A prospective study was done on 30 adult patients undergoing elective limb surgery requiring tourniquet application for haemodynamic and End tidal CO2 (EtCO2) changes. After the induction of general anaesthesia a tourniquet was applied on the limb. There was gradual increase in heart rate & EtCO2 through out the whole period of tourniquet inflation. There was also significant increase of mean arterial pressure during the inflation period. At the end of surgery tourniquet was deflated. Tourniquet time was 76.83+/-16.94 minutes. After deflation of the tourniquet, heart rate & EtCO2 value increased & the values were maximum at 5 minutes. These values came down to the base line at 15 minutes. There was significant decrease of mean arterial pressure (MAP) at 5 minute; it also came to the base at 15 minute. These changes are usually benign but can be significant in patients with co-existing cardiovascular & intracranial diseases. In conclusion, we recommend the haemodynamic and End tidal CO2 monitoring as well as rapid fluid infusion along with hyperventilation for 15-30 minutes after deflation of tourniquet.

Effect of clonidine and magnesium sulphate on anaesthetic consumption, haemodynamics and postoperative recovery: A comparative study

Directory of Open Access Journals (Sweden)

Manjushree Ray

2010-01-01

Full Text Available This randomised, placebo-controlled, double-blind study was designed to assess the effect of intravenous clonidine and magnesium sulphate on intraoperative haemodynamics, anaesthetic consumption and postoperative recovery. Seventy five patients undergoing elective upper limb orthopaedic surgery were randomised into three groups. Group C received clonidine 3 μg/kg as a bolus before induction and 1μg/kg/hour by infusion intraopertively. Group M received magnesium sulphate 30 mg/kg as a bolus before induction and 10 mg/kg/hour by infusion. Group P received same volume of isotonic saline. Anaesthesia was induced and maintained with fentanyl citrate and propofol. Muscular relaxation was achieved by vecuronium bromide. Induction time, recovery time and consumption of propofol as well as fentanyl citrate were recorded. Induction of anaesthesia was rapid with both clonidine and magnesium sulphate. Time of bispectral index (BIS to reach 60 was significantly lower in Group C and Group M (P < 0.0001. Requirements of propofol and fentanyl were significantly less in Group C and Group M (P < 0.001. Postoperative recovery was slower in Group M compared with other two groups (P < 0.001. Perioperative use of both clonidine and magnesium sulphate significantly reduced the consumption of propofol and fentanyl citrate. Magnesium sulphate caused a delayed recovery.

Haemodynamic changes in hepatocellular carcinoma and liver parenchyma under balloon occlusion of the hepatic artery

Energy Technology Data Exchange (ETDEWEB)

Sugihara, Fumie; Murata, Satoru; Ueda, Tatsuo; Yasui, Daisuke; Yamaguchi, Hidenori; Miki, Izumi; Kumita, Shin-ichiro [Nippon Medical School, Department of Radiology, Center for Advanced Medical Technology, Tokyo (Japan); Kawamoto, Chiaki [Nippon Medical School, Department of Internal Medicine, Tokyo (Japan); Uchida, Eiji [Nippon Medical School, Department of Surgery, Tokyo (Japan)

2017-06-15

To investigate haemodynamic changes in hepatocellular carcinoma (HCC) and liver under hepatic artery occlusion. Thirty-eight HCC nodules in 25 patients were included. Computed tomography (CT) during hepatic arteriography (CTHA) with and without balloon occlusion of the hepatic artery was performed. CT attenuation and enhancement volume of HCC and liver with and without balloon occlusion were measured on CTHA. Influence of balloon position (segmental or subsegmental branch) was evaluated based on differences in HCC-to-liver attenuation ratio (H/L ratio) and enhancement volume of HCC and liver. In the segmental group (n = 20), H/L ratio and enhancement volume of HCC and liver were significantly lower with balloon occlusion than without balloon occlusion. However, in the subsegmental group (n = 18), H/L ratio was significantly higher and liver enhancement volume was significantly lower with balloon occlusion; HCC enhancement volume was similar with and without balloon occlusion. Rate of change in H/L ratio and enhancement volume of HCC and liver were lower in the segmental group than in the subsegmental group. There were significantly more perfusion defects in HCC in the segmental group. Hepatic artery occlusion causes haemodynamic changes in HCC and liver, especially with segmental occlusion. (orig.)

Central and peripheral haemodynamic effects of non-steroidal anti-inflammatory drugs in man.

Science.gov (United States)

Wennmalm, A; Carlsson, I; Edlund, A; Eriksson, S; Kaijser, L; Nowak, J

1984-01-01

The haemodynamic effects of non-steroidal anti-inflammatory (NSAI) drugs can be attributed either to their common property of inhibiting the formation of prostaglandins (PG) in the cardiovascular system, or to direct actions on the tone and sensitivity of the resistance vessels in various regions. Indomethacin (IND) is the most frequently studied NSAI drug, in animals and in man. Its cardiovascular effects differ somewhat from those of other NSAI, due to the fact that, besides inhibiting PG formation, IND acts as a direct vasoconstrictor. The stimulatory effect of IND in vascular smooth muscle results in an increased systemic vascular resistance which, although partially compensated by a decreased cardiac output, gives rise to a moderate increase in systemic blood pressure. The vasoconstrictor effect of IND is of particular interest in patients with ischemic heart disease, since it lowers their already decreased coronary flow, and may thereby accentuate the risk of myocardial infarction. Administration of IND also leads to a decreased blood flow in the splanchnic region, the kidneys, and the brain. The cerebral blood flow is lowered by 25-35%; in addition, IND almost entirely erases the hyperemic flow response to hypercapnia. Of other NSAI drugs, at least aspirin and naproxen are completely devoid of such actions on the cerebral circulation. A common vascular effect of all NSAI drugs is a diminution of reactive hyperemia, the local hyperemia that develops in a tissue subjected to a short period of arterial occlusion. Part of this hyperemic response is dependent on an intact vascular PG formation and consequently it is inhibited when PG formation is blocked. In contrast, NSAI drugs do not affect the functional increase in the blood flow in working skeletal muscle.

Evaluation of standard haemodynamic tests of autonomic function and HbA1c as predictors of delayed gastric emptying in patients with type 1 diabetes mellitus.

LENUS (Irish Health Repository)

Lydon, A

2012-02-03

We examined the relation between chronic glycaemic control (using glycosylated haemoglobin), haemodynamic autonomic function and rate of gastric emptying in 16 patients with type 1 diabetes mellitus. Gastric emptying was measured using a paracetamol absorption technique. Parameters of gastric emptying include area under the plasma paracetamol concentration time curve. Patients were classified as diabetic autonomic neuropathy positive or negative using five standardized haemodynamic reflex tests. Area under the plasma paracetamol concentration time curve in the neuropathy positive (10.36 (4.5) mmol.-1. min) and negative (9.84 (3.0) mmol.-1. min) groups were similar (.P.=0.42) using unpaired Student\\'s.t. -tests. Glycosylated haemoglobin concentration and area under the plasma paracetamol concentration time curve (.n.=16) demonstrated a Pearson\\'s correlation co-efficient of 0.24. Neither tests of haemodynamic autonomic function, nor concentration of glycosylated haemoglobin, are predictive of diabetic gastroparesis.

Respiratory-haemodynamic reactions in patients with lung cancer complicated by atelectasis

International Nuclear Information System (INIS)

Krasnosel'skij, N.V.; Krut'ko, E.N.; Pilipenko, S.A.

2017-01-01

The article contains published research materials confirming paradoxical respiratory-haemodynamic reactions in patients with lung atelectasis. The physiopathology mechanisms of these reactions were estimated by means of non-invasive arterial pressure, blood saturation and pulse values. The outcomes obtained are indicative of two pathophysiologic compensation mechanisms in patients with lung atelectasis. After pressing carotid artery branch - increased tonicity of the arteries in this lung area decreases blood flow resulting in ventilation/blood flow rate balancing that corresponds to Euler-Liljestrand mechanism. Resection of atelectized lung area leads to increased thoraco-pulmonary pressure, which has been reduced through atelectasis, that aids in higher lung tissue compliance.

[The relationship between ophthalmic nerve lesion in glaucoma and ocular and systemic haemodynamic disturbance].

Science.gov (United States)

Liu, L; Yuan, S; Yang, W

1999-04-01

To explore the relationship between the optic nerve lesion in glaucoma and ocular and systemic haemodynamic disturbance. The color Doppler imaging was used to study blood velocity in the ophthalmic, the central retinal and the short posterior ciliary arteries in 34 patients with primary open angle glaucoma, 31 patients with low tension glaucoma and 90 healthy controls. The peak systolic velocity(PSV), the end diastolic velocity (EDV) and resistive index (RI) in each artery were measured, moreover the nailfold microcirculation and blood viscosity in each patient were examined. Compared with the control group, the PSV and EDV of the central retinal arteries were significantly lower while the RI of the central retinal arteries was significantly higher in both POAG and LTG patients. The RI of the short posterior ciliary arteries however was significantly higher in POAG. Nailfold microcirculation shows that some important parameters, including flow pattern, loop surrounding, morphological weighted value, total weighted value and capillary deformity rate in the two glaucoma groups were higher, whereas the flow velocity was lower than in the control group. The plasm viscosity and the whole blood viscosity (low spear) were higher than normal. According to our measurements, the nailfold microcirculation and blood viscosity was worse at the end stage of glaucoma than at early stage. The correlative analysis between measurement results of color doppler imaging and microcirculation and heamorrheology showed that nailfold microcirculation morphological weighted value was negatively correlated with the EDV of the central retinal artery and positively correlated with the RI of the central retinal artery in LTG patients. The abnormity of ocular haemodynamics and systemic microcirculation and blood viscosity is one important factor of optic nerve damage in glaucoma.

Comparison of the effects of two intrathecal anaesthetic techniques for transurethral prostatectomy on haemodynamic and pulmonary function.

LENUS (Irish Health Repository)

Walsh, K H

2012-02-03

BACKGROUND AND OBJECTIVE: Transurethral prostatectomy is routinely performed under spinal anaesthesia. This technique can cause hypotension, which is particularly undesirable in the elderly. The objective was to compare spinal anaesthesia for transurethral prostatectomy using hyperbaric bupivacaine 15 mg (control group) and hyperbaric bupivacaine 10 mg (limiting spread by maintaining the upright position for 15 min) and fentanyl 25 microg (fentanyl group) in terms of haemodynamic and pulmonary function. METHODS: Thirty ASA I-III patients were randomly selected and underwent spinal anaesthesia with either hyperbaric bupivacaine 15 mg (immediately positioned supine) or hyperbaric bupivacaine 10 mg (upright for 15 min) and fentanyl 25 microg. RESULTS: The greatest changes in mean arterial pressure (P = 0.9), ephedrine requirements (P = 0.8) and mean maximum change in forced vital capacity (P = 0.5) were similar in both groups. CONCLUSIONS: The addition of fentanyl 25 microg to bupivacaine 10 mg and limiting the spread of the block does not improve either haemodynamic or pulmonary function compared with bupivacaine 15 mg in patients undergoing transurethral prostatectomy.

Wide-field optical mapping of neural activity and brain haemodynamics: considerations and novel approaches

Science.gov (United States)

Ma, Ying; Shaik, Mohammed A.; Kozberg, Mariel G.; Thibodeaux, David N.; Zhao, Hanzhi T.; Yu, Hang

2016-01-01

Although modern techniques such as two-photon microscopy can now provide cellular-level three-dimensional imaging of the intact living brain, the speed and fields of view of these techniques remain limited. Conversely, two-dimensional wide-field optical mapping (WFOM), a simpler technique that uses a camera to observe large areas of the exposed cortex under visible light, can detect changes in both neural activity and haemodynamics at very high speeds. Although WFOM may not provide single-neuron or capillary-level resolution, it is an attractive and accessible approach to imaging large areas of the brain in awake, behaving mammals at speeds fast enough to observe widespread neural firing events, as well as their dynamic coupling to haemodynamics. Although such wide-field optical imaging techniques have a long history, the advent of genetically encoded fluorophores that can report neural activity with high sensitivity, as well as modern technologies such as light emitting diodes and sensitive and high-speed digital cameras have driven renewed interest in WFOM. To facilitate the wider adoption and standardization of WFOM approaches for neuroscience and neurovascular coupling research, we provide here an overview of the basic principles of WFOM, considerations for implementation of wide-field fluorescence imaging of neural activity, spectroscopic analysis and interpretation of results. This article is part of the themed issue ‘Interpreting BOLD: a dialogue between cognitive and cellular neuroscience’. PMID:27574312

Wide-field optical mapping of neural activity and brain haemodynamics: considerations and novel approaches.

Science.gov (United States)

Ma, Ying; Shaik, Mohammed A; Kim, Sharon H; Kozberg, Mariel G; Thibodeaux, David N; Zhao, Hanzhi T; Yu, Hang; Hillman, Elizabeth M C

2016-10-05

Although modern techniques such as two-photon microscopy can now provide cellular-level three-dimensional imaging of the intact living brain, the speed and fields of view of these techniques remain limited. Conversely, two-dimensional wide-field optical mapping (WFOM), a simpler technique that uses a camera to observe large areas of the exposed cortex under visible light, can detect changes in both neural activity and haemodynamics at very high speeds. Although WFOM may not provide single-neuron or capillary-level resolution, it is an attractive and accessible approach to imaging large areas of the brain in awake, behaving mammals at speeds fast enough to observe widespread neural firing events, as well as their dynamic coupling to haemodynamics. Although such wide-field optical imaging techniques have a long history, the advent of genetically encoded fluorophores that can report neural activity with high sensitivity, as well as modern technologies such as light emitting diodes and sensitive and high-speed digital cameras have driven renewed interest in WFOM. To facilitate the wider adoption and standardization of WFOM approaches for neuroscience and neurovascular coupling research, we provide here an overview of the basic principles of WFOM, considerations for implementation of wide-field fluorescence imaging of neural activity, spectroscopic analysis and interpretation of results.This article is part of the themed issue 'Interpreting BOLD: a dialogue between cognitive and cellular neuroscience'. © 2016 The Authors.

Endothelin-1 and endothelin-3 in cirrhosis: relations to systemic and splanchnic haemodynamics

DEFF Research Database (Denmark)

Møller, S; Gülberg, V; Gerbes, A L

1995-01-01

correlated with the hepatic venous pressure gradient (r = 0.61, p blood pressure (r = -0.31, p blood volume (-0.36, p ... haemodynamics. METHODS: Endothelin-1 and endothelin-3 were measured in samples from a hepatic vein and the femoral artery in 42 patients with cirrhosis, eight hypertensive controls and 10 normotensive controls. RESULTS: Hepatic venous endothelin-1 was significantly higher in the patients with cirrhosis, mean 21.......002). The same pattern was found in arterial endothelin-3. Hepatic venous endothelin-3 correlated significantly with central and arterial blood volume (r = 0.56, p

The haemodynamic effects of intravenous paracetamol (acetaminophen) in healthy volunteers: a double-blind, randomized, triple crossover trial.

Science.gov (United States)

Chiam, Elizabeth; Weinberg, Laurence; Bailey, Michael; McNicol, Larry; Bellomo, Rinaldo

2016-04-01

The haemodynamic effects of intravenous paracetamol have not been systematically investigated. We compared the physiological effects of intravenous mannitol-containing paracetamol, and an equivalent dosage of mannitol, and normal saline 0.9% in healthy volunteers. We performed a blinded, triple crossover, randomized trial of 24 adult healthy volunteers. Participants received i.v. paracetamol (1 g paracetamol +3.91 g mannitol 100 ml(-1) ), i.v. mannitol (3.91 g mannitol 100 ml(-1) ) and i.v. normal saline (100 ml). Composite primary end points were changes in mean arterial pressure (MAP), systolic blood pressure (SBP) and diastolic blood pressure (DBP) measured pre-infusion, during a 15 min infusion period and over a 45 min observation period. Systemic vascular resistance index (SVRI) and cardiac index were measured at the same time points. Infusion of paracetamol induced a transient yet significant decrease in blood pressures from pre-infusion values (MAP -1.85 mmHg, 95% CI -2.6, -1.1, SBP -0.54 mmHg, 95% CI -1.7, 0.6 and DBP -1.92 mmHg, 95% CI -2.6, -1.2, P paracetamol caused a transient decrease in blood pressure immediately after infusion. These effects were not seen with mannitol or normal saline. The physiological mechanism was consistent with vasodilatation. This study provides plausible physiological data in a healthy volunteer setting, supporting transient changes in haemodynamic variables with i.v. paracetamol and justifies controlled studies in the peri-operative and critical care setting. © 2015 The British Pharmacological Society.

To evaluate the effects of dexmedetomidine on intraocular pressure and haemodynamic changes in response to laryngoscopy and tracheal intubation

Directory of Open Access Journals (Sweden)

Tanuja

2014-01-01

Full Text Available Background: The most important prerequisites for neurosurgeries are brain relaxation, need of stable haemodynamics with less fluctuation in intracranial pressure and speedy recovery from anaesthesia. Endotracheal intubation is the major stressful stimuli that can elicit a marked pressor response. Various drugs have been used to attenuate these reflexes. Dexmedetomidine, a highly selective alpha 2-adrenoceptor agonist, have neuroprotective, cardioprotective, and sedative effects so it is potentially useful during neuroanaesthesia. This is a prospective randomised control trial carried out to see whether administration of Dexmedetomidine prior to intubation can attenuate the various haemodynamic responses, intraocular pressure (IOP and the requirement of induction dose of propofol in control and study group. Materials and Methods: Fifty patients (ASA grade 1, 2 scheduled for intracranial tumour surgeries were divided into two groups (25 each. Group D received Dexmedetomidine 0.8 μg/kg i.v. over 10 mins and group C received 20 ml saline. Anaesthesia induced with Propofol, dose adjusted using bispectral index monitor. The groups were compared with IOP, Heart rate (HR, Mean arterial pressure (MAP, and dose of Propofol required for induction. Results : Groups were well matched for their demographic data and pre-operative. IOP in both the eyes decreases significantly after premedication and remained below baseline even after 10 th min of intubation in group D while in Group C; it increased significantly after intubation and remained above baseline. The difference between groups was also statistically significant. HR and MAP decreased significantly in patients of group D compared to group C (P < 0.05. Patients were more haemodynamicaly stable at all time points after premedication in group D (P < 0.05. Propofol requirements for induction was lesser in group D (P < 0.05. Bradycardia and hypotension incidences were higher in group D. Conclusion

Different injection techniques in the assessment of central haemodynamics in patients with cirrhosis

DEFF Research Database (Denmark)

Christensen, Tine N; Mortensen, Christian; Henriksen, Jens H

2013-01-01

Objective. Patients with cirrhosis often present with an abnormal distribution of blood volume with a reduced central blood volume (CBV) and central circulation time (CCT). In this group of patients it is important to determine the central haemodynamics as accurately as possible. The purpose...... of the present study was to compare an alternative injection technique by injecting technetium-labelled human serum albumin ((99m)Tc-HSA) from a deposit within the catheter lumen with the conventional injection technique by injecting iodine-labelled human serum albumin ((125)I-HSA) directly from a syringe...... was significantly shorter, and CO and CBV were significantly lower when determined by the alternative catheter deposit injection technique compared to determination by the traditional syringe deposit injection technique. The mean difference (bias) between CCT measured with the two methods was 0.38 s with limits...

Effects of dopamine on renal haemodynamics tubular function and sodium excretion in normal humans

DEFF Research Database (Denmark)

Olsen, Niels Vidiendal

1998-01-01

The renal functional changes following infusion of dopamine are well documented. The most pronounced effect is the increase in renal blood flow and a marked natriuretic response. Due to its specific renal effects, dopamine has become one of the most frequently used drugs in the treatment...... of critically ill patients with low cardiac output states and/or acute oliguric renal failure. Pharmacological effects of dopamine are dose dependent. Low doses of dopamine predominantly stimulate dopaminergic receptors, but with increasing doses actions secondary to stimulation of adrenergic beta(1) and alpha...... indirectly may dilate the vessels by inhibition of norepinephrine release. Consistent with previous results in animals, the present haemodynamic studies revealed that dopamine in normal subjects elicits a dose dependent biphasic effect on the mean arterial blood pressure. With 1 and 2 micrograms...

Posture with elevated and extended thorax. The influence of the position on some haemodynamic and ventilatory parameters under general anaesthesia.

Science.gov (United States)

Videbaek, F

1980-12-01

The effects of a change in posture from flat supine to supine with elevated and extended thorax have been investigated in 12 healthy patients under general anaesthesia prior to elective surgery on the stomach. The following parameters were measured: pulse rate, mean arterial blood pressure (MABP), central venous pressure (CVP), ventilation pressure, oesophageal pressure, and arterial oxygen and carbon dioxide tensions. Changes were measured as deviations from initial values before the change of position at 4 and 15 min after the change. One patient (8%) had a 31% fall in MABP and a 87% fall in CVP, requiring treatment outside the standard procedure, but acceptable values were obtained by simple means. Eleven patients showed only minor changes: a mean initial rise in pulse rate of 10% and a fall in CVP of 25%, after which the pulse rate returned to the initial level and the CVP remained stable. MABP was unchanged, as were ventilation pressure, oesophageal pressure and gas tensions. On the basis of reports in the literature and findings in this study, it is concluded that otherwise healthy patients tolerate the posture well, the slight risk of haemodynamic complications being outweighed by the surgical advantages. This posture should be used with caution in patients who may be haemodynamically unable to compensate.

Resting and exercise haemodynamics in relation to six-minute walk test in patients with heart failure and preserved ejection fraction

DEFF Research Database (Denmark)

Wolsk, Emil; Kaye, David; Borlaug, Barry A

2018-01-01

AIMS: Patients with heart failure and preserved ejection fraction (HFpEF) are characterized by functional impairment and an abnormal haemodynamic response to exercise. The six-minute walk test (6MWT) serves as a standardized test for functional capacity quantification in heart failure patients, a...

The haemodynamic effects of intravenous paracetamol (acetaminophen) in healthy volunteers: a double‐blind, randomized, triple crossover trial

Science.gov (United States)

Chiam, Elizabeth; Bailey, Michael; McNicol, Larry; Bellomo, Rinaldo

2016-01-01

Aim The haemodynamic effects of intravenous paracetamol have not been systematically investigated. We compared the physiological effects of intravenous mannitol‐containing paracetamol, and an equivalent dosage of mannitol, and normal saline 0.9% in healthy volunteers. Methods We performed a blinded, triple crossover, randomized trial of 24 adult healthy volunteers. Participants received i.v. paracetamol (1 g paracetamol +3.91 g mannitol 100 ml–1), i.v. mannitol (3.91 g mannitol 100 ml–1) and i.v. normal saline (100 ml). Composite primary end points were changes in mean arterial pressure (MAP), systolic blood pressure (SBP) and diastolic blood pressure (DBP) measured pre‐infusion, during a 15 min infusion period and over a 45 min observation period. Systemic vascular resistance index (SVRI) and cardiac index were measured at the same time points. Results Infusion of paracetamol induced a transient yet significant decrease in blood pressures from pre‐infusion values (MAP –1.85 mmHg, 95% CI –2.6, –1.1, SBP –0.54 mmHg, 95% CI –1.7, 0.6 and DBP −1.92 mmHg, 95% CI –2.6, –1.2, P paracetamol caused a transient decrease in blood pressure immediately after infusion. These effects were not seen with mannitol or normal saline. The physiological mechanism was consistent with vasodilatation. This study provides plausible physiological data in a healthy volunteer setting, supporting transient changes in haemodynamic variables with i.v. paracetamol and justifies controlled studies in the peri‐operative and critical care setting. PMID:26606263

Acute effects of 3G mobile phone radiations on frontal haemodynamics during a cognitive task in teenagers and possible protective value of Om chanting.

Science.gov (United States)

Bhargav, Hemant; N K, Manjunath; Varambally, Shivarama; Mooventhan, A; Bista, Suman; Singh, Deepeshwar; Chhabra, Harleen; Venkatasubramanian, Ganesan; T M, Srinivasan; H R, Nagendra

2016-06-01

Mobile phone induced electromagnetic field (MPEMF) as well as chanting of Vedic mantra 'OM' has been shown to affect cognition and brain haemodynamics, but findings are still inconclusive. Twenty right-handed healthy teenagers (eight males and 12 females) in the age range of 18.25 ± 0.44 years were randomly divided into four groups: (1) MPONOM (mobile phone 'ON' followed by 'OM' chanting); (2) MPOFOM (mobile phone 'OFF' followed by 'OM' chanting); (3) MPONSS (mobile phone 'ON' followed by 'SS' chanting); and (4) MPOFSS (mobile phone 'OFF' followed by 'SS' chanting). Brain haemodynamics during Stroop task were recorded using a 64-channel fNIRS device at three points of time: (1) baseline, (2) after 30 min of MPON/OF exposure, and (3) after 5 min of OM/SS chanting. RM-ANOVA was applied to perform within- and between-group comparisons, respectively. Between-group analysis revealed that total scores on incongruent Stroop task were significantly better after OM as compared to SS chanting (MPOFOM vs MPOFSS), pre-frontal activation was significantly lesser after OM as compared to SS chanting in channel 13. There was no significant difference between MPON and MPOF conditions for Stroop performance, as well as brain haemodynamics. These findings need confirmation through a larger trial in future.

Haemodynamic effects of adrenaline (epinephrine) depend on chest compression quality during cardiopulmonary resuscitation in pigs.

Science.gov (United States)

Pytte, Morten; Kramer-Johansen, Jo; Eilevstjønn, Joar; Eriksen, Morten; Strømme, Taevje A; Godang, Kristin; Wik, Lars; Steen, Petter Andreas; Sunde, Kjetil

2006-12-01

Adrenaline (epinephrine) is used during cardiopulmonary resuscitation (CPR) based on animal experiments without supportive clinical data. Clinically CPR was reported recently to have much poorer quality than expected from international guidelines and what is generally done in laboratory experiments. We have studied the haemodynamic effects of adrenaline during CPR with good laboratory quality and with quality simulating clinical findings and the feasibility of monitoring these effects through VF waveform analysis. After 4 min of cardiac arrest, followed by 4 min of basic life support, 14 pigs were randomised to ClinicalCPR (intermittent manual chest compressions, compression-to-ventilation ratio 15:2, compression depth 30-38 mm) or LabCPR (continuous mechanical chest compressions, 12 ventilations/min, compression depth 45 mm). Adrenaline 0.02 mg/kg was administered 30 s thereafter. Plasma adrenaline concentration peaked earlier with LabCPR than with ClinicalCPR, median (range), 90 (30, 150) versus 150 (90, 270) s (p = 0.007), respectively. Coronary perfusion pressure (CPP) and cortical cerebral blood flow (CCBF) increased and femoral blood flow (FBF) decreased after adrenaline during LabCPR (mean differences (95% CI) CPP 17 (6, 29) mmHg (p = 0.01), FBF -5.0 (-8.8, -1.2) ml min(-1) (p = 0.02) and median difference CCBF 12% of baseline (p = 0.04)). There were no significant effects during ClinicalCPR (mean differences (95% CI) CPP 4.7 (-3.2, 13) mmHg (p = 0.2), FBF -0.2 (-4.6, 4.2) ml min(-1)(p = 0.9) and CCBF 3.6 (-1.8, 9.0)% of baseline (p = 0.15)). Slope VF waveform analysis reflected changes in CPP. Adrenaline improved haemodynamics during laboratory quality CPR in pigs, but not with quality simulating clinically reported CPR performance.

Acute resistance exercise with blood flow restriction in elderly hypertensive women: haemodynamic, rating of perceived exertion and blood lactate.

Science.gov (United States)

Pinto, Roberta R; Karabulut, Murat; Poton, Roberto; Polito, Marcos D

2018-01-01

This study aimed to compare haemodynamic, rating of perceived exertion and blood lactate responses during resistance exercise with blood flow restriction (BFR) compared with traditional high-intensity resistance exercise in hypertensive older women. Eighteen hypertensive women (age = 67·0 ± 1·7 years.) undertook three random sessions: (i) three sets; 10 repetitions; 20% of one repetition maximum (1RM) with BFR; (ii) three sets; 10 repetitions; 65% of 1RM; without BFR; and (iii) no-exercise with BFR. The exercise sessions were performed on knee extension equipment. Systolic (SBP) and diastolic blood pressure (DBP), heart rate (HR), stroke volume (SV) and cardiac output (CO) were significantly higher (P<0·05) in all sets of exercise sessions than the control. No statistically significant differences were detected between exercise sessions. However, SBP, DBP and systemic vascular resistance were higher (P<0·05) and SV and CO were lower (P<0·05) during the rest intervals in the session with BFR. The perceived exertion was significantly higher (P<0·01) in the 1st (4·8 ± 0·4 versus 3·1 ± 0·3), 2nd (7·3 ± 0·4 versus 5·7 ± 0·4) and 3rd sets (8·6 ± 0·5 versus 7·5 ± 0·4) of the traditional high-intensity resistance exercise compared with the exercise with BFR. Blood lactate was higher (P<0·05) in the traditional high-intensity resistance exercise (6·2 ± 0·7 mmol) than in the exercise with BFR (4·5 ± 0·4 mmol). In comparison with high-intensity resistance exercise, low-intensity resistance exercise with BFR can elicit: (i) same haemodynamic values during exercise; (ii) lower rating of perceived exertion; (iii) lower blood lactate; (iv) higher haemodynamic demand during the rest intervals. © 2016 Scandinavian Society of Clinical Physiology and Nuclear Medicine. Published by John Wiley & Sons Ltd.

Assessing paedophilia based on the haemodynamic brain response to face images

DEFF Research Database (Denmark)

Ponseti, Jorge; Granert, Oliver; Van Eimeren, Thilo

2016-01-01

that human face processing is tuned to sexual age preferences. This observation prompted us to test whether paedophilia can be inferred based on the haemodynamic brain responses to adult and child faces. METHODS: Twenty-four men sexually attracted to prepubescent boys or girls (paedophiles) and 32 men......OBJECTIVES: Objective assessment of sexual preferences may be of relevance in the treatment and prognosis of child sexual offenders. Previous research has indicated that this can be achieved by pattern classification of brain responses to sexual child and adult images. Our recent research showed...... sexually attracted to men or women (teleiophiles) were exposed to images of child and adult, male and female faces during a functional magnetic resonance imaging (fMRI) session. RESULTS: A cross-validated, automatic pattern classification algorithm of brain responses to facial stimuli yielded four...

A piezo-film-based measurement system for global haemodynamic assessment

International Nuclear Information System (INIS)

Clemente, Fabrizio; Cimmino, Pasquale; Arpaia, Pasquale

2010-01-01

A non-invasive piezo-film-based measurement method for haemodynamic assessment is proposed. The design of a system, able to reconstruct the blood pressure waveform online by dealing with problems arising from the piezo-film capacitive nature in the targeted frequency range (from quasi-dc up to 12 Hz), is illustrated. The system is based on a commercial piezo-film placed easily on the radial artery with a special brace without any discomfort for the patient. The analogical conditioning circuit and digital signal processing are continuously tuned with the signal from the sensor to reconstruct the blood pressure signal online. Diagnostic schema, based on physio-pathological models, have been implemented in order to compute online trends of max[dP(t)/d(t)] and volemic status highly useful for the intensivist and anaesthesiologist. The system was characterized by numerical simulation and experimental in vivo comparison to the traditional reference system

Tissue oxygenation and haemodynamics measurement with spatially resolved NIRS

Science.gov (United States)

Zhang, Y.; Scopesi, F.; Serra, G.; Sun, J. W.; Rolfe, P.

2010-08-01

We describe the use of Near Infrared Spectroscopy (NIRS) for the non-invasive investigation of changes in haemodynamics and oxygenation of human peripheral tissues. The goal was to measure spatial variations of tissue NIRS oxygenation variables, namely deoxy-haemoglobin (HHb), oxy-haemoglobin (HbO2), total haemoglobin (HbT), and thereby to evaluate the responses of the peripheral circulation to imposed physiological challenges. We present a skinfat- muscle heterogeneous tissue model with varying fat thickness up to 15mm and a Monte Carlo simulation of photon transport within this model. The mean partial path length and the mean photon visit depth in the muscle layer were derived for different source-detector spacing. We constructed NIRS instrumentation comprising of light-emitting diodes (LED) as light sources at four wavelengths, 735nm, 760nm, 810nm and 850nm and sensitive photodiodes (PD) as the detectors. Source-detector spacing was varied to perform measurements at different depths within forearm tissue. Changes in chromophore concentration in response to venous and arterial occlusion were calculated using the modified Lambert-Beer Law. Studies in fat and thin volunteers indicated greater sensitivity in the thinner subjects for the tissue oxygenation measurement in the muscle layer. These results were consistent with those found using Monte Carlo simulation. Overall, the results of this investigation demonstrate the usefulness of the NIRS instrument for deriving spatial information from biological tissues.

Dynamic muscle O2 saturation response is impaired during major non-cardiac surgery despite goal-directed haemodynamic therapy.

Science.gov (United States)

Feldheiser, A; Hunsicker, O; Kaufner, L; Köhler, J; Sieglitz, H; Casans Francés, R; Wernecke, K-D; Sehouli, J; Spies, C

2016-03-01

Near-infrared spectroscopy combined with a vascular occlusion test (VOT) could indicate an impairment of microvascular reactivity (MVR) in septic patients by detecting changes in dynamic variables of muscle O2 saturation (StO2). However, in the perioperative context the consequences of surgical trauma on dynamic variables of muscle StO2 as indicators of MVR are still unknown. This study is a sub-analysis of a randomised controlled trial in patients with metastatic primary ovarian cancer undergoing debulking surgery, during which a goal-directed haemodynamic algorithm was applied using oesophageal Doppler. During a 3 min VOT, near-infrared spectroscopy was used to assess dynamic variables arising from changes in muscle StO2. At the beginning of surgery, values of desaturation and recovery slope were comparable to values obtained in healthy volunteers. During the course of surgery, both desaturation and recovery slope showed a gradual decrease. Concomitantly, the study population underwent a transition to a surgically induced systemic inflammatory response state shown by a gradual increase in norepinephrine administration, heart rate, and Interleukin-6, with a peak immediately after the end of surgery. Higher rates of norepinephrine and a higher heart rate were related to a faster decline in StO2 during vascular occlusion. Using near-infrared spectroscopy combined with a VOT during surgery showed a gradual deterioration of MVR in patients treated with optimal haemodynamic care. The deterioration of MVR was accompanied by the transition to a surgically induced systemic inflammatory response state. Copyright © 2015 Sociedad Española de Anestesiología, Reanimación y Terapéutica del Dolor. Publicado por Elsevier España, S.L.U. All rights reserved.

Noradrenaline and adrenaline concentrations in various vascular beds in patients with cirrhosis. Relation to haemodynamics

DEFF Research Database (Denmark)

Henriksen, Jens Henrik Sahl; Christensen, N J; Ring-Larsen, H

1981-01-01

indicates that sympathetic nervous activity is enhanced in patients with cirrhosis. Based on the above positive correlation between NA and heart rate and the significant release of NA from the kidney, it may be hypothesized that the increased sympathetic nervous activity especially involves heart and kidney......Plasma noradrenaline (NA) and adrenaline (A) concentrations were related to various haemodynamic parameters in fifteen patients with cirrhosis. In supine position at rest plasma NA and A in peripheral venous blood were significantly higher in patients with cirrhosis than in normal subjects. Mean...

Acute effects of Finnish sauna and cold-water immersion on haemodynamic variables and autonomic nervous system activity in patients with heart failure.

Science.gov (United States)

Radtke, Thomas; Poerschke, Daniel; Wilhelm, Matthias; Trachsel, Lukas D; Tschanz, Hansueli; Matter, Friederike; Jauslin, Daniel; Saner, Hugo; Schmid, Jean-Paul

2016-04-01

The haemodynamic response to Finnish sauna and subsequent cold-water immersion in heart failure patients is unknown. Haemodynamic response to two consecutive Finnish sauna (80℃) exposures, followed by a final head-out cold-water immersion (12℃) was measured in 37 male participants: chronic heart failure (n = 12, 61.8 ± 9.2 years), coronary artery disease (n = 13, 61.2 ± 10.6 years) and control subjects (n = 12, 60.9 ± 8.9 years). Cardiac output was measured non-invasively with an inert gas rebreathing method prior to and immediately after the first sauna exposure and after cold-water immersion, respectively. Blood pressure was measured before, twice during and after sauna. The autonomic nervous system was assessed by power spectral analysis of heart rate variability. Total power, low-frequency and high-frequency components were evaluated. The low frequency/high frequency ratio was used as a marker of sympathovagal balance. Sauna and cold-water immersion were well tolerated by all subjects. Cardiac output and heart rate significantly increased in all groups after sauna and cold-water immersion (p heart failure patients. In coronary artery disease patients and controls a prolonged increase in low frequency/high frequency ratio was observed after the first sauna exposure. Acute exposure to Finnish sauna and cold-water immersion causes haemodynamic alterations in chronic heart failure patients similarly to control subjects and in particular did not provoke an excessive increase in adrenergic activity or complex arrhythmias. © The European Society of Cardiology 2015.

Short and long-term effects of irbesartan on intradialytic central haemodynamics: A randomised double-blind placebo-controlled one-year intervention trial (the SAFIR study)

DEFF Research Database (Denmark)

Peters, Christian Daugaard; Kjærgaard, Krista Dybtved; Jensen, Jens Dam

2014-01-01

), stroke volume (SV), central blood volume (CBV), total peripheral resistance (TPR), mean arterial BP (MAP), and heart rate (HR) were measured within the first (HDSTART) and last (HDEND) 30 minutes during HD using the Transonic saline dilution technique. Results Eighty-two patients were randomised (placebo....../ARB: 41/41). Predialytic systolic BP decreased significantly, but similarly in both groups during the study period. The total number of IDH episodes was (placebo/ARB) 22/25 (P=0.7). Mean HDSTART and mean HDEND CO, SV, TPR, HR, and MAP were stable and similar in the two groups, whereas CBV increased...... equally and significantly over time. The mean intradialytic haemodynamic response showed decreased CO, SV, MAP, and CBV, whereas HR increased from HDSTART to HDEND. TPR did not change significantly. Overall, this pattern remained stable over time in both groups and there was no significant impact of ARB...

Predicting haemodynamic networks using electrophysiology: The role of non-linear and cross-frequency interactions

Science.gov (United States)

Tewarie, P.; Bright, M.G.; Hillebrand, A.; Robson, S.E.; Gascoyne, L.E.; Morris, P.G.; Meier, J.; Van Mieghem, P.; Brookes, M.J.

2016-01-01

Understanding the electrophysiological basis of resting state networks (RSNs) in the human brain is a critical step towards elucidating how inter-areal connectivity supports healthy brain function. In recent years, the relationship between RSNs (typically measured using haemodynamic signals) and electrophysiology has been explored using functional Magnetic Resonance Imaging (fMRI) and magnetoencephalography (MEG). Significant progress has been made, with similar spatial structure observable in both modalities. However, there is a pressing need to understand this relationship beyond simple visual similarity of RSN patterns. Here, we introduce a mathematical model to predict fMRI-based RSNs using MEG. Our unique model, based upon a multivariate Taylor series, incorporates both phase and amplitude based MEG connectivity metrics, as well as linear and non-linear interactions within and between neural oscillations measured in multiple frequency bands. We show that including non-linear interactions, multiple frequency bands and cross-frequency terms significantly improves fMRI network prediction. This shows that fMRI connectivity is not only the result of direct electrophysiological connections, but is also driven by the overlap of connectivity profiles between separate regions. Our results indicate that a complete understanding of the electrophysiological basis of RSNs goes beyond simple frequency-specific analysis, and further exploration of non-linear and cross-frequency interactions will shed new light on distributed network connectivity, and its perturbation in pathology. PMID:26827811

Ultrasonographic evaluation of cerebral arterial and venous haemodynamics in multiple sclerosis: a case-control study.

Directory of Open Access Journals (Sweden)

Pasquale Marchione

Full Text Available OBJECTIVE: Although recent studies excluded an association between Chronic Cerebrospinal Venous Insufficiency and Multiple Sclerosis (MS, controversial results account for some cerebrovascular haemodynamic impairment suggesting a dysfunction of cerebral autoregulation mechanisms. The aim of this cross-sectional, case-control study is to evaluate cerebral arterial inflow and venous outflow by means of a non-invasive ultrasound procedure in Relapsing Remitting (RR, Primary Progressive (PP Multiple Sclerosis and age and sex-matched controls subjects. MATERIAL AND METHODS: All subjects underwent a complete extra-intracranial arterial and venous ultrasound assessment with a color-coded duplex sonography scanner and a transcranial doppler equipment, in both supine and sitting position by means of a tilting chair. Basal arterial and venous morphology and flow velocities, postural changes in mean flow velocities (MFV of middle cerebral arteries (MCA, differences between cerebral venous outflow (CVF in clinostatism and in the seated position (ΔCVF and non-invasive cerebral perfusion pressure (CPP were evaluated. RESULTS: 85 RR-MS, 83 PP-MS and 82 healthy controls were included. ΔCVF was negative in 45/85 (52.9% RR-MS, 63/83 (75.9% PP-MS (p = 0.01 and 11/82 (13.4% controls (p<0.001, while MFVs on both MCAs in sitting position were significantly reduced in RR-MS and PP-MS patients than in control, particularly in EDSS ≥ 5 subgroup (respectively, 42/50, 84% vs. 66/131, 50.3%, p<0.01 and 48.3 ± 2 cm/s vs. 54.6 ± 3 cm/s, p = 0.01. No significant differences in CPP were observed within and between groups. CONCLUSIONS: The quantitative evaluation of cerebral blood flow (CBF and CVF and their postural dependency may be related to a dysfunction of autonomic nervous system that seems to characterize more disabled MS patients. It's not clear whether the altered postural control of arterial inflow and venous outflow is a specific MS condition or simply an

Effect of a physical activity programme in the aquatic environment on haemodynamic constants in pregnant women.

Science.gov (United States)

Vázquez-Lara, Juana María; Ruiz-Frutos, Carlos; Rodríguez-Díaz, Luciano; Ramírez-Rodrigo, Jesús; Villaverde-Gutiérrez, Carmen; Torres-Luque, Gema

2017-09-20

To evaluate the effect of a physical activity programme in the aquatic environment with immersion up to the neck, of six weeks duration, on haemodynamic constants in pregnant women. A six-week physical activity programme in the aquatic environment was carried out with a total of 46 pregnant women, who were distributed into an experimental group (n = 18), which participated in the programme, and a control group (n = 28), which followed routine care. In both groups different haemodynamic measurements were evaluated before and after the program. At the beginning of the programme the mean systolic blood pressure was similar between groups, but diastolic blood pressure was slightly higher in the experimental group. When the measurements at the last session were compared, arterial pressures (systolic, diastolic and mean) were significantly higher in the control group (p <.050). Similarly, the initial plasma volume values did not differ between groups, but after the intervention, the control group women showed a higher mean (p <.010). The fraction of sodium excretion (FENa) increased significantly in the experimental group, after the programme, with a mean three times higher (p <.050). Aldosterone plasma levels did not show significant differences between the groups in the different measurements. A programme of swimming and immersion exercises in pregnant women contributes to hydrosaline balance, preventing an excessive increase in usual plasma volume during pregnancy and in the activity of the renin-aldosterone axis. Copyright © 2017 Elsevier España, S.L.U. All rights reserved.

COMPARISON OF AIRWAY RESPONSES, HAEMODYNAMICS AND RECOVERY USING SEVOFLURANE AND DESFLURANE VIA LARYNGEAL MASK AIRWAY IN DAY CARE PAEDIATRIC SURGERIES

Directory of Open Access Journals (Sweden)

A. Satyanarayana

2017-11-01

Full Text Available BACKGROUND The general observation that children achieve better convalescence in the home environment supports the need for adoption of day care surgeries in them. Advantages of paediatric outpatient anaesthesia include- minimises parental separation, uninterrupted feeding schedule/sleeping patterns, less risk of nosocomial infections, reduced cost of hospitalisation, convenience and improved patient satisfaction. The aim of the study is to compare the airway responses, haemodynamic parameters and recovery using sevoflurane and desflurane via laryngeal mask airway in day care paediatric surgeries. MATERIALS AND METHODS 60 paediatric patients of both gender between the age group of 6 and 14 years with ASA grade 1 and 2 undergoing elective day care surgeries under general anaesthesia with LMA are divided into two groups. (Group S sevoflurane group received sevoflurane 2% to 3% and (group D desflurane group received desflurane 6% to 8% for maintenance of anaesthesia after induction with IV propofol 2 mg/kg. Airway responses, haemodynamics and recovery parameters are recorded. RESULTS Recovery parameters spontaneous eye opening, response to verbal commands, Aldrete score at 5 and 10 mins. showed statistically significant difference between two groups. Recovery is faster in desflurane group compared to sevoflurane group. The airway responses and adverse events were found to be more in desflurane group, but statistically not significant. CONCLUSION Recovery from anaesthesia was faster in patients maintained with desflurane (6% to 8% compared with sevoflurane (2% to 3%.

Haemodynamic imaging of thoracic stent-grafts by computational fluid dynamics (CFD): presentation of a patient-specific method combining magnetic resonance imaging and numerical simulations.

Science.gov (United States)

Midulla, Marco; Moreno, Ramiro; Baali, Adil; Chau, Ming; Negre-Salvayre, Anne; Nicoud, Franck; Pruvo, Jean-Pierre; Haulon, Stephan; Rousseau, Hervé

2012-10-01

In the last decade, there was been increasing interest in finding imaging techniques able to provide a functional vascular imaging of the thoracic aorta. The purpose of this paper is to present an imaging method combining magnetic resonance imaging (MRI) and computational fluid dynamics (CFD) to obtain a patient-specific haemodynamic analysis of patients treated by thoracic endovascular aortic repair (TEVAR). MRI was used to obtain boundary conditions. MR angiography (MRA) was followed by cardiac-gated cine sequences which covered the whole thoracic aorta. Phase contrast imaging provided the inlet and outlet profiles. A CFD mesh generator was used to model the arterial morphology, and wall movements were imposed according to the cine imaging. CFD runs were processed using the finite volume (FV) method assuming blood as a homogeneous Newtonian fluid. Twenty patients (14 men; mean age 62.2 years) with different aortic lesions were evaluated. Four-dimensional mapping of velocity and wall shear stress were obtained, depicting different patterns of flow (laminar, turbulent, stenosis-like) and local alterations of parietal stress in-stent and along the native aorta. A computational method using a combined approach with MRI appears feasible and seems promising to provide detailed functional analysis of thoracic aorta after stent-graft implantation. • Functional vascular imaging of the thoracic aorta offers new diagnostic opportunities • CFD can model vascular haemodynamics for clinical aortic problems • Combining CFD with MRI offers patient specific method of aortic analysis • Haemodynamic analysis of stent-grafts could improve clinical management and follow-up.

Mid-term haemodynamic and clinical results after aortic valve replacement using the Freedom Solo stentless bioprosthesis versus the Carpentier Edwards Perimount stented bioprosthesis.

Science.gov (United States)

van der Straaten, Ellen P J; Rademakers, Leonard M; van Straten, Albert H M; Houterman, Saskia; Tan, M Erwin S H; Soliman Hamad, Mohamed A

2016-04-01

The aim of this study was to investigate the mid-term haemodynamic and clinical results after aortic valve replacement (AVR) using the Sorin Freedom Solo (SFS) stentless bioprosthesis, compared with the standard Carpentier Edwards Perimount (CEP) stented bioprosthesis. In this retrospective cohort study of prospectively collected data, 116 patients were included in the SFS group (53 males; median age 74 years, range 56-85 years), and 122 patients in the CEP group (85 males; median age 73 years, range 43-88 years) between July 2007 and January 2013. Echocardiography was performed at 6 weeks after surgery in our centre, and the most recent echocardiography (in our centre or in referring cardiology departments) was requested. Between September 2013 and April 2014, all patients were called by the same researcher to gain clinical follow-up data. Mid-term mortality was 16.4% in the SFS group (19 patients) and 21.3% in the CEP group (26 patients); (P = 0.3). The mean transvalvular gradient was 7.4 ± 3.1 mmHg in the SFS group, and 11.6 ± 3.2 mmHg in the CEP group at 6 weeks postoperatively (P Solo stentless bioprosthesis is as safe as the Carpentier Edwards bioprosthesis, and provides better short- and mid-term haemodynamic performance than the Carpentier Edwards bioprosthesis. © The Author 2015. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

Association of haemodynamic changes measured by serial central venous saturation during ultrafiltration for acutely decompensated heart failure with diuretic resistance and change in renal function.

Science.gov (United States)

Vazir, Ali; Simpkin, Victoria L; Marino, Philip; Ludman, Andrew; Banya, Winston; Tavazzi, Guido; Bastin, Anthony J; Trenfield, Sarah; Ghori, Arshad; Alexander, Peter D; Griffiths, Mark; Price, Susanna; Sharma, Rakesh; Cowie, Martin R

2016-10-01

Patients with acute decompensated heart failure with diuretic resistance (ADHF-DR) have a poor prognosis. The aim of this study was to assess in patients with ADHF-DR, whether haemodynamic changes during ultrafiltration (UF) are associated with changes in renal function (Δcreatinine) and whether Δcreatinine post UF is associated with mortality. Seventeen patients with ADHF-DR underwent 20 treatments with UF. Serial bloods (4-6 hourly) from the onset of UF treatment were measured for renal function, electrolytes and central venous saturation (CVO2). Univariate and multivariate analysis were performed to assess the relationship between changes in markers of haemodynamics [heart rate (HR), systolic blood pressure (SBP), packed cell volume (PCV) and CVO2] and Δcreatinine. Patients were followed up and mortality recorded. Cox-regression survival analysis was performed to determine covariates associated with mortality. Renal function worsened after UF in 17 of the 20 UF treatments (baseline vs. post UF creatinine: 164±58 vs. 185±69μmol/l, Pchanges in SBP, HR and PCV [Pchanges during UF as measured by the surrogate of cardiac output was associated with Δcreatinine. Worsening renal function at end of UF treatment occurred in the majority of patients and was associated with mortality. Copyright © 2016. Published by Elsevier Ireland Ltd.

Neutrophil gelatinase-associated lipocalin and albuminuria as predictors of acute kidney injury in patients treated with goal-directed haemodynamic therapy after major abdominal surgery.

LENUS (Irish Health Repository)

Cullen, Mr

2013-10-11

Neutrophil gelatinase-associated lipocalin (NGAL) is emerging as a new biomarker for the early identification of acute kidney injury (AKI). There is also increasing evidence of an association between urinary albumin\\/creatinine ratio (ACR) and AKI. The primary aim of this study was to evaluate the clinical utility of these biomarkers to predict AKI in a population of perioperative patients treated with goal-directed haemodynamic therapy (GDHT). Secondary aims were to examine NGAL and ACR as sensitive biomarkers to detect the effects of GDHT and to investigate the association of these biomarkers with secondary outcomes.

Postoperative pulmonary and aortic 3D haemodynamics in patients after repair of transposition of the great arteries

Energy Technology Data Exchange (ETDEWEB)

Geiger, Julia; Buerk, Jonas; Jung, Bernd; Langer, Mathias [University Medical Center Freiburg, Department of Radiology, Medical Physics, Freiburg (Germany); Hirtler, Daniel; Stiller, Brigitte [University Medical Center Freiburg-Bad Krozingen, Department of Congenital Heart Disease and Paediatric Cardiology, Freiburg (Germany); Arnold, Raoul [University Medical Center Heidelberg, Department of Congenital Heart Disease and Paediatric Cardiology, Heidelberg (Germany); Markl, Michael [Northwestern University, Department of Radiology, Feinberg School of Medicine, Chicago (United States); Northwestern University, Department Biomedical Engineering, McCormick School of Engineering, Chicago (United States)

2014-01-15

To characterise aortic and pulmonary haemodynamics and investigate the correlation with post-surgical anatomy in patients with dextro-transposition of the great arteries (d-TGA). Four-dimensional (4D) MRI was performed in 17 patients after switch repair of TGA and 12 healthy controls (age, 11.9 ± 5.4 vs 23.3 ± 1.6 years). Patients were divided according to the pulmonary trunk (TP) position in relation to the ascending aorta (AAo): anterior (n = 10) and right/left anterior position (n = 7). Analysis included visual grading (ranking 0-2) of pulmonary and aortic vortical and helical flow, flow velocity quantification, blood-flow distribution to the right and left pulmonary arteries (flow ratio rPA:lPA), and vessel lumen areas. Anterior TP position was associated with increased vortices in six out of ten patients compared with right anterior TP position (one out of seven) and controls (none). Reduced systolic lPA and TP lumina in patients resulted in significantly increased peak systolic velocities (P < 0.001). Flow ratio rPA:lPA was more heterogeneous in patients (rPA:lPA = 1.56 ± 0.78 vs volunteers 1.09 ± 0.15; P < 0.05) with predominant flow to the rPA. Eleven patients presented increased helices in the AAo (grade 1.6). Evaluation of post-surgical haemodynamics in TGA patients revealed increased vortical flow for anterior TP position, asymmetric flow and increased systolic flow velocity in the pulmonary arteries owing to reduced vascular lumina. (orig.)

Cortical spreading ischaemia is a novel process involved in ischaemic damage in patients with aneurysmal subarachnoid haemorrhage

DEFF Research Database (Denmark)

Dreier, Jens P; Major, Sebastian; Manning, Andrew

2009-01-01

flow and electrocorticography were simultaneously recorded in 417 CSDs. Isolated CSDs occurred in 12 patients and were associated with either physiological, absent or inverse haemodynamic responses. Whereas the physiological haemodynamic response caused tissue hyperoxia, the inverse response led......, causing either transient hyperperfusion (physiological haemodynamic response) in healthy tissue; or hypoperfusion [inverse haemodynamic response = cortical spreading ischaemia (CSI)] in tissue at risk for progressive damage, which has so far only been shown experimentally. Here, we performed a prospective......, multicentre study in 13 patients with aneurysmal subarachnoid haemorrhage, using novel subdural opto-electrode technology for simultaneous laser-Doppler flowmetry (LDF) and direct current-electrocorticography, combined with measurements of tissue partial pressure of oxygen (ptiO(2)). Regional cerebral blood...

Regional heterogeneity of endothelial cells in the porcine vortex vein system.

Science.gov (United States)

Tan, Priscilla Ern Zhi; Yu, Paula K; Cringle, Stephen J; Morgan, William H; Yu, Dao-Yi

2013-09-01

The aim of this study was to investigate whether region-dependent endothelial heterogeneity is present within the porcine vortex vein system. The superior temporal vortex vein in young adult pig eyes were dissected out and cannulated. The intact vortex vein system down to the choroidal veins was then perfused with labels for f-actin and nucleic acid. The endothelial cells within the choroidal veins, pre-ampulla, anterior portion of the ampulla, mid-ampulla, posterior portion of the ampulla, post-ampulla, intra-scleral canal and the extra-ocular vortex vein regions were studied in detail using a confocal microscopy technique. The endothelial cell and nuclei length, width, area and perimeter were measured and compared between the different regions. Significant regional differences in the endothelial cell and nuclei length, width, area and perimeter were observed throughout the porcine vortex vein system. Most notably, very narrow and elongated endothelia were found in the post-ampulla region. A lack of smooth muscle cells was noted in the ampulla region compared to other regions. Heterogeneity in endothelial cell morphology is present throughout the porcine vortex vein system and there is a lack of smooth muscle cells in the ampulla region. This likely reflects the highly varied haemodynamic conditions and potential blood flow control mechanisms in different regions of the vortex vein system. Copyright © 2013 Elsevier Inc. All rights reserved.

Value of cerebral blood flow rate and regional oxygen consumption studies in cerebral ischaemia

Energy Technology Data Exchange (ETDEWEB)

Clanet, M

1987-06-18

Studies of experimentally-induced ischaemia have shown that the intensity of neuronal suffering is related to the fall in perfusion rate. Below a certain level, called functional threshold, cerebral function is reversibly altered, whereas at a lower level (tissue necrosis threshold) the damage inflicted on neurons is irreversible. Between these two thresholds lies a ''penumbra zone''. This concept of thresholds must be mitigated by 2 parameters: duration of ischaemia and selective vulnerability of the various structures affected. Variations in blood flow rate only indirectly affect the state of tissues. Techniques developed from positron emission tomography make it possible to evaluate the metabolic activity of brain tissue in vivo: oxygen consumption (CMRO/sub 2/), oxygen extraction (EO/sub 2/) and glucose consumption (CMRG) which are thus correlated to cerebral blood flow and cerebral blood volume, sometimes also to tissue pH. Normal relations between blood flow rate and metabolism may be altered. Misery perfusion reflects a fall in cerebral blood flow with an increase in EO/sub 2/ and often a decrease in CMRO/sub 2/, whereas luxury perfusion reflects an increase in cerebral blood flow rate with reduction of CMRO/sub 2/, EO/sub 2/ and CMRG. The type of alteration encountered in human ischaemia varies according to the nature of the accident: studies of transient accidents emphasize the different haemodynamic aspects of occlusion of the wider arteries. The metabolic and haemodynamic profiles of established ischaemic accidents vary according to their type and to the time of the study, reflecting the complexity of the physiopathological mechanisms involved; they are frequently associated with metabolic repercussions at a distance from the ischaemic focus, which supports the concept of diaschisis.

Value of cerebral blood flow rate and regional oxygen consumption studies in cerebral ischaemia

International Nuclear Information System (INIS)

Clanet, M.

1987-01-01

Studies of experimentally-induced ischaemia have shown that the intensity of neuronal suffering is related to the fall in perfusion rate. Below a certain level, called functional threshold, cerebral function is reversibly altered, whereas at a lower level (tissue necrosis threshold) the damage inflicted on neurons is irreversible. Between these two thresholds lies a ''penumbra zone''. This concept of thresholds must be mitigated by 2 parameters: duration of ischaemia and selective vulnerability of the various structures affected. Variations in blood flow rate only indirectly affect the state of tissues. Techniques developed from positron emission tomography make it possible to evaluate the metabolic activity of brain tissue in vivo: oxygen consumption (CMRO 2 ), oxygen extraction (EO 2 ) and glucose consumption (CMRG) which are thus correlated to cerebral blood flow and cerebral blood volume, sometimes also to tissue pH. Normal relations between blood flow rate and metabolism may be altered. Misery perfusion reflects a fall in cerebral blood flow with an increase in EO 2 and often a decrease in CMRO 2 , whereas luxury perfusion reflects an increase in cerebral blood flow rate with reduction of CMRO 2 , EO 2 and CMRG. The type of alteration encountered in human ischaemia varies according to the nature of the accident: studies of transient accidents emphasize the different haemodynamic aspects of occlusion of the wider arteries. The metabolic and haemodynamic profiles of established ischaemic accidents vary according to their type and to the time of the study, reflecting the complexity of the physiopathological mechanisms involved; they are frequently associated with metabolic repercussions at a distance from the ischaemic focus, which supports the concept of diaschisis [fr

Effects of organic and inorganic nitrate on aortic and carotid haemodynamics in heart failure with preserved ejection fraction.

Science.gov (United States)

Chirinos, Julio A; Londono-Hoyos, Francisco; Zamani, Payman; Beraun, Melissa; Haines, Philip; Vasim, Izzah; Varakantam, Swapna; Phan, Timothy S; Cappola, Thomas P; Margulies, Kenneth B; Townsend, Raymond R; Segers, Patrick

2017-11-01

To assess the haemodynamic effects of organic vs. inorganic nitrate administration among patients with heart failure with preserved ejection fraction (HFpEF). We assessed carotid and aortic pressure-flow relations non-invasively before and after the administration of 0.4 mg of sublingual nitroglycerin (n = 26), and in a separate sub-study, in response to 12.9 mmoL of inorganic nitrate (n = 16). Nitroglycerin did not consistently reduce wave reflections arriving at the proximal aorta (change in real part of reflection coefficient, 1st harmonic: -0.09; P = 0.01; 2nd harmonic: -0.045, P = 0.16; 3rd harmonic: +0.087; P = 0.05), but produced profound vasodilatation in the carotid territory, with a significant reduction in systolic blood pressure (133.6 vs. 120.5 mmHg; P = 0.011) and a marked reduction in carotid bed vascular resistance (19 580 vs. 13 078 dynes · s/cm 5 ; P = 0.001) and carotid characteristic impedance (3440 vs. 1923 dynes · s/cm 5 ; P = 0.002). Inorganic nitrate, in contrast, consistently reduced wave reflections across the first three harmonics (change in real part of reflection coefficient, 1st harmonic: -0.12; P = 0.03; 2nd harmonic: -0.11, P = 0.01; 3rd harmonic: -0.087; P = 0.09) and did not reduce blood pressure, carotid bed vascular resistance, or carotid characteristic impedance (P = NS). Nitroglycerin produces marked vasodilatation in the carotid circulation, with a pronounced reduction in blood pressure and inconsistent effects on central wave reflections. Inorganic nitrate, in contrast, produces consistent reductions in wave reflections, and unlike nitroglycerin, it does so without significant hypotension or cerebrovascular dilatation. These haemodynamic differences may underlie the different effects on exercise capacity and side effect profile of inorganic vs. organic nitrate in HFpEF. © 2017 The Authors. European Journal of Heart Failure © 2017 European Society of Cardiology.

Effects of Phenytoin Therapy on Bispectral Index and Haemodynamic Changes Following Induction and Tracheal Intubation

Directory of Open Access Journals (Sweden)

Parmod P Bithal

2009-01-01

Full Text Available Laryngoscopy and tracheal intubation (LTI increase blood pressure and heart rate (HR. Intensity of these changes is influenced by the anaesthetic depth assessed by the bispectral index (BIS. We determined the effect of phenytoin on anaesthetic depth and its influence on haemodynamics following LTI. Fifty patients of ASA grades I and II on oral phenytoin 200 to 300mg per day for more than one week were compared with 48 control patients. Standard anaesthesia technique was followed. BIS, non invasive mean blood pressure (MBP and HR were recorded 30, 60, 90 and 120 sec after LTI. Phenytoin group needed lesser thiopentone for induction, 5 mg (1.1 vs. 4.3 mg (0.7 [p=0.036]. BIS was significantly lower in the phenytoin group vs. the control 30, 60, 90 and 120 sec after LTI [43.1 (16.0 vs. 48.9 (14.9, p=0.068, 56.3 (16.7 vs. 64.3 (14.4, p=0.013, 59.8 (15.8 vs. 67.5 (12.1, p=0.008, 62.6 (14 vs. 68.9 (11.2, p=0.017, and 64.2 (11.3 vs. 69 (11.7, p=0.033], respectively. MBP was also lower in the phenytoin group 30, 60, 90 and 120 sec after LTI [112.8 mmHg (13.8, vs. 117.9 mmHg (18 p=0.013, 108.6 (12.8 vs. 117.5 (16 p=0.003, 106.1 mmHg (14.1 vs. 113.2 mmHg (14.9, p=0.017, 101.8 mmHg (13.8 vs. 109.5 mmHg (14.1, p=0.007], respectively. HR was lower in phenytoin group at 30 sec. (p=0.027, 60 sec (p=0.219, and again at 120 sec (p=0.022. Oral phenytoin therapy for over a week results in greater anaesthetic depth as observed using BIS, which also attenuated haemodynamic response of LTI.

Effects of Acute Bleeding Followed by Hydroxyethyl Starch 130/0.4 or a Crystalloid on Propofol Concentrations, Cerebral Oxygenation, and Electroencephalographic and Haemodynamic Variables in Pigs

Directory of Open Access Journals (Sweden)

Aura Silva

2014-01-01

Full Text Available Bleeding changes the haemodynamics, compromising organ perfusion. In this study, the effects of bleeding followed by replacement with hydroxyethyl starch 130/0.4 (HES or lactated Ringer’s (LR on cerebral oxygenation and electroencephalogram-derived parameters were investigated. Twelve young pigs under propofol-remifentanil anaesthesia were bled 30 mL/kg and, after a 20-minute waiting period, volume replacement was performed with HES (GHES; N=6 or LR (GRL; N=6. Bleeding caused a decrease of more than 50% in mean arterial pressure (P<0.01 and a decrease in cerebral oximetry (P=0.039, bispectral index, and electroencephalogram total power (P=0.04 and P<0.01, resp., while propofol plasma concentrations increased (P<0.01. Both solutions restored the haemodynamics and cerebral oxygenation similarly and were accompanied by an increase in electroencephalogram total power. No differences between groups were found. However, one hour after the end of the volume replacement, the cardiac output (P=0.03 and the cerebral oxygenation (P=0.008 decreased in the GLR and were significantly lower than in GHES (P=0.02. Volume replacement with HES 130/0.4 was capable of maintaining the cardiac output and cerebral oxygenation during a longer period than LR and caused a decrease in the propofol plasma concentrations.

Haemodynamic effects of dual-chamber pacing versus ventricular pacing during a walk test in patients with depressed or normal left ventricular function

Energy Technology Data Exchange (ETDEWEB)

Ferro, Adele; Salvatore, Marco; Cuocolo, Alberto [University Federico II, Department of Biomorphological and Functional Sciences, Institute of Biostructure and Bioimages of the National Council of Research, Naples (Italy); Duilio, Carlo; Santomauro, Maurizio [University Federico II, Department of Clinical Medicine, Cardiovascular and Immunological Sciences, Naples (Italy)

2005-09-01

Dual-chamber rate-modulated pacing provides haemodynamic benefits compared with ventricular pacing at rest, but it is unclear whether this also holds true during physical exercise in patients with heart failure. This study assessed the haemodynamic response to a walk test during dual-chamber pacing and ventricular pacing in patients with depressed or normal left ventricular (LV) function. Twelve patients with an LV ejection fraction <50% and 11 patients with an LV ejection fraction {>=}50% underwent two randomised 6-min walk tests under dual-chamber rate-modulated pacing and ventricular pacing at a fixed rate of 70 beats/min. All patients had a dual-chamber pacemaker implanted for complete heart block. LV function was monitored by a radionuclide ambulatory system. In patients with depressed LV function, the change from dual-chamber pacing to ventricular pacing induced a decrease in end-systolic volume at the peak of the walk test (P<0.05), with no difference in end-diastolic volume. As a consequence, higher increases in LV ejection fraction (P<0.0001) and stroke volume (P<0.01) were observed during ventricular pacing. No difference in cardiac output was found between the two pacing modes. In patients with normal LV function, the change from dual-chamber pacing to ventricular pacing induced a significant decrease in cardiac output (P<0.005 at rest and P<0.05 at the peak of the walk test). Compared with dual-chamber rate-modulated pacing, ventricular pacing improves cardiac function and does not affect cardiac output during physical activity in patients with depressed LV function, whereas it impairs cardiac output in those with normal function. (orig.)

Haemodynamic effects of dual-chamber pacing versus ventricular pacing during a walk test in patients with depressed or normal left ventricular function

International Nuclear Information System (INIS)

Ferro, Adele; Salvatore, Marco; Cuocolo, Alberto; Duilio, Carlo; Santomauro, Maurizio

2005-01-01

Dual-chamber rate-modulated pacing provides haemodynamic benefits compared with ventricular pacing at rest, but it is unclear whether this also holds true during physical exercise in patients with heart failure. This study assessed the haemodynamic response to a walk test during dual-chamber pacing and ventricular pacing in patients with depressed or normal left ventricular (LV) function. Twelve patients with an LV ejection fraction <50% and 11 patients with an LV ejection fraction ≥50% underwent two randomised 6-min walk tests under dual-chamber rate-modulated pacing and ventricular pacing at a fixed rate of 70 beats/min. All patients had a dual-chamber pacemaker implanted for complete heart block. LV function was monitored by a radionuclide ambulatory system. In patients with depressed LV function, the change from dual-chamber pacing to ventricular pacing induced a decrease in end-systolic volume at the peak of the walk test (P<0.05), with no difference in end-diastolic volume. As a consequence, higher increases in LV ejection fraction (P<0.0001) and stroke volume (P<0.01) were observed during ventricular pacing. No difference in cardiac output was found between the two pacing modes. In patients with normal LV function, the change from dual-chamber pacing to ventricular pacing induced a significant decrease in cardiac output (P<0.005 at rest and P<0.05 at the peak of the walk test). Compared with dual-chamber rate-modulated pacing, ventricular pacing improves cardiac function and does not affect cardiac output during physical activity in patients with depressed LV function, whereas it impairs cardiac output in those with normal function. (orig.)

Diagnostic value of transmural perfusion ratio derived from dynamic CT-based myocardial perfusion imaging for the detection of haemodynamically relevant coronary artery stenosis

Energy Technology Data Exchange (ETDEWEB)

Coenen, Adriaan; Lubbers, Marisa M.; Dedic, Admir; Chelu, Raluca G.; Geuns, Robert-Jan M. van; Nieman, Koen [Erasmus University Medical Center, Department of Radiology, Rotterdam (Netherlands); Erasmus University Medical Center, Department of Cardiology, Rotterdam (Netherlands); Kurata, Akira; Kono, Atsushi; Dijkshoorn, Marcel L. [Erasmus University Medical Center, Department of Radiology, Rotterdam (Netherlands); Rossi, Alexia [Erasmus University Medical Center, Department of Radiology, Rotterdam (Netherlands); Barts Health NHS Trust, NIHR Cardiovascular Biomedical Research Unit at Barts, William Harvey Research Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London and Department of Cardiology, London (United Kingdom)

2017-06-15

To investigate the additional value of transmural perfusion ratio (TPR) in dynamic CT myocardial perfusion imaging for detection of haemodynamically significant coronary artery disease compared with fractional flow reserve (FFR). Subjects with suspected or known coronary artery disease were prospectively included and underwent a CT-MPI examination. From the CT-MPI time-point data absolute myocardial blood flow (MBF) values were temporally resolved using a hybrid deconvolution model. An absolute MBF value was measured in the suspected perfusion defect. TPR was defined as the ratio between the subendocardial and subepicardial MBF. TPR and MBF results were compared with invasive FFR using a threshold of 0.80. Forty-three patients and 94 territories were analysed. The area under the receiver operator curve was larger for MBF (0.78) compared with TPR (0.65, P = 0.026). No significant differences were found in diagnostic classification between MBF and TPR with a territory-based accuracy of 77 % (67-86 %) for MBF compared with 70 % (60-81 %) for TPR. Combined MBF and TPR classification did not improve the diagnostic classification. Dynamic CT-MPI-based transmural perfusion ratio predicts haemodynamically significant coronary artery disease. However, diagnostic performance of dynamic CT-MPI-derived TPR is inferior to quantified MBF and has limited incremental value. (orig.)

Investigation of depth dependent changes in cerebral haemodynamics during face perception in infants

International Nuclear Information System (INIS)

Blasi, A; Fox, S; Everdell, N; Volein, A; Tucker, L; Csibra, G; Gibson, A P; Hebden, J C; Johnson, M H; Elwell, C E

2007-01-01

Near-infrared spectroscopy has been used to record oxygenation changes in the visual cortex of 4 month old infants. Our in-house topography system, with 30 channels and 3 different source-detector separations, recorded changes in the concentration of oxy-, deoxy- and total haemoglobin (HbO 2 , HHb and HbT) in response to visual stimuli (face, scrambled visual noise and cartoons as rest). The aim of this work was to demonstrate the capability of the system to spatially localize functional activation and study the possibility of depth discrimination in the haemodynamic response. The group data show both face stimulation and visual noise stimulation induced significant increases in HbO 2 from rest, but the increase in HbO 2 with face stimulation was not significantly different from that seen with visual noise stimulation. The face stimuli induced increases in HbO 2 were spread across a greater area across all depths than visual noise induced changes. In results from a single subject there was a significant increase of HbO 2 in the inferior area of the visual cortex in response to both types of stimuli, and a larger number of channels (source-detector pairs) showed HbO 2 increase to face stimuli, especially at the greatest depth. Activation maps were obtained using 3D reconstruction methods on multi source-detector separation optical topography data

Ischaemic preconditioning attenuates haemodynamic response and lipid peroxidation in lower-extremity surgery with unilateral pneumatic tourniquet application: a clinical pilot study.

Science.gov (United States)

Van, Mukaddes; Olguner, Cimen; Koca, Uğur; Sişman, Ali Riza; Muratli, Kivanç; Karci, Ayşe; Mavioğlu, Omür; Kilercik, Hakan

2008-04-01

The harmful effects of ischaemia-reperfusion on skeletal muscle during extremity surgery can be diminished by using medications or ischaemic preconditioning Twenty patients undergoing lower-limb surgery with use of a tourniquet for at least 1 hour were included in the study and randomised into two groups: a control group with only tourniquet application (T group; n=10); and an ischaemic preconditioning plus tourniquet group (IP-T group; n=10). Blood samples were obtained from the femoral vein of the relevant extremity before tourniquet application (baseline), immediately after tourniquet deflation (TD), at 10 minutes after the tourniquet deflation (TD(10min)) in the T group and additionally after ischaemic preconditioning in the IP-T group. Venous blood pH, partial oxygen pressure (P(vO2)), partial carbon dioxide pressure (P(vCO2)), lactate, potassium, sodium and glucose levels were analysed using a blood gas analyser. Plasma thiobarbituric acid reactive substances (TBARS) level, an index of lipid peroxidation and oxidative stress, was measured. Heart rate, noninvasive mean arterial pressure (MAP) and spontaneous breathing rate (SBR) were recorded at baseline, at TD, and TD(1min), TD(5min) and TD(10min). MAP decreased and SBR increased significantly at TD, TD(1min) and TD(5min) compared with baseline, and venous blood TBARS level significantly increased at TD and TD(10min) compared with baseline in the T group (all Plactate levels, which was significant compared with baseline (P<0.05) Ischaemic preconditioning attenuates haemodynamic response and lipid peroxidation during lower-extremity surgery with unilateral tourniquet application.

Haemodynamic improvement of older, previously replaced mechanical mitral valves by removal of the subvalvular pannus in redo cardiac surgery.

Science.gov (United States)

Kim, Jong Hun; Kim, Tae Youn; Choi, Jong Bum; Kuh, Ja Hong

2017-01-01

Patients requiring redo cardiac surgery for diseased heart valves other than mitral valves may show increased pressure gradients and reduced valve areas of previously placed mechanical mitral valves due to subvalvular pannus formation. We treated four women who had mechanical mitral valves inserted greater than or equal to 20 years earlier and who presented with circular pannus that protruded into the lower margin of the valve ring but did not impede leaflet motion. Pannus removal improved the haemodynamic function of the mitral valve. © The Author 2016. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

Haemodynamic changes and intubating conditions during tracheal intubation in children under anaesthesia: a comparative study of two induction regiments

Directory of Open Access Journals (Sweden)

Katarina Šakić

2009-02-01

Full Text Available Aim To compare the haemodynamic changes and intubation conditionsfollowing induction of anaesthesia with alfentanil-propofol-rocuronium with those following alfentanil-propofol combinationin children.Methods A prospective, non-randomized and non blinded trialwas performed in 208 children ( ASA I-II, both gender, aged 2-12years undergoing elective adenoidectomy with or without tonsillectomy.Children scheduled for tonsillectomy or adenotonsillectomyreceived alfentanil 0.02 mg kg-1, propofol 2 mg kg-1 androcuronium 0.45 mg kg-1 before tracheal intubation (R-group.Children scheduled for adenoidectomy received alfentanil 0.02mg kg-1and propofol 3 mg kg-1 before intubation (C-group. Haemodynamicvalues (heart rate, systolic arterial pressure, diastolicarterial pressure, mean arterial pressure were recorded at predeterminedtime intervals before surgical incision. The intubatingconditions were evaluated applying the Copenhagen Scoring System(excellent, good, poor.Results There was no statistical difference in haemodynamicbaseline values, neither prior nor after the intubation betweenthe two groups. There was a statistically significant increase inheart rate, systolic and diastolic arterial pressure after intubationin both groups (p<0.05. Mean arterial pressure after the intubationincreased statistically significantly only in R-group (p=0.001.There was no hypotension, bradycardia, hypoxemia or other complications.Overall intubation conditions were scored excellent in72.3%, good in 21.5% and poor in 6.2% patients. There were nosignificant differences in intubation conditions between the twogroups (p=0.244Conclusion Both induction regiments provided the clinically acceptablehaemodynamics and intubation conditions during trachealintubation in children.

Investigation of depth dependent changes in cerebral haemodynamics during face perception in infants

Energy Technology Data Exchange (ETDEWEB)

Blasi, A [Biomedical Optics Research Lab, Department of Medical Physics and Bioengineering, Malet Place Engineering Building, University College London, London WC1E 6BT (United Kingdom); Fox, S [Centre for Brain and Cognitive Development, Henry Wellcome Building, Birkbeck College, University of London, Malet Street, London WC1E 7HX (United Kingdom); Everdell, N [Biomedical Optics Research Lab, Department of Medical Physics and Bioengineering, Malet Place Engineering Building, University College London, London WC1E 6BT (United Kingdom); Volein, A [Centre for Brain and Cognitive Development, Henry Wellcome Building, Birkbeck College, University of London, Malet Street, London WC1E 7HX (United Kingdom); Tucker, L [Centre for Brain and Cognitive Development, Henry Wellcome Building, Birkbeck College, University of London, Malet Street, London WC1E 7HX (United Kingdom); Csibra, G [Centre for Brain and Cognitive Development, Henry Wellcome Building, Birkbeck College, University of London, Malet Street, London WC1E 7HX (United Kingdom); Gibson, A P [Biomedical Optics Research Lab, Department of Medical Physics and Bioengineering, Malet Place Engineering Building, University College London, London WC1E 6BT (United Kingdom); Hebden, J C [Biomedical Optics Research Lab, Department of Medical Physics and Bioengineering, Malet Place Engineering Building, University College London, London WC1E 6BT (United Kingdom); Johnson, M H [Centre for Brain and Cognitive Development, Henry Wellcome Building, Birkbeck College, University of London, Malet Street, London WC1E 7HX (United Kingdom); Elwell, C E [Biomedical Optics Research Lab, Department of Medical Physics and Bioengineering, Malet Place Engineering Building, University College London, London WC1E 6BT (United Kingdom)

2007-12-07

Near-infrared spectroscopy has been used to record oxygenation changes in the visual cortex of 4 month old infants. Our in-house topography system, with 30 channels and 3 different source-detector separations, recorded changes in the concentration of oxy-, deoxy- and total haemoglobin (HbO{sub 2}, HHb and HbT) in response to visual stimuli (face, scrambled visual noise and cartoons as rest). The aim of this work was to demonstrate the capability of the system to spatially localize functional activation and study the possibility of depth discrimination in the haemodynamic response. The group data show both face stimulation and visual noise stimulation induced significant increases in HbO{sub 2} from rest, but the increase in HbO{sub 2} with face stimulation was not significantly different from that seen with visual noise stimulation. The face stimuli induced increases in HbO{sub 2} were spread across a greater area across all depths than visual noise induced changes. In results from a single subject there was a significant increase of HbO{sub 2} in the inferior area of the visual cortex in response to both types of stimuli, and a larger number of channels (source-detector pairs) showed HbO{sub 2} increase to face stimuli, especially at the greatest depth. Activation maps were obtained using 3D reconstruction methods on multi source-detector separation optical topography data.

Haemodynamic responses to exercise, ATP infusion and thigh compression in humans: insight into the role of muscle mechanisms on cardiovascular function

DEFF Research Database (Denmark)

Gonzalez-Alonso, J.; Mortensen, S.P.; Jeppesen, Tina Dysgaard

2008-01-01

on cardiovascular function during exercise, we determined leg and systemic haemodynamic responses in healthy men during (1) incremental one-legged knee-extensor exercise, (2) step-wise femoral artery ATP infusion at rest, (3) passive exercise (n=10), (4)femoral vein or artery ATP infusion (n=6), and (5) cyclic...... exercise also increased blood flow (DeltaLBF 0.7 +/- 0.1 l min(-1)), yet the increase in muscle and systemic perfusion, unrelated to elevations in aerobic metabolism, accounted only for approximately 5% of peak exercise hyperaemia.Likewise, thigh compressions alone or in combination with passive exercise...

Age-dependent effects of milrinone and levosimendan on ventricular function and haemodynamics in newborn and mature pigs.

Science.gov (United States)

Hyldebrandt, Janus A; Larsen, Signe H; Schmidt, Michael R; Hjortdal, Vibeke E; Ravn, Hanne B

2011-10-01

Inodilators are used in the treatment of low cardiac output, mainly after cardiac surgery. At present, there is little knowledge of the effect of inodilators in the newborn heart. Immediately after birth and in the neonatal period, the metabolism and physiology of the heart undergo major changes. We hypothesised that effects of the inodilators milrinone and levosimendan on myocardial contractility and haemodynamics under normal physiological conditions were age dependent. Animal studies were conducted on 48 pigs using a closed-chest biventricular conductance catheter method. Pigs in two age groups, that is, 5-6 days and 5-6 weeks, were assigned to milrinone, levosimendan, or a control group. We observed that both milrinone - 19.2% with a p value of 0.05 - and levosimendan - 25.7% with a p value of 0.03 compared with the control group increased cardiac output, as well as myocardial contractility with a maximum pressure development over time: milrinone 28.2%, p = 0.01 and levosimendan 19.4%, p = 0.05. Milrinone improved diastolic performance (p milrinone 34.6%, p milrinone nor levosimendan was able to increase cardiac output in the newborn heart.

Impact of treatment delay on mortality in ST-segment elevation myocardial infarction (STEMI) patients presenting with and without haemodynamic instability: results from the German prospective, multicentre FITT-STEMI trial.

Science.gov (United States)

Scholz, Karl Heinrich; Maier, Sebastian K G; Maier, Lars S; Lengenfelder, Björn; Jacobshagen, Claudius; Jung, Jens; Fleischmann, Claus; Werner, Gerald S; Olbrich, Hans G; Ott, Rainer; Mudra, Harald; Seidl, Karlheinz; Schulze, P Christian; Weiss, Christian; Haimerl, Josef; Friede, Tim; Meyer, Thomas

2018-04-01

The aim of this study was to investigate the effect of contact-to-balloon time on mortality in ST-segment elevation myocardial infarction (STEMI) patients with and without haemodynamic instability. Using data from the prospective, multicentre Feedback Intervention and Treatment Times in ST-Elevation Myocardial Infarction (FITT-STEMI) trial, we assessed the prognostic relevance of first medical contact-to-balloon time in n = 12 675 STEMI patients who used emergency medical service transportation and were treated with primary percutaneous coronary intervention (PCI). Patients were stratified by cardiogenic shock (CS) and out-of-hospital cardiac arrest (OHCA). For patients treated within 60 to 180 min from the first medical contact, we found a nearly linear relationship between contact-to-balloon times and mortality in all four STEMI groups. In CS patients with no OHCA, every 10-min treatment delay resulted in 3.31 additional deaths in 100 PCI-treated patients. This treatment delay-related increase in mortality was significantly higher as compared to the two groups of OHCA patients with shock (2.09) and without shock (1.34), as well as to haemodynamically stable patients (0.34, P < 0.0001). In patients with CS, the time elapsing from the first medical contact to primary PCI is a strong predictor of an adverse outcome. This patient group benefitted most from immediate PCI treatment, hence special efforts to shorten contact-to-balloon time should be applied in particular to these high-risk STEMI patients. NCT00794001.

Acute renal haemodynamic and renin-angiotensin system responses to graded renal artery stenosis in the dog.

Science.gov (United States)

Anderson, W P; Johnston, C I; Korner, P I

1979-01-01

1. The acute renal haemodynamic and renin-angiotensin system responses to graded renal artery stenosis were studied in chronically instrumented, unanaesthetized dogs. 2. Stenosis was induced over 30 sec by inflation of a cuff around the renal artery to lower distal pressure to 60, 40 or 20 mmHg, with stenosis maintained for 1 hr. This resulted in an immediate fall in renal vascular resistance, but over the next 5--30 min both resistance and renal artery pressure were restored back towards prestenosis values. Only transient increases in systemic arterial blood pressure and plasma renin and angiotensin levels were seen with the two milder stenoses. Despite restoration of renal artery pressure, renal blood flow remained reduced at all grades of stenosis. 3. Pre-treatment with angiotensin I converting enzyme inhibitor or sarosine1, isoleucone8 angiotensin II greatly attenuated or abolished the restoration of renal artery pressure and renal vascular resistance after stenosis, and plasma renin and angiotensin II levels remained high. Renal dilatation was indefinitely maintained, but the normal restoration of resistance and pressure could be simulated by infusing angiotensin II into the renal artery. 4. The effective resistance to blood flow by the stenosis did not remain constant but varied with changes in the renal vascular resistance. PMID:219182

Effects of peripheral cold application on core body temperature and haemodynamic parameters in febrile patients.

Science.gov (United States)

Asgar Pour, Hossein; Yavuz, Meryem

2014-04-01

This study designed to assess the effects of peripheral cold application (PCA) on core body temperature and haemodynamic parameters in febrile patients. This study was an experimental, repeated-measures performed in the neurosurgical intensive-care unit. The research sample included all patients with fever in postoperative period. PCA was performed for 20 min. During fever, systolic blood pressure, mean arterial blood pressure and arterial oxygen saturation (O2 Sat) decreased by 5.07 ± 7.89 mm Hg, 0.191 ± 6.00 mm Hg and 0.742% ± 0.97%, respectively, whereas the pulse rate and diastolic blood pressure increased by 8.528 ± 4.42 beats/ min and 1.842 ± 6.9 mmHg, respectively. Immediately after PCA, core body temperature and pulse rate decreased by 0.3°C, 3.3 beats/min, respectively, whereas systolic, diastolic, mean arterial blood pressure and O2 Sat increased by, 1.40 mm Hg, 1.87 mm Hg, 0.98 mmHg and 0.27%, respectively. Thirty minutes after the end of PCA, core body temperature, diastolic, mean arterial blood pressure and pulse rate decreased by 0.57°C, 0.34 mm Hg, 0.60 mm Hg and 4.5 beats/min, respectively, whereas systolic blood pressure and O2 Sat increased by 0.98 mm Hg and 0.04%, respectively. The present results showed that PCA increases systolic, diastolic, mean arterial blood pressure and O2 Sat, and decreases core body temperature and pulse rate. © 2013 Wiley Publishing Asia Pty Ltd.

Significance of the determination of doppler sonography haemodynamic indices for the assessment of distal perfusion in patients with critical ischemia of lower limbs

Directory of Open Access Journals (Sweden)

Čizmić Milica

2006-01-01

Full Text Available Background/Aim: The perfusion of tissue, especially the muscles of the lower limbs (LL, implies the blood flow that carries enough nutrition, energy materials and oxygen. The aim of this study was to determine whether the decreased Doppler sonography parameters, resistance index (RI, and pulsatility index (PI were significant as indicators of irreversible ischemia of LL. Methods. In 40 patients (mean age 66±14.9 years, 21% women and 79% men with the signs of critical ischemia of LL, Lariche-Fontaine class III and IV, we performed contrast angiography of the LL arteries, and perfusion scintigraphy of LL using, thallium-201, while we performed Doppler sonography to determine resistance index (RI, as well as pulsatility index (PI. After that, all the patients were treated with vasodilatation using Bergmann's solution within a 10-day period. Following that, all the patients underwent the determination of haemodynamic indices RI and PI applying the methods of Doppler sonography. The obtained values of RI and PI indices revealed no clinical recovery which suggested the irreversibility of critical ischemia (unsuccessful therapy in 100% of the patients, and clinical recovery which suggested the reversibility of the disease (unsuccessful therapy in 80% of the patients. Results. The obtained values of PI = 0-0.3 and RI = 0-0.25 for the examined LL arteries were the indicators of irreversible ischemia. A significant correlation between the values of RI in the distal parts of a. tibialis anterior and posterior was proved, as well as between the decreased perfusion of LL determined by tallium-201 (p < 0.05, r = 0.43, and a tibialis anterior (p = 0.05, r = 0.38. There was, however, no statistically significant correlation between the angiographic values and perfusion scintigraphy of LL. Conclusion. The obtained values of haemodynamic RI and PI indices should be a novel approach for introducing a new criteria for the assessment of reversible and irreversible

Border region studies

DEFF Research Database (Denmark)

Makkonen, Teemu; Williams, Allan

2016-01-01

The contemporary conditions of academic capitalism exert pressures on researchers to avoid ‘peripheral’ journals and ‘unfashionable’ topics. Here an attempt is made to shed light onto the structure of one such ‘offbeat’ field, namely ‘border region studies’, by discussing its geographical...... distribution, key themes, significance and impact. The review suggests that border region studies can be considered a significant and important ‘branch’ of regional studies, which accounts for a small but increasing proportion of regional studies research particularly in Europe and North America. Four main...

Haemodynamic study of Flow in concentric and eccentric stenosed carotid Artery

Directory of Open Access Journals (Sweden)

Khader S. M. Abdul

2018-01-01

Full Text Available Study of flow through arteries is gaining importance in the recent times due to onset of several cardio-vascular diseases like atherosclerosis (block in artery, aneurysms (bulging of artery, hypertension etc. The application of CFD will be useful in demonstrating the underlying mechanism of flow past the diseased arteries. In the present study, initially an approximate eccentric and concentric 50% stenosed carotid model is generated in ANSYS 12.0 based on patient data obtained from ultrasound Doppler scan. Later the percentage of stenosis is increased to 60%, 70%, 80% and 90% in both the cases. A transient analysis has been performed for several pulse cycles in ANSYS FLOTRAN for various percentage cases. The results obtained from ECN and CCN cases are compared to observe the changes in flow behavior in the downstream of stenosis as compared with normal case. The formation of vortices and flow separation zone in downstream in eccentric case is higher than in concentric case. Comparison of results concludes that, with the increase in severity of stenosis, the flow changes abruptly causing an increase in velocity and WSS at throat region. The simulation results obtained agree well with clinically observed data and available literature.

The effects of sildenafil citrate on feto-placental development and haemodynamics in a rabbit model of intrauterine growth restriction.

Science.gov (United States)

López-Tello, Jorge; Arias-Álvarez, María; Jiménez-Martínez, Maria-Ángeles; Barbero-Fernández, Alicia; García-García, Rosa María; Rodríguez, María; Lorenzo, Pedro L; Torres-Rovira, Laura; Astiz, Susana; González-Bulnes, Antonio; Rebollar, Pilar G

2017-06-01

The present study evaluated the effectiveness of sildenafil citrate (SC) to improve placental and fetal growth in a diet-induced rabbit model of intrauterine growth restriction (IUGR). Pregnant rabbits were fed either ad libitum (Group C) or restricted to 50% of dietary requirements (Group R) or restricted and treated with SC (Group SC). The treatment with SC improved placental development by increasing vascularity and vessel hypertrophy in the decidua. The assessment of feto-placental haemodynamics showed higher resistance and pulsatility indices at the middle cerebral artery (MCA) in fetuses treated with SC when compared with Group R, which had increased systolic peak and time-averaged mean velocities at the MCA. Furthermore, fetuses in the SC group had significantly higher biparietal and thoracic diameters and longer crown-rump lengths than fetuses in Group R. Hence, the SC group had a reduced IUGR rate and a higher kit size at birth compared with Group R. In conclusion, SC may provide potential benefits in pregnancies with placental insufficiency and IUGR, partially counteracting the negative effects of food restriction on placental development and fetal growth. However, the present study also found evidence of a possible blood overflow in the brain that warrants further investigation.

Ten-year results of the Freedom Solo stentless heart valve: excellent haemodynamics but progressive valve dysfunction in the long term.

Science.gov (United States)

Sponga, Sandro; Barbera, Mila Della; Pavoni, Daisy; Lechiancole, Andrea; Mazzaro, Enzo; Valente, Marialuisa; Nucifora, Gaetano; Thiene, Gaetano; Livi, Ugolino

2017-05-01

Freedom Solo (FS) is a pericardial stentless heart valve showing excellent haemodynamic performance at mid-term. The aim of this study was to evaluate the long-term performance of such bioprostheses. Between December 2004 and November 2009, 109 patients (31 men; mean age 76 ± 6 years) underwent aortic valve replacement with FS. Preoperatively, the mean NYHA class was 2.5 ± 0.7, the mean EuroSCORE II, 2.8 ± 2.5. Mean prosthesis size was 22.7 ± 1.9 mm; concomitant procedures were performed in 65 patients. Structural valve deterioration (SVD) was diagnosed according to the Valve Academic Research Consortium-2 definition. Two patients (1.8%) died within 30 days. Follow-up (72 ± 36 months) was 100% completed. The 1-, 5- and 10-year actuarial survival rates were 89, 73 and 42%, respectively, with 8 valve-related deaths; the actuarial freedom from SVD was 99, 93 and 76%. During 61 ± 39 months of follow-up, echocardiographic findings worsened progressively: At discharge, 3-5 and 7-9 years, the mean gradient was 8 ± 4, 12 ± 11 and 19 ± 19 mmHg ( P  < 0.01); the indexed effective orifice area was 1.0 ± 0.2, 0.9 ± 0.2 and 0.8 ± 0.3 cm 2 /m 2 ( P  < 0.01). Of the 13 patients who developed SVD, it was due to aortic stenosis in 11. SVD was a predictor of cardiovascular mortality at univariate analysis (HR 2.87, 1.12-7.29); 2 explanted prostheses showed massive calcium deposits with mean calcium and phosphorus contents of 234 ± 16 and 116 ± 7 mg/g dry weight, respectively. The FS bioprosthesis shows excellent mid-term clinical and haemodynamic results and offers an alternative to other valves, particularly in the case of a small aortic annulus. Worsening of FS performance was observed at late follow-up because of progressive SVD with stenosis, questioning whether it should be used in patients with a long life expectancy. © The Author 2017. Published by Oxford University Press on behalf of the

Pregnancy-specific stress, fetoplacental haemodynamics, and neonatal outcomes in women with small for gestational age pregnancies: a secondary analysis of the multicentre Prospective Observational Trial to Optimise Paediatric Health in Intrauterine Growth Restriction.

LENUS (Irish Health Repository)

Levine, Terri A

2017-06-21

To examine associations between maternal pregnancy-specific stress and umbilical (UA PI) and middle cerebral artery pulsatility indices (MCA PI), cerebroplacental ratio, absent end diastolic flow (AEDF), birthweight, prematurity, neonatal intensive care unit admission and adverse obstetric outcomes in women with small for gestational age pregnancies. It was hypothesised that maternal pregnancy-specific stress would be associated with fetoplacental haemodynamics and neonatal outcomes.

Shape and compliance of endothelial cells after shear stress in vitro or from different aortic regions: scanning ion conductance microscopy study.

Directory of Open Access Journals (Sweden)

Claire M F Potter

Full Text Available To measure the elongation and compliance of endothelial cells subjected to different patterns of shear stress in vitro, and to compare these parameters with the elongation and compliance of endothelial cells from different regions of the intact aorta.Porcine aortic endothelial cells were cultured for 6 days under static conditions or on an orbital shaker. The shaker generated a wave of medium, inducing pulsatile shear stress with a preferred orientation at the edge of the well or steadier shear stress with changing orientation at its centre. The topography and compliance of these cells and cells from the inner and outer curvature of ex vivo porcine aortic arches were measured by scanning ion conductance microscopy (SICM.Cells cultured under oriented shear stress were more elongated and less compliant than cells grown under static conditions or under shear stress with no preferred orientation. Cells from the outer curvature of the aorta were more elongated and less compliant than cells from the inner curvature.The elongation and compliance of cultured endothelial cells vary according to the pattern of applied shear stress, and are inversely correlated. A similar inverse correlation occurs in the aortic arch, with variation between regions thought to experience different haemodynamic stresses.

The influence of high versus low sodium intake on blood pressure and haemodynamics in patients with morbid obesity

DEFF Research Database (Denmark)

Bonfils, Peter K; Taskiran, Mustafa; Damgaard, Morten

2013-01-01

fluid compartments and haemodynamic responses (at rest and during exercise) after 5 days of a low-sodium diet (90 mmol/day) and 5 days of a high-sodium diet (250 mmol/day) in 12 morbidly obese, hypertensive patients; 12 morbidly obese, normotensive patients and 12 nonobese controls. RESULTS: High sodium......BACKGROUND: Many patients with morbid obesity (BMI > 40 kg/m) have hypertension. The complex pathophysiological abnormalities linking hypertension to obesity have not been fully clarified, but abnormal sodium handling could be an important mechanism. METHOD: Therefore, we examined changes in body...... intake as compared to low sodium intake was associated with an increase in plasma volume (obese, hypertensive patients: 5 ± 4%; obese, normotensive patients: 10 ± 11%; nonobese controls: 7 ± 6%), cardiac output (CO) (obese, hypertensive patients: 17 ± 12%; obese, normotensive patients: 20 ± 16%; nonobese...

Impact on outcome of a targeted performance improvement programme in haemodynamically unstable patients with a pelvic fracture.

Science.gov (United States)

Perkins, Z B; Maytham, G D; Koers, L; Bates, P; Brohi, K; Tai, N R M

2014-08-01

We describe the impact of a targeted performance improvement programme and the associated performance improvement interventions, on mortality rates, error rates and process of care for haemodynamically unstable patients with pelvic fractures. Clinical care and performance improvement data for 185 adult patients with exsanguinating pelvic trauma presenting to a United Kingdom Major Trauma Centre between January 2007 and January 2011 were analysed with univariate and multivariate regression and compared with National data. In total 62 patients (34%) died from their injuries and opportunities for improved care were identified in one third of deaths. Three major interventions were introduced during the study period in response to the findings. These were a massive haemorrhage protocol, a decision-making algorithm and employment of specialist pelvic orthopaedic surgeons. Interventions which improved performance were associated with an annual reduction in mortality (odds ratio 0.64 (95% confidence interval (CI) 0.44 to 0.93), p = 0.02), a reduction in error rates (p = 0.024) and significant improvements in the targeted processes of care. Exsanguinating patients with pelvic trauma are complex to manage and are associated with high mortality rates; implementation of a targeted performance improvement programme achieved sustained improvements in mortality, error rates and trauma care in this group of severely injured patients. ©2014 The British Editorial Society of Bone & Joint Surgery.

Regional boundaries study

International Nuclear Information System (INIS)

Zavatsky, S.; Phaneuf, P.; Topaz, D.; Ward, D.

1978-02-01

The NRC Office of Inspection and Enforcement (IE) has elected to evaluate the effectiveness and efficiency of its existing regional boundary alignment because of the anticipated future growth of nuclear power generating facilities and corresponding inspection requirements. This report documents a management study designed to identify, analyze, and evaluate alternative regional boundary configurations for the NRC/IE regions. Eight boundary configurations were chosen for evaluation. These configurations offered alternatives ranging from two to ten regions, and some included the concepts of subregional or satellite offices. Each alternative configuration was evaluated according to three major criteria: project workload, cost, and office location. Each major criterion included elements such as management control, program uniformity, disruption, costs, and coordination with other agencies. The conclusion reached was that regional configurations with regions of equal and relatively large workloads, combined with the concepts of subregional or satellite offices, may offer a significant benefit to the Office of Inspection and Enforcement and the Commission and are worthy of further study. A phased implementation plan, which is suitable to some configurations, may help mitigate the disruption created by realignment

Evolution of target organ damage and haemodynamic parameters over 4 years in patients with increased insulin resistance: the LOD-DIABETES prospective observational study.

Science.gov (United States)

Gómez-Marcos, Manuel Ángel; Recio-Rodríguez, José Ignacio; Patino-Alonso, María Carmen; Agudo-Conde, Cristina; Rodríguez-Sanchez, Emiliano; Maderuelo-Fernandez, Jose Angel; Gómez-Sánchez, Leticia; Gomez-Sanchez, Marta; García-Ortiz, Luís

2016-06-01

We prospectively examined the impact of type 2 diabetes compared with metabolic syndrome (MetS) on the development of vascular disease over 4 years as determined by anatomic and functional markers of vascular disease. By comparing the vascular outcomes of the 2 disorders, we seek to determine the independent effect of elevated glucose levels on vascular disease. 2 primary care centres in Salamanca, Spain. We performed a prospective observational study involving 112 patients (68 with type 2 diabetes and 44 with MetS) who were followed for 4 years. Measurements included blood pressure, blood glucose, lipids, smoking, body mass index, waist circumference, Homeostasis Model Assessment Insulin Resistance (HOMA-IR), hs-c-reactive protein and fibrinogen levels. We also evaluated vascular, carotid intima media thickness (IMT), pulse wave velocity (PWV) and ankle/brachial index, heart and renal target organ damage (TOD). The haemodynamic parameters were central (CAIx) and peripheral (PAIx) augmentation indices. In year 4, participants with type 2 diabetes had increased IMT thickness. These patients had more plaques and an IMT>0.90 mm. In participants with MetS, we only found an increase in the number of plaques. We found no changes in PWV, CAIx and PAIx. The patients with diabetes had a greater frequency of vascular TOD. There were no differences neither in renal nor cardiac percentage of TOD in the patients with MetS or diabetes mellitus type 2. This prospective study showed that the evolution of vascular TOD is different in participants with type 2 diabetes compared with those with MetS. While IMT and PWV increased in type 2 diabetes, these were not modified in MetS. The renal and cardiac TOD evolution, as well as the PAIx and CAIx, did not change in either group. NCT01065155; Results. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Regional wall movement of the left ventricle in coronary heat diseases

International Nuclear Information System (INIS)

Schad, N.

1979-01-01

The regional wall movement of the left ventriculus is a substantial criterion for the treatment of coronary heart diseases. The non-invasive and riskless intravenous injections of a bolus of Technetium 99m-Pertechnetat and the recording of the first passage through the heart allow to present the regional wall movement of the left ventriculus and, in addition, to make a statement on the haemodynamic feed back effects on lungs and the right heart. The congruency with the wall movement determined invasively, in the contrast substance angiocardiogram, is high both for the normokinesis and for hypo-, A - and dyskinesis (90-92%). The examination proved good in following groups of patients and makes the decision on the further proceding easier: 1) After myocardial infarction. 2) In ishaemia-ECG or persistent ST-elevation. 3) In unstable progressive angina pectoris. 4) In unclear breast aches and negative ECG on exertion. 5) For course control after conservative and surgial therapy. The myocardial reserve can be shown using a after nitroglycerin administration. An investigation on exertion can find out affected vessel territories in the circulation. (orig.) [de

Predicting outcome of rethoracotomy for suspected pericardial tamponade following cardio-thoracic surgery in the intensive care unit

Directory of Open Access Journals (Sweden)

Beishuizen Albertus

2011-05-01

Full Text Available Abstract Objectives Pericardial tamponade after cardiac surgery is difficult to diagnose, thereby rendering timing of rethoracotomy hard. We aimed at identifying factors predicting the outcome of surgery for suspected tamponade after cardio-thoracic surgery, in the intensive care unit (ICU. Methods Twenty-one consecutive patients undergoing rethoracotomy for suspected pericardial tamponade in the ICU, admitted after primary cardio-thoracic surgery, were identified for this retrospective study. We compared patients with or without a decrease in severe haemodynamic compromise after rethoracotomy, according to the cardiovascular component of the sequential organ failure assessment (SOFA score. Results A favourable haemodynamic response to rethoracotomy was observed in 11 (52% of patients and characterized by an increase in cardiac output, and less fluid and norepinephrine requirements. Prior to surgery, the absence of treatment by heparin, a minimum cardiac index 2 and a positive fluid balance (> 4,683 mL were predictive of a beneficial haemodynamic response. During surgery, the evacuation of clots and > 500 mL of pericardial fluid was associated with a beneficial haemodynamic response. Echocardiographic parameters were of limited help in predicting the postoperative course, even though 9 of 13 pericardial clots found at surgery were detected preoperatively. Conclusion Clots and fluids in the pericardial space causing regional tamponade and responding to surgical evacuation after primary cardio-thoracic surgery, are difficult to diagnose preoperatively, by clinical, haemodynamic and even echocardiographic evaluation in the ICU. Only absence of heparin treatment, a large positive fluid balance and low cardiac index predicted a favourable haemodynamic response to rethoracotomy. These data might help in deciding and timing of reinterventions after primary cardio-thoracic surgery.

Replica sizing strategy for aortic valve replacement improves haemodynamic outcome of the epic supra valve.

Science.gov (United States)

Gonzalez-Lopez, David; Faerber, Gloria; Diab, Mahmoud; Amorim, Paulo; Zeynalov, Natig; Doenst, Torsten

2017-10-01

Current sizing strategies suggest valve selection based on annulus diameter despite supra-annular placement of biological prostheses potentially allowing placement of a larger size. We assessed the frequency of selecting a larger prosthesis if prosthesis size was selected using a replica (upsizing) and evaluated its impact on haemodynamics. We analysed all discharge echocardiograms between June 2012 and June 2014, where a replica sizer was used for isolated aortic valve replacement (Epic Supra: 266 patients, Trifecta: 49 patients). Upsizing was possible in 71% of the Epic Supra valves (by 1 size: 168, by 2 sizes: 20) and in 59% of the Trifectas (by 1 size: 26, by 2 sizes: 3). Patients for whom upsizing was possible had the lowest pressure gradients within their annulus size groups. The difference was significant in annulus diameters of 21-22 or 25-26 mm (Epic Supra) and 23-24 mm (Trifecta). Trifecta gradients were the lowest. However, the ability to upsize the Epic Supra by 2 sizes eliminated the differences between Epic Supra and Trifecta. Upsizing did not cause intraoperative complications. Using replica sizers for aortic prosthesis size selection allows the implantation of bigger prostheses than recommended in most cases and reduces postoperative gradients, specifically for Epic Supra. © The Author 2017. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

Pneumopyopericardium mimicking an inferior ST elevation myocardial infarction with regional electrocardiogram changes: a case report.

Science.gov (United States)

Ratnayake, Eranda Chamara; Premaratne, Sandamali; Lokunarangoda, Niroshan; Fernando, Sanduni; Fernando, Nilanthi; Ponnamperuma, Chandrike; Santharaj, W Samuel

2015-04-30

Pneumopyopericardium is a rare disease with poor prognosis. The usual presentation is with fever, shortness of breath and haemodynamic compromise. The Electrocardiogram changes associated with this disease entity would be similar to pericarditis such as concave shaped ST elevations in all leads with PR sagging. Pneumopyopericardium mimicking an acute ST Elevation Myocardial Infarction, with regional Electrocardiogram changes has hitherto not been described in world literature. We describe the case of a 48 year old native Sri Lankan man, presenting with chest pain and Electrocardiogram changes compatible with an Acute ST Elevation Myocardial Infarction, subsequently found to have Pneumopyopericardium secondary to an oesophageal tear. Retrospective history revealed repetitive vomiting due to heavy alcohol consumption, prior to presentation. It unfortunately led to a fatal outcome. Pneumopyopericardium may mimic an acute ST elevation myocardial infarction with associated regional Electrocardiogram changes. A high degree of suspicion should be maintained and an adequate history should always be obtained prior to any intervention in all ST Elevation Myocardial Infarction patients.

Benefits of smart pumps for automated changeovers of vasoactive drug infusion pumps: a quasi-experimental study.

Science.gov (United States)

Cour, M; Hernu, R; Bénet, T; Robert, J M; Regad, D; Chabert, B; Malatray, A; Conrozier, S; Serra, P; Lassaigne, M; Vanhems, P; Argaud, L

2013-11-01

Manual changeover of vasoactive drug infusion pumps (CVIP) frequently lead to haemodynamic instability. Some of the newest smart pumps allow automated CVIP. The aim of this study was to compare automated CVIP with manual 'Quick Change' relays. We performed a prospective, quasi-experimental study, in a university-affiliated intensive care unit (ICU). All adult patients receiving continuous i.v. infusion of vasoactive drugs were included. CVIP were successively performed manually (Phase 1) and automatically (Phase 2) during two 6-month periods. The primary endpoint was the frequency of haemodynamic incidents related to the relays, which were defined as variations of mean arterial pressure >15 mm Hg or heart rate >15 bpm. The secondary endpoints were the nursing time dedicated to relays and the number of interruptions in care because of CVIP. A multivariate mixed effects logistic regression was fitted for analytic analysis. We studied 1329 relays (Phase 1: 681, Phase 2: 648) from 133 patients (Phase 1: 63, Phase 2: 70). Incidents related to CVIP decreased from 137 (20%) in Phase 1 to 73 (11%) in Phase 2 (Ppumps in limiting the frequency of haemodynamic incidents related to relays and in reducing the nursing workload.

Effects of intravenous bumetanide administration on renal haemodynamics and proximal and distal tubular sodium reabsorption in conscious rats

Energy Technology Data Exchange (ETDEWEB)

Shalmi, M.; Petersen, J.S.; Christensen, S. (Department of pharmacology, University of Copenhagen (Denmark))

1989-01-01

The renal effects of 0.02-62.5 mg/kg bumetanide given as intravenous bolus injections were studied in water diuretic conscious rats. Clearances of {sup 14}C-tetraethylammonium, {sup 3}H-inulin and lithium were used as markers for renal plasma flow (RPF), glomerular filtion rate (GFR) and proximal tubular output, respectively. Bumetanide caused biphasic, transient and dose-independent changes in the renal haemodynamics without significant alterations of the filtration fraction. At dose-levels above 0.02 mg/kg bumetanide increased urine flow, absolute and fractional Na excretion as well as the indices for fractional output of Na from the proximal tubules (C{sub Li}/C{sub I}n) and the distal nephron segments (C{sub Na}/C{sub Li}). The changes in C{sub Li}/C{sub In} became maximal at doses above 0.5 mg/kg, whereas C{sub Na}/C{sub Li} was increased with the dose up to 12.5 mg/kg. Paradoxically, doses above 12.5 mg/kg were less natriuretic due to a decrease of C{sub Na}/C{sub Li}. It is concluded that in rats bumetanide is an effective although short-acting diuretic when administered intravenously. When comparing peak responses bumetanide is equipotent to furosemide but has a lower maximal efficacy. Judged from the changes in fractional lithium excretion, the natriuretic effect of bumetanide is effected by inhibition of Na reabsorption in the proximal tubule in addition to the well-known effect on the distal nephron segment. (author).

Trauma sternotomy for presumed haemopericardium with incidental coccidioidal pericarditis

Directory of Open Access Journals (Sweden)

Seth I. Felder

2015-02-01

Full Text Available Background: Disseminated cocciodiomycosis with extrapulmonary disease occurs in less than 1% of infected patients, with few cases involving the pericardium reported in the literature. A subxiphoid window in a focussed assessment with sonography for trauma is a fast and reliable study for detecting haemopericardium in the haemodynamically unstable injured patient. Methods: Case report and literature review. Case report: A 50-year old man presented in extremis following a stab wound to the right thoracoabdominal region with a positive pericardial ultrasound. At the time of emergent sternotomy, the pericardial effusion appeared non-traumatic and not the cause of haemodynamic instability. Lung, diaphragm, liver and transverse colon lacerations were controlled by laparotomy. He was discovered to have extensive adenopathy within the mediastinum, porta hepatis, and lesser sac, which after histopathologic examination, demonstrated granulomatous lymphadenitis consistent with disseminated cocciodiomycosis. Conclusions: This case report describes the first reported “incidental” pericardial effusion in a haemodynamically unstable patient sustaining a thoracoabdominal stab wound discovered on a positive ultrasound study. Emergent operative exploration and subsequent workup determined the pericardial fluid to be of infectious origin, rather than traumatic. With the incidence of cocciodiomycosis within endemic geographic regions significantly rising, coccidioidal pericarditis may become an increasingly relevant cause of fluid detected on noninvasive pericardial examination. Keywords: Trauma, Infection, Focussed assessment with sonography for trauma (FAST

A comparison of the clinical, haemodynamic and angiographic features in right ventricular endomyocardial fibrosis and Ebstein's anomaly of the tricuspid valve.

Science.gov (United States)

Balakrishnan, K G; Sapru, R P; Sasidharan, K; Venkitachalam, C G

1982-01-01

The clinical, haemodynamic and angiographic features of 18 patients with right ventricular endomyocardial fibrosis (RVEMF) and 8 patients with Ebstein's anomaly of the tricuspid valve (EATV) have been compared. Diagnosis was confirmed by selective angiography. The position of the tricuspid annulus was identified from selective right ventricular angiograms and confirmed by selective right coronary angiography. In 83% of RVEMF patients the tricuspid annulus was displaced to the left of the spine. A false impression of displacement of the tricuspid leaflet can thus be created. However, a tricuspid leaflet displaced away from the tricuspid annulus was found only in patients with EATV. A considerable overlap exists between the wide spectrum of clinical presentations of the two conditions. Helpful distinguishing features that favour EATV were, the presence of a scratchy diastolic murmur and polyphasic QRS complexes in the ECG. Atrial fibrillation in the ECG, and myocardial calcification or pericardial effusion, whenever present, favour RVEMF.

Impact of anticoagulation therapy on valve haemodynamic deterioration following transcatheter aortic valve replacement.

Science.gov (United States)

Del Trigo, María; Muñoz-García, Antonio J; Latib, Azeem; Auffret, Vincent; Wijeysundera, Harindra C; Nombela-Franco, Luis; Gutierrez, Enrique; Cheema, Asim N; Serra, Vicenç; Amat-Santos, Ignacio J; Kefer, Joelle; Benitez, Luis Miguel; Leclercq, Florence; Mangieri, Antonio; Le Breton, Hervé; Jiménez-Quevedo, Pilar; Garcia Del Blanco, Bruno; Dager, Antonio; Abdul-Jawad Altisent, Omar; Puri, Rishi; Pibarot, Philippe; Rodés-Cabau, Josep

2018-05-01

To evaluate the changes in transvalvular gradients and the incidence of valve haemodynamic deterioration (VHD) following transcatheter aortic valve replacement (TAVR), according to use of anticoagulation therapy. This multicentre study included 2466 patients (46% men; mean age 81±7 years) who underwent TAVR with echocardiography performed at 12-month follow-up. Anticoagulation therapy was used in 707 patients (28.7%) following TAVR (AC group). A total of 663 patients received vitamin K antagonists, and 44 patients received direct oral anticoagulants. A propensity score matching analysis was performed to adjust for intergroup (AC vs non-AC post-TAVR) differences. A total of 622 patients per group were included in the propensity-matched analysis. VHD was defined as a ≥10 mm Hg increase in the mean transprosthetic gradient at follow-up (vs hospital discharge). The mean clinical follow-up was 29±18 months. The mean transvalvular gradient significantly increased at follow-up in the non-AC group within the global cohort (P=0.003), whereas it remained stable over time in the AC group (P=0.323). The incidence of VHD was significantly lower in the AC group (0.6%) compared with the non-AC group (3.7%, P<0.001), and these significant differences remained within the propensity-matched populations (0.6% vs 3.9% in the AC and non-AC groups, respectively, P<0.001). The occurrence of VHD did not associate with an increased risk of all-cause death (P=0.468), cardiovascular death (P=0.539) or stroke (P=0.170) at follow-up. The lack of anticoagulation therapy post-TAVR was associated with significant increments in transvalvular gradients and a greater risk of VHD. VHD was subclinical in most cases and did not associate with major adverse clinical events. Future randomised trials are needed to determine if systematic anticoagulation therapy post-TAVR would reduce the incidence of VHD. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article

Immersed boundary simulation of flow through arterial junctions

Indian Academy of Sciences (India)

Dwaipayan Sarkar

haemodynamic activities in regions like carotid arteries, encephalic regions and ... immersed boundary method (IBM), has gained attention in the last few years .... the flow from left inlet and the flow is subsequently divided among the two ...

Real-time phase contrast magnetic resonance imaging for assessment of haemodynamics: from phantom to patients

Energy Technology Data Exchange (ETDEWEB)

Traber, Julius; Wurche, Lennart; Dieringer, Matthias A.; Utz, Wolfgang; Knobelsdorff-Brenkenhoff, Florian von; Schulz-Menger, Jeanette [Max-Delbrueck-Centrum and Charite -Medical University Berlin and HELIOS Klinikum Berlin-Buch, Department of Cardiology and Nephrology, Working Group on Cardiovascular Magnetic Resonance Imaging, Experimental and Clinical Research Center, Berlin (Germany); Greiser, Andreas [Siemens AG Healthcare Sector, Erlangen (Germany); Jin, Ning [Siemens Medical Solutions USA, Inc., Columbus, OH (United States)

2016-04-15

Assessment of haemodynamics is crucial in many cardiac diseases. Phase contrast MRI (PC-MRI) can accurately access it. Arrhythmia is a major limitation in conventional segmented PC-MRI (SEG). A real-time PC-MRI sequence (RT) could overcome this. We validated RT by comparing to SEG. A prototype RT using shared velocity encoding was tested against SEG at 1.5 T in a flow phantom and consecutively included patients with (n = 55) or without (n = 59) aortic valve disease. In patients with atrial fibrillation (Afib, n = 15), only RT was applied. Phantom: PC images were acquired in front of and behind an interchangeable aortic-stenosis-like inlay. Mean velocity and flow were quantified. Patients: PC images were acquired in the ascending aorta, pulmonary trunk and superior caval vein. Peak velocity, stroke volume and regurgitant fraction were quantified. Phantom: Mean velocities (11 ± 1 to 207 ± 10 cm/s) and flow correlated closely between SEG and RT (r ≥ 0.99, ICC ≥ 0.98, p < 0.0005). Patients without AVD or with aortic regurgitation: Concordance of SEG and RT was excellent regarding peak velocities, stroke volumes (r ≥ 0.91, ICC ≥ 0.94, p < 0.0005) and regurgitant fractions (r = 0.95, ICC = 0.95, p < 0.0005). RT was feasible in all patients with Afib. The real-time sequence is accurate compared to conventional segmented PC-MRI. Its applicability in Afib was shown. Real-time PC-MRI might become a valuable tool in arrhythmia. (orig.)

A contrast-enhanced ultrasound study of benign and malignant ...

African Journals Online (AJOL)

A contrast-enhanced ultrasound study of benign and malignant breast tissue. S Barnard, E Leen, T Cooke, W Angerson. Abstract. Objective. To determine the diagnostic value of haemodynamic contrast-enhanced ultrasound assessment in benign and malignant breast tissue, using histological examination as the reference ...

Antiorthostatic test as a model to study antigravity mechanisms of the cardiovascular system.

Science.gov (United States)

Yarullin, K K; Vasilyeva, T D; Alekseev, D A

1976-01-01

The paper presents rheographic investigations of regional haemodynamics (brain, lungs, liver and limbs) during antiorthostatic exposures of varying intensity (-15, -30, -45 degrees, times of exposure 20, 40 and 60 min). Our findings show that the pattern and time of the function of compensatory mechanisms preventing excessive vascular compliance [correction of complicance] under the influence of the hydrostatic blood column depend on the value and length of antiorthostasis, because prolonged venous congestion results not only in congestive circulatory hypoxia but also in arterial hypoxia due to compensatory limitation of arterial inflow.

Left ventricular mechanics in humans with high aerobic fitness: adaptation independent of structural remodelling, arterial haemodynamics and heart rate

Science.gov (United States)

Stöhr, Eric J; McDonnell, Barry; Thompson, Jane; Stone, Keeron; Bull, Tom; Houston, Rory; Cockcroft, John; Shave, Rob

2012-01-01

Individuals with high aerobic fitness have lower systolic left ventricular strain, rotation and twist (‘left ventricular (LV) mechanics’) at rest, suggesting a beneficial reduction in LV myofibre stress and more efficient systolic function. However, the mechanisms responsible for this functional adaptation are not known and the influence of aerobic fitness on LV mechanics during dynamic exercise has never been studied. We assessed LV mechanics, LV wall thickness and dimensions, central augmentation index (AIx), aortic pulse wave velocity (aPWV), blood pressure and heart rate in 28 males (age: 21 ± 2 years SD) with a consistent physical activity level (no change >6 months). Individuals were examined at rest and during exercise (40% peak exercise capacity) and separated post hoc into a moderate and high aerobic fitness group (: 49 ± 5 and 63 ± 7 ml kg−1 min−1, respectively, P 0.05). However, for the same AIx, the high group had significantly lower LV apical rotation (P = 0.002) and LV twist (P = 0.003) while basal rotation and strain indices did not differ between groups (P > 0.05). We conclude that young males with high aerobic fitness have lower LV apical rotation at rest and during submaximal exercise that can occur without changes in gross LV structure, arterial haemodynamics or heart rate. The findings suggest a previously unknown type of physiological adaptation of the left ventricle that may have important implications for exercise training in older individuals and patient populations in which exercise training has previously failed to show clear benefits for LV function. PMID:22431336

MRI assessment of cerebral blood volume in patients with brain infarcts

International Nuclear Information System (INIS)

Wu, R.H.; Bruening, R.; Berchtenbreiter, C.; Weber, J.; Peller, M.; Penzkofer, H.; Reiser, M.; Steiger, H.J.

1998-01-01

MRI perfusion studies have focussed mainly on acute ischaemia and characterisation in ischaemia. Our purpose was to analyse regional brain haemodynamic information in acute, subacute, and chronic ischaemia. We performed 16 examinations of 11 patients on a 1.5 T MR images. Conventional and dynamic contrast-enhanced imaging were employed in all examinations. For the dynamic susceptibility sequences, a bolus (0.2 mmol/kg) of gadopentetate dimeglumine was injected. Reconstructed regional relative cerebral blood volume (rCBV) maps, bolus maps, and conventional images were analysed by consensus reading. In all examinations decreases in rCBV were observed in the lesions. The distribution of regional rCBV in lesions was heterogeneous. The rCBV of the periphery of the lesions was higher than that at their center. There was a correlation between the time since onset and abnormalities on the rCBV map and T2-weighted images (T2WI). In the early stage of acute stroke, the abnormalities tended to be larger on the rCBV than on T2WI. Many patterns of bolus passage were observed in ischaemic regions. rCBV maps provide additional haemodynamic information in patients with brain infarcts. (orig.)

Oral paracetamol versus oral ibuprofen for closure of haemodynamically significant patent ductus arteriosus in preterm neonates (<32 weeks): a blinded, randomised, active-controlled, non-inferiority trial

Science.gov (United States)

Kumar, Ashutosh; Sundaram, Venkataseshan; Yadav, Rahul; Oleti, Tejo Pratap; Murki, Srinivas; Krishna, Arun; Sundaram, Mangalabharathi; Saini, Shiv Sajan; Dutta, Sourabh

2017-01-01

Introduction Haemodynamically significant patent ductus arteriosus (hsPDA) is a common cause of mortality and morbidity in preterm infants. Existing medical therapies with ibuprofen or indomethacin have multiple adverse effects. Hence, an alternative drug like paracetamol given through oral route with less side effects need to be tested in an appropriate study design with least risk of bias to arrive at a conclusion. Methods and analysis Multisite, randomised, active-controlled, non-inferiority design. The primary objective is to study the efficacy of oral paracetamol for closure of hsPDA in comparison to oral ibuprofen in preterm neonates of Closure of PDA by the end of last dose of study drug or earlier would be the study endpoint. A sample size of 196 neonates would be enrolled with a non-inferiority margin of 15%. Both intention-to-treat and per-protocol analysis will be done to assess the effect of contamination and protocol violations in the primary outcome. Ethics and dissemination The trial would follow international code of ethics for clinical trial. The trial protocol was approved by the Institute Ethics Committee of all three centres. All serious adverse events would be reported in detail to the Institute Ethics Committee. A written informed consent would be obtained from one of the parents. No plan has been made for dissemination. Trial registration number CTRI/2014/08/004805. PMID:29637155

Regional Resource Planning Study

International Nuclear Information System (INIS)

2001-01-01

Natural gas and electricity commodities are among the most volatile commodities in the world. Spurred on by the recent significant increases in the price of natural gas, the BC Utilities Commission initiated an investigation into factors impacting on natural gas prices, and the validity of the Sumas index (a market trading point, or interchange where multiple pipelines interconnect, allowing the purchase and sale of gas among market participants) as a price setting mechanism. The Commission also sought the opinions and perspectives of the the province's natural gas industry regarding the high volatility of the Sumas gas prices, and as to what could be done to alleviate the wild fluctuations. Following review of the responses from stakeholders, the Commission issued a directive to BC Gas to undertake discussions on regional resource planning with full representation from all stakeholders. This study is the result of the Commission's directive, and is intended to address the issues contained in the directives. Accordingly, the study examined gas demand in the region, demand growth, including power generation, natural gas resource balance in the region, the California impacts on demand and on supply to the region, supply shortfalls on a peak day, and on a seasonal and annual basis, near term remedies, possible resource additions in the longer term, the economic justification for adding major resources and proposed actions to develop needed resource additions. The study confirmed the existence of a growing capacity deficit, which limits the supply of natural gas to the region. Near term options to alleviate the regional capacity deficit were found to be limited to discouraging power generation from serving export markets, demand side management efforts, and expansion of the WEI's systems by 105 mmcf/d. Longer term solutions would involve larger scale expansion of WEI's T-South capacity, the BC Gas' Inland Pacific Connector Project and the Washington Lateral proposed by

The effects of music intervention on the emotion, haemodynamics and endocrine hormone level of senile patients during the perianesthesia period

Directory of Open Access Journals (Sweden)

Liang Feng

2017-01-01

Full Text Available Purpose: to explore the effects of music intervention on haemodynamics and endocrine hormone level of senile patients. Methods: choosing ASA II-III level and selecting 60 senile patients performed with intraspinal anesthesia; randomly dividing them into the intervention group and control group with 30 cases in each group. Both the two groups of patients completed the SAS before entering the operating room. When the patients of the intervention group entered the operating room, selected music would be played in a continuous loop immediately till the end of the operation while the doctors of the control group just told the patient to relax without music or other special treatment. Recording and comparing the SAS scores, SBP, HR and salivary cortisol concentration of the two groups before and after intervention. Results: the SAS scores, SBP, HR and salivary cortisol concentration of the intervention group were significantly decreased compared with the value before intervention and the differences within and between the groups were significant (P < 0.05. Conclusion: music intervention can effectively reduce the preoperative anxiety, ease intranperative tension and maintain the stability of hemodynamics, so it is beneficial for senile parents to live through the perianesthesia period.

Andean region study

Energy Technology Data Exchange (ETDEWEB)

NONE

1999-10-01

New opportunities for climate change mitigation arising from a higher energy integration among Andean Pact nations were analysed within the framework of the UNEP/GEF Project. Apart from the search for regional mitigation actions, the study was mainly aimed at detecting methodological problems which arise when passing from a strictly national view to the co-ordination of regional actions to deal with climate change. In accordance with the available resources and data, and in view of the mainly methodological nature of the project, it was decided to analyse the opportunities to delve into the energy integration of the Region as regards electricity and natural gas industries and their eventual impact on the emission of greenhouse gases. Although possibilities of setting up electricity and natural gas markets are real, their impacts on GHG emission from the energy system would not prove substantially higher than those which the nations could achieve through the use of their own energy resources, in view that the Andean systems are competitive rather than complementary. More in-depth studies and detail information will be required - unavailable for the present study - to be able to properly evaluate all benefits associated with higher energy integration. Nevertheless, the supply of natural gas to Ecuador seems to be the alternative with the highest impact on GHG emission. If we were to analyse the supply and final consumption of energy jointly, we would most certainly detect additional mitigation options resulting from higher co-operation and co-ordination in the energy field. (EHS)

COMPARATIVE STUDY TO EVALUATE ANALGESIC EFFICACY OF CAUDAL MIDAZOLAM AND CLONIDINE POSTOPERATIVE ANALGESIA IN CHILDREN

Directory of Open Access Journals (Sweden)

Ramalinga Raju A.V.S

2017-03-01

Full Text Available BACKGROUND Caudal epidural analgesia is one of the most popular regional techniques used in paediatric patients undergoing lower limb, anoperineal and abdominal surgical procedures for postoperative pain relief. The aim of postoperative pain relief is to provide subjective comfort and inhibit trauma-induced nociceptive impulses to blunt autonomic and reflex responses to pain and subsequently to enhance the restoration of function. Caudal epidural analgesia though practiced widely is of short duration even when used with long-acting local anaesthetics. MATERIALS AND METHODS Children of either sex undergoing elective hernia or hydrocele surgery within in the age group of 2-8 years belonging to ASA I and II were included in the study. Informed consent was obtained from the parents before procedure. RESULTS The duration of analgesia in the study group was 10.14 ± 4.69 hrs. and 6.83 ± 0.79 hrs. in the clonidine group and midazolam group. Duration of analgesia in clonidine group was significantly longer when compared to with midazolam group with a p value of <0.05. Sedation Score- There was decrease in heart rate and mean arterial pressure from baseline, but these were under allowable limits of 20%. The patient had pain scores of less than 8 for first 6-8 hrs. The patients were well sedated and were easily arousable. CONCLUSION We conclude that in our study we found that clonidine 8 μg/kg provided good analgesia for a longer duration when compared with midazolam. Clonidine also provided good sedation with minimal haemodynamic variations. This is in agreement with studies conducted to know haemodynamic stability with higher doses of clonidine.

Effects of high dose olive leaf extract on haemodynamic and oxidative stress parameters in normotensive and spontaneously hypertensive rats

Directory of Open Access Journals (Sweden)

Dekanski Dragana

2014-01-01

Full Text Available Antihypertensive activity of natural antioxidant, olive leaf extract (OLE is known, but its influence on cardiovascular system when administered in a high dose has not been investigated yet. Our aim was to determine the acute effects of excessive intake of standardized OLE on blood pressure, heart rate and oxidative status in both spontaneously hypertensive rats and normotensive Wistar rats. Systolic arterial pressure and heart rate were measured using a tail-cuff, pneumatic pulse detector, before, 60 and 120 minutes after intragastric OLE administration. Activities of catalase, glutathione peroxidase, superoxide dismutase (SOD and glutathione reductase in erythrocytes, as well as lipid peroxidation in plasma (pTBARS were measured at the same time points, spectrophotometrically. High-dose OLE did not influence blood pressure, heart rate and pTBARS in normotensive rats, while SOD, catalase, and glutathione reductase activities significantly increased. The same dose significantly decreased blood pressure in hypertensive rats, but increased pTBARS and SOD activity. Excessive oral intake of OLE induced moderate hypotensive effects in spontaneously hypertensive rats only, suggesting absence of harmful haemodynamic effects after oral overdose in both rats strain. However, its prooxidative role when given in high dose in hypertensive organism should not be neglected. [Projekat Ministarstva nauke Republike Srbije, br. 175096

Development of regional growth centres and impact on regional growth: A case study of Thailand’s Northeastern region

Directory of Open Access Journals (Sweden)

Nattapon Sang-arun

2013-01-01

Full Text Available This study investigates the spatial economic structure and inequality in Thailand at the national and regional levels, with a particular focus on the Northeastern region in the period from 1987 to 2007. The study has three main points: 1 examination of the economic structure and inequality at the national level and in the Northeastern region according to the Theil index, 2 determination of regional growth centres and satellite towns by using growth pole theory as a conceptual framework and incorporating spatial interaction analysis and 3 analysis of the relationship between regional growth centres and satellite towns with regard to the impact on growth and inequality. The results show that the Northeastern region is definitely the lagging region in the nation, by both gross domestic product (GDP and gross regional product (GRP per capita. It was therefore selected for a case study. Spatial analysis identified Nakhon Ratchasima, Khon Kaen, Udon Thani and Ubon Ratchathani as regional growth centres. Each of them has its own sphere of influence (or satellite towns, and the total area of regional growth centres and satellite towns are classified as sub-regions. The development of regional growth centres has a direct impact on sub-regional economic growth through economic and social relationships: urbanisation, industrial development, per capita growth, the number of higher educational institutes and so on. However, such growth negatively correlates with economic equality among the provinces in a sub-region. The inequality trend is obviously on an upswing. This study suggests that industrial links between regional growth centres and their satellite towns should be improved in order for regional growth centre development to have a consistently desirable effect on both economic growth and equality. Such a strong process means that the growth of regional growth centres will spread, leading to the development of their surrounding areas.

Electrophysiological, haemodynamic, and mitochondrial alterations induced by levobupivacaine during myocardial ischemia in a pig model: protection by lipid emulsions?

Science.gov (United States)

Mamou, Zahida; Descotes, Jacques; Chevalier, Philippe; Bui-Xuan, Bernard; Romestaing, Caroline; Timour, Quadiri

2015-10-01

Accidental intravascular or high-dose injection of local anesthetics (LA) can result in serious, potentially life-threatening complications. Indeed, adequate supportive measures and the administration of lipid emulsions are required in such complications. The study's objectives were threefold: (i) evaluate the myocardial toxicity of levobupivacaine when administered intravenously; (ii) investigate levobupivacaine toxicity on cardiomyocytes mitochondrial functions and cellular structure; (iii) assess the protective effects of a lipid emulsion in the presence or absence of myocardial ischemia. Domestic pigs randomized into two groups of 24 animals each, with either preserved coronary circulation or experimental myocardial ischemia. Six animals from each group received either: (i) single IV injection of saline, (ii) lipid emulsion (Intralipid(®) ), (iii) levobupivacaine, (iv) combination levobupivacaine-Intralipid(®) . Serially measured endpoints included: heart rate, duration of the monophasic action potentials (dMAP), mean arterial pressure, and peak of the time derivative of left ventricular pressure (LV dP/dtmax ). In addition, the following cardiomyocytes mitochondrial functions were measured: reactive oxygen species (ROS) production, oxidative phosphorylation, and calcium retention capacity (CRC) as well as the consequences of ROS production on lipids, proteins, and DNA. IV injection of levobupivacaine induced sinus bradycardia and reduced dMAP and LV dP/dtmax . At the mitochondrial level, oxygen consumption and CRC were decreased. In contrast, ROS production was increased leading to enhanced lipid peroxidation and structural alterations of proteins and DNA. Myocardial ischemia was associated with global worsening of all changes. Intralipid(®) quickly improved haemodynamics. However, beneficial effects of Intralipid(®) were less clear after myocardial ischemia. © 2015 Société Française de Pharmacologie et de Thérapeutique.

Clinical and haemodynamic evolution of lesions treated by means of atherectomy with SilverHawk in the femoropopliteal sector

Energy Technology Data Exchange (ETDEWEB)

Ibanez, Maria Antonia, E-mail: marianim5@yahoo.es [Department of Angiology and Vascular Surgery, Valladolid University Hospital, Valladolid, C/Ramon y Cajal no 3, 47005 Valladolid (Spain); Cenizo, Noelia, E-mail: noecen@yahoo.es [Department of Angiology and Vascular Surgery, Valladolid University Hospital, Valladolid, C/Ramon y Cajal no 3, 47005 Valladolid (Spain); Rio, Lourdes, E-mail: mlriosol@yahoo.es [Department of Angiology and Vascular Surgery, Valladolid University Hospital, Valladolid, C/Ramon y Cajal no 3, 47005 Valladolid (Spain); Sanchez, Ana, E-mail: assantiago@yahoo.es [Department of Angiology and Vascular Surgery, Valladolid University Hospital, Valladolid, C/Ramon y Cajal no 3, 47005 Valladolid (Spain); San Norberto, Enrique, E-mail: esannorberto@hotmail.com [Department of Angiology and Vascular Surgery, Valladolid University Hospital, Valladolid, C/Ramon y Cajal no 3, 47005 Valladolid (Spain); Brizuela, Jose-Antonio, E-mail: brizsanz@yahoo.es [Department of Angiology and Vascular Surgery, Valladolid University Hospital, Valladolid, C/Ramon y Cajal no 3, 47005 Valladolid (Spain); Gutierrez, Vicente, E-mail: vgutierrezalonso@gmail.com [Department of Angiology and Vascular Surgery, Valladolid University Hospital, Valladolid, C/Ramon y Cajal no 3, 47005 Valladolid (Spain); Vaquero, Carlos, E-mail: cvaquero@med.uva.es [Department of Angiology and Vascular Surgery, Valladolid University Hospital, Valladolid, C/Ramon y Cajal no 3, 47005 Valladolid (Spain)

2011-11-15

The objective of the work is to study the clinical and haemodynamic evolution, over 1 year, in patients with femoropopliteal arterial pathology treated by means of atherectomy with the SilverHawk device. Materials and methods: Nineteen (19) patients were treated between December 2008 and May 2009, collecting data on sex, age, comorbidity and clinical degree, with prospective monitoring over 12 months of clinical symptoms, physical examination and ecodoppler, obtaining results on diameter and peak systolic velocity at different arterial levels. Results: Of the 19 patients, 14 were men and 5 women, with a mean age of 70 years, hypertensive (73%), diabetic (63%) and smokers (63%). Six (6) presented disabling claudication and 13 critical ischemia with advanced distal trophic lesions in 5. A good arteriographic result was obtained in 12 cases, a stent was placed on the superficial femoral artery in 5 due to suboptimal outcome. Contrast extravasation was observed in 2, with femoropopliteal bypass performed and one exclusion with endoprosthesis for repair. In the ecodoppler after 1, 3, 6 and 12 months, a progressive reduction in lumen diameter and peak intraarterial systolic velocity was observed, particularly on the distal superficial femoral artery. After one year, 7 patients (36.8%) were symptom-free, 5 (26.3%) presented mild or moderate intermittent claudication and 1 patient (5.3%) presented localised distal trophic lesion. Four (4) major amputations were performed, in 2 the knee was preserved, there were 3 thromboses due to the procedure, a secondary endovascular procedure was performed in one case and a femoropopliteal bypass in another, and there were 2 non procedure-related deaths. Discussion: atherectomy with SilverHawk achieves an improvement in clinical degree, with a good rate of extremity salvage in patients with critical ischemia. In the first year, the ecodoppler shows evolution of the arteriopathy, without this necessarily meaning a clinical worsening.

Clinical and haemodynamic evolution of lesions treated by means of atherectomy with SilverHawk in the femoropopliteal sector

International Nuclear Information System (INIS)

Ibanez, Maria Antonia; Cenizo, Noelia; Rio, Lourdes; Sanchez, Ana; San Norberto, Enrique; Brizuela, Jose-Antonio; Gutierrez, Vicente; Vaquero, Carlos

2011-01-01

The objective of the work is to study the clinical and haemodynamic evolution, over 1 year, in patients with femoropopliteal arterial pathology treated by means of atherectomy with the SilverHawk device. Materials and methods: Nineteen (19) patients were treated between December 2008 and May 2009, collecting data on sex, age, comorbidity and clinical degree, with prospective monitoring over 12 months of clinical symptoms, physical examination and ecodoppler, obtaining results on diameter and peak systolic velocity at different arterial levels. Results: Of the 19 patients, 14 were men and 5 women, with a mean age of 70 years, hypertensive (73%), diabetic (63%) and smokers (63%). Six (6) presented disabling claudication and 13 critical ischemia with advanced distal trophic lesions in 5. A good arteriographic result was obtained in 12 cases, a stent was placed on the superficial femoral artery in 5 due to suboptimal outcome. Contrast extravasation was observed in 2, with femoropopliteal bypass performed and one exclusion with endoprosthesis for repair. In the ecodoppler after 1, 3, 6 and 12 months, a progressive reduction in lumen diameter and peak intraarterial systolic velocity was observed, particularly on the distal superficial femoral artery. After one year, 7 patients (36.8%) were symptom-free, 5 (26.3%) presented mild or moderate intermittent claudication and 1 patient (5.3%) presented localised distal trophic lesion. Four (4) major amputations were performed, in 2 the knee was preserved, there were 3 thromboses due to the procedure, a secondary endovascular procedure was performed in one case and a femoropopliteal bypass in another, and there were 2 non procedure-related deaths. Discussion: atherectomy with SilverHawk achieves an improvement in clinical degree, with a good rate of extremity salvage in patients with critical ischemia. In the first year, the ecodoppler shows evolution of the arteriopathy, without this necessarily meaning a clinical worsening.

A randomised comparative study of the effect of Airtraq optical laryngoscope vs. Macintosh laryngoscope on intraocular pressure in non-ophthalmic surgery

Directory of Open Access Journals (Sweden)

Bikramjit Das

2016-02-01

Full Text Available BACKGROUND: We compared intraocular pressure changes following laryngoscopy and intubation with conventional Macintosh blade and Airtraq optical laryngoscope. METHODS: Ninety adult patients were randomly assigned to study group or control group. Study group (n = 45 - Airtraq laryngoscope was used for laryngoscopy. Control group (n = 45 - conventional Macintosh laryngoscope was used for laryngoscopy. Preoperative baseline intraocular pressure was measured with Schiotz tonometer. Laryngoscopy was done as per group protocol. Intraocular pressure and haemodynamic parameters were recorded just before insertion of the device and subsequently three times at an interval of one minute after insertion of the device. RESULTS: Patient characteristics, baseline haemodynamic parameters and baseline intraocular pressure were comparable in the two groups. Following insertion of the endotracheal tube with Macintosh laryngoscope, there was statistically significant rise in heart rate and intraocular pressure compared to Airtraq group. There was no significant change in MAP. Eight patients in Macintosh group had tongue-lip-dental trauma during intubation, while only 2 patients received upper airway trauma in Airtraq group. CONCLUSION: We conclude that Airtraq laryngoscope in comparison to Macintosh laryngoscope results in significantly fewer rises in intraocular pressure and clinically less marked increase in haemodynamic response to laryngoscopy and intubation.

Thoughts turned into high-level commands: Proof-of-concept study of a vision-guided robot arm driven by functional MRI (fMRI) signals.

Science.gov (United States)

Minati, Ludovico; Nigri, Anna; Rosazza, Cristina; Bruzzone, Maria Grazia

2012-06-01

Previous studies have demonstrated the possibility of using functional MRI to control a robot arm through a brain-machine interface by directly coupling haemodynamic activity in the sensory-motor cortex to the position of two axes. Here, we extend this work by implementing interaction at a more abstract level, whereby imagined actions deliver structured commands to a robot arm guided by a machine vision system. Rather than extracting signals from a small number of pre-selected regions, the proposed system adaptively determines at individual level how to map representative brain areas to the input nodes of a classifier network. In this initial study, a median action recognition accuracy of 90% was attained on five volunteers performing a game consisting of collecting randomly positioned coloured pawns and placing them into cups. The "pawn" and "cup" instructions were imparted through four mental imaginery tasks, linked to robot arm actions by a state machine. With the current implementation in MatLab language the median action recognition time was 24.3s and the robot execution time was 17.7s. We demonstrate the notion of combining haemodynamic brain-machine interfacing with computer vision to implement interaction at the level of high-level commands rather than individual movements, which may find application in future fMRI approaches relevant to brain-lesioned patients, and provide source code supporting further work on larger command sets and real-time processing. Copyright © 2012 IPEM. Published by Elsevier Ltd. All rights reserved.

Overview of the regional geology of the Paradox Basin Study Region

International Nuclear Information System (INIS)

1983-03-01

The Geologic Project Manager for the Paradox Basin Salt Region (PBSR), Woodward-Clyde Consultants, has conducted geologic studies to characterize the region and evaluate selected geologic formations as potential repositories for the storage and disposal of nuclear waste. Evaluations have been made from the standpoint of engineering feasibility, safety, public health, and resource conflicts. The Regulatory Project Manager for the PBSR, Bechtel National, Inc., has performed environmental characterizations to ensure that data on ecological, socioeconomic, and other environmental factors required by the National Environmental Policy Act of 1969 are considered. This report characterizes, at a regional overview level of detail, the Paradox Basin Study Region Geology. Information sources include the published literature, field trip guidebooks, open file data of the US Geological Survey (USGC) and Utah Geologic and Mineral Survey, university theses, Geo-Ref Computer Search, and various unpublished sources of subsurface data such as well logs. Existing information has been synthesized and characterized. No field work was conducted as part of this study. Where possible, attempts were made to evaluate the data. All results of this study are subject to change as more data become available

[Regional ecological planning and ecological network construction: a case study of "Ji Triangle" Region].

Science.gov (United States)

Li, Bo; Han, Zeng-Lin; Tong, Lian-Jun

2009-05-01

By the methods of in situ investigation and regional ecological planning, the present ecological environment, ecosystem vulnerability, and ecological environment sensitivity in "Ji Triangle" Region were analyzed, and the ecological network of the study area was constructed. According to the ecological resources abundance degree, ecological recovery, farmland windbreak system, environmental carrying capacity, forestry foundation, and ecosystem integrity, the study area was classified into three regional ecological function ecosystems, i. e., east low hill ecosystem, middle plain ecosystem, and west plain wetland ecosystem. On the basis of marking regional ecological nodes, the regional ecological corridor (Haerbin-Dalian regional axis, Changchun-Jilin, Changchun-Songyuan, Jilin-Songyuan, Jilin-Siping, and Songyuan-Siping transportation corridor) and regional ecological network (one ring, three links, and three belts) were constructed. Taking the requests of regional ecological security into consideration, the ecological environment security system of "Ji Triangle" Region, including regional ecological conservation district, regional ecological restored district, and regional ecological management district, was built.

Sex, ageing and resting blood pressure: gaining insights from the integrated balance of neural and haemodynamic factors.

Science.gov (United States)

Hart, Emma C; Joyner, Michael J; Wallin, B Gunnar; Charkoudian, Nisha

2012-05-01

Young women tend to have lower blood pressure, and less risk of hypertension, compared to young men. As people age, both blood pressure and the risk of hypertension increase in both sexes; this occurs most strikingly in women after menopause. However, the mechanisms for these influences of sex and age remain incompletely understood. In this review we are specifically interested in the interaction between neural (sympathetic nerve activity; SNA) and haemodynamic factors (cardiac output, blood pressure and vascular resistance) and how these change with sex and age. While peripheral vascular SNA can vary 7- to 10-fold among normotensive young men and women, it is reproducible in a given individual. Surprisingly, higher levels of SNA are not associated with higher blood pressures in these groups. In young men, high SNA is associated with higher total peripheral vascular resistance (TPR), and appears to be balanced by lower cardiac output and less peripheral vascular responsiveness to adrenergic stimulation. Young women do not exhibit the SNA-TPR relationship. Recent evidence suggests that β-adrenergic vasodilatation offsets the vasoconstrictor effects of α-adrenergic vasoconstriction in young women, which may contribute to the generally lower blood pressures in this group. Sympathetic nerve activity increases with age, and in groups over 40, levels of SNA are more tightly linked to levels of blood pressure. The potentially protective β-adrenergic effect seen in young women appears to be lost after menopause and probably contributes to the increased blood pressure and increased risk of hypertension seen in older women.

Regional Studies Program

International Nuclear Information System (INIS)

Parzyck, D.C.

1978-01-01

Progress is reported on methodology studies with regard to hydrologic analysis; atmospheric transport; forest growth models; distribution of sensitive species; agricultural analysis; and environmental objectives in energy facility siting. National coal utilization assessment studies are reported with regard to technology characterization; air quality impacts; water resources; regional characterization; forest impacts; coal extraction impacts on sensitive animal species; and health impacts. The following special projects were carried out: water resource aspects of inexhaustible technology deployment; ecological constraints on the rapidly expanded use of coal; and U.S. coal and the global carbon problem

Regional EM studies in the 80's

Science.gov (United States)

Hjelt, S. E.

1987-09-01

The review describes in broad terms the development of regional EM studies during the last five-six years. Large simultaneous magnetometer arrays, broadband and dense profiling with five component instruments, the use of remote reference techniques and in-field data processing have increased both the number and the quality of EM surveys. The increase has been strong all over the world. An extensive list of references, divided geographically, is presented. Selected examples of regional resisitivity-versus-depth curves are shown for Africa, the Baikal region, the Baltic Shield, the Canadian Shield, the Carpathian regions, the Central Andes, Iceland, India, the Juan de Fuca Plate, the Münsterland Basin, the Rio Grande rift, the Scottish Caledonides, the Tasman Sea, and for the United States in general. Because of the influence of tectonic settings and the metamorphic grade of rocks, only qualitative aspects of the results are relevant. ‘Classical’ array studies, especially in Australia, in the Carpathian regions, in India, in North Germany and in Scotland have been reinterpreted and completed with more accurate 2D modelling and dense MT profiling. In the USA and Canada also new regions have been surveyed extensively. New regional EM work has been conducted extensively on the Baltic Shield and in Central and North Africa, Siberia, China, in the areas around the Caspian and Black Seas and in South America. The newest studies are supported by or compared with other geophysical data, which also are used in extrapolating for missing EM data density. There are several successful large-scale projects in operation: the European Geotraverse (EGT), the KAPG International Geotraverses and the EMSLAB project (with its first preliminary results). Regional EM studies have been increasingly applied to geothermal, hydrocarbon and mineral prospecting as well as local structural studies, e.g. studies of sites for nuclear waste disposal.

Pregnancy-specific stress, fetoplacental haemodynamics, and neonatal outcomes in women with small for gestational age pregnancies: a secondary analysis of the multicentre Prospective Observational Trial to Optimise Paediatric Health in Intrauterine Growth Restriction.

Science.gov (United States)

Levine, Terri A; Grunau, Ruth E; Segurado, Ricardo; Daly, Sean; Geary, Michael P; Kennelly, Mairead M; O'Donoghue, Keelin; Hunter, Alyson; Morrison, John J; Burke, Gerard; Dicker, Patrick; Tully, Elizabeth C; Malone, Fergal D; Alderdice, Fiona A; McAuliffe, Fionnuala M

2017-06-21

To examine associations between maternal pregnancy-specific stress and umbilical (UA PI) and middle cerebral artery pulsatility indices (MCA PI), cerebroplacental ratio, absent end diastolic flow (AEDF), birthweight, prematurity, neonatal intensive care unit admission and adverse obstetric outcomes in women with small for gestational age pregnancies. It was hypothesised that maternal pregnancy-specific stress would be associated with fetoplacental haemodynamics and neonatal outcomes. This is a secondary analysis of data collected for a large-scale prospective observational study. This study was conducted in the seven major obstetric hospitals in Ireland and Northern Ireland. Participants included 331 women who participated in the Prospective Observational Trial to Optimise Paediatric Health in Intrauterine Growth Restriction. Women with singleton pregnancies between 24 and 36 weeks gestation, estimated fetal weight <10th percentile and no major structural or chromosomal abnormalities were included. Serial Doppler ultrasound examinations of the umbilical and middle cerebral arteries between 20 and 42 weeks gestation, Pregnancy Distress Questionnaire (PDQ) scores between 23 and 40 weeks gestation and neonatal outcomes. Concerns about physical symptoms and body image at 35-40 weeks were associated with lower odds of abnormal UAPI (OR 0.826, 95% CI 0.696 to 0.979, p=0.028). PDQ score (OR 1.073, 95% CI 1.012 to 1.137, p=0.017), concerns about birth and the baby (OR 1.143, 95% CI 1.037 to 1.260, p=0.007) and concerns about physical symptoms and body image (OR 1.283, 95% CI 1.070 to 1.538, p=0.007) at 29-34 weeks were associated with higher odds of abnormal MCA PI. Concerns about birth and the baby at 29-34 weeks (OR 1.202, 95% CI 1.018 to 1.421, p=0.030) were associated with higher odds of AEDF. Concerns about physical symptoms and body image at 35-40 weeks were associated with decreased odds of neonatal intensive care unit admission (OR 0.635, 95% CI 0

Health region development from the perspective of system theory - an empirical cross-regional case study.

Science.gov (United States)

Volgger, Michael; Mainil, Tomas; Pechlaner, Harald; Mitas, Ondrej

2015-01-01

Governments are increasingly establishing health regions to deal with current challenges of public health service. These regions are seen as instruments to balance public and private stakeholders, and offer health care to regional citizens as well as to medical/health tourists. However, it is still unclear how the development of such health regions as well as their governance may be conceptualized. We apply Luhmann's system theory approach in the context of a cross-regional case study that compares health region developments in the Autonomous Province of Bolzano-South Tyrol (Italy) with particular regard to the Eastern Dolomites and in the province of Zeeland (the Netherlands). We suggest that Luhmann's system theory provides a useful set of criteria to evaluate and judge health region development. Fully developed health regions can be understood as auto-poietic systems. By emphasizing programs, personnel, and communication channels, these case studies illustrate the suitability of the system theory toolset to analyze the governance and spatial embeddedness of health regions. Additionally, the study contributes to literature by indicating that health regions are closely related to identity issues and to decision making in regions. Copyright © 2014 Elsevier Ltd. All rights reserved.

Regional development via high-speed rail : A study of the Stockholm-Mälaren region and possibilities for Melbourne-regional Victoria

OpenAIRE

Bayley, Michael

2012-01-01

The purpose of this thesis is to examine, based on a study of the regional high-speed corridors in the Stockholm-Mälaren Region, the possibilities for regional high-speed rail in Melbourne-regional Victoria (Australia) to improve accessibility, and achieve regional development and balanced growth between the capital and its surrounding regions. It deals with the concept of 'regional' high-speed rail, a variant of classic high-speed rail that serves centres along regional corridors stemming fr...

A STUDY OF TUMOURS OF THE SELLER REGION

Directory of Open Access Journals (Sweden)

Rame

2016-03-01

Full Text Available BACKGROUND The tumours of the sellar region that are encountered according to literature are Craniopharyngioma [WHO grade I], Granular cell tumour of the neurohypophysis [WHO grade I], Pituicytoma [WHO grade I], Spindle cells oncocytoma of the adenohypophysis [WHO grade I]. The aim of the study is to study the tumours that are encountered in the Sellar Region. The incidence of the sellar region is very less in this region of Karnataka. METHOD The sample size included 100 cases of intra-cranial neoplasms that turned in the Department of Medicine in KVJ Medical College, Sullia and different local private hospitals of Sullia and Mangalore. RESULTS Only one case of craniopharyngioma was encountered in this study. It accounts for 1(1% of all intracranial tumours studied in this series. Tumour was located in the suprasellar region. This case was reported in a 52-year-old female patient. Presenting complaint was bilateral visual loss and loss of memory. Microscopically-Stratified squamous epithelium was seen lining a cyst and solid ameloblastomatous tissue, calcification ossification and inflammatory reaction were common features. CONCLUSION The incidence of the sellar region is very less in this region of Karnataka.

Dopamine natriuresis in salt-repleted, water-loaded humans

DEFF Research Database (Denmark)

Olsen, Niels Vidiendal; Olsen, M H; Bonde, J

1997-01-01

The purpose of the present study was to define the dose-response relationship between exogenous dopamine and systemic haemodynamics, renal haemodynamics, and renal excretory function at infusion rates in the range 0 to 12.5 microg kg(-1) min(-1) in normal volunteers....

Comparison of TIVA and Desflurane Added to a Subanaesthetic Dose of Propofol in Patients Undergoing Coronary Artery Bypass Surgery: Evaluation of Haemodynamic and Stress Hormone Changes

Directory of Open Access Journals (Sweden)

Didem Onk

2016-01-01

Full Text Available Introduction. Increased levels of stress hormones are associated with mortality in patients undergoing coronary artery bypass grafting (CABG. Aim. To compare total intravenous anaesthesia (TIVA and desflurane added to a subanaesthetic dose of propofol. Material and Methods. Fifty patients were enrolled in this study. Fentanyl (3–5 mcg/kg/h was started in both groups. Patients were divided into two groups. The PD group (n=25 received 1 minimum alveolar concentration (MAC desflurane anaesthesia in addition to propofol infusion (2-3 mg/kg/h, while P group (n=25 received propofol infusion (5-6 mg/kg/h only. Biochemical data, cortisol, and insulin levels were measured preoperatively (T0, after initiation of CPB but before cross-clamping the aorta (T1, after removal of the cross-clamp (T2, and at the 24th postoperative hour (T3. Results. Systolic, diastolic, and mean arterial pressure levels were significantly higher in PD group than those in P group in T1 and T2 measurements (p≤0.05. CK-MB showed a significant decrease in group P (p≤0.05. When we compared both groups, cortisol levels were significantly higher in PD group than P group (p≤0.05. Conclusion. Stress and haemodynamic responses were better controlled using TIVA than desflurane inhalation added to a subanaesthetic dose of propofol in patients undergoing CABG.

Clinical examination, critical care ultrasonography and outcomes in the critically ill

DEFF Research Database (Denmark)

Hiemstra, Bart; Eck, Ruben J; Koster, Geert

2017-01-01

PURPOSE: In the Simple Intensive Care Studies-I (SICS-I), we aim to unravel the value of clinical and haemodynamic variables obtained by physical examination and critical care ultrasound (CCUS) that currently guide daily practice in critically ill patients. We intend to (1) measure all available...... patient used for guiding diagnostics, prognosis and interventions. Repeated evaluations of these sets of variables are needed for continuous improvement of the diagnostic and prognostic models. Future plans include: (1) more advanced imaging; (2) repeated clinical and haemodynamic measurements; (3...... clinical and haemodynamic variables, (2) train novices in obtaining values for advanced variables based on CCUS in the intensive care unit (ICU) and (3) create an infrastructure for a registry with the flexibility of temporarily incorporating specific (haemodynamic) research questions and variables...

New vasoactive peptides in cirrhosis

DEFF Research Database (Denmark)

Kimer, Nina; Goetze, Jens Peter; Bendtsen, Flemming

2014-01-01

BACKGROUND: Patients with cirrhosis have substantial circulatory imbalance between vasoconstrictive and vasodilating forces. The study of circulatory vasoactive peptides may provide important pathophysiological information. This study aimed to assess concentrations, organ extraction and relations...... to haemodynamic changes in the pro-peptides copeptin, proadrenomedullin and pro-atrial natriuretic peptide (proANP) in patients with cirrhosis. MATERIALS AND METHODS: Fifty-four cirrhotic patients and 15 controls were characterized haemodynamically during a liver vein catheterization. Copeptin, proadrenomedullin...... pressure (R=0·32, P0·31, Ppeptide is elevated in cirrhosis. Copeptin, proadrenomedullin and proANP are related to portal pressure and seem associated with systemic haemodynamics. These propeptides may...

Dose response from pharmacological interventions for CBF changes in a baboon model using 99Tcm-HMPAO and SPECT

International Nuclear Information System (INIS)

Dormehl, I.C.; Hugo, N.; Oliver, D.W.

1993-01-01

This study assesses the sensitivity of the baboon model under anaesthesia to determine by single photon emission computed tomography (SPECT) and 99 Tc m -hexamethylpropyleneamine oxime (HMPAO) dose responses from drugs (acetazolamide) with known regional cerebral blood flow (rCBF) effects on humans. Three dosages of acetazolamide were chosen: 250, 500 and 750 mg. The effects of these were studied by conventional SPECT 5 min after intravenous (i.v.) administration and compared to previous studies of rCBF with the baboons under anaesthesia only. An additional study concerned the effect of 500 mg acetazolamide at 15 min after administration. Haemodynamic parameters and blood gases were also monitored. No statistically significant regional effects were noted. The largest increase in CBF (39%) was observed from 500 mg acetazolamide after 5 min. This was statistically significantly different from control values only at a 10% level of confidence; then following a 27% increase above control values after 750 mg (5 min). At 15 min 500 mg yielded values lower by 10% than the high dose. No effects were observed from 250 mg acetazolamide; only pO 2 showed changes which largely confirm the CBF findings. The model did not give significant results at a 5% level of confidence but large fluctuations were observed, also in the haemodynamic and blood gas values. At a 10% level a significant dose response was confirmed for acetazolamide. (author)

Detroit regional transit study : a study of factors that enable and inhibit effective regional transit.

Science.gov (United States)

2014-03-01

An interdisciplinary team of six faculty members and six students at the University of Detroit Mercy (UDM) conducted a : comprehensive study of the factors enabling or inhibiting development of effective regional transit. Focusing on Metro Detroit an...

Regional Trends in Electromobility - Regional Study North America

OpenAIRE

Turrentine, Tom; Garas, Dhalia

2015-01-01

The subproject “Regional Trends in Electro mobility” aims at identifying and analyzing major trends in the field of electro mobility. The trend analysis will monitor research effort and upcoming technologies, policies, products and market developments in different focus regions around the world continuously to enable a systematic analysis of global trends. The regional trend analysis for electro mobility is a major keystone for the project success and therefore cooperation with...

Effect of chest compressions only during experimental basic life support on alveolar collapse and recruitment.

Science.gov (United States)

Markstaller, Klaus; Rudolph, Annette; Karmrodt, Jens; Gervais, Hendrik W; Goetz, Rolf; Becher, Anja; David, Matthias; Kempski, Oliver S; Kauczor, Hans-Ulrich; Dick, Wolfgang F; Eberle, Balthasar

2008-10-01

The importance of ventilatory support during cardiac arrest and basic life support is controversial. This experimental study used dynamic computed tomography (CT) to assess the effects of chest compressions only during cardiopulmonary resuscitation (CCO-CPR) on alveolar recruitment and haemodynamic parameters in porcine model of ventricular fibrillation. Twelve anaesthetized pigs (26+/-1 kg) were randomly assigned to one of the following groups: (1) intermittent positive pressure ventilation (IPPV) both during basic life support and advanced cardiac life support, or (2) CCO during basic life support and IPPV during advanced cardiac life support. Measurements were acquired at baseline prior to cardiac arrest, during basic life support, during advanced life support, and after return of spontaneous circulation (ROSC), as follows: dynamic CT series, arterial and central venous pressures, blood gases, and regional organ blood flow. The ventilated and atelectatic lung area was quantified from dynamic CT images. Differences between groups were analyzed using the Kruskal-Wallis test, and a pbasic life support in the CCO-CPR group remained clinically relevant throughout the subsequent advanced cardiac life support period and following ROSC, and was associated with prolonged impaired haemodynamics. No inter-group differences in myocardial and cerebral blood flow were observed. A lack of ventilation during basic life support is associated with excessive atelectasis, arterial hypoxaemia and compromised CPR haemodynamics. Moreover, these detrimental effects remain evident even after restoration of IPPV.

Sleep apnea termination decreases cerebral blood volume: a near-infrared spectroscopy case study

Science.gov (United States)

Virtanen, Jaakko; Noponen, Tommi; Salmi, Tapani; Toppila, Jussi; Meriläinen, Pekka

2009-07-01

Medical near-infrared spectroscopy (NIRS) can be used to estimate cerebral haemodynamic changes non-invasively. Sleep apnea is a common sleep disorder where repetitive pauses in breathing decrease the quality of sleep and exposes the individual to various health problems. We have measured oxygenated and deoxygenated haemoglobin concentration changes during apneic events in sleep from the forehead of one subject using NIRS and used principal component analysis to extract extracerebral and cortical haemodynamic changes from NIRS signals. Comparison of NIRS signals with EEG, bioimpedance, and pulse oximetry data suggests that termination of apnea leads to decreases in cerebral blood volume and flow that may be related to neurological arousal via neurovascular coupling.

Study of regional lung function with xenon 133

International Nuclear Information System (INIS)

Devaux, D.; Wagner, R.; Germain, M.; Chardon, G.

1975-01-01

Exploration of regional lung function includes study of the closed circuit perfusion and ventilation respectively by injection and inhalation of xenon 133. The radiation is measured across the chest using 4 fixed scintillation counters, placed opposite the subject's back, 2 per lung field. Theoretical regional values using 15 normal young subjects are determined. Three cases justified the practical interest of this method. The percentage of variation for the parameters studied was about 10%. The method proved very useful for the clinician to whom it provides a numerical assessment of regional ventilation and perfusion [fr

Increasing fill volume reduces cardiac performance in peritoneal dialysis

DEFF Research Database (Denmark)

Ivarsen, Per; Povlsen, Johan V; Jensen, Jens Dam

2007-01-01

BACKGROUND: It is generally accepted that peritoneal dialysis (PD) affects systemic haemodynamics less than haemodialysis, but little is known about changes in haemodynamics during PD. It is unknown if increasing PD volume causes changes in cardiovascular haemodynamics possibly increasing...

Haemodynamically Unstable Pelvic Fractures

Science.gov (United States)

2009-01-01

through the pubic symphysis, and posteriorlywith the sacrum forming the sacroiliac (SI) joints (Fig. 1). The SI joints are the strongest in the body...Gardner MJ, Kendoff D, Ostermeier S, et al. Sacroiliac joint compression using an anterior pelvic compressor: a mechanical study in synthetic bone. J

Regionalism in Services : A Study of ASEAN

OpenAIRE

Gootiiz, Batshur; Mattoo, Aaditya

2015-01-01

Can regionalism do what multilateralism has so far failed to do—promote greater openness of services markets? Although previous research has pointed to the wider and deeper legal commitments under regional agreements as proof that it can, no previous study has assessed the impact of such agreements on applied policies. This paper focuses on the Association of Southeast Asian Nations (ASEAN), where ...

Regional hydrogeological study in the Tono area

International Nuclear Information System (INIS)

Ogata, Nobuhisa; Ota, Kunio; Hama, Katsuhiro; Tsubota, Kouji

1998-01-01

Regional hydrogeological studies have been carried out since fiscal 1992 to determine the regional groundwater flow in the Tono area of Japan. The following items have been investigated: 1) Understanding the geological structure, groundwater flow and groundwater chemistry of the deep geological environment in the Tono area. 2) Constructing conceptual models of the geological structure, groundwater flow and groundwater chemistry. 3) Developing appropriate techniques to investigate the geological structure, groundwater flow and groundwater chemistry of the deep geological environment. This report presents the results of the last six years of the study in the Tono area. (author)

Interventional Radiology service provision and practice for the management of traumatic splenic injury across the Regional Trauma Networks of England.

Science.gov (United States)

Hughes, Jane; Scrimshire, Ashley; Steinberg, Laura; Yiannoullou, Petros; Newton, Katherine; Hall, Claire; Pearce, Lyndsay; Macdonald, Andrew

2017-05-01

The management of blunt splenic injuries (BSI) has evolved toward strategies that avoid splenectomy. There is growing adoption of interventional radiology (IR) techniques in non-operative management of BSI, with evidence suggesting a corresponding reduction in emergency laparotomy requirements and increased splenic preservation rates. Currently there are no UK national guidelines for the management of blunt splenic injury. This may lead to variations in management, despite the reorganisation of trauma services in England in 2012. A survey was distributed through the British Society of Interventional Radiologists to all UK members aiming to identify availability of IR services in England, radiologists' practice, and attitudes toward management of BSI. 116 responses from respondents working in 23 of the 26 Regional Trauma Networks in England were received. 79% provide a single dedicated IR service but over 50% cover more than one hospital within the network. All offer arterial embolisation for BSI. Only 25% follow guidelines. In haemodynamically stable patients, an increasing trend for embolisation was seen as grade of splenic injury increased from 1 to 4 (12.5%-82.14%, pSplenic embolisation is offered for a variety of injury grades, providing the patient remains stable. Variation in interventional radiology services remain despite the introduction of regional trauma networks. Copyright © 2017 Elsevier Ltd. All rights reserved.

Cardiovascular consequences of extreme prematurity: the EPICure study.

Science.gov (United States)

McEniery, Carmel M; Bolton, Charlotte E; Fawke, Joseph; Hennessy, Enid; Stocks, Janet; Wilkinson, Ian B; Cockcroft, John R; Marlow, Neil

2011-07-01

The long-term consequences of extreme prematurity are becoming increasingly important, given recent improvements in neonatal intensive care. The aim of the current study was to examine the cardiovascular consequences of extreme prematurity in 11-year-olds born at or before 25 completed weeks of gestation. Age and sex-matched classmates were recruited as controls. Information concerning perinatal and maternal history was collected, and current anthropometric characteristics were measured in 219 children born extremely preterm and 153 classmates. A subset of the extremely preterm children (n = 68) and classmates (n = 90) then underwent detailed haemodynamic investigations, including measurement of supine blood pressure (BP), aortic pulse wave velocity (aPWV, a measure of aortic stiffness) and augmentation index (AIx, a measure of arterial pressure wave reflections). Seated brachial systolic and diastolic BP were not different between extremely preterm children and classmates (P = 0.3 for both), although there was a small, significant elevation in supine mean and diastolic BP in the extremely preterm children (P prematurity is associated with altered arterial haemodynamics in children, not evident from the examination of brachial BP alone. Moreover, the smaller, preresistance and resistance vessels rather than large elastic arteries appear to be most affected. Children born extremely preterm may be at increased future cardiovascular risk.

Regional Novels in the Study of Rural Education.

Science.gov (United States)

Peters, Dianne S.

1983-01-01

Contrasts and compares historical research on rural and Native American education and regional novels ("To Kill a Mockingbird" and "Laughing Boy") in order to demonstrate the importance of diversity in the concept of rurality. Suggests regional novels are an important component in the study of rural education. (AH)

Observational study of choice of anaesthesia and outcome in ...

African Journals Online (AJOL)

Southern African Journal of Anaesthesia and Analgesia ... of anaesthetic that was administered was determined and compared for maternal intraoperative haemodynamic changes and maternal and neonatal outcomes. ... Neonatal morbidity and mortality occurred in 33.3% of GA and in 10.3% of spinal anaesthesia cases.

Prognostic variables in patients with cirrhosis and oesophageal varices without prior bleeding

DEFF Research Database (Denmark)

Møller, Søren; Bendtsen, Flemming; Christensen, E

1994-01-01

As identification of patients at risk of bleeding or death is essential for prophylaxis, we determined the prognostic influence of various patient characteristics on the risk of bleeding and death. Fifty-five patients with cirrhosis and oesophageal varices without previous bleeding were included...... in the study and followed up after an average observation period of 446 days (range: 5-1211 days). A total of 55 clinical, biochemical, haemodynamic, and endoscopic variables were classified as systemic haemodynamic, portal haemodynamic, or metabolic. Using univariate analysis, the following variables showed....... The prognostic significance of central circulation time stresses the importance of the hyperdynamic systemic circulation in assessing the increased risk of bleeding or death.(ABSTRACT TRUNCATED AT 250 WORDS)...

The regional approach and regional studies method in the process of geography teaching

Science.gov (United States)

Dermendzhieva, Stela; Doikov, Martin

2017-03-01

We define the regional approach as a manner of relations among the global trends of development of the "Society-man-nature" system and the local differentiating level of knowledge. Conditionally, interactions interlace under the influence of the character of Geography as a science, education, approaches, goals and teaching methods. Global, national and local development differentiates in three concentric circles at the level of knowledge. It is determined as a conception of modern, complex and effective mechanism for young people, through which knowledge develops in regional historical and cultural perspective; self-consciousness for socio-economic and cultural integration is formed as a part of the. historical-geographical image of the native land. This way an attitude to the. native land is formed as a connecting construct between patriotism to the motherland and the same in global aspect. The possibility for integration and cooperation of the educative geographical content with all the local historical-geographical, regional, profession orientating, artistic, municipal and district institutions, is outlined. Contemporary geographical education appears to be a powerful and indispensable mechanism for organization of human sciences, while the regional approach and the application of the regional studies method stimulate and motivate the development and realization of optimal capacities for direct connection with the local structures and environments.

California Migrant Student Movement Study--Region 3 Analysis.

Science.gov (United States)

Davis, Benjamin G.

The five counties of Madera, Merced, Contra Costa, San Joaquin and Stanislaus constitute Region 3 of the California Migrant Education Program. A study to evaluate movement patterns of migrant students from, to and within the state was conducted using data from the Migrant Student Record Transfer System. It indicates that in 1977 Region 3 ranked…

Ten good reasons why everybody can and should perform cardiac ultrasound in the ICU.

Science.gov (United States)

Charron, Cyril; Repessé, Xavier; Bodson, Laurent; Au, Siu-Ming; Vieillard-Baron, Antoine

2014-01-01

Critical care ultrasonography (CCUS) has been defined as an ultrasound evaluation of the heart, abdomen, pleura and lungs at the bedside by the intensivist, 24/7. Within CCUS, critical care echocardiography (CCE) is used to assess cardiac function and more generally haemodynamics. Experts in haemodynamics have published a 'consensus of 16' regarding an update on haemodynamic monitoring. They reported the ten key properties of an 'ideal' haemodynamic monitoring system, which perfectly match the ten good reasons we describe here for performing CCE in critically ill patients. Even though unfortunately no evidence-based medicine study is available to support this review, especially regarding CCE-related improvement of outcome, many clinical studies have demonstrated that CCE provides measurements of relevant, accurate, reproducible and interpretable variables, is easy to use, readily available, has a rapid response time, causes no harm, and is cost-effective. Whether it is operator-independent is obviously more debatable and is discussed in this review. All these characteristics are arguments for the extensive use of CCE by intensivists. This is why experts in the field have recommended that a basic level of CCE should be included in the training of all intensivists.

Mord studies in IR region by new dispersion relation

International Nuclear Information System (INIS)

Murthy, V.R.; Kumar, R. Jeevan

1994-01-01

This is the continuation of the series reporting MORD studies to typical problem in Chemistry and Polymer Science. In our earlier papers the MORDsup1.2 studied only in visible region. In this present investigation we extended the application of the New Dispersion Relation in IR region to determine the MORD and tested to some simple systems

Hydrogeology of rocks of low permeability: region studies

International Nuclear Information System (INIS)

Llamas, M.R.

1985-01-01

Hydrogeological regional studies on low permeability rocks are rather scarce in comparison to similar studies on normal permeability rocks. Economic and technological difficulties to develop ground water from these terrains may be the main cause of this scarcity. Several facts may indicate that these studies will increase in the near future. First, the need to supply water to the people living in underdeveloped arid zones over extensive areas of low permeability rocks. Second, the relevant role that some low permeability large groundwater basins may play in conjunctive ground and surface-water use. And last but not least the feasibility of some low permeability rock areas as sites for nuclear waste repositories. Some specific difficulties in these regional studies may be: a) intrinsic difficulties in obtaining representative water samples and measuring hydraulic heads; b) scarcity of observation and/or pumping wells; c) important hydraulic head and chemical properties variations in a vertical direction; d) old groundwater ages; this may require paleohydrological considerations to understand certain apparent anomalies. In most of these regional studies hydrogeochemical methods and modelling (flow and mass transport) may be very valuable tools. 77 references, 7 figures

A COMPARATIVE STUDY OF PREEMPTIVE USE OF 0.2% ROPIVACAINE AND 0.125% BUPIVACAINE ALONG WITH FENTANYL AND FENTANYL INCREMENTS TO PROVIDE POSTOPERATIVE EPIDURAL ANALGESIA UP TO 24 HOURS

Directory of Open Access Journals (Sweden)

Chiranji Lal Khedia

2016-06-01

Full Text Available BACKGROUND AND OBJECTIVES The present study was carried out to compare duration of analgesia, haemodynamic changes (Systolic and Diastolic Blood Pressure, Pulse Rate, Respiratory Rate, total incremental doses of epidural fentanyl required to maintain VAS 3 up to 24 hours in each group and total required incremental fentanyl doses were compared between both the groups. Once the data were collected from all the patients, they were compared using, chi-square test, two sample t-test. The p-value was calculated and P <0.05 was considered statistically significant. RESULTS The duration of analgesia was more with Group BF (245+17.58 min. than Group RF (217.6+22.41 min., thus it is concluded that difference in duration of analgesia was statistically significant between the groups (P<0.05. In this study, it was noticed that patients of Group RF required much more incremental doses of epidural fentanyl (218+31.88 μg to maintain VAS<3 up to 24 hours than group BF (170+32.27 μg, and difference was statistically significant (P<0.05. Haemodynamic parameters like SBP, DBP, HR and RR were comparable in both the groups. Hypotension and bradycardia were noted in two patients of group BF. CONCLUSION Duration of analgesia was longer and comparatively better in group BF and less incremental doses were required to maintain VAS <3 up to 24 hours as compared to group RF, but haemodynamic stability was more in group RF as compared to group BF.

Perfusion study in the pulmonary hilar region by SPECT

International Nuclear Information System (INIS)

Satoh, Katashi; Tanabe, Masatada; Kawase, Yoshiro

1990-01-01

Alveoli in the hilar region comprise the peripheral area containing daughter branches from subsegmental or one more divisional peripheral bronchi. Pulmonary perfusion in hilar region was examined by SPECT (single photon emission CT) in ten normal volunteers. ROI (region of interest) in the axial images were set in the hilar region, the upper, middle and lower lung fields with 10.8 mm thickness. Counts/one pixel (C/P) were calculated in these ROI. There was a tendency of C/P increase from upper to lower lung field. And there were no significant differences in C/P increase between hilar region and other axial fields. In the chronic obstructive pulmonary diseases, however, ventilation studies in the previous reports using Xe dynamic CT or PET (positron emission tomography) showed differences between outer region and hilar region. This method will be expected to evaluate the pulmonary perfusion not only in the whole lung but in different lung areas, including the hilar region in the chronic obstructive pulmonary diseases. (author)

[Current status of noninvasive hemodynamics in hypertension].

Science.gov (United States)

Waisman, G

Hypertension is a haemodynamic disorder resulting from a persistent mismatch between cardiac output and peripheral resistance. Hypertension undergoes haemodynamic progression during its natural history. Impedance cardiography is a method of evaluating the cardiovascular system that obtains haemodynamic information from beat to beat through the analysis of variations in the impedance of the thorax on the passage of an electric current. Impedance cardiography unmasks the haemodynamic deterioration underlying the increase in blood pressure as age and systolic blood pressure increases. This method may help to improve blood pressure control through individualized treatment with reduction of peripheral resistance, maintenance of cardiac output or its increase, improvement of arterial compliance and preservation of organ-tissue perfusion. It is useful in the management of patients with resistant hypertension, since a greater percentage of patients controlled with changes in the treatment in relation to the haemodynamic measurements are obtained. Impedance cardiography is important and has prognostic utility in relation to a haemodynamic deterioration pattern and increased cardiovascular events. Copyright © 2017 SEH-LELHA. Publicado por Elsevier España, S.L.U. All rights reserved.

Clinical and echocardiographic assessment of the Medtronic Advantage aortic valve prosthesis: the Scandinavian multicentre, prospective study

DEFF Research Database (Denmark)

Haaverstad, Rune; Vitale, Nicola; Karevold, Asbjørn

2006-01-01

OBJECTIVE: The aim of this report is the prospective, multicentre evaluation of clinical results and haemodynamic performance of the Medtronic Advantage aortic valve prosthesis. METHODS: From April 2001 to June 2003, 166 patients (male:female 125:41; mean (SD) age 61.8 (11.8) years) received...... an aortic advantage valve prosthesis. Complete cumulative follow-up was 242.7 patient-years (maximum 3.2; mean 1.6 years). Postoperatively, patients underwent early (within 30 days) and 1 year transthoracic echocardiography. RESULTS: 30 day mortality was 2.4% (n = 4). Kaplan-Meier estimates of freedom from...... echocardiography. CONCLUSIONS: Haemodynamic performance and early clinical results of Medtronic advantage in the aortic position were satisfactory and comparable with those of other bileaflet valves in current clinical use....

Effect of interval training on cognitive functioning and cerebral oxygenation in obese patients: a pilot study.

Science.gov (United States)

Drigny, Joffrey; Gremeaux, Vincent; Dupuy, Olivier; Gayda, Mathieu; Bherer, Louis; Juneau, Martin; Nigam, Anil

2014-11-01

To assess the effect of a 4-month high-intensity interval training programme on cognitive functioning, cerebral oxygenation, central haemodynamic and cardiometabolic parameters and aerobic capacity in obese patients. Cognitive functioning, cerebral oxygenation, central haemodynamic, cardiometabolic and exercise para-meters were measured before and after a 4-month high-intensity interval training programme in 6 obese patients (mean age 49 years (standard deviation 8), fat mass percentage 31 ± 7%). Body composition (body mass, total and trunk fat mass, waist circumference) and fasting insulin were improved after the programme (p attention and processing speed, was significantly improved after training (p training (p training programme in obese patients improved both cognitive functioning and cere-bral oxygen extraction, in association with improved exercise capacity and body composition.

Regional and detailed research studies for stone resources in Korea

Energy Technology Data Exchange (ETDEWEB)

NONE

1996-12-01

This report consists of 7 articles. 1) Detail drilling research works on granodiorite stock of Cheanan area near Onyang city in Chungnam province. 2) Regional research studies on granites distributed in Kimje - Jeongeup. 3) Regional survey and feasibility study on diorite rock mass in Kohyeng, Cheonnam province. 4) Regional research study on the stone resources of Hamyang area. 5) A study on variation trends of physical properties of 5 kinds of building stone by means of Weather-Ometer experiment. 6) Borehole radar survey at the granodiorite quarry mine, Cheonan, Chungnam province. 7) Radar velocity tomography in anisotropic media. (author). refs., tabs., figs.

Behandling af svaer hypovolaemi med hypertont saltvand

DEFF Research Database (Denmark)

Rask, H; Nielsen, S L; Crawford, M E

1996-01-01

of hypovolaemia HS instantaneously expands plasma volume and improves central haemodynamics through increased filling pressures and direct myocardial stimulation. HS, as compared to isotonic fluids, causes precapillary vasodilation, reduction of cell oedema and decreased haematocrit and hence improves regional...... and capillary perfusion. Furthermore HS-infusion has been shown to attenuate reperfusion injury and restore cell function in cells damaged during hypovolaemic shock. Animal experiments as well as clinical studies on the use of HS are reviewed. A short description of the pathophysiology of acute hypovolaemic...

Morphological study of maxillary canine region based on CT

International Nuclear Information System (INIS)

Yamada, Maiko; Takamori, Hitoshi; Ide, Yoshiaki; Yosue, Takashi

2010-01-01

The maxilla is generally known as a site where anatomical limitations make it difficult to obtain sufficient bone volume. A large amount of bone exists in the canine region between the anterior margin of the maxillary sinus and the piriform aperture margin. Although this region is crucial for implant treatments, there have not been any reports on morphological studies of the region. In this study, we investigated the morphology of the canine region based on CT, and also the morphology and position of the maxillary sinus located posterior to the canine region. The results were as follows: In the area above the anterior nasal spine, the higher the level, the smaller the mesio-distal length and the bucco-lingual width tended to become. In the area above the anterior nasal spine, the mesio-distal length and the bucco-lingual width tended to be smaller in female patients than in male patients. In the area above the anterior nasal spine, no significant differences in mesio-distal length and bucco-lingual width were observed between dentulous and edentulous jaws. The morphology of the maxillary sinus was mainly of an inverse-trapezoidal, circular, or triangular form. The position of the anterior wall of the maxillary sinus was most frequently found at the site corresponding to the second premolar. Through this study, we have reconfirmed that the canine region is vital for implant treatments in the maxilla. (author)

Haemodynamic Performance of Low Strength Below Knee Graduated Elastic Compression Stockings in Health, Venous Disease, and Lymphoedema.

Science.gov (United States)

Lattimer, C R; Kalodiki, E; Azzam, M; Geroulakos, G

2016-07-01

To test the in vivo haemodynamic performance of graduated elastic compression (GEC) stockings using air-plethysmography (APG) in healthy volunteers (controls) and patients with varicose veins (VVs), post-thrombotic syndrome (PTS), or lymphoedema. Responsiveness data were used to determine which group benefited the most from GEC. There were 12 patients per group compared using no compression, knee-length Class 1 (18-21 mmHg) compression, and Class 2 (23-32 mmHg) compression. Stocking/leg interface pressures (mmHg) were measured supine in two places using an air-sensor transducer. Stocking performance parameters, investigated before and after GEC, included the standard APG tests (working venous volume [wVV], venous filling index [VFI], venous drainage index [VDI], ejection fraction [EF]) and the occlusion plethysmography tests (incremental pressure causing the maximal increase in calf volume [IPMIV], outflow fraction [OF]). Results were expressed as median and interquartile range. Significant graduated compression was achieved in all four groups with higher interface pressures at the ankle. Only the VVs patients had a significant reduction in their wVV (without: 133 [109-146] vs. class1: 93 [74-113] mL) and the VFI (without: 4.6 [3-7.1] vs. class1: 3.1 [1.9-5] mL/s), both at p <.05. The IPMIV improved significantly in all groups except in the PTS group (p <.05). The OF improved only in the controls (without: 43 [38-51] vs. class1: 50 [48-53] %) and the VVs patients (without: 47 [39-58] vs. class1: 56 [50-64] %), both at p <.05. There were no significant differences in the VDI or the EF with GEC. Compression dose-response relationships were not observed. Patients with varicose veins improved the most, whereas those with PTS improved the least. Performance seemed to depend more on disease pathophysiology than compression strength. However, the lack of responsiveness to compression strength may be related to the low external pressures used. Stocking performance tests

Thermophysical Properties of the Phoenix Mars Landing Site Study Regions

Science.gov (United States)

Putzig, N. E.; Mellon, M. T.; Golombek, M. P.; Arvidson, R. E.

2006-03-01

Analysis of Phoenix Mars study regions places 4 of 5 in a previously-identified duricrust-dominated thermophysical unit which also contains the Viking and Spirit landing sites. Extrapolation of lander-observed properties to the study regions may be complicated by surface heterogeneity.

Brain activity underlying the recovery of meaning from degraded speech: A functional near-infrared spectroscopy (fNIRS) study.

Science.gov (United States)

Wijayasiri, Pramudi; Hartley, Douglas E H; Wiggins, Ian M

2017-08-01

The purpose of this study was to establish whether functional near-infrared spectroscopy (fNIRS), an emerging brain-imaging technique based on optical principles, is suitable for studying the brain activity that underlies effortful listening. In an event-related fNIRS experiment, normally-hearing adults listened to sentences that were either clear or degraded (noise vocoded). These sentences were presented simultaneously with a non-speech distractor, and on each trial participants were instructed to attend either to the speech or to the distractor. The primary region of interest for the fNIRS measurements was the left inferior frontal gyrus (LIFG), a cortical region involved in higher-order language processing. The fNIRS results confirmed findings previously reported in the functional magnetic resonance imaging (fMRI) literature. Firstly, the LIFG exhibited an elevated response to degraded versus clear speech, but only when attention was directed towards the speech. This attention-dependent increase in frontal brain activation may be a neural marker for effortful listening. Secondly, during attentive listening to degraded speech, the haemodynamic response peaked significantly later in the LIFG than in superior temporal cortex, possibly reflecting the engagement of working memory to help reconstruct the meaning of degraded sentences. The homologous region in the right hemisphere may play an equivalent role to the LIFG in some left-handed individuals. In conclusion, fNIRS holds promise as a flexible tool to examine the neural signature of effortful listening. Copyright © 2017 Elsevier B.V. All rights reserved.

Regions for Servicing Old People: Case study of Slovenia

Directory of Open Access Journals (Sweden)

Drobne Samo

2014-09-01

Full Text Available Background: Aging is one of the most serious problems that most developed countries are facing in the 21st century. In the European Union, Member States are responsible for the planning, funding and administration of health care and social protection systems. Local authorities and state governments should undertake research toward developing an appropriate array of community-based care services for old people. Objectives: This study analyses the regions of Slovenia for servicing old people in the 2000-2010 time horizon. Methods/Approach: Sets of functional regions were modelled for each year in the analysed period using the Intramax method. Functional regions were evaluated based on the attractiveness of central places for labour commuters and the propensity to commute between regions. Results: The results show that in addition to the nominally declared regional centres of Slovenia, there are also some other local centres that should be potentially included in the functional areas for servicing old people. Conclusions: The results suggest that the regionalization into seven functional regions is the most convenient for servicing old people in the region. Furthermore, some additional functional regions at a lower level are suggested.

REGIONAL CLIMATE MODELING STUDY FOR THE CARPATHIAN REGION USING REGCM4 EXPERIMENTS

Directory of Open Access Journals (Sweden)

PIECZKA I.

2015-03-01

Full Text Available The newest model version of RegCM is adapted with the ultimate aim of providing climate projection for the Carpathian region with 10 km horizontal resolution. For this purpose, first, coarse resolution reanalysis data and global climate model outputs are used to drive 50 km resolution model experiments, from which the outputs are used to provide necessary boundary conditions for the fine scale model runs. Besides the historical runs (for the period 1981-2010, RCP4.5 scenario is also analyzed in this paper for the 21st century. These experiments are essential since they form the basis of national climate and adaptation strategies by providing detailed regional scale climatic projections and enabling specific impact studies for various sectors.

A qualitative study of regional anaesthesia for vitreo-retinal surgery.

Science.gov (United States)

McCloud, Christine; Harrington, Ann; King, Lindy

2014-05-01

The aim of this research was to collect experiential knowledge about regional ocular anaesthesia - an integral component of most vitreo-retinal surgery. Anaesthesia for vitreo-retinal surgery has predominantly used general anaesthesia, because of the length and complexity of the surgical procedure. However, recent advances in surgical instrumentation and techniques have reduced surgical times; this decision has led to the adoption of regional ocular anaesthesia for vitreo-retinal day surgery. Although regional ocular anaesthesia has been studied from several perspectives, knowledge about patients' experience of the procedure is limited. An interpretive qualitative research methodology underpinned by Gadamer's philosophical hermeneutics. Eighteen participants were interviewed in-depth between July 2006-December 2007 following regional ocular anaesthesia. Interview data were thematically analysed by coding and grouping concepts. Four themes were identified: 'not knowing': the time prior to the experience of a regional eye block; 'experiencing': the experience of regional ocular anaesthesia; 'enduring': the capacity participants displayed to endure regional ocular anaesthesia with the hope that their vision would be restored; and 'knowing': when further surgery was required and past experiences were recalled. The experience of regional ocular anaesthesia had the capacity to invoke anxiety in the participants in this study. Many found the experience overwhelming and painful. What became clear was the participant's capacity to stoically 'endure' regional ocular anaesthesia, indicating the value people placed on visual function. © 2013 John Wiley & Sons Ltd.

Future prospects for studies in the VUV-SX region

International Nuclear Information System (INIS)

Tanaka, Kenichiro; Kitajima, Yoshinori

1989-09-01

This book carries papers presented at a workshop 'Future Prospects for Studies in the VUV-SX Region' held on March 22 and 23, 1989. The workshop focussed particularly on the promotion of research in the VUV and soft X-ray regions. Three sessions were held: Session 1 for studies in peripheral areas, Session 2 for theoretical studies, and Session 3 for recent developments. Session 1 covered five studies: 'Laser Spectroscopy: High-Resolution Observation of Highly Electronically Excited Gaseous Molecule', 'High-Resolution Electron Spectroscopy: Surface Phonon Spectroscopy', 'Experimental Study on Atoms and Molecules through Ion Trap', 'Basic Mechanism of Photo-Induced CVD', and 'Application of Circularly Polarized Light'. Session 2 covered five studies: 'Electronic State of High Tc Superconducting Oxide', 'Surface Condition and Electronic State', 'XES and XAS Study of Rare Earth Compound', 'Resonance Photoelectric Spectroscopy on Strongly Correlated Electronic System', and 'Circularly Polarized Light and Atomic Process in Soft X-Ray Region'. Session 3 covered six studies: 'Prospects of Application of Supercritical Liquid to Research on Physical Characteristics', 'Application of Orbit Radiation to Polarization Spectroscopy', 'XES Research for La Compounds', 'Characteristics of Ultra-Fine Particles', 'Surface Study by Angular-Resolution Photoelectric Spectroscopy', and 'EXAFS Study of Light Element'. (N.K.)

Regional South Australia Health (RESONATE) survey: study protocol

Science.gov (United States)

Jones, Martin; Gillam, Marianne; May, Esther

2018-01-01

Introduction Access to quality healthcare services is considered a moral right. However, for people living in regional locations, timely access to the services that they need may not always be possible because of structural and attitudinal barriers. This suggests that people living in regional areas may have unmet healthcare needs. The aim of this research will be to examine the healthcare needs, expectations and experiences of regional South Australians. Methods and analysis The Regional South Australia Health (RESONATE) survey is a cross-sectional study of adult health consumers living in any private or non-private dwelling, in any regional, rural, remote or very remote area of South Australia and with an understanding of written English. Data will be collected using a 45-item, multidimensional, self-administered instrument, designed to measure healthcare need, barriers to healthcare access and health service utilisation, attitudes, experiences and satisfaction. The instrument has demonstrated acceptable psychometric properties, including good content validity and internal reliability, good test–retest reliability and a high level of acceptability. The survey will be administered online and in hard-copy, with at least 1832 survey participants to be recruited over a 12-month period, using a comprehensive, multimodal recruitment campaign. Ethics and dissemination The study has been reviewed and approved by the Human Research Ethics Committee of the University of South Australia. The results will be actively disseminated through peer-reviewed journals, conference presentations, social media, broadcast media, print media, the internet and various community/stakeholder engagement activities. PMID:29654014

Regional Studies Program annual report, January 1 through December 31, 1976

International Nuclear Information System (INIS)

Davis, R.M.; Parzyck, D.C.; Bjornstad, D.J.; Honea, R.B.; Loebl, A.S.; Peelle, E.

1977-08-01

In 1976 the Regional Studies Program focused its attention on the analysis of national and regional effects of energy development and use. The major goal of this work has been to carry out comprehensive regional assessments to identify and evaluate potential environmental, social, and economic effects of energy resource development and use, including the effects of alternative energy technologies. This report presents the results of the assessments completed or under way in 1976, including a discussion of the environmental, social, and economic techniques and methods under development for use in future regional assessments. The report is organized and presented by the four research groups that participate in the Regional Studies Program

A Study of Some Rostrofacial Indices Related to Regional ...

African Journals Online (AJOL)

With increasing use of the porcine species as experimental models for improvement of human dental implants, this work will further aid the knowledge of the regional anaesthesia of this species in dental implant studies and could be of value in the surgical intervention of priced animals. Keywords: Rostrofacial, Regional ...

Computer mapping as an aid in air-pollution studies: Montreal region study

Energy Technology Data Exchange (ETDEWEB)

Granger, J M

1972-01-01

Through the use of computer-mapping programs, an operational technique has been designed which allows an almost-instant appraisal of the intensity of atmospheric pollution in an urban region on the basis of epiphytic sensitivity. The epiphytes considered are essentially lichens and mosses growing on trees. This study was applied to the Montreal region, with 349 samplings statiions distributed nearly uniformly. Computer graphics of the findings are included in the appendix.

Functional neuroimaging studies of prospective memory: what have we learnt so far?

Science.gov (United States)

Burgess, Paul W; Gonen-Yaacovi, Gil; Volle, Emmanuelle

2011-07-01

The complexity of the behaviour described by the term "prospective memory" meant that it was not at all clear, when the earliest studies were conducted, that this would prove a fruitful area for neuroimaging study. However, a consistent relation rapidly emerged between activation in rostral prefrontal cortex (approximating Brodmann Area 10) and performance of prospective memory paradigms. This consistency has greatly increased the accumulation of findings, since each study has offered perspectives on the previous ones. Considerable help too has come from broad agreement between functional neuroimaging findings and those from other methods (e.g. human lesion studies, electrophysiology). The result has been a quite startling degree of advance given the relatively few studies that have been conducted. These findings are summarised, along with those from other brain regions, and new directions suggested. Key points are that there is a medial-lateral dissociation within rostral PFC. Some (but not all) regions of medial rostral PFC are typically more active during performance of the ongoing task only, and lateral aspects are relatively more active during conditions involving delayed intentions. Some of these rostral PFC activations seem remarkably insensitive to the form of stimulus material presented, the nature of the ongoing task, the specifics of the intention, how easy or hard the PM cue is to detect, or the intended action is to recall. However there are other regions within rostral PFC where haemodynamic changes vary with alterations in these, and other, aspects of prospective memory paradigms. It is concluded that rostral PFC most likely plays a super-ordinate role during many stages of creating, maintaining and enacting delayed intentions, which in some cases may be linked to recent evidence showing that this brain region is involved in the control of stimulus-oriented vs. stimulus-independent attending. Other key brain regions activated during prospective

Fluid loading and norepinephrine infusion mask the left ventricular preload decrease induced by pleural effusion

DEFF Research Database (Denmark)

Wemmelund, Kristian Borup; Ringgård, Viktor Kromann; Vistisen, Simon Tilma

2017-01-01

BACKGROUND: Pleural effusion (PLE) may lead to low blood pressure and reduced cardiac output. Low blood pressure and reduced cardiac output are often treated with fluid loading and vasopressors. This study aimed to determine the impact of fluid loading and norepinephrine infusion on physiologic d...... global haemodynamic parameters. Inferior vena cava distensibility remained unchanged. The haemodynamic significance of PLE may be underestimated during fluid or norepinephrine administration, potentially masking the presence of PLE....

Cardiac and renal effects of a transjugular intrahepatic portosystemic shunt in cirrhosis

DEFF Research Database (Denmark)

Busk, Troels M; Bendtsen, Flemming; Møller, Søren

2013-01-01

Refractory ascites and recurrent variceal bleeding are among the serious complications of portal hypertension and cirrhosis for which a transjugular intrahepatic portosystemic shunt (TIPS) can be used. Cirrhotic patients have varying degrees of haemodynamic derangement, mainly characterized...... to improve in patients with the hepatorenal syndrome. The clinical and haemodynamic effects of TIPS have been studied intensively and will be reviewed in the present paper. Considerable knowledge on the effects of TIPS on the pathophysiology of cirrhosis has been gained, but studies on the central...

Abnormalities by pulmonary regions studied with computer tomography following local or local-regional radiotherapy for breast cancer

International Nuclear Information System (INIS)

Lind, Pehr; Svane, Gunilla; Gagliardi, Giovanna; Svensson, Christer

1999-01-01

Purpose: To study pulmonary radiological abnormalities with computer tomography (CT) following different radiotherapy (RT) techniques for breast cancer with respect to regions and density, and their correlation to pulmonary complications and reduction in vital capacity (VC). Methods and Materials: CT scans of the lungs were performed prior to and 4 months following RT in 105 breast cancer patients treated with local or local-regional RT. The radiological abnormalities were analyzed with a CT-adapted modification of a classification system originally proposed by Arriagada, and scored according to increasing density (0-3) and affected lung regions (apical-lateral, central-parahilar, basal-lateral). The highest density grade in each region were added together to form scores ranging from 0-9. The patients were monitored for RT-induced pulmonary complications. VC was measured prior to and 5 months following RT. Results: Increasing CT scores were correlated with both local-regional RT and pulmonary complications (p < 0.001). The mean reduction of VC for patients scoring 4-9 (-202 ml) was larger than for patients scoring 0-3 (-2 ml) (p = 0.035). The effect of confounding factors on the radiological scoring was tested in the local-regional RT group. Scores of 4-9 were less frequently seen in the patients who had received adjuvant chemotherapy prior to RT. The importance of the respective lung regions on the outcome of pulmonary complications was tested. Only radiological abnormalities in the central-parahilar and apical-lateral regions were significantly correlated to pulmonary complications. Discussion: Radiological abnormalities detected on CT images and scored with a modification of Arriagada's classification system can be used as an objective endpoint for pulmonary side effects in breast cancer. The described model should, however, be expanded with information about the volume of lung affected in each region before definite conclusions can be drawn concerning each

Study of regional pulmonary gas exchange using radiotracers

International Nuclear Information System (INIS)

Hichwa, R.D.

1981-01-01

Respiration involves the exchange of gases between the environment and the blood across the alveolar membrane. Four processes characterize the dynamics of gas exchange: ventilation, diffusion, perfusion and chemical binding with hemoglobin. A study was undertaken to investigate each of these processes, utilizing accelerator production and high yield synthesis of four gaseous radiotracers (/sup 81m/Kr, Ch 3 18 F, 11 CO, 15 O 2 ). Conventional gamma camera images and ancillary physiological data were acquired. Mathematical models were developed to predict the tracer clearance from the lungs during a breath hold and during washout post breath hold. Images of the insoluble /sup 81m/Kr synchronized with the tidal breathing maneuver depict regional ventilation. Tracer bolus inhalation, relative compliance and regional phase information are obtained from krypton dCynamic studies. More soluble CH 3 18 F is used to determine regional pulmonary perfusion during a breath hold. Respiratory clearance of seven, inert, positron-emitting radiotracers define the tracer volume of distribution. The tight-binding of 11 CO to hemoglobin permits the regional measurement of carbon monoxide pulmonary diffusion capacity. A relative CO blood:gas partition coefficient is calculated from the washout of no-carrier-added levels of 11 CO and verified by in vitro radiometric measurements. Regional oxygen pulmonary diffusion capacity determined from 15 O 2 clearance during a breath hold reveals results similar to those obtained with CO. All experimental data are in good agreement with the predictions of a two-compartment open model. A more advanced oxygen model is presented that incorporates radioactive oxygen exchange with stable oxygen on the hemoglobin molecule and metabolic removal of the tracer at the tissues

New York - New Jersey Highlands Regional Study: 2002 Update

Science.gov (United States)

Northeastern Area State and Private Forestry

2003-01-01

Stewardship Goals For The New York - New Jersey Highlands This 2002 Update of the 1992 New York - New Jersey Highlands Regional Study embodies the following goals for the long-term stewardship of the Highlands: 1. Manage future growth that is compatible with the region's ecological constraints; 2. Maintain an adequate surface and ground water supply that...

Cerebral haemodynamic and metabolic changes in carotid artery occlusion: a PET study

International Nuclear Information System (INIS)

Samson, Y.; Loc'h, C.; Ottaviani, M.; Baron, J.C.; Bousser, M.

1984-09-01

Using the positron emission tomography, with the O 15 inhalation technique, the cerebral blood flow (CBF), the oxygen extraction fraction (OEF) and the cerebral metabolic rate of oxygen (CMRO 2 ) were studied in 37 patients with internal carotid artery (ICA) occlusion. In the territory of the occluded ICA, two pattern of focal anomaly have been observed: a CBF decrease with a ''compensatory'' OEF increase or a matched CBF and CMRO 2 decrease. On the other hand, as compared to age matched control values, CMRO 2 is significantly decreased in the territory of the occluded carotid only in patients with extensive neck vessels obstructive disease

The effects of background noise on dichotic listening to consonant-vowel syllables: An fMRI study.

Science.gov (United States)

Dos Santos Sequeira, Sarah; Specht, Karsten; Moosmann, Matthias; Westerhausen, Rene; Hugdahl, Kenneth

2010-11-01

The present fMRI study attempts to identify brain areas that may underlie the effect of different background noises on functional brain asymmetry in a dichotic listening task. Previous studies have shown that the prominent right ear advantage in dichotic listening to consonant-vowel syllables is affected by background noise. To explore the underlying neuronal processes, haemodynamic brain responses using fMRI were recorded while participants performed the dichotic listening task in two different noisy backgrounds (conversational "babble" and traffic noise). The behavioural results showed a reduction of the right ear advantage in the background noise conditions, especially in the traffic noise condition. The behavioural results are discussed in terms of alertness-attentional mechanisms. The effects of background noise on brain activation involved significant activations in a speech-processing network. Specifically the changes in activations in the peri-Sylvian region of the superior temporal gyrus and in the temporo-parietal junction part in the left hemisphere, as well as in the superior temporal gyrus/sulcus area in the right hemisphere may mirror the effects of noise on behavioural performance. The effects of noise on brain activation are discussed with regard to pre-activation mechanisms.

Konference European Studies: between Globalisation and Regionalism

Czech Academy of Sciences Publication Activity Database

Laštovková, Jitka

2006-01-01

Roč. 42, č. 5 (2006), s. 1009-1010 ISSN 0038-0288. [European Studies: between Globalisation and Regionalism. Šiauliai, 12.05.2006-03.05.2006] Institutional research plan: CEZ:AV0Z70280505 Keywords : conference * European identitiy * globalization Subject RIV: AO - Sociology, Demography Impact factor: 0.128, year: 2006

Prospective regional studies: The Rhine Meuse study and the Tennessee Valley study

International Nuclear Information System (INIS)

Bayer, A.

1980-01-01

Within the scope of this report two regional studies are presented: - the 'Rhein-Maas-Study' within which the expected radiological impact of the population in the Rhein and Maas basin - which is situated within Central Europe - is assessed on the basis of the planned and forecasted development of nuclear energy in the coming decades. - The 'Tennessee Valley Study' within which the expected radiological impact of the population in the Tennessee-Cumberland basis - which is situated within North America - is assessed likewise on the basis of the planned and forecasted development of nuclear energy in the coming decades. (orig./RW)

Tono regional hydrogeological study project. Annual report 2004

International Nuclear Information System (INIS)

Iwatsuki, Teruki; Ota, Kunio; Takeuchi, Shinji; Amano, Kenji; Takeuchi, Ryuji; Saegusa, Hiromitsu; Osawa, Hideaki

2005-09-01

Tono Geoscience Center, Japan Nuclear Cycle Development Institute has been conducting a wide range of geoscientific research in order to build firm scientific and technological basis for the research and development of geological disposal. One of the geoscientific research programme is a Regional Hydrogeological Study (RHS) project in the Tono region, central Japan. This report mainly summarizes the results of research in DH-14 and DH-15 boreholes at Toki city and Mizunami city in fiscal year 2004 which were carried out to support and improve the results in fiscal year 2003. The research in the regional scale area shows the reliability of conceptual hydrogeological model and numerical simulation for the evaluation of regional hydrogeology. On the other hand, the geological and geophysical investigation, and borehole investigation during the surface-based investigations in the local scale area provide the pragmatic distribution of hydrogeological structure that may control regional groundwater hydrology. Hydrogeological simulations regarding the geological structure such as fault and hydrogeological property demonstrate the priority of investigation of geological structure for the evaluation of hydrogeology. The fault perpendicular to groundwater flow direction crucially affects on regional hydrology. Such fault is necessary to be investigated by priority. Hydrochemical investigation shows that chemical evolution process in this groundwater illustrated is mixing between groundwaters with different salinities. Principal component analysis and mass balance calculation reveal reliable chemistry of end-member waters for mixing. Regarding methodology development, the strategy and procedure of investigations are summarized based on the results of surface-based investigation. Moreover the multi interval monitoring system for water pressure and temperature has developed and started to monitor the in-situ condition of groundwater. The geology, geological structure, hydraulic

Focus Studies of Geographically Connected Countries: Analysis of Regionally Oriented Studies in Political Science Publications 1996-2012

Directory of Open Access Journals (Sweden)

Andreja Petković

2013-01-01

Full Text Available This article studies the focus studies of geographically connected and geographically not connected countries, i.e. regional and comparative regional studies. In the first part of the article, a description of the role and development of this type of studies as a subdiscipline of comparative politics is provided. In the second part, I present the results of quantitative analysis of the content of articles published in the academic journals published or co-published by the Faculty of Political Science, University of Zagreb. The objects of analysis are regional studies of South-East Europe published in the journals. The main goal of this article is to determine which countries in their regional surroundings are researched the most by Croatian political scientists (and other authors who publish such articles in Croatian or English language in those journals, and which countries Croatia is most often compared to. This research has shown that, with regard to studies of the region, Croatian political scientists mostly focus on the countries of the former Yugoslavia.

A study of lightning activity over land and oceanic regions of India

Indian Academy of Sciences (India)

important point and above results have strongly motivated us to take up the study of land–land and land–ocean contrast in lightning activity over. India. The geographic regions of India chosen for the present study include: • Eastern region (ER) and western region (WR) of India,. • East coast of India and a strip of six oceanic.

CONCEPTUAL APPROACHES TO STUDY THE INNOVATIVE DEVELOPMENT OF REGIONAL SOCIO-ECONOMIC SYSTEMS

Directory of Open Access Journals (Sweden)

Svitlana Fedulova

2017-12-01

Full Text Available The purpose of the paper is to find out and identify conceptual approaches to the study of the innovative development of regional socio-economic systems to take into account global requirements for global water security. Methodology. We used in our study traditional and special methods, including: historical and logical method, abstraction and analogy, and system analysis methods. Results. The article deals with the problems of innovative development of regional socio-economic systems. Conceptual approaches to the study of the innovative development of these systems are determined. Theoretical approaches to regionalization are generalized and the regional typology in world regionalism is presented. The study devotes a sufficient attention to the issues of infrastructure support for regional systems, which is a prerequisite for the functioning and development of such systems. The article focuses on the priority of research of such a component of regional infrastructure as engineering and technical infrastructure. The model of regulation of development of regional socio-economic systems on the basis of infrastructure support with the consideration of world requirements of global water security is offered. Practical implications. In recent times, the discussion on the definition of the essence of the concept of “region” is rather lively. The new paradigm of the regional economy represents the region as a variety of spatial systems of various scales. Yes, there are ongoing discussions that under the region can be understood as a group of states and small-sized administrative-territorial units. Despite the important role played by such regional systems in the economy of many countries, this topic in domestic studies is not given with enough attention. Also, in the domestic scientific schools of the regional economy, studies devoted to the problems of patterns and tendencies of the formation and development of regional systems of Ukraine, the

Application of computerised penile arterial waveform analysis in the diagnosis of arteriogenic impotence. An initial study in potent and impotent men.

Science.gov (United States)

Desai, K M; Gingell, J C; Skidmore, R; Follett, D H

1987-11-01

A new method is described for evaluating arteriogenic impotence by means of noninvasive quantification of penile Doppler arterial waveforms using computerised analysis based on the Laplace Transform model. The haemodynamic changes occurring during a papaverine-induced erection in healthy potent volunteers have been recorded by this technique, which has also been shown to be capable of discriminating between a normal and an abnormal penile arterial supply in an initial study of potent and impotent men.

Exploratory assessment of left ventricular strain–volume loops in severe aortic valve diseases

Science.gov (United States)

Hulshof, Hugo G.; van Dijk, Arie P.; George, Keith P.; Hopman, Maria T. E.; Thijssen, Dick H. J.

2017-01-01

Key points Severe aortic valve diseases are common cardiac abnormalities that are associated with poor long‐term survival.Before any reduction in left ventricular (LV) function, the left ventricle undergoes structural remodelling under the influence of changing haemodynamic conditions.In this study, we combined temporal changes in LV structure (volume) with alterations in LV functional characteristics (strain, ԑ) into a ԑ–volume loop, in order to provide novel insight into the haemodynamic cardiac consequences of aortic valve diseases in those with preserved LV ejection fraction.We showed that our novel ԑ–volume loop and the specific loop characteristics provide additional insight into the functional and mechanical haemodynamic consequences of severe aortic valve diseases (with preserved LV ejection fraction).Finally, we showed that the ԑ–volume loop characteristics provide discriminative capacity compared with conventional measures of LV function. Abstract The purpose of this study was to examine left ventricular (LV) strain (ԑ)–volume loops to provide novel insight into the haemodynamic cardiac consequences of aortic valve stenosis (AS) and aortic valve regurgitation (AR). Twenty‐seven participants were retrospectively recruited: AR (n = 7), AS (n = 10) and control subjects (n = 10). Standard transthoracic echocardiography was used to obtain apical four‐chamber images to construct ԑ–volume relationships, which were assessed using the following parameters: early systolic ԑ (ԑ_ES); slope of ԑ–volume relationship during systole (Sslope); end‐systolic peak ԑ (peak ԑ); and diastolic uncoupling (systolic ԑ–diastolic ԑ at same volume) during early diastole (UNCOUP_ED) and late diastole (UNCOUP_LD). Receiver operating characteristic curves were used to determine the ability to detect impaired LV function. Although LV ejection fraction was comparable between groups, longitudinal peak ԑ was reduced compared with control subjects

Exploratory assessment of left ventricular strain-volume loops in severe aortic valve diseases.

Science.gov (United States)

Hulshof, Hugo G; van Dijk, Arie P; George, Keith P; Hopman, Maria T E; Thijssen, Dick H J; Oxborough, David L

2017-06-15

Severe aortic valve diseases are common cardiac abnormalities that are associated with poor long-term survival. Before any reduction in left ventricular (LV) function, the left ventricle undergoes structural remodelling under the influence of changing haemodynamic conditions. In this study, we combined temporal changes in LV structure (volume) with alterations in LV functional characteristics (strain, ԑ) into a ԑ-volume loop, in order to provide novel insight into the haemodynamic cardiac consequences of aortic valve diseases in those with preserved LV ejection fraction. We showed that our novel ԑ-volume loop and the specific loop characteristics provide additional insight into the functional and mechanical haemodynamic consequences of severe aortic valve diseases (with preserved LV ejection fraction). Finally, we showed that the ԑ-volume loop characteristics provide discriminative capacity compared with conventional measures of LV function. The purpose of this study was to examine left ventricular (LV) strain (ԑ)-volume loops to provide novel insight into the haemodynamic cardiac consequences of aortic valve stenosis (AS) and aortic valve regurgitation (AR). Twenty-seven participants were retrospectively recruited: AR (n = 7), AS (n = 10) and control subjects (n = 10). Standard transthoracic echocardiography was used to obtain apical four-chamber images to construct ԑ-volume relationships, which were assessed using the following parameters: early systolic ԑ (ԑ_ES); slope of ԑ-volume relationship during systole (Sslope); end-systolic peak ԑ (peak ԑ); and diastolic uncoupling (systolic ԑ-diastolic ԑ at same volume) during early diastole (UNCOUP_ED) and late diastole (UNCOUP_LD). Receiver operating characteristic curves were used to determine the ability to detect impaired LV function. Although LV ejection fraction was comparable between groups, longitudinal peak ԑ was reduced compared with control subjects. In contrast, ԑ_ES and Sslope were

Building Viable and Sustainable Regional Netchains: Case Studies of Regional Pork Netchains in Spain, Germany, and The Netherlands

Directory of Open Access Journals (Sweden)

Rannia Nijhoff‐Savvaki

2012-06-01

Full Text Available The present paper aims to give insight into critical issues contributing to the successful building of viable and sustainable regional netchains, focussing on chain governance mechanisms (coordination mechanisms, quality management systems, information systems and social embedding. It uses three representative case studies from the regional pork sector in Spain, Germany, and The Netherlands, illustrating different trajectories to commercially viable and sustainable regional netchains. By analysing the cases on each critical aspect, the present paper describes important issues and proposes specific elements of further research, including on the roles for(nongovernmental organisations.

Epinephrine syringe exchange events in a paediatric cardiovascular ICU: analysing the storm.

Science.gov (United States)

Achuff, Barbara-Jo; Achuff, Jameson C; Park, Hwan H; Moffett, Brady; Acosta, Sebastian; Rusin, Craig G; Checchia, Paul A

2018-03-01

Introduction Haemodynamically unstable patients can experience potentially hazardous changes in vital signs related to the exchange of depleted syringes of epinephrine to full syringes. The purpose was to determine the measured effects of epinephrine syringe exchanges on the magnitude, duration, and frequency of haemodynamic disturbances in the hour after an exchange event (study) relative to the hours before (control). Materials and methods Beat-to-beat vital signs recorded every 2 seconds from bedside monitors for patients admitted to the paediatric cardiovascular ICU of Texas Children's Hospital were collected between 1 January, 2013 and 30 June, 2015. Epinephrine syringe exchanges without dose/flow change were obtained from electronic records. Time, magnitude, and duration of changes in systolic blood pressure and heart rate were characterised using Matlab. Significant haemodynamic events were identified and compared with control data. In all, 1042 syringe exchange events were found and 850 (81.6%) had uncorrupted data for analysis. A total of 744 (87.5%) exchanges had at least 1 associated haemodynamic perturbation including 2958 systolic blood pressure and 1747 heart-rate changes. Heart-rate perturbations occurred 37% before exchange and 63% after exchange, and 37% of systolic blood pressure perturbations happened before syringe exchange, whereas 63% occurred after syringe exchange with significant differences found in systolic blood pressure frequency (pexchange events.

The trauma concept: the role of MDCT in the diagnosis and management of visceral injuries

Energy Technology Data Exchange (ETDEWEB)

Becker, C.D.; Poletti, P.A. [Diagnostic and Interventional Radiology, Geneva Univ. Hospital (Switzerland)

2005-11-15

The imaging concept in the acute trauma victim includes abdominal ultrasonography during initial triage, and contrast-enhanced computed tomography (CT) for further assessment of visceral organ injuries and active bleeding sites if haemodynamic stability can be established during initial resuscitation. Integration of modern multidetector CT (MDCT) scanners in the emergency admission area greatly facilitates initial assessment of the extent of injuries in all body regions, and is therefore the emerging standard in all major centresinvolved in acute trauma care. Initial assessment of visceral injuries by means of CT not only allows determining the presence and extent of organ injuries and detecting active bleeding sources that may require transarterial embolisation for haemostasis, but also serves as a baseline for monitoring of conservative treatment. Specific indications for CT monitoring of conservative treatment exist in each individual organ. This concept enables the vast majority of blunt injuries of the parenchymal abdominal organs in the haemodynamically stable trauma victim to be managed without surgery. (orig.)

The trauma concept: the role of MDCT in the diagnosis and management of visceral injuries

International Nuclear Information System (INIS)

Becker, C.D.; Poletti, P.A.

2005-01-01

The imaging concept in the acute trauma victim includes abdominal ultrasonography during initial triage, and contrast-enhanced computed tomography (CT) for further assessment of visceral organ injuries and active bleeding sites if haemodynamic stability can be established during initial resuscitation. Integration of modern multidetector CT (MDCT) scanners in the emergency admission area greatly facilitates initial assessment of the extent of injuries in all body regions, and is therefore the emerging standard in all major centresinvolved in acute trauma care. Initial assessment of visceral injuries by means of CT not only allows determining the presence and extent of organ injuries and detecting active bleeding sources that may require transarterial embolisation for haemostasis, but also serves as a baseline for monitoring of conservative treatment. Specific indications for CT monitoring of conservative treatment exist in each individual organ. This concept enables the vast majority of blunt injuries of the parenchymal abdominal organs in the haemodynamically stable trauma victim to be managed without surgery. (orig.)

Ecosystem Services and Border Regions. Case Study from Czech – Polish Borderland

Directory of Open Access Journals (Sweden)

Marcin Spyra

2014-05-01

Full Text Available Land-use management and planning of cross-border regions is a complex problem. Different legislatures, development visions and interests on both sides of the border make it even more complicated. Introducing ecosystem services concept into land-use planning and management at cross-border regions is a challenge.  However not much is said about this issue in literature.This paper aims to present result of the study concerning to ecosystem services concept in the context of cross-border part of Pradziad Euroregion. The studyed area is situated within Czech – Polish borderland. First part of the research concerns to land-cover analyze of the region. The second one to Czech and Polish land-use strategies, which are binding at NUTS 4 and 5 level in the studyed area.Resoults of the research indicates asymmetry of the cross-border landscape of the analyzed region. The asymmetry is indicated by different types, biodiversities and areas of ecosystems identified on both sides of the border. It is also identified by differences in land-use strategies concerning to the region.It is discussed to what extend ecosystem services concept can be implemented in planning legislature of the cross-border region.

A study on the regional geological setting of uranium metallogenesis in Lu-Zong region

International Nuclear Information System (INIS)

Chen Yifeng; Ma Changming; Fan Huanxin

1996-01-01

This paper presents a new understanding of features of main ore-bearing horizons and magmatic rocks, evolution regularities, regional tectonic characteristics and the compositions and formation of the Yangtze tectonic belt in Lu-Zong region. Favourable horizons, magmatic series of Yangtze-type crust-mantle mixed melting magmatic rocks, activities of regional gigantic deep-seated faults and their subsidiary structures provided good regional geological setting for the formation of uranium and polymetallic mineral resources in this region

Regional study of ventilation with inhaled xenon 133 in children

International Nuclear Information System (INIS)

Gaultier, C.; Mensch, B.; Gerbeaux, J.

1975-01-01

A regional exploration of pulmonary ventilation in a population of 104 infants and children by a study of distribution and washout of xenon 133 inhaled with rebreathing is carried out. The results are expressed by photographs (gamma-camera) and time-activity curves. The indications for regional exploration were oriented by the existence on the straight X-ray film of a localised ventilation disorder (a hyperlucent area or an opacity). This study permitted physiopathological analysis and guided endobronchial examinations. The functional results obtained, complete and explain other methods of exploration of lung function by spirography, ventilatory mechanics, transthoracic electrical measurements and study of lung perfusion with technetium 99m [fr

Spiral inflector and central region study for three cyclotrons at CIAE

International Nuclear Information System (INIS)

Zhang Tianjue; Yao Hongjuan; Guan Fengping; Chu Chengjie; Lu Yinlong; Jia Xianlu; Zhong Junqing; Yang Jianjun; Xing Jiansheng; Lin Yuzheng

2007-01-01

The beam dynamics behaviour in the compact cyclotron central region is investigated. The design study for central region, including the spiral inflector, Dee tip, shield and posts, for three cyclotrons at CIAE will be described in this paper. The code development by CIAE and the UNIX based codes developed by TRIUMF were implemented on WINDOWS/PC by CIAE for the spiral inflector and central region design will be given too

Regional nuclear fuel cycle centers study project

International Nuclear Information System (INIS)

Bennett, L.; Catlin, R.G.; Meckoni, V.

1977-01-01

The concept of regional fuel cycle centers (RFCC) has attracted wide interest. The concept was endorsed by many countries in discussions at the General Conference of the International Atomic Energy Agency and at the General Assembly of the United Nations. Accordingly, in 1975, the IAEA initiated a detailed study of the RFCC concept. The Agency study has concentrated on what is referred to as the ''back-end'' of the fuel cycle because that is the portion which is currently problematic. The study covers transport, storage, processing and recycle activities starting from the time the spent fuel leaves the reactor storage pools and through all steps until the recycled fuel is in finished fuel elements and shipped to the reactor. A detailed evaluation of the specific features of large regional fuel cycle centers established on a multinational basis vis-a-vis smaller dispersed fuel cycle facilities set up on a national basis has been carried out. The methodology for assessment of alternative strategies for fuel storage, reprocessing, and recycling of plutonium has been developed, characteristic data on material flows and cost factors have been generated, and an analytic system has been developed to carry out such evaluations including appropriate sensitivity analysis. Studies in related areas on institutional and legal, organizational, environmental, materials control and other essential aspects have also been made. The material developed during the course of this Study would enable any group of interested Member States to examine and work out alternative strategies pertinent to their present and projected nuclear fuel cycle needs, as well as evolve institutional, legal and other appropriate frameworks or agreements for the establishment of fuel cycle centers on a multinational cooperative basis

Comparison of propofol based anaesthesia to conventional inhalational general anaesthesia for spine surgery

Directory of Open Access Journals (Sweden)

L D Mishra

2011-01-01

Full Text Available Background : Often conventional Inhalational agents are used for maintenance of anaesthesia in spine surgery. This study was undertaken to compare propofol with isoflurane anaesthesia with regard to haemodynamic stability, early emergence, postoperative nausea and vomiting (PONV and early assessment of neurological functions. Patients & Methods: Eighty ASA grade I &II adult patients were randomly allocated into two groups. Patients in study group received inj propofol for induction as well as for maintenance along with N 2O+O2 and the control group patients received inj thiopentone for induction and N 2 O+O 2 +isoflurane for maintenance. BIS monitoring was used for titrating the anaesthetic dose adjustments in all patients. All patients received fentanyl boluses for intraoperative analgesia and atracurium as muscle relaxant. Statistical data containing haemodynamic parameters, PONV, emergence time, dose of drug consumed & quality of surgical field were recorded and compared using student t′ test and Chi square test. Results: The haemodynamic stability was coparable in both the groups. The quality of surgical field were better in study group. Though there was no significant difference in the recovery profile (8.3% Vs 9.02% between both the groups, the postoperative nausea and vomiting was less in propofol group than isoflurane group (25%Vs60%. The anaesthesia cost was nearly double for propofol than isoflurane anaesthesia. Conclusion: Haemodynamic stability was comparable in both the groups. There was no significant difference in the recovery time between intravenous and inhalational group. Patients in propofol group were clear headed at awakening and were better oriented to place than inhalational group.

Regional issue identification and assessment: study methodology. First annual report

Energy Technology Data Exchange (ETDEWEB)

1980-01-01

The overall assessment methodologies and models utilized for the first project under the Regional Issue Identification and Assessment (RIIA) program are described. Detailed descriptions are given of the methodologies used by lead laboratories for the quantification of the impacts of an energy scenario on one or more media (e.g., air, water, land, human and ecology), and by all laboratories to assess the regional impacts on all media. The research and assessments reflected in this document were performed by the following national laboratories: Argonne National Laboratory; Brookhaven National Laboratory; Lawrence Berkeley Laboratory; Los Alamos Scientific Laboratory; Oak Ridge National Laboratory; and Pacific Northwest Laboratory. This report contains five chapters. Chapter 1 briefly describes the overall study methodology and introduces the technical participants. Chapter 2 is a summary of the energy policy scenario selected for the RIIA I study and Chapter 3 describes how this scenario was translated into a county-level siting pattern of energy development. The fourth chapter is a detailed description of the individual methodologies used to quantify the environmental and socioeconomic impacts of the scenario while Chapter 5 describes how these impacts were translated into comprehensive regional assessments for each Federal Region.

SUPRAGLOTTIC JET VENTILATION VERSUS CONVENTIONAL ENDOTRACHEAL VENTILATION IN MINOR LARYNGEAL SURGERIES

Directory of Open Access Journals (Sweden)

Illendual Upendranath

2016-08-01

Full Text Available Any attempt at intubation will cause many cardiovascular responses and the major concern during this time is to attenuate the same. Similar response is seen during procedures on Larynx in microlaryngeal surgery which produces an intense cardiovascular stimulation during suspension laryngoscopy and intubation. AIM OF STUDY Supraglottic jet ventilation versus conventional endotracheal ventilation in minor laryngeal surgeries. To evaluate the haemodynamic response in supraglottic jet ventilation and conventional intubation in minor laryngeal surgeries. METHODS Patients were randomised to 2 Groups: 30 patients in each group; Group A - in whom supraglottic jet ventilation was planned and Group B - in whom endotracheal intubation was planned. RESULT The haemodynamic response in terms of increase in MAP and HR is significantly more with endotracheal intubation than with supraglottic jet ventilation. CONCLUSION Our study showed that supraglottic jet ventilation showed a better haemodynamic stability when compared to conventional endotracheal intubation in patients undergoing minor laryngeal surgeries. Statistical scores were also in favour of the patients treated with supraglottic jet ventilation based on the p values.

Transpulmonary thermodilution (TPTD before, during and after Sustained Low Efficiency Dialysis (SLED. A Prospective Study on Feasibility of TPTD and Prediction of Successful Fluid Removal.

Directory of Open Access Journals (Sweden)

Wolfgang Huber

Full Text Available Acute kidney injury (AKI is common in critically ill patients. AKI requires renal replacement therapy (RRT in up to 10% of patients. Particularly during connection and fluid removal, RRT frequently impairs haemodyamics which impedes recovery from AKI. Therefore, "acute" connection with prefilled tubing and prolonged periods of RRT including sustained low efficiency dialysis (SLED has been suggested. Furthermore, advanced haemodynamic monitoring using trans-pulmonary thermodilution (TPTD and pulse contour analysis (PCA might help to define appropriate fluid removal goals.Since data on TPTD to guide RRT are scarce, we investigated the capabilities of TPTD- and PCA-derived parameters to predict feasibility of fluid removal in 51 SLED-sessions (Genius; Fresenius, Germany; blood-flow 150 mL/min in 32 patients with PiCCO-monitoring (Pulsion Medical Systems, Germany. Furthermore, we sought to validate the reliability of TPTD during RRT and investigated the impact of "acute" connection and of disconnection with re-transfusion on haemodynamics. TPTDs were performed immediately before and after connection as well as disconnection.Comparison of cardiac index derived from TPTD (CItd and PCA (CIpc before, during and after RRT did not give hints for confounding of TPTD by ongoing RRT. Connection to RRT did not result in relevant changes in haemodynamic parameters including CItd. However, disconnection with re-transfusion of the tubing volume resulted in significant increases in CItd, CIpc, CVP, global end-diastolic volume index GEDVI and cardiac power index CPI. Feasibility of the pre-defined ultrafiltration goal without increasing catecholamines by >10% (primary endpoint was significantly predicted by baseline CPI (ROC-AUC 0.712; p = 0.010 and CItd (ROC-AUC 0.662; p = 0.049.TPTD is feasible during SLED. "Acute" connection does not substantially impair haemodynamics. Disconnection with re-transfusion increases preload, CI and CPI. The extent of these changes

The pulsatility index and the resistive index in renal arteries in patients with hypertension and chronic renal failure

DEFF Research Database (Denmark)

Petersen, L J; Petersen, J R; Ladefoged, S D

1995-01-01

The pulsatility index (PI) and the resistive index (RI) are used as pulsed-wave Doppler measurement of downstream renal artery resistance. Little information is available on their value in chronic renal failure and their correlation to parameters of renal function and haemodynamics. The aim...... was to compare PI and RI of renal arteries in healthy volunteers and in patients with hypertension and chronic renal failure, and furthermore to study the correlation of these indices to measurements of renal haemodynamics and function by standard methods in patients with renal failure and hypertension....

Sustaining Continuous Improvement: A Longitudinal and Regional Study

Directory of Open Access Journals (Sweden)

Henry J. Quesada-Pineda

2013-09-01

companies, no changes in perception were found during the period of study for any of the factors. For the other two, however, changes were perceived in at least one of the five constructs in the study. Changes were also found across the regions included. By leveraging the quantitative analysis with qualitative data collected through interviews and visits to the case study companies, we were able to explain the changes in perception and single out the best CI management process to sustain CI in the long term.

Site study plan for regional hydrologic sampling and monitoring: Preliminary draft

International Nuclear Information System (INIS)

Dutton, A.R.

1987-01-01

The purpose of the Regional Hydrologic Studies Plan is to describe those field activities required for completion of the objectives of hydrologic activities. Many of these activities are regional in scope and are designed to provide a framework for understanding the hydrologic setting of the site and the hydrologic processes that influence site characteristics. Site Study Plans (SSPs) define activates at and in the immediate vicinity of the site. The activities specified in the Regional Hydrologic Studies Plan are performed beyond the confines of the site because the hydrologic systems extend beyond the site boundaries, because pertinent data that bear on site suitability are available outside of the site, and because natural analogues exist outside of the site that allow analysis of processes that are expected to operate within the site. 15 refs., 5 figs., 1 tab

Wind tunnel study of the wind turbine interaction with a boundary-layer flow: Upwind region, turbine performance, and wake region

Science.gov (United States)

Bastankhah, M.; Porté-Agel, F.

2017-06-01

Comprehensive wind tunnel experiments were carried out to study the interaction of a turbulent boundary layer with a wind turbine operating under different tip-speed ratios and yaw angles. Force and power measurements were performed to characterize the variation of thrust force (both magnitude and direction) and generated power of the wind turbine under different operating conditions. Moreover, flow measurements, collected using high-resolution particle-image velocimetry as well as hot-wire anemometry, were employed to systematically study the flow in the upwind, near-wake, and far-wake regions. These measurements provide new insights into the effect of turbine operating conditions on flow characteristics in these regions. For the upwind region, the results show a strong lateral asymmetry under yawed conditions. For the near-wake region, the evolution of tip and root vortices was studied with the use of both instantaneous and phase-averaged vorticity fields. The results suggest that the vortex breakdown position cannot be determined based on phase-averaged statistics, particularly for tip vortices under turbulent inflow conditions. Moreover, the measurements in the near-wake region indicate a complex velocity distribution with a speed-up region in the wake center, especially for higher tip-speed ratios. In order to elucidate the meandering tendency of far wakes, particular focus was placed on studying the characteristics of large turbulent structures in the boundary layer and their interaction with wind turbines. Although these structures are elongated in the streamwise direction, their cross sections are found to have a size comparable to the rotor area, so that they can be affected by the presence of the turbine. In addition, the study of spatial coherence in turbine wakes reveals that any statistics based on streamwise velocity fluctuations cannot provide reliable information about the size of large turbulent structures in turbine wakes due to the effect of wake

Acoustic study of stratification region of melts in In-Se system

International Nuclear Information System (INIS)

Glazov, V.M.; Kim, S.G.; Nurova, K.B.

1989-01-01

Stratification region of melts in In-Se system was studied in detail with the use of the method of measuring ultrasound velocity. The curve, limiting the region of stratification into two liquid solutions was plotted. It is shown that the curve is characterized as symmetrical finodal

Sistema regional de inovação: estudo das regiões brasileiras Regional innovation system: a study of brazilian regions

Directory of Open Access Journals (Sweden)

Giovana F. Rossi Casali

2010-12-01

Full Text Available Este trabalho analisou o processo de formação regional do Brasil, os desequilíbrios existentes entre as regiões e as perspectivas futuras. Teve como proposta básica analisar o possível processo de convergência de renda das regiões brasileiras, utilizando o conceito de gap tecnológico. Segundo esse conceito, os desequilíbrios regionais são o resultado de diferentes taxas de desenvolvimento econômico, que, por sua vez, resultam de diferentes níveis de desenvolvimento tecnológico, os quais, por fim, são consequências de condições históricas, sociais e culturais específicas de cada região. Dessa forma, pressupôs-se a existência de relação positiva entre nível de desenvolvimento tecnológico, dependência tecnológica, dependência econômica, nível de desenvolvimento econômico e convergência de renda. Os resultados mostram que, em relação à possibilidade de as regiões e os estados menos desenvolvidos realizarem o catching up com aqueles mais desenvolvidos, as variáveis que representam tanto a geração quanto a apropriação de novas tecnologias são significativas e diretamente relacionadas com o produto. Dessa forma, pode-se afirmar que o catching up seria possível caso houvesse um maior investimento no processo de desenvolvimento e apropriação de novas tecnologias por parte dos governos regionais.This research developed an analysis on the regional imbalances at the Brazilian economy, the historic formation of the regions and perspectives. As a result of the distinctive courses followed by each region, an economical concentration process occurs in the Southeast. In this sense, this study intended to analyze the possible process of the Brazilian regional formation, using the concept of technological gap. The result show that, in relation to the possibilities of the regions and states that are less developed to accomplish the catching up with those that are more developed, the variables that represent generation

Different Regions, Diverse Classrooms? a Study of Primary Classrooms in China

Science.gov (United States)

McNaught, Carmel; Lok, Beatrice; Yin, Hongbiao; Lee, John Chi-Kin; Song, Huan

2014-01-01

Classroom experience is shaped by a number of factors. In this paper, we report a classroom observation study in China, illustrating regional variation in students' classroom learning experiences. Through comparing and contrasting observed classroom practices in three different regions in China (Chongqing, Hong Kong and Shanghai), the paper…

5th Regional Study on Cadastre and Spatial Data Infrastructure

Directory of Open Access Journals (Sweden)

Ivica Skender

2012-12-01

Full Text Available In the aftermath of the 5th Regional Conference on Cadastre and Spatial Data Infrastructure (Banja Luka and Laktaši, Bosnia and Herzegovina, June 6–8, 2012, the Republic Authority for Geodetic and Property Affairs of the Republic of Srpska and the Federal Administration for Geodetic and Real Property Affairs published the 5th Regional Study on Cadastre and Spatial Data Infrastructure. The study was produced in the frame of the Project INSPIRATION – Spatial Data Infrastructure in the Western Balkans, which is being realized for the benefit and with cooperation of representatives of eight geodetic administrations in the region (Albania, Bosnia and Herzegovina, Montenegro, Croatia, Kosovo, Macedonia, Serbia by consortium led by German company GFA of Hamburg, in cooperation with GDi GISDATA of Zagreb, experts from the Austrian Environmental Agency and German company con terra GmbH and financed from the European Union IPA funding programme for 2010.

Regional risk assessment approaches to land planning for industrial polluted areas in China: the Hulunbeier region case study.

Science.gov (United States)

Li, Daiqing; Zhang, Chen; Pizzol, Lisa; Critto, Andrea; Zhang, Haibo; Lv, Shihai; Marcomini, Antonio

2014-04-01

The rapid industrial development and urbanization processes that occurred in China over the past 30years has increased dramatically the consumption of natural resources and raw materials, thus exacerbating the human pressure on environmental ecosystems. In result, large scale environmental pollution of soil, natural waters and urban air were recorded. The development of effective industrial planning to support regional sustainable economy development has become an issue of serious concern for local authorities which need to select safe sites for new industrial settlements (i.e. industrial plants) according to assessment approaches considering cumulative impacts, synergistic pollution effects and risks of accidental releases. In order to support decision makers in the development of efficient and effective regional land-use plans encompassing the identification of suitable areas for new industrial settlements and areas in need of intervention measures, this study provides a spatial regional risk assessment methodology which integrates relative risk assessment (RRA) and socio-economic assessment (SEA) and makes use of spatial analysis (GIS) methodologies and multicriteria decision analysis (MCDA) techniques. The proposed methodology was applied to the Chinese region of Hulunbeier which is located in eastern Inner Mongolia Autonomous Region, adjacent to the Republic of Mongolia. The application results demonstrated the effectiveness of the proposed methodology in the identification of the most hazardous and risky industrial settlements, the most vulnerable regional receptors and the regional districts which resulted to be the most relevant for intervention measures since they are characterized by high regional risk and excellent socio-economic development conditions. Copyright © 2013 Elsevier Ltd. All rights reserved.

Contribution of intracranial vertebral artery asymmetry to vestibular neuropathy.

Science.gov (United States)

Chuang, Y M; Chern, C M; Liao, W H; Hsu, L C; Lien, C F; Lirng, J F; Shiao, A S; Ko, J S C

2011-07-01

To test the hypothesis that vertebral artery hypoplasia (VAH) may affect the lateralisation of vestibular neuropathy (VN), probably through haemodynamic effect on the vestibular labyrinth. 69 patients with unilateral VN were examined with a magnetic resonance angiographic (MRA) and caloric test. 50 healthy subjects served as controls. The diagnosis of intracranial VAH was based on MRA if 40%. The authors then correlated the canal paretic side with the VAH side. MRA study revealed 29 VAH (right/left: 23/6) in VN subjects and six VAH in controls (right/left: 5/1). The RR of VAH in VN subjects compared with controls was elevated (RR=2.2; 95% CI 1.8 to 2.8). There was a high accordance rate between the side of VAH and VN. Among 29 patients with unilateral VAH, 65.5% (N=19) had an ipsilateral VN, in which left VAH showed a higher accordance rate (83.3%) than the right side (60.9%). VN subjects with vascular risk factors also had a higher VAH accordance rate (81%) than those without (25%). VAH may serve as a regional haemodynamic negative contributor and impede blood supply to the ipsilateral vestibular labyrinth, contributing to the development of VN, which could be enhanced by atherosclerotic risk factors and the left-sided location.

REGIONAL TRADE AGREEMENTS AND COMPETITION POLICY. CASE STUDY: EU, ASEAN AND NAFTA

Directory of Open Access Journals (Sweden)

Fora Andreea-Florina

2014-07-01

Full Text Available The large number of regional trade agreements notified to the World Trade Organization (WTO significantly influenced the flow of world trade. By April 2014 there had been notified 583 regional trade agreements to the WTO, of which only 379 are in force. The objective of this paper is to highlight the importance of regional trade agreements in world trade, especially the importance of establishing a regional competition policy in these agreements. The research methodology used is the analysis of legislation governing preferential trade agreements at the level of WTO, the collection and interpretation of statistical data provided by the WTO Secretariat, the case study, namely the study of literature. The paper is structured in three parts. The first part of the paper examines the basic laws based on which regional trade agreements are notified to the WTO and the evolution of these agreements in the period 1958-2013. The second part of the paper is devoted to the analysis of competition policy in regional trade agreements. In this part of the paper, to highlight the patterns of competition policy adopted under these agreements was analyzed by three case studies of competition policy in the EU, ASEAN and NAFTA. The three case studies have revealed that the three preferential trade agreements present regional competition policies with varying degrees of integration. The most complex form of competition policy is found in the European Union, because we are talking about a centralized model of competition policy. ASEAN presents a partially decentralized model, while NAFTA scrolls with a decentralized model of competition policy. The last part of the paper presents the characteristics of the four models of competition policy identified in the preferential trade agreements in force. It should be emphasized that if the initial preferential trade agreements have not put a great emphasis on the rules of competition policy, practice has shown the importance

EMPIRICAL ANALYSIS OF THE ENTREPRENEURIAL ENVIRONMENT AT REGIONAL LEVEL IN ROMANIA. CASE STUDY: THE REGION OF SOUTH-WEST OLTENIA

Directory of Open Access Journals (Sweden)

BĂLĂCESCU ANIELA

2016-10-01

Full Text Available The present study is a descriptive statistic of the regional entrepreneurial environment in Romania, focusing on South-West Oltenia, with the aim that surprised the level of entrepreneurship in this area. In this study we considered the demographic analysis of active enterprises at the 8 development regions of Romania, the survival rate of enterprises, the competitiveness, and profile of the entrepreneur. The period under review is 2008-2014, and the main sources of information were the databases of the National Institute of Statistics and the National Trade Register Office

Current status of regional hydrogeological studies and numerical simulations on geological disposal

International Nuclear Information System (INIS)

Nakao, Shinsuke; Kikuchi, Tsuneo; Ishido, Tsuneo

2004-01-01

Current status of regional hydrogeological studies on geological disposal including hydrogeological modeling using numerical simulators is reviewed in this report. A regional scale and boundary conditions of numerical models are summarized mainly from the results of the RHS (regional hydrogeological study) project conducted by Japan Nuclear Cycle Development Institute (JNC) in the Tono area. We also refer to the current conceptual modes of hydrology and numerical models of unsaturated zone flow at Yucca Mountain, Nevada, which is the arid site proposed for consideration as the United States' first underground high-level radioactive waste repository. Understanding behavior of a freshwater-saltwater transition zone seems to play a key role in the hydrogeological modeling in a coastal region. Technical features of a numerical simulator as a tool for geothermal reservoir modeling is also briefly described. (author)

Characterization of Quaternary and suspected Quaternary faults, regional studies, Nevada and California

Energy Technology Data Exchange (ETDEWEB)

Anderson, R.E.; Bucknam, R.C.; Crone, A.J.; Haller, K.M.; Machette, M.N.; Personius, S.F.; Barnhard, T.P.; Cecil, M.J.; Dart, R.L.

1995-12-31

This report presents the results of geologic studies that help define the Quaternary history of selected faults in the region around Yucca Mountain, Nevada. These results are relevant to the seismic-design basis of a potential nuclear waste repository at Yucca Mountain. The relevancy is based, in part, on a need for additional geologic data that became apparent in ongoing studies that resulted in the identification of 51 relevant and potentially relevant individual and compound faults and fault zones in the 100-km-radius region around the Yucca Mountain site. Geologic data used to characterize the regional faults and fault zones as relevant or potentially relevant seismic sources includes age and displacement information, maximum fault lengths, and minimum distances between the fault and the Yucca Mountain site. For many of the regional faults, no paleoseismic field studies have previously been conducted, and age and displacement data are sparse to nonexistent. In November 1994, the Branch of Earthquake and Landslide Hazards entered into two Memoranda of Agreement with the Yucca Mountain Project Branch to conduct field reconnaissance, analysis, and interpretation of six relevant and six potentially relevant regional faults. This report describes the results of study of those faults exclusive of those in the Pahrump-Stewart Valley-Ash Meadows-Amargosa Valley areas. We also include results of a cursory study of faults on the west flank of the Specter Range and in the northern part of the Last Chance Range. A four-phase strategy was implemented for the field study.

Study of a conceptual nuclear energy center at Green River, Utah: regional considerations

International Nuclear Information System (INIS)

1982-01-01

This document constitutes one segment of a feasibility study investigating the ramifications of constructing a nuclear energy center in an arid and remote Western region. This phase of the study discusses regional considerations involved in nuclear energy center development at Green River, Utah. Regional support for NEC development is assessed. In addition, possible regulatory constraints to NEC development are identified and analyzed. Possible resource allocation shortages resulting from NEC development are also considered. A comparison with a similar study on NEC development in the Southeastern United States is also included

THE STUDY FOR REGIONAL RETAIL PHARMACEUTICAL MARKET

Directory of Open Access Journals (Sweden)

O. V. Sokolova

2015-01-01

Full Text Available Pharmacy organizations are an element of regional pharmaceutical market infrastructure formation. They have different character and activity type, organizational and legal forms, types of properties. The revelation of the features of retail pharmaceutical market of Yaroslavl oblast was the purpose of the study. The analysis of the data of regional department of Federal Service on Surveillance in Healthcare and Social Development of Russian Federation  n Yaroslavl oblast in the beginning of 2014 showed that there are 137 acting commercial entities, which have licenses for pharmaceutical activity. The region has 487  pharmacy organizations which implement pharmaceutical activity of state (14.6%, municipal (7.4%, and private (78.0% forms of ownership. Some companies function in Yaroslavl (43.9% and Rybinsk (22.4% municipal district. The analysis of organization and legal forms revealed that 48.9% of pharmacy organizations are registered as ltd, 14.6% are state, and 14.2% are private entrepreneurs, public limited companies amount to 10.9%, the rest pharmacy organizations are included into municipal unitary enterprises and private limited companies – 7.39% and 4.1% correspondingly. The structure of retail market is represented by single pharmacy organizations (51.1% as well as organizations joined into pharmacy chains from two and more PO (48.9%. The share of commercial entities which include one PO amounted to 14.4% of all PO. Share of pharmacy chains (42.3% which include from 2 to 9 PO are 46.8% of all PO. Pharmacy chains, which have more than 9 retails spots amount to 6.6% of the total number of commercial entities. 38.8% of PO function within them. Pharmacy chains prevalence (42.3%, joined into 9 PO; pharmacy chains, which have more than 9 PO, and include state sector PO (14.6% are the features of the regional market.

Studies on Enhancing Nuclear Transparency in the Asia-Pacific Region

International Nuclear Information System (INIS)

Kawakubo, Y.; Tomikawa, H.

2015-01-01

Nuclear transparency is defined as ''a cooperative process of providing information to all interested parties so that they can independently assess the safety, security, and legitimate management of nuclear materials'' by Sandia National Laboratories (SNL). Since the Asia- Pacific region has a broad spectrum of nuclear development underway and planned in the future, nuclear transparency is recognized as essential to provide additional assurance and enhance confidence building in this area. It is expected that elevated nuclear transparency should also supplement International Atomic Energy Agency (IAEA) safeguards. With this recognition, JAEA has committed various studies and activities for enhancing regional nuclear transparency mainly with U.S. Department of Energy (DOE) and its national laboratories. The efforts include concept study, development of secure data transmission technologies at the Experimental Fast Reactor ''Joyo'' for the use of regional nuclear transparency, and support for Council for Security and Cooperation in Asia Pacific (CSCAP) to develop internet-based transparency tools. JAEA also organized several workshops to discuss with stakeholder organizations to build acceptance for transparency tools and activities. Based on the past studies, JAEA, jointly with SNL, Korea Institute of Nuclear Nonproliferation and Control (KINAC) and Korea Atomic Energy Research Institute (KAERI), initiated a new phase of study in 2011 to design and establish an Information Sharing Framework (ISF) which was defined as ''a communication platform on which nuclear nonproliferation experts can provide and/or receive relevant information in a practical and sustainable manner''. During the period of two-year study, partner organizations identified essential elements to establish ISF and developed the requirements. Currently, JAEA and KINAC are planning to implement demonstration of ISF under Asia Pacific

ASEAN : Extra-Regional Cooperation Triggers Regional Integration

NARCIS (Netherlands)

Krapohl, S.; Krapohl, S.

2017-01-01

This chapter contains two case studies of regional cooperation within Southeast Asia. The network analysis of ASEAN demonstrates that the region is dependent on extra-regional trade with the EU and the USA, but also with China and Japan. However, the region is not dominated by a single regional

Mass transport properties of the rabbit aortic wall.

Directory of Open Access Journals (Sweden)

Emma L Bailey

Full Text Available Uptake of circulating macromolecules by the arterial wall may be a critical step in atherogenesis. Here we investigate the age-related changes in patterns of uptake that occur in the rabbit. In immature aortas, uptake was elevated in a triangle downstream of branch ostia, a region prone to disease in immature rabbits and children. By 16-22 months, uptake was high lateral to ostia, as is lesion prevalence in mature rabbits and young adults. In older rabbits there was a more upstream pattern, similar to the disease distribution in older people. These variations were predominantly caused by the branches themselves, rather than reflecting larger patterns within which the branches happened to be situated (as may occur with patterns of haemodynamic wall shear stress. The narrow streaks of high uptake reported in some previous studies were shown to be post mortem artefacts. Finally, heparin (which interferes with the NO pathway had no effect on the difference in uptake between regions upstream and downstream of branches in immature rabbits but reversed the difference in older rabbits, as does inhibiting NO synthesis directly. Nevertheless, examination of uptake all around the branch showed that changes occurred at both ages and that they were quite subtle, potentially explaining why inhibiting NO has only minor effects on lesion patterns in mature rabbits and contradicting the earlier conclusion that mechanotransduction pathways change with age. We suggest that recently-established changes in the patterns of haemodynamic forces themselves are more likely to account for the age-dependence of uptake patterns.

Sigma and beta convergence in regional mortality: A case study of the Netherlands

Directory of Open Access Journals (Sweden)

Fanny Janssen

2016-07-01

Full Text Available Background: For allocation of health budgets it is important to know whether regional mortality differences tend to decline or to increase. Sigma convergence tests can measure whether the dispersion of the regional distribution of mortality has declined. Beta convergence tests can examine whether regions with a low level of life expectancy have experienced a stronger increase than regions with a high level. In demographic research, however, sigma and beta convergence have not been formally assessed simultaneously. Objective: We demonstrate the application of both sigma and beta convergence tests to the study of trends in regional mortality differences for the Netherlands. Methods: Using all-cause mortality and population data for 40 Dutch NUTS-3 regions, by year (1988‒2009, age group, and sex, we assess both sigma and beta convergence, and ist significance. Results: Beta convergence proved statistically significant. The regions with the lowest life expectancy in 1988 generally exhibited the highest increase from 1988 to 2009, and vice versa. However, dispersion measures displayed no statistically significant sigma convergence. Conclusions: Whereas the absence of sigma convergence shows that regional mortality differences have not declined, beta convergence indicates that the disadvantage of regions with low life expectancy is not persistent. Contribution: We demonstrated the added value of simultaneously studying sigma convergence, beta convergence, and trajectories of regions in the tails of the distribution. Where absence of sigma convergence does not imply that disadvantaged regions did not improve, beta convergence does not always indicate complete convergence due to structural differences across regions.

Nuclear Hybrid Energy Systems Regional Studies: West Texas & Northeastern Arizona

Energy Technology Data Exchange (ETDEWEB)

Garcia, Humberto E. [Idaho National Lab. (INL), Idaho Falls, ID (United States); Chen, Jun [Idaho National Lab. (INL), Idaho Falls, ID (United States); Kim, Jong Suk [Idaho National Lab. (INL), Idaho Falls, ID (United States); McKellar, Michael George [Idaho National Lab. (INL), Idaho Falls, ID (United States); Deason, Wesley R [Idaho National Lab. (INL), Idaho Falls, ID (United States); Vilim, Richard B. [Idaho National Lab. (INL), Idaho Falls, ID (United States); Bragg-Sitton, Shannon M. [Idaho National Lab. (INL), Idaho Falls, ID (United States); Boardman, Richard D. [Idaho National Lab. (INL), Idaho Falls, ID (United States)

2015-04-01

The primary objective of this study is to conduct a preliminary dynamic analysis of two realistic hybrid energy systems (HES) including a nuclear reactor as the main baseload heat generator (denoted as nuclear HES or nuclear hybrid energy systems [[NHES]) and to assess the local (e.g., HES owners) and system (e.g., the electric grid) benefits attainable by the application of NHES in scenarios with multiple commodity production and high penetration of renewable energy. It is performed for regional cases not generic examples based on available resources, existing infrastructure, and markets within the selected regions. This study also briefly addresses the computational capabilities developed to conduct such analyses, reviews technical gaps, and suggests some research paths forward.

Extraction of temporal information in functional MRI

Science.gov (United States)

Singh, M.; Sungkarat, W.; Jeong, Jeong-Won; Zhou, Yongxia

2002-10-01

The temporal resolution of functional MRI (fMRI) is limited by the shape of the haemodynamic response function (hrf) and the vascular architecture underlying the activated regions. Typically, the temporal resolution of fMRI is on the order of 1 s. We have developed a new data processing approach to extract temporal information on a pixel-by-pixel basis at the level of 100 ms from fMRI data. Instead of correlating or fitting the time-course of each pixel to a single reference function, which is the common practice in fMRI, we correlate each pixel's time-course to a series of reference functions that are shifted with respect to each other by 100 ms. The reference function yielding the highest correlation coefficient for a pixel is then used as a time marker for that pixel. A Monte Carlo simulation and experimental study of this approach were performed to estimate the temporal resolution as a function of signal-to-noise ratio (SNR) in the time-course of a pixel. Assuming a known and stationary hrf, the simulation and experimental studies suggest a lower limit in the temporal resolution of approximately 100 ms at an SNR of 3. The multireference function approach was also applied to extract timing information from an event-related motor movement study where the subjects flexed a finger on cue. The event was repeated 19 times with the event's presentation staggered to yield an approximately 100-ms temporal sampling of the haemodynamic response over the entire presentation cycle. The timing differences among different regions of the brain activated by the motor task were clearly visualized and quantified by this method. The results suggest that it is possible to achieve a temporal resolution of /spl sim/200 ms in practice with this approach.

Cardiac and proinflammatory markers predict prognosis in cirrhosis

DEFF Research Database (Denmark)

Wiese, Signe; Mortensen, Christian; Gøtze, Jens P

2014-01-01

changes, and long-term survival. METHODS: One hundred and ninety-three stable cirrhotic patients (Child class: A = 46; B = 97; C = 50) had a full haemodynamic investigation performed with measurement of splanchnic and systemic haemodynamics and measurement of circulating levels of proBNP, proANP, copeptin...

Universities' Role in Regional Development: A Case Study of University for Development Studies, Ghana

Science.gov (United States)

Abonyi, Usman Kojo

2016-01-01

This study, employing an interpretive research paradigm, sought to investigate into how University for Development Studies (UDS) is responding to its regional development mandate with a specific focus on how it is responding to human capital development, innovation capabilities, and social and environmental development in northern Ghana. A study…

Bat study in the Kharaa region, Mongolia

Directory of Open Access Journals (Sweden)

Ariunbold Jargalsaikhan

2016-06-01

Full Text Available Our study objectives were to determine bat species composition and to study the genetic variations and sound characteristics in bats of the Kharaa, Shatan, and Ulgii areas of Mongolia. This study is the first bat survey in this area. Nineteen species were from Mongolia. Six bat species belonged to three genera. We performed mitochondrial DNA sequencing of Myotis bombinus, Myotis gracilis, and Myotis petax to confirm the morphological identification of these species. We also determined the sound frequencies of the six bat species, based on their echolocation calls. The conservation status was determined using World Conservation Union red list categories and criteria. Sixteen bats from three species were ringed during this study and three artificial boxes were placed on trees in the Kharaa River Valley. Other than the northern bat, all species were eastern Palearctic. The northern bat (Eptesicus nilssonii species is widespread in the northern Palearctic region.

Travel industry as a focus on regional development: Case study of the Mediterranean France

Directory of Open Access Journals (Sweden)

Terzić Aleksandra

2015-01-01

Full Text Available This paper presents a regionalization of the Mediterranean France with regard to tourism, as well as basic economic sectors present in the region. The study included three administrative regions of this part of France: Provence - Alpes - Cote d'Azur, Languedoc - Roussillon and the Island of Corsica, where the travel industry is defined as dominant. The subject of this research is to study the area of the Mediterranean France, primarily from the aspect of tourism. Special attention is focused on the identification of economic and socioeconomic importance that tourism has on the overall economic development of the region, in order to enable the implementation of tourism regionalization. In order to tourism regionalization of this area carried out, it is necessary to include research components, such as geographic environment, tourist motives and attractions that are located in this area, as well as other elements relevant to the separation of the region from the neighboring regions of France.

A study of the solar wind deceleration in the Earth's foreshock region

Science.gov (United States)

Zhang, T.-L.; Schwingenschuh, K.; Russell, C. T.

1995-01-01

Previous observations have shown that the solar wind is decelerated and deflected in the earth's upstream region populated by long-period waves. This deceleration is corelated with the 'diffuse' but not with the 'reflected' ion population. The speed of the solar wind may decrease tens of km/s in the foreshock region. The solar wind dynamic pressure exerted on the magnetopause may vary due to the fluctuation of the solar wind speed and density in the foreshock region. In this study, we examine this solar wind deceleration and determine how the solar wind deceleration varies in the foreshock region.

Causal hierarchy within the thalamo-cortical network in spike and wave discharges.

Directory of Open Access Journals (Sweden)

Anna E Vaudano

2009-08-01

Full Text Available Generalised spike wave (GSW discharges are the electroencephalographic (EEG hallmark of absence seizures, clinically characterised by a transitory interruption of ongoing activities and impaired consciousness, occurring during states of reduced awareness. Several theories have been proposed to explain the pathophysiology of GSW discharges and the role of thalamus and cortex as generators. In this work we extend the existing theories by hypothesizing a role for the precuneus, a brain region neglected in previous works on GSW generation but already known to be linked to consciousness and awareness. We analysed fMRI data using dynamic causal modelling (DCM to investigate the effective connectivity between precuneus, thalamus and prefrontal cortex in patients with GSW discharges.We analysed fMRI data from seven patients affected by Idiopathic Generalized Epilepsy (IGE with frequent GSW discharges and significant GSW-correlated haemodynamic signal changes in the thalamus, the prefrontal cortex and the precuneus. Using DCM we assessed their effective connectivity, i.e. which region drives another region. Three dynamic causal models were constructed: GSW was modelled as autonomous input to the thalamus (model A, ventromedial prefrontal cortex (model B, and precuneus (model C. Bayesian model comparison revealed Model C (GSW as autonomous input to precuneus, to be the best in 5 patients while model A prevailed in two cases. At the group level model C dominated and at the population-level the p value of model C was approximately 1.Our results provide strong evidence that activity in the precuneus gates GSW discharges in the thalamo-(fronto cortical network. This study is the first demonstration of a causal link between haemodynamic changes in the precuneus -- an index of awareness -- and the occurrence of pathological discharges in epilepsy.

Cardiovascular complications of cirrhosis

DEFF Research Database (Denmark)

Møller, S; Henriksen, Jens Henrik Sahl

2008-01-01

Cardiovascular complications of cirrhosis include cardiac dysfunction and abnormalities in the central, splanchnic and peripheral circulation, and haemodynamic changes caused by humoral and nervous dysregulation. Cirrhotic cardiomyopathy implies systolic and diastolic dysfunction and electrophysi......Cardiovascular complications of cirrhosis include cardiac dysfunction and abnormalities in the central, splanchnic and peripheral circulation, and haemodynamic changes caused by humoral and nervous dysregulation. Cirrhotic cardiomyopathy implies systolic and diastolic dysfunction....... The clinical significance of cardiovascular complications and cirrhotic cardiomyopathy is an important topic for future research, and the initiation of new randomised studies of potential treatments for these complications is needed....

Regional specific groundwater arsenic levels and neuropsychological functioning: a cross-sectional study.

Science.gov (United States)

Edwards, Melissa; Johnson, Leigh; Mauer, Cortney; Barber, Robert; Hall, James; O'Bryant, Sid

2014-01-01

The purpose of the study was to examine the link between geographic information system (GIS)-estimated regional specific groundwater levels and neuropsychological functioning in a sample of individuals with and without cognitive impairment. This cross-sectional study design analyzed data from 1390 participants (733 Alzheimer's disease, 127 Mild Cognitive Impairment, and 530 with normal cognition) enrolled in the Texas Alzheimer's Research and Care Consortium. GISs analyses were used to estimate regional specific groundwater arsenic concentrations using the Environmental Systems Research Institute and arsenic concentrations from the Texas Water Development Board. In the full cohort, regional specific arsenic concentrations were positively associated with language abilities (p = 0.008), but associated with poorer verbal memory, immediate (p = 0.008), and delayed (p arsenic being related with cognition most prominently among mild cognitive impairment cases. Overall, estimated regional specific groundwater arsenic levels were negatively associated with neuropsychological performance.

The Economy of a Regional Metropolis. Case-Study: Iasi, Romania

Directory of Open Access Journals (Sweden)

Claudia POPESCU

2011-06-01

Full Text Available The city of Iaşi with a population of over 300,000 people is the biggest European Union city at the border with the former-Soviet space. The article, part of an extended study on territorial development of Iaşi and its peri-urban area, focuses on the role of the city to trigger regional growth and to enhance cross border cooperation. Recent processes at work generating economic cohesion and integration are explored drawing on the catalytic factors of development and the specialization of local economies. The paper discusses also the externalities of urban growth such as the urban sprawl that causes land use conflicts at the rural-urban fringe. It argues that human capital and higher birth rates than the national average are the strengths, and low connectivity and accessibility are the weaknesses for regional growth. The regional polarization of the city is based on the supply of high level services over the entire North-East Region and opportunities to cross border cooperation through the expansion of an agro-alimentary supply-chain are highlighted. Building on the main capabilities and assets of the agglomeration economies of Iaşi, the paper finally identifies some of the mechanisms and structures that foster urban and regional growth.

Study on regional stratagem for coal mine disasters control and prevention in China

Energy Technology Data Exchange (ETDEWEB)

Shen, B.; Lei, Y. [China Coal Research Institute, Beijing (China)

2009-09-15

A regional strategy study was aimed at coal mine disaster control and prevention, which deepens and enriches the macro-strategy of coal mine disaster control and prevention, and provides an important support for the rapid and healthy development of China's regional coal industry. The country was divided into 4 regions: Northeast, North, South and Xinqing. In view of the regional status of coal mine disasters, the regulation and development trend of regional coal mine disasters was analysed, the outstanding problems and key factors were identified, and general thoughts on regional coal mine disaster control and prevention are put forward. 4 refs., 4 figs., 1 tab.

Comparison of the hemodynamic response to induction and intubation during a target-controlled infusion of propofol with 2 different pharmacokinetic models. A prospective ramdomized trial.

Science.gov (United States)

Ramos Luengo, A; Asensio Merino, F; Castilla, M S; Alonso Rodriguez, E

2015-11-01

Determine the best propofol pharmacokinetic model that meets patient requirements and is devoid of major haemodynamic side effects. Prospective, randomised, open-label, clinical trial was performed on an intention to treat basis. It included 280 patients with ASA physical status i-iii, aged 18 to 80 years and weight range between 45 to 100kg, scheduled for surgery under general anaesthesia. They were randomized into 2 groups according to the pharmacokinetic model: Modified Marsh group and Schnider group. The haemodynamic changes that occurred during the induction and intubation were analysed. A propofol target controlled infusion was started to achieve and maintain a bispectral index value between 35 and 55. At minute 6, orotracheal intubation was performed and the study finished at minute 11. Heart rate, mean arterial pressure and their product (HR×MAP) were measured and recorded every minute throughout the study. Every HR×MAP value was compared to its baseline value to determine the minimum value before intubation, the maximum value after intubation, the maximum variation after intubation, and its final value. The GRADIENTE (MIN, MAX) variable (primary endpoint of this study) analyses the difference between maximal and minimal values related to intubation. Propofol doses and calculated concentrations and any hypotensive events were also recorded. No differences were found between groups regarding haemodynamic performance. GRADIENTE (MIN, MAX) values and the percentage of hypotensive events were: Modified Marsh group median 77.41% vs. Schnider group 84.86% (p= 0.821) and 17.3% vs. 12.8% (p = 0.292), respectively. The study failed to demonstrate any haemodynamic difference between the 2 groups, even though the Modified Marsh group received a larger dose of propofol. Copyright © 2014 Sociedad Española de Anestesiología, Reanimación y Terapéutica del Dolor. Publicado por Elsevier España, S.L.U. All rights reserved.

Regional enteritis and gluten-free diet. A clinical study

NARCIS (Netherlands)

Merwe, Christiaan Frederik van der

1974-01-01

The purpose of this clinical study was to determine whether the use of a gluten-free diet influenced the course and prognosis of regional enteritis. Following a few clinical communications in the Dutch medical literature reporting favourable results obtained with the gluten-free diet in the

Cross-Country Entrepreneurial Intentions Study: The Danube Region Perspective

Directory of Open Access Journals (Sweden)

Urban Šebjan

2016-12-01

Full Text Available In this article, we investigate how entrepreneurial intentions of individuals in the eight countries of the Danube region are shaped by different components of individuals’ personal attitudes, the subjective norm and personal behavioral control. We analyze the internal structure of these components as well as some demographic and human capital factors. Cultural and developmental differences influencing variation in causal effects among variables in the model are analyzed. Structural equation modeling is used for data obtained by adult population surveys within the GEM research. Results of our study show that the entrepreneurial intention model is applicable across countries and that the internal effects among components of motivational antecedents exist, although not all hypothesized relationships are confirmed. Our study suggests that the process from perception to intention is similarly shaped across the eight countries of the Danube region, although there are several differences in the magnitude of causal effects as well as differences regarding influential factors.

MHC Region and Its Related Disease Study

DEFF Research Database (Denmark)

Cao, Hongzhi

The major histocompatibility complex (MHC) is one of the most gene dense regions in the human genome and many disorders, including primary immune deficiencies, autoimmune conditions, infections, cancers and mental disorder have been found to be associated with this region. However, due to a high ...

Cultural similarities and differences in medical professionalism: a multi-region study.

Science.gov (United States)

Chandratilake, Madawa; McAleer, Sean; Gibson, John

2012-03-01

Over the last two decades, many medical educators have sought to define professionalism. Initial attempts to do so were focused on defining professionalism in a manner that allowed for universal agreement. This quest was later transformed into an effort to 'understand professionalism' as many researchers realised that professionalism is a social construct and is culture-sensitive. The determination of cultural differences in the understanding of professionalism, however, has been subject to very little research, possibly because of the practical difficulties of doing so. In this multi-region study, we illustrate the universal and culture-specific aspects of medical professionalism as it is perceived by medical practitioners. Forty-six professional attributes were identified by reviewing the literature. A total of 584 medical practitioners, representing the UK, Europe, North America and Asia, participated in a survey in which they indicated the importance of each of these attributes. We determined the 'essentialness' of each attribute in different geographic regions using the content validity index, supplemented with kappa statistics. With acceptable levels of consensus, all regional groups identified 29 attributes as 'essential', thereby indicating the universality of these professional attributes, and six attributes as non-essential. The essentialness of the rest varied by regional group. This study has helped to identify regional similarities and dissimilarities in understandings of professionalism, most of which can be explained by cultural differences in line with the theories of cultural dimensions and cultural value. However, certain dissonances among regions may well be attributable to socio-economic factors. Some of the responses appear to be counter-cultural and demonstrate practitioners' keenness to overcome cultural barriers in order to provide better patient care. © Blackwell Publishing Ltd 2012.

A Study on management plan of pollutants in agricultural region

Energy Technology Data Exchange (ETDEWEB)

Choi, Jee Yong; Shin, Eun Sung [Korea Environment Institute, Seoul (Korea)

1998-12-01

The water environment in fishing and agricultural region in Korea is getting poor. For improving the quality of water, it is essential to manage pollutants by agricultural activities. For an efficient water quality control, a reasonable examination of the amount of agricultural pollutant load, and the development of efficient technology and policy for reducing the amount of pollution load are required. The management of pollutants considering agricultural characteristics was derived in this study and the amount of discharged pollutants by land usage in agricultural region was researched. 43 refs., 17 figs., 61 tabs.

Geophysical study of the Clear Lake region, California

Energy Technology Data Exchange (ETDEWEB)

Chapman, R.H.

1975-01-01

Results of geophysical studies in the Clear Lake region of California, north of San Francisco, have revealed a prominent, nearly circular negative gravity anomaly with an amplitude of more than 25 milligals (mgal) and an areal extent of approximately 250 square miles and, in addition, a number of smaller positive and negative anomalies. The major negative gravity anomaly is closely associated with the Clear Lake volcanic field and with an area characterized by hot springs and geothermal fields. However, the anomaly cannot be explained by mapped surface geologic features of the area. Aeromagnetic data in the Clear Lake region show no apparent correlation with the major negative gravity anomaly; the local magnetic field is affected principally by serpentine. An electrical resistivity low marks the central part of the gravity minimum, and a concentration of earthquake epicenters characterizes the Clear Lake volcanic field area. The primary cause of the major negative gravity anomaly is believed to be a hot intrusive mass, possibly a magma chamber, that may underlie the Clear Lake volcanic field and vicinity. This mass may serve as a source of heat for the geothermal phenomena in the area. Other smaller gravity anomalies in the Clear Lake region are apparently caused by near-surface geologic features, including relatively dense units of the Franciscan Formation and less dense Cenozoic sedimentary and volcanic rock units.

[Myxomatosis in Tunisia: seroepidemiological study in the Monastir region (Tunisia)].

Science.gov (United States)

Ghram, A; Benzarti, M; Amira, A; Amara, A

1996-01-01

A sero-epidemiological study of myxomatosis, realized in the region of Monastir, confirmed the existence and the prevalence of the disease in its nodular form. Different strains of the myxomatosis virus were isolated and identified by gel immunodiffusion test (GID) using specific polyclonal sera. Serological analyses using complement fixation (FC) and (GID) tests allowed the detection of specific antibodies in sera from both healthy and sick animals. The results also confirmed the better sensitivity of the FC over the GID. Overall rates infection of herds and animals were 54.9% and 32.63% (p myxomatosis cases suggests that the disease first appeared in the coastal region then moved inside the Sabel area. Breeding and farming conditions, associated with deficiency in sanitary and medical measures, are at the origin of the introduction and the wide distribution of myxomatosis in this region.

A region-based palliative care intervention trial using the mixed-method approach: Japan OPTIM study

Directory of Open Access Journals (Sweden)

Morita Tatsuya

2012-01-01

Full Text Available Abstract Background Disseminating palliative care is a critical task throughout the world. Several outcome studies explored the effects of regional palliative care programs on a variety of end-points, and some qualitative studies investigated the process of developing community palliative care networks. These studies provide important insights into the potential benefits of regional palliative care programs, but the clinical implications are still limited, because: 1 many interventions included fundamental changes in the structure of the health care system, and, thus, the results would not be applicable for many regions where structural changes are difficult or unfeasible; 2 patient-oriented outcomes were not measured or explored only in a small number of populations, and interpretation of the results from a patient's view is difficult; and 3 no studies adopted a mixed-method approach using both quantitative and qualitative methodologies to interpret the complex phenomenon from multidimensional perspectives. Methods/designs This is a mixed-method regional intervention trial, consisting of a pre-post outcome study and qualitative process studies. The primary aim of the pre-post outcome study is to evaluate the change in the number of home deaths, use of specialized palliative care services, patient-reported quality of palliative care, and family-reported quality of palliative care after regional palliative care intervention. The secondary aim is to explore the changes in a variety of outcomes, including patients' quality of life, pain intensity, family care burden, and physicians' and nurses' knowledge, difficulties, and self-perceived practice. Outcome measurements used in this study include the Care Evaluation Scale, Good Death Inventory, Brief pain Inventory, Caregiving Consequence Inventory, Sense of Security Scale, Palliative Care Knowledge test, Palliative Care Difficulties Scale, and Palliative Care Self-reported Practice Scale. Study

Toward Intelligent Hemodynamic Monitoring: A Functional Approach

Directory of Open Access Journals (Sweden)

Pierre Squara

2012-01-01

Full Text Available Technology is now available to allow a complete haemodynamic analysis; however this is only used in a small proportion of patients and seems to occur when the medical staff have the time and inclination. As a result of this, significant delays occur between an event, its diagnosis and therefore, any treatment required. We can speculate that we should be able to collect enough real time information to make a complete, real time, haemodynamic diagnosis in all critically ill patients. This article advocates for “intelligent haemodynamic monitoring”. Following the steps of a functional analysis, we answered six basic questions. (1 What is the actual best theoretical model for describing haemodynamic disorders? (2 What are the needed and necessary input/output data for describing this model? (3 What are the specific quality criteria and tolerances for collecting each input variable? (4 Based on these criteria, what are the validated available technologies for monitoring each input variable, continuously, real time, and if possible non-invasively? (5 How can we integrate all the needed reliably monitored input variables into the same system for continuously describing the global haemodynamic model? (6 Is it possible to implement this global model into intelligent programs that are able to differentiate clinically relevant changes as opposed to artificial changes and to display intelligent messages and/or diagnoses?

A comparative study of induction, maintenance and recovery characteristics of sevoflurane and halothane anaesthesia in pediatric patients (6 months to 6 years

Directory of Open Access Journals (Sweden)

Shruti Redhu

2010-01-01

Conclusion: We conclude that induction with sevoflurane in nitrous oxide and oxygen leads to fast loss of consciousness and provides ideal conditions for managing the airway without supplemental opioids or muscle relaxants with haemodynamic stability and is therefore a reasonable alternative to halothane for paediatric patients.

HISTORIOGRAPHY GENERAL, REGIONAL AND SPECIAL STUDIES OF JUDICIAL REFORM IN RUSSIA 1864

Directory of Open Access Journals (Sweden)

Sergei Evgenievich Strakhov

2014-10-01

Full Text Available In today's world, a crucial role is played by the judiciary. In the period lasting judicial reform, it is important to explore this institution not only at the present stage, but also to trace the history of its development, including - through analysis and synthesis of existing studies of the judiciary and judicial reforms.The purpose of this study - to explore the historiography of general, special and regional studies of judicial reform of1864 inRussia, to classify research on history and on the subject of the study.Scientific, theoretical and practical significance of the work lies in the fact that the study of this topic will summarize the significant weight of the studies of the judicial reform of 1864 and classified by facilitating orientation interested in individuals in the study subjects.The author uses historical, comparative, hermeneutical, mathematical methods, as well as general methods of scientific research.The author analyzes the historiography of general, special and regional studies of the judicial reform of1864 inRussia, introducing a classification of such studies in chronological order (pre-revolutionary, Soviet and modern stages and subject matter (common - affecting all aspects of judicial reform, special - dedicated to a particular aspect (legal agencies, prosecutors, legal, etc. and regional - dedicated to judicial reform, or some aspects of it in some regions of Russia.The results of this study are scientific and practical value, because they can be useful for teaching students - in industry disciplines "judiciary", "advocacy", "notary public", "public prosecutor's supervision" and general theoretical "History of State and Law," "History of the fatherland" ; in science - by picking up information about the historiography of the judicial reform, and in practice - said work can serve as a guide to research judicial reform, which may be useful to practitioners of judicial and investigative bodies, as well as - prosecutors

Histological grade of differentiation of hepatocellular carcinoma: comparison of the efficacy of diffusion-weighted MRI with T2-weighted imaging and angiography-assisted CT

International Nuclear Information System (INIS)

Saito, Kazuhiro; Nishio, Ryota; Saguchi, Toru; Akata, Soichi; Tokuuye, Koichi; Moriyasu, Fuminori; Sugimoto, Katsutoshi

2012-01-01

The purpose of this study is to determine the usefulness of diffusion-weighted imaging (DWI) for evaluating the histological grade of differentiation of hepatocellular carcinoma (HCC) compared with T2-weighted imaging (T2WI) and tumour haemodynamics. We retrospectively evaluated 32 patients with 42 pathologically confirmed HCC nodules. These patients underwent MRI, CT during arterial portography and CT hepatic arteriography. We evaluated the relationship between the histological grade of differentiation and the apparent diffusion coefficient (ADC) values, conspicuity of tumour on DWI, DWI and T2WI contrast-to-noise (C/N) ratios and tumour haemodynamics. There was no correlation between the histological grade of differentiation and the ADC values. The DWI C/N ratio was significantly different among all histological grades, but the T2WI C/N ratio was not. Tumour conspicuity on DWI correlated well with the histological grade of differentiation, but tumour haemodynamics only partially correlated with the histological grade of differentiation. DWI was useful for evaluating the histological grade of differentiation of HCC.

A spatial study of networking in the Vistula Lagoon region using geoinformation systems

Directory of Open Access Journals (Sweden)

Gritsenko Vladimir

2013-12-01

Full Text Available Network cooperation — the most efficient form of unlocking the economic and natural potential of territories — is rapidly developing in Russia under the influence of global processes. Due to its unique geopolitical position, the Kaliningrad region is one of the regions where such networks develop at both the regional and international levels. When studying such forms of cooperation, the traditional methods of social sciences as research tools are not sufficient, which is explained by the dynamic nature of network cooperation as well as the fact that it involves a significant number of independent agents. We believe that one of the important tools of research on network cooperation is regional integral geoinformation systems (GIS. Modern GIS are successfully used in related fields, such as environmental and climate studies, geology, urban studies, and serve as rather efficient tools of analysing spatial objects and phenomena. One of such systems has been developed and is successfully functioning at the Immanuel Kant Baltic Federal University, which makes it possible to use it in studying network cooperation in the framework of crossborder development with the involvement of Kaliningrad municipalities. The key objective set by the authors of the article is to justify the need for studying the emerging network cooperation with the help of both traditional methods of geography and modern GIS; a specific case is made of the cross-border Vistula lagoon region — the one that brings together Russian and Polish municipalities. The authors provide with the background for the search of possible development strategies in the region, and note that the creation of a regional GIS structure can become a necessary component of the region’s information and communication structure; this conclusion can be considered the key result of the research conducted. The practical significance of the article lies in justifying the use of modern geoinformation systems

In-vitro study on haemodiluted blood flow in a sinusoidal microstenosis.

Science.gov (United States)

Kang, M J; Ji, H-S; Lee, S J

2010-01-01

In-vitro experiments were carried out to investigate the haemodynamic and haemorheological behaviours of haemodiluted blood flow through a microstenosis using a micro-particle image velocimetry (PIV) technique. The micro-PIV system employed in this study consisted of a two-head neodymium:yttrium-aluminium-garnet (Nd:YAG) laser, a cooled charge-coupled device camera, and a delay generator. To simulate blood flow in a stenosed vascular vessel, a polydimethylsiloxane (PDMS) microchannel with a sinusoidal throat of 80 per cent severity was employed. The width and depth of the microchannel were 100 microm and 50 microm, respectively. To compare the flow characteristics in the microstenosis, the same experiments were repeated in a straight microchannel under the same flow conditions. Using a syringe pump, human blood with 5 per cent haematocrit was supplied into the microstenosis channel. The flow characteristics and transport of blood cells through the microstenosis were investigated with various flowrates. The mean velocity fields were nearly symmetric with respect to the channel centreline. In the contraction section, the oncoming blood flow was accelerated rapidly, and the maximum velocity at the throat was almost 4.99 times faster than that of the straight microchannel without stenosis. In the diffusion section, the blood cells show rolling, deformation, twisting, and tumbling motion due to the flow-choking characteristics at the stenotic region. The results from this study will provide useful basic data for comparison with those obtained by clinical researchers.

Creativity in fashion design in Slovakia: the case study of Bratislava region

OpenAIRE

Rudolf Pástor; Jana Parízková

2013-01-01

This paper is focused on creativity in the fashion design in Slovakia. The fashion design in Bratislava region was selected as one of the creative industry for our research. The aim of the paper is to analyze creativity and innovation activities between Slovak fashion designers. In the paper will be presented results from research carried out between Slovak fashion designers located in Bratislava region. The empirical work that provides the basis for this case study used a case study approach...

THE ROLE OF SMALL AND MEDIUM ENTERPRISES IN THE REGIONALIZATION PROCESS – CASE STUDY

Directory of Open Access Journals (Sweden)

AMALIA VENERA TODORUȚ

2013-12-01

Full Text Available The study presents a short economic incursion concerning the role of small and medium enterprises in the complex regionalization process of Romania and the impact of this sector on the economic development of the regions, as generating new value. In this paper I have approached aspects related to the problematic of regionalization within the new economic context, which is marked by major turbulence with medium and long-term effects. The development disparities are a reality and, therefore, the interventions of the regional development process is designed to reduce these disparities. Through the case study presented, based on the scientific investigations in the field of small and medium enterprises, I have shown which the analyzed economic disparities are, using the following indicators: the grand domestic product per inhabitant, the number of small and medium enterprises on regions, the number of SMEs in economic sectors and development regions, the average number of employees in SMEs, the share of the turnover in SMEs at the regional level. I have also presented several factors that contribute to eliminate the disparities and develop the regions, focusing on the importance of the innovation and creation process, the development of the human resource, the specialization of regions, infrastructure and accessibility.

Study of Stroke Incidence in the Aseer Region, Southwestern Saudi Arabia.

Science.gov (United States)

Alhazzani, Adel A; Mahfouz, Ahmed A; Abolyazid, Ahmed Y; Awadalla, Nabil J; Aftab, Razia; Faraheen, Aesha; Khalil, Shamsun Nahar

2018-01-26

Recent data regarding first-stroke incidence in Saudi Arabia in general and in the Aseer region in particular are scarce and even lacking. The aim of this work was to study the first-time stroke incidence in the Aseer region, southwestern Saudi Arabia. All first-stroke patients admitted to all hospitals in the Aseer region over a one-year period (January through December 2016) were included. Stroke patients outside the Aseer region were excluded from the study. The incidence per 100,000 patients and the concomitant 95% CI (Confidence Intervals) were computed. The present study included 1249 first-time stroke patients and calculated an overall minimal incidence rate of hospitalized first-time stroke of 57.64 per 100,000 persons per year (95% CI: 57.57-57.70). A steady increase was noticed depending on the patients' age, reaching a figure of 851.81 (95% CI: 849.2-854.5) for those patients aged 70 years and more. Overall, the incidence rate for females (48.14; 95% CI: 48.04-48.24) was lower compared to males (65.52; 95% CI: 65.1-66.0). Taking into consideration the expected rise of the elderly because of the prominent medical services provided by the Saudi government, leading to a subsequent change in the horizontal and vertical age distribution structure of the population, an increase in the number of stroke patients is expected. It is suggested to establish a nationwide stroke surveillance system in the Kingdom, with the objective to report, analyze, and maintain an updated overview of the stroke status in Saudi Arabia.

Site specific transfer factor studies for Kaiga region

International Nuclear Information System (INIS)

Karunakara, N.

2012-01-01

The Radioecology Laboratory of University Science Instrumentation Centre, Mangalore University is engaged in frontline research studies on different aspects of environmental radioactivity and radiation protection for the last 20 years. Extensive studies have been carried out on radiation levels, radionuclides distribution, and transfer of radionuclides through terrestrial, aquatic and atmospheric pathways in the environment of West Coast of India including the Kaiga nuclear power plant. The baseline studies on radioactivity levels around Kaiga region was carried out well before the nuclear power plant became operational and the data generated under these studies are considered to be highly valuable for future impact assessments. The nuclear power plant became operational in the year 1999 and since then this laboratory is involved in radiological impact assessment studies around the nuclear power plant. Detailed Kaiga specific studies are now ongoing to estimate the transfer factors and transfer coefficients for radionuclides for different pathways, such as, (i) soil to rice (ii) soil to different types of vegetables (iii) water/sediment to fish (iv) soil to grass (v) grass to cow milk and (vi) milk to child. For these studies, rice and vegetable fields were developed very close to the nuclear power plant in Kaiga to study the transfer of radionuclides. The water required for this field was drawn from coolant water discharge canal of the power plant. Rice and different types of vegetables were grown in the experimental fields in different seasons of the year and the uptake of radionuclides was studied. For a comparative study, rice and vegetables were also collected from the fields of farmers of nearby villages and analysed. The transfer of artificial radionuclides through pathway involving cow milk was also studied in detail. A grass field was developed and cows were adopted specifically for this study. The cows were allowed to graze freely in this grass field

A regional strategy for ecological sustainability: A case study in Southwest China.

Science.gov (United States)

Wu, Xue; Liu, Shiliang; Cheng, Fangyan; Hou, Xiaoyun; Zhang, Yueqiu; Dong, Shikui; Liu, Guohua

2018-03-01

Partitioning, a method considering environmental protection and development potential, is an effective way to provide regional management strategies to maintain ecological sustainability. In this study, we provide a large-scale regional division approach and present a strategy for Southwest China, which also has extremely high development potential because of the "Western development" policy. Based on the superposition of 15 factors, including species diversity, pattern restriction, agricultural potential, accessibility, urbanization potential, and topographical limitations, the environmental value and development benefit in the region were quantified spatially by weighting the sum of indicators within environmental and development categories. By comparing the scores with their respective median values, the study area was divided into four different strategy zones: Conserve zones (34.94%), Construction zones (32.95%), Conflict zones (16.96%), and Low-tension zones (15.16%). The Conflict zones in which environmental value and development benefit were both higher than the respective medians were separated further into the following 5 levels: Extreme conflict (36.20%), Serious conflict (28.07%), Moderate conflict (12.28%), Minor conflict (6.55%), and Slight conflict (16.91%). We found that 9.04% of nature reserves were in Conflict zones, and thus should be given more attention. This study provides a simple and feasible method for regional partitioning, as well as comprehensive support that weighs both the environmental value and development benefit for China's current Ecological Red Line and space planning and for regional management in similar situations. Copyright © 2017 Elsevier B.V. All rights reserved.

Hemodiafiltración en línea pre-dilucional, frente a post-dilucional: estudio comparativo de eficacia dialítica y tolerancia hemodinámica Pre-dilution versus post-dilution on-line haemodiafiltration: a comparative study of dialytic efficacy and haemodynamic tolerance

Directory of Open Access Journals (Sweden)

Raquel Menezo Viadero

2012-06-01

-dilucional en relación a los parámetros estudiados siempre que no se tenga en cuenta la problemática de los accesos vasculares. Con dicha técnica logramos mejores resultados de KT precisando la mitad de volumen de sustitución, con el consiguiente ahorro de agua ultrapura. La hemodiafiltración pre-dilucional puede ser una alternativa para aquellos pacientes que no se consiga un flujo arterial alto.On-line haemodiafiltration is a dialysis technique which combines the advantages of high-flow haemodialysis (diffusive transport and haemofiltration (convective transport. This technique allows different alternatives depending on how the reinfusion liquid is added: pre-dilution (before the dialyser and post-dilution (after the dialyser, each of them having advantages and disadvantages. The object of this study was to compare different dialytic and haemodynamic parameters in the pre- and post-dilution haemodiafiltration modes. A transversal prospective study was conducted of a population in dialysis already being treated with on-line haemodiafiltration, using each of the modes (pre- and post-dilution with them for 4 weeks. The following values were recorded: systolic and diastolic arterial pressure and cardiac frequency pre- and post-session, blood flow, venous pressure, volume of blood dialysed and replacement volume. Dialysis dosage was measured by means of ionic dialysance. 26 patients were studied: 30% women and 70% men, with an average age of 61±13 years. The average time under renal replacement treatment was 117±124.45 months, and the average time in haemodialysis was 50±54.38 months. The haemodynamic parameters showed no significant differences between the two modes studied (pre- and post-dilution. A statistically significant higher value for KT was obtained for the post-dilution haemodiafiltration technique, requiring half the replacement volume of the pre-dilution mode. Conclusions: The on-line haemodiafiltration technique is tolerated well in both infusion modes. With

Effect of the left lateral recumbent position compared with the supine and upright positions on placental blood flow in normal late pregnancy.

Science.gov (United States)

Suonio, S; Simpanen, A L; Olkkonen, H; Haring, P

1976-02-01

The placental blood flow was assessed by the 99mTc accumulation method in 10 normal pregnancies in the left lateral recumbent position accomplished by a 15 degree wedge and in the supine position. The postural change caused a 17% decrease in the mean placental accumulation rate, which was not statistically significant. Ten patients were moved from the left lateral recumbent position to the upright position, which caused a statistically significant 23% decrease in the mean accumulation rate. Other haemodynamic variables studied were the maternal heart rate and the systolic and diastolic blood pressures. The clinical significance of the haemodynamic changes produced by alterations in posture are briefly discussed.

World Regional Studies as a Research Framework and Academic Discipline

Directory of Open Access Journals (Sweden)

Ekaterina V. Koldunova

2016-01-01

Full Text Available Dynamic development of international processes at the regional level, various trajectories of regionalization in Europe, Asia, Latin America and other parts of the world created a complex and multidimensional picture of the contemporary international relations. However Social Sciences and IR retained a distinct eurocentrism. This eurocentrism only partly meant that students of IR did not take into account non-European or non-Western realities. Thus, a German Scholar J. Vullers from German Institute of Global and Area Studies analyzing in 2014 three leading International Relations journals (International Organization, World Politics, European Journal of International Relations diagnosed a serious geographic imbalance in the international studies, which meant a very limited number of articles based on the nonWestern empirical data.Even with such geographic imbalance in IR studies more important for preserving eurocentrism there was the absence of non-Western IR theories or IR theories originating from non-Western political context. The collective monograph edited by Barry Buzan and Amitav Acharya focused exactly on this problem. The title of the book was provocatively asking why there is no non-Western IR theory. Thus, the book in question provoked a lively academic debate on the topic. Russia was not covered in this book. Therefore, this very fact gives one some reasons to reflect on how Russian research in the field may face a double challenge of a changing international environment and an inappropriate level of its intellectual assessment. Against this background this article analyzes World Regional Studies, a research framework and discipline, which is rapidly developing in Russia and may to some extent contribute to a more correct understanding of the international processes.

Toward a regional power plant siting method: AEC-Maryland regional siting factors study, FY 1974 progress report

International Nuclear Information System (INIS)

Yaffee, S.L.; Miller, C.A.

1974-11-01

The ''AEC-Maryland Regional Siting Factors Study'' examines the process of siting in a regional context. It is developing an analysis method to delineate candidate areas for siting of several power plant technology packages, including both fossil-fueled and nuclear options. Tools that are being used include simulation modeling, economic and demographic forecasting, spatial analysis, and computer graphics and numerical manipulation. The approach will describe the trade-offs incurred if a power plant is located in one candidate area rather than in another. In FY 1974, a suitability analysis method was developed which uses engineering and environmental parameters to define a level of environmental cost incurred if a segment of land is used to site a specific technology package. (U.S.)

Spiral blood flow in aorta-renal bifurcation models.

Science.gov (United States)

Javadzadegan, Ashkan; Simmons, Anne; Barber, Tracie

2016-01-01

The presence of a spiral arterial blood flow pattern in humans has been widely accepted. It is believed that this spiral component of the blood flow alters arterial haemodynamics in both positive and negative ways. The purpose of this study was to determine the effect of spiral flow on haemodynamic changes in aorta-renal bifurcations. In this regard, a computational fluid dynamics analysis of pulsatile blood flow was performed in two idealised models of aorta-renal bifurcations with and without flow diverter. The results show that the spirality effect causes a substantial variation in blood velocity distribution, while causing only slight changes in fluid shear stress patterns. The dominant observed effect of spiral flow is on turbulent kinetic energy and flow recirculation zones. As spiral flow intensity increases, the rate of turbulent kinetic energy production decreases, reducing the region of potential damage to red blood cells and endothelial cells. Furthermore, the recirculation zones which form on the cranial sides of the aorta and renal artery shrink in size in the presence of spirality effect; this may lower the rate of atherosclerosis development and progression in the aorta-renal bifurcation. These results indicate that the spiral nature of blood flow has atheroprotective effects in renal arteries and should be taken into consideration in analyses of the aorta and renal arteries.

Nuclear Hybrid Energy Systems - Regional Studies. West Texas and Northeastern Arizona

Energy Technology Data Exchange (ETDEWEB)

Garcia, Humberto E. [Idaho National Lab. (INL), Idaho Falls, ID (United States); Chen, Jun [Idaho National Lab. (INL), Idaho Falls, ID (United States); Kim, Jong S. [Idaho National Lab. (INL), Idaho Falls, ID (United States); McKellar, Michael G. [Idaho National Lab. (INL), Idaho Falls, ID (United States); Deason, Wesley R. [Idaho National Lab. (INL), Idaho Falls, ID (United States); Vilim, Richard B. [Idaho National Lab. (INL), Idaho Falls, ID (United States); Bragg-Sitton, Shannon M. [Idaho National Lab. (INL), Idaho Falls, ID (United States); Boardman, Richard D. [Idaho National Lab. (INL), Idaho Falls, ID (United States)

2015-04-01

The primary objective of this study is to conduct a preliminary dynamic analysis of two realistic hybrid energy systems (HES) including a nuclear reactor as the main baseload heat generator (denoted as nuclear HES or nuclear hybrid energy systems [NHES]) and to assess the local (e.g., HES owners) and system (e.g., the electric grid) benefits attainable by the application of NHES in scenarios with multiple commodity production and high penetration of renewable energy. It is performed for regional cases - not generic examples - based on available resources, existing infrastructure, and markets within the selected regions. This study also briefly addresses the computational capabilities developed to conduct such analyses, reviews technical gaps, and suggests some research paths forward.

Nucleon electromagnetic structure studies in the spacelike and timelike regions

International Nuclear Information System (INIS)

Guttmann, Julia

2013-01-01

The thesis investigates the nucleon structure probed by the electromagnetic interaction. One of the most basic observables, reflecting the electromagnetic structure of the nucleon, are the form factors, which have been studied by means of elastic electron-proton scattering with ever increasing precision for several decades. In the timelike region, corresponding with the proton-antiproton annihilation into a electron-positron pair, the present experimental information is much less accurate. However, in the near future high-precision form factor measurements are planned. About 50 years after the first pioneering measurements of the electromagnetic form factors, polarization experiments stirred up the field since the results were found to be in striking contradiction to the findings of previous form factor investigations from unpolarized measurements. Triggered by the conflicting results, a whole new field studying the influence of two-photon exchange corrections to elastic electron-proton scattering emerged, which appeared as the most likely explanation of the discrepancy. The main part of this thesis deals with theoretical studies of two-photon exchange, which is investigated particularly with regard to form factor measurements in the spacelike as well as in the timelike region. An extraction of the two-photon amplitudes in the spacelike region through a combined analysis using the results of unpolarized cross section measurements and polarization experiments is presented. Furthermore, predictions of the two-photon exchange effects on the e + p/e - p cross section ratio are given for several new experiments, which are currently ongoing. The two-photon exchange corrections are also investigated in the timelike region in the process p anti p → e + e - by means of two factorization approaches. These corrections are found to be smaller than those obtained for the spacelike scattering process. The influence of the two-photon exchange corrections on cross section

Cardiac output response to changes of the atrioventricular delay in different body positions and during exercise in patients receiving cardiac resynchronization therapy

DEFF Research Database (Denmark)

Ståhlberg, Marcus; Damgaard, Morten; Norsk, Peter

2009-01-01

AIMS: The aim of this study was to study the haemodynamic effect of atrioventricular delay (AVD) modifications within a narrow range in different body positions and during exercise in patients receiving cardiac resynchronization therapy (CRT). METHODS: The previously optimized AVD was shortened...... and prolonged by 40 ms in 27 CRT patients and 9 controls without heart failure. Cardiac output (CO) was measured by inert gas rebreathing (Innocor) as the average over different body positions (left-lateral, supine, sitting, standing, and exercise). In eight CRT patients with an implantable haemodynamic monitor......, the estimated pulmonary artery diastolic pressure (ePAD) was analysed. RESULTS: The magnitude of CO response to AVD changes was greater in CRT patients than in controls (0.25 vs. 0.20 L/min, Psize (r=0...

Pulmonary dynamics of radiolabelled erythrocytes and leucocytes in early gram-negative sepsis in pigs

International Nuclear Information System (INIS)

Walther, Sten; Wenyao, Shi; Lennquist, Sten

1999-01-01

objective: to study the pulmonary dynamic of erythrocytes and leucocytes in vivo in early experimental sepsis. design: open, experimental study. setting: academic research laboratory, Sweden. material: 10 adolescent, domestic pigs. interventions: technetium (Tc 99) labelling of erythrocytes (n=5) and indium (In 111) labelling of autologous leucocytes (n=10). sepsis was induced by endotoxin (n=4) or live Escherichia Coli (n=3), given intravenously. major outcome measures: regional pulmonary scintigraphy, central haemodynamics and gas exchange followed for 180 minutes. results: septic animals developed arterial hypoxia, pulmonary hypertension and systemic hypotension. They also had an early increase in mean (SD) regional pulmonary erythrocyte and leucocyte counts (+10.3(7.7%) and + 12.0 (3.5%) respectively) with simultaneous maximum 27-32 minutes after the start of the septic insult. Conclusions: The immediate sepsis-induced pulmonary accumulation of leucocytes as detected by external scintigraphy can be ascribed at least in part, to a simultaneous sepsis-induced increase in pulmonary blood volume. 3 figs., 1 tab., 19 refs

Building a competitive regional innovation environment : the regional development platform method as a tool for regional innovation policy

OpenAIRE

Harmaakorpi, Vesa

2004-01-01

The study focuses on building a regional innovation policy tool that takes into account the demands of the present techno-economic and socio-institutional paradigms. Regions are seen to be strongly dependent on their history. The competitiveness of a region is based on the regional resource configurations. In a turbulent world these resource configurations have to be renewed over time setting demands for regional dynamic capabilities. This study emphasises five regional dynamic capabilities: ...

Monitoring road safety development at regional level: A case study in the ASEAN region.

Science.gov (United States)

Chen, Faan; Wang, Jianjun; Wu, Jiaorong; Chen, Xiaohong; Zegras, P Christopher

2017-09-01

Persistent monitoring of progress, evaluating the results of interventions and recalibrating to achieve continuous improvement over time is widely recognized as being crucial towards the successful development of road safety. In the ASEAN (Association of Southeast Asian Nations) region there is a lack of well-resourced teams that contain multidisciplinary safety professionals, and specialists in individual countries, who are able to carry out this work effectively. In this context, not only must the monitoring framework be effective, it must also be easy to use and adapt. This paper provides a case study that can be easily reproduced; based on an updated and refined Road Safety Development Index (RSDI), by means of the RSR (Rank-sum ratio)-based model, for monitoring/reporting road safety development at regional level. The case study was focused on the road safety achievements in eleven Southeast Asian countries; identifying the areas of poor performance, potential problems and delays. These countries are finally grouped into several classes based on an overview of their progress and achievements regarding to road safety. The results allow the policymakers to better understand their own road safety progress toward their desired impact; more importantly, these results enable necessary interventions to be made in a quick and timely manner. Keeping action plans on schedule if things are not progressing as desired. This would avoid 'reinventing the wheel' and trial and error approaches to road safety, making the implementation of action plans more effective. Copyright © 2017 Elsevier Ltd. All rights reserved.

Case control study of Electrocardiographic changes in pregnant women

Directory of Open Access Journals (Sweden)

Sharddha Singh

1995-09-01

Full Text Available Pregnancy causes significant haemodynamic changes and imposes stress on the cardiovascular system. Many healthy women develop signs and symptoms of cardiovascular overload during pregnancy. Knowledge of established normal changes in EKG during normal pregnancy is important. The aim of our study was to detect any early damage to myocardium during pregnancy with the help of electrocardiography. Total of 20 pregnant and 20 non pregnant women were studied. The most significant change observed in ECG was T wave inversion with odds ratio 7.43 (95%. Cl = 1.49 to 41.00. P= 0.005. Stratified analysis showed that there was no confounding role of age in the relationship of T wave inversion and ECG findings. Moreover, a significant relationship between anaemia and T wave inversion was also observed. (0=1.74 ■ 1101.06; P= 0.007.

Critical review of studies on atmospheric dispersion in coastal regions

International Nuclear Information System (INIS)

Shearer, D.L.; Kaleel, R.J.

1982-09-01

This study effort was required as a preliminary step prior to initiation of field measurements of atmospheric dispersion in coastal regions. The Nuclear Regulatory Commission (NRC) is in the process of planning an extensive field measurement program to generate data which will serve as improved data bases for licensing decisions, confirmation of regulations, standards, and guides, and for site characterizations. The study being reported here is an effort directed to obtaining as much information as is possible from existing studies that is relevant toward NRC's objectives. For this study, reports covering research and meteorological measurements conducted for industrial purposes, utility needs, military objectives, and academic studies were obtained and critically reviewed in light of NRC's current data needs. This report provides an interpretation of the extent of existing usable information, an indication of the potential for tailoring existing research toward current NRC information needs, and recommendations for several follow-on studies which could provide valuable additional information through reanalysis of the data. Recommendations are also offered regarding new measurement programs. Emphasis is placed on the identification and acquisition of data from atmospheric tracer studies conducted in coastal regions. A total of 225 references were identified which deal with the coastal atmosphere, including meteorological and tracer measurement programs, theoretical descriptions of the relevant processes, and dispersion models

The regionalization of climate scenarios: towards impact studies

International Nuclear Information System (INIS)

Cariolle, D.

1999-01-01

This article describes the different types of climate numerical models and their use to obtain scenarios for climate change due to the greenhouse gas increase. Results from global or meso-scale models are given. They illustrate the existing ways of representing climatic conditions at global and regional scales. Combined with statistical approaches based for example on the techniques of analogues, their use gives a coherent strategy going from global scale numerical simulations to the study of impacts at a local scale. In the future the increase of computer power should allow a better description of the small processes and a wider range of impact studies on natural ecosystems and various economic sectors. The results of these studies will be very useful to define a coherent policy in response to observed or predicted climate changes. (author)

Integrated study of basins in the Four Corners region

Science.gov (United States)

Fagbola, Olamide Olawumi

2007-12-01

This dissertation is an integrated study of basins in the four corners area of the central part of the Colorado Plateau. The Colorado Plateau is a structurally unique part of the Rocky Mountain region because it has only been moderately deformed when compared to the more intensely deformed areas around it. The Colorado Plateau covers a portion of Utah, Colorado, New Mexico and Arizona. The study area extends from latitude 34°N-40°N to longitude 106°W-111W° encompassing a series of major basins and uplifts: the San Juan, Black Mesa, Paradox, and the Blanding basins; and the Zuni, Defiance, Four Corners, Monument uplifts and the San Juan dome and volcanic field. An analysis of gravity anomalies, basement and crustal structure for basins in the four corners region was carried out. This involved using gravity, magnetic, well, outcrop, seismic estimates of crustal thickness, and geologic data in an integrated fashion. Six filtered gravity and three filtered magnetic maps were generated to aid in the interpretation of the gravity and magnetic anomalies in the study area. A detailed comparison of these maps was carried out. The results show a deep seated mafic structure in the basement acting as a crustal boundary separating the high gravity anomalies from the low. These maps also show that the sources of these anomalies are quite shallow resulting from the upper crust in the study area. The structures in the study area are characterized by northwest and northeast trends which correspond to the Precambrian and the Late Paleozoic structures, respectively. A crustal thickness map of the area was also constructed from seismic estimates of crustal thickness. A comparison was done between the crustal thickness map and the 45 km upward continuation Bouguer anomaly map. The result of this comparison shows that areas of thicker ix crust corresponded to low gravity while areas of thinner crust means mantle material is closer to the surface, thereby producing a high gravity

A multiscale modelling approach to understand atherosclerosis formation: A patient-specific case study in the aortic bifurcation

Science.gov (United States)

Alimohammadi, Mona; Pichardo-Almarza, Cesar; Agu, Obiekezie; Díaz-Zuccarini, Vanessa

2017-01-01

Atherogenesis, the formation of plaques in the wall of blood vessels, starts as a result of lipid accumulation (low-density lipoprotein cholesterol) in the vessel wall. Such accumulation is related to the site of endothelial mechanotransduction, the endothelial response to mechanical stimuli and haemodynamics, which determines biochemical processes regulating the vessel wall permeability. This interaction between biomechanical and biochemical phenomena is complex, spanning different biological scales and is patient-specific, requiring tools able to capture such mathematical and biological complexity in a unified framework. Mathematical models offer an elegant and efficient way of doing this, by taking into account multifactorial and multiscale processes and mechanisms, in order to capture the fundamentals of plaque formation in individual patients. In this study, a mathematical model to understand plaque and calcification locations is presented: this model provides a strong interpretability and physical meaning through a multiscale, complex index or metric (the penetration site of low-density lipoprotein cholesterol, expressed as volumetric flux). Computed tomography scans of the aortic bifurcation and iliac arteries are analysed and compared with the results of the multifactorial model. The results indicate that the model shows potential to predict the majority of the plaque locations, also not predicting regions where plaques are absent. The promising results from this case study provide a proof of concept that can be applied to a larger patient population. PMID:28427316

A comparative study of some productive traits in commercial poultry farms in Duhok Region.

OpenAIRE

TAYEB, Ihsan; HASSAN, Siamand; MUSTAFA, Merkhan; SADEQ, Shawkat; AMEEN, Gulizar; HASSAN, Asia; SHEKHU, Nareen

2011-01-01

Commercial Ross 308 hybrid broiler were used in this study to evaluate a number of production parameter's including live body weight, feed intake, feed conversion ratio, production index and mortality rate. Significant differences observed in term of Mortality rate also feed intake between region 1 and both region 2 and 3. The data was collected from three regions in Duhok/ Kurdistan Region, Iraq which then will be compared with each other to identify if there is any significant differen...

Understanding Regional Actors: A Case Study

National Research Council Canada - National Science Library

Harden, James

2002-01-01

.... It is possible the estimation process could improve if greater attention was given to the interests, challenges, and opportunities of the regional actors involved, rather than concentrating on U.S. interests...

A SIMULATION STUDY ON THE SHRUNK WETLAND AROUND QINGHAI LAKE AND REGIONAL CLIMATE

Institute of Scientific and Technical Information of China (English)

WANG HanJie; JING Li; GAO YunXiao

2005-01-01

Because of the increasing concerns about global climate change, it has been known by more and more peoples that there is a close relationship between wetland and/or peatland resources and climate change. This paper presents a new methodology to study the local climate variation caused by wetland shrinking around Qinghai Lake, the largest in-land salty lake in China, by use of a regional climate model (RCM) that commonly used in climate change study. The objective focuses on the regional climate effect of the shrunk wetland coverage in recent years. The results of numerical experiment showed that if the wetland coverage around Qinhai Lake were recovered as if in early 50s of last century,the regional climate in this area could be better with more cloud covers, higher relative humidity and more precipitation. In the other word, the area of wetland reduced is one of the most important reasons that caused regional climate aridification,eco-environmental deterioration and even desertification around Qinhai Lake.

RESTORATION AND SUSTAINABLE VALORIZATION OF CULTURAL HERITAGE AND REGIONAL POLICY IN NORTH-WEST REGION OF ROMANIA. CASE STUDY OF REVITALIZATION OF THE ORADEA FORTRESS

Directory of Open Access Journals (Sweden)

Anca Dodescu

2014-12-01

Full Text Available The paper presents cultural heritage, cultural tourism potential of North-West Region of Romania face to face with restoration and sustainable valorization of cultural heritage as a major domain of intervention of regional policy in Romania. Due to Romanian regionalization form, the Regional Operational Programme (ROP is currently the only programme of regional policy in Romania in 2007-2013. One of the major domains of intervention of ROP 2007-2013 in Romania was restoration and sustainable valorization of cultural heritage. The first paper specific objective is to explore projects contracted until 31.12.2013 in the field of restoration and sustainable valorization of cultural heritage in North-West Region of Romania and their regional development relevance in the context of existing regional development strategies. The second paper specific objective is to present a model of restoration of cultural heritage in a sustainable way throughout the case study of Revitalization of the Oradea Fortress in order to introduce it in the tourism circuit - that could become an example for other cultural sites around the region and a succes story in the field of cultural tourism based of ROP 2007-2013 experience. Exploring rich cultural heritage of the North-West Region face to face with poor condition of cultural heritage sites and investments required in order to introduce them in touristic circuit, the paper concludes that all contracted projects are relevant for sustainable valorization of regional cultural heritage and cultural tourism potential in the context of existing regional development strategies, but they contributed only partially to regional specific needs. Also, the paper concludes that number of ROP 2007-2013 projects implemented in the field of cultural heritage is surprisingly small, area of interest of these projects is rather narrow and analyzes the most important causes for these gaps. Based on the case study presented, the paper

An integrated tool to study MHC region: accurate SNV detection and HLA genes typing in human MHC region using targeted high-throughput sequencing.

Directory of Open Access Journals (Sweden)

Hongzhi Cao

Full Text Available The major histocompatibility complex (MHC is one of the most variable and gene-dense regions of the human genome. Most studies of the MHC, and associated regions, focus on minor variants and HLA typing, many of which have been demonstrated to be associated with human disease susceptibility and metabolic pathways. However, the detection of variants in the MHC region, and diagnostic HLA typing, still lacks a coherent, standardized, cost effective and high coverage protocol of clinical quality and reliability. In this paper, we presented such a method for the accurate detection of minor variants and HLA types in the human MHC region, using high-throughput, high-coverage sequencing of target regions. A probe set was designed to template upon the 8 annotated human MHC haplotypes, and to encompass the 5 megabases (Mb of the extended MHC region. We deployed our probes upon three, genetically diverse human samples for probe set evaluation, and sequencing data show that ∼97% of the MHC region, and over 99% of the genes in MHC region, are covered with sufficient depth and good evenness. 98% of genotypes called by this capture sequencing prove consistent with established HapMap genotypes. We have concurrently developed a one-step pipeline for calling any HLA type referenced in the IMGT/HLA database from this target capture sequencing data, which shows over 96% typing accuracy when deployed at 4 digital resolution. This cost-effective and highly accurate approach for variant detection and HLA typing in the MHC region may lend further insight into immune-mediated diseases studies, and may find clinical utility in transplantation medicine research. This one-step pipeline is released for general evaluation and use by the scientific community.

Study of Y Chromosome Microdeletion in AZF Region in Infertile Males of Isfahan Population

Directory of Open Access Journals (Sweden)

M Motovali-Bashi

2013-02-01

Full Text Available Abstract Background & aim: One of the main genetic factors of infertility is the deletions in the chromosome Y. Accordingly this study was conducted to determine the frequency of microdeletion of AZF region in infertile men of Isfahan, Iran. Methods: In this case-control study, 100 infertile men referred to the Infertility Center of Isfahan and 100 fertile men as controls were randomly selected. Genomic DNA was extracted from their blood and amplified by sequence tagged sites-polymerase chain reaction (STS-PCR method. The presence of microdeletion in AZF locus was diagnosed. Results: No AZFa, AZFb or AZFc deletions were found in the control group. Microdeletions were observed in one patient in AZFb region, eight patients in AZFc region and two patients in AZFa region. Conclusion: The incidence of Yq microdeletions in Iranian population is similar to the international frequency. Our data agree with other studies regarding microdeletions of AZFc, but for microdeletions of AZFa (2% our results show smaller frequency and differ significantly with many studies. Key words: Infertility, Y chromosome, Microdeletion

Globalization and suicide: an ecological study across five regions of the world.

Science.gov (United States)

Milner, Allison; McClure, Rod; De Leo, Diego

2012-01-01

The impact of globalization on health is recognized to be influenced by country and regional-level factors. This study aimed to investigate the possible relationship between globalization and suicide in five world regions. An index measure of globalization was developed at the country level over 1980 to 2006. The association between the index and sex specific suicide rates was tested using a fixed-effect regression model. Over time, the globalization index seemed to be associated with increased suicide rates in Asia and the Eastern European/Baltic region. In contrast, it was associated with decreased rates in Scandinavia. There was no significant relationship between globalization and suicide in Southern and Western Europe. The effects of globalization could be determined by specific regional (i.e., cultural and societal) factors. Identification of these mediators might provide opportunities to protect countries from the adverse impacts of globalization.

Integrated regional assessment of global climatic change. Lessons from the Mackenzie Basin Impact Study (MBIS)

International Nuclear Information System (INIS)

Cohen, Stewart J.

1996-01-01

This paper outlines the potential role integrated regional assessments of global climatic change scenarios could play in building better links between science and related policy concerns. The concept is illustrated through description of an ongoing case study from Canada-the Mackenzie Basin Impact Study (MBIS). As part of the Government of Canada's Green Plan, the Global Warming Science Program includes a study of regional impacts of global warming scenarios in the Mackenzie Basin, located in northwestern Canada. The MBIS is a six-year program focussing on potential climate-induced changes in the land and water resource base, and the implications of four scenarios of global climatic change on land use and economic policies in this region. These policy issues include interjurisdictional water management, sustainability of native lifestyles, economic development opportunities (agriculture, forestry, tourism, etc.), sustainability of ecosystems and infrastructure maintenance. MBIS is due to be completed in 1997. MBIS represents an attempt to address regional impacts by incorporating a 'family of integrators' into the study framework, and by directly involving stakeholders in planning and research activities. The experience in organizing and carrying out this project may provide some lessons for others interested in organizing regional or country studies

Effects of Climatic Region on Peritonitis Risk, Microbiology, Treatment, and Outcomes: a Multicenter Registry Study

Science.gov (United States)

Cho, Yeoungjee; Badve, Sunil V.; Hawley, Carmel M.; McDonald, Stephen P.; Brown, Fiona G.; Boudville, Neil; Wiggins, Kathryn J.; Bannister, Kym M.; Clayton, Philip; Johnson, David W.

2013-01-01

♦ Background: The impact of climatic variations on peritoneal dialysis (PD)-related peritonitis has not been studied in detail. The aim of the current study was to determine whether various climatic zones influenced the probability of occurrence or the clinical outcomes of peritonitis. ♦ Methods: Using ANZDATA registry data, the study in cluded all Australian patients receiving PD between 1 October 2003 and 31 December 2008. Climatic regions were defined according to the Köppen classification. ♦ Results: The overall peritonitis rate was 0.59 episodes per patient-year. Most of the patients lived in Temperate regions (65%), with others residing in Subtropical (26%), Tropical (6%), and Other climatic regions (Desert, 0.6%; Grassland, 2.3%). Compared with patients in Temperate regions, those in Tropical regions demonstrated significantly higher overall peritonitis rates and a shorter time to a first peritonitis episode [adjusted hazard ratio: 1.15; 95% confidence interval (CI): 1.01 to 1.31]. Culture-negative peritonitis was significantly less likely in Tropical regions [adjusted odds ratio (OR): 0.42; 95% CI: 0.25 to 0.73]; its occurrence in Subtropical and Other regions was comparable to that in Temperate regions. Fungal peritonitis was independently associated with Tropical regions (OR: 2.18; 95% CI: 1.22 to 3.90) and Other regions (OR: 3.46; 95% CI: 1.73 to 6.91), where rates of antifungal prophylaxis were also lower. Outcomes after first peritonitis episodes were comparable in all groups. ♦ Conclusions: Tropical regions were associated with a higher overall peritonitis rate (including fungal peritonitis) and a shorter time to a first peritonitis episode. Augmented peritonitis prophylactic measures such as antifungal therapy and exit-site care should be considered in PD patients residing in Tropical climates. PMID:22942270

An ecological study of regional variation in work injuries among young workers

Directory of Open Access Journals (Sweden)

Smith Peter

2007-05-01

Full Text Available Abstract Background The investigation of geographic variation in occupational injuries has received little attention. Young workers 15 to 24 years are of particular concern because they consistently show elevated occupational injury rates compared to older workers. The present study sought to: (a to describe the geographic variation of work injuries; (b to determine whether geographic variation remained after controlling for relevant demographic and job characteristics; (c to identify the region-level factors that correlate with the geographic variation. Methods Using workers compensation claims and census data, we estimated claim rates per 100 full-time equivalents for 15 to 24 year olds in 46 regions in Ontario. A total of 21 region-level indicators were derived primarily from Census and Labour Force Survey data to reflect social and material deprivation of the region as well as demographic and employment characteristics of youth living in those areas. Results Descriptive findings showed substantial geographic variation in young worker injury rates, even after controlling for several job and demographic variables. Region-level characteristics such as greater residential stability were associated with low work injury rates. Also, regions with the lowest claim rates tended to have proportionally fewer cuts and burns than high-claim-rate regions. Conclusion The finding of substantial geographic variation in youth claim rates even after controlling for demographic and job factors can aid in targeting prevention resource. The association between region-level indicators such as residential stability and youth work injury suggests that work injury prevention strategies can be integrated with other local economic development measures. The findings partially support the notion that work safety measures may be unevenly distributed with respect to regional socio-economic factors.

Regional and detailed research studies for stone resources in Korea

Energy Technology Data Exchange (ETDEWEB)

NONE

1997-12-01

This report consists of 6 subjects. 1) A study on the potentiality of building stone development from granite mass within Pocheon area, Kyeonggi Province. 2) The research on the variance of color and glossiness by means of Weather-Ometer. 3) Regional research studies on granites in Gimje-Yeonggwang area. 4) A study on the industrialization of building stones and industrial stone crafts - Study on the causes of stone weathering. 5) Borehole radar survey at the granite quarry mine, Pocheon, Kyounggi province. 6) Borehole radar diffraction tomography. (author). refs., tabs., figs.

Frontolateral Approach Applied to Sellar Region Lesions: A Retrospective Study in 79 Patients

Directory of Open Access Journals (Sweden)

Hao-Cheng Liu

2016-01-01

Conclusions: FLA was an effective approach in the treatment of sellar region lesions with good preservation of visual function. FLA classification enabled tailored craniotomies for each patient according to the anatomic site of tumor invasion. This study found that FLA had similar outcomes to other surgical approaches of sellar region lesions.

Revitalisation of Orlík reservoir – case study of a regional restoration project

Directory of Open Access Journals (Sweden)

Ivana Očásková

2014-06-01

Full Text Available This case study describes the bottom-up formation of a regional project for restoring a reservoir. Land use changes in the upper Vltava river basin caused the eutrophication of Orlík reservoir, which resulted in water blooms, which in association with socio-economic changes caused a decline in tourism in this region and serious difficulties for local people. The study examines how public awareness helped in the establishment of a restoration project, its framework and strategy. Regional governance of the project management took into consideration both knowledge-based solutions and the interests of local people and municipalities. The project has the potential for resolving both environmental and socio-economic problems and providing a sustainable win-win strategy for the region, residents, tourists and stakeholders.

Infusion of hypertonic saline before elective hysterectomy: effects on cytokines and stress hormones

DEFF Research Database (Denmark)

Kolsen-Petersen, J A; Bendtzen, K; Tonnesen, E

2008-01-01

Infusion of hypertonic saline provides early haemodynamic benefits and may affect the immune system. It is unknown if infusion of hypertonic saline affects plasma cytokines and stress hormones after surgery.......Infusion of hypertonic saline provides early haemodynamic benefits and may affect the immune system. It is unknown if infusion of hypertonic saline affects plasma cytokines and stress hormones after surgery....

Hypobaric Unilateral Spinal Anaesthesia versus General Anaesthesia in Elderly Patients Undergoing Hip Fracture Surgical Repair: A Prospective Randomised Open Trial.

Science.gov (United States)

Meuret, Pascal; Bouvet, Lionel; Villet, Benoit; Hafez, Mohamed; Allaouchiche, Bernard; Boselli, Emmanuel

2018-04-01

Intraoperative hypotension during hip fracture surgery is frequent in the elderly. No study has compared the haemodynamic effect of hypobaric unilateral spinal anaesthesia (HUSA) and standardised general anaesthesia (GA) in elderly patients undergoing hip fracture surgical repair. We performed a prospective, randomised open study, including 40 patients aged over 75 years, comparing the haemodynamic effects of HUSA (5 mg isobaric bupivacaine with 5 μg sufentanil and 1 mL sterile water) and GA (induction with etomidate/remifentanil and maintenance with desflurane/remifentanil). An incidence of severe hypotension, defined by a decrease in systolic blood pressure of >40% from baseline, was the primary endpoint. The incidence of severe hypotension was lower in the HUSA group compared with that in the GA group (32% vs. 71%, respectively, p=0.03). The median [IQR] ephedrine consumption was lower (p=0.001) in the HUSA group (6 mg, 0-17 mg) compared with that in the GA group (36 mg, 21-57 mg). Intraoperative muscle relaxation and patients' and surgeons' satisfaction were similar between groups. No difference was observed in 5-day complications or 30-day mortality. This study shows that HUSA provides better haemodynamic stability than GA, with lower consumption of ephedrine and similar operating conditions. This new approach of spinal anaesthesia seems to be safe and effective in elderly patients undergoing hip fracture surgery.

Innervation of periesophageal region of cat's diaphragm - Implication for studies of control of vomiting

Science.gov (United States)

Tan, L. K.; Miller, A. D.

1986-01-01

The extent of the region of the diaphragm around the esophagus that displays greatly reduced activity during the expulsive phase of vomiting was determined from electromyographic studies in cats to be about 0.75-1.0 cm from the esophagus. Horseradish peroxidase injected into this region retrogradely labeled motoneurons throughout most of the rostral-caudal extent of the phrenic nucleus, with the exception of caudal C6 and rostral C7. This widespread intermingling of motoneurons that innervate the region of reduced activity with other phrenic motoneurons creates a difficulty for needed follow-up studies of diaphragmatic control during vomiting.

Comparison of effects on heamodynamic response between Promethazine and Droperidol for patients of elective surgery

Directory of Open Access Journals (Sweden)

Jahangiry B

1998-09-01

Full Text Available Effects of preanaesthetic medication are as follows: 1 Promotion of mental and emotional relaxation. 2 Inhibition of nausea and vomiting after surgery. 3 Stability of haemodynamic response. We performed 105 patients, randomized, single blind clinical trial, preanaesthetic drugs, promethazine and droperidol: A comparison of haemodynamic response for patients in elective surgery at imam hospital. 105 patients were divided in three groups. Promethazine group 35 patients, dropetidol group 35 patients and normal saline group 35 patients. Systolic and diastolic blood pressure and pulse rate were recorded before and after intramuscular injection. Patients of promethazine and droperidol groups responded with decreasing in blood pressure and pulse rat lower than normal saline. But haemodynamic response did not show any difference between two groups (promethazine and droperidol.

Diffusion tensor imaging detects ventilation-induced brain injury in preterm lambs.

Directory of Open Access Journals (Sweden)

Dhafer M Alahmari

Full Text Available Injurious mechanical ventilation causes white matter (WM injury in preterm infants through inflammatory and haemodynamic pathways. The relative contribution of each of these pathways is not known. We hypothesised that in vivo magnetic resonance imaging (MRI can detect WM brain injury resulting from mechanical ventilation 24 h after preterm delivery. Further we hypothesised that the combination of inflammatory and haemodynamic pathways, induced by umbilical cord occlusion (UCO increases brain injury at 24 h.Fetuses at 124±2 days gestation were exposed, instrumented and either ventilated for 15 min using a high tidal-volume (VT injurious strategy with the umbilical cord intact (INJ; inflammatory pathway only, or occluded (INJ+UCO; inflammatory and haemodynamic pathway. The ventilation groups were compared to lambs that underwent surgery but were not ventilated (Sham, and lambs that did not undergo surgery (unoperated control; Cont. Fetuses were placed back in utero after the 15 min intervention and ewes recovered. Twenty-four hours later, lambs were delivered, placed on a protective ventilation strategy, and underwent MRI of the brain using structural, diffusion tensor imaging (DTI and magnetic resonance spectroscopy (MRS techniques.Absolute MRS concentrations of creatine and choline were significantly decreased in INJ+UCO compared to Cont lambs (P = 0.03, P = 0.009, respectively; no significant differences were detected between the INJ or Sham groups and the Cont group. Axial diffusivities in the internal capsule and frontal WM were lower in INJ and INJ+UCO compared to Cont lambs (P = 0.05, P = 0.04, respectively. Lambs in the INJ and INJ+UCO groups had lower mean diffusivities in the frontal WM compared to Cont group (P = 0.04. DTI colour mapping revealed lower diffusivity in specific WM regions in the Sham, INJ, and INJ+UCO groups compared to the Cont group, but the differences did not reach significance. INJ+UCO lambs more likely to exhibit

Nucleon electromagnetic structure studies in the spacelike and timelike regions

Energy Technology Data Exchange (ETDEWEB)

Guttmann, Julia

2013-07-23

The thesis investigates the nucleon structure probed by the electromagnetic interaction. One of the most basic observables, reflecting the electromagnetic structure of the nucleon, are the form factors, which have been studied by means of elastic electron-proton scattering with ever increasing precision for several decades. In the timelike region, corresponding with the proton-antiproton annihilation into a electron-positron pair, the present experimental information is much less accurate. However, in the near future high-precision form factor measurements are planned. About 50 years after the first pioneering measurements of the electromagnetic form factors, polarization experiments stirred up the field since the results were found to be in striking contradiction to the findings of previous form factor investigations from unpolarized measurements. Triggered by the conflicting results, a whole new field studying the influence of two-photon exchange corrections to elastic electron-proton scattering emerged, which appeared as the most likely explanation of the discrepancy. The main part of this thesis deals with theoretical studies of two-photon exchange, which is investigated particularly with regard to form factor measurements in the spacelike as well as in the timelike region. An extraction of the two-photon amplitudes in the spacelike region through a combined analysis using the results of unpolarized cross section measurements and polarization experiments is presented. Furthermore, predictions of the two-photon exchange effects on the e{sup +}p/e{sup -}p cross section ratio are given for several new experiments, which are currently ongoing. The two-photon exchange corrections are also investigated in the timelike region in the process p anti p → e{sup +}e{sup -} by means of two factorization approaches. These corrections are found to be smaller than those obtained for the spacelike scattering process. The influence of the two-photon exchange corrections on

2013 Asia-Pacific Education Research Institutes Network (ERI-Net) Regional Study on Transversal Competencies in Education Policy & Practice (Phase I). Regional Synthesis Report

Science.gov (United States)

Yoko, Satoko

2015-01-01

This report provides an understanding of how transversal competencies are viewed, implemented, and adapted in education policy and curriculum across the Asia-Pacific region. The publication consolidates the results of ten country studies carried out in 2013-2014 in ten countries and economies of the Asia-Pacific region, including: Australia; China…

Study and design on the typical plan for regional hybrid energy internet

Science.gov (United States)

Zou, Zhenyu; Zheng, Shuai; Sha, Zhicheng

2018-04-01

The emergence of the energy internet has changed people's understanding of energy production, transmission, storage, conversion, consumption and so on. However, how to promote the development of the energy of the Internet, how to make it with the existing various types of energy entities organic integration, so that it can play an important role, we still need do more in-depth research and practice. After introducing the current situation for energy internet at home and abroad, the definition, character and motion traits of regional energy internet, this paper comprehensively studied typical scheme for regional energy internet based on Multi-energy complementary and developed the feasible suggestion key techniques and directions on development for regional energy internet.

Induction position for spinal anaesthesia: Sitting versus lateral position

International Nuclear Information System (INIS)

Shahzad, K.; Afshan, G.

2013-01-01

Objective: To compare the effect of induction position on block characteristics (sensory and motor nerves) and haemodynamic stability in elderly patients with isobaric bupivacaine. Patient comfort was also looked at. Methods: The randomized single blinded study was conducted at the Aga Khan University Hospital, Karachi, from September 2007 to August 2008. A total of 70 patients aged >60 years of both genders were included. Spinal anaesthesia was performed either in sitting or lateral position according to random allocation. Assessments of sensory, motor block and heart rate, systolic and diastolic blood pressure were recorded for 20 minutes. SPSS 16 was used for statistical analysis. Results: There was no significant difference for haemodynamic variables heart rate, systolic and diastolic blood pressure. The onset of anaesthesia was faster in the sitting group (4.5 minutes vs 5.4 minutes). The motor block characteristics were similar in both the groups. The majority of patients who reported 'very comfortable' for induction position belonged to the lateral group. Conclusion: Both sitting and lateral positions have similar effects on sensory and motor blockade and haemodynamic stability. However, patients generally found lateral position very comfortable. (author)

Regionalism, Regionalization and Regional Development

Directory of Open Access Journals (Sweden)

Liviu C. Andrei

2016-03-01

Full Text Available Sustained development is a concept associating other concepts, in its turn, in the EU practice, e.g. regionalism, regionalizing and afferent policies, here including structural policies. This below text, dedicated to integration concepts, will limit on the other hand to regionalizing, otherwise an aspect typical to Europe and to the EU. On the other hand, two aspects come up to strengthen this field of ideas, i.e. the region (al-regionalism-(regional development triplet has either its own history or precise individual outline of terms.

Criteria for selecting a CO2/climate change region of study

International Nuclear Information System (INIS)

Cushman, R.; Easterling, W.; Rosenberg, N.; Malone, T.; Edmonds, J.; Scott, M.; Stoke, G.

1989-01-01

This effort has three near-term goals: (1) to develop robust methods of analysis including the analysis of uncertainty; (2) to develop information systems to support CO 2 /climate change analysis; and (3) to develop channels of communication among researchers and between researchers and parties potentially affected by CO 2 /climate change. Initially, the program will focus on a single region of the United States, employ a historical analog climate, and analyze the interactions of all of the resources resident within that region as they might evolve under current conditions and under evolving CO 2 /climate change over the next 50 years. Five elements of the program will address the issues of: Analysis, Information Systems, Uncertainty, Knowledge Transfer, and Coordination. This paper will give special attention to the analytical framework and in particular to the criteria for selecting a region for study. 19 refs., 2 figs

Gold-195m for studies on regional pulmonary circulation

International Nuclear Information System (INIS)

Eriksson, L.; Andersson, L.; Jonson, B.; Westling, H.; White, T.; Wollmer, P.

1985-01-01

Six healthy controls, seven patients with coronary heart disease (CHD), and five patients with exercise-induced asthma (EIA) were studied in the sitting position at rest and during maximum exercise. The radionuclide gold-195m was used in the studies. A redistribution of activity toward the lung apex was found during exercise, the change being more pronounced in the healthy controls than in the patients with CHD. In two of the three patients in which exercise induced an asthmatic attack, gross reductions in the activity were seen in different areas of the lung. The authors conclude that gold-195m can be used for studies of rapid changes in regional pulmonary circulation

Anaesthesia for awake craniotomy: A retrospective study of 54 cases.

Science.gov (United States)

Sokhal, Navdeep; Rath, Girija Prasad; Chaturvedi, Arvind; Dash, Hari Hara; Bithal, Parmod Kumar; Chandra, P Sarat

2015-05-01

The anaesthetic challenge of awake craniotomy is to maintain adequate sedation, analgesia, respiratory and haemodynamic stability in an awake patient who should be able to co-operate during intraoperative neurological assessment. The current literature, sharing the experience on awake craniotomy, in Indian context, is minimal. Hence, we carried out a retrospective study with the aim to review and analyse the anaesthetic management and perioperative complications in patients undergoing awake craniotomy, at our centre. Medical records of 54 patients who underwent awake craniotomy for intracranial lesions over a period of 10 years were reviewed, retrospectively. Data regarding anaesthetic management, intraoperative complications and post-operative course were recorded. Propofol (81.5%) and dexmedetomidine (18.5%) were the main agents used for providing conscious sedation to facilitate awake craniotomy. Hypertension (16.7%) was the most commonly encountered complication during intraoperative period, followed by seizures (9.3%), desaturation (7.4%), tight brain (7.4%), and shivering (5.6%). The procedure had to be converted to general anaesthesia in one of patients owing to refractory brain bulge. The incidence of respiratory and haemodynamic complications were comparable in the both groups (P > 0.05). There was less incidence of intraoperative seizures in patients who received propofol (P = 0.03). In post-operative period, 20% of patients developed new motor deficit. Mean intensive care unit stay was 2.8 ± 1.9 day (1-14 days) and mean hospital stay was 7.0 ± 5.0 day (3-30 days). 'Conscious sedation' was the technique of choice for awake craniotomy, at our institute. Fentanyl, propofol, and dexmedetomidine were the main agents used for this purpose. Patients receiving propofol had less incidence of intraoperative seizure. Appropriate selection of patients, understanding the procedure of surgery, and judicious use of sedatives or anaesthetic agents are key to the

[Study on ecological suitability regionalization of Eucommia ulmoides in Guizhou].

Science.gov (United States)

Kang, Chuan-Zhi; Wang, Qing-Qing; Zhou, Tao; Jiang, Wei-Ke; Xiao, Cheng-Hong; Xie, Yu

2014-05-01

To study the ecological suitability regionalization of Eucommia ulmoides, for selecting artificial planting base and high-quality industrial raw material purchase area of the herb in Guizhou. Based on the investigation of 14 Eucommia ulmoides producing areas, pinoresinol diglucoside content and ecological factors were obtained. Using spatial analysis method to carry on ecological suitability regionalization. Meanwhile, combining pinoresinol diglucoside content, the correlation of major active components and environmental factors were analyzed by statistical analysis. The most suitability planting area of Eucommia ulmoides was the northwest of Guizhou. The distribution of Eucommia ulmoides was mainly affected by the type and pH value of soil, and monthly precipitation. The spatial structure of major active components in Eucommia ulmoides were randomly distributed in global space, but had only one aggregation point which had a high positive correlation in local space. The major active components of Eucommia ulmoides had no correlation with altitude, longitude or latitude. Using the spatial analysis method and statistical analysis method, based on environmental factor and pinoresinol diglucoside content, the ecological suitability regionalization of Eucommia ulmoides can provide reference for the selection of suitable planting area, artificial planting base and directing production layout.

Risk factors associated with hantavirosis fatality: a regional analysis from a case-control study in Brazil

Directory of Open Access Journals (Sweden)

Maria Cristina Antunes Willemann

2014-01-01

Full Text Available Introduction: In Brazil, hantavirus cardiopulmonary syndrome (HCPS has a high lethality rate that varies by region. This study aimed to identify the risk factors associated with fatal hantavirosis. Methods: This study was a case-control study that included all laboratory confirmed cases of hantavirosis. The cases were stratified by the different Brazilian regions using data from the Notifiable Diseases Information System. “Cases” were patients who progressed to death, whereas “controls” were patients who were cured. The odds ratio (OR and the adjusted OR were calculated. Results: Overall, 158 cases and 281 controls were included in this study. In the Midwest region, the cases were 60% less likely to present with flank pain, and the time between the beginning of symptoms and death was shorter than the time between the beginning of symptoms and a cure. In the Southeast region, the cases were 60% less likely to present with thrombocytopenia or reside in rural areas compared to those who progressed to a cure. Additionally, the cases sought medical assistance, notification and investigation more quickly than the controls. In the Southern region, the cases that died were 70% less likely to be male compared to the controls. Conclusions: HCPS manifests with nonspecific symptoms, and there are few published studies related to the condition, so determining a patient's therapeutic strategy is difficult. This study presents findings from different Brazilian regions and highlights the need for further investigations to improve comprehension about regional risk factors associated with hantavirosis and to reduce morbimortality.

A subspecies of region crossing change, region freeze crossing change

OpenAIRE

Inoue, Ayumu; Shimizu, Ryo

2016-01-01

We introduce a local move on a link diagram named a region freeze crossing change which is close to a region crossing change, but not the same. We study similarity and difference between region crossing change and region freeze crossing change.

Assessing Regional Sustainability Using a Model of Coordinated Development Index: A Case Study of Mainland China

Directory of Open Access Journals (Sweden)

Qing Yang

2014-12-01

Full Text Available From a holistic view, this paper addresses a perspective of coordinated development of economy, society, and environment for regional sustainability assessment. Firstly, a comprehensive indicator system for co-evaluating the level of economic, social, and environmental subsystems is presented based on a holistic understanding of regional sustainability. Then, a coordinated development index model focusing on the level of coordination among the subsystems as well as their comprehensive development level is established. Furthermore, an empirical study of all the provinces and municipalities is conducted by collecting the panel data from 2004 to 2010. The result shows that: (1 the coordinated developments of the most developed and the most underdeveloped regions stay stable while the regions with medium development level possess more fluctuant trends during the study years; (2 regional disparities are indicated according to the grading of CDI (the coordinated development index, which are further analyzed to be related to the local economic development patterns; (3 the conditions and causes of economic, social, and environmental development in real situations under different grades of CDI are discussed through detailed case studies of typical regions, which indicate specific suggestions of sustainable development for regions in the same pattern.

Imbalanced geodemographical structures in Târnave regional system. Case study: population ageing.

Directory of Open Access Journals (Sweden)

H.-V. CONȚIU

2017-05-01

Full Text Available The demographic prospects of a regional system, the natural dynamics of the population, the potential of manpower resources, planning and forecast of its use, show a high degree of dependence on the demographical structure by age, the identified imbalances involving an increase in the vulnerability of the regional system and therefore an enhancement of geodemographical risks (acceleration of population ageing, decreasing population trend, disappearance of some rural settlements, socio-economic failures etc.. In this study, a special attention is paid to the analysis of ageing index and demographical dependency ratio, and the share of young and old people to the Târnave regional system, taking into account as milestones, the population censuses from 1910, 1992 2002 and 2011.

Does Regional Lung Strain Correlate With Regional Inflammation in Acute Respiratory Distress Syndrome During Nonprotective Ventilation? An Experimental Porcine Study.

Science.gov (United States)

Retamal, Jaime; Hurtado, Daniel; Villarroel, Nicolás; Bruhn, Alejandro; Bugedo, Guillermo; Amato, Marcelo Britto Passos; Costa, Eduardo Leite Vieira; Hedenstierna, Göran; Larsson, Anders; Borges, João Batista

2018-06-01

It is known that ventilator-induced lung injury causes increased pulmonary inflammation. It has been suggested that one of the underlying mechanisms may be strain. The aim of this study was to investigate whether lung regional strain correlates with regional inflammation in a porcine model of acute respiratory distress syndrome. Retrospective analysis of CT images and positron emission tomography images using [F]fluoro-2-deoxy-D-glucose. University animal research laboratory. Seven piglets subjected to experimental acute respiratory distress syndrome and five ventilated controls. Acute respiratory distress syndrome was induced by repeated lung lavages, followed by 210 minutes of injurious mechanical ventilation using low positive end-expiratory pressures (mean, 4 cm H2O) and high inspiratory pressures (mean plateau pressure, 45 cm H2O). All animals were subsequently studied with CT scans acquired at end-expiration and end-inspiration, to obtain maps of volumetric strain (inspiratory volume - expiratory volume)/expiratory volume, and dynamic positron emission tomography imaging. Strain maps and positron emission tomography images were divided into 10 isogravitational horizontal regions-of-interest, from which spatial correlation was calculated for each animal. The acute respiratory distress syndrome model resulted in a decrease in respiratory system compliance (20.3 ± 3.4 to 14.0 ± 4.9 mL/cm H2O; p < 0.05) and oxygenation (PaO2/FIO2, 489 ± 80 to 92 ± 59; p < 0.05), whereas the control animals did not exhibit changes. In the acute respiratory distress syndrome group, strain maps showed a heterogeneous distribution with a greater concentration in the intermediate gravitational regions, which was similar to the distribution of [F]fluoro-2-deoxy-D-glucose uptake observed in the positron emission tomography images, resulting in a positive spatial correlation between both variables (median R = 0.71 [0.02-0.84]; p < 0.05 in five of seven animals

The Rationale for Comparative Effectiveness of Tourist Potential Realization (Case Study of the Volga Region

Directory of Open Access Journals (Sweden)

Anna Nikolaevna Polukhina

2016-11-01

Full Text Available The article presents the analysis of long-term tourism development programs of the Volga Region. Great attention is given to the sector’s financing measures set out in development programs. Domestic and foreign tourist potential assessment methods are analyzed. Tourist potential dynamics of the Volga Region is studied based on expert opinion. Using econometric approach the authors study the correlation between tourism investments and incomes of the Volga Region for the past six years – from 2009 to 2014. The analysis was carried out using statistics provided by the Russian Tourism Association and the Federal State Statistics Service of the Russian Federation by category of profitability from paid tourist services and from hospitality and catering services. The conducted analysis helped construct the figures showing the differentiation of the Volga regions by tourism investment efficiency and tourist potential realization. It is shown that tourist potential of the territories and its realization are highly differentiated. The sub-regions of the Volga Region are divided into groups according to the effectiveness of potential realization. The effectiveness of implementation of natural recreational and historical and cultural potential is higher in the sub-regions where places of tourist accommodation and entertainment are developed enough, effective mechanisms for programs implementation control are formed and the indicators of expected effectiveness of measures implementation are elaborated. The study has revealed the need for the development of common indicators of expected final results of tourism development programs. The use of a unified system of standardized indicators should become the principle of monitoring the implementation of regional tourism development programs. Data obtained by the research will be useful for the improvement of the existing regional tourism development programs

Serum cortisol concentration with exploratory cut-off values do not predict the effects of hydrocortisone administration in children with low cardiac output after cardiac surgery

NARCIS (Netherlands)

Verweij, E. J.; Hogenbirk, Karin; Roest, Arno A. W.; van Brempt, Ronald; Hazekamp, Mark G.; de Jonge, Evert

2012-01-01

Low cardiac output syndrome is common after paediatric cardiac surgery. Previous studies suggested that hydrocortisone administration may improve haemodynamic stability in case of resistant low cardiac output syndrome in critically ill children. This study was set up to test the hypothesis that the

Study on embodied CO2 transfer between the Jing-Jin-Ji region and other regions in China: a quantification using an interregional input-output model.

Science.gov (United States)

Chen, Mengmeng; Wu, Sanmang; Lei, Yalin; Li, Shantong

2018-03-08

Jing-Jin-Ji region (i.e., Beijing, Tianjin, and Hebei) is China's key development region, but it is also the leading and most serious air pollution region in China. High fossil fuel consumption is the major source of both carbon dioxide (CO 2 ) emissions and air pollutants. Therefore, it is important to reveal the source of CO 2 emissions to control the air pollution in the Jing-Jin-Ji region. In this study, an interregional input-output model was applied to quantitatively estimate the embodied CO 2 transfer between Jing-Jin-Ji region and other region in China using China's interregional input-output data in 2010. The results indicated that there was a significant difference in the production-based CO 2 emissions in China, and furthermore, the Jing-Jin-Ji region and its surrounding regions were the main regions of the production-based CO 2 emissions in China. Hebei Province exported a large amount of embodied CO 2 to meet the investment, consumption, and export demands of Beijing and Tianjin. The Jing-Jin-Ji regions exported a great deal of embodied CO 2 to the coastal provinces of southeast China and imported it from neighboring provinces.

How Does a Regional Climate Model Modify the Projected Climate Change Signal of the Driving GCM: A Study over Different CORDEX Regions Using REMO

Directory of Open Access Journals (Sweden)

Claas Teichmann

2013-06-01

Full Text Available Global and regional climate model simulations are frequently used for regional climate change assessments and in climate impact modeling studies. To reflect the inherent and methodological uncertainties in climate modeling, the assessment of regional climate change requires ensemble simulations from different global and regional climate model combinations. To interpret the spread of simulated results, it is useful to understand how the climate change signal is modified in the GCM-RCM modelmodelgeneral circulation model-regional climate model (GCM-RCM chain. This kind of information can also be useful for impact modelers; for the process of experiment design and when interpreting model results. In this study, we investigate how the simulated historical and future climate of the Max-Planck-Institute earth system model (MPI-ESM is modified by dynamic downscaling with the regional model REMO in different world regions. The historical climate simulations for 1950–2005 are driven by observed anthropogenic forcing. The climate projections are driven by projected anthropogenic forcing according to different Representative Concentration Pathways (RCPs. The global simulations are downscaled with REMO over the Coordinated Regional Climate Downscaling Experiment (CORDEX domains Africa, Europe, South America and West Asia from 2006–2100. This unique set of simulations allows for climate type specific analysis across multiple world regions and for multi-scenarios. We used a classification of climate types by Köppen-Trewartha to define evaluation regions with certain climate conditions. A systematic comparison of near-surface temperature and precipitation simulated by the regional and the global model is done. In general, the historical time period is well represented by the GCM and the RCM. Some different biases occur in the RCM compared to the GCM as in the Amazon Basin, northern Africa and the West Asian domain. Both models project similar warming

Local Helioseismology of Emerging Active Regions: A Case Study

Science.gov (United States)

Kosovichev, Alexander G.; Zhao, Junwei; Ilonidis, Stathis

2018-04-01

Local helioseismology provides a unique opportunity to investigate the subsurface structure and dynamics of active regions and their effect on the large-scale flows and global circulation of the Sun. We use measurements of plasma flows in the upper convection zone, provided by the Time-Distance Helioseismology Pipeline developed for analysis of solar oscillation data obtained by Helioseismic and Magnetic Imager (HMI) on Solar Dynamics Observatory (SDO), to investigate the subsurface dynamics of emerging active region NOAA 11726. The active region emergence was detected in deep layers of the convection zone about 12 hours before the first bipolar magnetic structure appeared on the surface, and 2 days before the emergence of most of the magnetic flux. The speed of emergence determined by tracking the flow divergence with depth is about 1.4 km/s, very close to the emergence speed in the deep layers. As the emerging magnetic flux becomes concentrated in sunspots local converging flows are observed beneath the forming sunspots. These flows are most prominent in the depth range 1-3 Mm, and remain converging after the formation process is completed. On the larger scale converging flows around active region appear as a diversion of the zonal shearing flows towards the active region, accompanied by formation of a large-scale vortex structure. This process occurs when a substantial amount of the magnetic flux emerged on the surface, and the converging flow pattern remains stable during the following evolution of the active region. The Carrington synoptic flow maps show that the large-scale subsurface inflows are typical for active regions. In the deeper layers (10-13 Mm) the flows become diverging, and surprisingly strong beneath some active regions. In addition, the synoptic maps reveal a complex evolving pattern of large-scale flows on the scale much larger than supergranulation

Active region structures in the transition region and corona

International Nuclear Information System (INIS)

Webb, D.F.

1981-01-01

Observational aspects of the transition region and coronal structures of the solar active region are reviewed with an emphasis on imaging of the plasma loops which act as tracers of the magnetic flux loops. The study of the basic structure of an active region is discussed in terms of the morphological and thermal classifications of active region loops, including umbral structures, and observational knowledge of the thermal structure of loops is considered in relation to scaling laws, emission measures and the structures of individual loops. The temporal evolution of active region loop structures is reviewed with emphasis on ephemeral regions and the emergence of active regions. Planned future spaceborne observations of active region loop structures in the EUV and soft X-ray regions are also indicated

Study of tourists exposure rate in Mahallat hot Spring Region

Energy Technology Data Exchange (ETDEWEB)

Tavakoli, H. M.B. [Isfahan Univ. of Medical Sciences, Isfahan (Iran, Islamic Republic of); Fallah, M.G. [Isfahan University of Medical Sciences (Iran, Islamic Republic of); Ghiasinejad, M. [Iran Atomic Energy Organization, Tehran (Iran, Islamic Republic of)

2006-07-01

Introduction: High level radiation areas have been recognized on various parts of the earth. Some of these areas include: Brasilia, India, and Iran. Mahallat hot spring region in the central part of Iran is also one of these areas. Study of exposure in these areas could be helpful in investigating the effects of ionizing radiation. Materials and Methods: In addition to several seasonal springs, Mahallat hot spring region contains five permanent springs named: Soleimani, Shafa, Dombe, Romatism and Sauda. Internal exposure (due to inhalation of radon gas and drinking water) and external exposure (due to cosmic rays and radioactive elements in the ground) to the tourists was studied. Used materials and apparatus include: RSS -112 ionizing chamber for environmental gamma rays exposure measurement, highly pure germanium detector for measuring radioactive elements in the ground, liquid scintillation counter for measuring {sup 222}Rn gas concentration in water samples, Bubbler chamber and Locus cells for Rn concentration measurements (Emanation method) and Alfa guard detector for {sup 226}Ra concentration measurements. Conclusions and Discussion: A total of 270 visitors are included in this study. Considering residual durations of the studied group in open and closed environment of bathrooms, hotel and inn rooms, obtained annual external effective dose is 75.4{+-}8.7{mu}Sv and 138.3{+-}11.8{mu}Sv for natives and travelers respectively. EEC coefficients has been used for calculating annual internal effective dose due to radon gas inhalation. Annual internal effective dose, in this path, is 0.9 and 2.1 mSv in open and closed environment for native and visitors respectively. Annual internal effective dose due to drinking water, is 0.43 and 0.09{mu}Sv for natives people and travelers, respectively. Measurements show that more than 90% of the received dose in the studied groups is due to radon gas inhalation. External and internal dose summation is 0.98 mSv for natives and 2

Study of tourists exposure rate in Mahallat hot Spring Region

International Nuclear Information System (INIS)

Tavakoli, H. M.B.; Fallah, M.G.; Ghiasinejad, M.

2006-01-01

Introduction: High level radiation areas have been recognized on various parts of the earth. Some of these areas include: Brasilia, India, and Iran. Mahallat hot spring region in the central part of Iran is also one of these areas. Study of exposure in these areas could be helpful in investigating the effects of ionizing radiation. Materials and Methods: In addition to several seasonal springs, Mahallat hot spring region contains five permanent springs named: Soleimani, Shafa, Dombe, Romatism and Sauda. Internal exposure (due to inhalation of radon gas and drinking water) and external exposure (due to cosmic rays and radioactive elements in the ground) to the tourists was studied. Used materials and apparatus include: RSS -112 ionizing chamber for environmental gamma rays exposure measurement, highly pure germanium detector for measuring radioactive elements in the ground, liquid scintillation counter for measuring 222 Rn gas concentration in water samples, Bubbler chamber and Locus cells for Rn concentration measurements (Emanation method) and Alfa guard detector for 226 Ra concentration measurements. Conclusions and Discussion: A total of 270 visitors are included in this study. Considering residual durations of the studied group in open and closed environment of bathrooms, hotel and inn rooms, obtained annual external effective dose is 75.4±8.7μSv and 138.3±11.8μSv for natives and travelers respectively. EEC coefficients has been used for calculating annual internal effective dose due to radon gas inhalation. Annual internal effective dose, in this path, is 0.9 and 2.1 mSv in open and closed environment for native and visitors respectively. Annual internal effective dose due to drinking water, is 0.43 and 0.09μSv for natives people and travelers, respectively. Measurements show that more than 90% of the received dose in the studied groups is due to radon gas inhalation. External and internal dose summation is 0.98 mSv for natives and 2.2 mSv for for

Non-invasive determination of pulmonary hypertension with dynamic contrast-enhanced computed tomography: a pilot study

International Nuclear Information System (INIS)

Pienn, Michael; Balint, Zoltan; Kovacs, Gabor; Tscherner, Maria; Olschewski, Horst; Avian, Alexander; Johnson, Thorsten R.; Kullnig, Peter; Stollberger, Rudolf; Olschewski, Andrea

2014-01-01

In this pilot study we explored whether contrast-material bolus propagation time and speed in the pulmonary arteries (PAs) determined by dynamic contrast-enhanced computed tomography (DCE-CT) can distinguish between patients with and without pulmonary hypertension (PH). Twenty-three patients (18 with and 5 without PH) were examined with a DCE-CT sequence following their diagnostic or follow-up right-sided heart catheterisation (RHC). X-ray attenuation over time curves were recorded for regions of interest in the main, right and left PA and fitted with a spline fit. Contrast material bolus propagation speeds and time differences between the peak concentrations were compared with haemodynamic parameters from RHC. Bolus speed correlated (ρ = -0.55) with mean pulmonary arterial pressure (mPAP) and showed a good discriminative power between patients with and without PH (cut-off speed 317 mm/s; sensitivity 100 %/specificity 100 %). Additionally, time differences between peaks correlated with mPAP (ρ = 0.64 and 0.49 for right and left PA, respectively) and discrimination was achieved with sensitivity 100 %/specificity 100 % (cut-off time 0.15 s) and sensitivity 93 %/specificity 80 % (cut-off time 0.45 s), respectively. Bolus propagation speed and time differences between contrast material peaks in the PA can identify PH. This method could be used to confirm the indication for RHC in patients screened for pulmonary hypertension. (orig.)

Non-invasive determination of pulmonary hypertension with dynamic contrast-enhanced computed tomography: a pilot study

Energy Technology Data Exchange (ETDEWEB)

Pienn, Michael; Balint, Zoltan [Ludwig Boltzmann Institute for Lung Vascular Research, Graz (Austria); Kovacs, Gabor; Tscherner, Maria; Olschewski, Horst [Ludwig Boltzmann Institute for Lung Vascular Research, Graz (Austria); Medical University of Graz, Division of Pulmonology, Department of Internal Medicine, Graz (Austria); Avian, Alexander [Ludwig Boltzmann Institute for Lung Vascular Research, Graz (Austria); Medical University of Graz, Institute for Medical Informatics, Statistics and Documentation, Graz (Austria); Johnson, Thorsten R. [Ludwig Maximilians University, Department of Clinical Radiology, Munich (Germany); Kullnig, Peter [DiagnostikZentrum Graz, Graz (Austria); Stollberger, Rudolf [Graz University of Technology, Institute for Medical Engineering, Graz (Austria); Olschewski, Andrea [Ludwig Boltzmann Institute for Lung Vascular Research, Graz (Austria); Medical University of Graz, Experimental Anesthesiology, Department of Anesthesia and Intensive Care Medicine, Graz (Austria)

2014-03-15

In this pilot study we explored whether contrast-material bolus propagation time and speed in the pulmonary arteries (PAs) determined by dynamic contrast-enhanced computed tomography (DCE-CT) can distinguish between patients with and without pulmonary hypertension (PH). Twenty-three patients (18 with and 5 without PH) were examined with a DCE-CT sequence following their diagnostic or follow-up right-sided heart catheterisation (RHC). X-ray attenuation over time curves were recorded for regions of interest in the main, right and left PA and fitted with a spline fit. Contrast material bolus propagation speeds and time differences between the peak concentrations were compared with haemodynamic parameters from RHC. Bolus speed correlated (ρ = -0.55) with mean pulmonary arterial pressure (mPAP) and showed a good discriminative power between patients with and without PH (cut-off speed 317 mm/s; sensitivity 100 %/specificity 100 %). Additionally, time differences between peaks correlated with mPAP (ρ = 0.64 and 0.49 for right and left PA, respectively) and discrimination was achieved with sensitivity 100 %/specificity 100 % (cut-off time 0.15 s) and sensitivity 93 %/specificity 80 % (cut-off time 0.45 s), respectively. Bolus propagation speed and time differences between contrast material peaks in the PA can identify PH. This method could be used to confirm the indication for RHC in patients screened for pulmonary hypertension. (orig.)

Student`s research initiatives in the study of strategic planning of regional development

OpenAIRE

Malchykova, Daria; Korobov, Volodymyr; Pylypenko, Ihor

2017-01-01

An article describes methodological foundations and principles of the various aspects of the process of strategic planning of regional development study. One of the priorities of innovative pedagogical and methodological work in teaching the competence approach appears. Competence in this approach is the ability of students to solve concrete tasks of regional development evaluation. According to dalto-competence approach the following principles were offered: scientific, systematic, interdisc...

Ecological studies on the freshwater fishes of the Alligator Rivers Region, Northern Territory

International Nuclear Information System (INIS)

Bishop, K.A.; Allen, S.A.; Pollard, D.A.; Cook, M.G.

1986-01-01

The tropical climate of the Alligator Rivers Region of the Northern Territory has a distinctive Wet-Dry cycle resulting in seasonal flows in the creeks and rivers of its catchments. The present study, begun during August 1978, aimed at developing an ecological monitoring system that would detect changes in freshwater fish communities brought about by recent uranium mining and processing in the lowlands of the region

Prevalence of Dyslipidemias in Three Regions in Venezuela: The VEMSOLS Study Results

Science.gov (United States)

González-Rivas, Juan P.; Nieto-Martínez, Ramfis; Brajkovich, Imperia; Ugel, Eunice; Rísquez, Alejandro

2018-01-01

Background The prevalence of dyslipidemia in multiple regions of Venezuela is unknown. The Venezuelan Metabolic Syndrome, Obesity and Lifestyle Study (VEMSOLS) was undertaken to evaluate cardiometabolic risk factors in Venezuela. Objective To determine the prevalence of dyslipidemia in five populations from three regions of Venezuela. Methods During the years 2006 to 2010, 1320 subjects aged 20 years or older were selected by multistage stratified random sampling from all households in five municipalities from 3 regions of Venezuela: Lara State (Western region), Merida State (Andean region), and Capital District (Capital region). Anthropometric measurements and biochemical analysis were obtained from each participant. Dyslipidemia was defined according to the NCEP/ATPIII definitions. Results Mean age was 44.8 ± 0.39 years and 68.5% were females. The prevalence of lipids abnormalities related to the metabolic syndrome (low HDL-c [58.6%; 95% CI 54.9 - 62.1] and elevated triglycerides [39.7%; 36.1 - 43.2]) were the most prevalent lipid alterations, followed by atherogenic dyslipidemia (25.9%; 22.7 - 29.1), elevated LDL-c (23.3%; 20.2 - 26.4), hypercholesterolemia (22.2%; 19.2 - 25.2), and mix dyslipidemia (8.9%; 6.8 - 11.0). Dyslipidemia was more prevalent with increasing body mass index. Conclusion Dyslipidemias are prevalent cardiometabolic risk factors in Venezuela. Among these, a higher prevalence of low HDL is a condition also consistently reported in Latin America. PMID:29538522

Microscopic study of (p, γ) reactions in mass region A = 110-125

International Nuclear Information System (INIS)

Chakraborty, Dipti; Dutta, Saumi; Gangopadhyay, G.; Bhattacharyya, Abhijit

2014-01-01

To calculate the actual abundance of different nuclei and evolution of the process, a network calculation is needed involving reaction rates for a large number of nuclei. Thus we need to know the interaction potential. As the p-process proceeds along proton rich side of the stability valley, it involves many nuclei which are unstable and inaccessible as targets on earth to do experiments. So theory remains the sole guide to gather information about the reactions. Presently, we are concerned about the nuclei in the mass region A = 110-125. It is imperative to test the theoretical calculations, where experimental data are available, to verify its applicability before extending it to unknown regions. Thus reactions for stable targets in the mass region have been studied in the present work

Radiation-induced vasculopathy implicated by depressed blood flow and metabolism in a pineal glioma

Energy Technology Data Exchange (ETDEWEB)

Mineura, K; Sasajima, T; Kowada, M [Akita University Hospital (Japan). Neurosurgical Service; Saitoh, H [Oodate Municipal Hospital (Japan). Dept. of Neurosurgery; Shishido, F [Research Inst. of Brain and Blood Vessels, Akita (Japan)

1993-08-01

A case of radiation-induced vasculopathy of a pineal glioma was presented with haemodynamic and metabolic changes before and after radiotherapy. After radiation of 60 Gy with conventional fractionation (1.8-2.0 Gy daily, 5 days per week), regional blood flow, oxygen extraction fraction, metabolic rate of oxygen, kinetic metabolic rate of glucose and the rate constants (K2, K3) were markedly depressed (20% or greater) compared with the pre-irradiated study. 7 months after radiotherapy, the patient developed transient episodes of both right and left upper limb convulsion, terminating in generalized convulsion. When she developed status epilepticus, computed tomography showed extensive low density areas in the territory supplied by the right middle cerebral and the right posterior cerebral arteries. (author).

Radiation-induced vasculopathy implicated by depressed blood flow and metabolism in a pineal glioma

International Nuclear Information System (INIS)

Mineura, K.; Sasajima, T.; Kowada, M.

1993-01-01

A case of radiation-induced vasculopathy of a pineal glioma was presented with haemodynamic and metabolic changes before and after radiotherapy. After radiation of 60 Gy with conventional fractionation (1.8-2.0 Gy daily, 5 days per week), regional blood flow, oxygen extraction fraction, metabolic rate of oxygen, kinetic metabolic rate of glucose and the rate constants (K2, K3) were markedly depressed (20% or greater) compared with the pre-irradiated study. 7 months after radiotherapy, the patient developed transient episodes of both right and left upper limb convulsion, terminating in generalized convulsion. When she developed status epilepticus, computed tomography showed extensive low density areas in the territory supplied by the right middle cerebral and the right posterior cerebral arteries. (author)

Statistical Study of Corruption in the Region (on the Example of the Rostov Region

Directory of Open Access Journals (Sweden)

Kirill A. Belokrylov

2016-09-01

Full Text Available The paper proves the effectiveness of the using of statistical methods for evaluation of the corruption level as a result of its, on the one hand, latency, concealment of official statistical accounting, and on the other - the scale of corruption in Russia. The comparative analysis of the substantial characteristics of the nature of corruption by Russian and foreign scientists, as well as their reflection in the law has allowed to develop a questionnaire to adequately assess the levels, causes and the effectiveness of implementation of the policy on the fight against corruption as the most important social indicator of inefficient institutions. Analysis of the results of the economic and sociological survey of the population of the Rostov region revealed a shift of corruption performance in the region in the direction of the education system as a result of the dominance in the selection of students, but it led to the conclusion about the need to tighten legislation on the fight against corruption (72% of respondents, including the confiscation of the property (79,1%, the dismissal of corrupt officials, the ban on public office. The necessity of further in-depth statistical studies of corruption on the development of more effective measures is improved to combat it as a tool for removal of the Russian economy from the crisis and ensure that it is more sustainable growth than projected in the 2020s (the lost decade 1,5% positive GDP dynamics.

[Usefulness of brain natriuretic propeptide in the diagnosis and management of patent ductus arteriosus].

Science.gov (United States)

Montaner Ramón, Alicia; Galve Pradel, Zenaida; Fernández Espuelas, Cristina; Jiménez Montañés, Lorenzo; Samper Villagrasa, María Pilar; Rite Gracia, Segundo

2017-06-01

Patent ductus arteriosus (PDA) is a prevalent condition in preterm infants, and may be related to increased morbidity and mortality in the most immature newborns. Recent studies have examined the usefulness of brain natriuretic propeptide (proBNP) in the diagnosis of this pathology. The aim of the study was to evaluate the diagnostic efficacy of proBNP as a marker of hemodynamic overload in PDA. A retrospective study was conducted on preterm infants less than 32 weeks of gestation and/or weight less than 1500 grams. Echocardiogram and determination of proBNP levels were performed on all patients. Comparison was made by subgroups according to the presence of PDA and their haemodynamic characteristics. Of the 60 patients enrolled, 71.7% had PDA, of which 86% had haemodynamically significant patent ductus arteriosus (HS-PDA). All of them, but one, received medical treatment with ibuprofen or acetaminophen. Surgical closure was required in 29.7% of HS-PDA. Higher values of proBNP were found in patients with HS-PDA (33338±34494.47pg/mL; p=.000) compared with patients with closed or non-haemodynamically significant ductus arteriosus. Higher values were also found in patients who required surgical closure of PDA (30596.8±14910.9; p=.004). A greater decrease inproBNP levels was found in the group of patients which duct closure after pharmacological treatment (68±24.69% vs -12.22±99.4%; p=.030). ProBNP cutoff-level for HS-PDA was calculated by ROC curve and it was 9321.5pg/mL (Specificity: 100%, Sensitivity: 94.6%). ProBNP levels are related to the presence or absence of haemodynamically significant patent ductus arteriosus; and its variations with treatment response. High values are also related to the need for surgical closure of PDA. Copyright © 2015 Asociación Española de Pediatría. Publicado por Elsevier España, S.L.U. All rights reserved.

Safety and clinical effect of i.v. infusion of cyclopropyl-methoxycarbonyl etomidate (ABP-700), a soft analogue of etomidate, in healthy subjects.

Science.gov (United States)

Valk, B I; Absalom, A R; Meyer, P; Meier, S; den Daas, I; van Amsterdam, K; Campagna, J A; Sweeney, S P; Struys, M M R F

2018-06-01

Cyclopropyl-methoxycarbonyl metomidate, or ABP-700, is a second generation analogue of etomidate, developed to retain etomidate's beneficial haemodynamic and respiratory profile but diminishing its suppression of the adrenocortical axis. The objective of this study was to characterise the safety and efficacy of 30-min continuous infusions of ABP-700, and to assess its effect on haemodynamics and the adrenocortical response in healthy human volunteers. Five cohorts involving 40 subjects received increasing infusion doses of ABP-700, propofol 60 μg kg -1  min -1 or placebo. Safety was evaluated through adverse event (AE) monitoring, safety laboratory tests, and arterial blood gasses. Haemodynamic and respiratory stability were assessed by continuous monitoring. Adrenocortical function was analysed by adrenocorticotropic hormone (ACTH) stimulation tests. Clinical effect was measured using the modified observer's assessment of alertness/sedation (MOAA/S) and continuous bispectral index monitoring. No serious AEs were reported. Haemodynamic and respiratory effects included mild dose-dependent tachycardia, slightly elevated blood pressure, and no centrally mediated apnoea. Upon stimulation with ACTH, no adrenocortical depression was observed in any subject. Involuntary muscle movements (IMM) were reported, which were more extensive with higher dosing regimens. Higher dosages of ABP-700 were associated with deeper sedation and increased likelihood of sedation. Time to onset of clinical effect was variable throughout the cohorts and recovery was swift. Infusions of ABP-700 showed a dose-dependent hypnotic effect, and did not cause severe hypotension, severe respiratory depression, or adrenocortical suppression. The presentation and nature of IMM is a matter of concern. NTR4735. Copyright © 2018 British Journal of Anaesthesia. Published by Elsevier Ltd. All rights reserved.

Green Infrastructure and Ecological Corridors: A Regional Study Concerning Sardinia

Directory of Open Access Journals (Sweden)

Ignazio Cannas

2018-04-01

Full Text Available We propose a methodological approach to identify a multifunctional green infrastructure (GI on the basis of four values (conservation value, natural value, recreation value and anthropic heritage that represent many functions (biodiversity conservation, supply of ecosystem services, recreation, identity building performed by the landscape. By taking the Italian region of Sardinia as a case study, we argue that the methodology can support the making of landscape plans as understood in the European Landscape Convention. Moreover, we propose and implement a methodology to identify ecological corridors (ECs connecting Natura 2000 sites (N2Ss, based on the prioritization of functional land patches related to their suitability to ecosystem services delivery, paying particular attention to biodiversity maintenance and enhancement, and taking Sardinia as spatial regional context. The methodology consists of two steps: (i identifying the most suitable patches to be included in ECs on the basis of their connectivity, that is, on their negative attitude towards contributing to landscape fragmentation; (ii assessing, through a discrete-choice-model, the suitability of these ECs to be included in a regional GI, starting from the territorial taxonomy based on biodiversity characteristics related to N2Ss, habitat suitability, and recreational and landscape potentials.

EFFECTS OF LORAZEPAM ON CARDIAC VAGAL TONE DURING REST AND MENTAL STRESS - ASSESSMENT BY MEANS OF SPECTRAL-ANALYSIS

NARCIS (Netherlands)

TULEN, JHM; MULDER, G; PEPPLINKHUIZEN, L; INTVELD, AJM; VANSTEENIS, HG; MOLEMAN, P

Dose-dependent effects of intravenously administered lorazepam on haemodynamic fluctuations were studied by means of spectral analysis, in order to elucidate sympathetic and parasympathetic components in cardiovascular control during situations of rest and mental stress after benzodiazepine

Effects of lorazepam on cardiac vagal tone during rest and mental stress: assessment by means of spectral analysis

NARCIS (Netherlands)

J.H.M. Tulen (Joke); G. Mulder (G.); L. Pepplinkhuizen (Lolke); A.J. Man in't Veld (A.); H.G. van Steenis (H.); P. Moleman (Peter)

1994-01-01

textabstractDose-dependent effects of intravenously administered lorazepam on haemodynamic fluctuations were studied by means of spectral analysis, in order to elucidate sympathetic and parasympathetic components in cardiovascular control during situations of rest and mental stress after

Global Source Parameters from Regional Spectral Ratios for Yield Transportability Studies

Science.gov (United States)

Phillips, W. S.; Fisk, M. D.; Stead, R. J.; Begnaud, M. L.; Rowe, C. A.

2016-12-01

We use source parameters such as moment, corner frequency and high frequency rolloff as constraints in amplitude tomography, ensuring that spectra of well-studied earthquakes are recovered using the ensuing attenuation and site term model. We correct explosion data for path and site effects using such models, which allows us to test transportability of yield estimation techniques based on our best source spectral estimates. To develop a background set of source parameters, we applied spectral ratio techniques to envelopes of a global set of regional distance recordings from over 180,000 crustal events. Corner frequencies and moment ratios were determined via inversion using all event pairs within predetermined clusters, shifting to absolute levels using independently determined regional and teleseismic moments. The moment and corner frequency results can be expressed as stress drop, which has considerable scatter, yet shows dramatic regional patterns. We observe high stress in subduction zones along S. America, S. Mexico, the Banda Sea, and associated with the Yakutat Block in Alaska. We also observe high stress at the Himalayan syntaxes, the Pamirs, eastern Iran, the Caspian, the Altai-Sayan, and the central African rift. Low stress is observed along mid ocean spreading centers, the Afar rift, patches of convergence zones such as Nicaragua, the Zagros, Tibet, and the Tien Shan, among others. Mine blasts appear as low stress events due to their low corners and steep rolloffs. Many of these anomalies have been noted by previous studies, and we plan to compare results directly. As mentioned, these results will be used to constrain tomographic imaging, but can also be used in model validation procedures similar to the use of ground truth in location problems, and, perhaps most importantly, figure heavily in quality control of local and regional distance amplitude measurements.

Randomised clinical study: the effects of oral taurine 6g/day vs placebo on portal hypertension.

Science.gov (United States)

Schwarzer, R; Kivaranovic, D; Mandorfer, M; Paternostro, R; Wolrab, D; Heinisch, B; Reiberger, T; Ferlitsch, M; Gerner, C; Trauner, M; Peck-Radosavljevic, M; Ferlitsch, A

2018-01-01

The amino sulphonic acid taurine reduces oxidative endoplasmatic reticulum stress and inhibits hepatic stellate cell activation, which might lead to reduction of portal pressure in cirrhosis. To assess the haemodynamic effects of taurine supplementation in patients with cirrhosis and varices. Patients with hepatic venous pressure gradient (HVPG) ≥12 mm Hg were included in this prospective proof of concept study. Concomitant nonselective beta-blockers therapy was not allowed. Patients received either 4 weeks of oral taurine (6 g/day), or placebo, prior to evaluation of HVPG response. Thirty patients were screened and 22 included in the efficacy analysis (12 taurine/10 placebo; 64% male, mean age: 52 ± 11 years, Child A: 9%, B:64%, C:27%, ascites:68%). In the taurine group, mean HVPG dropped from 20 mm Hg (±4) at baseline to 18 mm Hg (±4) on day 28 (mean relative change: -12%, P = .0093). In the placebo group, mean HVPG increased from 20 mm Hg (±5) at baseline to 21 mm Hg (±5) on day 28 (mean relative change:+2%, P = .4945). Taurine had no significant effects on systemic haemodynamics. Seven of 12 patients (58%) on taurine achieved a HVPG response >10%, compared to none in the placebo group (P = .0053). In a multivariate linear model, HVPG reduction was significantly larger in the taurine group compared to placebo group (P = .0091 and P = .0109 for absolute and relative change respectively). Treatment-related adverse events included gastrointestinal discomfort and fatigue, and were usually mild and comparable between treatment groups. Taurine is safe and may reduce portal pressure in cirrhotic patients. More studies on the underlying mechanisms of action and long-term effects of taurine supplementation are warranted. © 2017 John Wiley & Sons Ltd.

Implementing the first regional hospice palliative care program in Ontario: the Champlain region as a case study.

Science.gov (United States)

Pereira, José; Contant, Jocelyne; Barton, Gwen; Klinger, Christopher

2016-07-26

Regionalization promotes planning and coordination of services across settings and providers to meet population needs. Despite the potential advantages of regionalization, no regional hospice palliative care program existed in Ontario, Canada, as of 2010. This paper describes the process and early results of the development of the first regional hospice palliative care program in Ontario. The various activities and processes undertaken and the formal agreements, policies and documents are described. A participative approach, started in April 2009, was used. It brought together over 26 health service providers, including residential hospices, a palliative care unit, community and hospital specialist consultation teams, hospitals, community health and social service agencies (including nursing), individual health professionals, volunteers, patients and families. An extensive stakeholder and community vetting process was undertaken that included work groups (to explore key areas such as home care, the hospital sector, hospice and palliative care unit beds, provision of care in rural settings, e-health and education), a steering committee and input from over 320 individuals via e-mail and town-halls. A Transitional Leadership Group was elected to steer the implementation of the Regional Program over the summer of 2010. This group established the by-laws and details regarding the governance structure of the Regional Program, including its role, responsibilities, reporting structures and initial performance indicators that the Local Health Integration Network (LHIN) approved. The Regional Program was formally established in November 2010 with a competency-based Board of 14 elected members to oversee the program. Early work involved establishing standards and performance indicators for the different sectors and settings in the region, and identifying key clinical needs such as the establishment of more residential hospice capacity in Ottawa and a rural framework to ensure

A comparison of intraperitoneal bupivacaine-tramadol with bupivacaine-magnesium sulphate for pain relief after laparoscopic cholecystectomy: A prospective, randomised study

Directory of Open Access Journals (Sweden)

Anurag Yadava

2016-01-01

Full Text Available Background and Aims: In laparoscopic surgeries, intraperitoneal instillation of local anaesthetics and opioids is gaining popularity, for better pain relief. This study compared the quality and duration of post-operative analgesia using intraperitoneal tramadol plus bupivacaine (TB or magnesium plus bupivacaine (MB. Methods: In this study, 186 patients undergoing laparoscopic cholecystectomy were randomly divided into two groups: group TB received intraperitoneal tramadol with bupivacaine and group MB received intraperitoneal magnesium sulphate (MgSO 4 with bupivacaine. The visual analogue scale (VAS to assess pain, haemodynamic variables and side effects were noted and compared at different time points. The primary outcome was to compare the analgesic efficacy and duration of pain relief. The secondary outcomes included comparison of haemodynamic parameters and side effects among the two groups. The data analysis was carried out with unpaired Student′s t-test and Chi-square test using software SPSS 20.0 version. Results: The mean of VAS pain score after 1, 2, 4, 6 and 24 h of surgery was more in TB group compared to MB group, and the difference was statistically significant (P < 0.05. The total rescue analgesia consumption in 24 h after surgery was 2.4 g (mean of paracetamol in TB group and 1.4 g (mean of paracetamol in MB group which was statistically significant (P < 0.05. There were no statistically significant differences in the secondary outcomes. Conclusion: Intraperitoneal instillation of bupivacaine-MgSO 4 renders patients relatively pain-free in first 24 h after surgery, with longer duration of pain-free period and less consumption of rescue analgesic as compared to bupivacaine-tramadol combination.

Admixture mapping in the Hispanic Community Health Study/Study of Latinos reveals regions of genetic associations with blood pressure traits.

Directory of Open Access Journals (Sweden)

Tamar Sofer

Full Text Available Admixture mapping can be used to detect genetic association regions in admixed populations, such as Hispanics/Latinos, by estimating associations between local ancestry allele counts and the trait of interest. We performed admixture mapping of the blood pressure traits systolic and diastolic blood pressure (SBP, DBP, mean arterial pressure (MAP, and pulse pressure (PP, in a dataset of 12,116 participants from the Hispanic Community Health Study/Study of Latinos (HCHS/SOL. Hispanics/Latinos have three predominant ancestral populations (European, African, and Amerindian, for each of which we separately tested local ancestry intervals across the genome. We identified four regions that were significantly associated with a blood pressure trait at the genome-wide admixture mapping level. A 6p21.31 Amerindian ancestry association region has multiple known associations, but none explained the admixture mapping signal. We identified variants that completely explained this signal. One of these variants had p-values of 0.02 (MAP and 0.04 (SBP in replication testing in Pima Indians. A 11q13.4 Amerindian ancestry association region spans a variant that was previously reported (p-value = 0.001 in a targeted association study of Blood Pressure (BP traits and variants in the vitamin D pathway. There was no replication evidence supporting an association in the identified 17q25.3 Amerindian ancestry association region. For a region on 6p12.3, associated with African ancestry, we did not identify any candidate variants driving the association. It may be driven by rare variants. Whole genome sequence data may be necessary to fine map these association signals, which may contribute to disparities in BP traits between diverse populations.

Lack of agreement and trending ability of the endotracheal cardiac output monitor compared with thermodilution

DEFF Research Database (Denmark)

Møller-Sørensen, H; Hansen, K L; Ostergaard, M

2012-01-01

BACKGROUND: Minimally invasive monitoring systems of central haemodynamics are gaining increasing popularity. The present study investigated the precision of the endotracheal cardiac output monitor (ECOM) system and its agreement with pulmonary artery catheter thermodilution (PAC TD) for measuring...

Elevated uptake of plasma macromolecules by regions of arterial wall predisposed to plaque instability in a mouse model.

Directory of Open Access Journals (Sweden)

Zahra Mohri

Full Text Available Atherosclerosis may be triggered by an elevated net transport of lipid-carrying macromolecules from plasma into the arterial wall. We hypothesised that whether lesions are of the thin-cap fibroatheroma (TCFA type or are less fatty and more fibrous depends on the degree of elevation of transport, with greater uptake leading to the former. We further hypothesised that the degree of elevation can depend on haemodynamic wall shear stress characteristics and nitric oxide synthesis. Placing a tapered cuff around the carotid artery of apolipoprotein E -/- mice modifies patterns of shear stress and eNOS expression, and triggers lesion development at the upstream and downstream cuff margins; upstream but not downstream lesions resemble the TCFA. We measured wall uptake of a macromolecular tracer in the carotid artery of C57bl/6 mice after cuff placement. Uptake was elevated in the regions that develop lesions in hyperlipidaemic mice and was significantly more elevated where plaques of the TCFA type develop. Computational simulations and effects of reversing the cuff orientation indicated a role for solid as well as fluid mechanical stresses. Inhibiting NO synthesis abolished the difference in uptake between the upstream and downstream sites. The data support the hypothesis that excessively elevated wall uptake of plasma macromolecules initiates the development of the TCFA, suggest that such uptake can result from solid and fluid mechanical stresses, and are consistent with a role for NO synthesis. Modification of wall transport properties might form the basis of novel methods for reducing plaque rupture.

Uranium series disequilibrium: application to studies of the groundwater regime of the Harwell region

International Nuclear Information System (INIS)

Ivanovich, M.; Alexander, J.

1985-03-01

Regional groundwater systems incorporating argillaceous formations beneath the Harwell site have been studied as part of a national research programme of investigation into the feasibility of disposal of low and intermediate radioactive wastes into argillaceous rocks. The principal aim of the programme is to establish the groundwater flow patterns using hydrogeological and geochemical methods in association with isotope contents and uranium series disequilibrium and thus provide an independent approach to the study of effective permeabilities of clay lithologies in a sedimentary sequence. Thirty four groundwater samples derived from the high permeability formations in the Harwell region have been analysed for uranium and thorium content and 234 U/ 238 U, 230 Th/ 234 U and 230 Th/ 232 Th activity ratios. The uranium isotopic signatures have been interpreted in terms of the regional groundwater circulation and mixing patterns. The most significant zones of groundwater mixing determined from uranium isotopic data are situated just beneath the edge of the confined strata. These zones coincide with the locations of hydraulic lows in the Great Oolite and the Corallian formations towards which the regional groundwaters move. It is concluded that the uranium isotopic signatures can be used to identify water masses and to evaluate mixing of groundwaters in a sedimentary sequence on a regional scale. (author)

Study of the shallow convection over the Belem region in Brazil

Science.gov (United States)

Bassi Marinho Pires, Luciana; Suselj, Kay; Rossato, Luciana; Teixeira, Joao

2016-04-01

The largest forest of the world, the Amazon, presents an interesting and very complex system mixing forests, various topographies, sites of deforestation, cities, and regions close and far from the coast, which influence the climatology of the region. This study was focused in the region of Belem which is considered the rainiest region in the eastern Amazon with precipitation around 2000 mm/year. Belem is the capital of Para state, which is located in northern Brazil, 2,146 kilometers from Brasilia with an area of about 1,059,458 km² and a population of 1,432,844 inhabitants with 26% of the area of the Brazilian Amazon and having 49% of its natural attractions, according to the Organization of American States. Shallow convection and deep convection are among the main components of the local energy balance. An analysis of the performance of the Jet Propulsion Laboratory /NASA model of shallow convection parameterization in a framework of the single column model (SCM) in relation to the cluster of cumulus clouds formed in the coastal region of the Amazon forest due to squall lines is provided. To achieve this purpose infrared images from the Geostationary Operational Environmental Satellite (GOES), visible images from the GOES-12/METEOSAT satellites, and data obtained by the "Cloud processes of the main precipitation systems in Brazil: A contribUtion to cloud resolVing modeling and to the GPM (GlobAl Precipitation Measurement)" - CHUVA - campaign, during the month of June of 2011, were used. Results demonstrated that the parameterizations performed well in the case where only a core of clouds was observed.

The pulmonary vasculature in a neonatal porcine model with increased pulmonary blood flow and pressure

DEFF Research Database (Denmark)

Stenbøg, Elisabeth Vidstid; Steinbruchel, Daniel Andreas; Thomsen, Anne Bloch

2001-01-01

Introduction: Hypertension and hyperperfusion of the pulmonary vascular bed in the setting of congenital cardiac malformations may lead to progressive pulmonary vascular disease. To improve the understanding of the basic mechanisms of this disease, there is a need for clinically relevant animal....... By three months of age, nearly all shunts had closed spontaneously, and haemodynamics were normal. Ligation of the left pulmonary artery resulted in a normal total pulmonary blood flow, despite only the right lung being perfused, and a 33% increase in systolic pulmonary arterial pressure...... in humans. Elevated circulating levels of endothelin were associated with abnormal haemodynamics rather than abnormal pathology. These findings could be valuable for future studies on the pathogenesis of hypertensive pulmonary vascular disease associated with congenital cardiac malformations....

Evaluation of the interpretative skills of participants of a limited transthoracic echocardiography training course (H.A.R.T.scan course).

Science.gov (United States)

Royse, C F; Haji, D L; Faris, J G; Veltman, M G; Kumar, A; Royse, A G

2012-05-01

Limited transthoracic echocardiography performed by treating physicians may facilitate assessment of haemodynamic abnormalities in perioperative and critical care patients. The interpretative skills of one hundred participants who completed an education program in limited transthoracic echocardiography were assessed by reporting five pre-recorded case studies. A high level of agreement was observed in ventricular volume assessment (left 95%, right 96%), systolic function (left 99%, right 96%), left atrial pressure (96%) and haemodynamic state (97%). The highest failure to report answers (that is, no answer given) was for right ventricular volume and function. For moderate or severe valve lesions, agreement ranged from 90 to 98%, with failure to report educational program showed good agreement with experts in interpretation of valve and ventricular function.

Study on relationship between evolution of regional gravity field and seismic hazard

Science.gov (United States)

Li, W.; Xu, C.; Shen, C.

2017-12-01

The lack of anomalous signal is a big issue for the study of geophysics using historical geodesy observations, which is a relatively new area of earth gravimetry application in seismology. Hence the use of the gravity anomaly (GA) derived from either a global geopotential model (GGM) or a regional gravity reanalysis (Ground Gravity Survey, GGS) becomes an important alternative solution. In this study, the GGS at 186 points for the period of 2010 2014 in the Sichuan-Yunnan region (SYR) stations are analyzed. To study the temporal and spatial distribution characteristics of regional gravity filed (RGF) and its evolution mechanism. Taking the geological and geophysical data as constraints. From the GGM expanded up to degree 360, GA were obtained after gravity reduction, especially removing the reference field. The dynamically evolutional characteristics of gravity field are closely relative to fault activity. The gravity changes with time about 5 years at LongMenShan fault (LMSF) have a slop of -12.83±2.9 μGal/a, indicating that LMSF has an uplift. To test the signal extraction algorithm in some geodynamic processes, GA from the SYR were inverted and it was also imposed as a priori information. Fortunately, some significant gravity variation have been detected at some stations in the thrust fault before and after four earthquakes, in which typical anomalies (earthquake precursor, EP) were positive GA variation near the epicenter and the occurrence of a high-gravity-gradient zone across the epicenter prior to the Lushan earthquake (Ms 7.0). The repeated observation results during about 5 years indicate that no significant gravity changes related to other geodynamical events were observed in most observation epochs. In addition, the mechanism of gravity changes at Lushan was also explored. We calculated the gravity change rates based on the model of Songpan-Ganze block (SGB) to Sichuan basin (SCB). And the changes is in good agreement with observed one, indicating

Bacterial CRISPR Regions: General Features and their Potential for Epidemiological Molecular Typing Studies.

Science.gov (United States)

Karimi, Zahra; Ahmadi, Ali; Najafi, Ali; Ranjbar, Reza

2018-01-01

CRISPR (Clustered Regularly Interspaced Short Palindromic Repeats) loci as novel and applicable regions in prokaryotic genomes have gained great attraction in the post genomics era. These unique regions are diverse in number and sequence composition in different pathogenic bacteria and thereby can be a suitable candidate for molecular epidemiology and genotyping studies. Results:Furthermore, the arrayed structure of CRISPR loci (several unique repeats spaced with the variable sequence) and associated cas genes act as an active prokaryotic immune system against viral replication and conjugative elements. This property can be used as a tool for RNA editing in bioengineering studies. The aim of this review was to survey some details about the history, nature, and potential applications of CRISPR arrays in both genetic engineering and bacterial genotyping studies.

Economic feasibility study of regional centers for nuclear fuel reprocessing in the developing countries

International Nuclear Information System (INIS)

Bakeshloo, A.A.

1977-01-01

The fuel cycle costs for the following three different economic alternatives were studied: (1) Reprocessing in an industrialized country (such as the U.S.); (2) Reprocessing in the individual developing country; (3) Reprocessing in a regional center. The nuclear fuel cycle cost for the ''Throw-away'' fuel cycle was evaluated. Among the six regions which were considered in this study, region one (South America including Mexico) was selected for the economic analysis of the nuclear fuel cycle for the above three alternatives. For evaluation of the cases where the fuel is reprocessed in a regional center or in an individual developing country, a unit reprocessing cost equation was developed. An economic evaluation was developed to estimate the least expensive method for transporting radioactive nuclear material by either leased or purchased shipping casks. The necessary equations were also developed for estimating plutonium transportation and the safeguard costs. On the basis of nuclear material and services requirements and unit costs for each component, the levelized nuclear fuel cycle costs for each alternative were estimated. Finally, by a comparison of cost, among these three alternatives plus the ''Throw-away'' case,it was found that it is not at all economical to build individual reprocessing plants inside the developing countries in region one. However, it also was found that the economic advantage of a regional center with respect to the first alternative is less than a 4% difference between their total fuel cycle costs. It is concluded that there is no great economic advantage in any developing countries to seek to process their fuel in one of the advanced countries. Construction of regional reprocessing centers is an economically viable concept

Study on indoor thermal environment in winter for rural residences in Yulin region

Science.gov (United States)

Yanjun, Li; Weixiao, Han

2018-02-01

Yulin region is located in the northern part of Shaanxi Province, China. The winter here is very cold and it has a long duration. In this paper, a rural residence which was located in Yulin region was taken as a study object. Indoor thermal environment of the rural residence were tested, including indoor air temperature and air relative humidity. Then, test data were analyzed. It was summarized that indoor thermal environment of test room can not fully meet human thermal comfort needs, and some tactics of regulation building thermal environment were proposed. This research contributes to improvement of indoor thermal environment for local rural residences and it provides reference for rural residences in other cold regions.

Imputation-based analysis of association studies: candidate regions and quantitative traits.

Directory of Open Access Journals (Sweden)

Bertrand Servin

2007-07-01

Full Text Available We introduce a new framework for the analysis of association studies, designed to allow untyped variants to be more effectively and directly tested for association with a phenotype. The idea is to combine knowledge on patterns of correlation among SNPs (e.g., from the International HapMap project or resequencing data in a candidate region of interest with genotype data at tag SNPs collected on a phenotyped study sample, to estimate ("impute" unmeasured genotypes, and then assess association between the phenotype and these estimated genotypes. Compared with standard single-SNP tests, this approach results in increased power to detect association, even in cases in which the causal variant is typed, with the greatest gain occurring when multiple causal variants are present. It also provides more interpretable explanations for observed associations, including assessing, for each SNP, the strength of the evidence that it (rather than another correlated SNP is causal. Although we focus on association studies with quantitative phenotype and a relatively restricted region (e.g., a candidate gene, the framework is applicable and computationally practical for whole genome association studies. Methods described here are implemented in a software package, Bim-Bam, available from the Stephens Lab website http://stephenslab.uchicago.edu/software.html.

Charleston Harbor, SC, Regional Sediment Management Study: Beneficial Use of Dredged Material through Nearshore Placement

Science.gov (United States)

2017-05-01

Modeling System (CMS) that were developed and applied previously for the Charleston Harbor numerical modeling study (Kashlan 2013) were used in...Particle Tracking Model; Report 1: Model theory, implementation, and example applications. ERDC/CHL TR-6-20. Vicksburg, MS: U.S. Army Engineer Research ...ER D C/ CH L TR -1 7- 7 Regional Sediment Management (RSM) Program Charleston Harbor, SC, Regional Sediment Management Study

Charleston Harbor, SC, Regional Sediment Management Study; Beneficial Use of Dredged Material through Nearshore Placement

Science.gov (United States)

2017-05-01

Modeling System (CMS) that were developed and applied previously for the Charleston Harbor numerical modeling study (Kashlan 2013) were used in...Particle Tracking Model; Report 1: Model theory, implementation, and example applications. ERDC/CHL TR-6-20. Vicksburg, MS: U.S. Army Engineer Research ...ER D C/ CH L TR -1 7- 7 Regional Sediment Management (RSM) Program Charleston Harbor, SC, Regional Sediment Management Study

Local economic development in theories of regional economies and rural studies

Directory of Open Access Journals (Sweden)

Kačar Bahrija

2016-01-01

Full Text Available In this paper is a detailed analysis of the basics in the theory of economic development during the period from mid last century until today. It states the most significant theories, points out their ranges, offers a critical review regarding their treatment of development, especially regional, rural and local one. It observes those theories according to different classifications existing in scientific literature, primarily the ascend theory, stagnation theory, balanced economic growth theory; then, short-term and long-term development and growth theories; traditional and endogenous theories; economic growth stages theory emphasized after the WWII; structural changes theory; dependency theory, neo-classic counter-revolution theory and endogenous theory as a new growth theory. The analysis becomes wider with a study on development in regional economy theories and rural studies and it systematizes the classification of those theories according to regional economy academics. Distancing ourselves from any particular division as the most suitable and acceptable one, the theories are treated separately and in an historic context, in order to encircle the time framework which from modern theories, dealing with local level development difficulties, resulted. It asserts The Community-led Rural Development Theory, often referred to as the Community Development Theory, or marked as Bottom-up Partnership Approach. The analysis of development theories asserts that mixed exogenous - endogenous approach to development links the rural/local development to the globalization process mostly due to fast technology changes of the IT and communication sectors.

Efficacy of premixed versus sequential administration of ...

African Journals Online (AJOL)

sequential administration in separate syringes on block characteristics, haemodynamic parameters, side effect profile and postoperative analgesic requirement. Trial design: This was a prospective, randomised clinical study. Method: Sixty orthopaedic patients scheduled for elective lower limb surgery under spinal ...

Change Agent Strategies: A Study of the Michigan-Ohio Regional Educational Laboratory.

Science.gov (United States)

Miller, Peggy Lynne

This dissertation reports on a study of the planning and development activities of the Michigan-Ohio Regional Educational Laboratory (MOREL). The study attempted to assess (1) whether MOREL has accepted a change agent role, and (2) whether it has taken action that indicates recognition of what is known through the literature and research about…

A study of regional-scale aerosol assimilation using a Stretch-NICAM

Science.gov (United States)

Misawa, S.; Dai, T.; Schutgens, N.; Nakajima, T.

2013-12-01

Although aerosol is considered to be harmful to human health and it became a social issue, aerosol models and emission inventories include large uncertainties. In recent studies, data assimilation is applied to aerosol simulation to get more accurate aerosol field and emission inventory. Most of these studies, however, are carried out only on global scale, and there are only a few researches about regional scale aerosol assimilation. In this study, we have created and verified an aerosol assimilation system on regional scale, in hopes to reduce an error associated with the aerosol emission inventory. Our aerosol assimilation system has been developed using an atmospheric climate model, NICAM (Non-hydrostaric ICosahedral Atmospheric Model; Satoh et al., 2008) with a stretch grid system and coupled with an aerosol transport model, SPRINTARS (Takemura et al., 2000). Also, this assimilation system is based on local ensemble transform Kalman filter (LETKF). To validate this system, we used a simulated observational data by adding some artificial errors to the surface aerosol fields constructed by Stretch-NICAM-SPRINTARS. We also included a small perturbation in original emission inventory. This assimilation with modified observational data and emission inventory was performed in Kanto-plane region around Tokyo, Japan, and the result indicates the system reducing a relative error of aerosol concentration by 20%. Furthermore, we examined a sensitivity of the aerosol assimilation system by varying the number of total ensemble (5, 10 and 15 ensembles) and local patch (domain) size (radius of 50km, 100km and 200km), both of which are the tuning parameters in LETKF. The result of the assimilation with different ensemble number 5, 10 and 15 shows that the larger the number of ensemble is, the smaller the relative error become. This is consistent with ensemble Kalman filter theory and imply that this assimilation system works properly. Also we found that assimilation system

Study, Talk, and Action. A Report of a National Conference on Regionalism and Regionalization in American Postsecondary Education.

Science.gov (United States)

Martorana, S. V., Ed.; Nespoli, Lawrence A., Ed.

This report of a National Conference on Regionalism and Regionalization in American Postsecondary Education contains an overview and summary of the final project report, a keynote address, four papers on the implications of regionalism, some reactor comments, an essay on leadership, and four descriptive accounts of operational regionalization…

Great Lakes O shore Wind Project: Utility and Regional Integration Study

Energy Technology Data Exchange (ETDEWEB)

Sajadi, Amirhossein [Case Western Reserve Univ., Cleveland, OH (United States); Loparo, Kenneth A. [Case Western Reserve Univ., Cleveland, OH (United States); D' Aquila, Robert [General Electric (GE), Albany, NY (United States); Clark, Kara [National Renewable Energy Lab. (NREL), Golden, CO (United States); Waligorski, Joseph G. [FirstEnergy, Akron, OH (United States); Baker, Scott [PJM Interconnection, Audubon, PA (United States)

2016-06-30

This project aims to identify transmission system upgrades needed to facilitate offshore wind projects as well as operational impacts of offshore generation on operation of the regional transmission system in the Great Lakes region. A simulation model of the US Eastern Interconnection was used as the test system as a case study for investigating the impact of the integration of a 1000MW offshore wind farm operating in Lake Erie into FirstEnergy/PJM service territory. The findings of this research provide recommendations on offshore wind integration scenarios, the locations of points of interconnection, wind profile modeling and simulation, and computational methods to quantify performance, along with operating changes and equipment upgrades needed to mitigate system performance issues introduced by an offshore wind project.

Optical and near-IR study of LMC HII region N11AB

International Nuclear Information System (INIS)

Lee, M.G.

1990-01-01

N11 (DEM 34), complex HII region located about 4 degrees from the center of the LMC bar, is a very interesting giant interstellar shell. It has a complicated structure and motion. It is located on the edge of an HI concentration. This is the progress report of the study of its two components, A and B at the optical and near-IR wavelengths to investigate stars, dust and ionized gas associated with them. N11A is a compact high-excitation blob and N11B is a bright HII region in this complex, which embeds OB association Lucke-Hodge 10

Geophysical analysis for the Ada Tepe region (Bulgaria) - case study

Science.gov (United States)

Trifonova, Petya; Metodiev, Metodi; Solakov, Dimcho; Simeonova, Stela; Vatseva, Rumiana

2013-04-01

According to the current archeological investigations Ada Tepe is the oldest gold mine in Europe with Late Bronze and Early Iron age. It is a typical low-sulfidation epithermal gold deposit and is hosted in Maastrichtian-Paleocene sedimentary rocks above a detachment fault contact with underlying Paleozoic metamorphic rocks. Ada Tepe (25o.39'E; 41o.25'N) is located in the Eastern Rhodope unit. The region is highly segmented despite the low altitude (470-750 m) due to widespread volcanic and sediment rocks susceptible to torrential erosion during the cold season. Besides the thorough geological exploration focused on identifying cost-effective stocks of mineral resources, a detailed geophysical analysis concernig diferent stages of the gold extraction project was accomplished. We present the main results from the geophysical investigation aimed to clarify the complex seismotectonic setting of the Ada Tepe site region. The overall study methodology consists of collecting, reviewing and estimating geophysical and seismological information to constrain the model used for seismic hazard assessment of the area. Geophysical information used in the present work consists of gravity, geomagnetic and seismological data. Interpretation of gravity data is applied to outline the axes of steep gravity transitions marked as potential axes of faults, flexures and other structures of dislocation. Direct inverse techniques are also utilized to estimate the form and depth of anomalous sources. For the purposes of seismological investigation of the Ada Tepe site region an earthquake catalogue is compiled for the time period 510BC - 2011AD. Statistical parameters of seismicity - annual seismic rate parameter, ?, and the b-value of the Gutenberg-Richter exponential relation for Ada Tepe site region, are estimated. All geophysical datasets and derived results are integrated using GIS techniques ensuring interoperability of data when combining, processing and visualizing obtained

Comparison of cancer mortality in the Limousin and Poitou-Charentes regions (preliminary study 1968-1975)

International Nuclear Information System (INIS)

Dousset, M.; Jammet, H.

1985-01-01

The geology of the Limousin and Poitou-Charentes regions is very different; on an average, in the Limousin region, an inhabitant receives a supplementary dose of 65 mrem per year (terrestrial radiation) and the indoor radon concentration is 3-4 times higher than in the Poitou-Charentes region. The comparative rates of mortality for different types of malignant tumours (No. 20-27 of the INSERM DM list) were studied for the period extending from the 1968 to the 1975 census and for all ages according to the 1968 reference population. No significant difference appeared for these different types of cancers, except for cancers of the digestive system, which require a more thorough study. The more surprising result concernes malignant tumours of the respiratory system for which no difference -even small- appears; tobacco consumption per inhabitant was practically the same, on an average, in both regions [fr

Cooking up the Culinary Nation or Savoring its Regions? Teaching Food Studies in Vietnam

Directory of Open Access Journals (Sweden)

Christopher Annear

2018-05-01

Full Text Available “In food, as in death, we feel the essential brotherhood of man.” Vietnamese Proverb This paper explores whether or not there is an identifiably Vietnamese national cuisine, one in which the ingredients, recipes, and/or dishes socially, culturally, and politically unite Vietnamese people. It contends that Vietnam, with its long history of foreign invaders, its own appropriation of the middle and southern regions, and its varied regional geographies, provides a critical example for Food Studies of the need to interrogate the idea of a national cuisine and to differentiate it from regional and local cuisines. The paper examines how cookbook authors and cooking schools have more generally sought to represent Vietnamese dishes as national, but that there is a strong argument against the claim of a Vietnamese national cuisine. We advocate a Food Studies methodology that creates an effective pedagogy that explores whether or not national populations are unified as single gastro-states or atomized by a plurality of regional cuisines. Through experiential assignments and student work we illustrate how Food Studies presents the pedagogical opportunity for students to study and learn at the intersection of national politics and the everyday lives of people, providing a framework for understanding connections of labor, gender, class, and, essentially, taste, among many other values. In the case of Vietnamese food, the critical details of ingredients, preparation, and consumption both reveal and conceal truths about the Vietnamese people.

Modeling and analysis of PET studies with norepinephrine transporter ligands: the search for a reference region

Energy Technology Data Exchange (ETDEWEB)

Logan, Jean [Chemistry Department, Brookhaven National Laboratory, Upton, NY 11973 (United States)]. E-mail: logan@bnl.gov; Ding, Y.-S. [Chemistry Department, Brookhaven National Laboratory, Upton, NY 11973 (United States); Lin, K.-S. [Chemistry Department, Brookhaven National Laboratory, Upton, NY 11973 (United States); Pareto, Deborah [Medical Department, Brookhaven National Laboratory, Upton, NY 11973 (United States); Functional Imaging, Berkeley National Laboratory, Berkeley, CA 94720 (United States); Fowler, Joanna [Chemistry Department, Brookhaven National Laboratory, Upton, NY 11973 (United States); Biegon, Anat [Medical Department, Brookhaven National Laboratory, Upton, NY 11973 (United States)

2005-07-01

The development of positron emission tomography (PET) ligands for the norepinephrine transporter (NET) has been slow compared to the development of radiotracers for others systems, such as the dopamine (DAT) or the serotonin transporters (SERT). The main reason for this appears to be the high nonspecific (non-NET) binding exhibited by many of these tracers, which makes the identification of a reference region difficult. With other PET ligands the use of a reference region increases the reproducibility of the outcome measure in test/retest studies. The focus of this work is to identify a suitable reference region or means of normalizing data for the NET ligands investigated. Methods: We have analyzed the results of PET studies in the baboon brain with labeled reboxetine derivatives (S,S)-[{sup 11}C]O-methyl reboxetine (SS-MRB), (S,S)-[{sup 18}F]fluororeboxetine (SS-FRB) as well as O-[{sup 11}C]nisoxetine and N-[{sup 11}C]nisoxetine (NIS), and, for comparison, the less active (R,R) enantiomers (RR-MRB, RR-FRB) in terms of the distribution volume (DV) using measured arterial input functions. Results: (1) For a given subject, a large variation in DV for successive baseline studies was observed in regions with both high and low NET density. (2) The occipital cortex and the basal ganglia were found to be the regions with the smallest change between baseline (SS-MRB) and pretreatment with cocaine, and were therefore used as a composite reference region for calculation of a distribution volume ratio (DVR). (3) The variability [as measured by the coefficient of variation (CV)=standard deviation/mean] in the distribution volume ratio (DVR) of thalamus (to reference region) was considerably reduced over that of the DV using this composite reference region. (4) Pretreatment with nisoxetine (1.0 mg/kg 10 min prior to tracer) in one study produced (in decreasing order) reductions in thalamus, cerebellum, cingulate and frontal cortex consistent with known NET densities. (5) [{sup

Modeling and analysis of PET studies with norepinephrine transporter ligands: the search for a reference region.

Science.gov (United States)

Logan, Jean; Ding, Yu-Shin; Lin, Kuo-Shyan; Pareto, Deborah; Fowler, Joanna; Biegon, Anat

2005-07-01

The development of positron emission tomography (PET) ligands for the norepinephrine transporter (NET) has been slow compared to the development of radiotracers for others systems, such as the dopamine (DAT) or the serotonin transporters (SERT). The main reason for this appears to be the high nonspecific (non-NET) binding exhibited by many of these tracers, which makes the identification of a reference region difficult. With other PET ligands the use of a reference region increases the reproducibility of the outcome measure in test/retest studies. The focus of this work is to identify a suitable reference region or means of normalizing data for the NET ligands investigated. We have analyzed the results of PET studies in the baboon brain with labeled reboxetine derivatives (S,S)-[(11)C]O-methyl reboxetine (SS-MRB), (S,S)-[(18)F]fluororeboxetine (SS-FRB) as well as O-[(11)C]nisoxetine and N-[(11)C]nisoxetine (NIS), and, for comparison, the less active (R,R) enantiomers (RR-MRB, RR-FRB) in terms of the distribution volume (DV) using measured arterial input functions. (1) For a given subject, a large variation in DV for successive baseline studies was observed in regions with both high and low NET density. (2) The occipital cortex and the basal ganglia were found to be the regions with the smallest change between baseline (SS-MRB) and pretreatment with cocaine, and were therefore used as a composite reference region for calculation of a distribution volume ratio (DVR). (3) The variability [as measured by the coefficient of variation (CV) = standard deviation/mean] in the distribution volume ratio (DVR) of thalamus (to reference region) was considerably reduced over that of the DV using this composite reference region. (4) Pretreatment with nisoxetine (1.0 mg/kg 10 min prior to tracer) in one study produced (in decreasing order) reductions in thalamus, cerebellum, cingulate and frontal cortex consistent with known NET densities. (5) [(11)C]Nisoxetine had a higher

Modeling and analysis of PET studies with norepinephrine transporter ligands: the search for a reference region

International Nuclear Information System (INIS)

Logan, Jean; Ding, Y.-S.; Lin, K.-S.; Pareto, Deborah; Fowler, Joanna; Biegon, Anat

2005-01-01

The development of positron emission tomography (PET) ligands for the norepinephrine transporter (NET) has been slow compared to the development of radiotracers for others systems, such as the dopamine (DAT) or the serotonin transporters (SERT). The main reason for this appears to be the high nonspecific (non-NET) binding exhibited by many of these tracers, which makes the identification of a reference region difficult. With other PET ligands the use of a reference region increases the reproducibility of the outcome measure in test/retest studies. The focus of this work is to identify a suitable reference region or means of normalizing data for the NET ligands investigated. Methods: We have analyzed the results of PET studies in the baboon brain with labeled reboxetine derivatives (S,S)-[ 11 C]O-methyl reboxetine (SS-MRB), (S,S)-[ 18 F]fluororeboxetine (SS-FRB) as well as O-[ 11 C]nisoxetine and N-[ 11 C]nisoxetine (NIS), and, for comparison, the less active (R,R) enantiomers (RR-MRB, RR-FRB) in terms of the distribution volume (DV) using measured arterial input functions. Results: (1) For a given subject, a large variation in DV for successive baseline studies was observed in regions with both high and low NET density. (2) The occipital cortex and the basal ganglia were found to be the regions with the smallest change between baseline (SS-MRB) and pretreatment with cocaine, and were therefore used as a composite reference region for calculation of a distribution volume ratio (DVR). (3) The variability [as measured by the coefficient of variation (CV)=standard deviation/mean] in the distribution volume ratio (DVR) of thalamus (to reference region) was considerably reduced over that of the DV using this composite reference region. (4) Pretreatment with nisoxetine (1.0 mg/kg 10 min prior to tracer) in one study produced (in decreasing order) reductions in thalamus, cerebellum, cingulate and frontal cortex consistent with known NET densities. (5) [ 11 C]Nisoxetine had

Infrared studies of H II regions: the Sharpless regions S148, 184, 198, 206 and 269

International Nuclear Information System (INIS)

Pismis, Paris

1991-01-01

We present the results of a combined near-infrared and IRAS mapping study of five H II regions for which fairly complete information at optical and radio wavelengths previously existed. The near-infrared observations, carried out with the 2.1-m telescope at Observatorio de San Pedro Martir (Mexico), allowed us to study the the stellar content at the core of each nebula, while an analysis of extended near-infrared emission zones showed these to arise mainly from ionized gas (S148 and S206) or through scattering and thermal emission from dust grains surrounding a massive young star (S269-IRS2). The analysis of IRAS data, on the other hand, suggests that two different populations of grains contribute to the observed 12- to 100-μm fluxes. (author)

Determinants of the Shadow Economy in the Czech Regions: A Region-Level Study

Directory of Open Access Journals (Sweden)

Buček Jakub

2017-09-01

Full Text Available This paper investigates the size and development of the shadow economy in the Czech Republic on the state-level base over the 2005-2014 period. The multiple indicators multiple causes (MIMIC model is used to assess the estimation of the shadow economy size. I investigate how labour market, number of people with at least one distraint, and the burden of taxation might contribute to the existence of the shadow economy. While the former two are important determinants of the shadow economy, I find no evidence to prove any significant impact of distraints on the shadow economy size. As for the country’s particular regions, I find that those surrounding big cities, especially Prague, have, on average, a smaller shadow economy size, whereas regions in the borderlands (former Sudetenland suffer from a larger shadow economy.

Endocrine and haemodynamic changes in resistant hypertension, and blood pressure responses to spironolactone or amiloride: the PATHWAY-2 mechanisms substudies.

Science.gov (United States)

Williams, Bryan; MacDonald, Thomas M; Morant, Steve V; Webb, David J; Sever, Peter; McInnes, Gordon T; Ford, Ian; Cruickshank, J Kennedy; Caulfield, Mark J; Padmanabhan, Sandosh; Mackenzie, Isla S; Salsbury, Jackie; Brown, Morris J

2018-04-11

In the PATHWAY-2 study of resistant hypertension, spironolactone reduced blood pressure substantially more than conventional antihypertensive drugs. We did three substudies to assess the mechanisms underlying this superiority and the pathogenesis of resistant hypertension. PATHWAY-2 was a randomised, double-blind crossover trial done at 14 UK primary and secondary care sites in 314 patients with resistant hypertension. Patients were given 12 weeks of once daily treatment with each of placebo, spironolactone 25-50 mg, bisoprolol 5-10 mg, and doxazosin 4-8 mg and the change in home systolic blood pressure was assessed as the primary outcome. In our three substudies, we assessed plasma aldosterone, renin, and aldosterone-to-renin ratio (ARR) as predictors of home systolic blood pressure, and estimated prevalence of primary aldosteronism (substudy 1); assessed the effects of each drug in terms of thoracic fluid index, cardiac index, stroke index, and systemic vascular resistance at seven sites with haemodynamic monitoring facilities (substudy 2); and assessed the effect of amiloride 10-20 mg once daily on clinic systolic blood pressure during an optional 6-12 week open-label runout phase (substudy 3). The PATHWAY-2 trial is registered with EudraCT, number 2008-007149-30, and ClinicalTrials.gov, number NCT02369081. Of the 314 patients in PATHWAY-2, 269 participated in one or more of the three substudies: 126 in substudy 1, 226 in substudy 2, and 146 in substudy 3. Home systolic blood pressure reduction by spironolactone was predicted by ARR (r 2 =0·13, p<0·0001) and plasma renin (r 2 =0·11, p=0·00024). 42 patients had low renin concentrations (predefined as the lowest tertile of plasma renin), of which 31 had a plasma aldosterone concentration greater than the mean value for all 126 patients (250 pmol/L). Thus, 31 (25% [95% CI 17-33]) of 126 patients were deemed to have inappropriately high aldosterone concentrations. Thoracic fluid content was reduced by 6·8% from

Only Moderate Intra- and Inter-observer Agreement between Radiologists and Surgeons when Grading Blunt Paediatric Hepatic Injury on CT Scan

NARCIS (Netherlands)

Nellensteijn, D. R.; ten Duis, H. J.; Oldenziel, J.; Polak, W. G.; Hulscher, J. B. F.

2009-01-01

Introduction: The American Pediatric Surgical Association developed guidelines for the management of haemodynamically stable children with hepatic or splenic injury, based on grade of injury on CF scan. This study investigated the intra- and inter-observer agreement of radiologists, paediatric

Vaccination Coverage for Infants: Cross-Sectional Studies in Two Regions of Belgium

Directory of Open Access Journals (Sweden)

Emmanuelle Robert

2014-01-01

Full Text Available Methods and Objectives. To estimate infant vaccination coverage in the French-speaking region of Belgium (Wallonia and in the Brussels-Capital Region, two cross-sectional studies were performed in 2012. A face-to-face questionnaire was administered by trained investigators. The objective was to evaluate infant vaccination coverage retrospectively in 18- to 24-month-old children. These studies offered the opportunity to assess some factors influencing vaccine uptake in infants. Results and Discussion. Approximately 99% of the children had received the first dose of IPV-DTaP, 90% the fourth dose, 94% the MMR vaccine, 97% the first dose of pneumococcal vaccine, and 90% the third dose. In both regions, when fitting a logistic model, the most associated factor was attendance at maternal and child clinics (MCH. No association was observed between vaccination coverage and the mother’s level of education. For the last immunization session, where the mother was a Belgian native and when she worked more hours, child was better immunized, but only in Brussels. Conclusion. Coverage for the fourth dose of hexavalent vaccine (DTaP-IPV-HBV/Hib needs to be increased. Indeed, additional effort is needed to increase HIB and pertussis coverage rates because the herd immunity threshold for these two diseases has not been reached.

The Regional Dimension

DEFF Research Database (Denmark)

Eskjær, Mikkel Fugl

2013-01-01

is largely dependent on regional media systems, yet the role this regional dimension plays has been largely overlooked. This article presents a comparative study of climate-change coverage in three geo-cultural regions, The Middle East, Scandinavia, and North America, and explores the link between global......Global perspectives and national approaches have dominated studies of climate-change communication, reflecting the global nature of climate change as well as the traditional research focus on national media systems. In the absence of a global public sphere, however, transnational issue attention...... climate-change communication and regional media systems. It finds that regional variations in climate-change communication carry important communicative implications concerning perceptions of climate change's relevance and urgency...

Management strategies for regional airports: A study applied to -Lleida-Alguaire airport

Directory of Open Access Journals (Sweden)

Natalia Daries-Ramon

2017-05-01

Full Text Available Purpose: The main objective of this article is to analyse the current situation at Lleida-Alguaire Airport and propose possible actions to increase its profitability. Design/methodology/approach: This study presents the method as a research tool applied to regional airports, in particular, Lleida-Alguaire Airport. Findings: The study shows the importance of air transport and the current situation of Spanish airports, specifically in Catalonia, exposing the main air traffic imbalances between different airports and their effect on tourism. Finally, it describes and analyses the situation of Lleida-Alguaire Airport. Practical implications: Some actions in relation with aeronautical traffic are presented in order to improve and increase the efficiency of the system. Originality/value: This article is one of the first works to focus on regional airports and it seeks ways to improve their economic and social efficiency.

Regional study on investment for transmission infrastructure in China based on the State Grid data

Science.gov (United States)

Wei, Wendong; Wu, Xudong; Wu, Xiaofang; Xi, Qiangmin; Ji, Xi; Li, Guoping

2017-03-01

Transmission infrastructure is an integral component of safeguarding the stability of electricity delivery. However, existing studies of transmission infrastructure mostly rely on a simple review of the network, while the analysis of investments remains rudimentary. This study conducted the first regionally focused analysis of investments in transmission infrastructure in China to help optimize its structure and reduce investment costs. Using State Grid data, the investment costs, under various voltages, for transmission lines and transformer substations are calculated. By analyzing the regional profile of cumulative investment in transmission infrastructure, we assess correlations between investment, population, and economic development across the regions. The recent development of ultra-high-voltage transmission networks will provide policy-makers new options for policy development.

Regional brain structural abnormality in ischemic stroke patients: a voxel-based morphometry study

Directory of Open Access Journals (Sweden)

Ping Wu

2016-01-01

Full Text Available Our previous study used regional homogeneity analysis and found that activity in some brain areas of patients with ischemic stroke changed significantly. In the current study, we examined structural changes in these brain regions by taking structural magnetic resonance imaging scans of 11 ischemic stroke patients and 15 healthy participants, and analyzing the data using voxel-based morphometry. Compared with healthy participants, patients exhibited higher gray matter density in the left inferior occipital gyrus and right anterior white matter tract. In contrast, gray matter density in the right cerebellum, left precentral gyrus, right middle frontal gyrus, and left middle temporal gyrus was less in ischemic stroke patients. The changes of gray matter density in the middle frontal gyrus were negatively associated with the clinical rating scales of the Fugl-Meyer Motor Assessment (r = -0.609, P = 0.047 and the left middle temporal gyrus was negatively correlated with the clinical rating scales of the nervous functional deficiency scale (r = -0.737, P = 0.010. Our findings can objectively identify the functional abnormality in some brain regions of ischemic stroke patients.

Identification of Differentially Expressed Genes through Integrated Study of Alzheimer's Disease Affected Brain Regions.

Directory of Open Access Journals (Sweden)

Nisha Puthiyedth

Full Text Available Alzheimer's disease (AD is the most common form of dementia in older adults that damages the brain and results in impaired memory, thinking and behaviour. The identification of differentially expressed genes and related pathways among affected brain regions can provide more information on the mechanisms of AD. In the past decade, several studies have reported many genes that are associated with AD. This wealth of information has become difficult to follow and interpret as most of the results are conflicting. In that case, it is worth doing an integrated study of multiple datasets that helps to increase the total number of samples and the statistical power in detecting biomarkers. In this study, we present an integrated analysis of five different brain region datasets and introduce new genes that warrant further investigation.The aim of our study is to apply a novel combinatorial optimisation based meta-analysis approach to identify differentially expressed genes that are associated to AD across brain regions. In this study, microarray gene expression data from 161 samples (74 non-demented controls, 87 AD from the Entorhinal Cortex (EC, Hippocampus (HIP, Middle temporal gyrus (MTG, Posterior cingulate cortex (PC, Superior frontal gyrus (SFG and visual cortex (VCX brain regions were integrated and analysed using our method. The results are then compared to two popular meta-analysis methods, RankProd and GeneMeta, and to what can be obtained by analysing the individual datasets.We find genes related with AD that are consistent with existing studies, and new candidate genes not previously related with AD. Our study confirms the up-regualtion of INFAR2 and PTMA along with the down regulation of GPHN, RAB2A, PSMD14 and FGF. Novel genes PSMB2, WNK1, RPL15, SEMA4C, RWDD2A and LARGE are found to be differentially expressed across all brain regions. Further investigation on these genes may provide new insights into the development of AD. In addition, we

Study on radon concentration in nursery school in the mining region

International Nuclear Information System (INIS)

Skowronek, J.; Wysocka, M.; Mielnikow, A.

1999-01-01

Study on children exposure from natural radon background has been performed on the example of nursery schools being localized in Piekary Slaskie in the coal mining region of Silesia. Indoor air contamination has been measured as well as soil air and air outside the houses. In none of examined places the exposure do not exceeded the IAEA acceptable level

Freshwater Ecosystem Service Flow Model To Evaluate Regional Water Security: A Case Study In Beijing-Tianjin-Hebei Region, China

Science.gov (United States)

Li, D.; Li, S.

2016-12-01

Freshwater service, as the most important support ecosystem service, is essential to human survival and development. Many studies have evidenced the spatial differences in the supply and demand of ecosystem services and raised the concept of ecosystem service flow. However, rather few studies quantitatively characterize the freshwater service flow. This paper aims to quantify the effect of freshwater ecosystem service flow on downstream areas in Beijing-Tianjin-Hebei (BTH) region, China over 2000, 2005 and 2010. We computed the freshwater ecosystem service provision with InVEST model. We calculated freshwater ecosystem service consumption with water quota method. We simulated the freshwater ecosystem service flow using our simplified flow model and assessed the regional water security with the improved freshwater security index. The freshwater provision service mainly depends on climatic factors that cannot be influenced by management, while the freshwater consumption service is constrained by human activities. Furthermore, the decrease of water quota for agricultural, domestic and industrial water counteracts the impact of increasing freshwater demand. The analysis of freshwater ecosystem service flow reveals that the majority area of the BTH (69.2%) is affected by upstream freshwater. If freshwater ecosystem service flow is considered, the water safety areas of the whole BTH account for 66.9%, 66.1%, 71.3%, which increase 6.4%, 6.8% and 5.7% in 2000, 2005 and 2010, respectively. These results highlight the need to understand the teleconnections between distant freshwater ecosystem service provision and local freshwater ecosystem service use. This approach therefore helps managers choose specific management and investment strategies for critical upstream freshwater provisions across different regions.

A Study on Regional Frequency Analysis using Artificial Neural Network - the Sumjin River Basin

Science.gov (United States)

Jeong, C.; Ahn, J.; Ahn, H.; Heo, J. H.

2017-12-01

Regional frequency analysis means to make up for shortcomings in the at-site frequency analysis which is about a lack of sample size through the regional concept. Regional rainfall quantile depends on the identification of hydrologically homogeneous regions, hence the regional classification based on hydrological homogeneous assumption is very important. For regional clustering about rainfall, multidimensional variables and factors related geographical features and meteorological figure are considered such as mean annual precipitation, number of days with precipitation in a year and average maximum daily precipitation in a month. Self-Organizing Feature Map method which is one of the artificial neural network algorithm in the unsupervised learning techniques solves N-dimensional and nonlinear problems and be shown results simply as a data visualization technique. In this study, for the Sumjin river basin in South Korea, cluster analysis was performed based on SOM method using high-dimensional geographical features and meteorological factor as input data. then, for the results, in order to evaluate the homogeneity of regions, the L-moment based discordancy and heterogeneity measures were used. Rainfall quantiles were estimated as the index flood method which is one of regional rainfall frequency analysis. Clustering analysis using SOM method and the consequential variation in rainfall quantile were analyzed. This research was supported by a grant(2017-MPSS31-001) from Supporting Technology Development Program for Disaster Management funded by Ministry of Public Safety and Security(MPSS) of the Korean government.

Climate, transports and regions. A study of goal-conflicts and goal-synergies; Klimat, transporter och regioner. En studie om maalkonflikter och maalsynergier

Energy Technology Data Exchange (ETDEWEB)

Andersson, Matts; Hammarqvist, Jarl; Jarlebring, Isak; Algers, Staffan; Baeckstroem, Sebastian; Svalgaard, Stehn; Hultin, Kia [WSP Analys och Strategi, Stockholm (Sweden); Lundgren, Tommy [Dept. of Forest Economics, Swedish Univ. of Agricultural Sciences, Umeaa (Sweden)

2007-05-15

In this report, we address how climate gas emissions and regional development are influenced by policy instruments. We compare costs in terms of decreased regional development with the benefits in CO{sub 2} reductions. Regional development is measured by production and employment within the manufacturing industry, and by the size of the labour markets. For two reasons, we study policy instruments in the transport system: 1. The transport system represents a large and constantly increasing part of CO{sub 2} emissions. 2. Within the transport industry, analytical tools are readily available. We study tax on fossil fuels, three levels of kilometer tax and car benefit tax based on CO{sub 2} emissions. The two first instruments are taken from a Swedish parliamentary investigation on road taxes, the third from an investigation by the Swedish environmental Protection Agency. All instruments have little impact on production. In total, production in the manufacturing industry is decreased by SEK 2 billion annually, or 0.1 per cent of GDP, when the highest kilometer tax is applied. For some industries the effects are noticeable in absolute values, though the largest decrease is only 2.5 percent of the production in the industry (earth and stone). The impact on employment is greater and positive. Employment in the manufacturing industry increases by 1.2 per cent, or 5,000 individuals, with the highest kilometer tax. Labour intense industries grow on behalf of transport intense industries and transports are exchanged for labour within each industry. As shown in the figure on the next page, the greatest increase is in the food and beverage industry and the largest decrease in paper and pulp. Our calculations of goods transport emissions are quite rough. The highest level of kilometer tax will decrease emissions from heavy goods vehicles with 5 to 11 per cent (which means a 1 to 2 percent decrease in emissions from the transport sector), whereas the middle level is decreases

Urban archetypes project: community case study: Halifax Regional Municipality

Energy Technology Data Exchange (ETDEWEB)

NONE

2009-07-01

A comparative analysis of the energy consumption of typical households in four neighbourhoods in the Halifax regional municipality is presented. Representative household annual energy inputs and services are summarized in Sankey-style graphics. Depending on consumption in common house and apartment types within the study areas, energy costs ranged from $4,156 to $6,316 per year for the combined use of oil and electricity. Associated greenhouse gas (GHG) emissions ranged from 4.9 to 13.5 tonnes of carbon dioxide equivalent (CO2e) per year. Average annual household Vehicle Kilometres Travelled ranged from 13 500 to 41 400 km.

The application of near infrared spectroscopy in nutritional intervention studies

Directory of Open Access Journals (Sweden)

Philippa A Jackson

2013-08-01

Full Text Available Functional near infrared spectroscopy (NIRS is a non-invasive optical imaging technique used to monitor cerebral blood flow (CBF and by proxy neuronal activation. The use of NIRS in nutritional intervention studies is a relatively novel application of this technique, with only a small, but growing, number of trials published to date. These trials—in which the effects on CBF following administration of dietary components such as caffeine, polyphenols and omega-3 polyunsaturated fatty acids are assessed—have successfully demonstrated NIRS as a sensitive measure of change in haemodynamic response during cognitive tasks in both acute and chronic treatment intervention paradigms. The existent research in this area has been limited by the constraints of the technique itself however advancements in the measurement technology, paired with studies endeavouring increased sophistication in number and locations of channels over the head should render the use of NIRS in nutritional interventions particularly valuable in advancing our understanding of the effects of nutrients and dietary components on the brain.

Whole-brain dynamic CT angiography and perfusion imaging

Energy Technology Data Exchange (ETDEWEB)

Orrison, W.W. [CHW Nevada Imaging Company, Nevada Imaging Centers, Spring Valley, Las Vegas, NV (United States); College of Osteopathic Medicine, Touro University Nevada, Henderson, NV (United States); Department of Health Physics and Diagnostic Sciences, University of Nevada Las Vegas, Las Vegas, NV (United States); Department of Medical Education, University of Nevada School of Medicine, Reno, NV (United States); Snyder, K.V.; Hopkins, L.N. [Department of Neurosurgery, Millard Fillmore Gates Circle Hospital, Buffalo, NY (United States); Roach, C.J. [School of Life Sciences, University of Nevada Las Vegas, Las Vegas, NV (United States); Advanced Medical Imaging and Genetics (Amigenics), Las Vegas, NV (United States); Ringdahl, E.N. [Department of Psychology, University of Nevada Las Vegas, Las Vegas, NV (United States); Nazir, R. [Shifa International Hospital, Islamabad (Pakistan); Hanson, E.H., E-mail: eric.hanson@amigenics.co [College of Osteopathic Medicine, Touro University Nevada, Henderson, NV (United States); Department of Health Physics and Diagnostic Sciences, University of Nevada Las Vegas, Las Vegas, NV (United States); Advanced Medical Imaging and Genetics (Amigenics), Las Vegas, NV (United States)

2011-06-15

The availability of whole brain computed tomography (CT) perfusion has expanded the opportunities for analysing the haemodynamic parameters associated with varied neurological conditions. Examples demonstrating the clinical utility of whole-brain CT perfusion imaging in selected acute and chronic ischaemic arterial neurovascular conditions are presented. Whole-brain CT perfusion enables the detection and focused haemodynamic analyses of acute and chronic arterial conditions in the central nervous system without the limitation of partial anatomical coverage of the brain.

Study nonlinear dynamics of stratospheric ozone concentration at Pakistan Terrestrial region

Science.gov (United States)

Jan, Bulbul; Zai, Muhammad Ayub Khan Yousuf; Afradi, Faisal Khan; Aziz, Zohaib

2018-03-01

This study investigates the nonlinear dynamics of the stratospheric ozone layer at Pakistan atmospheric region. Ozone considered now the most important issue in the world because of its diverse effects on earth biosphere, including human health, ecosystem, marine life, agriculture yield and climate change. Therefore, this paper deals with total monthly time series data of stratospheric ozone over the Pakistan atmospheric region from 1970 to 2013. Two approaches, basic statistical analysis and Fractal dimension (D) have adapted to study the nature of nonlinear dynamics of stratospheric ozone level. Results obtained from this research have shown that the Hurst exponent values of both methods of fractal dimension revealed an anti-persistent behavior (negatively correlated), i.e. decreasing trend for all lags and Rescaled range analysis is more appropriate as compared to Detrended fluctuation analysis. For seasonal time series all month follows an anti-persistent behavior except in the month of November which shown persistence behavior i.e. time series is an independent and increasing trend. The normality test statistics also confirmed the nonlinear behavior of ozone and the rejection of hypothesis indicates the strong evidence of the complexity of data. This study will be useful to the researchers working in the same field in the future to verify the complex nature of stratospheric ozone.

Hydrogeochemical characterization of groundwater in the Outaouais Region (Québec, Canada) - A regional scale study

Science.gov (United States)

Montcoudiol, N.; Molson, J. W.; Lemieux, J.

2013-12-01

rainwater in unconfined aquifers (bromide below detection limit). Secondary processes, related to the bedrock geology, are responsible for exceedances of Canadian drinking water standards. They include the dissolution of F-, U-, Fe- and Mn-bearing minerals known to be abundant in the region (deposits and mines throughout the study area). Chloride contamination was identified in some recharge areas, related to anthropogenic activities. The study has identified Champlain Sea invasion, cation exchange and freshwater recharge as the main geochemical processes affecting groundwater chemistry in this region. Secondary processes were also identified, based on exceedances of Canadian drinking water standards. These results will be applied at the local scale, along a flow path, to relate geochemical evolution to groundwater flow conditions. More data are available at this scale such as stable isotope content (δ18O and δ2H), groundwater age (tritium and 14C) and noble gas content. These additional data will help improve our understanding about groundwater chemical evolution and define a complete conceptual model.

Regional homogeneity changes in prelingually deafened patients: a resting-state fMRI study

Science.gov (United States)

Li, Wenjing; He, Huiguang; Xian, Junfang; Lv, Bin; Li, Meng; Li, Yong; Liu, Zhaohui; Wang, Zhenchang

2010-03-01

Resting-state functional magnetic resonance imaging (fMRI) is a technique that measures the intrinsic function of brain and has some advantages over task-induced fMRI. Regional homogeneity (ReHo) assesses the similarity of the time series of a given voxel with its nearest neighbors on a voxel-by-voxel basis, which reflects the temporal homogeneity of the regional BOLD signal. In the present study, we used the resting state fMRI data to investigate the ReHo changes of the whole brain in the prelingually deafened patients relative to normal controls. 18 deaf patients and 22 healthy subjects were scanned. Kendall's coefficient of concordance (KCC) was calculated to measure the degree of regional coherence of fMRI time courses. We found that regional coherence significantly decreased in the left frontal lobe, bilateral temporal lobes and right thalamus, and increased in the postcentral gyrus, cingulate gyrus, left temporal lobe, left thalamus and cerebellum in deaf patients compared with controls. These results show that the prelingually deafened patients have higher degree of regional coherence in the paleocortex, and lower degree in neocortex. Since neocortex plays an important role in the development of auditory, these evidences may suggest that the deaf persons reorganize the paleocortex to offset the loss of auditory.

Large-scale wind power in New Brunswick : a regional scenario study towards 2025

International Nuclear Information System (INIS)

2008-08-01

This paper discussed the large-scale development of wind power in New Brunswick and evaluated Danish experiences with wind development as a template for developing wind resources in the Maritimes region. The study showed that New Brunswick and the Maritimes region have good wind resources, and that the province will gain significant economic benefits from deploying between 5500 and 7500 MW of wind power capacity by 2025. Wind power development will contribute to the security of supply in the region and reduce air pollution. Carbon regulation and renewable portfolio standards will improve the competitiveness of wind power. Electricity generated by wind power plants in the Maritimes can be sold to other provinces in Canada, as well as to the heavily populated New England region of the United States. A high level of cooperation between markets in the Maritimes area and neighbouring New England and Quebec systems will be required in addition to load flow analyses of electricity systems. Denmark's experiences with developing wind power indicate that existing market designs must be restructured to allow for higher levels of competition. A strong system operator is required to integrate wind power into the system. It was concluded that strong political leadership is required to ensure the sustainable development of the region. 5 refs., 4 tabs., 9 figs

Northeast Regional environmental impact study: Waste disposal technical report

Science.gov (United States)

Saguinsin, J. L. S.

1981-04-01

The potential for cumulative and interactive environmental impacts associated with the conversion of multiple generating stations in the Northeast is assessed. The estimated quantities and composition of wastes resulting from coal conversion, including ash and SO2 scrubber sludge, are presented. Regulations governing the use of ash and scrubber sludge are identified. Currently available waste disposal schemes are described. The location, capacity, and projected life of present and potential disposal sites in the region are identified. Waste disposal problems, both hazardous and nonhazardous, are evaluated. Environmental regulations within the region as they pertain to coal conversion and as they affect the choice of conversion alternatives are discussed. A regional waste management strategy for solid waste disposal is developed.

Dopexamine increases internal mammary artery blood flow following coronary artery bypass grafting.

LENUS (Irish Health Repository)

Flynn, Michael J

2012-02-03

OBJECTIVE: Vasoactive agents and inotropes influence conduit-coronary blood flow following coronary artery bypass grafting (CABG). It was hypothesized that dopexamine hydrochloride, a dopamine A-1 (DA-1) and beta(2) agonist would increase conduit-coronary blood flow. A prospective randomized double blind clinical trial was carried out to test this hypothesis. DA-1 receptors have previously been localized to human left ventricle. METHODS: Twenty-six American Society of Anaesthesiology class 2-3 elective coronary artery bypass graft patients who did not require inotropic support on separation from cardiopulmonary bypass (CPB) were studied. According to a randomized allocation patients received either dopexamine (1 microg\\/kg per min) or placebo (saline) by intravenous infusion for 15 min. Immediately prior to and at 5,10 and 15 min of infusion, blood flow through the internal mammary and vein grafts (Transit time flow probes, Transonic Ltd.), heart rate, cardiac index, mean arterial pressure and pulmonary haemodynamics were noted. The data were analysed using multivariate analysis of variance. RESULTS: Low-dose dopexamine (1 microg\\/kg per min) caused a significant increase in mammary graft blood flow compared to placebo at 15 min of infusion (P=0.028, dopexamine group left internal mammary artery (LIMA) flow of 43.3+\\/-14.2 ml\\/min, placebo group LIMA flow at 26.1+\\/-16.3 ml\\/min). Dopexamine recipients demonstrated a non-significant trend to increased saphenous vein graft flow (P=0.059). Increased heart rate was the only haemodynamic change induced by dopexamine (P=0.004, dopexamine group at 85.2+\\/-9.6 beats\\/min and placebo group at 71.1+\\/-7.6 beats\\/min after 15 min of infusion). CONCLUSION: This study demonstrates that administration of dopexamine (1 microg\\/kg per min) was associated with a significant increase in internal mammary artery graft blood flow with mild increase in heart rate being the only haemodynamic change. Low-dose dopexamine may

Non-dimensional physics of pulsatile cardiovascular networks and energy efficiency.

Science.gov (United States)

Yigit, Berk; Pekkan, Kerem

2016-01-01

In Nature, there exist a variety of cardiovascular circulation networks in which the energetic ventricular load has both steady and pulsatile components. Steady load is related to the mean cardiac output (CO) and the haemodynamic resistance of the peripheral vascular system. On the other hand, the pulsatile load is determined by the simultaneous pressure and flow waveforms at the ventricular outlet, which in turn are governed through arterial wave dynamics (transmission) and pulse decay characteristics (windkessel effect). Both the steady and pulsatile contributions of the haemodynamic power load are critical for characterizing/comparing disease states and for predicting the performance of cardiovascular devices. However, haemodynamic performance parameters vary significantly from subject to subject because of body size, heart rate and subject-specific CO. Therefore, a 'normalized' energy dissipation index, as a function of the 'non-dimensional' physical parameters that govern the circulation networks, is needed for comparative/integrative biological studies and clinical decision-making. In this paper, a complete network-independent non-dimensional formulation that incorporates pulsatile flow regimes is developed. Mechanical design variables of cardiovascular flow systems are identified and the Buckingham Pi theorem is formally applied to obtain the corresponding non-dimensional scaling parameter sets. Two scaling approaches are considered to address both the lumped parameter networks and the distributed circulation components. The validity of these non-dimensional number sets is tested extensively through the existing empirical allometric scaling laws of circulation systems. Additional validation studies are performed using a parametric numerical arterial model that represents the transmission and windkessel characteristics, which are adjusted to represent different body sizes and non-dimensional haemodynamic states. Simulations demonstrate that the proposed non

Effects of virtual water flow on regional water resources stress: A case study of grain in China.

Science.gov (United States)

Sun, Shikun; Wang, Yubao; Engel, Bernie A; Wu, Pute

2016-04-15

Scarcity of water resources is one of the major challenges in the world, particularly for the main water consumer, agriculture. Virtual water flow (VWF) promotes water redistribution geographically and provides a new solution for resolving regional water shortage and improving water use efficiency in the world. Virtual water transfer among regions will have a significant influence on the water systems in both grain export and import regions. In order to assess the impacts of VWF related grain transfer on regional water resources conditions, the study takes mainland China as study area for a comprehensive evaluation of virtual water flow on regional water resources stress. Results show that Northeast China and Huang-Huai-Hai region are the major grain production regions as well as the major virtual water export regions. National water savings related to grain VWF was about 58Gm(3), with 48Gm(3) blue water and 10Gm(3) green water. VWF changes the original water distribution and has a significant effect on water resources in both virtual water import and export regions. Grain VWF significantly increased water stress in grain export regions and alleviated water stress in grain import regions. Water stress index (WSI) of Heilongjiang and Inner Mongolia has been increased by 138% and 129% due to grain export. Stress from water shortages is generally severe in export regions, and issues with the sustainability of grain production and VWF pattern are worthy of further exploration. Copyright © 2016 Elsevier B.V. All rights reserved.

The wind forecasting improvement project. Description and results from the Southern study region

Energy Technology Data Exchange (ETDEWEB)

Freedman, Jeffrey [AWS Truepower LLC, Albany, NY (United States); Benjamin, Stan; Wilczak, James [National Oceanic and Atmospheric Administration, Washington, DC and Boulder, CO (United States)] [and others

2012-07-01

The Wind Forecasting Improvement Project (WFIP) is a multi-year U.S. Department of Energy (DOE)/National Oceanographic and Atmospheric Administration (NOAA) sponsored study whose main purpose is to demonstrate the scientific and economic benefits of additional atmospheric observations and model enhancements on wind energy production forecasts. WFIP covers two geographical regions of the U.S.: (1) the upper Great Plains, or Northern Study Area, and (2) most of Texas-the Southern Study Area. The Southern campaign is being led by AWS Truepower LLC, and includes a team of private, government, and academic partners with collective experience and expertise in all facets required to ensure a successful completion of the project. In addition presenting a summary of the state-of-the-art forecasting techniques used and phenomena-based analysis mentioned above, a brief synopsis of how ''lessons learned'' from the WFIP Southern Study Area can be articulated and applied to other wind resource regions will be described. (orig.)

Study of the cathodic region of a hydrogen luminescent discharge: spectroscopic diagnoses

International Nuclear Information System (INIS)

Barbeau, Claude

1991-01-01

This research thesis addresses the study of the cathodic region of a hydrogen luminescent discharge in direct current, and belongs to the field of studies on plasma-surface interactions, notably in order to understand and optimise electric discharges in H_2CH_4 mixtures used for steel cementation and hard carbon deposition. The author first presents the main characteristics of the abnormal discharge, and details operation conditions as well as the characteristics of the different experimental assemblies. The experimental study of the cathodic region has been mainly performed by high resolution emission spectroscopy, and multi-photon laser spectroscopy (laser-induced fluorescence, optogalvanic effect). In the second part, the author reports an analysis of the Doppler broadening of emission profiles of atomic lines (notably the Balmer series). Experimental results are compared with those of Monte Carlo simulation which addresses mechanisms of creation of excited atoms as well as their energetic distribution. The next parts report the development of methods and techniques for the measurement of the electric field of the cathodic drop and of gas temperature, experimental results and their interpretation [fr

A Declining Region: Provincial Renaissance Revisited (Case of Volgograd Region

Directory of Open Access Journals (Sweden)

Drozdova Yuliya

2014-12-01

Full Text Available The paper analyzes findings yielded by the empirical study performed in the framework of an RGNF grant entitled “Image of a region as a communicative strategy for the authorities and mass media”. The methods of study included expert survey and formal survey (N=1000, July-September 2013, studying the opinion of respondents who were either internal experts residing in the Volgograd region (N=20; May-September 2013 or external experts who reside outside the region but maintain stable ties with the representatives of state and municipal authorities, regional mass media and business. The findings indicate that the Volgograd region has fallen behind other modernized Russian regions, that young people tend to leave it, that a negative image of the region as a declining territory persists. Answers to the open question “What is unacceptable for you in the existing image of the Volgograd region?” revealed major problems determining the local context of a declining region, and those were issues associated with inefficient regional/municipal administration: “the condition of the roads”, “constant replacement of people in the administration”, “politics as a whole”, “a destitute region without a good manager”, “unemployment”, “countryside is dying off”, “indifference of the authorities”, “roads, housing and public utilities and the administration”, “the authorities are not responsible for the people”, “the authorities do not solve the problems of the city or its people”, “thieving”, “dishonest authorities”, “the region goes to rack and ruin, no kindergartens or jobs”, “one cannot even walk in the streets”, “corruption”, “a stagnant region with low pay”, “no perspectives in the future”, “the region is stagnating due to corruption among officials”. According to the local Census Bureau, the Volgograd region can be classified as a declining territory where the population decline

Midterm performance of a novel restorative pulmonary valved conduit: preclinical results

NARCIS (Netherlands)

Soliman, Osama I.; Miyazaki, Yosuke; Abdelghani, Mohammad; Brugmans, Marieke; Witsenburg, Maarten; Onuma, Yoshinobu; Cox, Martijn; Serruys, Patrick W.

2017-01-01

Aims: The Xeltis bioabsorbable pulmonary valved conduit (XPV), designed to guide functional restoration of patients' own tissue, is potentially more durable than current pulmonary bioprosthetic valves/valved conduits. The aim of this study was to assess the haemodynamic performance of the novel XPV

Numerical study for two phase flow in the near nozzle region of turbine combustors

International Nuclear Information System (INIS)

Pervez, K.; Mushtaq, S.

1999-01-01

In the present study flow conditions in the near nozzle region of the combustion chamber have been investigated. There exists two-phase flow in this region. The overall performance and pollutant formation in the combustion chamber have been investigated. There exists two-phase flow in this region. The overall performance and pollutant formation in the combustion zone largely depends on the spray field in the near nozzle region the studies are conducted to determined the effects of multi jets on the flow pattern in the near nozzle region The phase doppler particle analyzer (PDPA) has been used to measure the velocities and sizes of the droplets. The flow field of two-phase liquid drop-air jets is formed from three injectors arranged in t line. Furthermore the two-phase flow field has been analyzed numerically also. The numerical analysis consists of two computational models, namely (i) 3 non-evaporating two-phase jets, (II) 3 evaporating two phase jets. The Eulerian-Eulerian approach in incorporated in both the numerical models. Since the flow is turbulent, a two-equation model (k-Epsilon) is implemented in the numerical analysis. Numerical solution of the conservation equation is obtained using PHOENICS computer code. Boundary conditions are provided from the experimental measurements. Numerical domain for the two models of the analysis starts at some distance (about 10 diameters of the injector orifice) where the atomization process is complete and droplet size and velocity could be measured experimentally. (author)

Regional climate scenarios for use in Nordic water resources studies

DEFF Research Database (Denmark)

Rummukainen, Markku; Räisänen, J.; Bjørge, D.

2003-01-01

in the Nordic region than in the global mean, regional increases and decreases in net precipitation, longer growing season, shorter snow season etc. These in turn affect runoff, snowpack, groundwater, soil frost and moisture, and thus hydropower production potential, flooding risks etc. Regional climate models......-users of water resources scenarios are the hydropower industry, dam safety instances and planners of other lasting infrastructure exposed to precipitation, river flows and flooding....

Regional cerebral blood flow in pure dysarthria. A 3D-SSP study

International Nuclear Information System (INIS)

Okamoto, Kensho; Kamogawa, Kenji; Okuda, Bungo; Kawabata, Keita; Tachibana, Hisao

2007-01-01

Pure dysarthria from brain infarction is a rare condition, and its pathophysiology remains unclear. To clarify the underlying mechanism of pure dysarthria, we investigated the lesion sites and regional cerebral blood flow in patients with pure dysarthria. We examined 18 consecutive patients with pure dysarthria (9 men and 9 women; mean age, 71 years) who underwent MRI and cerebral blood flow studies. To visualize the regional cerebral blood flow, we generated Z score images using the three-dimensional stereotactic surface projection (3D-SSP) method with single-photon emission computed tomography (SPECT) and N-isopropyl-p [ 123 I]iodoamphetamine. Data on the brain surface perfusion extracted by the 3D-SSP analysis were compared between the pure dysarthria (PD) patients and 9 control subjects. MRI revealed multiple lacunar infarctions involving the internal capsule and/or corona radiata in 11 patients, left internal capsule-corona radiata infarction in 4 patients, and pontine infarction in 3 patients. SPECT with 3D-SSP demonstrated bilateral frontal cortical hypoperfusion in all patients, particularly in the anterior opercular region. Based on intergroup comparisons, the PD group exhibited pronounced cortical hypoperfusion in the opercular and medial frontal regions, left more than right. In conclusion, pure dysarthria is considered to originate from frontal cortical hypoperfusion, mainly in the anterior opercular and medial frontal regions, which is probably due to interruption of the corticosubcortical neural networks relevant to speech expression and articulation. In addition, it is suggested that left hemispheric lesions may make a greater contribution to the development of pure dysarthria than do right ones. (author)

Factors Related to the Selection of Information Sources: A Study of Ramkhamhaeng University Regional Campuses Graduate Students

Science.gov (United States)

Angchun, Peemasak

2011-01-01

This study assessed students' satisfaction with Ramkhamhaeng University regional library services (RURLs) and the perceived quality of information retrieved from other information sources. In particular, this study investigated factors relating to regional students' selection of information sources to meet their information needs. The researcher…

Region-specific study of the electric utility industry: financial history and future power requirements for the VACAR region

International Nuclear Information System (INIS)

Pochan, M.J.

1985-07-01

Financial data for the period 1966 to 1981 are presented for the four investor-owned electric utilities in the VACAR (Virginia-Carolinas) region. This region was selected as representative for the purpose of assessing the availability, reliability, and cost of electric power for the future in the United States. The estimated demand for power and planned additions to generating capacity for the region through the year 2000 are also given

A Comparison of Tourist Expectations and Satisfaction: A Case Study from Antalya Region of Turkey

Directory of Open Access Journals (Sweden)

Akın Aksu

2010-06-01

Full Text Available For several years the number of tourists visiting Antalya Region has been increasing. It could be argued that Antalya is comparable with a capital city in terms of tourist numbers. Antalya Region hosted over 9 million tourists in 2008. To sustain demand and increase competition of operators in Antalya, it is necessary to create a powerful brand image. This will require a combination effort from all tourism stakeholders. Consequently, it is important to define the current tourist profile visiting Antalya Region, evaluate tourists’ expectations and satisfaction, and identify future tourism related research. These outcomes are all important in developing regional tourism. The aim of this study is comparison of expectation-levels and satisfaction-levels of a selected sample of tourists. The findings culminate from research conducted in Antalya Region from a sample of 10.393 tourists during 2008.

Sufentanil Vs Fentanyl for Fast-Track Cardiac Anaesthesia

Directory of Open Access Journals (Sweden)

C M Deshpande

2009-01-01

Full Text Available A perioperative anaesthetic management that aims to facilitate tracheal extubation of patients within 1-6 hrs after cardiac surgery is called "fast-track′. Main advantage of ′fast-track" method is better usage of medical resources and lowering hospital costs without increasing morbidity and mortality of the patients. Standard fast-track protocols contain short acting anaesthetic agents, smaller incisions and decreased pump times without hypothermia. In this study we compared two short acting opioid drugs, fentanyl versus Sufentanil when used as a part of the balanced anaesthesia technique for fast track in cardiac surgery patients& evaluated the time taken for extubation, haemodynamic stability, analgesia requirements& incidence of awareness. The results from the study show thatboth agents provide good haemodynamic stability and postoperative analgesia. Although Sufentanil provides earlier extuba-tion, both agents reduce the ICU stay equally. In conclusion both agents can be used effectively for fasttrack cardiac anaesthesia.

Multimolecular studies of Galactic star-forming regions

NARCIS (Netherlands)

Baan, W. A.; Loenen, A. F.; Spaans, M.

2014-01-01

Molecular emission-line observations of isolated Galactic star-forming regions are used to model the physical properties of the molecular interstellar medium in these systems. Observed line ratios are compared with the results predicted by models that incorporate gas-phase chemistry and the heating

Bridging regional innovation

DEFF Research Database (Denmark)

Hansen, Teis

2013-01-01

to assess the progress of integration in the regions, as well as the effect of cross-border innovation policies. Consequently, important questions are left unanswered, including the central research question of this paper: does the sudden removal of significant physical barriers directly impacts......The topics of regional innovation systems (RIS) and cross-border regions attract increasing attention, but few studies combine the themes. Further, the existing empirical studies of cross-border innovation and knowledge creation analyse one case at one point in time, thus, making it difficult...... collaboration activity in cross-border innovation systems? This paper examines regional integration in the Oresund Region over time. It deals with a specific part of the RIS, as it analyses research collaboration between actors from the Danish and Swedish sides, with a specific emphasis on the biotech industry...

Spatial Planning and High-tech Development A comparative study of Eindhoven city-region, the Netherlands and Hsinchu City-region, Taiwan

Directory of Open Access Journals (Sweden)

Wei-Ju Huang

2013-08-01

Full Text Available High-tech development—which lies at the very heart of the processes of economic growth—has been recognised by many developed and developing countries as a strategic instrument to enhance and sustain their competitiveness in the global economic network. Although the concept of high-tech development differs between countries, many share the underlying assumption that the core of high-tech development is to create a sound environment where innovation thrives. This ideology implies a definite spatial dimension. As a result, various spatial strategies have been formulated and implemented to support high-tech development. This has had intentional and unintentional effects on the economy, society and space. Numerous studies have been devoted to exploring, analysing and theorising this global phenomenon. However, there has been less attention given to the role spatial planning may play in the process of high-tech development and to the factors that shape the spatial planning approaches to high-tech development in a particular place. The major objectives of this research are to advance the knowledge of the role of spatial planning in the process of high-tech development, and to establish an analytical framework that helps reveal the major institutional factors that shape spatial planning mechanisms for dealing with the spatial issues of high-tech development in different places. This contributes to the field of high-tech spatial policies transfer and lesson-drawing. In order to explore the major factors that shape the practices of spatial planning in hightech development, a comparative approach is applied in this research. The Eindhoven city-region in the Netherlands and the Hsinchu city-region in Taiwan are selected as case study areas. Both city-regions can be recognised as success stories of high-tech development not only on a national scale but also on a global scale, despite the fact that they apply different approaches. In the Eindhoven city-region

Constructing Perceptions of Climate Change: a case study of regional political decision makers

Science.gov (United States)

Bray, D.

2012-12-01

This case study of climate change communications assesses the salient means of communication and the message adopted by regional political decision makers on the German Baltic coast. Realizing that cultural factors and local values (and not simply knowledge) are significant influences in explaining attitudes towards climate change, this analysis draws from the records of regional weather, from scientists with a specific focus on the region, from the political decision makers for that region, and the media message reaching the decision makers, ensuring all elements of the analysis are drawn from the same socioeconomic, geophysical, political and cultural context. This is important as the social dynamics surrounding the trust in science is of critical importance and, as such, all elements of the case study are specifically contained within a common context. If the utility of climate change knowledge is to prompt well conceived adaptation/mitigation strategies then the political decision process, or at least the perceptions shaping it, can best be understood by locating it within the world view of the decision makers involved in the production process. Using the results of two survey questionnaires, one of regional climate scientists and one of regional political decision makers, ten years of local weather records, and a summary of the message from mass media circulation, the discord in perceptions of regional climate change are quantitatively explored. The conclusions drawn from the analysis include, compared to the scientific assessment: The decision makers' perceptions of recent past differ from actual observations. The decision makers' perceptions of the future differ from scientific assessments. The decision makers tend to over estimate the magnitude of regional climate change and its impacts. The decision makers tend to over estimate the sense of immediacy for adaptation measures. The conclusions drawn suggest that in the regional political realm, it is often a

Silicon isotope study of thermal springs in Jiaodong Region,Shandong Province

Institute of Scientific and Technical Information of China (English)

徐跃通; 李红梅; 冯海霞; 周晨; 吴元芳; 张邦花

2001-01-01

Based on δ30Si and δ32Si isotope geochemistry, the origin and evolutionary mechanism of thermal springs in Jiaodong region are studied. The mean value of δ30Si of dissolved silica of thermal spring water in Jiaodong is 0.1‰. Thermal spring water ages using δ32Si dating method range from 387a to 965a.

Radon and lung cancer: protocol and procedures of the multicentre studies in the Ardennes-Eifel region, Brittany and the Massif Central region

International Nuclear Information System (INIS)

Poffijn, A.; Darby, S.

1992-01-01

As part of a European coordinated project, the Ardennes-Eifel study was set up. In this project the study area coincides more or less with a geological zone, situated partly in France, Belgium, Luxembourg and Germany. In a first phase, a common protocol was worked out, dealing with general items as the selection of cases and (hospital/community) controls, the residential criteria for inclusion in the study and the specifications of the radon measurements. Much attention was given to the disease for the hospital controls and a list of ineligible diseases, most strongly related to tobacco, was agreed upon. A common core questionnaire is used, including items such as residential history since birth, occupational history, exposure to passive smoke (for non-smokers and occasional smokers) and educational attainment of the partner. Each country is also free to include additional items of its own. In France, this case-control study is extended to the granitic region of Britanny and in a second period to the region of the Massif Central. In these studies as well as in the national German study on radon and lung cancer, a protocol in all points comparable to that of the Ardennes study is used. (author)

The impact of regional and neighbourhood deprivation on physical health in Germany: a multilevel study

Directory of Open Access Journals (Sweden)

Razum Oliver

2010-07-01

Full Text Available Abstract Background There is increasing evidence that individual health is at least partly determined by neighbourhood and regional factors. Mechanisms, however, remain poorly understood, and evidence from Germany is scant. This study explores whether regional as well as neighbourhood deprivation are associated with physical health and to what extent this association can be explained by specific neighbourhood exposures. Methods Using 2004 data from the German Socio-Economic Panel Study (SOEP merged with regional and neighbourhood characteristics, we fitted multilevel linear regression models with subjective physical health, as measured by the SF-12, as the dependent variable. The models include regional and neighbourhood proxies of deprivation (i.e. regional unemployment quota, average purchasing power of the street section as well as specific neighbourhood exposures (i.e. perceived air pollution. Individual characteristics including socioeconomic status and health behaviour have been controlled for. Results This study finds a significant association between area deprivation and physical health which is independent of compositional factors and consistent across different spatial scales. Furthermore the association between neighbourhood deprivation and physical health can be partly explained by specific features of the neighbourhood environment. Among these perceived air pollution shows the strongest association with physical health (-2.4 points for very strong and -1.5 points for strong disturbance by air pollution, standard error (SE = 0.8 and 0.4, respectively. Beta coefficients for perceived air pollution, perceived noise and the perceived distance to recreational resources do not diminish when including individual health behaviour in the models. Conclusions This study highlights the difference regional and in particular neighbourhood deprivation make to the physical health of individuals in Germany. The results support the argument that

Regional governance: strategies and disputes in health region management

Directory of Open Access Journals (Sweden)

Adriano Maia dos Santos

2014-08-01

Full Text Available OBJECTIVE To analyze the regional governance of the health systemin relation to management strategies and disputes. METHODOLOGICAL PROCEDURES A qualitative study with health managers from 19 municipalities in the health region of Bahia, Northeastern Brazil. Data were drawn from 17 semi-structured interviews of state, regional, and municipal health policymakers and managers; a focus group; observations of the regional interagency committee; and documents in 2012. The political-institutional and the organizational components were analyzed in the light of dialectical hermeneutics. RESULTS The regional interagency committee is the chief regional governance strategy/component and functions as a strategic tool for strengthening governance. It brings together a diversity of members responsible for decision making in the healthcare territories, who need to negotiate the allocation of funding and the distribution of facilities for common use in the region. The high turnover of health secretaries, their lack of autonomy from the local executive decisions, inadequate technical training to exercise their function, and the influence of party politics on decision making stand as obstacles to the regional interagency committee’s permeability to social demands. Funding is insufficient to enable the fulfillment of the officially integrated agreed-upon program or to boost public supply by the system, requiring that public managers procure services from the private market at values higher than the national health service price schedule (Brazilian Unified Health System Table. The study determined that “facilitators” under contract to health departments accelerated access to specialized (diagnostic, therapeutic and/or surgical services in other municipalities by direct payment to physicians for procedure costs already covered by the Brazilian Unified Health System. CONCLUSIONS The characteristics identified a regionalized system with a conflictive pattern of

A photon dominated region code comparison study

NARCIS (Netherlands)