WorldWideScience

Sample records for relative total control

  1. Quality control related to total quality: why not to nuclear area too?

    International Nuclear Information System (INIS)

    Vasques, R.J.

    1992-01-01

    We're living in a new economical age, where quality, productivity, competence, competitiveness and costumer satisfaction are necessary. We must develop our capacity more and more, daily, for could survive and to excel in this new age. Only through Total Quality Control (TQC) is that we'll go to achieve these requirements. TQC is expanding all over the world and is already, the new universal language. Why not get the TQC's benefits to nuclear area too? We must stay within this reality. With our quality assurance systems turned to TQC, certainly we'll get best results. This is the intention of this paper: to call the nuclear professionals attention to knowledge, application and commitment to TQC's philosophy. (author)

  2. The Relative Effects of Manual Versus Automatic Exposure Control on Radiation Dose to Vital Organs in Total Hip Arthroplasty.

    Science.gov (United States)

    Harper, Katharine D; Li, Shidong; Jennings, Rachel; Amer, Kamil M; Haydel, Christopher; Ali, Sayed

    2018-01-01

    Technologic advances have reduced medical radiation exposure while maintaining image quality. The purpose of this study was to determine the effects of the presence of total hip arthroplasty implants, compared with native hips, on radiation exposure of the most radiosensitive organs when manual and automatic exposure control settings are used. Detection probes were placed at six locations (stomach, sigmoid colon, right pelvic wall, left pelvic wall, pubic symphysis, and anterior pubic skin) in a cadaver. Radiographs were obtained with the use of manual and automatic exposure control protocols, with exposures recorded. A total hip arthroplasty implant was placed in the cadaver, probe positioning was confirmed, and the radiographs were repeated, with exposure values recorded. The control probe placed at the stomach had values ranging from 0.00 mSv to 0.01 mSv in protocols with and without implants. With the manual protocol, exposures in the pelvis ranged from 0.36 mSv to 2.74 mSv in the native hip and from 0.33 mSv to 2.24 mSv after implant placement. The increases in exposure after implant placement, represented as relative risk, were as follows: stomach, 1.000; pubic symphysis, 0.818; left pelvic wall, 1.381; sigmoid colon, 1.550; right pelvic wall, 0.917; and anterior pubic skin, 1.015. With automatic exposure control, exposures in the pelvis ranged from 0.07 mSv to 0.89 mSv in the native hip and from 0.21 mSv to 1.15 mSv after implant placement. With automatic exposure control, the increases in exposure after implant placement, represented as relative risk, were as follows: stomach, 1.000; pubic symphysis, 1.292; left pelvic wall, 1.476; sigmoid colon, 2.182; right pelvic wall, 3.000; and anterior pubic skin, 1.378. The amount of radiation to which patients are exposed as a result of medical procedures or imaging, and whether exposure is associated with an increased risk of malignant transformation, are the subject of ongoing debate. We found that after insertion

  3. Appropriate control time constant in relation to characteristics of the baroreflex vascular system in 1/R control of the total artificial heart.

    Science.gov (United States)

    Mizuta, Sora; Saito, Itsuro; Isoyama, Takashi; Hara, Shintaro; Yurimoto, Terumi; Li, Xinyang; Murakami, Haruka; Ono, Toshiya; Mabuchi, Kunihiko; Abe, Yusuke

    2017-09-01

    1/R control is a physiological control method of the total artificial heart (TAH) with which long-term survival was obtained with animal experiments. However, 1/R control occasionally diverged in the undulation pump TAH (UPTAH) animal experiment. To improve the control stability of the 1/R control, appropriate control time constant in relation to characteristics of the baroreflex vascular system was investigated with frequency analysis and numerical simulation. In the frequency analysis, data of five goats in which the UPTAH was implanted were analyzed with first Fourier transform technique to examine the vasomotion frequency. The numerical simulation was carried out repeatedly changing baroreflex parameters and control time constant using the elements-expanded Windkessel model. Results of the frequency analysis showed that the 1/R control tended to diverge when very low frequency band that was an indication of the vasomotion frequency was relative high. In numerical simulation, divergence of the 1/R control could be reproduced and the boundary curves between the divergence and convergence of the 1/R control varied depending on the control time constant. These results suggested that the 1/R control tended to be unstable when the TAH recipient had high reflex speed in the baroreflex vascular system. Therefore, the control time constant should be adjusted appropriately with the individual vasomotion frequency.

  4. A case-control study to identify risk factors for totally implantable central venous port-related bloodstream infection.

    Science.gov (United States)

    Lee, Guk Jin; Hong, Sook Hee; Roh, Sang Young; Park, Sa Rah; Lee, Myung Ah; Chun, Hoo Geun; Hong, Young Seon; Kang, Jin Hyoung; Kim, Sang Il; Kim, Youn Jeong; Chun, Ho Jong; Oh, Jung Suk

    2014-07-01

    To date, the risk factors for central venous port-related bloodstream infection (CVPBSI) in solid cancer patients have not been fully elucidated. We conducted this study in order to determine the risk factors for CVP-BSI in patients with solid cancer. A total of 1,642 patients with solid cancer received an implantable central venous port for delivery of chemotherapy between October 2008 and December 2011 in a single center. CVP-BSI was diagnosed in 66 patients (4%). We selected a control group of 130 patients, who were individually matched with respect to age, sex, and catheter insertion time. CVP-BSI occurred most frequently between September and November (37.9%). The most common pathogen was gram-positive cocci (n=35, 53.0%), followed by fungus (n=14, 21.2%). Multivariate analysis identified monthly catheter-stay as a risk factor for CVP-BSI (p=0.000), however, its risk was lower in primary gastrointestinal cancer than in other cancer (p=0.002). Initial metastatic disease and long catheter-stay were statistically significant factors affecting catheter life span (p=0.005 and p=0.000). Results of multivariate analysis showed that recent transfusion was a risk factor for mortality in patients with CVP-BSI (p=0.047). In analysis of the results with respect to risk factors, prolonged catheter-stay should be avoided as much as possible. It is necessary to be cautious of CVP-BSI in metastatic solid cancer, especially non-gastrointestinal cancer. In addition, avoidance of unnecessary transfusion is essential in order to reduce the mortality of CVP-BSI. Finally, considering the fact that confounding factors may have affected the results, conduct of a well-designed prospective controlled study is warranted.

  5. Effect of Medications for Gastric Acid-Related Symptoms on Total Motile Sperm Count and Concentration: A Case-Control Study in Men of Subfertile Couples from the Netherlands.

    Science.gov (United States)

    Huijgen, Nicole A; Goijen, Hedwig J; Twigt, John M; Mulders, Annemarie G M G J; Lindemans, Jan; Dohle, Gert R; Laven, Joop S E; Steegers-Theunissen, Régine P M

    2017-03-01

    Gastric acid-related symptoms are highly prevalent in the general population (21-40%), and more than 11% of individuals use medication for the treatment of these symptoms. The uptake of micronutrients is dependent on the gastrointestinal potential of hydrogen (pH). We hypothesized that medication affecting gastrointestinal pH reduces the availability of B vitamins, thereby deranging one-carbon metabolism and detrimentally affecting spermatogenesis. This explorative nested case-control study in men of subfertile couples investigated associations between medication used for gastric acid-related symptoms and semen parameters. We included 40 men using medication for gastric acid-related symptoms and 843 men not using medication. Semen analyses were performed between 70 days before and 21 days after the visit. The use of medication was associated with a twofold higher risk of a low total motile sperm count [TMSC sperm concentration (β -0.320, p = 0.028). Red blood cell folate was positively associated with TMSC (β 0.257, p = 0.026), sperm count (β 1.679, p = 0.013) and ejaculate volume (β 0.120, p = 0.023), and total homocysteine (tHcy) was negatively associated with sperm count (β -0.077, p = 0.021). Here we delineate associations between the use of medication for gastric acid-related symptoms and poor semen quality in men of subfertile couples. The use of medication for gastric acid-related symptoms is associated with a twofold higher risk of a low TMSC and a decreased sperm concentration. Although these findings warrant further research on causality, the associations between folate, tHcy and semen quality emphasize the importance of preconception counselling in male subfertility.

  6. Analysing relations between specific and total liking scores

    DEFF Research Database (Denmark)

    Menichelli, Elena; Kraggerud, Hilde; Olsen, Nina Veflen

    2013-01-01

    The objective of this article is to present a new statistical approach for the study of consumer liking. Total liking data are extended by incorporating liking for specific sensory properties. The approach combines different analyses for the purpose of investigating the most important aspects...... of liking and indicating which products are similarly or differently perceived by which consumers. A method based on the differences between total liking and the specific liking variables is proposed for studying both relative differences among products and individual consumer differences. Segmentation...... is also tested out in order to distinguish consumers with the strongest differences in their liking values. The approach is illustrated by a case study, based on cheese data. In the consumer test consumers were asked to evaluate their total liking, the liking for texture and the liking for odour/taste. (C...

  7. Novel Strategies Using Total Gastrodin and Gastrodigenin, or Total Gastrodigenin for Quality Control of Gastrodia elata.

    Science.gov (United States)

    Tang, Chunlan; Wu, Bingchu; Wu, Jinyi; Zhang, Zheng; Yu, Bocheng

    2018-01-29

    Gastrodia elata Blume ( G. elata ), a traditional Chinese medicine, is widely used for treatment of various neuro dysfunctions. However, its quality control is still limited to the determination of gastrodin. In the present study, two novel strategies based on quantitative evaluation of total gastrodin and gastrodigenin with base hydrolysis and total gastrodigenin with base-enzymatic hydrolysis followed by HPLC-FLD were put forward and successfully applied to evaluate the quality of 47 batches of G. elata from eight localities. Meanwhile, a systematic comparison of the novel strategy with the multiple markers and the Pharmacopeia method was performed. The results showed that the parishins category could be completely hydrolyzed to gastrodin by sodium hydroxide solution, and gastrodin could further utterly hydrolyze to gastrodigenin with β-d-glucosidase buffer solution. The contents of total gastrodin and gastrodigenin ranged from 1.311% to 2.034%, and total gastrodigenin from 0.748% to 1.120% at the eight localities. From the comparison, we can conclude that the two novel strategies can comprehensively reveal the characteristics of overall active ingredients in G. elata for quality control. The present study provides a feasible and credible strategy for the quality control of G. elata , suggesting a revision of the latest Chinese Pharmacopoeia or European Pharmacopoeia methods for the modernization of G. elata use.

  8. Despeckling Polsar Images Based on Relative Total Variation Model

    Science.gov (United States)

    Jiang, C.; He, X. F.; Yang, L. J.; Jiang, J.; Wang, D. Y.; Yuan, Y.

    2018-04-01

    Relatively total variation (RTV) algorithm, which can effectively decompose structure information and texture in image, is employed in extracting main structures of the image. However, applying the RTV directly to polarimetric SAR (PolSAR) image filtering will not preserve polarimetric information. A new RTV approach based on the complex Wishart distribution is proposed considering the polarimetric properties of PolSAR. The proposed polarization RTV (PolRTV) algorithm can be used for PolSAR image filtering. The L-band Airborne SAR (AIRSAR) San Francisco data is used to demonstrate the effectiveness of the proposed algorithm in speckle suppression, structural information preservation, and polarimetric property preservation.

  9. Quality control of dosimetry in total body irradiation

    International Nuclear Information System (INIS)

    Kallinger, W.

    1986-11-01

    An on-line dose measurement system for the quality control of the treatment of leukemia by means of total body irradiation with Co-60 gamma radiation is introduced. An ionization chamber and 5 diodes arranged on the surface of the patient incorporated with a microprocessor provides useful information and data necessary for the treatment. Following the concerted treatment procedure employing this system, the treatment of leukemia by means of total body irradiation is expected to be improved

  10. Microgrid Stability Controller Based on Adaptive Robust Total SMC

    OpenAIRE

    Su, Xiaoling; Han, Minxiao; Guerrero, Josep M.; Sun, Hai

    2015-01-01

    This paper presents a microgrid stability controller (MSC) in order to provide existing distributed generation units (DGs) the additional functionality of working in islanding mode without changing their control strategies in grid-connected mode and to enhance the stability of the microgrid. Microgrid operating characteristics and mathematical models of the MSC indicate that the system is inherently nonlinear and time-variable. Therefore, this paper proposes an adaptive robust total sliding...

  11. Determination of dilution and quality control of total and anti ...

    African Journals Online (AJOL)

    Objective: To determine the correct dilution and Quality control commercial ELISA of total and anti-measles antibodies for HIV infected pregnant women. Design: A laboratory based study. Setting: The University of Nairobi, Department of Paediatrics laboratory. Subjects: HIV infected pregnant women enrolled and exposed to ...

  12. Microgrid Stability Controller Based on Adaptive Robust Total SMC

    DEFF Research Database (Denmark)

    Su, Xiaoling; Han, Minxiao; Guerrero, Josep M.

    2015-01-01

    This paper presents a microgrid stability controller (MSC) in order to provide existing DGs the additional functionality of working in islanding mode without changing their control strategies in grid-connected mode and to enhance the stability of the microgrid. Microgrid operating characteristics....... The MSC provides fast dynamic response and robustness to the microgrid. When the system is operating in grid-connected mode, it is able to improve the controllability of the exchanged power between the microgrid and the utility grid, while smoothing DG’s output power. When the microgrid is operating...... and mathematical models of the MSC indicate that the system is inherently nonlinear and time-variable. Therefore, this paper proposes an adaptive robust total sliding-mode control (ARTSMC) system for the MSC. It is proved that the ARTSMC system is insensitive to parametric uncertainties and external disturbances...

  13. Time related total lactic acid bacteria population diversity and ...

    African Journals Online (AJOL)

    The total lactic acid bacterial community involved in the spontaneous fermentation of malted cowpea fortified cereal weaning food was investigated by phenotypically and cultivation independent method. A total of 74 out of the isolated 178 strains were Lactobacillus plantarum, 32 were Pediococcus acidilactici and over 60% ...

  14. Japanese style total quality control: A first hand experience

    Science.gov (United States)

    Cook, S. C.

    1991-11-01

    The scope, concepts and practices of Total Quality Control (TQC) as operated in Japan today are described. The following mechanisms and elements are introduced: policy deployment, cross functional management, small group activities, suggestion systems, standardization, the TQC promotion department, and TQC education. It is shown on a practical level, how TQC operates in the research and engineering divisions of the aeroengine and space operation at Ishikawajima Harima Industries in Japan. Japanese style TQC is a well developed, well promoted, well structured, common approach to achieving customer satisfaction through continuous improvements. Furthermore, TQC itself is being continuously improved with the Japanese still refining, extending, and developing TQC.

  15. Microgrid Stability Controller Based on Adaptive Robust Total SMC

    Directory of Open Access Journals (Sweden)

    Xiaoling Su

    2015-03-01

    Full Text Available This paper presents a microgrid stability controller (MSC in order to provide existing distributed generation units (DGs the additional functionality of working in islanding mode without changing their control strategies in grid-connected mode and to enhance the stability of the microgrid. Microgrid operating characteristics and mathematical models of the MSC indicate that the system is inherently nonlinear and time-variable. Therefore, this paper proposes an adaptive robust total sliding-mode control (ARTSMC system for the MSC. It is proved that the ARTSMC system is insensitive to parametric uncertainties and external disturbances. The MSC provides fast dynamic response and robustness to the microgrid. When the system is operating in grid-connected mode, it is able to improve the controllability of the exchanged power between the microgrid and the utility grid, while smoothing the DGs’ output power. When the microgrid is operating in islanded mode, it provides voltage and frequency support, while guaranteeing seamless transition between the two operation modes. Simulation and experimental results show the effectiveness of the proposed approach.

  16. Relative Hom-Hopf modules and total integrals

    Energy Technology Data Exchange (ETDEWEB)

    Guo, Shuangjian [School of Mathematics and Statistics, Guizhou University of Finance and Economics, Guiyang 550025 (China); Zhang, Xiaohui [Department of Mathematics, Southeast University, Nanjing 210096 (China); Wang, Shengxiang, E-mail: wangsx-math@163.com [School of Mathematics and Finance, Chuzhou University, Chuzhou 239000 (China); Department of Mathematics, Nanjing University, Nanjing 210093 (China)

    2015-02-15

    Let (H, α) be a monoidal Hom-Hopf algebra and (A, β) a right (H, α)-Hom-comodule algebra. We first investigate the criterion for the existence of a total integral of (A, β) in the setting of monoidal Hom-Hopf algebras. Also, we prove that there exists a total integral ϕ : (H, α) → (A, β) if and only if any representation of the pair (H, A) is injective in a functorial way, as a corepresentation of (H, α), which generalizes Doi’s result. Finally, we define a total quantum integral γ : H → Hom(H, A) and prove the following affineness criterion: if there exists a total quantum integral γ and the canonical map ψ : A⊗{sub B}A → A ⊗ H, a⊗{sub B}b ↦ β{sup −1}(a) b{sub [0]} ⊗ α(b{sub [1]}) is surjective, then the induction functor A⊗{sub B}−:ℋ{sup ~}(ℳ{sub k}){sub B}→ℋ{sup ~}(ℳ{sub k}){sub A}{sup H} is an equivalence of categories.

  17. Relative Hom-Hopf modules and total integrals

    International Nuclear Information System (INIS)

    Guo, Shuangjian; Zhang, Xiaohui; Wang, Shengxiang

    2015-01-01

    Let (H, α) be a monoidal Hom-Hopf algebra and (A, β) a right (H, α)-Hom-comodule algebra. We first investigate the criterion for the existence of a total integral of (A, β) in the setting of monoidal Hom-Hopf algebras. Also, we prove that there exists a total integral ϕ : (H, α) → (A, β) if and only if any representation of the pair (H, A) is injective in a functorial way, as a corepresentation of (H, α), which generalizes Doi’s result. Finally, we define a total quantum integral γ : H → Hom(H, A) and prove the following affineness criterion: if there exists a total quantum integral γ and the canonical map ψ : A⊗ B A → A ⊗ H, a⊗ B b ↦ β −1 (a) b [0] ⊗ α(b [1] ) is surjective, then the induction functor A⊗ B −:ℋ ~ (ℳ k ) B →ℋ ~ (ℳ k ) A H is an equivalence of categories

  18. Association Between Maternal Serum Total Oxidant Status Total Antioxidant Status and Preterm Labor: A Prospective - Controlled Clinical Study

    OpenAIRE

    Hakan Kalaycı; Mete Gürol Uğur; Ebru Öztürk; Özcan Balat; Özcan Erel

    2011-01-01

    OBJECTIVE: To measure the levels of individual antioxidant components of pregnants with preterm labor to evaluate their total antioxidant status (TAS), total oxidant status (TOS) and oxidative stress index (OSI). STUDY DESIGN: Prospectively-controlled 31 pregnants with a diagnosis of preterm labor (group Ι) and 32 controls (group ΙΙ) were evaluated for demographic data, general and obstetrical physical examination, obstetrical sonography, and routine laboratory tests. TAS, TOS and OSI leve...

  19. Effect of Medications for Gastric Acid-Related Symptoms on Total Motile Sperm Count and Concentration: A Case–Control Study in Men of Subfertile Couples from the Netherlands

    NARCIS (Netherlands)

    N.A. Otte-Huijgen (Nicole); Goijen, H.J. (Hedwig J.); J.M. Twigt (John); A.G.M.G.J. Mulders (Annemarie); J. Lindemans (Jan); G.R. Dohle (Gert); J.S.E. Laven (Joop); R.P.M. Steegers-Theunissen (Régine)

    2017-01-01

    textabstractIntroduction: Gastric acid-related symptoms are highly prevalent in the general population (21–40%), and more than 11% of individuals use medication for the treatment of these symptoms. The uptake of micronutrients is dependent on the gastrointestinal potential of hydrogen (pH).

  20. Total antioxidant capacity and total oxidant status in saliva of periodontitis patients in relation to bacterial load

    Directory of Open Access Journals (Sweden)

    Taowen eZhang

    2016-01-01

    Full Text Available The detection of salivary biomarkers has a potential application in early diagnosis and monitoring of periodontal inflammation. However, searching sensitive salivary biomarkers for periodontitis is still ongoing. Oxidative stress is supposed to play an important role in periodontitis progression and tissue destruction. In this cross-sectional study, we investigated total antioxidant capacity (TAC and total oxidant status (TOS in saliva of periodontitis patients compared to healthy controls and their relationship with periodontopathic bacteria and periodontal disease severity. Unstimulated saliva was collected from 45 patients with generalized severe periodontitis and 37 healthy individuals and the TAC/TOS were measured. In addition, salivary levels of Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, Tannerella forsythia, Treponema denticola, and Fusobacterium nucleatum in saliva were measured. Salivary TAC was lower in periodontitis patients compared to healthy controls. Moreover, a significant negative correlation of salivary TAC with clinical attachment loss was observed in periodontitis patients. No significant difference in the salivary TOS was observed between periodontitis patients and healthy controls. Bacterial load was enhanced in periodontitis patients and exhibited correlation with periodontal disease severity but not with salivary TAC/TOS. Our data suggest that changes in antioxidant capacity in periodontitis patients are not associated with increased bacterial load and are probably due to a dysregulated immune response.

  1. Total Antioxidant Capacity and Total Oxidant Status in Saliva of Periodontitis Patients in Relation to Bacterial Load

    Science.gov (United States)

    Zhang, Taowen; Andrukhov, Oleh; Haririan, Hady; Müller-Kern, Michael; Liu, Shutai; Liu, Zhonghao; Rausch-Fan, Xiaohui

    2016-01-01

    The detection of salivary biomarkers has a potential application in early diagnosis and monitoring of periodontal inflammation. However, searching sensitive salivary biomarkers for periodontitis is still ongoing. Oxidative stress is supposed to play an important role in periodontitis progression and tissue destruction. In this cross-sectional study, we investigated total antioxidant capacity (TAC) and total oxidant status (TOS) in saliva of periodontitis patients compared to healthy controls and their relationship with periodontopathic bacteria and periodontal disease severity. Unstimulated saliva was collected from 45 patients with generalized severe periodontitis and 37 healthy individuals and the TAC/TOS were measured. In addition, salivary levels of Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, Tannerella forsythia, Treponema denticola, and Fusobacterium nucleatum in saliva were measured. Salivary TAC was lower in periodontitis patients compared to healthy controls. Moreover, a significant negative correlation of salivary TAC with clinical attachment loss was observed in periodontitis patients. No significant difference in the salivary TOS was observed between periodontitis patients and healthy controls. Bacterial load was enhanced in periodontitis patients and exhibited correlation with periodontal disease severity but not with salivary TAC/TOS. Our data suggest that changes in antioxidant capacity in periodontitis patients are not associated with increased bacterial load and are probably due to a dysregulated immune response. PMID:26779448

  2. Renin secretion and total body sodium: Pathways of integrative control

    DEFF Research Database (Denmark)

    Bie, Peter; Damkjaer, Mads

    2009-01-01

    to a spring/shock absorber set-up: Non-adaptive RAAS functions determine the new steady state position while TGF controls the rate of change. Recruitment of renin-secreting cells during sustained stimulation may be essential for chronic adaptation, although details of this afferent arteriolar cell plasticity...

  3. Heterogenic control groups in randomized, controlled, analgesic trials of total hip and knee arthroplasty.

    Science.gov (United States)

    Karlsen, Anders P; Mathiesen, Ole; Dahl, Jørgen B

    2018-03-01

    Postoperative analgesic interventions are often tested adjunct to basic non-opioid analgesics in randomized controlled trials (RCTs). Consequently, treatment in control groups, and possible assay sensitivity, differs between trials. We hypothesized that postoperative opioid requirements and pain intensities vary between different control groups in analgesic trials. Control groups from RCTs investigating analgesic interventions after total hip and knee arthroplasty were categorized based on standardized basic analgesic treatment. Morphine consumption 0 to 24 hours postoperatively, and resting pain scores at 6 and 24 hours for subgroups of basic treatments, were compared with ANOVA. In an additional analysis, we compared pain and opioid requirements in trials where a non-steroidal anti-inflammatory drug (NSAID) was administered as an intervention with trial where NSAID was administered in a control group. We included 171 RCTs employing 28 different control groups with large variability in pain scores and opioid requirements. Four types of control groups (comprising 78 trials) were eligible for subgroup comparisons. These subgroups received "opioid" alone, "NSAID + opioid", "acetaminophen + opioid", or "NSAID + acetaminophen + opioid", respectively. Morphine consumption and pain scores varied substantially between these groups, with no consistent superior efficacy in any subgroup. Additionally, trials administering NSAID as an intervention demonstrated lower pain scores and opioid requirements than trials where NSAID was administered in a control group. Analgesic treatment in RCT control groups varies considerably. Control groups receiving various combinations of opioid, NSAID and acetaminophen did not differ consistently in pain and opioid requirements. Pain and opioid requirements were lower in trials administering NSAID as an intervention compared with trials administering NSAID in a control group.

  4. A Total Quality-Control Plan with Right-Sized Statistical Quality-Control.

    Science.gov (United States)

    Westgard, James O

    2017-03-01

    A new Clinical Laboratory Improvement Amendments option for risk-based quality-control (QC) plans became effective in January, 2016. Called an Individualized QC Plan, this option requires the laboratory to perform a risk assessment, develop a QC plan, and implement a QC program to monitor ongoing performance of the QC plan. Difficulties in performing a risk assessment may limit validity of an Individualized QC Plan. A better alternative is to develop a Total QC Plan including a right-sized statistical QC procedure to detect medically important errors. Westgard Sigma Rules provides a simple way to select the right control rules and the right number of control measurements. Copyright © 2016 Elsevier Inc. All rights reserved.

  5. Loss of knee-extension strength is related to knee swelling after total knee arthroplasty

    DEFF Research Database (Denmark)

    Holm, Bente; Kristensen, Morten T; Bencke, Jesper

    2010-01-01

    To examine whether changes in knee-extension strength and functional performance are related to knee swelling after total knee arthroplasty (TKA).......To examine whether changes in knee-extension strength and functional performance are related to knee swelling after total knee arthroplasty (TKA)....

  6. A randomised, controlled trial of circumpatellar electrocautery in total knee replacement without patellar resurfacing.

    Science.gov (United States)

    van Jonbergen, H P W; Scholtes, V A B; van Kampen, A; Poolman, R W

    2011-08-01

    The efficacy of circumpatellar electrocautery in reducing the incidence of post-operative anterior knee pain is unknown. We conducted a single-centre, outcome-assessor and patient-blinded, parallel-group, randomised, controlled trial to compare circumpatellar electrocautery with no electrocautery in total knee replacement in the absence of patellar resurfacing. Patients requiring knee replacement for primary osteoarthritis were randomly assigned circumpatellar electrocautery (intervention group) or no electrocautery (control group). The primary outcome measure was the incidence of anterior knee pain. A secondary measure was the standardised clinical and patient-reported outcomes determined by the American Knee Society scores and the Western Ontario and McMaster Universities (WOMAC) osteoarthritis index. A total of 131 knees received circumpatellar electrocautery and 131 had no electrocautery. The overall incidence of anterior knee pain at follow-up at one year was 26% (20% to 31%), with 19% (12% to 26%) in the intervention group and 32% (24% to 40%) in the control group (p = 0.02). The relative risk reduction from electrocautery was 40% (9% to 61%) and the number needed to treat was 7.7 (4.3 to 41.4). The intervention group had a better mean total WOMAC score at follow-up at one year compared with the control group (16.3 (0 to 77.7) versus 21.6 (0 to 76.7), p = 0.04). The mean post-operative American Knee Society knee scores and function scores were similar in the intervention and control groups (knee score: 92.4 (55 to 100) versus 90.4 (51 to 100), respectively (p = 0.14); function score: 86.5 (15 to 100) versus 84.5 (30 to 100), respectively (p = 0.49)). Our study suggests that in the absence of patellar resurfacing electrocautery around the margin of the patella improves the outcome of total knee replacement.

  7. Gender Disparities in Osteoarthritis-Related Health Care Utilization Before Total Knee Arthroplasty.

    Science.gov (United States)

    Bawa, Harpreet S; Weick, Jack W; Dirschl, Douglas R

    2016-10-01

    Women older than 50 years have higher prevalence of knee osteoarthritis (OA) and experience greater functional disability than men. No studies have examined large populations to identify knee OA-related health care utilization differences. The purpose of this investigation was to evaluate gender differences in the utilization of OA-related health care resources in the 12 months preceding total knee arthroplasty (TKA). Truven Health MarketScan Commercial Claims and Encounters and Medicare Supplemental and Coordination of Benefit databases were reviewed from 2005 to 2012. Subjects were included if they underwent TKA, had associated diagnosis of lower leg OA, and were continuously in the database for 12 months preceding TKA. Patient-specific OA-related health care utilization was identified. Multivariate logistic regression analysis controlling for age, region, and Charlson Comorbidity Index was performed to isolate the influence of gender. A total of 244,059 patients with a mean age of 64.8 years consisting of 61.2% women were included. Multivariate logistic regression adjusted odds ratios showed that when compared to men, women were 30%, 20%, 31%, 18%, 19%, 29%, and 39%, more likely to receive a narcotic analgesic, nonnarcotic analgesics, corticosteroid injection, hyaluronic acid injection, knee magnetic resonance imaging, a physical therapy evaluation, and occupational therapy evaluation in the 12 months preceding TKA, respectively. Women have a significantly higher utilization of knee OA-related health care in the 12 months preceding TKA. Although the precise cause for this discrepancy in care cannot be determined from this study, it highlights a potential bias in management of advanced knee OA and directions for further investigation. Copyright © 2016 Elsevier Inc. All rights reserved.

  8. Abstracts of the 8th Conference on total reflection x-ray fluorescence analysis and related methods

    International Nuclear Information System (INIS)

    Wobrauschek, P.

    2000-01-01

    The 8. conference on total reflection x-ray fluorescence analysis and related methods held from 25.9 to 29.9.2000 contains 79 abstracts about x-ray fluorescence analysis (XRFA) as a powerful tool used for industrial production, geological prospecting and for environmental control. Total reflection x-ray fluorescence spectroscopy is also a tool used for chemical analysis in medicine, industry and research. (E.B.)

  9. Renin–angiotensin–aldosterone system related gene polymorphisms and urinary total arsenic is related to chronic kidney disease

    International Nuclear Information System (INIS)

    Chen, Wei-Jen; Huang, Ya-Li; Shiue, Horng-Sheng; Chen, Tzen-Wen; Lin, Yuh-Feng; Huang, Chao-Yuan; Lin, Ying-Chin; Han, Bor-Cheng; Hsueh, Yu-Mei

    2014-01-01

    A recent study demonstrated that an increased risk of chronic kidney disease (CKD) was associated with high urinary total arsenic levels. However, whether genomic instability is related to CKD remains unclear. An association between CKD and genetic polymorphisms of regulation enzymes of the renin–angiotensin–aldosterone system (RAAS), such as angiotensin-converting enzyme (ACE), angiotensinogen (AGT), angiotensin II type I receptor (AT1R), and aldosterone synthase (CYP11B2) has not been shown. The aim of the present study was to investigate the relationship between arsenic, genetic polymorphisms of RAAS enzymes and CKD. A total of 233 patients and 449 age- and gender-matched controls were recruited from the Taipei Medical University Hospital, Taipei Municipal Wan Fang Hospital and the Shin Kong Wu Ho-Su Memorial Hospital. Concentrations of urinary arsenic were determined by a high-performance liquid chromatography-linked hydride generator, and atomic absorption spectrometry. Polymorphisms of ACE(I/D), AGT(A[− 20]C), (T174M), (M235T), AT1R(A1166C) and CYP11B2(C[− 344]T) were examined by polymerase chain reaction and restriction fragment length polymorphism. Subjects carrying the CYP11B2 TT genotype had a higher odds ratio (OR), 1.39 (0.96–2.01), of CKD; while those with the AGT(A[− 20]C) CC genotype had an inverse OR of CKD (0.20 (0.05–0.81)), and a high-risk genotype was defined as A/A + A/C for AGT(A[− 20C]) and T/T for CYP11B2(C[− 344]T). The trend test showed a higher OR for CKD in patients who had either high urinary total arsenic levels or carried the high-risk genotype, or both, compared to patients with low urinary total arsenic levels, who carried the low-risk genotype, and could also be affected by the hypertension or diabetes status. - Highlights: • AGT(− 20 C) and CYP11B2(− 344 T) genotypes were significantly associated with CKD. • Combined effect of high-risk genotypes and high urinary total arsenic on OR of CKD. • Combined

  10. Renin–angiotensin–aldosterone system related gene polymorphisms and urinary total arsenic is related to chronic kidney disease

    Energy Technology Data Exchange (ETDEWEB)

    Chen, Wei-Jen [School of Public Health, College of Public Health and Nutrition, Taipei Medical University, Taipei, Taiwan (China); Huang, Ya-Li [Department of Public Health, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan (China); Shiue, Horng-Sheng [Department of Chinese Medicine, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taoyuan, Taiwan (China); Chen, Tzen-Wen [Division of Nephrology, Department of Internal Medicine, Taipei Medical University Hospital, Taipei, Taiwan (China); Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan (China); Lin, Yuh-Feng [Graduate Institute of Clinical Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan (China); Division of Nephrology, Department of Internal Medicine, Shuang Ho Hospital, New Taipei, Taiwan (China); Huang, Chao-Yuan [Department of Urology, National Taiwan University Hospital, College of Medicine National Taiwan University, Taipei, Taiwan (China); Lin, Ying-Chin [Department of Family Medicine, Shung Ho Hospital, Taipei Medical University, New Taipei, Taiwan (China); Department of Health Examination, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan (China); Division of Family Medicine, School of Medicine, Taipei Medical University, Taipei, Taiwan (China); Han, Bor-Cheng [School of Public Health, College of Public Health and Nutrition, Taipei Medical University, Taipei, Taiwan (China); Hsueh, Yu-Mei, E-mail: ymhsueh@tmu.edu.tw [School of Public Health, College of Public Health and Nutrition, Taipei Medical University, Taipei, Taiwan (China); Department of Public Health, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan (China)

    2014-09-01

    A recent study demonstrated that an increased risk of chronic kidney disease (CKD) was associated with high urinary total arsenic levels. However, whether genomic instability is related to CKD remains unclear. An association between CKD and genetic polymorphisms of regulation enzymes of the renin–angiotensin–aldosterone system (RAAS), such as angiotensin-converting enzyme (ACE), angiotensinogen (AGT), angiotensin II type I receptor (AT1R), and aldosterone synthase (CYP11B2) has not been shown. The aim of the present study was to investigate the relationship between arsenic, genetic polymorphisms of RAAS enzymes and CKD. A total of 233 patients and 449 age- and gender-matched controls were recruited from the Taipei Medical University Hospital, Taipei Municipal Wan Fang Hospital and the Shin Kong Wu Ho-Su Memorial Hospital. Concentrations of urinary arsenic were determined by a high-performance liquid chromatography-linked hydride generator, and atomic absorption spectrometry. Polymorphisms of ACE(I/D), AGT(A[− 20]C), (T174M), (M235T), AT1R(A1166C) and CYP11B2(C[− 344]T) were examined by polymerase chain reaction and restriction fragment length polymorphism. Subjects carrying the CYP11B2 TT genotype had a higher odds ratio (OR), 1.39 (0.96–2.01), of CKD; while those with the AGT(A[− 20]C) CC genotype had an inverse OR of CKD (0.20 (0.05–0.81)), and a high-risk genotype was defined as A/A + A/C for AGT(A[− 20C]) and T/T for CYP11B2(C[− 344]T). The trend test showed a higher OR for CKD in patients who had either high urinary total arsenic levels or carried the high-risk genotype, or both, compared to patients with low urinary total arsenic levels, who carried the low-risk genotype, and could also be affected by the hypertension or diabetes status. - Highlights: • AGT(− 20 C) and CYP11B2(− 344 T) genotypes were significantly associated with CKD. • Combined effect of high-risk genotypes and high urinary total arsenic on OR of CKD. • Combined

  11. Total Water Level Fun Facts: The Relative Contribution of Extreme Total Water Levels Along the US West Coast

    Science.gov (United States)

    Serafin, K.; Ruggiero, P.; Stockdon, H. F.

    2016-02-01

    In the fall of 2014, parts of the US West Coast endured some of the highest monthly mean sea level anomalies on record, likely due to the presence of "the blob" (Bond et al., 2015), an anomalously warm water mass in the NE Pacific. However, despite the significantly above average water levels, the coastline experienced only marginal coastal flooding and erosion hazards because the ensuing winter lacked significant storms, underscoring the fact that extreme total water levels (TWLs) are compound events. To better understand how several individual processes combine to cause devastating coastal hazards, we investigate the relative contribution that each component (waves, tides, and non-tidal residuals) has on extreme TWLs on sandy beaches. Water level records along the US West Coast are decomposed into mean sea level, astronomical tide, and non-tidal residuals (NTRs). The NTR is further split into an intra-annual seasonal signal, monthly mean sea level anomalies (inter-annual variability), and meteorological surge. TWL time series are then generated by combining water levels with wave runup, computed using wave data and beach morphology. We use this data-driven, structural function approach to investigate the spatial variability of the relative contribution of each component to the maximum TWL event on record. We also use a probabilistic, full simulation TWL model (Serafin and Ruggiero, 2014) to generate multiple, synthetic TWL records, to explore the relative contribution of each component to extreme TWL return levels. We assess the sensitivity to local beach morphology by computing TWLs for a range of observed beach slopes. Extreme TWLs are higher in Oregon and Washington than in California. Wave runup typically comprises > 50% of the TWL signal, while NTRs often compose < 5%, illustrating the importance wave climate has on the potential for extreme TWLs. While waves are typically larger in the North, California experiences greater contributions to extreme TWLs from

  12. Seminal plasma total antioxidant capacity and vitamin- C levels in asthenozoospermia: a case- control study

    Directory of Open Access Journals (Sweden)

    Ali Bidmeshkipour

    2010-03-01

    Full Text Available "n Normal 0 false false false EN-US X-NONE AR-SA MicrosoftInternetExplorer4 /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-qformat:yes; mso-style-parent:""; mso-padding-alt:0in 5.4pt 0in 5.4pt; mso-para-margin:0in; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri","sans-serif"; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:"Times New Roman"; mso-fareast-theme-font:minor-fareast; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:Arial; mso-bidi-theme-font:minor-bidi;} Background: Defective sperm function is now recognized as one of the most important causes of male infertility. Seminal plasma possesses a rich source of different enzymatic and non-enzymatic antioxidants such as vitamin C (ascorbic acid that protect spermatozoa against oxidative stress as one of the mediators of infertility causing sperm dysfunction and low sperm quality. The aim of this study was investigation of seminal total antioxidant capacity and determination of vitamin C effects on sperm motility. "n"nMethods: We designed a case-control study with a total subject of 62 males. Sperm parameters were analyzed according to World Health Organization guidelines (WHO, 1999. Total antioxidant capacity and vitamin C level of seminal plasma were measured in the 32 normozoospermic as the control group and 32 asthenospermic men as the case group using FRAP (Ferric Reducing of Antioxidants Powers and RP-HPLC (Reverse Phase High Performance Liquid Chromatography methods, respectively. "n"nResults: Our results indicated that total antioxidant capacity levels in the seminal plasma of asthenospermic men were significantly lower than healthy men (p=0.002. In addition, we found a positive correlation between reduced total

  13. Safety-related control air systems

    International Nuclear Information System (INIS)

    Anon.

    1977-01-01

    This Standard applies to those portions of the control air system that furnish air required to support, control, or operate systems or portions of systems that are safety related in nuclear power plants. This Standard relates only to the air supply system(s) for safety-related air operated devices and does not apply to the safety-related air operated device or to air operated actuators for such devices. The objectives of this Standard are to provide (1) minimum system design requirements for equipment, piping, instruments, controls, and wiring that constitute the air supply system; and (2) the system and component testing and maintenance requirements

  14. Total protein analysis as a reliable loading control for quantitative fluorescent Western blotting.

    Directory of Open Access Journals (Sweden)

    Samantha L Eaton

    Full Text Available Western blotting has been a key technique for determining the relative expression of proteins within complex biological samples since the first publications in 1979. Recent developments in sensitive fluorescent labels, with truly quantifiable linear ranges and greater limits of detection, have allowed biologists to probe tissue specific pathways and processes with higher resolution than ever before. However, the application of quantitative Western blotting (QWB to a range of healthy tissues and those from degenerative models has highlighted a problem with significant consequences for quantitative protein analysis: how can researchers conduct comparative expression analyses when many of the commonly used reference proteins (e.g. loading controls are differentially expressed? Here we demonstrate that common controls, including actin and tubulin, are differentially expressed in tissues from a wide range of animal models of neurodegeneration. We highlight the prevalence of such alterations through examination of published "-omics" data, and demonstrate similar responses in sensitive QWB experiments. For example, QWB analysis of spinal cord from a murine model of Spinal Muscular Atrophy using an Odyssey scanner revealed that beta-actin expression was decreased by 19.3±2% compared to healthy littermate controls. Thus, normalising QWB data to β-actin in these circumstances could result in 'skewing' of all data by ∼20%. We further demonstrate that differential expression of commonly used loading controls was not restricted to the nervous system, but was also detectable across multiple tissues, including bone, fat and internal organs. Moreover, expression of these "control" proteins was not consistent between different portions of the same tissue, highlighting the importance of careful and consistent tissue sampling for QWB experiments. Finally, having illustrated the problem of selecting appropriate single protein loading controls, we demonstrate

  15. Longitudinal Changes in Total Brain Volume in Schizophrenia: Relation to Symptom Severity, Cognition and Antipsychotic Medication

    NARCIS (Netherlands)

    Veijola, J.; Guo, J.Y.; Moilanen, J.S.; Jaaskelainen, E.; Miettunen, J.; Kyllonen, M.; Haapea, M.; Huhtaniska, S.; Alaraisanen, A.; Maki, P.; Kiviniemi, V.; Nikkinen, J.; Starck, T.; Remes, J.J.; Tanskanen, P.; Tervonen, O.; Wink, A.M.; Kehagia, A.; Suckling, J.; Kobayashi, H.; Barnett, J.H.; Barnes, A.; Koponen, H.J.; Jones, P.B.; Isohanni, M.; Murray, G.K.

    2014-01-01

    Studies show evidence of longitudinal brain volume decreases in schizophrenia. We studied brain volume changes and their relation to symptom severity, level of function, cognition, and antipsychotic medication in participants with schizophrenia and control participants from a general population

  16. Relative controllability and null controllability of linear delay systems ...

    African Journals Online (AJOL)

    Necessary and sufficient conditions are established for the relative, absolute controllability and null controllability of the generalized linear delay system and its discrete prototype. The paper presents illuminating examples on previous controllability results by Manitius and Olbrot [7] and carries over the results of Onwuatu [8] ...

  17. New photon-nucleon dispersion relation for evaluating the Thomson limit using rising total cross sections

    International Nuclear Information System (INIS)

    Dean, N.W.

    1978-01-01

    New data showing that the photon-nucleon total cross section increases with energy for ν > or = 50 GeV invalidate earlier comparisons with dispersion relations. Parametrization of the data are presented and used in a new formulation of the dispersion relations, in which an assumed asymptotic behavior avoids the need for subtraction. With this form the fitted amplitude can be compared directly with the Thomson limit. The experimental uncertainties are shown to have a significant effect upon such a comparison

  18. Total greenhouse gas emissions related to the Dutch crop production system

    NARCIS (Netherlands)

    Kramer, K.J.; Moll, H.C.; Nonhebel, S.

    1999-01-01

    This article discusses the greenhouse gas emissions (CO2, CH4, N2O) related to Dutch agricultural crop production. Emissions occur during agricultural processes (direct emissions) as well as in the life cycle of the required inputs (indirect emissions). An integrated approach assesses the total

  19. Effect of weed control treatments on total leaf area of plantation black walnut (Juglans nigra)

    Science.gov (United States)

    Jason Cook; Michael R. Saunders

    2013-01-01

    Determining total tree leaf area is necessary for describing tree carbon balance, growth efficiency, and other measures used in tree-level and stand-level physiological growth models. We examined the effects of vegetation control methods on the total leaf area of sapling-size plantation black walnut trees using allometric approaches. We found significant differences in...

  20. Is total lymphocyte count related to nutritional markers in hospitalized older adults?

    Directory of Open Access Journals (Sweden)

    Vânia Aparecida LEANDRO-MERHI

    Full Text Available ABSTRACT BACKGROUND Older patients are commonly malnourished during hospital stay, and a high prevalence of malnutrition is found in hospitalized patients aged more than 65 years. OBJECTIVE To investigate whether total lymphocyte count is related to other nutritional markers in hospitalized older adults. METHODS Hospitalized older adults (N=131 were recruited for a cross-sectional study. Their nutritional status was assessed by the Nutritional Risk Screening (NRS, anthropometry, and total lymphocyte count. The statistical analyses included the chi-square test, Fisher's exact test, and Mann-Whitney test. Spearman's linear correlation coefficient determined whether total lymphocyte count was correlated with the nutritional markers. Multiple linear regression determined the parameters associated with lymphocyte count. The significance level was set at 5%. RESULTS According to the NRS, 41.2% of the patients were at nutritional risk, and 36% had mild or moderate depletion according to total lymphocyte count. Total lymphocyte count was weakly correlated with mid-upper arm circumference (r=0.20507; triceps skinfold thickness (r=0.29036, and length of hospital stay (r= -0.21518. Total lymphocyte count in different NRS categories differed significantly: older adults who were not at nutritional risk had higher mean and median total lymphocyte count ( P =0.0245. Multiple regression analysis showed that higher lymphocyte counts were associated with higher triceps skinfold thicknesses and no nutritional risk according to the NRS. CONCLUSION Total lymphocyte count was correlated with mid-upper arm circumference, triceps skinfold thickness, and nutritional risk according to the NRS. In multiple regression the combined factors that remained associated with lymphocyte count were NRS and triceps skinfold thickness. Therefore, total lymphocyte count may be considered a nutritional marker. Other studies should confirm these findings.

  1. Frequency-Weighted Balancing Related Controller Reduction

    OpenAIRE

    Varga, Andras; Anderson, Brian D.O.

    2002-01-01

    The efficient solution of a class of controller approximation problems by using frequency-weighted balancing related model reduction approaches is considered. It is shown that for certain standard performance and stability enforcing frequency-weights, the computation of the frequency-weighted controllability and observability grammians can be done by solving reduced order Lyapunov equations regardless the controller itself is stable or unstable. The new approach can be used in conjunction wit...

  2. Level of response to telematic questionnaires on Health Related Quality of Life on total knee replacement.

    Science.gov (United States)

    Besalduch-Balaguer, M; Aguilera-Roig, X; Urrútia-Cuchí, G; Puntonet-Bruch, A; Jordan-Sales, M; González-Osuna, A; Celaya-Ibáñez, F; Colomina-Morales, J

    2015-01-01

    Questionnaires measuring health-related quality of life are difficult to perform and obtain for patients and professionals. Computerised tools are now available to collect this information. The objective of this study was to assess the ability of patients undergoing total knee replacement to fill in health-related quality-of-life questionnaires using a telematic platform. Ninety eight consecutive patients undergoing total knee arthroplasty were included. Participants were given an access code to enter the website where they had to respond to 2 questionnaires (SF8 and the reduced WOMAC), and 3 additional questions about the difficulty in completing the questionnaires. A total of 98 patients agreed to participate: 45 males and 53 females (mean age 72.7 years). Fourteen did not agree to participate due to lack of internet access. Of the final 84 participants, 50% entered the website, and only 36 answered all questions correctly. Of the patients who answered the questionnaire, 80% were helped by a relative or friend, and 22% reported difficulty accessing internet. The use of telematic systems to respond to health-related quality of life questionnaires should be used cautiously, especially in elderly population. It is likely that the population they are directed at is not prepared to use this type of technology. Therefore, before designing telematics questionnaires it must be ensured that they are completed properly. Copyright © 2014 SECOT. Published by Elsevier Espana. All rights reserved.

  3. Cashew consumption reduces total and LDL cholesterol: a randomized, crossover, controlled-feeding trial.

    Science.gov (United States)

    Mah, Eunice; Schulz, Jacqueline A; Kaden, Valerie N; Lawless, Andrea L; Rotor, Jose; Mantilla, Libertie B; Liska, DeAnn J

    2017-05-01

    Background: Cashews are the third most-consumed tree nut in the United States and are abundant with monounsaturated fatty acids and polyunsaturated fatty acids, which are associated with reduced cardiovascular disease risk. Although a qualified Food and Drug Administration health claim exists for nuts and heart health, cashews have been exempt from its use because cashews exceed the disqualifying amount of saturated fatty acids. Approximately one-third of the saturated fat in cashews is stearic acid, which is relatively neutral on blood lipids, thereby suggesting that cashews could have effects that are similar to those of other nuts. However, clinical data on cashews and blood lipids have been limited. Objective: We investigated the effect of reasonable intakes of cashews on serum lipids in adults with or at risk of high LDL cholesterol. Design: In a randomized, crossover, isocaloric, controlled-feeding study, 51 men and women (aged 21-73 y) with a median LDL-cholesterol concentration of 159 mg/dL (95% CI: 146, 165 mg/dL) at screening consumed typical American diets with cashews (28-64 g/d; 50% of kilocalories from carbohydrate, 18% of kilocalories from protein, and 32% of kilocalories from total fat) or potato chips (control; 54% of kilocalories from carbohydrate, 18% of kilocalories from protein, and 29% of kilocalories from total fat) for 28 d with a ≥2-wk washout period. Results: Consumption of the cashew diet resulted in a significantly greater median change from baseline (compared with the control, all P cholesterol [-3.9% (95% CI: -9.3%, 1.7%) compared with 0.8% (95% CI: -1.5%, 4.5%), respectively], LDL cholesterol [-4.8% (95% CI: -12.6%, 3.1%) compared with 1.2% (95% CI: -2.3%, 7.8%), respectively], non-HDL cholesterol [-5.3% (95% CI: -8.6%, 2.1%) compared with 1.7% (95% CI: -0.9%, 5.6%), respectively], and the total-cholesterol:HDL-cholesterol ratio [-0.0% (95% CI: -4.3%, 4.8%) compared with 3.4% (95% CI: 0.6%, 5.2%), respectively]. There were no

  4. Proposta do uso de pool de sangue total como controle interno de qualidade em hematologia

    OpenAIRE

    Schons,Carina Daniele; Tavares,Rejane Giacomelli

    2010-01-01

    INTRODUÇÃO: A confiabilidade dos resultados do laboratório é garantida pela realização do controle de qualidade, que tem como funções básicas análise, pesquisa e prevenção da ocorrência de erros laboratoriais por meio de programas que abrangem tanto o controle interno quanto o externo. OBJETIVO: Propor a padronização de utilização de pool de sangue total como controle interno de qualidade no setor de hematologia. MÉTODO: Foram selecionadas amostras de sangue total, colhidas com ácido etilenod...

  5. Coping strategies related to total stress score among post graduate medical students and residents

    Directory of Open Access Journals (Sweden)

    R. Irawati Ismail

    2013-05-01

    several dominant coping strategies related to total stress score levels.Methods:A cross-sectional purposive sampling method study among postgraduate medical students of the Faculty of Medicine, Universitas Indonesia was done April-July 2011. We used a coping strategies questionnaire and the WHO SRQ-20. Linear regression was used to identify dominant coping strategies related to stress levels.Results:This study had 272 subjects, aged 23-47 years. Four items decreased the total stress score (accepting the reality of the fact, talking to someone who could do something, seeking God’s help, and laughing about the situation. However, three factors increased the total stress score (taking one step at a time has to be done, talking to someone to find out more about the situation, and admitting can’t deal solving the situation. One point of accepting the reality of the situation reduced 0.493 points the total stress score [regression coefficient (β= -0.493; P=0.002]. While one point seeking God’s help reduced 0.307 points the total stress score (β= -0.307; P=0.056. However, one point of doing one step at a time increased 0.54 point the total stress score (β=0.540; P=0.005.Conclusions: Accepting the reality of the situation, talking to someone who could do something, seeking God’s help, and laughing about the situation decreased the stress level. However, taking one step at a time, talking to someone to find out more about the situation and admitting can’t deal solving the situation, increased the total stress score.Key words:stress level, coping strategies, age, seeking God’s help

  6. Study on the relation between uranium content and total phosphorus in some sudanese phosphate ore samples

    International Nuclear Information System (INIS)

    Eltayeb, M. A. H.; Mohammed, A. A.

    2003-01-01

    In the present work uranium content and total phosphorus were determined in 30 phosphate ore samples collected from Kurun and Uro areas in Nuba Mountains in Sudan. Spectrophotometry technique was used for this purpose. Uranium analysis is based on the use of nitrogen (V) acid for leaching the rock, and treatment with ammonium carbonate solution, whereby uranium (Vi) is kept in solution as its carbonate complex. The ion exchange technique was used for the recovery of uranium. Uranium was eluted from the resin with 1 M hydrochloric acid. In the elute, uranium was determined spectrophotometrically by measurement of absorbance of the yellow uranium (Vi)-8-hydroxyquinolate complex at λ 400 nm. The total phosphorus was measured as (P 2 O 5 %) by treatment of the total liquor with ammonium molybdate solution. The absorbance of the blue complex was measured at λ 880 nm. The results show that a limited relation is existed between uranium content and total phosphorus in phosphate samples from kurun area, which contain 58.8 ppm uranium in average, where there are no relation is existed in phosphate samples from uro area, which contain 200 ppm uranium in average. (Author)

  7. Do Pilates-based exercises following total knee arthroplasty improve postural control and quality of life?

    Science.gov (United States)

    Karaman, Aysenur; Yuksel, Inci; Kinikli, Gizem Irem; Caglar, Omur

    2017-04-01

    The aim of this prospective, randomized, controlled study was to investigate the effects of the addition of Pilates-based exercises to standard exercise programs performed after total knee arthroplasty on quality of life and balance. Forty-six volunteers were divided into two groups. The control group (n = 17) was assigned a standard exercise program after discharge; the study group (n = 17) was assigned Pilates-based exercises along with the standard exercise program. We carried out clinical evaluations of all patients on the day of discharge and after the completion of the 6-week exercise program. We also recorded sociodemographic data, Berg Balance test scores, and Short Form-36 (SF-36) health-related quality of life measurements. When we compared the differences between pre- and post-treatment balance scores of the groups, we found a significant change in favor of the Pilates-based exercise group (13.64 ± 1.45; p Pilates-based exercises group were found to be significant in terms of physical function (p = 0.001), physical role restriction (p = 0.01), and physical component score (p = 0.001). Pilates-based exercises performed along with standard exercise programs were more effective for improving balance and quality of life than standard exercise programs alone.

  8. [Relativity among starch quantity, polysaccharides content and total alkaloid content of Dendrobium loddigesii].

    Science.gov (United States)

    Zhu, Hua; Teng, Jianbei; Cai, Yi; Liang, Jie; Zhu, Yilin; Wei, Tao

    2011-12-01

    To find out the relativity among starch quantity, polysaccharides content and total alkaloid content of Dendrobium loddigesii. Microscopy-counting process was applied to starch quantity statistics, sulfuric acid-anthrone colorimetry was used to assay polysaccharides content and bromocresol green colorimetry was used to assay alkaloid content. Pearson product moment correlation analysis, Kendall's rank correlation analysis and Spearman's concordance coefficient analysis were applied to study their relativity. Extremely significant positive correlation was found between starch quantity and polysaccharides content, and significant negative correlation between alkaloid content and starch quantity was discovered, as well was between alkaloid content and polysaccharides content.

  9. Manual instructivo de instalación y control de prótesis totales Instructive manual of installation and control of total prostheses

    Directory of Open Access Journals (Sweden)

    Marcia Hortensia Corona Carpio

    2007-12-01

    Full Text Available Se realizó un estudio de la literatura con el objetivo de describir el paso clínico de instalación y control de prótesis total, durante el período comprendido de enero a mayo del 2005 en la Clínica Estomatológica Provincial Docente de Santiago de Cuba. Se abordaron diversos aspectos, definición de conceptos, así como todo el proceder clínico, instrucciones al paciente y consejo s a los portadores de prótesis. Se enfatizó en el paciente geriátrico, destacándose que precisamente este paso es el indicado para eliminar los defectos evidentes y donde el paciente adquiere el hábito de utilizarlos y el organismo de aceptarlo.A literature study was conducted aimed at describing the clinical step of installation and control of total prosthesis at the Provincial Teaching Dental Clinic of Santiago de Cuba from January to May, 2005. Diverse aspects were dealt with, as well as the definition of concepts, the whole clinical procedure, instructions to the patients and advises to prosthesis wearers. Emphasis was made on the geriatric patient, and it was stressed that this step is the indicated to eliminate the evident defects, and where the patient acquires the habit to use them and the body to accept them.

  10. Controlling total spot power from holographic laser by superimposing a binary phase grating.

    Science.gov (United States)

    Liu, Xiang; Zhang, Jian; Gan, Yu; Wu, Liying

    2011-04-25

    By superimposing a tunable binary phase grating with a conventional computer-generated hologram, the total power of multiple holographic 3D spots can be easily controlled by changing the phase depth of grating with high accuracy to a random power value for real-time optical manipulation without extra power loss. Simulation and experiment results indicate that a resolution of 0.002 can be achieved at a lower time cost for normalized total spot power.

  11. Total antioxidants in plasma of hemodialysed patients and healthy controls measured by two commercial assays

    OpenAIRE

    Ruskovska, Tatjana; Jansen, Eugene

    2012-01-01

    Introduction: As a result of an increased interest in oxidative stress research, in both basic and clinical studies, numerous commercial test kits became available. The aim of this study was to evaluate the results for total antioxidants measured by two commercial assays in a complex clinical condition such as single hemodialysis session in patients on chronic hemodialysis treatment, in comparison to healthy controls. Methods: The level of plasma total antioxidants was measured by BAP ...

  12. Relation between total shock energy and mortality in patients with implantable cardioverter-defibrillator.

    Science.gov (United States)

    Tenma, Taro; Yokoshiki, Hisashi; Mitsuyama, Hirofumi; Watanabe, Masaya; Mizukami, Kazuya; Kamada, Rui; Takahashi, Masayuki; Sasaki, Ryo; Maeno, Motoki; Okamoto, Kaori; Chiba, Yuki; Anzai, Toshihisa

    2018-05-15

    Implantable Cardioverter-Defibrillator (ICD) shocks have been associated with mortality. However, no study has examined the relation between total shock energy and mortality. The aim of this study is to assess the association of total shock energy with mortality, and to determine the patients who are at risk of this association. Data from 316 consecutive patients who underwent initial ICD implantation in our hospital between 2000 and 2011 were retrospectively studied. We collected shock energy for 3 years from the ICD implantation, and determined the relation of shock energy on mortality after adjusting confounding factors. Eighty-seven ICD recipients experienced shock(s) within 3 years from ICD implantation and 43 patients had died during the follow-up. The amount of shock energy was significantly associated with all-cause death [adjusted hazard ratio (HR) 1.26 (per 100 joule increase), p energy accumulation (≥182 joule) was lower (p energy accumulation (energy accumulation and all-cause death was remarkable in the patients with low left ventricular ejection fraction (LVEF ≤40%) or atrial fibrillation (AF). Increase of shock energy was related to mortality in ICD recipients. This relation was evident in patients with low LVEF or AF. Copyright © 2018 Elsevier B.V. All rights reserved.

  13. Study on the relation between uranium content and total phosphorus in some sudanese phosphate ore samples

    International Nuclear Information System (INIS)

    Mohammed, A.A.; Eltayeb, M.A.H.

    2003-01-01

    In the present work uranium content and total phosphorous were determined in 30 phosphate ore samples collected from Kurun and Uro areas in Nuba mountains in sudan. Spectrophotometry technique was used for this purpose. Uranium analysis is based on the use of nitrogen (V) acid for leaching the rock, and treatment with ammonium carbonate solution, whereby uranium (VI) is kept in solution as its carbonate complex. The ion-exchange technique was used for the recovery of uranium. Uranium was eluted from the resin with 1 M hydrochloric acid. In the elute, uranium was determined spectrophotometrically by measurement of the absorbance of the yellow uranium (VI) - 8- hydroxyquinolate complex at λ 400 nm. The total phosphorus was measured as (P 2 O 5 %) by treatment of the leach liquor with ammonium molybdate solution. The absorbance of the blue complex was measured at λ 880 nm. The results show that a limited relation is existed between uranium content and total phosphorus in phosphate samples from Kurun area, which contain 58.8 ppm uranium in average, where there are no relation is existed in phosphate samples samples from Uro area, which contain 200 ppm uranium in average

  14. Association of peripheral total and differential leukocyte counts with obesity-related complications in young adults.

    Science.gov (United States)

    Yoshimura, Aya; Ohnishi, Shunsuke; Orito, Chieko; Kawahara, Yukako; Takasaki, Hiroyo; Takeda, Hiroshi; Sakamoto, Naoya; Hashino, Satoshi

    2015-01-01

    Obesity has been demonstrated to be associated with elevated leukocytes in adults and children. This study assessed the associations between peripheral total and differential leukocyte counts and obesity-related complications in young adults. 12 obese (median age 21.5 (range 19-28) years, median BMI 35.7 (range 32.0-44.9) kg/m(2)) and 11 normal (median age 23 (range 18-27) years, median BMI 19.5 (range 18.1-21.7) kg/m(2)) adults were enrolled. Complete blood count and serum levels of liver enzymes, fasting blood glucose, insulin and lipids were measured, and the homeostasis model assessment of insulin resistance was calculated. Fat mass was calculated using a bioimpedance analysis device, and ultrasonography was performed to measure fat thickness and to detect fatty change of the liver. Total leukocyte and monocyte counts were significantly increased in obese young adults. Total leukocyte count was associated with liver enzyme levels, insulin resistance as well as visceral and subcutaneous fat thickness. Neutrophil count was associated with insulin resistance. Lymphocyte count was associated with serum liver enzymes, insulin resistance, and dyslipidemia. Monocyte count was associated with serum liver enzyme, insulin resistance, visceral and subcutaneous fat thickness, body fat mass, and percentage body fat. The results of this study suggest that chronic low-grade systemic inflammation is associated with obesity-related complications such as nonalcoholic fatty liver disease, insulin resistance, and dyslipidemia in young adults. © 2015 S. Karger GmbH, Freiburg.

  15. Assessment of voice related quality of life and its correlation with socioeconomic status after total laryngectomy.

    Science.gov (United States)

    Agarwal, Sangeet Kumar; Gogia, Shweta; Agarwal, Alok; Agarwal, Rajiv; Mathur, Ajay Swaroop

    2015-10-01

    After total laryngectomy for laryngeal cancer, the major determinants of QOL is the patient's voice related quality of life (V-RQOL). The primary aim of this study was to assess the V-RQOL and impact of socioeconomic status over it in Indian population by using two validated scales [voice handicap index (VHI) and V-RQOL questionnaires]. Total 104 patients underwent total laryngectomy but 71 were eligible for study. Patients filled the VHI and V-RQOL questionnaires after completion of 1 year of usage of the TEP voice. The socioeconomic status of the patients was calculated according to various domains related to their life and were divided into lower and higher status. A total of 76.1% patients had VHI score between 0 to 30 (minimal voice handicap), 19.7% had score between 31 to 60 (moderate voice handicap) and only 4.2% patients had VHI score more than 61 (serious voice handicap). On V-RQOL scores, 16.9% patients had score between 10 to 15 (excellent), 40.8% patients, between 16 to 20 (very good), 22.5% patients, between 21 and 25 (good voice), 15.5% patients, between 26 and 30 (fair) and only 4.2% patients scored more than 30 with poor quality of voice. Patients with lower socioeconomic group had better V-RQOL than with high socioeconomic group. VHI and V-RQOL scores in our series were superior to other studies due to major population with lower socioeconomic status and better social support which exists in our society.

  16. Clinical and cost effectiveness-related aspects of retransfusion in total hip and knee arthroplasty.

    Science.gov (United States)

    Dobosz, Bartłomiej; Dutka, Julian; Dutka, Lukasz; Maleta, Paweł

    2012-01-01

    An increasing demand for blood products forces the rationalisation of management and conservation of blood. The aim of the study is to evaluate the possibility of retransfusion of blood conservation and the cost-effectiveness of this procedure when employed in Total Hip Replacement and Total Knee Arthroplasty. This prospective cohort study involved two groups of patients. Group I comprised 50 patients who underwent blood retransfusion and in several cases had supplementary allogeneic transfusion. Group II, a control group, consisted of 50 patients who did not receive retransfusion. The retransfusion in Group I enabled the recovery of a mean amount of 364.5 ml (± 52.7) of blood in THR patients and 403.8 ml (± 110.7) in TKA patients. Demand for allogeneic blood transfusions in Group I versus Group II was 46% lower in THR patients and 42% lower in TKA patients. The blood recovered for retransfusion is biologically valuable with regard to cellular elements and plasma chemistries. In the costs evaluation, the total savings in Group I were 5,000 PLN. Retransfusion of recuperated blood from postoperative drainage tubing is a simple and safe method that provides clinical and cost-effectiveness advantages.

  17. Quality control on the accuracy of the total Beta activity index in different sample matrices water

    International Nuclear Information System (INIS)

    Pujol, L.; Pablo, M. A. de; Payeras, J.

    2013-01-01

    The standard ISO/IEC 17025:2005 of general requirements for the technical competence of testing and calibration laboratories, provides that a laboratory shall have quality control procedures for monitoring the validity of tests and calibrations ago. In this paper, the experience of Isotopic Applications Laboratory (CEDEX) in controlling the accuracy rate of total beta activity in samples of drinking water, inland waters and marine waters is presented. (Author)

  18. Relation of organizational citizenship behavior and locus of control.

    Science.gov (United States)

    Turnipseed, David L; Bacon, Calvin M

    2009-12-01

    The relation of organizational citizenship behavior and locus of control was assessed in a sample of 286 college students (52% men; M age = 24 yr.) who worked an average of 26 hr. per week. Measures were Spector's Work Locus of Control Scale and Podsakoff, et al.'s Organization Citizenship Behavior scale. Hierarchical multiple regressions indicated positive association of scores on work locus of control with scores on each of the four tested dimensions of organizational citizenship, as well as total organizational citizenship behavior.

  19. Controllability and synchronizability: Are they related?

    International Nuclear Information System (INIS)

    Aguirre, Luis A.; Letellier, Christophe

    2016-01-01

    Highlights: • We investigate if controllability coefficients correlate with measures of synchronization performance. • We use two toy-models: the Rössler and cord systems. • We considered four different synchronization schemes. • We did not find any general relation between controllability coefficients and synchronizability for the investigated systems. - Abstract: In the two last decades the concept of observability has been formally linked to that of embedding in the context of nonlinear dynamics. Such a concept has been shown to play an important role in global modeling, data analysis and filtering, to mention a few examples. Preliminary results suggested that observability, at least in some cases, has some influence in synchronization problems. Could the dual concept of controllability also be important in such problems? In the context of synchronization, in general, the role played by controllability properties may not be as relevant as observability is for data analysis. In this work we compute controllability coefficients analogous to the observability ones, now established in the literature, and evaluate their importance in synchronization problems. Two benchmarks have been used in the simulations: the Rössler and the cord systems. The following schemes were investigated: synchronization to external sinusoidal force, complete replacement, uni- and bi-directional coupling of identical oscillators. The results discussed in this work show that controllability and synchronizability are not related in general.

  20. Tranexamic acid for control of blood loss in bilateral total knee replacement in a single stage

    Directory of Open Access Journals (Sweden)

    Mandeep S Dhillon

    2011-01-01

    Full Text Available Background: Tranexamic acid (TEA reduces blood loss and red cell transfusions in patients undergoing unilateral total knee arthroplasty (TKA. However, there is not much literature regarding the use of TEA in patients undergoing bilateral TKA in a single stage and the protocols for administration of TEA in such patients are ill-defined. Materials and Methods: We carried out a case control study evaluating the effect of TEA on postoperative hemoglobin (Hb, total drain output, and number of blood units transfused in 52 patients undergoing bilateral TKA in a single stage, and compared it with 56 matched controls who did not receive TEA. Two doses of TEA were administered in doses of 10 mg / kg each (slow intravenous (IV infusion, with the first dose given just before tourniquet release of the first knee and the second dose three hours after the first one. Results: A statistically significant reduction in the total drain output and requirement of allogenic blood transfusion in cases who received TEA, as compared to the controls was observed. The postoperative Hb and Hb at the time of discharge were found to be lower in the control group, and this result was found to be statistically significant. Conclusion: TEA administered in patients undergoing single stage bilateral TKA helped reduce total blood loss and decreased allogenic blood transfusion requirements. This might be particularly relevant, where facilities such as autologous reinfusion might not be available.

  1. Patient-Controlled Oral Analgesia for Postoperative Pain Management Following Total Knee Replacement

    Directory of Open Access Journals (Sweden)

    Patti Kastanias

    2010-01-01

    Full Text Available PURPOSE: To investigate whether patient-controlled oral analgesia (PCOA used by individuals receiving a total knee replacement could reduce pain, increase patient satisfaction, reduce opioid use and/or reduce opioid side effects when compared with traditional nurse (RN-administered oral analgesia.

  2. Scientific Opinion on the essential composition of total diet replacements for weight control

    DEFF Research Database (Denmark)

    Tetens, Inge

    2015-01-01

    or authoritative bodies. Derived from the minimum content of macronutrients, the Panel proposed a minimum energy content of total diet replacements for weight control of 2 510 kJ/day (600 kcal/day). The Panel also advised on potential conditions and restrictions of use for these products....

  3. A randomised, controlled clinical study on total hip arthroplasty using 4 different bearings

    DEFF Research Database (Denmark)

    Borgwardt, Arne; Zerahn, Bo; Fabricius, Sandra D

    2017-01-01

    PURPOSE: To compare 4 different bearings in total hip arthroplasty (THA) in a randomised controlled clinical study on clinical performance. METHODS: 393 patients with osteoarthritis of the hip or avascular necrosis were included and allocated to 1 of the head-and-cup couples zirconia...

  4. A Controlled Study to Assess the Clinical Efficacy of Totally Self-Administered Systematic Desensitization

    Science.gov (United States)

    Rosen, Gerald M.; And Others

    1976-01-01

    Highly anxious self-referred snake phobics received either (a) therapist-administered desensitization, (b) self-administered desensitization with weekly therapist phone calls, (c) totally self-administered desensitization, (d) self-administered double-blind placebo control, or (e) no treatment. Pretreatment to posttreatment measures revealed…

  5. The construction of distant total distributed measuring and controlling system based on RS-232 communication

    International Nuclear Information System (INIS)

    Shi Chengying; Li Tiantuo; Zhu Wenkai; Zhang Quanhu

    1999-01-01

    The author discusses the construction of distant total distributed measuring and controlling system based on RS-232 communication. The merits of this system are simple construction, reliable performance, big communication distance, and wide covering range. The system fits in with application in radiation environment. The author also discusses the system's hardware equipment and communication protocol

  6. FY1990 Nuclear-related budget demand totals 398 billion yen, up 2.7%

    International Nuclear Information System (INIS)

    Anon.

    1989-01-01

    Funds needed to promote the development and utilization of nuclear energy in fiscal 1990 in a planned and integrated way total yen398,427 million on a cash basis, up 2.7% over fiscal 1989. The Science and Technology Agency, which has two major nuclear RandD organizations -- the Japan Atomic Energy Research Institute and the Power Reactor and Nuclear Fuel Development Corp. -- within its jurisdiction, has asked for a total of yen297,765 million (up 5.7%), about three-fourths of the total nuclear-related budget demand. The budget demand of the Ministry of International Trade and Industry aggregates yen96.375 million, down 5.1%. The budget demand of the Ministry of Foreign Affairs is yen2,962 million, including subscriptions and contributions to IAEA, and that of the Ministry of Transport, yen42 million, including research and analysis costs for setting safety standards for the transportation of radioactive materials. The budget demand of the Ministry of Agriculture, Forestry and Fisheries is yen167 million, including costs for the prevention and elimination of melon-flies in the Amami Islands, and for the Tsukuba Agriculture and Forestry Research Exchange Center. (N.K.)

  7. Hypoparathyroidism after total thyroidectomy: prospective evaluation and relation with early hypocalcemia.

    Science.gov (United States)

    D'Alessandro, Nicola; Tramutola, Giuseppe; Fasano, Giovanni Michele; Gilio, Francesco; Iside, Giovanni; Izzo, Maria Lucia; Loffredo, Andrea; Pici, Mariano; Pinto, Margherita; Tramontano, Salvatore; Citro, Giuseppe

    2016-01-01

    Definitive hypoparathyrodism (hypo-PTH) represents one of the most dangerous complication after total thyroidectomy. Partial or total lesion or accidental removal of parathyroid glands is an unpredictable adverse event, although real incidence is not well defined, such as management of this deficit. We started a prospective evaluation of patients treated with total thyroidectomy in our centre, to identify incidence of hypo-PTH, symptomatic or not, in relation to incidence of early postoperative hypocalcemia in our experience. We prospectively evaluated 177 patients treated for benign and malign pathology, measuring calcium before surgery and calcium and PTH at least three months after surgery. Postoperative hypocalcemia was observed in 37.3% of cases. Eight patients (4.5% of cohort) presented low level of PTH, at mean follow-up of 9.1 months. Positive predictive value for postoperative hypocalcemia was 12.1%, while negative predictive was 95.4%; confirming high sensitivity (100%) and low specificity (65.4%) for detecting hypo-PTH. All patients with late hypo-PTH presented hypocalcemia on early analysis, while no case with normal postoperative calcemia accounted with hypo-PTH: this may indicate calcemia as valid prognostic factor of good gland production, when is in the range. Moreover, isolated analysis is too limited to determine real predictability. Technical standardization represents the best method for prevention of hypo-PTH. Early hypocalcemia is a prognostic factor, even with a low specificity, of deficit of PTH-production. This observation must be related to other known prognostic factors. Postoperative normal calcemia should be a positive prognostic factor of an acceptable PTHfunction, supported by large cohorts. Hypocalcemia, Parathormone, Thyroidectomy.

  8. Breakfast Dietary Patterns among Mexican Children Are Related to Total-Day Diet Quality.

    Science.gov (United States)

    Afeiche, Myriam C; Taillie, Lindsey Smith; Hopkins, Sinead; Eldridge, Alison L; Popkin, Barry M

    2017-03-01

    Background: Mexico has experienced shifts in food availability and consumption patterns over the past few decades from traditional diets to those containing more high-energy density foods, resulting in the development of unhealthful dietary patterns among children and adults. However, to our knowledge it is not known whether breakfast consumption patterns contribute to the overall daily diet of Mexican children. Objective: We examined total-day diet among breakfast consumers compared with breakfast skippers, identified and investigated breakfast dietary patterns in relation to energy and nutrient intakes at breakfast and across the day, and examined these patterns in relation to sociodemographic characteristics. Methods: With the use of nationally representative dietary data (one 24-h recall) from the 2012 Mexican National Health and Nutrition Survey, 3760 children aged 4-13 y were categorized into mutually exclusive breakfast patterns with the use of cluster analysis. The association between breakfast patterns and breakfast skippers with dietary intake at breakfast and for the total day was investigated with the use of multivariate linear regression. Results: Most children (83%) consumed breakfast. Six breakfast dietary patterns were identified (milk and sweetened breads, tortillas and beans, sweetened beverages, sandwiches and quesadillas, eggs, and cereal and milk) and reflected both traditional and more Westernized dietary patterns. Sugar-sweetened beverages were consumed across all patterns. Compared with all breakfast dietary patterns, breakfast skippers had the lowest intake of several nutrients of public health concern. Nutrients to limit that were high at breakfast tended to be high for the total day and vice versa for nutrients to encourage. Conclusions: There was not a single pattern that complied perfectly with the Mexican School Breakfast Guidelines, but changes such as increasing dietary fiber by encouraging more whole grains, fruits, vegetables, and

  9. The Total Synthesis Problem of linear multivariable control. II - Unity feedback and the design morphism

    Science.gov (United States)

    Sain, M. K.; Antsaklis, P. J.; Gejji, R. R.; Wyman, B. F.; Peczkowski, J. L.

    1981-01-01

    Zames (1981) has observed that there is, in general, no 'separation principle' to guarantee optimality of a division between control law design and filtering of plant uncertainty. Peczkowski and Sain (1978) have solved a model matching problem using transfer functions. Taking into consideration this investigation, Peczkowski et al. (1979) proposed the Total Synthesis Problem (TSP), wherein both the command/output-response and command/control-response are to be synthesized, subject to the plant constraint. The TSP concept can be subdivided into a Nominal Design Problem (NDP), which is not dependent upon specific controller structures, and a Feedback Synthesis Problem (FSP), which is. Gejji (1980) found that NDP was characterized in terms of the plant structural matrices and a single, 'good' transfer function matrix. Sain et al. (1981) have extended this NDP work. The present investigation is concerned with a study of FSP for the unity feedback case. NDP, together with feedback synthesis, is understood as a Total Synthesis Problem.

  10. After total knee replacement younger patients demonstrate superior balance control compared to older patients when recovering from a forward fall.

    Science.gov (United States)

    Street, Brian D; Gage, William

    2017-05-01

    National joint replacement registries have reported a substantial growth in younger knee osteoarthritic patients (controlled perturbation have shown age-related differences between younger and older healthy adults, whether similar age-related differences exist among total knee replacement patients is unknown. A total of 59 participants, including 29 unilateral total knee replacement patients (six-months post-surgery) made up the four experimental groups: 1) younger patient (54.3 (SD 7.9) years), 2) younger control (55.2 (SD 4.0) years), 3) older patient (76.9 (SD 4.7) years), and 4) older control (77.7 (SD 4.1) years). Using a tether-release method to perturb balance and simulate a forward fall, center of mass and stepping characteristics were analyzed. Younger patients recovered following the perturbation with a significantly smaller center of mass displacement compared to the older patients (14.85 (SD 0.01) v. 18.13 (SD 0.02) %ht, p=0.02); utilizing a longer (0.43 (SD 0.02) v. 0.39 (SD 0.03) m, pcontrols in center of mass displacement or recovery step characteristics (p>0.05). The younger patients demonstrated superior center of mass control in response to a forward perturbation, suggesting that younger patients would be at a reduced risk of falling when recovering from a forward-directed postural perturbation compared to older patients. Copyright © 2017 Elsevier Ltd. All rights reserved.

  11. Blood volume, blood pressure and total body sodium: internal signalling and output control

    DEFF Research Database (Denmark)

    Bie, P

    2009-01-01

    Total body sodium and arterial blood pressure (ABP) are mutually dependent variables regulated by complex control systems. This review addresses the role of ABP in the normal control of sodium excretion (NaEx), and the physiological control of renin secretion. NaEx is a pivotal determinant of ABP......, and under experimental conditions, ABP is a powerful, independent controller of NaEx. Blood volume is a function of dietary salt intake; however, ABP is not, at least not in steady states. A transient increase in ABP after a step-up in sodium intake could provide a causal relationship between ABP...... and the regulation of NaEx via a hypothetical integrative control system. However, recent data show that subtle sodium loading (simulating salty meals) causes robust natriuresis without changes in ABP. Changes in ABP are not necessary for natriuresis. Normal sodium excretion is not regulated by pressure. Plasma...

  12. Estimation of salivary flow rate, pH, buffer capacity, calcium, total protein content and total antioxidant capacity in relation to dental caries severity, age and gender.

    Science.gov (United States)

    Pandey, Pallavi; Reddy, N Venugopal; Rao, V Arun Prasad; Saxena, Aditya; Chaudhary, C P

    2015-03-01

    The aim of the study was to evaluate salivary flow rate, pH, buffering capacity, calcium, total protein content and total antioxidant capacity in relation to dental caries, age and gender. The study population consisted of 120 healthy children aged 7-15 years that was further divided into two groups: 7-10 years and 11-15 years. In this 60 children with DMFS/dfs = 0 and 60 children with DMFS/dfs ≥5 were included. The subjects were divided into two groups; Group A: Children with DMFS/dfs = 0 (caries-free) Group B: Children with DMFS/dfs ≥5 (caries active). Unstimulated saliva samples were collected from all groups. Flow rates were determined, and samples analyzed for pH, buffer capacity, calcium, total protein and total antioxidant status. Salivary antioxidant activity is measured with spectrophotometer by an adaptation of 2,2'-azino-di-(3-ethylbenzthiazoline-6-sulphonate) assays. The mean difference of the two groups; caries-free and caries active were proved to be statistically significant (P salivary calcium, total protein and total antioxidant level for both the sexes in the age group 7-10 years and for the age 11-15 years the mean difference of the two groups were proved to be statistically significant (P salivary calcium level for both the sexes. Salivary total protein and total antioxidant level were proved to be statistically significant for male children only. In general, total protein and total antioxidants in saliva were increased with caries activity. Calcium content of saliva was found to be more in caries-free group and increased with age.

  13. Development of a totally computer-controlled triple quadrupole mass spectrometer system

    International Nuclear Information System (INIS)

    Wong, C.M.; Crawford, R.W.; Barton, V.C.; Brand, H.R.; Neufeld, K.W.; Bowman, J.E.

    1983-01-01

    A totally computer-controlled triple quadrupole mass spectrometer (TQMS) is described. It has a number of unique features not available on current commercial instruments, including: complete computer control of source and all ion axial potentials; use of dual computers for data acquisition and data processing; and capability for self-adaptive control of experiments. Furthermore, it has been possible to produce this instrument at a cost significantly below that of commercial instruments. This triple quadrupole mass spectrometer has been constructed using components commercially available from several different manufacturers. The source is a standard Hewlett-Packard 5985B GC/MS source. The two quadrupole analyzers and the quadrupole CAD region contain Balzers QMA 150 rods with Balzers QMG 511 rf controllers for the analyzers and a Balzers QHS-511 controller for the CAD region. The pulsed-positive-ion-negative-ion-chemical ionization (PPINICI) detector is made by Finnigan Corporation. The mechanical and electronics design were developed at LLNL for linking these diverse elements into a functional TQMS as described. The computer design for total control of the system is unique in that two separate LSI-11/23 minicomputers and assorted I/O peripherals and interfaces from several manufacturers are used. The evolution of this design concept from totally computer-controlled instrumentation into future self-adaptive or ''expert'' systems for instrumental analysis is described. Operational characteristics of the instrument and initial results from experiments involving the analysis of the high explosive HMX (1,3,5,7-Tetranitro-1,3,5,7-Tetrazacyclooctane) are presented

  14. Postoperative Complications of Laparoscopic Total Gastrectomy versus Open Total Gastrectomy for Gastric Cancer in a Meta-Analysis of High-Quality Case-Controlled Studies

    Directory of Open Access Journals (Sweden)

    Mikito Inokuchi

    2016-01-01

    Full Text Available Background. Some meta-analyses of case-controlled studies (CCSs have shown that laparoscopic or laparoscopy-assisted total gastrectomy (LTG had some short-term advantages over open total gastrectomy (OTG. However, postoperative complications differed somewhat among the meta-analyses, and some CCSs included in the meta-analyses had mismatched factors between LTG and OTG. Methods. CCSs comparing postoperative complications between LTG and OTG were identified in PubMed and Embase. Studies matched for patients’ status, tumor stage, and the extents of lymph-node dissection were included. Outcomes of interest, such as anastomotic, other intra-abdominal, wound, and pulmonary complications, were evaluated in a meta-analysis performed using Review Manager version 5.3 software. Result. This meta-analysis included a total of 2,560 patients (LTG, 1,073 patients; OTG, 1,487 patients from 15 CCSs. Wound complications were significantly less frequent in LTG than in OTG (n = 2,430; odds ratio [OR] 0.30, 95% confidence interval [CI] 0.29–0.85, P=0.01, I2 = 0%, and OR 0.46, 95% CI 0.17–0.52, P<0.0001, I2 = 0%. However, the incidence of anastomotic complications was slightly but not significantly higher in LTG than in OTG (n = 2,560; OR 1.44, 95% CI 0.96–2.16, P=0.08, I2 = 0%. Conclusion. LTG was associated with a lower incidence of wound-related postoperative complications than was OTG in this meta-analysis of CCSs; however, some concern remains about anastomotic problems associated with LTG.

  15. Automatic control of the NMB level in general anaesthesia with a switching total system mass control strategy.

    Science.gov (United States)

    Teixeira, Miguel; Mendonça, Teresa; Rocha, Paula; Rabiço, Rui

    2014-12-01

    This paper presents a model based switching control strategy to drive the neuromuscular blockade (NMB) level of patients undergoing general anesthesia to a predefined reference. A single-input single-output Wiener system with only two parameters is used to model the effect of two different muscle relaxants, atracurium and rocuronium, and a switching controller is designed based on a bank of total system mass control laws. Each of such laws is tuned for an individual model from a bank chosen to represent the behavior of the whole population. The control law to be applied at each instant corresponds to the model whose NMB response is closer to the patient's response. Moreover a scheme to improve the reference tracking quality based on the analysis of the patient's response, as well as, a comparison between the switching strategy and the Extended Kalman Kilter (EKF) technique are presented. The results are illustrated by means of several simulations, where switching shows to provide good results, both in theory and in practice, with a desirable reference tracking. The reference tracking improvement technique is able to produce a better reference tracking. Also, this technique showed a better performance than the (EKF). Based on these results, the switching control strategy with a bank of total system mass control laws proved to be robust enough to be used as an automatic control system for the NMB level.

  16. Lifestyle and health-related quality of life in Asian patients with total hip arthroplasties.

    Science.gov (United States)

    Fujita, Kimie; Xia, Zhenlan; Liu, Xueqin; Mawatari, Masaaki; Makimoto, Kiyoko

    2014-09-01

    Total hip arthroplasty reduces pain and restores physical function in patients with hip joint problems. This study examined lifestyle and health-related quality of life before and after total hip arthroplasty in Japanese and Chinese patients. Two hospitals in China recruited 120 patients and 120 Japanese patients matched by age and operative status were drawn from a prospective cohort database. Oxford Hip Score, EuroQol, and characteristics of Asian lifestyle and attitudes toward the operation were assessed. There were no differences between patients from the two countries in quality-of-life-scale scores: postoperative patients had significantly better quality-of-life scores than preoperative patients in both countries. In China, patients who reported that living at home was inconvenient had significantly worse Oxford Hip Scores than those who did not. Mean scores for anxiety items concerning possible dislocation and durability of the implant were significantly higher in Japanese than in Chinese subjects. Our findings suggest that providing information about housing conditions and lifestyles would result in improved quality of life and reduced anxiety in patients with implanted joints. © 2014 Wiley Publishing Asia Pty Ltd.

  17. Enchanced total dose damage in junction field effect transistors and related linear integrated circuits

    International Nuclear Information System (INIS)

    Flament, O.; Autran, J.L.; Roche, P.; Leray, J.L.; Musseau, O.

    1996-01-01

    Enhanced total dose damage of Junction Field-effect Transistors (JFETs) due to low dose rate and/or elevated temperature has been investigated for elementary p-channel structures fabricated on bulk and SOI substrates as well as for related linear integrated circuits. All these devices were fabricated with conventional junction isolation (field oxide). Large increases in damage have been revealed by performing high temperature and/or low dose rate irradiations. These results are consistent with previous studies concerning bipolar field oxides under low-field conditions. They suggest that the transport of radiation-induced holes through the oxide is the underlying mechanism. Such an enhanced degradation must be taken into account for low dose rate effects on linear integrated circuits

  18. Development of a microcontroller-based automatic control system for the electrohydraulic total artificial heart.

    Science.gov (United States)

    Kim, H C; Khanwilkar, P S; Bearnson, G B; Olsen, D B

    1997-01-01

    An automatic physiological control system for the actively filled, alternately pumped ventricles of the volumetrically coupled, electrohydraulic total artificial heart (EHTAH) was developed for long-term use. The automatic control system must ensure that the device: 1) maintains a physiological response of cardiac output, 2) compensates for an nonphysiological condition, and 3) is stable, reliable, and operates at a high power efficiency. The developed automatic control system met these requirements both in vitro, in week-long continuous mock circulation tests, and in vivo, in acute open-chested animals (calves). Satisfactory results were also obtained in a series of chronic animal experiments, including 21 days of continuous operation of the fully automatic control mode, and 138 days of operation in a manual mode, in a 159-day calf implant.

  19. Total glucosides of paeony for rheumatoid arthritis: A systematic review of randomized controlled trials.

    Science.gov (United States)

    Luo, Jing; Jin, Di-Er; Yang, Guo-Yan; Zhang, Ying-Ze; Wang, Jian-Ming; Kong, Wei-Ping; Tao, Qing-Wen

    2017-10-01

    Total glucosides of paeony (TGP) is commonly used to treat rheumatoid arthritis (RA) in China. However, clinical practice hasn't been well informed by evidence from appropriately conducted systematic reviews. This PRISMA-compliant systematic review aims at examining the effectiveness and safety of TGP for RA. Randomized controlled trials (RCTs) comparing TGP with placebo, no treatment, or disease-modifying antirheumatic drugs (DMARDs) for patients with RA were retrieved by searching seven databases. Primary outcomes included disease improvement and disease remission. Secondary outcomes included adverse effects, pain, health-related quality of life, C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR). Data extraction and analyses were conducted according to the Cochrane standards. We assessed risk of bias for each included studies and quality of evidence on pre-specified outcomes. Eight studies enrolling 1209 patients with active RA were included in this systematic review. On the basis of traditional DMARD(s), TGP might be beneficial for patients with RA in improvement of American College of Rheumatology (ACR) 20 response rate, ACR 50 response rate, ACR70 response rate, and in reduction of adverse effects, compared with no treatment. The overall methodological quality of included studies and the quality of evidence for each outcome were limited. Current trials suggested potential benefits of TGP for RA on the basis of traditional DMARD(s). Therefore, TGP may be a good choice for RA as an adjuvant therapy. However, considering the limited methodological quality and strength of evidence, high-quality RCTs are warranted to support the use of TGP for RA. Copyright © 2017. Published by Elsevier Ltd.

  20. Study on the total amount control of atmospheric pollutant based on GIS.

    Science.gov (United States)

    Wang, Jian-Ping; Guo, Xi-Kun

    2005-08-01

    To provide effective environmental management for total amount control of atmospheric pollutants. An atmospheric diffusion model of sulfur dioxide on the surface of the earth was established and tested in Shantou of Guangdong Province on the basis of an overall assessment of regional natural environment, social economic state of development, pollution sources and atmospheric environmental quality. Compared with actual monitoring results in a studied region, simulation values fell within the range of two times of error and were evenly distributed in the two sides of the monitored values. Predicted with the largest emission model method, the largest emission of sulfur dioxide would be 54,279.792 tons per year in 2010. The mathematical model established and revised on the basis of GIS is more rational and suitable for the regional characteristics of total amount control of air pollutants.

  1. Application of the control variate technique to estimation of total sensitivity indices

    International Nuclear Information System (INIS)

    Kucherenko, S.; Delpuech, B.; Iooss, B.; Tarantola, S.

    2015-01-01

    Global sensitivity analysis is widely used in many areas of science, biology, sociology and policy planning. The variance-based methods also known as Sobol' sensitivity indices has become the method of choice among practitioners due to its efficiency and ease of interpretation. For complex practical problems, estimation of Sobol' sensitivity indices generally requires a large number of function evaluations to achieve reasonable convergence. To improve the efficiency of the Monte Carlo estimates for the Sobol' total sensitivity indices we apply the control variate reduction technique and develop a new formula for evaluation of total sensitivity indices. Presented results using well known test functions show the efficiency of the developed technique. - Highlights: • We analyse the efficiency of the Monte Carlo estimates of Sobol' sensitivity indices. • The control variate technique is applied for estimation of total sensitivity indices. • We develop a new formula for evaluation of Sobol' total sensitivity indices. • We present test results demonstrating the high efficiency of the developed formula

  2. Lifetime total and beverage specific - alcohol intake and prostate cancer risk: a case-control study

    Directory of Open Access Journals (Sweden)

    Carruba Giuseppe

    2004-12-01

    Full Text Available Abstract Background We investigated lifetime alcohol consumption and prostate cancer risk in a case-control study conducted in Buffalo, NY (1998–2001. Methods The study included 88 men, aged 45 to 85 years with incident, histologically-confirmed prostate cancer and 272 controls. We conducted extensive in-person interviews regarding lifetime alcohol consumption and other epidemiologic data. Results Prostate cancer risk was not associated with lifetime intake of total and beverage specific ethanol. In addition we found no association with number of drinks per day (average drinks per day over the lifetime or drinks per drinking day (average drinks per day on drinking days only over the lifetime. However, we observed an inverse association with the total number of drinking years. Men in the lowest tertile of total drinking years had a two-fold prostate cancer risk than men in the highest tertile (OR 2.16, 95% CI 0.98–4.78, p for trend Conclusion Our results suggest that alcohol intake distribution across lifetime may play a more important role in prostate cancer etiology than total lifetime consumption.

  3. FY97 nuclear-related budgets total 493 billion yen (4.4 billion dollars)

    International Nuclear Information System (INIS)

    Anon.

    1996-01-01

    On September 13, the Atomic Energy Commission of Japan announced the estimated nuclear-related budget requests for FY1997 (April, 1997 - Mach, 1998), giving the breakdowns for eight ministries and agencies. The total amount requested by the government bodies was 493.3 billion yen, 0.8% increase as compared with FY96. this figure includes the budget requests of the Science and Technology Agency (STA), the Ministry of International Trade and Industry (MITI), the Ministry of Foreign Affairs, the Ministry of Transport, the Ministry of Agriculture, Forestry and Fisheries, the Okinawa Development Agency, and the Ministry of Home Affairs, but excludes the budget request made by the Ministry of Education. The budget requests of STA and MITI are 360 billion yen and 126 billion yen, respectively. On August 29, STA released its estimated FY97 budget request. The nuclear-related 360.4 billion yen is 0.9% more than that in year before. Of this sum, 199.9 billion yen is in the general account, and 160.6 billion yen is in the special account for power source development. The details of the nuclear-related amounts are explained. On August 26, MITI released its estimated budget request for FY97, and of the nuclear-related 125.7 billion yen (0.1% increase from FY96), 200 million yen is in the general account, and 98.9 billion yen and 26.6 billion yen are in the special accounts for power resource development and power source diversification, respectively. (K.I.)

  4. Feasibility Study of Correcting Circuit Scheme for Automatic Control System of Total Air in Boiler

    Directory of Open Access Journals (Sweden)

    V. I. Nazarov

    2013-01-01

    Full Text Available The paper contains results of investigations on dynamic characteristics automatic control system (ACS for total air consumption (TAC in a boiler with corrections for О2 and СО. From transition process point of view the ACS TAC with correction for СО is considered as the most optimum one as with disturbance attack on fuel expenditure so discharging beyond boiler furnace.

  5. Total reduction of distorted echelle spectrograms - An automatic procedure. [for computer controlled microdensitometer

    Science.gov (United States)

    Peterson, R. C.; Title, A. M.

    1975-01-01

    A total reduction procedure, notable for its use of a computer-controlled microdensitometer for semi-automatically tracing curved spectra, is applied to distorted high-dispersion echelle spectra recorded by an image tube. Microdensitometer specifications are presented and the FORTRAN, TRACEN and SPOTS programs are outlined. The intensity spectrum of the photographic or electrographic plate is plotted on a graphic display. The time requirements are discussed in detail.

  6. Longitudinal changes in total brain volume in schizophrenia: relation to symptom severity, cognition and antipsychotic medication.

    Directory of Open Access Journals (Sweden)

    Juha Veijola

    Full Text Available Studies show evidence of longitudinal brain volume decreases in schizophrenia. We studied brain volume changes and their relation to symptom severity, level of function, cognition, and antipsychotic medication in participants with schizophrenia and control participants from a general population based birth cohort sample in a relatively long follow-up period of almost a decade. All members of the Northern Finland Birth Cohort 1966 with any psychotic disorder and a random sample not having psychosis were invited for a MRI brain scan, and clinical and cognitive assessment during 1999-2001 at the age of 33-35 years. A follow-up was conducted 9 years later during 2008-2010. Brain scans at both time points were obtained from 33 participants with schizophrenia and 71 control participants. Regression models were used to examine whether brain volume changes predicted clinical and cognitive changes over time, and whether antipsychotic medication predicted brain volume changes. The mean annual whole brain volume reduction was 0.69% in schizophrenia, and 0.49% in controls (p = 0.003, adjusted for gender, educational level, alcohol use and weight gain. The brain volume reduction in schizophrenia patients was found especially in the temporal lobe and periventricular area. Symptom severity, functioning level, and decline in cognition were not associated with brain volume reduction in schizophrenia. The amount of antipsychotic medication (dose years of equivalent to 100 mg daily chlorpromazine over the follow-up period predicted brain volume loss (p = 0.003 adjusted for symptom level, alcohol use and weight gain. In this population based sample, brain volume reduction continues in schizophrenia patients after the onset of illness, and antipsychotic medications may contribute to these reductions.

  7. Insight into the Physical and Dynamical Processes that Control Rapid Increases in Total Flash Rate

    Science.gov (United States)

    Schultz, Christopher J.; Carey, Lawrence D.; Schultz, Elise V.; Blakeslee, Richard J.; Goodman, Steven J.

    2015-01-01

    Rapid increases in total lightning (also termed "lightning jumps") have been observed for many decades. Lightning jumps have been well correlated to severe and hazardous weather occurrence. The main focus of lightning jump work has been on the development of lightning algorithms to be used in real-time assessment of storm intensity. However, in these studies it is typically assumed that the updraft "increases" without direct measurements of the vertical motion, or specification of which updraft characteristic actually increases (e.g., average speed, maximum speed, or convective updraft volume). Therefore, an end-to-end physical and dynamical basis for coupling rapid increases in total flash rate to increases in updraft speed and volume must be understood in order to ultimately relate lightning occurrence to severe storm metrics. Herein, we use polarimetric, multi-Doppler, and lightning mapping array measurements to provide physical context as to why rapid increases in total lightning are closely tied to severe and hazardous weather.

  8. Total deposition of inhaled particles related to age: comparison with age-dependent model calculations

    International Nuclear Information System (INIS)

    Becquemin, M.H.; Bouchikhi, A.; Yu, C.P.; Roy, M.

    1991-01-01

    To compare experimental data with age-dependent model calculations, total airway deposition of polystyrene aerosols (1, 2.05 and 2.8 μm aerodynamic diameter) was measured in ten adults, twenty children aged 12 to 15 years, ten children aged 8 to 12, and eleven under 8 years old. Ventilation was controlled, and breathing patterns were appropriate for each age, either at rest or at light exercise. Individually, deposition percentages increased with particle size and also from rest to exercise, except in children under 12 years, in whom they decreased from 20-21.5 to 14-14.5 for 1 μm particles and from 36.8-36.9 to 32.2-33.1 for 2.05 μm particles. Comparisons with the age-dependent model showed that, at rest, the observed data concerning children agreed with those predicted and were close to the adults' values, when the latter were higher than predicted. At exercise, child data were lower than predicted and lower than adult experimental data, when the latter agreed fairly well with the model. (author)

  9. Use of intravenous tranexamic acid in total knee arthroplasty: a meta-analysis of randomized controlled trials

    Directory of Open Access Journals (Sweden)

    FU De-jie

    2013-04-01

    Full Text Available 【Abstract】 Objective: The effect of tranexamic acid (TA on patients receiving total knee arthroplasty (TKA has been reported in many small clinical trials. But single trials are not sufficient enough to clarify the effectiveness and safety of TA. So, we carried out a meta-analysis of randomized controlled trials to investigate the efficacy and safety of the intravenous use of TA in TKA. Methods: Literatures were retrieved in Cochrane Library, OVID, PubMed, EMBASE, CNKI and Wanfang Data. All the related literatures were checked by two independent investigators and only the high quality randomized con-trolled trials were enrolled. Relevant data were analyzed using RevMan 5.1 to compare the difference of blood loss, transfusion and complications between TA group and con-trol group. Results: There were 353 related literatures and only 22 randomized controlled trials met the inclusion criteria. The use of TA in TKA significantly reduced total blood loss by a mean of 435.41 ml (95% CI 300.62-570.21, P<0.01, post-operative blood loss by a mean of 406.69 ml (95% CI 333.16-480.22, P<0.01. TA also significantly lowered the transfu-sion rate (risk difference 0.30, 95% CI 0.21-0.39, P<0.01 and transfusion volume (mean difference 0.95 unit, 95% CI 0.53-1.37, P<0.01. The risks between TA group and control group in developing deep vein thrombosis and pulmonary embo-lism were not statistically significant. Conclusion: TA is beneficial for patients undergoing TKA, which can significantly reduce total blood loss, post-operative blood loss, transfusion rate, and transfusion volume. Meanwhile TA is recommended to reduce deep vein thrombosis and pulmonary embolism following TKA. Key words: Tranexamic acid; Arthroplasty; Knee; Blood loss, surgical; Meta-analysis

  10. Total quality control: the deming management philosophy applied to nuclear power plants

    International Nuclear Information System (INIS)

    Heising, C.D.; Wetherell, D.L.; Melhem, S.A.; Sato, M.

    1987-01-01

    In recent years, a call has come for the development of inherently safe nuclear reactor systems that cannot have large-scale accidents. In the search for the perfect inherently safe reactor system, some are calling for the institution of computerized automated control of reactors eliminating most human operators from the control room. A different approach to the problem of the control of inherently safe reactors is that both future and present nuclear power plants need to institute total quality control (TQC) to plant operations and management. The Deming management philosophy of TQC has been implemented in a wide range of industries - particularly in Japan and the US. Specific attention is given, however, to TQC implementation in the electric power industry as applied to nuclear plants. The Kansai Electric Power Company and Florida Power and Light Company have recently implemented TQC. Statistical quality control methods have been applied to monitor and control reactor variables (for example, to the steam generator water level important to start-up operations of pressurized water reactors)

  11. Liposomal bupivacaine versus traditional bupivacaine for pain control after total hip arthroplasty

    Science.gov (United States)

    Ma, Ting-Ting; Wang, Yu-Hui; Jiang, Yun-Feng; Peng, Cong-Bin; Yan, Chao; Liu, Zi-Gui; Xu, Wei-Xing

    2017-01-01

    Abstract Background: In the past, the efficacy of local infiltration of liposomal bupivacaine for total hip arthroplasty (THA) patients was in debate. Therefore, this meta-analysis was conducted to determine whether local infiltration of liposomal bupivacaine provides better pain relief after THA. Methods: We searched Web of Science, PubMed, Embase, and the Cochrane Library databases to the April 2017. Any studies comparing liposomal bupivacaine and traditional bupivacaine were included in our meta-analysis. The outcomes included visual analog scale (VAS) at 24, 48, and 72 hours, total morphine consumption at 24 hours, and the length of hospital stay. We assessed the pooled data using a random-effect model. Results: Six studies were finally included in this meta-analysis. Our pooled data analysis demonstrated that liposomal bupivacaine was more effective than the traditional bupivacaine in terms of VAS at 24 hours (P  =  .018) and the length of hospital stay (P  =  .000). There was no significant difference in terms of the VAS at 48 and 72 hours and total morphine consumption at 24 hours (P >.05). Conclusion: Compared with the traditional bupivacaine, liposomal bupivacaine shows better pain control at 24 hours and reduces the length of hospital stay after THA. Its economic costs must be assessed in multimodal center randomized controlled trials when being recommended as a long-acting alternative analgesic agent for a THA patient. PMID:28640101

  12. Liposomal bupivacaine versus traditional bupivacaine for pain control after total hip arthroplasty: A meta-analysis.

    Science.gov (United States)

    Ma, Ting-Ting; Wang, Yu-Hui; Jiang, Yun-Feng; Peng, Cong-Bin; Yan, Chao; Liu, Zi-Gui; Xu, Wei-Xing

    2017-06-01

    In the past, the efficacy of local infiltration of liposomal bupivacaine for total hip arthroplasty (THA) patients was in debate. Therefore, this meta-analysis was conducted to determine whether local infiltration of liposomal bupivacaine provides better pain relief after THA. We searched Web of Science, PubMed, Embase, and the Cochrane Library databases to the April 2017. Any studies comparing liposomal bupivacaine and traditional bupivacaine were included in our meta-analysis. The outcomes included visual analog scale (VAS) at 24, 48, and 72 hours, total morphine consumption at 24 hours, and the length of hospital stay. We assessed the pooled data using a random-effect model. Six studies were finally included in this meta-analysis. Our pooled data analysis demonstrated that liposomal bupivacaine was more effective than the traditional bupivacaine in terms of VAS at 24 hours (P  =  .018) and the length of hospital stay (P  =  .000). There was no significant difference in terms of the VAS at 48 and 72 hours and total morphine consumption at 24 hours (P >.05). Compared with the traditional bupivacaine, liposomal bupivacaine shows better pain control at 24 hours and reduces the length of hospital stay after THA. Its economic costs must be assessed in multimodal center randomized controlled trials when being recommended as a long-acting alternative analgesic agent for a THA patient.

  13. Perioperative celecoxib administration for pain management after total knee arthroplasty – A randomized, controlled study

    Directory of Open Access Journals (Sweden)

    Lin Wei-Peng

    2008-06-01

    Full Text Available Abstract Background Non-steroidal anti-inflammatory drugs (NSAIDs are recommended for multimodal postoperative pain management. We evaluated opioid-sparing effects and rehabilitative results after perioperative celecoxib administration for total knee arthroplasty. Methods This was a prospective, randomized, observer-blind control study. Eighty patients that underwent total knee arthroplasty were randomized into two groups of 40 each. The study group received a single 400 mg dose of celecoxib, one hour before surgery, and 200 mg of celecoxib every 12 hours for five days, along with patient-controlled analgesic (PCA morphine. The control group received only PCA morphine for postoperative pain management. Visual analog scale (VAS pain scores, active range of motion (ROM, total opioid use and postoperative nausea/vomiting were analyzed. Results Groups were comparable for age, pre-operative ROM, operation duration and intraoperative blood loss. Resting VAS pain scores improved significantly in the celecoxib group, compared with controls, at 48 hrs (2.13 ± 1.68 vs. 3.43 ± 1.50, p = 0.03 and 72 hrs (1.78 ± 1.66 vs. 3.17 ± 2.01, p = 0.02 after surgery. Active ROM also increased significantly in the patients that received celecoxib, especially in the first 72 hrs [40.8° ± 17.3° vs. 25.8° ± 11.5°, p = 0.01 (day 1; 60.7° ± 18.1° vs. 45.0° ± 17.3°, p = 0.004 (day 2; 77.7° ± 15.1° vs. 64.3° ± 16.9°, p = 0.004 (day 3]. Opioid requirements decreased about 40% (p = 0.03 in the celecoxib group. Although patients suffering from post-operative nausea/vomiting decreased from 43% in control group to 28% in celecoxib group, this was not significant (p = 0.57. There were no differences in blood loss (intra- and postoperative between the groups. Celecoxib resulted in no significant increase in the need for blood transfusions. Conclusion Perioperative celecoxib significantly improved postoperative resting pain scores at 48 and 72 hrs, opioid

  14. Quality control for total evaporation technique by surface/thermal ionization mass spectrometer

    International Nuclear Information System (INIS)

    Kato, Seikou; Inoue, Sinichi; Yamaguchi, Katsuyuki; Tsutaki, Yasuhiro

    2007-01-01

    For the measurement of uranium and plutonium isotopic composition, the surface/thermal ionization mass spectrometry is widely used at the both nuclear facilities and safeguards verification laboratories. The progress of instrument specification makes higher sensitivity. The total evaporation technique is one of the latest measurement techniques by using this progress, in which all of uranium or plutonium on the filament would be evaporated by increasing the filament current. The accuracy and precision of this technique is normally checked by using the certified isotope reference materials measurement. But the fluctuation of ion beam is very different by each filament, depending on the chemical form of evaporation. So, it should be considered how to check the measurement quality of unknown samples which has no certified values. This presentation is focused on the monitoring of ion yields and pattern of isotope ratio fluctuation to attain the traceability between reference material and unknown sample as quality control approach of total evaporation technique. (author)

  15. Strategies to determine and control the contributions of indoor air pollution to total inhalation exposure (STRATEX)

    DEFF Research Database (Denmark)

    Cochet, C.; Fernandes, E.O.; Jantunen, M.

    ECA-IAQ (European Collaborative Action, Urban Air, Indoor Environment and Human Exposure), 2006. Strategies to determine and control the contributions of indoor air pollution to total inhalation exposure (STRATEX), Report No 25. EUR 22503 EN. Luxembourg: Office for Official Publications...... of the European Communities It is now well established that indoor air pollution contributes significantly to the global burden of disease of the population. Therefore, the knowledge of this contribution is essential in view of risk assessment and management. The ECA STRATEX report collates the respective...... information and describes the strategies to determine population exposure to indoor air pollutants. Its major goal is to emphasise the importance of the contribution of indoor air to total air exposure. Taking this contribution into account is a prerequisite for sound risk assessment of air pollution...

  16. Does circumpatellar electrocautery improve the outcome after total knee replacement?: a prospective, randomised, blinded controlled trial.

    Science.gov (United States)

    Baliga, S; McNair, C J; Barnett, K J; MacLeod, J; Humphry, R W; Finlayson, D

    2012-09-01

    The incidence of anterior knee pain following total knee replacement (TKR) is reported to be as high as 49%. The source of the pain is poorly understood but the soft tissues around the patella have been implicated. In theory circumferential electrocautery denervates the patella thereby reducing efferent pain signals. However, there is mixed evidence that this practice translates into improved outcomes. We aimed to investigate the clinical effect of intra-operative circumpatellar electrocautery in patients undergoing TKR using the LCS mobile bearing or Kinemax fixed bearing TKR. A total of 200 patients were randomised to receive either circumpatellar electrocautery (diathermy) or not (control). Patients were assessed by visual analogue scale (VAS) for anterior knee pain and Oxford knee score (OKS) pre-operatively and three months, six months and one year post-operatively. Patients and assessors were blinded. There were 91 patients in the diathermy group and 94 in the control. The mean VAS improvement at one year was 3.9 in both groups (control; -10 to 6, diathermy; -9 to 8, p electrocautery on either VAS anterior knee pain or OKS for patients undergoing LCS and Kinemax TKR.

  17. Total aircraft flight-control system - Balanced open- and closed-loop control with dynamic trim maps

    Science.gov (United States)

    Smith, G. A.; Meyer, G.

    1979-01-01

    The availability of the airborne digital computer has made possible a Total Aircraft Flight Control System (TAFCOS) that uses virtually the complete nonlinear propulsive and aerodynamic data for the aircraft to construct dynamic trim maps that represent an inversion of the aircraft model. The trim maps, in series with the aircraft, provide essentially a linear feed-forward path. Basically, open-loop trajectory control is employed with only a small perturbation feedback signal required to compensate for inaccuracy in the aircraft model and for external disturbances. Simulation results for application to an automatic carrier-landing system are presented. Flight-test results for a STOL aircraft operating automatically over a major portion of its flight regime are presented. The concept promises a more rapid and straightforward design from aerodynamic principles, particularly for highly nonlinear configurations, and requires substantially less digital computer capacity than conventional automatic flight-control system designs.

  18. Control of total voltage in the large distributed RF system of LEP

    CERN Document Server

    Ciapala, Edmond

    1995-01-01

    The LEP RF system is made up of a large number of independent RF units situated around the ring near the interaction points. These have different available RF voltages depending on their type and they may be inactive or unable to provide full voltage for certain periods. The original RF voltage control system was based on local RF unit voltage function generators pre-loaded with individual tables for energy ramping. This was replaced this year by a more flexible global RF voltage control system. A central controller in the main control room has direct access to the units over the LEP TDM system via multiplexers and local serial links. It continuously checks the state of all the units and adjusts their voltages to maintain the desired total voltage under all conditions. This voltage is distributed among the individual units to reduce the adverse effects of RF voltage asymmetry around the machine as far as possible. The central controller is a VME system with 68040 CPU and real time multitasking operating syste...

  19. Driver electronics design and control for a total artificial heart linear motor.

    Science.gov (United States)

    Unthan, Kristin; Cuenca-Navalon, Elena; Pelletier, Benedikt; Finocchiaro, Thomas; Steinseifer, Ulrich

    2018-01-27

    For any implantable device size and efficiency are critical properties. Thus, a linear motor for a Total Artificial Heart was optimized with focus on driver electronics and control strategies. Hardware requirements were defined from power supply and motor setup. Four full bridges were chosen for the power electronics. Shunt resistors were set up for current measurement. Unipolar and bipolar switching for power electronics control were compared regarding current ripple and power losses. Here, unipolar switching showed smaller current ripple and required less power to create the necessary motor forces. Based on calculations for minimal power losses Lorentz force was distributed to the actor's four coils. The distribution was determined as ratio of effective magnetic flux through each coil, which was captured by a force test rig. Static and dynamic measurements under physiological conditions analyzed interaction of control and hardware and all efficiencies were over 89%. In conclusion, the designed electronics, optimized control strategy and applied current distribution create the required motor force and perform optimal under physiological conditions. The developed driver electronics and control offer optimized size and efficiency for any implantable or portable device with multiple independent motor coils. Graphical Abstract ᅟ.

  20. Application of Adaptive Starling-Like Controller to Total Artificial Heart Using Dual Rotary Blood Pumps.

    Science.gov (United States)

    Ng, Boon C; Smith, Peter A; Nestler, Frank; Timms, Daniel; Cohn, William E; Lim, Einly

    2017-03-01

    The successful clinical applicability of rotary left ventricular assist devices (LVADs) has led to research interest in devising a total artificial heart (TAH) using two rotary blood pumps (RBPs). The major challenge when using two separately controlled LVADs for TAH support is the difficulty in maintaining the balance between pulmonary and systemic blood flows. In this study, a starling-like controller (SLC) hybridized with an adaptive mechanism was developed for a dual rotary LVAD TAH. The incorporation of the adaptive mechanism was intended not only to minimize the risk of pulmonary congestion and atrial suction but also to match cardiac demand. A comparative assessment was performed between the proposed adaptive starling-like controller (A-SLC) and a conventional SLC as well as a constant speed controller. The performance of all controllers was evaluated by subjecting them to three simulated scenarios [rest, exercise, head up tilt (HUT)] using a mock circulation loop. The overall results showed that A-SLC was superior in matching pump flow to cardiac demand without causing hemodynamic instabilities. In contrast, improper flow regulation by the SLC resulted in pulmonary congestion during exercise. From resting supine to HUT, overpumping of the RBPs at fixed speed (FS) caused atrial suction, whereas implementation of SLC resulted in insufficient flow. The comparative study signified the potential of the proposed A-SLC for future TAH implementation particularly among outpatients, who are susceptible to variety of clinical scenarios.

  1. What is the Quality of Online Resources About Pain Control After Total Knee Arthroplasty?

    Science.gov (United States)

    Schairer, William W; Kahlenberg, Cynthia A; Sculco, Peter K; Nwachukwu, Benedict U

    2017-12-01

    With the growing opioid crisis in the United States, there has been a push to reduce the utilization of opioids in favor of multimodal analgesia options. The purpose of this study was to evaluate the quality of online resources that patients may use to learn about pain control after total knee arthroplasty (TKA). We identified websites using a combination of search terms about TKA and pain control. A novel grading rubric was created with 25 maximum points, consisting of items that were deemed important for patients to know about the subject. Three authors then independently graded websites and the results averaged. Flesch-Kinkaid reading level was also evaluated. After identifying 166 unique websites, 32 met final inclusion criteria. The overall scores were low-4.7 of 25 total points (18.8%), written at an average 10th grade level. Subgroup scores were 50% for route of administration, 40% for types of analgesia, 23% for opioid-specific items, and 30% for general guidance. Only about half discussed the risks of opioid dependency. The top 3 website total scores ranged from 10.7-12.5 of 25 points. There is a paucity of online information for TKA patients to read about pain control. Most websites provide limited educational content, particularly about opioids. Higher quality information is needed to help patients make decisions with their physicians and to help combat the opioid epidemic. Given the lack of quality information available, there is an opportunity for subspecialty organizations to take a leadership role in such efforts. Copyright © 2017 Elsevier Inc. All rights reserved.

  2. Factors controlling upper tropospheric relative humidity

    Directory of Open Access Journals (Sweden)

    B. Kärcher

    2004-03-01

    Full Text Available Factors controlling the distribution of relative humidity in the absence of clouds are examined, with special emphasis on relative humidity over ice (RHI under upper tropospheric and lower stratospheric conditions. Variations of temperature are the key determinant for the distribution of RHI, followed by variations of the water vapor mixing ratio. Multiple humidity modes, generated by mixing of different air masses, may contribute to the overall distribution of RHI, in particular below ice saturation. The fraction of air that is supersaturated with respect to ice is mainly determined by the distribution of temperature. The nucleation of ice in cirrus clouds determines the highest relative humdity that can be measured outside of cirrus clouds. While vertical air motion and ice microphysics determine the slope of the distributions of RHI, as shown in a separate study companion (Haag et al., 2003, clouds are not required to explain the main features of the distributions of RHI below the ice nucleation threshold. Key words. Atmospheric composition and structure (pressure, density and temperature; troposphere – composition and chemistry; general or miscellaneous

  3. Factors controlling upper tropospheric relative humidity

    Directory of Open Access Journals (Sweden)

    B. Kärcher

    2004-03-01

    Full Text Available Factors controlling the distribution of relative humidity in the absence of clouds are examined, with special emphasis on relative humidity over ice (RHI under upper tropospheric and lower stratospheric conditions. Variations of temperature are the key determinant for the distribution of RHI, followed by variations of the water vapor mixing ratio. Multiple humidity modes, generated by mixing of different air masses, may contribute to the overall distribution of RHI, in particular below ice saturation. The fraction of air that is supersaturated with respect to ice is mainly determined by the distribution of temperature. The nucleation of ice in cirrus clouds determines the highest relative humdity that can be measured outside of cirrus clouds. While vertical air motion and ice microphysics determine the slope of the distributions of RHI, as shown in a separate study companion (Haag et al., 2003, clouds are not required to explain the main features of the distributions of RHI below the ice nucleation threshold.

    Key words. Atmospheric composition and structure (pressure, density and temperature; troposphere – composition and chemistry; general or miscellaneous

  4. Early and total neonatal mortality in relation to birth setting in the United States, 2006-2009.

    Science.gov (United States)

    Grünebaum, Amos; McCullough, Laurence B; Sapra, Katherine J; Brent, Robert L; Levene, Malcolm I; Arabin, Birgit; Chervenak, Frank A

    2014-10-01

    We examined neonatal mortality in relation to birth settings and birth attendants in the United States from 2006 through 2009. Data from the Centers for Disease Control and Prevention-linked birth and infant death dataset in the United States from 2006 through 2009 were used to assess early and total neonatal mortality for singleton, vertex, and term births without congenital malformations delivered by midwives and physicians in the hospital and midwives and others out of the hospital. Deliveries by hospital midwives served as the reference. Midwife home births had a significantly higher total neonatal mortality risk than deliveries by hospital midwives (1.26 per 1000 births; relative risk [RR], 3.87 vs 0.32 per 1000; P home births of 41 weeks or longer (1.84 per 1000; RR, 6.76 vs 0.27 per 1000; P home births of women with a first birth (2.19 per 1000; RR, 6.74 vs 0.33 per 1000; P home births, neonatal mortality for first births was twice that of subsequent births (2.19 vs 0.96 per 1000; P home births compared with midwife hospital births was 9.32 per 10,000 births, and the excess early neonatal mortality was 7.89 per 10,000 births. Our study shows a significantly increased total and early neonatal mortality for home births and even higher risks for women of 41 weeks or longer and women having a first birth. These significantly increased risks of neonatal mortality in home births must be disclosed by all obstetric practitioners to all pregnant women who express an interest in such births. Copyright © 2014 Elsevier Inc. All rights reserved.

  5. Integration of virtual control units in the total vehicle simulation; Integration virtueller Steuergeraete in die Gesamtfahrzeugsimulation

    Energy Technology Data Exchange (ETDEWEB)

    Soppa, Andreas; Lund, Christoph [Volkswagen AG, Wolfsburg (Germany)

    2012-11-01

    In this article the simulation of information and energetics of vehicles with model-integration of electronic control units (ECU) in a simulation, based on the coupling of physical and control components of the total vehicle are investigated. For that simplified models of ECU's, simulating the functionally of the real ECU's, were used. The integration of virtual EUC's in models of full vehicles makes it possible to simulate the energetics for different driving cycles in a realistic way. By better simulation results an evaluation of physical components and the amount of functions are possible. In the area of the thermal management of vehicles by this analyses and optimizations of functions become possible. This article shows the advantages of embedding virtual ECU's in simulations of full vehicles. (orig.)

  6. Changes in Psychological Status and Health-Related Quality of Life Following Total Shoulder Arthroplasty.

    Science.gov (United States)

    Cho, Chul-Hyun; Song, Kwang-Soon; Hwang, Ilseon; Coats-Thomas, Margaret S; Warner, Jon J P

    2017-06-21

    There has been little documentation of the effects of total shoulder arthroplasty (TSA) on psychological status and health-related quality of life (HRQoL). We investigated changes in psychological status (depression and anxiety) and HRQoL following TSA and assessed the effect of preoperative psychological status on postoperative clinical and functional outcome. We hypothesized that TSA would improve both psychological status and HRQoL. We prospectively enrolled 46 patients undergoing TSA for osteoarthritis. Preoperatively and at 3, 6, and 12 months postoperatively, all of the subjects completed the visual analog scale (VAS) for pain, the American Shoulder and Elbow Surgeons Scale (ASES), the Subjective Shoulder Value (SSV) measure, the Hospital Anxiety and Depression Scale (HADS), and the World Health Organization Quality of Life Scale Abbreviated Version (WHOQOL-BREF). From 3 months after surgery, significant improvement in HADS-depression, HADS-anxiety, and WHOQOL-BREF scores as well as in the other outcome measures of VAS pain score, ASES score, and SSV were observed. The prevalence of depression and anxiety decreased from a rate of 15.2% and 19.5%, respectively, preoperatively to a rate of 6.5% for each at 12 months postoperatively. Preoperative HADS-depression and HADS-anxiety scores did not correlate with any of the clinical and functional outcome measures at 12 months after surgery. This study showed significant improvement in psychological status and HRQoL as well as in pain and functional ability from 3 months after TSA in patients with osteoarthritis. Preoperative depression and anxiety did not predict poor postoperative outcome. Our findings suggest that TSA offers an excellent chance of improving psychological status and HRQoL. Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.

  7. Mitigation of naphthenate related production upsets in high TAN (Total Acid Number) crude oil

    Energy Technology Data Exchange (ETDEWEB)

    Ostojic, Nik [Maersk Oil, Copenhagen (Denmark); Vijn, Pieter; Reiners, Robert [Champion Technologies Europe BV, Delden (Netherlands)

    2012-07-01

    This paper describes a strategy for prediction, evaluation and mitigation of calcium naphthenate related production problems. Developing fields with acidic crude in the North Sea, West Africa, Bohai Bay (China) and Brazil is becoming more common in recent years. The high acid crude contains a considerable amount of naphthenic acids, typically having a Total Acid Number (TAN) higher than 0.5 mg KOH/g. Formation of either hard type 'calcium naphthenate precipitates' or soft type 'sodium carboxylate/emulsions' during crude oil production can lead to severe flow assurance and separation problems. In severe cases this may lead to production shutdowns to clean-up the equipment. A number of different naphthenate mitigation approaches have been published but no one particular approach is considered to be the most efficient as it depends significantly on the particular field conditions. Initially, this problem was addressed by deploying large volumes of (usually organic) acid, but more recently high efficiency low dose naphthenate inhibitors have been introduced. For predicting naphthenate scaling potential, methods were developed to determine the concentration of 1230 Dalton naphthenic tetra acid (ARN acids) in either deposit or crude oil and this information can be used to locate and potentially isolate the problem to a certain reservoir. Also, methods were developed to design suitable low dose naphthenate inhibitors. As these inhibitors are field tested, monitoring is required to ensure the product is performing most efficiently. In cases of tight emulsions however, this is less difficult as the oil dehydration and water quality is affected instantly. Methods were developed to allow monitoring of the calcium naphthenate deposition in field trails, thus allow trending and evaluation of the chemicals performance. After detailed analyses and discussions of the developed methods, a North Sea case history is presented reviewing several years of treating

  8. Review of the total system related to operation of nuclear-powered ship

    International Nuclear Information System (INIS)

    Takamasa, Tomoji; Miyashita, Kunio

    2000-01-01

    It is essential to establish a marine reactor having excellent safety and reliability, which is capable of competing economically with conventional ships, and which can be accepted by international society, in order to be prepared for practical application of future nuclear-powered ships. For this purpose, it is important not only to demonstrate a marine reactor using a model or test device to simulate actual operation, but also to establish the environmental requirements for operation of a nuclear-powered ship, such as safety standards that are operationally and internationally common for ships, and to establish a repair base for nuclear-powered ships. Systems research for the practical application of nuclear-powered ships was conducted for five years, fiscal years 1992 through 1996, by a group in the Japan Atomic Energy Research Institute (JAERI), under the project title 'Review of the total system related to operation of nuclear-powered ships.' The project sought to summarize requirements for the practical application of nuclear-powered ships from the standpoint of the need side, e.g., what nuclear-powered ships will be requested, and what functions will be provided under the expected future social environment; to show a complete system concept for the operation of nuclear-powered ships; and to clarify the situations creating demand for nuclear-powered ships, as well as the system and environmental conditions to be established for operation of practical nuclear-powered ships. Study considerations included the size of the operation system for a nuclear-powered ship, a scenario for introducing a nuclear-powered container ship, and economic evolution from the effects on the whole shipping system, based on container ships, of introducing a nuclear-powered ship. The results of these considerations were made the framework for constructing an entire system and evaluating its economy. The treatment and disposal of radioactive waste from a nuclear-powered ship, and the

  9. Retrograde approach for the recanalization of coronary chronic total occlusion: collateral selection and collateral related complication.

    Science.gov (United States)

    Ma, Jian-Ying; Qian, Ju-Ying; Ge, Lei; Fan, Bing; Wang, Qi-Bing; Yan, Yan; Zhang, Feng; Yao, Kang; Huang, Dong; Ge, Jun-Bo

    2013-03-01

    The retrograde approach through collaterals has been applied in the treatment of chronic total occlusion (CTO) lesions during percutaneous recanalization of coronary arteries. This study was to investigate the success rate of recanalization and collateral related complications in patients when using the retrograde approach. Eighty-four cases subjected to retrograde approach identified from July 2005 to July 2012 were included in this study. Patient characteristics, procedural outcomes and in-hospital clinical events were evaluated. Mean age of the patient was (59.6 ± 11.2) years old and 91.7% were men. The target CTO lesions were distributed among the left anterior descending artery in 45 cases (53.5%), left circumflex artery in one case (1.2%), right coronary artery in 34 cases (40.5%), and left main in four cases (4.8%). The overall success rate of recanalization was 79.8%. The septal collateral was three times more frequently used for retrograde access than the epicardial collateral, 68/84 (81%) vs. 16/84 (19%). Successful wire passage through the collateral channel was achieved in 58 (72.6%) patients. The success rate of recanalization was 93.1% (54/58) in patients with and 50% (13/26) in patients without successful retrograde wire passage of the collateral channel (P collaterals was achieved in 49 of 68 septal collaterals (72.1%) and in 9 of 16 epicardial collaterals (56.3%) (P = NS). There was no significant difference between the septal collateral group and the epicardial group in the success rate of recanalization after retrograde wire crossing the collaterals (91.8% vs. 100%, P > 0.05). CART or reverse CART technique was used in 15 patients, and 14 patients (93.3%) were recanalized successfully. Collateral related perforation occurred in three (18.8%) cases with the epicardial collateral as the first choice (compared with the septal collateral group (0), P collaterals. The retrograde approach is an effective technique to recanalize CTO lesions, the septal

  10. Total hip arthroplasty and perioperative oral carbohydrate treatment: a randomised, double-blind, controlled trial.

    Science.gov (United States)

    Harsten, Andreas; Hjartarson, Hjörtur; Toksvig-Larsen, Sören

    2012-06-01

    Perioperative oral carbohydrate intake is beneficial to general surgery patients. Total hip arthroplasty is a common surgical procedure, and even a moderate improvement in patient outcome could have a significant effect on the resources needed for these patients. However, few studies have focused on the effects of carbohydrate intake on orthopaedic patients. The purpose of this study was to investigate if perioperative oral carbohydrate intake alters the postoperative course for patients undergoing total hip arthroplasty. The primary hypothesis was that pain scores would be lower in patients treated with carbohydrate. A randomised, double-blind, controlled trial. This study was carried out between September 2009 and April 2011 at a district Swedish hospital that specialises in orthopaedic surgery. Sixty ASA physical status I-III patients scheduled for elective total hip arthroplasty were included. Exclusion criteria were obesity, diabetes, prior hip surgery to the same hip, ongoing infection, immunological deficiency or age less than 50 or more than 80 years. Patients were given 400 ml of either an oral 12.5% carbohydrate solution or a placebo beverage (flavoured water) 1.5 h before and 2 h after surgery. Visual analogue scales were used to score six discomfort parameters. Immediately prior to surgery, the carbohydrate-treated patients were less hungry (median score 9.5 vs. 22 mm) and experienced less nausea (0 vs. 1.5 mm) (Phip arthroplasty.

  11. Randomized Controlled Trial to Evaluate Splenectomy in Total Gastrectomy for Proximal Gastric Carcinoma.

    Science.gov (United States)

    Sano, Takeshi; Sasako, Mitsuru; Mizusawa, Junki; Yamamoto, Seiichiro; Katai, Hitoshi; Yoshikawa, Takaki; Nashimoto, Atsushi; Ito, Seiji; Kaji, Masahide; Imamura, Hiroshi; Fukushima, Norimasa; Fujitani, Kazumasa

    2017-02-01

    To clarify the role of splenectomy in total gastrectomy for proximal gastric cancer. Splenectomy in total gastrectomy is associated with increased operative morbidity and mortality, but its survival benefit is unclear. Previous randomized controlled trials were underpowered and inconclusive. We conducted a multiinstitutional randomized controlled trial. Proximal gastric adenocarcinoma of T2-4/N0-2/M0 not invading the greater curvature was eligible. During the operation, surgeons confirmed that R0 resection was possible with negative lavage cytology, and patients were randomly assigned to either splenectomy or spleen preservation. The primary endpoint was overall survival (OS) and the secondary endpoints were relapse-free survival, operative morbidity, operation time, and blood loss. The trial was designed to confirm noninferiority of spleen preservation to splenectomy in OS with a noninferiority margin of the hazard ratio as 1.21 and 1-sided alpha of 5%. Between June 2002 and March 2009, 505 patients (254 splenectomy, 251 spleen preservation) were enrolled from 36 institutions. Splenectomy was associated with higher morbidity and larger blood loss, but the operation time was similar. The 5-year survivals were 75.1% and 76.4% in the splenectomy and spleen preservation groups, respectively. The hazard ratio was 0.88 (90.7%, confidence interval 0.67-1.16) (splenectomy should be avoided as it increases operative morbidity without improving survival.

  12. Impact of postoperative glycemic control and nutritional status on clinical outcomes after total pancreatectomy.

    Science.gov (United States)

    Shi, Hao-Jun; Jin, Chen; Fu, De-Liang

    2017-01-14

    To evaluate the impact of glycemic control and nutritional status after total pancreatectomy (TP) on complications, tumor recurrence and overall survival. Retrospective records of 52 patients with pancreatic tumors who underwent TP were collected from 2007 to 2015. A series of clinical parameters collected before and after surgery, and during the follow-up were evaluated. The associations of glycemic control and nutritional status with complications, tumor recurrence and long-term survival were determined. Risk factors for postoperative glycemic control and nutritional status were identified. High early postoperative fasting blood glucose (FBG) levels (OR = 4.074, 95%CI: 1.188-13.965, P = 0.025) and low early postoperative prealbumin levels (OR = 3.816, 95%CI: 1.110-13.122, P = 0.034) were significantly associated with complications after TP. Postoperative HbA1c levels over 7% (HR = 2.655, 95%CI: 1.299-5.425, P = 0.007) were identified as one of the independent risk factors for tumor recurrence. Patients with postoperative HbA1c levels over 7% had much poorer overall survival than those with HbA1c levels less than 7% (9.3 mo vs 27.6 mo, HR = 3.212, 95%CI: 1.147-8.999, P = 0.026). Patients with long-term diabetes mellitus (HR = 15.019, 95%CI: 1.278-176.211, P = 0.031) and alcohol history (B = 1.985, SE = 0.860, P = 0.025) tended to have poor glycemic control and lower body mass index levels after TP, respectively. At least 3 mo are required after TP to adapt to diabetes and recover nutritional status. Glycemic control appears to have more influence over nutritional status on long-term outcomes after TP. Improvement in glycemic control and nutritional status after TP is important to prevent early complications and tumor recurrence, and improve survival.

  13. Functional exercise after total hip replacement (FEATHER a randomised control trial

    Directory of Open Access Journals (Sweden)

    Monaghan Brenda

    2012-11-01

    Full Text Available Abstract Background Prolonged physical impairments in range of movement, postural stability and walking speed are commonly reported following total hip replacement (THR. It is unclear from the current body of evidence what kind of exercises should be performed to maximize patient function and quality of life. Methods/design This will be a single blind multi centre randomized control trial with two arms. Seventy subjects post primary total hip arthroplasty will be randomized into either an experimental group (n=35, or to a control group (n=35. The experimental group will attend a functional exercise class twice weekly for a six week period from week 12 to week 18 post surgery. The functional exercise group will follow a circuit based functional exercise class supervised by a chartered Physiotherapist. The control group will receive usual care. The principal investigator (BM will perform blinded outcome assessments on all patients using validated measures for pain, stiffness, and function using the Western Ontario and Mc Master Universities Osteoarthritis index (WOMAC. This is the primary outcome measurement tool. Secondary outcome measurements include Quality of life (SF-36, 6 min walk test, Visual Analogue Scale, and the Berg Balance score. The WOMAC score will be collated on day five post surgery and repeated at week twelve and week eighteen. All other measurements will be taken at week 12 and repeated at week eighteen. In addition a blinded radiologist will measure gluteus medius cross sectional area using real time ultrasound for all subjects at week 12 and at week 18 to determine if the functional exercise programme has any effect on muscle size. Discussion This randomised controlled trial will add to the body of evidence on the relationship between muscle size, functional ability, balance, quality of life and time post surgery in patients following total hip arthroplasty. The CONSORT guidelines will be followed to throughout. Ethical

  14. Some Operational Aspects Relating to Quality Management and Total Quality Management

    OpenAIRE

    Sorin GRESOI; Aurelian DIACONU

    2013-01-01

    The work pass in review a few basic concepts found in quality management focusing on operational aspects of quality assurance in production activity and continue with issues regarding total quality strategy, the vector of competitiveness on the market.

  15. A Comparison of Concentrations of Sodium and Related Nutrients (Potassium, Total Dietary Fiber, Total and Saturated Fat, and Total Sugar) in Private-Label and National Brands of Popular, Sodium-Contributing, Commercially Packaged Foods in the United States.

    Science.gov (United States)

    Ahuja, Jaspreet K C; Pehrsson, Pamela R; Cogswell, Mary

    2017-05-01

    Private-label brands account for about one in four foods sold in US supermarkets. They provide value to consumers due to their low cost. We know of no US studies comparing the nutrition content of private-label products with corresponding national brand products. The objective was to compare concentrations of sodium and related nutrients (potassium, total dietary fiber, total and saturated fat, and total sugar) in popular sodium-contributing, commercially packaged foods by brand type (national or private-label brand). During 2010 to 2014, the Nutrient Data Laboratory of the US Department of Agriculture obtained 1,706 samples of private-label and national brand products from up to 12 locations nationwide and chemically analyzed 937 composites for sodium and related nutrients. The samples came from 61 sodium-contributing, commercially packaged food products for which both private-label and national brands were among the top 75% to 80% of brands for US unit sales. In this post hoc comparative analysis, the authors assigned a variable brand type (national or private label) to each composite and determined mean nutrient contents by brand type overall and by food product and type. The authors tested for significant differences (Pfoods sampled, differences between brand types were not statistically significant for any of the nutrients studied. However, differences in both directions exist for a few individual food products and food categories. Concentrations of sodium and related nutrients (potassium, total dietary fiber, total and saturated fat, and total sugar) do not differ systematically between private-label and national brands, suggesting that brand type is not a consideration for nutritional quality of foods in the United States. The study data provide public health officials with baseline nutrient content by brand type to help focus US sodium-reduction efforts. Published by Elsevier Inc.

  16. Intra-articular versus intravenous tranexamic acid application in total knee arthroplasty: a meta-analysis of randomized controlled trials.

    Science.gov (United States)

    Mi, Bobin; Liu, Guohui; Zhou, Wu; Lv, Huijuan; Liu, Yi; Zha, Kun; Wu, Qipeng; Liu, Jing

    2017-07-01

    The purpose of this meta-analysis was to compare the blood loss and complications of intra-articular (IA) with intravenous (IV) tranexamic acid (TXA) for total knee arthroplasty (TKA). A comprehensive search of studies was conducted to identify related articles in Pubmed, Embase, Cochrane central Register of Controlled Trials, springerLink, OVID and the Research published from January 1980 to September 2016. All studies that compared IA TXA with IV TXA application on TKA were included. Main outcomes of the two methods were collected and analyzed by using Review Manager 5.3. There were 16 randomized controlled trials with 1308 cases met the criteria. Compared with IV TXA, IA TXA had similar blood volume of drainage, hidden blood loss, transfusion rate and complications (P > 0.05). IA TXA had lower total blood loss than IV TXA, and there was significant difference (P  0.05) when compared with IA TXA. Both IA TXA and single dose of IV TXA are effective in reducing total blood loss and postoperative hemoglobin drop without increasing complications of DVT or PE. The current meta-analysis suggests that 1.5 g TXA by IA administration or 1 g TXA by IV administration 10 min before tourniquet deflation is effective and safe in patients undergoing TKA.

  17. Relation between lower extremity alignment and proximal femur anatomy. Parameters during total hip arthroplasty.

    Science.gov (United States)

    Ollivier, M; Parratte, S; Lecoz, L; Flecher, X; Argenson, J-N

    2013-09-01

    Lower extremity alignment correlates with native femoral offset. Eventual impact of the change in femoral offset induced by total hip arthroplasty (THA) on lower extremity alignment has not been documented. THA significantly changes lower extremity alignment, and the change correlates with the change in femoral offset. We conducted a prospective study of 200 patients with primary hip osteoarthritis or avascular femoral head necrosis who underwent cementless THA. Pre-operative computed-tomography templating was performed and the femoral component was then custom-manufactured to replicate the native femoral anatomy. Mean age was 58 years (range, 28-83 years). Before and at least two years after THA, two observers who were not involved in the surgical procedures used standing antero-posterior long-leg radiographs to determine the mechanical axis of the lower-limb (hip-knee-ankle [HKA] angle), femoral offset, neck-shaft angle (NSA), and lower-limb length discrepancy (LLLD). Mean values pre-operatively and at last follow-up were as follows: HKA angle, 179.2° ± 3.9° (range, 170.5° to 190.5°) and 177.7° ± 3.5°(range, 173° to 187°); LLLD, -0.7 mm (range, -30 mm to +25 mm) and +5.1 mm (range, -7 mm to +21 mm); NSA, 134° ± 7.5° (range, 100° to 124°) and 135° ± 4.2° (range, 124° to 146°); and femoral offset, 42 ± 7.8 mm (range, 24 mm to 68 mm) and 49 ± 7.5 mm (range, 33 mm to 70 mm). Although THA significantly altered lower-limb alignment, univariate and multivariate analyses showed no significant association between the change in HKA angle and the change in femoral offset. Lower-limb alignment was significantly affected by THA, although the HKA angle changes were small. The small impact of THA on HKA angle values may be ascribable to efforts aimed at replicating the native femoral offset during arthroplasty, as well as to the limited sample size and to potential measurement errors related to the small size of the changes. Our results suggest that

  18. The effects of probiotics on total cholesterol: A meta-analysis of randomized controlled trials.

    Science.gov (United States)

    Wang, Lang; Guo, Mao-Juan; Gao, Qing; Yang, Jin-Feng; Yang, Lin; Pang, Xiao-Li; Jiang, Xi-Juan

    2018-02-01

    Probiotics supplements provide a new nonpharmacological alternative to reduce cardiovascular risk factors. The impact of probiotics on the reduction of total cholesterol (TC) remains controversial. We conducted a meta-analysis to showcase the most updated and comprehensive evaluation of the studies. Randomized controlled trials (RCTs) were searched from electronic databases, including PubMed, Embase, Cochrane Central Register of Controlled Trials, Chinese Biomedical Literature Database, China National Knowledge Infrastructure, Wanfang database dating from January 2007 to January 2017. The curative effects of probiotics on the reduction of TC were assessed using mean difference (MD), as well as their 95% confidence interval (CI). RevMan software (version 5.3) was used to carry out this meta-analysis. Thirty-two RCTs including 1971 patients met the inclusion criteria. Results of this analysis showed that compared with the control group serum TC was significantly reduced in probiotics group [MD = -13.27, 95% CI (-16.74 to 9.80), P  6 weeks: [MD = -22.18, 95% CI (-28.73, -15.63), P probiotics forms and intervention duration might have a significant impact on the results. However, strains and doses of probiotics had no significant influence on curative effects. Available evidence indicates that probiotics supplements can significantly reduce serum TC. Furthermore, higher baseline TC, longer intervention time, and probiotics in capsules form might contribute to a better curative effect.

  19. Plasma and salivary total antioxidant capacity in healthy controls compared with aggressive and chronic periodontitis patients.

    Science.gov (United States)

    Baser, Ulku; Gamsiz-Isik, Hikmet; Cifcibasi, Emine; Ademoglu, Evin; Yalcin, Funda

    2015-07-01

    To evaluate the plasma and salivary total antioxidant capacity (TAOC) in patients with generalized chronic periodontitis (CP), generalized aggressive periodontitis (AgP), and periodontally healthy controls. This cross-sectional study includes of 88 individuals seeking dental treatment at the Faculty of Dentistry, Istanbul University, Istanbul, Turkey between January 2011 and March 2012. Fifteen AgP patients were compared with 21 healthy controls (C1), while 36 CP patients were compared with 16 healthy controls (C2). Clinical periodontal measurements were recorded, and plasma and saliva samples were collected. The TAOC of the plasma and saliva samples were determined using a commercially available colorimetric kit. The plasma TAOC of both AgP and CP patients was significantly lower for C1 and C2. The salivary TAOC of CP patients was significantly lower for C2, but there was no significant difference between AgP patients and C1. Our results demonstrate that severe periodontitis may be associated with a lower plasma antioxidant capacity. The reduced antioxidant capacity in patients with severe periodontitis, especially with aggressive forms may be an important contributing factor to severe tissue destruction.

  20. Interventions for the prediction and management of chronic postsurgical pain after total knee replacement: systematic review of randomised controlled trials.

    Science.gov (United States)

    Beswick, Andrew D; Wylde, Vikki; Gooberman-Hill, Rachael

    2015-05-12

    Total knee replacement can be a successful operation for pain relief. However, 10-34% of patients experience chronic postsurgical pain. Our aim was to synthesise evidence on the effectiveness of applying predictive models to guide preventive treatment, and for interventions in the management of chronic pain after total knee replacement. We conducted a systematic review of randomised controlled trials using appropriate search strategies in the Cochrane Library, MEDLINE and EMBASE from inception to October 2014. No language restrictions were applied. Adult patients receiving total knee replacement. Predictive models to guide treatment for prevention of chronic pain. Interventions for management of chronic pain. Reporting of specific outcomes was not an eligibility criterion but we sought outcomes relating to pain severity. No studies evaluated the effectiveness of predictive models in guiding treatment and improving outcomes after total knee replacement. One study evaluated an intervention for the management of chronic pain. The trial evaluated the use of a botulinum toxin A injection with antinociceptive and anticholinergic activity in 49 patients with chronic postsurgical pain after knee replacement. A single injection provided meaningful pain relief for about 40 days and the authors acknowledged the need for a large trial with repeated injections. No trials of multidisciplinary interventions or individualised treatments were identified. Our systematic review highlights a lack of evidence about the effectiveness of prediction and management strategies for chronic postsurgical pain after total knee replacement. As a large number of people are affected by chronic pain after total knee replacement, development of an evidence base about care for these patients should be a research priority. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  1. Age Related Macular Degeneration and Total Hip Replacement Due to Osteoarthritis or Fracture: Melbourne Collaborative Cohort Study.

    Directory of Open Access Journals (Sweden)

    Elaine W Chong

    Full Text Available Osteoarthritis is the leading cause of total hip replacement, accounting for more than 80% of all total hip replacements. Emerging evidence suggests that osteoarthritis has a chronic inflammatory component to its pathogenesis similar to age-related macular degeneration. We evaluated the association between age-related macular degeneration and total hip replacement as proxy for severe osteoarthritis or fractured neck of femur in the Melbourne Collaborative Cohort Study. 20,744 participants had complete data on both age-related macular degeneration assessed from colour fundus photographs taken during 2003-2007 and total hip replacement. Total hip replacements due to hip osteoarthritis and fractured neck of femur during 2001-2011 were identified by linking the cohort records to the Australian Orthopedic Association National Joint Replacement Registry. Logistic regression was used to examine the association between age-related macular degeneration and risk of total hip replacement due to osteoarthritis and fracture separately, adjusted for confounders. There were 791 cases of total hip replacement for osteoarthritis and 102 cases of total hip replacement due to fractured neck of femur. After adjustment for age, sex, body mass index, smoking, and grouped country of birth, intermediate age-related macular degeneration was directly associated with total hip replacement for osteoarthritis (odds ratio 1.22, 95% CI 1.00-1.49. Late age-related macular degeneration was directly associated with total hip replacement due to fractured neck of femur (odds ratio 5.21, 95% CI2.25-12.02. The association between intermediate age-related macular degeneration and an increased 10-year incidence of total hip replacement due to osteoarthritis suggests the possibility of similar inflammatory processes underlying both chronic diseases. The association of late age-related macular degeneration with an increased 10-year incidence of total hip replacement due to fractured

  2. Relation between vitamin D and calcium and post operation hypocalcemia in total thyroidectomy

    Directory of Open Access Journals (Sweden)

    Leila Asefkabiri

    2017-06-01

    Full Text Available Background: Hypocalcemia is one of the most prevalent complications following total thyroidectomy. Over recent years, in addition to hormone parathyroid hormone (PTH, vitamin D has been also studied as a factor causing post-total thyroidectomy hypocalcemia. This survey seeks to study the relationship between the serum level of vitamin D before surgery and during post-total thyroidectomy hypocalcemia. Methods: A group of 57 patients volunteering for total thyroidectomy were studied on Vali-e-Asr Hospital, Tehran, Iran, from March 2013 to March 2015. In all these patients, pre-surgery calcium, vitamin D and parathyroid hormone (PTH as well as the level of calcium during the post-surgery first two days were measured. Based on objectives of this study, the relationship be-tween pre-surgery vitamin D level and post-surgery hypocalcemia was examined. Results: The average age of patients participating in the survey was 24.1±13.3. They included 19 women (33.3% and 38 men, total of 40 patients (70.2%. Their average post-surgery calcium level was 9.2±0.77 milligrams per deciliters (mg/dl and their average vitamin D content before the surgery was 42±12.1 nanomole per liter (nmol/l. The average calcium level before the surgery and the first post-surgery day were meaningfully different in terms of statistics (P0.001. Of 37 patients with pre-surgery vitamin D deficiency, 31 suffered post-surgery second-day hypocalcemia and of 20 patients with vitamin D insufficiency, 18 suffered second-day hypocalcemia. This difference was not statistically meaningful either (P>0.001. Conclusion: The current study showed that the serum level of vitamin D before total thyroidectomy does not have any role in the occurrence of post-surgery hypocalcemia which is almost common after this type of surgery.

  3. [Operative treatment strategies for multiple trauma patients : early total care versus damage control].

    Science.gov (United States)

    Klüter, T; Lippross, S; Oestern, S; Weuster, M; Seekamp, A

    2013-09-01

    The treatment of multiple trauma patients is a great challenge for an interdisciplinary team. After preclinical care and subsequent treatment in the emergency room the order of the interventions is prioritized depending of the individual risk stratification. For planning the surgery management it is essential to distinguish between absolutely essential operations to prevent life-threatening situations for the patient and interventions with shiftable indications, depending on the general condition of the patient. All interventions need to be done without causing significant secondary damage to prohibit hyperinflammation and systemic inflammatory response syndrome. The challenge consists in determination of the appropriate treatment at the right point in time. In general the early primary intervention, early total care, is differentiated from the damage control concept.

  4. Catechol-O-methyltransferase (COMT) genotype affects cognitive control during total sleep deprivation.

    Science.gov (United States)

    Satterfield, Brieann C; Hinson, John M; Whitney, Paul; Schmidt, Michelle A; Wisor, Jonathan P; Van Dongen, Hans P A

    2018-02-01

    Adaptive decision making is profoundly impaired by total sleep deprivation (TSD). This suggests that TSD impacts fronto-striatal pathways involved in cognitive control, where dopamine is a key neuromodulator. In the prefrontal cortex (PFC), dopamine is catabolized by the enzyme catechol-O-methyltransferase (COMT). A functional polymorphism (Val158Met) influences COMT's enzymatic activity, resulting in markedly different levels of prefrontal dopamine. We investigated the effect of this polymorphism on adaptive decision making during TSD. Sixty-six healthy young adults participated in one of two in-laboratory studies. After a baseline day, subjects were randomized to either a TSD group (n = 32) with 38 h or 62 h of extended wakefulness or a well-rested control group (n = 34) with 10 h nighttime sleep opportunities. Subjects performed a go/no-go reversal learning (GNGr) task at well-rested baseline and again during TSD or equivalent control. During the task, subjects were required to learn stimulus-response relationships from accuracy feedback. The stimulus-response relationships were reversed halfway through the task, which required subjects to learn the new stimulus-response relationships from accuracy feedback. Performance on the GNGr task was quantified by discriminability (d') between go and no-go stimuli before and after the stimulus-response reversal. GNGr performance did not differ between COMT genotypes when subjects were well-rested. However, TSD exposed a significant vulnerability to adaptive decision making impairment in subjects with the Val allele. Our results indicate that sleep deprivation degrades cognitive control through a fronto-striatal, dopaminergic mechanism. Copyright © 2017 Elsevier Ltd. All rights reserved.

  5. Indicators for the total duration of premenopausal endogenous estrogen exposure in relation to BMD

    NARCIS (Netherlands)

    Hagemans, M.L.C.; Schouw, van der Y.T.; Kleijn, de M.J.J.; Staveren, van W.A.; Pop, V.J.M.; Leusink, G.L.; Grobbee, D.E.

    2004-01-01

    BACKGROUND: Previous studies have shown that age at menopause is an important indicator of duration of endogenous estrogen exposure. The present study investigates whether combining more information on reproductive factors is useful in estimating individual total duration of exposure to endogenous

  6. Gender Differences in Health-Related Quality of Life Following Total Laryngectomy

    Science.gov (United States)

    Lee, Mary T.; Gibson, Sam; Hilari, Katerina

    2010-01-01

    Background: The impact of a total laryngectomy on an individual's life has primarily been measured from a male viewpoint reflecting the demographics of a diagnosis of laryngeal cancer. A small number of studies have looked specifically at females, but very few are comparison studies. Consequently, there is little consistent research regarding any…

  7. The Relation among School District Health, Total Quality Principles for School Organization and Student Achievement

    Science.gov (United States)

    Marshall, Jon; Pritchard, Ruie; Gunderson, Betsey

    2004-01-01

    The purpose of this study was to determine the congruence among W. E. Deming's 14 points for Total Quality Management (TQM), the organizational health of school districts, and student achievement. Based on Kanter's (1983) concept of a Culture of Pride with a Climate of Success, healthy districts were defined as having an organizational culture…

  8. Large head metal-on-metal cementless total hip arthroplasty versus 28mm metal-on-polyethylene cementless total hip arthroplasty: design of a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    van Raaij Jos JAM

    2008-10-01

    Full Text Available Abstract Background Osteoarthritis of the hip is successfully treated by total hip arthroplasty with metal-on-polyethylene articulation. Polyethylene wear debris can however lead to osteolysis, aseptic loosening and failure of the implant. Large head metal-on-metal total hip arthroplasty may overcome polyethylene wear induced prosthetic failure, but can increase systemic cobalt and chromium ion concentrations. The objective of this study is to compare two cementless total hip arthroplasties: a conventional 28 mm metal-on-polyethylene articulation and a large head metal-on-metal articulation. We hypothesize that the latter arthroplasties show less bone density loss and higher serum metal ion concentrations. We expect equal functional scores, greater range of motion, fewer dislocations, fewer periprosthetic radiolucencies and increased prosthetic survival with the metal-on-metal articulation. Methods A randomized controlled trial will be conducted. Patients to be included suffer from non-inflammatory degenerative joint disease of the hip, are aged between 18 and 80 and are admitted for primary cementless unilateral total hip arthroplasty. Patients in the metal-on-metal group will receive a cementless titanium alloy acetabular component with a cobalt-chromium liner and a cobalt-chromium femoral head varying from 38 to 60 mm. Patients in the metal-on-polyethylene group will receive a cementless titanium alloy acetabular component with a polyethylene liner and a 28 mm cobalt-chromium femoral head. We will assess acetabular bone mineral density by dual energy x-ray absorptiometry (DEXA, serum ion concentrations of cobalt, chromium and titanium, self reported functional status (Oxford hip score, physician reported functional status and range of motion (Harris hip score, number of dislocations and prosthetic survival. Measurements will take place preoperatively, perioperatively, and postoperatively (6 weeks, 1 year, 5 years and 10 years. Discussion

  9. Total belowground carbon flux in subalpine forests is related to leaf area index, soil nitrogen, and tree height

    Science.gov (United States)

    Berryman, Erin Michele; Ryan, Michael G.; Bradford, John B.; Hawbaker, Todd J.; Birdsey, R.

    2016-01-01

    In forests, total belowground carbon (C) flux (TBCF) is a large component of the C budget and represents a critical pathway for delivery of plant C to soil. Reducing uncertainty around regional estimates of forest C cycling may be aided by incorporating knowledge of controls over soil respiration and TBCF. Photosynthesis, and presumably TBCF, declines with advancing tree size and age, and photosynthesis increases yet C partitioning to TBCF decreases in response to high soil fertility. We hypothesized that these causal relationships would result in predictable patterns of TBCF, and partitioning of C to TBCF, with natural variability in leaf area index (LAI), soil nitrogen (N), and tree height in subalpine forests in the Rocky Mountains, USA. Using three consecutive years of soil respiration data collected from 22 0.38-ha locations across three 1-km2 subalpine forested landscapes, we tested three hypotheses: (1) annual soil respiration and TBCF will show a hump-shaped relationship with LAI; (2) variability in TBCF unexplained by LAI will be related to soil nitrogen (N); and (3) partitioning of C to TBCF (relative to woody growth) will decline with increasing soil N and tree height. We found partial support for Hypothesis 1 and full support for Hypotheses 2 and 3. TBCF, but not soil respiration, was explained by LAI and soil N patterns (r2 = 0.49), and the ratio of annual TBCF to TBCF plus aboveground net primary productivity (ANPP) was related to soil N and tree height (r2 = 0.72). Thus, forest C partitioning to TBCF can vary even within the same forest type and region, and approaches that assume a constant fraction of TBCF relative to ANPP may be missing some of this variability. These relationships can aid with estimates of forest soil respiration and TBCF across landscapes, using spatially explicit forest data such as national inventories or remotely sensed data products.

  10. Laparoscopic versus open total mesorectal excision: a case-control study.

    Science.gov (United States)

    Breukink, S O; Pierie, J P E N; Grond, A J K; Hoff, C; Wiggers, T; Meijerink, W J H J

    2005-09-01

    Because definitive long-term results are not yet available, the oncological safety of laparoscopic surgery for treatment of rectal cancer remains unproven. The aim of this prospective non-randomised study was to assess the feasibility and short-term outcome of laparoscopic total mesorectal excision (LTME) after 25--30 Gy preoperative radiotherapy and to compare the results with a matched-control group of open TME (OTME). A series of 41 patients with primary rectal cancer underwent LTME for rectal cancer and were matched with a historical control group of 41 patients who underwent OTME. Both groups received preoperative short-term radiotherapy. There was no mortality in the LTME group and 2% mortality in the OTME group. The overall postoperative morbidity was 37% in the LTME group and 51% in the OTME group, including an anastomotic leakage of 9 and 14% in the LTME and OTME groups respectively. A positive circumferential margin was found in 7% of patients in the LTME group and in 12% of the patients in the OTME group. This study shows that LTME is technically feasible and can be performed safely. We show at least a similar surgical completeness using a laparoscopic technique compared with open surgery.

  11. Interrelationships between lipid peroxidation and total antioxidant status in sedentary controls and unprofessional athletes.

    Science.gov (United States)

    Caimi, Gregorio; Canino, Baldassare; Lo Presti, Rosalia

    2010-01-01

    We examined the thiobarbituric acid-reactive substances (TBARS) as an index of lipid peroxidation, and the total antioxidant status (TAS) in 81 unprofessional athletes subdivided into three subgroups. The first group included 28 subjects who practised endurance sports, the second included 30 subjects who practised mixed sports, the third included 23 subjects who practised power sports. We enrolled also a group of 61 sedentary controls (SC). TBARS were increased and TAS was decreased in the whole group of athletes in comparison with SC; an almost similar behaviour was present also subdividing athletes according to the practised sport. A significant negative correlation between these two parameters emerged in SC but not in the whole group of athletes. Unless for the athletes that practised endurance sports a similar trend was found in athletes that practised mixed and power sports. In conclusion, at rest the symmetrical behaviour between the lipid peroxidation increase and the TAS decrease, observed in sedentary controls, was not evident in unprofessional athletes who practised different sports.

  12. Stop of loss of cognitive performance during rehabilitation after total hip arthroplasty-prospective controlled study.

    Science.gov (United States)

    Brem, Matthias H; Lehrl, Siegfried; Rein, Anna K; Massute, Sylvia; Schulz-Drost, Stefan; Gelse, Kolja; Schlechtweg, Phillip M; Hennig, Friedrich F; Olk, Alexander; Jacob, Harald J; Gusinde, Johannes

    2010-01-01

    Prolonged hospitalization is known to be associated with a loss of cognitive performance. Does playing video games (VGs) developed to improve cognitive properties delay this loss or even lead to an increase in cognitive performance? We performed a 10-day longitudinal study of patients who received total hip arthroplasty. We compared 16 patients (6 male) aged 66 ± 9 years (mean ± standard deviation) who played Dr. Kawashima's Brain Training: How Old Is Your Brain? (Nintendo; Redmond, Washington) on a Nintendo DS handheld console with 16 control patients (6 male) aged 69 ± 14 years. We measured cognitive performance 1 day preoperation, as well as on days 2 and 9 postoperation. With the daily exercise of a specific VG by the play group, the patients' fluid intelligence (median intelligence quotient 99-106), working memory capacity, and rate of information processing significantly improved over the course of 7 postoperative days. The cognitive performance of the control group did not increase. However, the memory spans of both groups did not systematically change. Exercise with VGs can prevent the loss of cognitive performance during prolonged hospitalization.

  13. Position controlled Knee Rehabilitation Orthotic Device for Patients after Total Knee Replacement Arthroplasty

    Science.gov (United States)

    Wannaphan, Patsiri; Chanthasopeephan, Teeranoot

    2016-11-01

    Knee rehabilitation after total knee replacement arthroplasty is essential for patients during their post-surgery recovery period. This study is about designing one degree of freedom knee rehabilitation equipment to assist patients for their post-surgery exercise. The equipment is designed to be used in sitting position with flexion/extension of knee in sagittal plane. The range of knee joint motion is starting from 0 to 90 degrees angle for knee rehabilitation motion. The feature includes adjustable link for different human proportions and the torque feedback control at knee joint during rehabilitation and the control of flexion/extension speed. The motion of the rehabilitation equipment was set to move at low speed (18 degrees/sec) for knee rehabilitation. The rehabilitation link without additional load took one second to move from vertical hanging up to 90° while the corresponding torque increased from 0 Nm to 2 Nm at 90°. When extra load is added, the link took 1.5 seconds to move to 90° The torque is then increased from 0 Nm to 4 Nm. After a period of time, the speed of the motion can be varied. User can adjust the motion to 40 degrees/sec during recovery activity of the knee and users can increase the level of exercise or motion up to 60 degrees/sec to strengthen the muscles during throughout their rehabilitation program depends on each patient. Torque control is included to prevent injury. Patients can use the equipment for home exercise to help reduce the number of hospital visit while the patients can receive an appropriate therapy for their knee recovery program.

  14. Symptoms of mothers and infants related to total volatile organic compounds in household products

    OpenAIRE

    Farrow, A; Taylor, H; Northstone, K; Golding, J

    2003-01-01

    The authors sought to determine whether reported symptoms of mothers and infants were associated significantly with the use of household products that raised indoor levels of total volatile organic compounds (TVOCs). Data collected from 170 homes within the Avon Longitudinal Study of Parents and Children (ALSPAC: a large birth cohort of more than 10,000) had determined which household products were associated with the highest levels of TVOCs. The latter data were collected over a period that ...

  15. Fibrosis-Related Biomarkers and Risk of Total and Cause-Specific Mortality

    Science.gov (United States)

    Agarwal, Isha; Glazer, Nicole L.; Barasch, Eddy; Biggs, Mary L.; Djoussé, Luc; Fitzpatrick, Annette L.; Gottdiener, John S.; Ix, Joachim H.; Kizer, Jorge R.; Rimm, Eric B.; Siscovick, David S.; Tracy, Russell P.; Zieman, Susan J.; Mukamal, Kenneth J.

    2014-01-01

    Fibrosis has been implicated in diverse diseases of the liver, kidney, lungs, and heart, but its importance as a risk factor for mortality remains unconfirmed. We determined the prospective associations of 2 complementary biomarkers of fibrosis, transforming growth factor-β (TGF-β) and procollagen type III N-terminal propeptide (PIIINP), with total and cause-specific mortality risks among community-living older adults in the Cardiovascular Health Study (1996–2010). We measured circulating TGF-β and PIIINP levels in plasma samples collected in 1996 and ascertained the number of deaths through 2010. Both TGF-β and PIIINP were associated with elevated risks of total and pulmonary mortality after adjustment for sociodemographic, clinical, and biochemical risk factors. For total mortality, the hazard ratios per doubling of TGF-β and PIIINP were 1.09 (95% confidence interval (CI): 1.01, 1.17; P = 0.02) and 1.14 (CI: 1.03, 1.27; P = 0.01), respectively. The corresponding hazard ratios for pulmonary mortality were 1.27 (CI: 1.01, 1.60; P = 0.04) for TGF-β and 1.52 (CI: 1.11, 2.10; P = 0.01) for PIIINP. Associations of TGF-β and PIIINP with total and pulmonary mortality were strongest among individuals with higher C-reactive protein concentrations (P for interaction < 0.05). Our findings provide some of the first large-scale prospective evidence that circulating biomarkers of fibrosis measured late in life are associated with death. PMID:24771724

  16. First trimester serum levels of the soluble transcobalamin receptor, holo-transcobalamin, and total transcobalamin in relation to preeclampsia risk

    DEFF Research Database (Denmark)

    Abuyaman, Omar; Torring, Niels; Obeid, Rima

    2016-01-01

    transcobalamin (TC) with the risk of subsequent preeclampsia using serum samples from asymptomatic first trimester pregnant women. Moreover, we aimed to establish reference intervals of the aforementioned biomarkers for first trimester pregnant women who remained healthy throughout pregnancy. STUDY DESIGN...... preeclampsia while the controls remained normotensive throughout pregnancy. We measured the serum concentration of sCD320, holoTC, and total TC by using in-house ELISA methods. RESULTS: First trimester median concentrations of sCD320, holoTC and total TC were not significantly different between cases...... and controls. The odd ratio for developing preeclampsia based on exposure to low or high levels of sCD320, holoTC or total TC at first trimester was not significant. The reference intervals (2.5-97.5% percentiles (median)) derived from the controls were 50-170 (90) pmol\\L for sCD320, 20-140 (70) pmol...

  17. Patient-controlled oral analgesia for postoperative pain management following total knee replacement.

    Science.gov (United States)

    Kastanias, Patti; Gowans, Sue; Tumber, Paul S; Snaith, Kianda; Robinson, Sandra

    2010-01-01

    To investigate whether patient-controlled oral analgesia (PCOA) used by individuals receiving a total knee replacement could reduce pain, increase patient satisfaction, reduce opioid use and/or reduce opioid side effects when compared with traditional nurse (RN)-administered oral analgesia. Patients who underwent an elective total knee replacement at a quaternary care centre (Toronto Western Hospital, Toronto, Ontario) were randomly assigned to either PCOA or RN-administered short-acting oral opioids on postoperative day 2. Subjects in the RN group called the RN to receive their prescribed short-acting opioid. Subjects in the PCOA group kept a single dose of their prescribed oral opioid at their bedside and took this dose when they felt they needed it, to a maximum of one dose every 2 h. Study outcomes, collected on postoperative day 2, included pain (measured by the Brief Pain Inventory - Short Form), patient satisfaction (measured by the Pain Outcome Questionnaire Satisfaction subscale - component II), opioid use (oral morphine equivalents), opioid side effects (nausea, pruritus and/or constipation) and knee measures (maximum passive knee flexion and pain at maximum passive knee flexion, performed on the operative knee). Study outcomes were analyzed twice. First, for a subset of 73 subjects who remained in their randomly assigned group (PCOA group, n=36; RN group, n=37), randomized analyses were performed. Second, for the larger sample of 88 subjects who were categorized by their actual method of receiving oral opioids (PCOA group, n=41; RN group, n=47), as-treated analyses were performed. There were no differences in study outcomes between the PCOA and RN groups in either analysis. PCOA was not superior to RN administration on study outcomes. However, PCOA did not increase opioid use or pain. PCOA remains an important element in the patient-centred care facility.

  18. Can therapy dogs improve pain and satisfaction after total joint arthroplasty? A randomized controlled trial.

    Science.gov (United States)

    Harper, Carl M; Dong, Yan; Thornhill, Thomas S; Wright, John; Ready, John; Brick, Gregory W; Dyer, George

    2015-01-01

    The use of animals to augment traditional medical therapies was reported as early as the 9th century but to our knowledge has not been studied in an orthopaedic patient population. The purpose of this study was to evaluate the role of animal-assisted therapy using therapy dogs in the postoperative recovery of patients after THA and TKA. We asked: (1) Do therapy dogs have an effect on patients' perception of pain after total joint arthroplasty as measured by the VAS? (3) Do therapy dogs have an effect on patients' satisfaction with their hospital stay after total joint arthroplasty as measured by the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS)? A randomized controlled trial of 72 patients undergoing primary unilateral THA or TKA was conducted. Patients were randomized to a 15-minute visitation with a therapy dog before physical therapy or standard postoperative physical therapy regimens. Both groups had similar demographic characteristics. Reduction in pain was assessed using the VAS after each physical therapy session, beginning on postoperative Day 1 and continuing for three consecutive sessions. To ascertain patient satisfaction, the proportion of patients selecting top-category ratings in each subsection of the HCAHPS was compared. Patients in the treatment group had lower VAS scores after each physical therapy session with a final VAS score difference of 2.4 units (animal-assisted therapy VAS, 1.7; SD, 0.97 [95% CI, 1.4-2.0] versus control VAS, 4.1; SD, 0.97 [95% CI, 3.8-4.4], pphysical therapy session. Patients in the treatment group had a higher proportion of top-box HCAHPS scores in the following fields: nursing communication (33 of 36, 92% [95% CI, 78%-98%] versus 69%, 25 of 36 [95% CI, 52%-84%], p=0.035; risk ratio, 1.3 [95% CI of risk ratio, 1.0-1.7]; risk difference, 23% [95% CI of risk difference, 5%-40%]), pain management (34 of 36, 94% [95% CI, 81%-99%], versus 26 of 36, 72% [95% CI, 55%-86%], p=0.024; risk ratio, 1.3 [95

  19. A ppendicitis with Positive Ultrasound and its Relation to Total and Differential Leucocytic Count

    International Nuclear Information System (INIS)

    Saleh, G.M.; Sabek, E.A.S.; Elessiely, E.S.; Ibrahim, E.M.

    2016-01-01

    Background:The most common cause of acute surgical abdomen is acute appendicitis and the most commonly done emergency surgery is appendectomy. Although a battery of tests and different scoring methods are available for diagnosis of acute appendicitis, it is very difficult to prevent negative explorations for appendicectomy (15 - 30%). None of the tests has satisfactory Sensitivity and specificity that can be relied upon. Objectives: The aim of the present study was to evaluate the role of total and differential leukocyte count, and ultrasonography (USG) of abdomen in diagnosing acute appendicitis and reducing the rates of negative appendicectomies and to prevent complications like perforation, peritonitis, and the longer the delay between diagnosis and surgery, the more likely is the perforation leading to peritonitis. In addition, emphasis was given to whether combining the investigations for the same patient would improve the diagnostic accuracy. Materials and Methods : A total of 76 clinically diagnosed patients of acute appendicitis, posted for emergency appendicectomy were included in the study in General Surgery Department of EL-Salam Hospital. This study was conducted in the period October 2012 to September 2013. Preoperatively blood tests for, total leukocyte count, differential leukocyte count(DLC) and USG abdomen were done. All patients were subjected to histological examination postoperatively, which was taken as the gold standard. The three investigations results were correlated with histopathological examination reports to evaluate their role in diagnosis of acute appendicitis. Results: In the present study, the US has the highest sensitivity and specificity (90%, 80%) followed by Total leucocyte count (87.5%, 90%), white Neutrophil count (78.75%, 80%). Combining US and WBC count increases the sensitivity and specificity of the tests (96.25%, 80%). Conclusion: US contains important diagnostic information and hence should always be included in the

  20. Beyond deficit or compensation: new insights on postural control after long-term total visual loss.

    Science.gov (United States)

    Russo, Maitê M; Lemos, Thiago; Imbiriba, Luís A; Ribeiro, Nathalia L; Vargas, Claudia D

    2017-02-01

    Loss of vision is well known to affect postural control in blind subjects. This effect has classically been framed in terms of deficit or compensation depending on whether body sway increases or decreases in comparison with that of sighted subjects with the eyes open. However, studies have shown that postural responses can be modulated by the context and that changes in postural sway may not necessarily mean a worsened or improved postural control. The goal of our study was to test whether balance is affected by the context in blind subjects. Additional to the quantification of center of pressure (COP) displacement, measurements of body motion (COG) and the correspondent net neuromuscular response (COP-COG) were evaluated in anterior-posterior and medial-lateral directions. Thirty-eight completely blind and thirty-two sighted subjects participated of this study. The volunteers were asked to stand barefoot on a force platform for 60 s in two different conditions: feet apart and feet together. Sighted participants performed the tests with both the eyes open and eyes closed. Results showed that the COP-COG displacements in the blind group were greater than those of the sighted group with eyes open in almost all conditions tested, but not in eyes closed condition. However, the COP and COG results confirmed that the postural responses were context dependent. Together these results suggest that total visual loss does not just lead to a balance deficit or compensation, but to a specific postural signature that might imply in enhancing COP, COG and/or COP-COG in specific postural conditions.

  1. Postoperative Care Navigation for Total Knee Arthroplasty Patients: A Randomized Controlled Trial.

    Science.gov (United States)

    Losina, Elena; Collins, Jamie E; Wright, John; Daigle, Meghan E; Donnell-Fink, Laurel A; Strnad, Doris; Usiskin, Ilana M; Yang, Heidi Y; Lerner, Vladislav; Katz, Jeffrey N

    2016-09-01

    To establish the efficacy of motivational interviewing-based postoperative care navigation in improving functional status after total knee arthroplasty (TKA) and to identify subgroups likely to benefit from the intervention. We conducted a parallel randomized controlled trial in TKA recipients with 2 arms: postoperative care with frequent followup by a care navigator or usual care. The primary outcome was the difference between the arms in Western Ontario and McMaster Universities Osteoarthritis Index function score change, over 6 months postsurgery. We performed a preplanned subgroup analysis of differential efficacy by obesity and exploratory subgroup analyses on sex and pain catastrophizing. We enrolled 308 subjects undergoing TKA for osteoarthritis. Mean ± SD preoperative function score was 41 ± 17 (0-100 scale, where 100 = worst function). At 6 months, subjects in the navigation arm improved by mean ± SD 30 ± 16 points compared to 27 ± 18 points in the usual-care arm (P = 0.148). Participants with moderate to high levels of pain catastrophizing were unlikely to benefit from navigation compared to those with lower levels of pain catastrophizing (P = 0.013 for interaction). Subjects assigned to the navigation intervention did not demonstrate greater functional improvement compared to those in the control group. The negative overall result could be explained by the large effect on functional improvement of TKA itself compared to the smaller, additional benefit from care navigation, as well as by potential differential effects for subjects with moderate to high degrees of pain catastrophizing. Greater focus on developing programs for reducing pain catastrophizing could lead to better functional outcomes following TKA. © 2016, American College of Rheumatology.

  2. Reduction in total plasma ghrelin levels following catecholamine depletion: relation to bulimic and depressive symptoms.

    Science.gov (United States)

    Homan, Philipp; Grob, Simona; Milos, Gabriella; Schnyder, Ulrich; Hasler, Gregor

    2013-09-01

    There is increasing preclinical and clinical evidence of the important role played by the gastric peptide hormone ghrelin in the pathogenesis of symptoms of depression and eating disorders. To investigate the role of ghrelin and its considered counterpart, peptide tyrosine tyrosine (PYY), in the development of bulimic and depressive symptoms induced by catecholamine depletion, we administered the tyrosine hydroxylase inhibitor alpha-methyl-paratyrosine (AMPT) in a randomized, double-blind, placebo-controlled crossover, single-site experimental trial to 29 healthy controls and 20 subjects with fully recovered bulimia nervosa (rBN). We found a decrease between preprandial and postprandial plasma ghrelin levels (psymptoms (psymptoms induced by catecholamine depletion. These findings suggest a relationship between catecholamines and ghrelin with depressive symptoms. Copyright © 2013 Elsevier Ltd. All rights reserved.

  3. The effect of low-dose total body irradiation on tumor control

    International Nuclear Information System (INIS)

    Sakamoto, Kiyohiko; Miyamoto, Miyako; Watabe, Nobuyuki.

    1987-01-01

    Total body irradiation (TBI) is considered to bring about an immunosuppressive effect on an organism, on the basis of data obtained from sublethal doses of TBI. However, there are no data on how low-dose TBI affects an organism. Over the last five years, we have been studying the effects of low-dose TBI on normal or tumor-bearing mice and the immunological background of these effects. In experimental studies, an increase in the TD50 value (the number of cells required for a tumor incidence of 50 %) in mice exposed to 10 rad was recognized and showed a remarkable increase at 6 hours to 15 hours after irradiation. TBI of 10 rad also showed an enhancement effect on tumor cell killing when given 12 hours before local tumor irradiation. In order to clarify the mechanism of this kind of effect, some immunological studies were performed using several immunological procedures, and the results suggested that 10 rad of TBI caused increasing tumor immunity in irradiated mice. Clinical trials in some patients with advanced tumors are now being undertaken on the basis of these experimental data, and the effect of TBI on tumor control appears promising, although it is too early to draw conclusions. (author)

  4. Relative effect of radiation dose rate on hemopoietic and nonhemopoietic lethality of total-body irradiation

    International Nuclear Information System (INIS)

    Peters, L.J.; McNeill, J.; Karolis, C.; Thames, H.D. Jr.; Travis, E.L.

    1986-01-01

    Experiments were undertaken to determine the influence of dose rate on the toxicity of total-body irrdiation (TBI) with and without syngeneic bone-marrow rescue in mice. The results showed a much greater dose-rate dependence for death from nonhemopoietic toxicity than from bone-marrow ablation, with the ratio of LD 50 's increasing from 1.73 at 25 cGy/min to 2.80 at 1 cGy/min. At the higher dose rates, dose-limiting nonhemopoietic toxicity resulted from late organ injury, affecting the lungs, kidneys, and liver. At 1 cGy/min the major dose-limiting nonhemopoietic toxicity was acute gastrointestinal injury. The implications of these results in the context of TBI in preparation for bone-marrow transplantation are discussed. 15 refs., 4 figs

  5. Relative blood volume changes underestimate total blood volume changes during hemodialysis

    NARCIS (Netherlands)

    Dasselaar, Judith J.; Lub-de Hooge, Marjolijn N.; Pruim, Jan; Nijnuis, Hugo; Wiersum, Anneke; de Jong, Paul E.; Huisman, Roel M.; Franssen, Casper F. M.

    Background: Measurements of relative blood volume changes (ARBV) during hemodialysis (HD) are based on hemoconcentration and assume uniform mixing of erythrocytes and plasma throughout the circulation. However, whole-body hematocrit (Ht) is lower than systemic Ht. During HD, a change in the ratio

  6. Total synthesis and related studies of large, strained, and bioactive natural products

    Science.gov (United States)

    HIRAMA, Masahiro

    2016-01-01

    Our chemical syntheses and related scientific investigations of natural products with complex architectures and powerful biological activities are described, focusing on the very large 3 nm-long polycyclic ethers called the ciguatoxins, highly strained and labile chromoprotein antitumor antibiotics featuring nine-membered enediyne cores, and extremely potent anthelmintic macrolides called the avermectins. PMID:27725470

  7. Scanning with a Total Information Storage and Controlled Data Presentation System

    Energy Technology Data Exchange (ETDEWEB)

    Rejali, A. M.; Gregg, E. C.; Voelker, W. H.; Friedell, H. L. [Case Western Reserve University, Cleveland, OH (United States)

    1969-01-15

    This presentation demonstrates improved clinical results obtained from storing all available information received by the detector or detectors without prior modifications in a permanent memory. Permanently stored information is modified later with a special electronic imaging system with kinescope presentation in black and white or colour. Under carefully controlled circumstances this system permits immediate and innumerable degrees of erase and contrast enhancement or colour coding in fractions of a second. A profile representing the count-rate through any slice in the scanned area may be performed to determine relative distribution of radioisotopes. The advantage of this system and various clinical results in scans of myocardiums, pancreas, cardiac blood pool, placenta, etc. will be presented. (author)

  8. Hip Hip Hurrah! Hip size inversely related to heart disease and total mortality

    DEFF Research Database (Denmark)

    Heitmann, B L; Lissner, L

    2011-01-01

    During the past decade a series of published reports have examined the value of studying the relation between hip circumferences and cardiovascular end points. Specifically, in a series of recent studies the independent effects of hip circumference have been studied after adjustment for general o...... for women than men, but is evident in both genders. In this 'viewpoint', we wish to draw attention to the emerging body of evidence and to encourage researchers to continue collecting measures of lower body size in their surveys....... obesity and/or waist circumference. These studies have been remarkable in terms of their consistency, and in the unexpected finding of an adverse effect of small hip size, after statistically correcting for differences in general and abdominal size. The hazard related to a small hip size may be stronger...

  9. Usefulness of gram staining of blood collected from total parenteral nutrition catheter for rapid diagnosis of catheter-related sepsis.

    Science.gov (United States)

    Moonens, F; el Alami, S; Van Gossum, A; Struelens, M J; Serruys, E

    1994-01-01

    The accuracy of Gram staining of blood drawn from catheters used to administer total parenteral nutrition was compared with paired quantitative blood cultures for the diagnosis of catheter-related sepsis. Gram staining was positive in 11 of 18 episodes of catheter-related sepsis documented by quantitative culture (sensitivity, 61%) but in none of the 5 episodes of fever unrelated to catheter infection. Thus, this procedure enabled the rapid presumptive diagnosis and guidance of antimicrobial therapy for total parenteral nutrition catheter sepsis, with a positive predictive value of 100% and a negative predictive value of 42%. PMID:7521359

  10. Locus of control in relation to flow

    Directory of Open Access Journals (Sweden)

    Celeste M Taylor

    2006-04-01

    Full Text Available The principal objective of the study was to examine the relationship between locus of control and optimal experience (flow in carrying out work and/or study activities. Two questionnaires measuring the aforementioned constructs were administered to a group of first and second-year Human Resource Management students (n=168 between the ages of 16 and 30. The results suggest that more frequent experience of flow is positively correlated with Autonomy and Internal Locus of Control. Limitations, lines of future research, implications and further contributions are discussed.

  11. Symptoms of mothers and infants related to total volatile organic compounds in household products.

    Science.gov (United States)

    Farrow, Alexandra; Taylor, Hazel; Northstone, Kate; Golding, Jean

    2003-10-01

    The authors sought to determine whether reported symptoms of mothers and infants were associated significantly with the use of household products that raised indoor levels of total volatile organic compounds (TVOCs). Data collected from 170 homes within the Avon Longitudinal Study of Parents and Children (ALSPAC: a large birth cohort of more than 10,000) had determined which household products were associated with the highest levels of TVOCs. The latter data were collected over a period that approximated 6 mo of pregnancy and the infants' first 6 mo of life. This paper presents (a) the mothers' self-reports of the use of these products in their homes and (b) self-reported medical symptoms of mothers and infants postnatally. Higher TVOC levels were associated with air freshener and aerosol use. Infant diarrhea and earache were statistically significantly associated with air freshener use, and diarrhea and vomiting were significantly associated with aerosol use. Headache experienced by mothers 8 mo after birth was significantly associated with the use of air fresheners and aerosols; maternal depression was significantly associated with the use of air fresheners. The results of the study suggest a link between the use of products that raise indoor levels of TVOCs and an increased risk of certain symptoms among infants and their mothers.

  12. Randomized controlled trial on postoperative pulmonary humidification after total laryngectomy: External humidifier versus heat and moisture exchanger

    NARCIS (Netherlands)

    Mérol, Jean-Claude; Charpiot, Anne; Langagne, Thibault; Hémar, Patrick; Ackerstaff, Annemieke H.; Hilgers, Frans J. M.

    2012-01-01

    Objectives/Hypothesis: Assessment of immediate postoperative airway humidification after total laryngectomy (TLE), comparing the use of an external humidifier (EH) with humidification through a heat and moisture exchanger (HME). Study Design: Randomized controlled trial (RCT). Methods: Fifty-three

  13. Randomized controlled trial on postoperative pulmonary humidification after total laryngectomy: external humidifier versus heat and moisture exchanger

    NARCIS (Netherlands)

    Mérol, J.-C.; Charpiot, A.; Langagne, T.; Hémar, P.; Ackerstaff, A.H.; Hilgers, F.J.M.

    2012-01-01

    Objectives/Hypothesis: Assessment of immediate postoperative airway humidification after total laryngectomy (TLE), comparing the use of an external humidifier (EH) with humidification through a heat and moisture exchanger (HME). Study Design: Randomized controlled trial (RCT). Methods: Fifty-three

  14. Landscape controls on total and methyl mercury in the upper Hudson River basin of New York State

    Science.gov (United States)

    Burns, D. A.; Murray, K. R.; Bradley, P. M.; Brigham, M. E.; Aiken, G.; Smith, M.

    2010-12-01

    High levels of mercury (Hg) in aquatic biota have been identified in surface waters of the Adirondack region of New York, and factors such as the prevalence of wetlands, extensive forest cover, and oligotrophic waters promote Hg bioaccumulation in this region. Past research in this region has focused on improved understanding of the Hg cycle in lake ecosystems. In the study described herein, the landscape controls on total Hg and methylmercury (MeHg) concentrations in riverine ecosystems were explored through synoptic surveys of 27 sites in the upper Hudson River basin of the Adirondack region. Stream samples were collected and analyzed for total Hg, MeHg, dissolved organic carbon (DOC), and ultraviolet absorbance at 254 nm (UV254) during spring and summer of 2006-08. Landscape indices including many common land cover, hydrographic, and topographic-based measures were explored as predictors of Hg through multivariate linear regression. Multivariate models that included a wetland or riparian area-based metric, an index for open water area, and in some cases a topographic metric such as the wetness index explained 55 to 65 percent of the variation in MeHg concentrations, and 55 to 80 percent of the variation in total Hg concentrations. An open water index (OWI) was developed that incorporated both the basin area drained by ponded water and the surface area of these ponds. This index was inversely related to concentrations of total Hg and MeHg. This OWI was also inversely related to specific ultra-violet absorbance, consistent with previous studies showing that open water increases the influence of algal-derived carbon on DOC, decreasing aromaticity, which should decrease the ability of the dissolved carbon pool to bind Hg. The OWI was not significant in models for total Hg that also included UV254 as a predictive variable, but the index did remain significant in similar models for MeHg suggesting that biogeochemical factors in addition to decreasing carbon

  15. Measuring the importance of oil-related revenues in total fiscal income for Mexico

    Energy Technology Data Exchange (ETDEWEB)

    Reyes-Loya, Manuel Lorenzo; Blanco, Lorenzo [Facultad de Economia, Universidad Autonoma de Nuevo Leon, Loma Redonda 1515 Pte., Col. Loma Larga, C.P. 64710, Monterrey, Nuevo Leon (Mexico)

    2008-09-15

    Revenues from oil exports are an important part of government budgets in Mexico. A time-series analysis is conducted using monthly data from 1990 to 2005 examining three different specifications to determine how international oil price fluctuations and government income generated from oil exports influence fiscal policy in Mexico. The behavior of government spending and taxation is consistent with the spend-tax hypothesis. The results show that there is an inverse relationship between oil-related revenues and tax revenue from non-oil sources. Fiscal policy reform is urgently needed in order to improve tax collection as oil reserves in Mexico become more and more depleted. (author)

  16. Measuring the importance of oil-related revenues in total fiscal income for Mexico

    International Nuclear Information System (INIS)

    Reyes-Loya, Manuel Lorenzo; Blanco, Lorenzo

    2008-01-01

    Revenues from oil exports are an important part of government budgets in Mexico. A time-series analysis is conducted using monthly data from 1990 to 2005 examining three different specifications to determine how international oil price fluctuations and government income generated from oil exports influence fiscal policy in Mexico. The behavior of government spending and taxation is consistent with the spend-tax hypothesis. The results show that there is an inverse relationship between oil-related revenues and tax revenue from non-oil sources. Fiscal policy reform is urgently needed in order to improve tax collection as oil reserves in Mexico become more and more depleted. (author)

  17. Periacetabular Bone Mineral Density Changes After Resurfacing Hip Arthroplasty Versus Conventional Total Hip Arthroplasty. A Randomized Controlled DEXA Study

    NARCIS (Netherlands)

    Smolders, J.M.H.; Pakvis, D.F.; Hendrickx, B.W.; Verdonschot, Nicolaas Jacobus Joseph; van Susante, J.L.C.

    2013-01-01

    A randomized controlled trial was performed to evaluate acetabular bone mineral density (BMD) changes after hip resurfacing (RHA) versus an established conventional total hip arthroplasty (THA). A total of 71 patients were allocated randomly to receive either an RHA press-fit cobalt–chromium cup (n

  18. Arsenic speciation in total contents and bioaccessible fractions in atmospheric particles related to human intakes

    International Nuclear Information System (INIS)

    Huang, Minjuan; Chen, Xunwen; Zhao, Yinge; Yu Chan, Chuen; Wang, Wei; Wang, Xuemei; Wong, Ming Hung

    2014-01-01

    Speciation of inorganic trivalent arsenicals (iAs III ), inorganic pentavalent arsenicals (iAs V ), monomethylarsonic acid (MMA) and dimethylarsinic acid (DMA) in total arsenic (As) content and its bioaccessible fractions contained in road dust, household air-conditioning (AC) filter dust and PM 2.5 was investigated. Inorganic As, especially iAs V , was observed as the dominant species. Physiologically based extraction test (PBET), an in-vitro gastrointestinal method, was used to estimate the oral As bioaccessibility in coarse particles and the species present in the oral bioaccessible fraction. A composite lung simulating serum was used to mimic the pulmonary condition to extract the respiratory bioaccessible As and its species in PM 2.5 . Reduction of iAs V to iAs III occurred in both in-vitro gastrointestinal and lung simulating extraction models. The inorganic As species was the exclusive species for absorption through ingestion and inhalation of atmospheric particles, which was an important exposure route to inorganic As, in addition to drinking water and food consumption. - Highlights: • Inorganic As species was the predominant species in dust and airborne particles. • Existence of iAs III in dust and airborne particles increases human health risks. • Reduction from iAs V to iAs III occurred through in-vitro gastrointestinal model. • Reduction from iAs V to iAs III occurred in the simulating pulmonary region. • Atmospheric particles were important exposure sources of inorganic As. - Atmospheric particles are important exposure sources of inorganic As, of which the bioaccessibility is dependent on the extraction phases and models used

  19. The semiotics of control and modeling relations in complex systems.

    Science.gov (United States)

    Joslyn, C

    2001-01-01

    We provide a conceptual analysis of ideas and principles from the systems theory discourse which underlie Pattee's semantic or semiotic closure, which is itself foundational for a school of theoretical biology derived from systems theory and cybernetics, and is now being related to biological semiotics and explicated in the relational biological school of Rashevsky and Rosen. Atomic control systems and models are described as the canonical forms of semiotic organization, sharing measurement relations, but differing topologically in that control systems are circularly and models linearly related to their environments. Computation in control systems is introduced, motivating hierarchical decomposition, hybrid modeling and control systems, and anticipatory or model-based control. The semiotic relations in complex control systems are described in terms of relational constraints, and rules and laws are distinguished as contingent and necessary functional entailments, respectively. Finally, selection as a meta-level of constraint is introduced as the necessary condition for semantic relations in control systems and models.

  20. The Relation between Hepatotoxicity and the Total Coumarin Intake from Traditional Japanese Medicines Containing Cinnamon Bark.

    Science.gov (United States)

    Iwata, Naohiro; Kainuma, Mosaburo; Kobayashi, Daisuke; Kubota, Toshio; Sugawara, Naoko; Uchida, Aiko; Ozono, Sahoko; Yamamuro, Yuki; Furusyo, Norihiro; Ueda, Koso; Tahara, Eiichi; Shimazoe, Takao

    2016-01-01

    Cinnamon bark is commonly used in traditional Japanese herbal medicines (Kampo medicines). The coumarin contained in cinnamon is known to be hepatotoxic, and a tolerable daily intake (TDI) of 0.1 mg/kg/day, has been quantified and used in Europe to insure safety. Risk assessments for hepatotoxicity by the cinnamon contained in foods have been reported. However, no such assessment of cinnamon bark has been reported and the coumarin content of Kampo medicines derived from cinnamon bark is not yet known. To assess the risk for hepatotoxicity by Kampo medicines, we evaluated the daily coumarin intake of patients who were prescribed Kampo medicines and investigated the relation between hepatotoxicity and the coumarin intake. The clinical data of 129 outpatients (18 male and 111 female, median age 58 years) who had been prescribed keishibukuryogankayokuinin (TJ-125) between April 2008 and March 2013 was retrospectively investigated. Concurrent Kampo medicines and liver function were also surveyed. In addition to TJ-125, the patients took some of the other 32 Kampo preparations and 22 decoctions that include cinnamon bark. The coumarin content of these Kampo medicines was determined by high performance liquid chromatography (HPLC). TJ-125 had the highest daily content of coumarin (5.63 mg/day), calculated from the daily cinnamon bark dosage reported in the information leaflet inserted in each package of Kampo medicine. The coumarin content in 1g cinnamon bark decoction was 3.0 mg. The daily coumarin intake of the patients was 0.113 (0.049-0.541) mg/kg/day, with 98 patients (76.0%) exceeding the TDI. Twenty-three patients had an abnormal change in liver function test value, but no significant difference was found in the incidence of abnormal change between the group consuming less than the TDI value (6/31, 19.4%) and the group consuming equal to or greater than the TDI value (17/98, 17.3%). In addition, no abnormal change related to cinnamon bark was found for individual

  1. EOS-based cup navigation: Randomised controlled trial in 78 total hip arthroplasties.

    Science.gov (United States)

    Verdier, N; Billaud, A; Masquefa, T; Pallaro, J; Fabre, T; Tournier, C

    2016-06-01

    Minimising the risk of cup implantation outside the safe zone is among the objectives of navigation during total hip arthroplasty (THA). However, given the technical challenges raised by navigation when the patient is lying on the side, many surgeons still use the freehand technique. We conducted a randomised controlled trial to evaluate the new navigation system NAVEOS in the iliac plane, which is easily identified in the lateral decubitus position, with the objective of determining whether NAVEOS navigation decreased the frequency of cup implantation outside the safe zone compared to freehand cup positioning, without increasing the operative time or the frequency of complications. NAVEOS navigation decreases the frequency of cup positioning outside the safe zone compared to freehand positioning. This randomised controlled trial compared cup positioning using NAVEOS navigation versus the freehand technique in patients undergoing primary THA. The safe zone was defined according to Lewinnek as 15±10° of radiological anteversion and 40±10° of radiological inclination. Cup position parameters were measured on computed tomography images obtained 3months after THA. The images were read by two independent observers who were blinded to group assignment. The primary evaluation criterion was cup position within the safe zone. A 1:1 randomisation scheme was used to assign 78 patients (mean age, 68years; age range, 44-91years) to NAVEOS navigation or freehand cup positioning. The two groups were comparable for age, gender distribution, body mass index, and preoperative functional scores. In the NAVEOS group, navigation was discontinued prematurely in 6 patients, because of technical difficulties (n=2) or a marked discrepancy with clinical findings (n=4); however, the intention-to-treat approach was used for the analysis. The proportion of cups in the safe zone was 67% (28/39) in the NAVEOS group and 38% (17/39) in the freehand group (P=0.012). Anteversion was within the

  2. Control perceptions and control appraisal: Relation to measures of ...

    African Journals Online (AJOL)

    Objectives: To investigate the relationship between control variables and measures of subjective wellbeing. The primary question asked was “who is happy and well, and why?” Design: A questionnaire survey and the data was analyzed by examining bivariate relationships between variables of interest. Participants: Two ...

  3. Telerehabilitation Versus Traditional Care Following Total Hip Replacement: A Randomized Controlled Trial Protocol.

    Science.gov (United States)

    Nelson, Mark; Bourke, Michael; Crossley, Kay; Russell, Trevor

    2017-03-02

    Total hip replacement (THR) is the gold standard treatment for severe hip osteoarthritis. Effectiveness of physical rehabilitation for THR patients following discharge from hospital is supported by evidence; however, barriers such as geographical location and transport can limit access to appropriate health care. One solution to this issue is using an alternative model of care using telerehabilitation technology to deliver rehabilitation programs directly into patients' homes. A telerehabilitation model may also have potential health care cost savings for health care providers. This study aims to determine if a telerehabilitation model of care delivered remotely is as effective as face-to-face rehabilitation in the THR population and cost effective for health care providers and patients. A total of 70 people undergoing THR will be recruited to participate in a randomized, single-blind, controlled noninferiority clinical trial. The trial will compare a technology-based THR rehabilitation program to in-person care. On discharge from hospital, participants randomized to the in-person group will receive usual care, defined as a paper home exercise program (HEP) targeting strengthening exercises for quadriceps, hip abductors, extensors, and flexors; they will be advised to perform their HEP 3 times per day. At 2, 4, and 6 weeks postoperatively, they will receive a 30-minute in-person physiotherapy session with a focus on gait retraining and reviewing and progressing their HEP. The telerehabilitation protocol will involve a program similar in content to the in-person rehabilitation program, except delivery will be directly into the homes of the participants via telerehabilitation technology on an iPad. Outcomes will be evaluated preoperatively, day of discharge from in-patient physiotherapy, 6 weeks and 6 months postoperatively. The primary outcome will be the quality of life subscale of the hip disability and osteoarthritis outcome score, measured at 6 weeks. Both

  4. Integrated Autopilot/Autothrottle Based on a Total Energy Control Concept: Design and Evaluation of Additional Autopilot Modes

    Science.gov (United States)

    Bruce, Kevin R.

    1988-01-01

    An integrated autopilot/autothrottle system was designed using a total energy control design philosophy. This design ensures that the system can differentiate between maneuvers requiring a change in thrust to accomplish a net energy change, and those maneuvers which only require elevator control to redistribute energy. The system design, the development of the system, and a summary of simulation results are defined.

  5. Comparison of total disc replacement with lumbar fusion: a meta-analysis of randomized controlled trials

    International Nuclear Information System (INIS)

    Nie, H.

    2015-01-01

    A meta-analysis was performed to evaluate whether a beneficial clinical effect of the Total Disc Replacement (TDR) over lumbar fusion for the treatment of patients with Degenerative Disc Disease (DDD). An electronic search of PubMed, Cochrane Central Register of Controlled Trials, and EMBASE from their inception to 2012 was completed, and we assessed risk bias and retrieved relevant data, and meta-analysis was performed, if appropriate. Oswestry Disability Index (ODI), Visual Analog Score (VAS), patient satisfaction or VAS patient satisfaction, narcotic use, overall success rate, reoperation rate, work status, surgery again, complications and radiographic outcomes were evaluated. Six RCTs were included in this meta-analysis. At 2 years, TDR was demonstrated to be more beneficial for patients compared to lumbar fusion in the following outcomes, including ODI scores (MD: -4.87, 95% CI: -7.77 to -1.97, p=0.001), patient satisfaction (OR:1.91, 95% CI: 1.27 to 2.86, p=0.002) and VAS patient satisfaction (MD:9.10, 95% CI: 3.20 to 14.99, p=0.002), the percentage of using narcotics (OR=0.54, 95%CI: 0.31 to 0.96, p=0.03), overall success rate (OR:1.68, 95% CI: 1.26 to 2.25, p=0.005), the rate of patients to chose the same surgical treatment again (OR:2.38, 95% CI: 1.72 to 3.28, p < 0.001), and complications (OR=0.50, 95% CI: 0.29 to 0.84, p=0.008). Other outcomes, including re-operation rate (OR:0.62, 95% CI: 0.36 to 1.06, p=0.08) and work status (OR=1.05, 95% CI: 0.75 to 1.47, p=0.80), were demonstrated to be no differences between the two groups. In a long-term of follow-up (2 years), TDR shows a significant superiority for the treatment of lumbar DDD compared with fusion. (author)

  6. Relative controllability of nonlinear neutral systems with distributed ...

    African Journals Online (AJOL)

    In this paper we study the relative controllability of nonlinear neutral system with distributed and multiple lumped time varying delays in control. Using Schauder's fixed point theorem sufficient conditions for relative controllability in a given time interval are formulated and proved. Journal of the Nigerian Association of ...

  7. A randomized, controlled trial comparing local infiltration analgesia with epidural infusion for total knee arthroplasty

    DEFF Research Database (Denmark)

    Andersen, Karen Vestergaard; Bak, Marie; Christensen, Birgitte Viebæk

    2010-01-01

    There have been few studies describing wound infiltration with additional intraarticular administration of multimodal analgesia for total knee arthroplasty (TKA). In this study, we assessed the efficacy of wound infiltration combined with intraarticular regional analgesia with epidural infusion...

  8. Related regulation of quality control of industrial products

    International Nuclear Information System (INIS)

    1983-04-01

    This book introduce related regulation of quality control of industrial products, which includes regulations of industrial products quality control, enforcement ordinance of industrial products quality control, enforcement regulation of quality control of industrial products, designated items with industrial production quality indication, industrial production quality test, and industrial production quality test organization and management tips of factory quality by grade.

  9. Relational databases for SSC design and control

    International Nuclear Information System (INIS)

    Barr, E.; Peggs, S.; Saltmarsh, C.

    1989-01-01

    Most people agree that a database is A Good Thing, but there is much confusion in the jargon used, and in what jobs a database management system and its peripheral software can and cannot do. During the life cycle of an enormous project like the SSC, from conceptual and theoretical design, through research and development, to construction, commissioning and operation, an enormous amount of data will be generated. Some of these data, originating in the early parts of the project, will be needed during commissioning or operation, many years in the future. Two of these pressing data management needs-from the magnet research and industrialization programs and the lattice design-have prompted work on understanding and adapting commercial database practices for scientific projects. Modern relational database management systems (rDBMS's) cope naturally with a large proportion of the requirements of data structures, like the SSC database structure built for the superconduction cable supplies, uses, and properties. This application is similar to the commercial applications for which these database systems were developed. The SSC application has further requirements not immediately satisfied by the commercial systems. These derive from the diversity of the data structures to be managed, the changing emphases and uses during the project lifetime, and the large amount of scientific data processing to be expected. 4 refs., 5 figs

  10. Glioma-related seizures in relation to histopathological subtypes: a report from the glioma international case-control study.

    Science.gov (United States)

    Berntsson, Shala G; Merrell, Ryan T; Amirian, E Susan; Armstrong, Georgina N; Lachance, Daniel; Smits, Anja; Zhou, Renke; Jacobs, Daniel I; Wrensch, Margaret R; Olson, Sara H; Il'yasova, Dora; Claus, Elizabeth B; Barnholtz-Sloan, Jill S; Schildkraut, Joellen; Sadetzki, Siegal; Johansen, Christoffer; Houlston, Richard S; Jenkins, Robert B; Bernstein, Jonine L; Lai, Rose; Shete, Sanjay; Amos, Christopher I; Bondy, Melissa L; Melin, Beatrice S

    2018-04-23

    The purpose of this study was to evaluate the distribution of glioma-related seizures and seizure control at the time of tumor diagnosis with respect to tumor histologic subtypes, tumor treatment and patient characteristics, and to compare seizure history preceding tumor diagnosis (or study enrollment) between glioma patients and healthy controls. The Glioma International Case Control study (GICC) risk factor questionnaire collected information on demographics, past medical/medication history, and occupational history. Cases from eight centers were also asked detailed questions on seizures in relation to glioma diagnosis; cases (n = 4533) and controls (n = 4171) were also asked about seizures less than 2 years from diagnosis and previous seizure history more than 2 years prior to tumor diagnosis, including childhood seizures. Low-grade gliomas (LGGs), particularly oligodendrogliomas/oligoastrocytomas, had the highest proportion of glioma-related seizures. Patients with low-grade astrocytoma demonstrated the most medically refractory seizures. A total of 83% of patients were using only one antiepileptic drug (AED), which was levetiracetam in 71% of cases. Gross total resection was strongly associated with reduced seizure frequency (p related seizures were most common in low-grade gliomas. Gross total resection was associated with lower seizure frequency. Additionally, having a history of childhood seizures is not a risk factor ***for developing glioma-related seizures or glioma.

  11. Chooz B1 start-up marked by total computer control

    International Nuclear Information System (INIS)

    Anon.

    1995-01-01

    The start-up of Chooz B1, the first of EdF's latest generation 1450 MWe N4 reactors, marks the first use in a nuclear power plant of a fully computerised control room. Working in partnership with EdF, Sema Group designed and supplied the advanced command and control system for this plant. (Author)

  12. Quality control on the accuracy of the total Beta activity index in different sample matrices water; Control de calidad en la precision del indice de actividad beta total en diferentes matrices de muestras de aguas

    Energy Technology Data Exchange (ETDEWEB)

    Pujol, L.; Pablo, M. A. de; Payeras, J.

    2013-07-01

    The standard ISO/IEC 17025:2005 of general requirements for the technical competence of testing and calibration laboratories, provides that a laboratory shall have quality control procedures for monitoring the validity of tests and calibrations ago. In this paper, the experience of Isotopic Applications Laboratory (CEDEX) in controlling the accuracy rate of total beta activity in samples of drinking water, inland waters and marine waters is presented. (Author)

  13. Functional exercise after total hip replacement (FEATHER): a randomised control trial.

    LENUS (Irish Health Repository)

    Monaghan, Brenda

    2012-11-01

    Prolonged physical impairments in range of movement, postural stability and walking speed are commonly reported following total hip replacement (THR). It is unclear from the current body of evidence what kind of exercises should be performed to maximize patient function and quality of life.

  14. [Case-control study on effect of rivaroxaban on the risk of hidden bleeding after total hip arthroplasty].

    Science.gov (United States)

    Li, Jun; Jing, Jue-Hua; Shi, Zhan-Jun; Zhou, Yun

    2014-01-01

    To investigate the risk of hidden blood loss about applying rivaroxaban after total hip arthroplasty. From October 2009 to May 2012,88 patients with femoral head necrosis were treated with primary total hip arthroplasty. All the patients were divided into Rivaroxaban group(44 cases)and control group(44 cases). There were 25 males and 19 females in the Rivaroxaban group, with an average age of (58.48 +/- 15.19) years old; in the control group,24 patients were male and 20 patients were female, with an average age of (61.11 +/- 13.54) years old. The patients in the Rivaroxaban group took Rivaroxaban orally from the first day after operation with a dose of 10 mg each day, and treatment course was 14 days. The patients in the control group took placebo orally at the same time. Dominant blood loss and transfusion were recorded, blood routine examinations were taken before operation and at 3 days after operation. The total blood loss and hidden blood loss were calculated according to the formula. The mean total blood loss was (1509.56 +/- 325.23) ml and the hidden blood loss was(581.47 +/- 215.01) ml, accounting for (37.88 +/- 10.42)% in the Rivaroxaban group. The mean total blood loss was (1262.30 +/- 397.95) ml and the hidden blood loss was (395.59 +/- 97.33) ml, accounting for (30.62 +/- 0.20)% in the control group. The total blood loss, hidden blood loss and transfusion in the Rivaroxaban group was significantly more than those in control group,b ut there was no significant difference on dominant blood loss between two groups. Rivaroxaban increased the overall bleeding risk of total hip arthroplasty, especially hidden bleeding risk, which should be careful used.

  15. Quality Control of Valerianae Radix by Attenuated Total Reflection Fourier Transform Infrared (ATR-FTIR) Spectroscopy.

    Science.gov (United States)

    Nikzad-Langerodi, Ramin; Arth, Katharina; Klatte-Asselmeyer, Valerie; Bressler, Sabine; Saukel, Johannes; Reznicek, Gottfried; Dobeš, Christoph

    2018-04-01

    (Acetoxy-)valerenic acid and total essential oil content are important quality attributes of pharmacy grade valerian root (Valerianae radix). Traditional analysis of these quantities is time-consuming and necessitates (harmful) solvents. Here we investigated an application of attenuated total reflection Fourier transform infrared spectroscopy for extractionless analysis of these quality attributes on a representative sample comprising 260 wild-crafted individuals covering the Central European taxonomic diversity of the Valeriana officinalis L. s. l. species aggregate with its three major ploidy cytotypes (i.e., di-, tetra- and octoploid). Calibration models were built by orthogonal partial least squares regression for quantitative analysis of (acetoxy-)valerenic acid and total essential oil content. For the latter, we propose a simplistic protocol involving apolar extraction followed by gas chromatography as a reference method for multivariate calibration in order to handle the analysis of samples taken from individual plants. We found good predictive ability of chemometric models for quantification of valerenic acid, acetoxyvalerenic acid, total sesquiterpenoid acid, and essential oil content with a root mean squared error of cross-validation of 0.064, 0.043, and 0.09 and root mean squared error of prediction of 0.066, 0.057, and 0.09 (% content), respectively. Orthogonal partial least squares discriminant analysis revealed good discriminability between the most productive phenotype (i.e., the octoploid cytotype) in terms of sesquiterpenoid acids, and the less productive ones (i.e., di- and tetraploid). All in all, our results demonstrate the application of attenuated total reflection Fourier transform infrared spectroscopy for rapid, extractionless estimation of the most important quality attributes of valerian root and minimally invasive identification of the most productive phenotype in terms of sesquiterpenoid acids. Georg Thieme Verlag KG Stuttgart · New

  16. Relatives in older patients' fast-track treatment programme during total hip or knee replacement. A grounded theory study

    DEFF Research Database (Denmark)

    Berthelsen, Connie Bøttcher

    and considerate support in concern for the patients; Substituting mode, with practical and cognitive support; and Adapting mode, by trying to fit in with the patients’ and health professionals’ requirements. Study II: 16 patients aged 70 to 94 were included and data was collected through 15 non......The aim of this Ph.D.-dissertation was to generate grounded theories of relatives, patients, and health professionals’ pattern of behaviour, respectively, in relation to the relatives of older patients’ fast-track treatment programmes during total hip or knee replacement. The dissertation includes...... to the older patients’ self-determination of being autonomous and how they adapt and are perceived in the health professionals’ environment. This may be useful to the health professionals in orthopaedic fast-track treatment programmes and their future collaboration with older patients and their relatives....

  17. Postural control in rheumatoid arthritis patients scheduled for total knee arthroplasty

    NARCIS (Netherlands)

    Tjon A Hen, S.S.K.; Bosch, P.V.; Laan, R.F.J.M.; Mulder, T.

    2000-01-01

    Objective: To investigate the use of compensatory visual and attentional control strategies for standing balance in patients with rheumatoid arthritis (RA) with severe knee joint impairment. Design: Experimental 2-group design. Setting: Specialized clinic for orthopedics, rheumatology, and

  18. Semiotic aspects of control and modeling relations in complex systems

    Energy Technology Data Exchange (ETDEWEB)

    Joslyn, C.

    1996-08-01

    A conceptual analysis of the semiotic nature of control is provided with the goal of elucidating its nature in complex systems. Control is identified as a canonical form of semiotic relation of a system to its environment. As a form of constraint between a system and its environment, its necessary and sufficient conditions are established, and the stabilities resulting from control are distinguished from other forms of stability. These result from the presence of semantic coding relations, and thus the class of control systems is hypothesized to be equivalent to that of semiotic systems. Control systems are contrasted with models, which, while they have the same measurement functions as control systems, do not necessarily require semantic relations because of the lack of the requirement of an interpreter. A hybrid construction of models in control systems is detailed. Towards the goal of considering the nature of control in complex systems, the possible relations among collections of control systems are considered. Powers arguments on conflict among control systems and the possible nature of control in social systems are reviewed, and reconsidered based on our observations about hierarchical control. Finally, we discuss the necessary semantic functions which must be present in complex systems for control in this sense to be present at all.

  19. Transversus abdominis plane block after ambulatory total laparoscopic hysterectomy: randomized controlled trial.

    Science.gov (United States)

    Calle, Gustavo A; López, Claudia C; Sánchez, Enrique; De Los Ríos, José F; Vásquez, Elsa M; Serna, Eduardo; Arango, Adriana M; Castañeda, Juan D; Vásquez, Ricardo A; González, Antonio; Escobar, Alvaro; Almanza, Luis A

    2014-04-01

    To determine if transversus abdominis plane anesthetic blockage (TAP block) diminishes early postoperative pain scores and facilitates ambulatory management following total laparoscopic hysterectomy. Randomized triple blind trial. Gynecological endoscopy unit at a referral center for laparoscopic surgery. A total of 197 patients. Comparison of a treatment group receiving TAP block with bupivacaine 0.25% and placebo group with comparably placed bilateral injection of sterile saline solution. Pain scores at discharge 24, 48 and 72 h after surgery, opioid requirement after procedure. Patients who had TAP block had a significant reduction in their pain score at discharge compared with the placebo group (p = 0.017). There were no significant differences in the pain scores between groups at 24 h (95% CI 1.36-0.133, p = 0.237), 48 h (95% CI 0.689-0.465, p = 0.702) and 72 h (95% CI -0.631 to 0.223, p = 0.347). No differences were found between the groups regarding opioid requirements following the procedure (χ(2)  = 3.62, p = 0.46). Although TAP block after a total laparoscopic hysterectomy reduced the pain score at discharge compared with placebo, its role in this setting is debatable due to the possible lack of clinical significance of the small difference found. © 2014 Nordic Federation of Societies of Obstetrics and Gynecology.

  20. Controlling costs without compromising quality: paying hospitals for total knee replacement.

    Science.gov (United States)

    Pine, Michael; Fry, Donald E; Jones, Barbara L; Meimban, Roger J; Pine, Gregory J

    2010-10-01

    Unit costs of health services are substantially higher in the United States than in any other developed country in the world, without a correspondingly healthier population. An alternative payment structure, especially for high volume, high cost episodes of care (eg, total knee replacement), is needed to reward high quality care and reduce costs. The National Inpatient Sample of administrative claims data was used to measure risk-adjusted mortality, postoperative length-of-stay, costs of routine care, adverse outcome rates, and excess costs of adverse outcomes for total knee replacements performed between 2002 and 2005. Empirically identified inefficient and ineffective hospitals were then removed to create a reference group of high-performance hospitals. Predictive models for outcomes and costs were recalibrated to the reference hospitals and used to compute risk-adjusted outcomes and costs for all hospitals. Per case predicted costs were computed and compared with observed costs. Of the 688 hospitals with acceptable data, 62 failed to meet effectiveness criteria and 210 were identified as inefficient. The remaining 416 high-performance hospitals had 13.4% fewer risk-adjusted adverse outcomes (4.56%-3.95%; P costs ($12,773-$11,512; P costs. A payment system based on the demonstrated performance of effective, efficient hospitals can produce sizable cost savings without jeopardizing quality. In this study, 96% of total excess hospital costs resulted from higher routine costs at inefficient hospitals, whereas only 4% was associated with ineffective care.

  1. Galectin-3 levels relate in children to total body fat, abdominal fat, body fat distribution, and cardiac size.

    Science.gov (United States)

    Dencker, Magnus; Arvidsson, Daniel; Karlsson, Magnus K; Wollmer, Per; Andersen, Lars B; Thorsson, Ola

    2018-03-01

    Galectin-3 has recently been proposed as a novel biomarker for cardiovascular disease in adults. The purpose of this investigation was to assess relationships between galectin-3 levels and total body fat, abdominal fat, body fat distribution, aerobic fitness, blood pressure, left ventricular mass, left atrial size, and increase in body fat over a 2-year period in a population-based sample of children. Our study included 170 children aged 8-11 years. Total fat mass and abdominal fat were measured by dual-energy x-ray absorptiometry (DXA). Body fat distribution was expressed as abdominal fat/total fat mass. Maximal oxygen uptake was assessed by indirect calorimetry during a maximal exercise test and scaled to body mass. Systolic and diastolic blood pressure and pulse pressure were measured. Left atrial size, left ventricular mass, and relative wall thickness were measured by echocardiography. Frozen serum samples were analyzed for galectin-3 by the Proximity Extension Assay technique. A follow-up DXA scan was performed in 152 children 2 years after the baseline exam. Partial correlations, with adjustment for sex and age, between galectin-3 versus body fat measurements indicated weak to moderate relationships. Moreover, left atrial size, left ventricular mass, and relative wall thickness and pulse pressure were also correlated with galectin-3. Neither systolic blood pressure nor maximal oxygen uptake was correlated with galectin-3. There was also a correlation between galectin-3 and increase in total body fat over 2 years, while no such correlations were found for the other fat measurements. More body fat and abdominal fat, more abdominal body fat distribution, more left ventricular mass, and increased left atrial size were all associated with higher levels of galectin-3. Increase in total body fat over 2 years was also associated with higher levels of galectin-3. What is Known: • Galectin-3 has been linked to obesity and been proposed to be a novel biomarker

  2. SF-36 total score as a single measure of health-related quality of life: Scoping review.

    Science.gov (United States)

    Lins, Liliane; Carvalho, Fernando Martins

    2016-01-01

    According to the 36-Item Short Form Health Survey questionnaire developers, a global measure of health-related quality of life such as the "SF-36 Total/Global/Overall Score" cannot be generated from the questionnaire. However, studies keep on reporting such measure. This study aimed to evaluate the frequency and to describe some characteristics of articles reporting the SF-36 Total/Global/Overall Score in the scientific literature. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses method was adapted to a scoping review. We performed searches in PubMed, Web of Science, SCOPUS, BVS, and Cochrane Library databases for articles using such scores. We found 172 articles published between 1997 and 2015; 110 (64.0%) of them were published from 2010 onwards; 30.0% appeared in journals with Impact Factor 3.00 or greater. Overall, 129 (75.0%) out of the 172 studies did not specify the method for calculating the "SF-36 Total Score"; 13 studies did not specify their methods but referred to the SF-36 developers' studies or others; and 30 articles used different strategies for calculating such score, the most frequent being arithmetic averaging of the eight SF-36 domains scores. We concluded that the "SF-36 Total/Global/Overall Score" has been increasingly reported in the scientific literature. Researchers should be aware of this procedure and of its possible impacts upon human health.

  3. Adductor canal block with local infiltrative analgesia compared with local infiltrate analgesia for pain control after total knee arthroplasty

    OpenAIRE

    Xing, Qiujuan; Dai, Weiwei; Zhao, Dongfeng; Wu, Ji; Huang, Chunshui; Zhao, Yun

    2017-01-01

    Abstract Background: This meta-analysis aimed to evaluate the efficiency and safety of the combined adductor canal block with peri-articular infiltration versus periarticular infiltration alone for pain control after total knee arthroplasty (TKA). Methods: PubMed, Medline, Embase, Web of Science, and the Cochrane Library were searched to identify articles comparing the combined adductor canal block with peri-articular infiltration and periarticular infiltration alone for pain control after TK...

  4. Pulmonary function in relation to total dust exposure at a bauxite refinery and alumina-based chemical products plant.

    Science.gov (United States)

    Townsend, M C; Enterline, P E; Sussman, N B; Bonney, T B; Rippey, L L

    1985-12-01

    A cross-sectional study of 1,142 male employees at the Arkansas Operations of a large aluminum production company examined the effect on pulmonary function of chronic exposure to total dust produced in the mining and refining of bauxite and the production of alumina chemicals. Never smokers, ex-smokers, and current smokers were analyzed separately. Among never smokers, a pattern of decreasing FEV1 was observed in relation to increasing duration and cumulative total dust exposure. Among never smokers with cumulative total dust exposures of greater than or equal to 100 mg/m3 yr and greater than or equal to 20 yr of exposure, there was a mean reduction from the predicted FEV1 of 0.29 to 0.39 L, in addition to a 3- to 4-fold excess of observed/expected numbers of subjects with FEV1 less than 80% of predicted. These results were observed relative to an external and an internal comparison group. Among current smokers, the deviations from predicted and the excess numbers of subjects with FEV1 less than 80% of predicted were larger in all exposure groups than for the never smokers. However, the quality of the smoking data was inadequate to allow separation of the effects of smoking and dust exposure.

  5. Trust and control interrelatedness: New perspectives on the trust-control nexus in organizational relations

    NARCIS (Netherlands)

    Costa, A.C.; Bijlsma-Frankema, K.M.

    2007-01-01

    This article introduces the special issue on New Perspectives on the Trust-Control Nexus in Organizational Relations. Trust and control are interlinked processes commonly seen as key to reach effectiveness in inter- and intraorganizational relations. The relation between trust and control is,

  6. Relative controllability of nonlinear systems with delays in state and ...

    African Journals Online (AJOL)

    In this work, sufficient conditions are developed for the relative controllability of perturbed nonlinear systems with time varying multiple delays in control with the perturbation function having implicit derivative with delays depending on both state and control variable, using Darbo's fixed points theorem. Journal of the Nigerian ...

  7. Mediator effect of statistical process control between Total Quality Management (TQM) and business performance in Malaysian Automotive Industry

    Science.gov (United States)

    Ahmad, M. F.; Rasi, R. Z.; Zakuan, N.; Hisyamudin, M. N. N.

    2015-12-01

    In today's highly competitive market, Total Quality Management (TQM) is vital management tool in ensuring a company can success in their business. In order to survive in the global market with intense competition amongst regions and enterprises, the adoption of tools and techniques are essential in improving business performance. There are consistent results between TQM and business performance. However, only few previous studies have examined the mediator effect namely statistical process control (SPC) between TQM and business performance. A mediator is a third variable that changes the association between an independent variable and an outcome variable. This study present research proposed a TQM performance model with mediator effect of SPC with structural equation modelling, which is a more comprehensive model for developing countries, specifically for Malaysia. A questionnaire was prepared and sent to 1500 companies from automotive industry and the related vendors in Malaysia, giving a 21.8 per cent rate. Attempts were made at findings significant impact of mediator between TQM practices and business performance showed that SPC is important tools and techniques in TQM implementation. The result concludes that SPC is partial correlation between and TQM and BP with indirect effect (IE) is 0.25 which can be categorised as high moderator effect.

  8. Cemented versus uncemented fixation in total hip replacement: a systematic review and meta-analysis of randomized controlled trials.

    LENUS (Irish Health Repository)

    Abdulkarim, Ali

    2013-02-22

    The optimal method of fixation for primary total hip replacements (THR), particularly fixation with or without the use of cement is still controversial. In a systematic review and metaanalysis of all randomized controlled trials comparing cemented versus uncemented THRS available in the published literature, we found that there is no significant difference between cemented and uncemented THRs in terms of implant survival as measured by the revision rate. Better short-term clinical outcome, particularly an improved pain score can be obtained with cemented fixation. However, the results are unclear for the long-term clinical and functional outcome between the two groups. No difference was evident in the mortality and the post operative complication rate. On the other hand, the radiographic findings were variable and do not seem to correlate with clinical findings as differences in the surgical technique and prosthesis design might be associated with the incidence of osteolysis. We concluded in our review that cemented THR is similar if not superior to uncemented THR, and provides better short term clinical outcomes. Further research, improved methodology and longer follow up are necessary to better define specific subgroups of patients in whom the relative benefits of cemented and uncemented implant fixation can be clearly demonstrated.

  9. Cemented versus uncemented fixation in total hip replacement: a systematic review and meta-analysis of randomized controlled trials

    Directory of Open Access Journals (Sweden)

    Ali Abdulkarim

    2013-03-01

    Full Text Available The optimal method of fixation for primary total hip replacements (THR, particularly fixation with or without the use of cement is still controversial. In a systematic review and metaanalysis of all randomized controlled trials comparing cemented versus uncemented THRS available in the published literature, we found that there is no significant difference between cemented and uncemented THRs in terms of implant survival as measured by the revision rate. Better short-term clinical outcome, particularly an improved pain score can be obtained with cemented fixation. However, the results are unclear for the long-term clinical and functional outcome between the two groups. No difference was evident in the mortality and the post operative complication rate. On the other hand, the radiographic findings were variable and do not seem to correlate with clinical findings as differences in the surgical technique and prosthesis design might be associated with the incidence of osteolysis. We concluded in our review that cemented THR is similar if not superior to uncemented THR, and provides better short term clinical outcomes. Further research, improved methodology and longer follow up are necessary to better define specific subgroups of patients in whom the relative benefits of cemented and uncemented implant fixation can be clearly demonstrated.

  10. The total workload of male and female white collar workers as related to age, occupational level, and number of children.

    Science.gov (United States)

    Lundberg, U; Mårdberg, B; Frankenhaeuser, M

    1994-12-01

    A questionnaire assessing various aspects of paid as well as unpaid forms of productive activity was mailed to stratified samples of male and female white collar workers, approximately matched for educational and occupational level. Data from 501 men and 679 women employed full time revealed traditional gender differences in terms of main responsibility for household duties, child care etc. In keeping with this, women reported higher levels of work overload, stress and conflict than men, which increased significantly with the number of children at home. The various stress indices reached a peak between the ages of 35 and 39. Men reported more autonomy in their paid work whereas women reported more control at home. Men and women at the upper managerial levels reported more control over their total work situation and less conflict between demands.

  11. Safety-related control air systems - approved 1977

    International Nuclear Information System (INIS)

    Anon.

    1978-01-01

    This standard applies to those portions of the control air system that furnish air required to support, control, or operate systems or portions of systems that are safety related in nuclear power plants. This standard relates only to the air supply system(s) for safety-related air operated devices and does not apply to the safety-related air operated device or to air operated actuators for such devices. The objectives of this standard are to provide (1) minimum system design requirements for equipment, piping, instruments, controls, and wiring that constitute the air supply system; and (2) the system and component testing and maintenance requirements

  12. On the controllability and run-away possibility of a totally free piston, pulsed compression reactor

    NARCIS (Netherlands)

    Roestenberg, T.; Glouchenkov, Maxim Joerjevisj; glushenkov, M.J.; Kronberg, Alexandre E.; van der Meer, Theodorus H.

    2010-01-01

    The pulsed compression reactor promises to be a compact, economical and energy efficient alternative to conventional chemical reactors. While its design and operation is similar to that of a free piston internal combustion engine, it does not benefit from any controllability through the load.

  13. A randomised, controlled trial of circumpatellar electrocautery in total knee replacement without patellar resurfacing

    NARCIS (Netherlands)

    Jonbergen, H.P. van; Scholtes, V.A.; Kampen, A. van; Poolman, R.W.

    2011-01-01

    The efficacy of circumpatellar electrocautery in reducing the incidence of post-operative anterior knee pain is unknown. We conducted a single-centre, outcome-assessor and patient-blinded, parallel-group, randomised, controlled trial to compare circumpatellar electrocautery with no electrocautery in

  14. Development and Relative Validity of a Food Frequency Questionnaire to Assess Intakes of Total and Free Sugars in Australian Toddlers.

    Science.gov (United States)

    Devenish, Gemma; Mukhtar, Aqif; Begley, Andrea; Do, Loc; Scott, Jane

    2017-11-08

    Background : Dental research into early childhood caries is hindered by a lack of suitable dietary assessment tools that have been developed and validated for the population and outcomes of interest. The aim of this study was to develop and investigate the relative validity and reproducibility of the Study of Mothers' and Infants' Life Events Food Frequency Questionnaire (SMILE-FFQ), to assess the total and free sugars intakes of Australian toddlers. Methods : The SMILE-FFQ was designed to capture the leading dietary contributors to dental caries risk in toddlers aged 18-30 months via a proxy report. Ninety-five parents of Australian toddlers completed the questionnaire online before and after providing three 24-h recalls (24HR), collected on non-consecutive days using the multipass method. Total and free sugars were compared between the two SMILE-FFQ administrations and between each SMILE-FFQ and the 24HR using multiple statistical tests and standardised validity criteria. Correlation (Pearson), mean difference (Wilcoxon rank test) and Bland Altman analyses were conducted to compare absolute values, with cross-classification (Chi-Square and Weighted Kappa) used to compare agreement across tertiles. Results : All reproducibility tests showed good agreement except weighted kappa, which showed acceptable agreement. Relative validity tests revealed a mix of good and acceptable agreement, with total sugars performing better at the individual level than free sugars. Compared to the 24HR, the SMILE-FFQ tended to underestimate absolute values at lower levels and overestimate them at higher levels. Conclusions : The combined findings of the various tests indicate that the SMILE-FFQ performs comparably to the 24HR for assessing both total and free sugars among individuals, is most effective for ranking participants rather than determining absolute intakes, and is therefore suitable for use in observational studies of Australian toddlers.

  15. Comparison of natural drainage group and negative drainage groups after total thyroidectomy: prospective randomized controlled study.

    Science.gov (United States)

    Woo, Seung Hoon; Kim, Jin Pyeong; Park, Jung Je; Shim, Hyun Seok; Lee, Sang Ha; Lee, Ho Joong; Won, Seong Jun; Son, Hee Young; Kim, Rock Bum; Son, Young-Ik

    2013-01-01

    The aim of this study was to compare a negative pressure drain with a natural drain in order to determine whether a negative pressure drainage tube causes an increase in the drainage volume. Sixty-two patients who underwent total thyroidectomy for papillary thyroid carcinoma (PTC) were enrolled in the study between March 2010 and August 2010 at Gyeongsang National University Hospital. The patients were prospectively and randomly assigned to two groups, a negative pressure drainage group (n=32) and natural drainage group (n=30). Every 3 hours, the volume of drainage was checked in the two groups until the tube was removed. The amount of drainage during the first 24 hours postoperatively was 41.68 ± 3.93 mL in the negative drain group and 25.3 ± 2.68 mL in the natural drain group (pdrain group was 35.19 ± 4.26 mL and natural drain groups 21.53 ± 2.90 mL (pdrain may increase the amount of drainage during the first 24-48 hours postoperatively. Therefore, it is not necessary to place a closed suction drain when only a total thyroidectomy is done.

  16. Total energy intake may be more associated with glycemic control compared to each proportion of macronutrients in the korean diabetic population.

    Science.gov (United States)

    Kang, Hye Mi; Kim, Dong-Jun

    2012-08-01

    Major macronutrients for energy intake vary among countries and cultures. Carbohydrates, including rice, are the major component of daily energy intake in Korea. The aim of this study was to examine the association of daily energy intake or each proportion of macronutrients, especially carbohydrates, with glycemic control in diabetic Koreans. A total of 334 individuals with diabetes (175 men, age 57.4±0.8 years; 159 women, age 60.9±0.9 years) who participated in the 2005 Korean National Health and Nutrition Examination Survey were examined. Glycemic control was categorized based on concentration of glycated hemoglobin (HbA1c; HbA1c ≤6.5%; 6.6% to 8.0%; ≥8.1%). Dietary intake was assessed by using a 24-recall item questionnaire. High total energy intake was associated with poor glycemic control (HbA1c ≤6.5%, 1,824±75 kcal; 6.6% to 8.0%, 1,990±57 kcal; ≥8.1%, 2,144±73 kcal; P value for trend=0.002). Each proportion of protein, fat, or carbohydrate was not associated with glycemic control. Even after adjusting for several parameters, the association of daily energy intake with glycemic control still persisted. Total energy intake may be more closely related to glycemic control than each proportionof macronutrients in Korean diabetics.

  17. Total Energy Intake May Be More Associated with Glycemic Control Compared to Each Proportion of Macronutrients in the Korean Diabetic Population

    Directory of Open Access Journals (Sweden)

    Hye Mi Kang

    2012-08-01

    Full Text Available BackgroundMajor macronutrients for energy intake vary among countries and cultures. Carbohydrates, including rice, are the major component of daily energy intake in Korea. The aim of this study was to examine the association of daily energy intake or each proportion of macronutrients, especially carbohydrates, with glycemic control in diabetic Koreans.MethodsA total of 334 individuals with diabetes (175 men, age 57.4±0.8 years; 159 women, age 60.9±0.9 years who participated in the 2005 Korean National Health and Nutrition Examination Survey were examined. Glycemic control was categorized based on concentration of glycated hemoglobin (HbA1c; HbA1c ≤6.5%; 6.6% to 8.0%; ≥8.1%. Dietary intake was assessed by using a 24-recall item questionnaire.ResultsHigh total energy intake was associated with poor glycemic control (HbA1c ≤6.5%, 1,824±75 kcal; 6.6% to 8.0%, 1,990±57 kcal; ≥8.1%, 2,144±73 kcal; P value for trend=0.002. Each proportion of protein, fat, or carbohydrate was not associated with glycemic control. Even after adjusting for several parameters, the association of daily energy intake with glycemic control still persisted.ConclusionTotal energy intake may be more closely related to glycemic control than each proportionof macronutrients in Korean diabetics.

  18. Comparison of Total RNA Isolation Methods for Analysis of Immune-Related microRNAs in Market Milks.

    Science.gov (United States)

    Oh, Sangnam; Park, Mi Ri; Son, Seok Jun; Kim, Younghoon

    2015-01-01

    Bovine milk provides essential nutrients, including immunologically important molecules, as the primary source of nutrition to newborns. Recent studies showed that RNAs from bovine milk contain immune-related microRNAs (miRNA) that regulate various immune systems. To evaluate the biological and immunological activity of miRNAs from milk products, isolation methods need to be established. Six methods for extracting total RNAs from bovine colostrums were adopted to evaluate the isolating efficiency and expression of miRNAs. Total RNA from milk was presented in formulation of small RNAs, rather than ribosomal RNAs. Column-combined phenol isolating methods showed high recovery of total RNAs, especially the commercial columns for biofluid samples, which demonstrated outstanding efficiency for recovering miRNAs. We also evaluated the quantity of five immune-related miRNAs (miR-93, miR-106a, miR-155, miR-181a, miR-451) in milk processed by temperature treatments including low temperature for long time (LTLT, 63℃ for 30 min)-, high temperature for short time (HTST, 75℃ for 15 s)-, and ultra heat treatment (UHT, 120-130℃ for 0.5-4 s). All targeted miRNAs had significantly reduced levels in processed milks compared to colostrum and raw mature milk. Interestingly, the amount of immune-related miRNAs from HTST milk was more resistant than those of LTLT and UHT milks. Our present study examined defined methods of RNA isolation and quantification of immune-specific miRNAs from small volumes of milk for use in further analysis.

  19. Periarticular Injection of Liposomal Bupivacaine Offers No Benefit Over Standard Bupivacaine in Total Knee Arthroplasty: A Prospective, Randomized, Controlled Trial.

    Science.gov (United States)

    Alijanipour, Pouya; Tan, Timothy L; Matthews, Christopher N; Viola, Jessica R; Purtill, James J; Rothman, Richard H; Parvizi, Javad; Austin, Matthew S

    2017-02-01

    Periarticular injection of liposomal bupivacaine has been adopted as part of multimodal pain management after total knee arthroplasty (TKA). In this prospective, randomized clinical trial, we enrolled 162 patients undergoing primary TKA in a single institution between January 2014 and May 2015. Eighty-seven patients were randomized to liposomal bupivacaine (experimental group), and 75 patients were randomized to free bupivacaine (control group). All patients received spinal anesthesia and otherwise identical surgical approaches, pain management, and rehabilitation protocols. Outcomes evaluated include the patient-reported visual analog pain scores, narcotic consumption, and narcotic-related side effects (Brief Pain Inventory) within 96 hours after surgery as well as functional outcomes using the Knee Society Score and the Short-Form 12 measured preoperatively and at 4-6 weeks after surgery. There were no statistically significant differences between the groups in terms of postoperative daily pain scores, narcotic consumption (by-day and overall), or narcotic-related side effects. There were no statistically significant differences between the groups in terms of surgical (P = .76) and medical complications or length of hospital stay (P = .35). There were no statistically significant differences in satisfaction between the groups (P = .56) or between the groups in postoperative Knee Society Score (P = .53) and the Short-Form 12 at 4-6 weeks (P = .82, P = .66). As part of multimodal pain management protocol, periarticular injection of liposomal bupivacaine compared with bupivacaine HCl did not result in any clinically or statistically significant improvement of the measured outcomes following TKA. Copyright © 2016 Elsevier Inc. All rights reserved.

  20. Functional outcome in contemporary children with total cavopulmonary connection - Health-related physical fitness, exercise capacity and health-related quality of life.

    Science.gov (United States)

    Hock, Julia; Reiner, Barbara; Neidenbach, Rhoia C; Oberhoffer, Renate; Hager, Alfred; Ewert, Peter; Müller, Jan

    2018-03-15

    Children and adolescents with an univentricular heart after total cavopulmonary connection (TCPC) have functional impairments. This study assesses health-related physical fitness (HRPF) and exercise capacity, as well as their relation to health-related quality of life (HRQoL) in patients with an univentricular heart after total-pulmonary connection (TCPC). Between July 2014 and October 2016 a total of 78 children and adolescents with TCPC (12.0±3.2years, 21 female) performed a motor test including five tasks for strength and flexibility during their routine follow-up appointment. They also underwent a symptom limited cardio-pulmonary exercise test and filled in a HRQoL questionnaire (KINDL-R). Patients' data were compared to a recent sample of healthy children (n=1650, 12.6±2.4years, 49% female). Multivariable regressions corrected for sex, age and BMI showed that TCPC patients achieved 12.4 repetitions of curl-ups (pflexibility (-4.7cm; pmotor competence and exercise capacity, early screening for HRPF and early treatment, if indicated, is recommended. Copyright © 2017 Elsevier Ireland Ltd. All rights reserved.

  1. Multivariable polynomial fitting of controlled single-phase nonlinear load of input current total harmonic distortion

    Science.gov (United States)

    Sikora, Roman; Markiewicz, Przemysław; Pabjańczyk, Wiesława

    2018-04-01

    The power systems usually include a number of nonlinear receivers. Nonlinear receivers are the source of disturbances generated to the power system in the form of higher harmonics. The level of these disturbances describes the total harmonic distortion coefficient THD. Its value depends on many factors. One of them are the deformation and change in RMS value of supply voltage. A modern LED luminaire is a nonlinear receiver as well. The paper presents the results of the analysis of the influence of change in RMS value of supply voltage and the level of dimming of the tested luminaire on the value of the current THD. The analysis was made using a mathematical model based on multivariable polynomial fitting.

  2. Multivariable polynomial fitting of controlled single-phase nonlinear load of input current total harmonic distortion

    Directory of Open Access Journals (Sweden)

    Sikora Roman

    2018-04-01

    Full Text Available The power systems usually include a number of nonlinear receivers. Nonlinear receivers are the source of disturbances generated to the power system in the form of higher harmonics. The level of these disturbances describes the total harmonic distortion coefficient THD. Its value depends on many factors. One of them are the deformation and change in RMS value of supply voltage. A modern LED luminaire is a nonlinear receiver as well. The paper presents the results of the analysis of the influence of change in RMS value of supply voltage and the level of dimming of the tested luminaire on the value of the current THD. The analysis was made using a mathematical model based on multivariable polynomial fitting.

  3. Changes in lifestyle and total homocysteine in relation to MTHFR (C677T) genotype: the Inter99 study

    DEFF Research Database (Denmark)

    Husemoen, LL; Thomsen, TF; Fenger, M

    2006-01-01

    BACKGROUND: Reduction in total homocysteine (tHcy) may be clinically relevant in the prevention of cardiovascular disease (CVD) in the general population. OBJECTIVE: To examine the effects of changes in various lifestyle habits and lifestyle related biological CVD risk markers on changes in t...... intervention and re-examination after one year. RESULTS: None of the studied lifestyle changes-- smoking, physical activity, dietary habits, and coffee, tea, and alcohol consumption-- was significantly associated with changes in tHcy, either overall, or in any of the MTHFR genotype subgroups. In addition...

  4. Potential Cardiovascular and Total Mortality Benefits of Air Pollution Control in Urban China.

    Science.gov (United States)

    Huang, Chen; Moran, Andrew E; Coxson, Pamela G; Yang, Xueli; Liu, Fangchao; Cao, Jie; Chen, Kai; Wang, Miao; He, Jiang; Goldman, Lee; Zhao, Dong; Kinney, Patrick L; Gu, Dongfeng

    2017-10-24

    Outdoor air pollution ranks fourth among preventable causes of China's burden of disease. We hypothesized that the magnitude of health gains from air quality improvement in urban China could compare with achieving recommended blood pressure or smoking control goals. The Cardiovascular Disease Policy Model-China projected coronary heart disease, stroke, and all-cause deaths in urban Chinese adults 35 to 84 years of age from 2017 to 2030 if recent air quality (particulate matter with aerodynamic diameter ≤2.5 µm, PM 2.5 ) and traditional cardiovascular risk factor trends continue. We projected life-years gained if urban China were to reach 1 of 3 air quality goals: Beijing Olympic Games level (mean PM 2.5 , 55 μg/m 3 ), China Class II standard (35 μg/m 3 ), or World Health Organization standard (10 μg/m 3 ). We compared projected air pollution reduction control benefits with potential benefits of reaching World Health Organization hypertension and tobacco control goals. Mean PM 2.5 reduction to Beijing Olympic levels by 2030 would gain ≈241,000 (95% uncertainty interval, 189 000-293 000) life-years annually. Achieving either the China Class II or World Health Organization PM 2.5 standard would yield greater health benefits (992 000 [95% uncertainty interval, 790 000-1 180 000] or 1 827 000 [95% uncertainty interval, 1 481 00-2 129 000] annual life-years gained, respectively) than World Health Organization-recommended goals of 25% improvement in systolic hypertension control and 30% reduction in smoking combined (928 000 [95% uncertainty interval, 830 000-1 033 000] life-years). Air quality improvement in different scenarios could lead to graded health benefits ranging from 241 000 life-years gained to much greater benefits equal to or greater than the combined benefits of 25% improvement in systolic hypertension control and 30% smoking reduction. © 2017 American Heart Association, Inc.

  5. Segmental translation after lumbar total disc replacement using Prodisc-L®: associated factors and relation to facet arthrosis.

    Science.gov (United States)

    Shin, Myung H; Ryu, Kyeong S; Rathi, Nitesh K; Park, Chun K

    2017-02-01

    Segmental translation after lumbar total disc replacement (TDR) with ProDisc-L® prosthesis frequently observed radiographic findings during follow-up period. However its precise pathomechanism and relation with facet arthrosis have not been investigated yet. This study was performed to evaluate possible factors that affect postoperative segmental translation and to identify its relation with facet joint degeneration after lumbar TDR using ProDisc-L® prosthesis. Thirty-five consecutive patients, who underwent lumbar TDR using ProDisc-L®, completed minimum 24 months follow-up. Segmental translation was assessed postoperatively at 1 month and at least at 24 months by using dynamic plain radiograph. Segmental translation was assessed in relation to patient age, sex, change of functional spinal unit (FSU) height, segmental range of motion (ROM), global lumbar ROM, implanted level, relative prosthesis size and prosthesis position. The comparison of segmental translation between progressive facet arthrosis (PFA) group and non-PFA group was also made. The mean segmental translation was 0.49±0.49 mm at 1 month after surgery and showed significant increase to 0.83±0.78 mm at last follow-up (P=0.014). Change of FSU height, segmental ROM, global lumbar ROM, implanted level and relative size of prosthesis were the significant factors among the variables related to segmental translation that authors assessed (P=0.032, P=0.000, P=0.001, P=0.046 and P=0.042, respectively). There was no significant intergroup difference of mean segmental translation between PFA group and non-PFA group (P=0.586). This study demonstrates that segmental translation after TDR using ProDisc-L® has significant relations with change of FSU height, segmental ROM, global lumbar ROM, implanted level and relative size of prosthesis. With the intergroup comparison, PFA group did not show significant higher segmental translation than non-PFA group.

  6. Epigenomics of Total Acute Sleep Deprivation in Relation to Genome-Wide DNA Methylation Profiles and RNA Expression.

    Science.gov (United States)

    Nilsson, Emil K; Boström, Adrian E; Mwinyi, Jessica; Schiöth, Helgi B

    2016-06-01

    Despite an established link between sleep deprivation and epigenetic processes in humans, it remains unclear to what extent sleep deprivation modulates DNA methylation. We performed a within-subject randomized blinded study with 16 healthy subjects to examine the effect of one night of total sleep deprivation (TSD) on the genome-wide methylation profile in blood compared with that in normal sleep. Genome-wide differences in methylation between both conditions were assessed by applying a paired regression model that corrected for monocyte subpopulations. In addition, the correlations between the methylation of genes detected to be modulated by TSD and gene expression were examined in a separate, publicly available cohort of 10 healthy male donors (E-GEOD-49065). Sleep deprivation significantly affected the DNA methylation profile both independently and in dependency of shifts in monocyte composition. Our study detected differential methylation of 269 probes. Notably, one CpG site was located 69 bp upstream of ING5, which has been shown to be differentially expressed after sleep deprivation. Gene set enrichment analysis detected the Notch and Wnt signaling pathways to be enriched among the differentially methylated genes. These results provide evidence that total acute sleep deprivation alters the methylation profile in healthy human subjects. This is, to our knowledge, the first study that systematically investigated the impact of total acute sleep deprivation on genome-wide DNA methylation profiles in blood and related the epigenomic findings to the expression data.

  7. Total and Differential Leukocyte Counts in Relation to Incidence of Diabetes Mellitus: A Prospective Population-Based Cohort Study.

    Science.gov (United States)

    Borné, Yan; Smith, J Gustav; Nilsson, Peter M; Melander, Olle; Hedblad, Bo; Engström, Gunnar

    2016-01-01

    High concentrations of leukocytes in blood have been associated with diabetes mellitus. This prospective study aimed to explore whether total and differential leukocyte counts are associated with incidence of diabetes. A missense variant R262W in the SH2B3 (SH2B adaptor protein 3) gene, coding for a protein that negatively regulates hematopoietic cell proliferation, was also studied in relation to incidence of diabetes. Leukocyte count and its subtypes (neutrophils, lymphocytes and mixed cells) were analyzed in 26,667 men and women, 45-73 years old, from the population-based Malmö Diet and Cancer study. Information about the R262W polymorphism (rs3184504) in SH2B3 was genotyped in 24,489 subjects. Incidence of diabetes was studied during a mean follow-up of 14 years. Cox proportional hazards regression was used to examine incidence of diabetes by total and differential leukocyte counts. Mendelian randomization analysis using R262W as an instrumental variable was performed with two-stage least squares regression. A total of 2,946 subjects developed diabetes during the follow-up period. After taking several possible confounders into account, concentrations of total leukocyte count, neutrophils and lymphocytes were all significantly associated with incidence of diabetes. The adjusted hazard ratios (95% confidence interval; quartile 4 vs quartile 1) were 1.37 (1.22-1.53) for total leukocytes, 1.33 (1.19-1.49) for neutrophils and 1.29 (1.15-1.44) for lymphocytes. The R262W polymorphism was strongly associated with leukocytes (0.11x109 cells/l per T allele, p = 1.14 x10-12), lymphocytes (p = 4.3 x10-16), neutrophils (p = 8.0 x10-6) and mixed cells (p = 3.0 x10-6). However, there was no significant association between R262W and fasting glucose, HbA1c or incidence of diabetes. Concentrations of total leukocytes, neutrophils and lymphocytes are associated with incidence of diabetes. However, the lack of association with the R262W polymorphism suggests that the associations

  8. High-Density Genetic Map Construction and Stem Total Polysaccharide Content-Related QTL Exploration for Chinese Endemic Dendrobium (Orchidaceae)

    Science.gov (United States)

    Lu, Jiangjie; Liu, Yuyang; Xu, Jing; Mei, Ziwei; Shi, Yujun; Liu, Pengli; He, Jianbo; Wang, Xiaotong; Meng, Yijun; Feng, Shangguo; Shen, Chenjia; Wang, Huizhong

    2018-01-01

    Plants of the Dendrobium genus are orchids with not only ornamental value but also high medicinal value. To understand the genetic basis of variations in active ingredients of the stem total polysaccharide contents (STPCs) among different Dendrobium species, it is of paramount importance to understand the mechanism of STPC formation and identify genes affecting its process at the whole genome level. Here, we report the first high-density single-nucleotide polymorphism (SNP) integrated genetic map with a good genome coverage of Dendrobium. The specific-locus amplified fragment sequencing (SLAF-seq) technology led to identification of 7,013,400 SNPs from 1,503,626 high-quality SLAF markers from two parents (Dendrobium moniliforme ♀ × Dendrobium officinale ♂) and their interspecific F1 hybrid population. The final genetic map contained 8, 573 SLAF markers, covering 19 linkage groups (LGs). This genetic map spanned a length of 2,737.49 cM, where the average distance between markers is 0.32 cM. In total, 5 quantitative trait loci (QTL) related to STPC were identified, 3 of which have candidate genes within the confidence intervals of these stable QTLs based on the D. officinale genome sequence. This study will build a foundation up for the mapping of other medicinal-related traits and provide an important reference for the molecular breeding of these Chinese herb. PMID:29636767

  9. Effectiveness of Active Packaging on Control of Escherichia Coli O157:H7 and Total Aerobic Bacteria on Iceberg Lettuce.

    Science.gov (United States)

    Lu, Haixia; Zhu, Junli; Li, Jianrong; Chen, Jinru

    2015-06-01

    Contaminated leafy green vegetables have been linked to several outbreaks of human gastrointestinal infections. Antimicrobial interventions that are adoptable by the fresh produce industry for control of pathogen contamination are in great demand. This study was undertaken to evaluate the efficacy of sustained active packaging on control of Escherichia coli O157:H7 and total aerobic bacteria on lettuce. Commercial Iceberg lettuce was inoculated with a 3-strain mixture of E. coli O157:H7 at 10(2) or 10(4) CFU/g. The contaminated lettuce and un-inoculated controls were placed respectively in 5 different active packaging structures. Traditional, nonactive packaging structure was included as controls. Packaged lettuce was stored at 4, 10, or 22 °C for 3 wk and sampled weekly for the population of E. coli O157:H7 and total aerobic bacteria. Results showed that packaging structures with ClO2 generator, CO2 generator, or one of the O2 scavengers effectively controlled the growth of E. coli O157:H7 and total aerobic bacteria under all storage conditions. Packaging structure with the ClO2 generator was most effective and no E. coli O157:H7 was detected in samples packaged in this structure except for those that were inoculated with 4 log CFU/g of E. coli O157:H7 and stored at 22 °C. Packaging structures with an oxygen scavenger and the allyl isothiocyanate generator were mostly ineffective in control of the growth of the bacteria on Iceberg lettuce. The research suggests that some of the packaging structures evaluated in the study can be used to control the presence of foodborne pathogens on leafy green vegetables. © 2015 Institute of Food Technologists®

  10. Purex Process Improvements for Pu and NP Control in Total Actinide Recycle Flowsheets

    International Nuclear Information System (INIS)

    Birkett, J.E.; Carrott, M.J.; Crooks, G.; Fox, O.D.; Maher, C.J.; Taylor, R.J.; Woodhead, D.A.

    2006-01-01

    Significant improvements are required in the Purex process to optimise it for Advanced Fuel Cycles. Two key challenges we have identified are, firstly, developing more efficient methods for U/Pu separations especially at elevated Pu concentrations and, secondly, improving recovery, control and routing of Np in a modified Purex process. A series of Purex-like flowsheets for improved Pu separations based on hydroxamic acids and are reported. Purex-like flowsheets have been tested on a glovebox-housed 30-stage miniature centrifugal contactor train. A series of trials have been performed to demonstrate the processing of feeds with varying Pu contents ranging from 7 - 40% by weight. These flowsheets have demonstrated hydroxamic acids are excellent reagents for complexant stripping of Pu being able to achieve high decontamination factors (DF) on both the U and Pu product streams and co - recover Np with Pu. The advantages of a complexant-based approach are shown to be especially relevant when AFC scenarios are considered, where the Pu content of the fuel is expected to b e significantly higher. Recent results towards modifying the Purex process to improve recovery and control of Np in short residence time contactors are reported. Work on the development of chemical and process models to describe the complicated behaviour of Np under primary separation conditions (i.e. the HA extraction contactor) is described. To test the performance of the model a series of experiments were performed including testing of flowsheets on a fume-hood housed miniature centrifugal contactor train. The flowsheet was designed to emulate the conditions of a primar y separations contactor with the Np split between the U-solvent product and aqueous raffinate. In terms of Np routing the process model showed good agreement with flowsheet trial however much further work is required to fully understand this complex system. (authors)

  11. Estimation of the Relative Contribution of Postprandial Glucose Exposure to Average Total Glucose Exposure in Subjects with Type 2 Diabetes

    Directory of Open Access Journals (Sweden)

    Bo Ahrén

    2016-01-01

    Full Text Available We hypothesized that the relative contribution of fasting plasma glucose (FPG versus postprandial plasma glucose (PPG to glycated haemoglobin (HbA1c could be calculated using an algorithm developed by the A1c-Derived Average Glucose (ADAG study group to make HbA1c values more clinically relevant to patients. The algorithm estimates average glucose (eAG exposure, which can be used to calculate apparent PPG (aPPG by subtracting FPG. The hypothesis was tested in a large dataset (comprising 17 studies from the vildagliptin clinical trial programme. We found that 24 weeks of treatment with vildagliptin monotherapy (n=2523 reduced the relative contribution of aPPG to eAG from 8.12% to 2.95% (by 64%, p<0.001. In contrast, when vildagliptin was added to metformin (n=2752, the relative contribution of aPPG to eAG insignificantly increased from 1.59% to 2.56%. In conclusion, glucose peaks, which are often prominent in patients with type 2 diabetes, provide a small contribution to the total glucose exposure assessed by HbA1c, and the ADAG algorithm is not robust enough to assess this small relative contribution in patients receiving combination therapy.

  12. Combined impact of lifestyle-related factors on total and cause-specific mortality among Chinese women: prospective cohort study.

    Directory of Open Access Journals (Sweden)

    Sarah J Nechuta

    2010-09-01

    Full Text Available Although cigarette smoking, excessive alcohol drinking, obesity, and several other well-studied unhealthy lifestyle-related factors each have been linked to the risk of multiple chronic diseases and premature death, little is known about the combined impact on mortality outcomes, in particular among Chinese and other non-Western populations. The objective of this study was to quantify the overall impact of lifestyle-related factors beyond that of active cigarette smoking and alcohol consumption on all-cause and cause-specific mortality in Chinese women.We used data from the Shanghai Women's Health Study, an ongoing population-based prospective cohort study in China. Participants included 71,243 women aged 40 to 70 years enrolled during 1996-2000 who never smoked or drank alcohol regularly. A healthy lifestyle score was created on the basis of five lifestyle-related factors shown to be independently associated with mortality outcomes (normal weight, lower waist-hip ratio, daily exercise, never exposed to spouse's smoking, higher daily fruit and vegetable intake. The score ranged from zero (least healthy to five (most healthy points. During an average follow-up of 9 years, 2,860 deaths occurred, including 775 from cardiovascular disease (CVD and 1,351 from cancer. Adjusted hazard ratios for mortality decreased progressively with an increasing number of healthy lifestyle factors. Compared to women with a score of zero, hazard ratios (95% confidence intervals for women with four to five factors were 0.57 (0.44-0.74 for total mortality, 0.29 (0.16-0.54 for CVD mortality, and 0.76 (0.54-1.06 for cancer mortality. The inverse association between the healthy lifestyle score and mortality was seen consistently regardless of chronic disease status at baseline. The population attributable risks for not having 4-5 healthy lifestyle factors were 33% for total deaths, 59% for CVD deaths, and 19% for cancer deaths.In this first study, to our knowledge, to

  13. The transfer of Cfunc contextual control through equivalence relations.

    Science.gov (United States)

    Perez, William F; Fidalgo, Adriana P; Kovac, Roberta; Nico, Yara C

    2015-05-01

    Derived relational responding is affected by contextual stimuli (Cfunc) that select specific stimulus functions. The present study investigated the transfer of Cfunc contextual control through equivalence relations by evaluating both (a) the maintenance of Cfunc contextual control after the expansion of a relational network, and (b) the establishment of novel contextual stimuli by the transfer of Cfunc contextual control through equivalence relations. Initially, equivalence relations were established and contingencies were arranged so that colors functioned as Cfunc stimuli controlling participants' key-pressing responses in the presence of any stimulus from a three-member equivalence network. To investigate the first research question, the three-member equivalence relations were expanded to five members and the novel members were presented with the Cfunc stimuli in the key-pressing task. To address the second goal of this study, the colors (Cfunc) were established as equivalent to certain line patterns. The transfer of contextual cue function (Cfunc) was tested replacing the colored backgrounds with line patterns in the key-pressing task. Results suggest that the Cfunc contextual control was transferred to novel stimuli that were added to the relational network. In addition, the line patterns indirectly acquired the contextual cue function (Cfunc) initially established for the colored backgrounds. The conceptual and applied implications of Cfunc contextual control are discussed. © Society for the Experimental Analysis of Behavior.

  14. Controllable transmission and total reflection through an impedance-matched acoustic metasurface

    KAUST Repository

    Mei, Jun

    2014-12-02

    A general design paradigm for a novel type of acoustic metasurface is proposed by introducing periodically repeated supercells on a rigid thin plate, where each supercell contains multiple cut-through slits that are filled with materials possessing different refractive indices but the same impedance as that of the host medium. When the wavelength of the incident wave is smaller than the periodicity, the direction of the transmitted wave with nearly unity transmittance can be chosen by engineering the phase discontinuities along the transverse direction. When the wavelength is larger than the periodicity, even though the metasurface is impedance matched to the host medium, most of the incident energy is reflected back and the remaining portion is converted into a surface-bound mode. We show that both the transmitted wave control and the high reflection with the surface mode excitation can be interpreted by a unified analytic model based on mode-coupling theory. Our general design principle not only supplies the functionalities of reflection-type acoustic metasurfaces, but also exhibits unprecedented flexibility and efficiency in various domains of wave manipulation for possible applications in fields like refracting, collimating, focusing or absorbing wave energy.

  15. 'Locus of control', health-related quality of life, emotional distress and disability in Parkinson's disease.

    Science.gov (United States)

    Rizza, Federica; Gison, Annalisa; Bonassi, Stefano; Dall'Armi, Valentina; Tonto, Francesca; Giaquinto, Salvatore

    2017-06-01

    This cross-sectional study evaluated locus of control and its subscales in Parkinson's disease. A total of 50 consecutive Parkinson's disease participants and 50 healthy volunteers (control group) were enrolled. External locus of control was significantly higher in Parkinson's disease participants, whereas internal locus of control had no significant differences. External locus of control and internal locus of control were correlated in control group, but not in Parkinson's disease. In Parkinson's disease participants, external locus of control was negatively associated with health-related quality of life as well as positively associated with emotional distress and disease severity (but not with disability). After adjusting to confound variables, the associations remained. On the other hand, internal locus of control was negatively associated with depression.

  16. The Total In-Flight Simulator (TIFS) aerodynamics and systems: Description and analysis. [maneuver control and gust alleviators

    Science.gov (United States)

    Andrisani, D., II; Daughaday, H.; Dittenhauser, J.; Rynaski, E.

    1978-01-01

    The aerodynamics, control system, instrumentation complement and recording system of the USAF Total In/Flight Simulator (TIFS) airplane are described. A control system that would allow the ailerons to be operated collectively, as well as, differentially to entrance the ability of the vehicle to perform the dual function of maneuver load control and gust alleviation is emphasized. Mathematical prediction of the rigid body and the flexible equations of longitudinal motion using the level 2.01 FLEXSTAB program are included along with a definition of the vehicle geometry, the mass and stiffness distribution, the calculated mode frequencies and mode shapes, and the resulting aerodynamic equations of motion of the flexible vehicle. A complete description of the control and instrumentation system of the aircraft is presented, including analysis, ground test and flight data comparisons of the performance and bandwidth of the aerodynamic surface servos. Proposed modification for improved performance of the servos are also presented.

  17. Dynamics and control of Lorentz-augmented spacecraft relative motion

    CERN Document Server

    Yan, Ye; Yang, Yueneng

    2017-01-01

    This book develops a dynamical model of the orbital motion of Lorentz spacecraft in both unperturbed and J2-perturbed environments. It explicitly discusses three kinds of typical space missions involving relative orbital control: spacecraft hovering, rendezvous, and formation flying. Subsequently, it puts forward designs for both open-loop and closed-loop control schemes propelled or augmented by the geomagnetic Lorentz force. These control schemes are entirely novel and represent a significantly departure from previous approaches.

  18. Evaluation of Total Daily Dose and Glycemic Control for Patients on U-500 Insulin Admitted to the Hospital

    Science.gov (United States)

    2016-05-20

    regular insulin has significantly increased in recent years. These patients are severely insulin resistant requiring high doses of insulin to achieve...on U-500 Insulin Admitted to the Hospital presented at SURF Conference, San Antonio, TX 20 May 201 6 with MDWI 41-108, and has been assigned local...59th CSPG/SGVU) C.201 4 . I 52d PROTOCOL TITLE Evaluation of Total Dai ly Dose and Glycemic Control for Patients on U-500 Insulin Admitted to the

  19. Total antioxidant intake and prostate cancer in the Cancer of the Prostate in Sweden (CAPS) study. A case control study

    International Nuclear Information System (INIS)

    Russnes, Kjell M.; Möller, Elisabeth; Wilson, Kathryn M.; Carlsen, Monica; Blomhoff, Rune; Smeland, Sigbjørn; Adami, Hans-Olov; Grönberg, Henrik; Mucci, Lorelei A.; Bälter, Katarina

    2016-01-01

    The total intake of dietary antioxidants may reduce prostate cancer risk but available data are sparse and the possible role of supplements unclear. We investigated the potential association between total and dietary antioxidant intake and prostate cancer in a Swedish population. We used FFQ data from 1499 cases and 1112 controls in the population based case–control study Cancer of the Prostate in Sweden (CAPS). The ferric reducing antioxidant potential (FRAP) assay was used to assess the total antioxidant capacity (TAC) of diet and supplements. We calculated odds ratios (ORs) for the risk of prostate cancer across quintiles of antioxidant intake from all foods, from fruit and vegetables only, and from dietary supplements using unconditional logistic regression. Coffee comprised 62 % of the dietary antioxidant intake, tea 4 %, berries 4 %, chocolate 2 %, and boiled potatoes 2 %. In total 19 % and 13 % of the population took multivitamins and supplemental Vitamin C respectively, on a regular basis. Antioxidant intake from all foods and from fruits and vegetables separately measured by the FRAP assay was not associated with prostate cancer risk. For antioxidant intake from supplements we found a positive association with total, advanced, localized, high grade and low grade prostate cancer in those above median supplemental TAC intake of users compared to non-users (Adjusted ORs for total prostate cancer: 1.37, 95 % CI 1.08–1.73, advanced: 1.51, 95 % CI 1.11–2.06, localized: 1.36. 95 % CI 1.06–1.76, high grade 1.60, 95 % CI 1.06–2.40, low grade 1.36, 95 % CI 1.03–1.81). A high intake of coffee (≥6 cups/day) was associated with a possible risk reduction of fatal and significantly with reduced risk for high grade prostate cancer, adjusted OR: 0.45 (95 % CI: 0.22–0.90), whereas a high intake of chocolate was positively associated with risk of total, advanced, localized and low grade disease (adjusted OR for total: 1.43, 95 % CI 1.12–1.82, advanced: 1

  20. Impaired postural control in children with developmental coordination disorder is related to less efficient central as well as peripheral control

    DEFF Research Database (Denmark)

    Speedtsberg, Merete Brink; Christensen, Sofie Bouschinger; Andersen, Ken Kjøller

    2017-01-01

    BACKGROUND: Developmental coordination disorder (DCD) is a neurodevelopmental impairment that affects approximately 6% of children in primary school age. Children with DCD are characterized by impaired postural control. It has yet to be determined what effect peripheral and central neuromuscular...... control has on their balance control. OBJECTIVE: The aim of this study was to investigate the underlying mechanisms to impaired postural control in children with DCD using the rambling-trembling decomposition of the center of pressure (CoP). METHOD: Nine children with DCD (9.0±0.5years, 7 boys, 2 girls...... with fixed support surface. In ML direction children with DCD had a lower relative contribution of rambling to total sway (p=0.013). CONCLUSION: This study showed that impaired postural control in children with DCD is associated with less efficient supraspinal control represented by increased rambling...

  1. Establishment of a paediatric age-related reference interval for the measurement of urinary total fractionated metanephrines.

    LENUS (Irish Health Repository)

    Griffin, Alison

    2012-02-01

    INTRODUCTION: Normetanephrine and metanephrine are intermediate metabolites of noradrenaline and adrenaline metabolism. To assess whether normetanephrine and metanephrine analysis may aid in the diagnosis of Neuroblastoma, a reference interval for these metabolites must first be established. AIM: The overall aim of this study was to establish a paediatric age-related reference interval for the measurement of total fractionated metanephrines. METHODS: A total of 267 urine samples were analysed following acid hydrolysis. This releases the metanephrines from their sulphate-bound metabolites. The samples were analysed using reverse phase high-performance liquid chromatography with electro-chemical detection on a Gilson automated sequential trace enrichment of dialysate sample system. RESULTS: Data were analysed using Minitab Release version 14. Outliers were removed using the Dixon\\/Reed one-third rule. Partitioning of the age groups was achieved using Harris and Boyd\\'s standard normal deviate test. Non-parametric analysis of the data was performed, followed by the establishment of the 2.5th and the 97.5th reference limits. CONCLUSIONS: The established reference intervals are described in Table 2.

  2. Ice formation via deposition nucleation on mineral dust and organics: dependence of onset relative humidity on total particulate surface area

    International Nuclear Information System (INIS)

    Kanji, Zamin A; Florea, Octavian; Abbatt, Jonathan P D

    2008-01-01

    We present ice nucleation results for Arizona test dust, kaolinite, montmorillonite, silica, silica coated with a hydrophobic octyl chain, oxalic acid dihydrate, Gascoyne leonardite (a humic material), and Aldrich humic acid (sodium salt). The focus was on deposition mode nucleation below water saturation at 233 K. Particles were deposited onto a hydrophobic cold stage by atomization of a slurry/solution and exposed to a constant partial pressure of water vapor. By lowering the temperature of the stage, the relative humidity with respect to ice (RH i ) was gradually increased until ice nucleation was observed using digital photography. Different numbers of particles were deposited onto the cold stage by varying the atomization solution concentration and deposition time. For the same total particulate surface area, mineral dust particles nucleated ice at lower supersaturations than all other materials. The most hydrophobic materials, i.e. Gascoyne leonardite and octyl silica, were the least active. For our limit of detection of one ice crystal, the ice onset RH i values were dependent on the total surface area of the particulates, indicating that no unique threshold RH i for ice nucleation prevails

  3. Ice formation via deposition nucleation on mineral dust and organics: dependence of onset relative humidity on total particulate surface area

    Energy Technology Data Exchange (ETDEWEB)

    Kanji, Zamin A; Florea, Octavian; Abbatt, Jonathan P D [Department of Chemistry, University of Toronto, 80 St George Street, Toronto, ON, M5S 3H6 (Canada)], E-mail: zkanji@chem.utoronto.ca

    2008-04-15

    We present ice nucleation results for Arizona test dust, kaolinite, montmorillonite, silica, silica coated with a hydrophobic octyl chain, oxalic acid dihydrate, Gascoyne leonardite (a humic material), and Aldrich humic acid (sodium salt). The focus was on deposition mode nucleation below water saturation at 233 K. Particles were deposited onto a hydrophobic cold stage by atomization of a slurry/solution and exposed to a constant partial pressure of water vapor. By lowering the temperature of the stage, the relative humidity with respect to ice (RH{sub i}) was gradually increased until ice nucleation was observed using digital photography. Different numbers of particles were deposited onto the cold stage by varying the atomization solution concentration and deposition time. For the same total particulate surface area, mineral dust particles nucleated ice at lower supersaturations than all other materials. The most hydrophobic materials, i.e. Gascoyne leonardite and octyl silica, were the least active. For our limit of detection of one ice crystal, the ice onset RH{sub i} values were dependent on the total surface area of the particulates, indicating that no unique threshold RH{sub i} for ice nucleation prevails.

  4. Criticality accident in uranium fuel processing plant. The estimation of the total number of fissions with related reactor physics parameters

    International Nuclear Information System (INIS)

    Nishina, Kojiro; Oyamatsu, Kazuhiro; Kondo, Shunsuke; Sekimoto, Hiroshi; Ishitani, Kazuki; Yamane, Yoshihiro; Miyoshi, Yoshinori

    2000-01-01

    This accident occurred when workers were pouring a uranium solution into a precipitation tank with handy operation against the established procedure and both the cylindrical diameter and the total mass exceeded the limited values. As a result, nuclear fission chain reactor in the solution reached not only a 'criticality' state continuing it independently but also an instantly forming criticality state exceed the criticality and increasing further nuclear fission number. The place occurring the accident at this time was not reactor but a place having not to form 'criticality' called by a processing process of uranium fuel. In such place, as because of relating to mechanism of chain reaction, it is required naturally for knowledge on the reactor physics, it is also necessary to understand chemical reaction in chemical process, and functions of tanks, valves and pumps mounted at the processes. For this purpose, some information on uranium concentration ratio, atomic density of nuclides largely affecting to chain reaction such as uranium, hydrogen, and so forth in the solution, shape, inner structure and size of container for the solution, and its temperature and total volume, were necessary for determining criticality volume of the accident uranium solution by using nuclear physics procedures. Here were described on estimation of energy emission in the JCO accident, estimation from analytical results on neutron and solution, calculation of various nuclear physics property estimation on the JCO precipitation tank at JAERI. (G.K.)

  5. Improved Sensitivity Relations in State Constrained Optimal Control

    International Nuclear Information System (INIS)

    Bettiol, Piernicola; Frankowska, Hélène; Vinter, Richard B.

    2015-01-01

    Sensitivity relations in optimal control provide an interpretation of the costate trajectory and the Hamiltonian, evaluated along an optimal trajectory, in terms of gradients of the value function. While sensitivity relations are a straightforward consequence of standard transversality conditions for state constraint free optimal control problems formulated in terms of control-dependent differential equations with smooth data, their verification for problems with either pathwise state constraints, nonsmooth data, or for problems where the dynamic constraint takes the form of a differential inclusion, requires careful analysis. In this paper we establish validity of both ‘full’ and ‘partial’ sensitivity relations for an adjoint state of the maximum principle, for optimal control problems with pathwise state constraints, where the underlying control system is described by a differential inclusion. The partial sensitivity relation interprets the costate in terms of partial Clarke subgradients of the value function with respect to the state variable, while the full sensitivity relation interprets the couple, comprising the costate and Hamiltonian, as the Clarke subgradient of the value function with respect to both time and state variables. These relations are distinct because, for nonsmooth data, the partial Clarke subdifferential does not coincide with the projection of the (full) Clarke subdifferential on the relevant coordinate space. We show for the first time (even for problems without state constraints) that a costate trajectory can be chosen to satisfy the partial and full sensitivity relations simultaneously. The partial sensitivity relation in this paper is new for state constraint problems, while the full sensitivity relation improves on earlier results in the literature (for optimal control problems formulated in terms of Lipschitz continuous multifunctions), because a less restrictive inward pointing hypothesis is invoked in the proof, and because

  6. [The effects of transversus abdominis plane block on analgesic and anesthetic consumption during total abdominal hysterectomy: a randomized controlled study].

    Science.gov (United States)

    Karaman, Tugba; Ozsoy, Asker Zeki; Karaman, Serkan; Dogru, Serkan; Tapar, Hakan; Sahin, Aynur; Dogru, Hatice; Suren, Mustafa

    A transversus abdominis plane block is a peripheral block method that has been used successfully for pain relief after total abdominal hysterectomy. However, the effects of the combination of the transversus abdominis plane block and general anesthesia on analgesic and anesthetic requirements remain unclear. This randomized placebo-controlled study is aimed to evaluate the effects of transversus abdominis plane block on analgesic and anesthetic consumption during total abdominal hysterectomy under general anesthesia. Sixty-six women undergoing total abdominal hysterectomy were randomized into two groups to receive general anesthesia alone (control group) or with transversus abdominis plane block using 20mL of 0.25% bupivacaine (transversus abdominis plane group). Intraoperative remifentanil and sevoflurane consumption were recorded. We also evaluated the postoperative pain, nausea, quality of recovery scores and rescue analgesic requirement during postoperative 24hours. The total remifentanil and sevoflurane consumption is significantly lower in transversus abdominis plane group; respectively mean (SD) 0.130 (0.25) vs. 0.094 (0.02) mcg.kg -1 .min -1 ; pplane group soon after surgery; median (range) 6 (2-10) vs. 3 (0-5); pplane group had significantly higher QoR-40 scores 190.5 (175-197) vs. 176.5 (141-187); pplane block with general anesthesia can provide reduced opioid and anesthetic consumption and can improve postoperative pain and quality of recovery scores in patients undergoing total abdominal hysterectomy. Copyright © 2018 Sociedade Brasileira de Anestesiologia. Publicado por Elsevier Editora Ltda. All rights reserved.

  7. Reduced endogenous urinary total antioxidant power and its relation of plasma antioxidant activity of superoxide dismutase in individuals with autism spectrum disorder.

    Science.gov (United States)

    Yui, Kunio; Tanuma, Nasoyuki; Yamada, Hiroshi; Kawasaki, Yohei

    2017-08-01

    Individuals with autism spectrum disorders (ASD) have impaired detoxification capacity. Investigating the neurobiological bases of impaired antioxidant capacity is thus a research priority in the pathophysiology of ASD. We measured the urinary levels of hexanoyl-lysine (HEL) which is a new oxidative stress biomarker, total antioxidant power (TAP) and DNA methylation biomarker 8-hydroxy-2'-deoxyguanosine (8-OHdG), and the plasma levels of superoxide dismutase (SOD), which is a major antioxidant enzyme. We examined whether the urinary levels of these enzymes and biomarkers may be related to symptoms of social impairment in 20 individuals with ASD (meanage,11.1±5.2years) and 12 age- and gender-matched healthy controls (meanage,14.3±6.2years). Symptoms of social impairment were assessed using the Social Responsiveness Scale (SRS). The dietary TAP of the fruit juice, chocolate, cookies, biscuits, jam and marmalade were significantly higher in the ASD group than in the control group, although the intake of nutrients was not significantly different between the groups. The urinary TAP levels were significantly lower in the ASD group than in the control group. There were no significantly differences in urinary HEL and 8-OHdG levels between the ASD and control groups. The SRS scores were significantly higher in the ASD group than in the control group. Stepwise regression analysis revealed that urinary TAP levels and plasma SOD levels can differences in the biomarkers and the SRS scores between the ASD group and the control group. The endogenous antioxidant capacity may be deficient without altered urinary HEL and 8-OHdG levels in individuals with ASD. The plasma SOD levels may be related to reduced endogenous antioxidant capacity. Copyright © 2016 ISDN. Published by Elsevier Ltd. All rights reserved.

  8. Auricular Acupressure for Managing Postoperative Pain and Knee Motion in Patients with Total Knee Replacement: A Randomized Sham Control Study

    Directory of Open Access Journals (Sweden)

    Ling-hua Chang

    2012-01-01

    Full Text Available Background. Postoperative pain management remains a significant challenge for all healthcare providers. A randomized controlled trial was conducted to examine the adjuvant effects of auricular acupressure on relieving postoperative pain and improving the passive range of motion in patients with total knee replacement (TKR. Method. Sixty-two patients who had undergone a TKR were randomly assigned to the acupressure group and the sham control group. The intervention was delivered three times a day for 3 days. A visual analog scale (VAS and the Short-Form McGill Pain Questionnaire were used to assess pain intensity. Pain medication consumption was recorded, and the knee motion was measured using a goniometer. Results. The patients experienced a moderately severe level of pain postoperatively (VAS 58.66 ± 20.35 while being on the routine PCA. No differences were found in pain scores between the groups at all points. However, analgesic drug usage in the acupressure group patients was significantly lower than in the sham control group (<0.05, controlling for BMI, age, and pain score. On the 3rd day after surgery, the passive knee motion in the acupressure group patients was significantly better than in the sham control group patients (<0.05, controlling for BMI. Conclusion. The application of auricular acupressure at specific therapeutic points significantly reduces the opioid analgesia requirement and improves the knee motion in patients with TKR.

  9. The Spectroscopy and H-band Imaging of Virgo Cluster Galaxies (SHIVir) Survey: Scaling Relations and the Stellar-to-total Mass Relation

    Energy Technology Data Exchange (ETDEWEB)

    Ouellette, Nathalie N.-Q.; Courteau, Stéphane [Department of Physics, Engineering Physics and Astronomy, Queen’s University, Kingston, ON K7L 3N6 (Canada); Holtzman, Jon A. [Department of Physics and Astronomy, New Mexico State University, Las Cruces, NM, 88003-8001 (United States); Dutton, Aaron A. [Department of Physics, New York University Abu Dhabi, Abu Dhabi (United Arab Emirates); Cappellari, Michele [Sub-department of Astrophysics, Department of Physics, University of Oxford, Denys Wilkinson Building, Keble Road, Oxford, OX1 3RH (United Kingdom); Dalcanton, Julianne J. [Department of Astronomy, University of Washington, Seattle, WA, 98195 (United States); McDonald, Michael [MIT Kavli Institute for Astrophysics and Space Research, MIT, Cambridge, MA, 02139 (United States); Roediger, Joel C.; Côté, Patrick; Ferrarese, Laura [Herzberg Institute of Astrophysics, National Research Council, Victoria, BC, V9E 2E7 (Canada); Taylor, James E. [Department of Physics and Astronomy, University of Waterloo, Waterloo, ON, N2L 3G1 (Canada); Tully, R. Brent [Institute for Astronomy, University of Hawaii, 2680 Woodlawn Drive, Honolulu, HI 96822-1839 (United States); Peng, Eric W. [Department of Astronomy, Peking University, Beijing 100871 (China)

    2017-07-01

    We present parameter distributions and fundamental scaling relations for 190 Virgo cluster galaxies in the SHIVir survey. The distribution of galaxy velocities is bimodal about V {sub circ} ∼ 125 km s{sup −1}, hinting at the existence of dynamically unstable modes in the inner regions of galaxies. An analysis of the Tully-Fisher relation (TFR) of late-type galaxies (LTGs) and the fundamental plane (FP) of early-type galaxies (ETGs) is presented, yielding a compendium of galaxy scaling relations. The slope and zero-point of the Virgo TFR match those of field galaxies, while scatter differences likely reflect distinct evolutionary histories. The velocities minimizing scatter for the TFR and FP are measured at large apertures where the baryonic fraction becomes subdominant. While TFR residuals remain independent of any galaxy parameters, FP residuals (i.e., the FP “tilt”) correlate strongly with the dynamical-to-stellar mass ratio, yielding stringent galaxy formation constraints. We construct a stellar-to-total mass relation (STMR) for ETGs and LTGs and find linear but distinct trends over the range M {sub *} = 10{sup 8–11} M {sub ⊙}. Stellar-to-halo mass relations (SHMRs), which probe the extended dark matter halo, can be scaled down to masses estimated within the optical radius, showing a tight match with the Virgo STMR at low masses; possibly inadequate halo abundance matching prescriptions and broad radial scalings complicate this comparison at all masses. While ETGs appear to be more compact than LTGs of the same stellar mass in projected space, their mass-size relations in physical space are identical. The trends reported here may soon be validated through well-resolved numerical simulations.

  10. "It's Totally Okay to Be Sad, but Never Lose Hope": Content Analysis of Infertility-Related Videos on YouTube in Relation to Viewer Preferences.

    Science.gov (United States)

    Kelly-Hedrick, Margot; Grunberg, Paul H; Brochu, Felicia; Zelkowitz, Phyllis

    2018-05-23

    Infertility patients frequently use the internet to find fertility-related information and support from people in similar circumstances. YouTube is increasingly used as a source of health-related information and may influence health decision making. There have been no studies examining the content of infertility-related videos on YouTube. The purpose of this study was to (1) describe the content of highly viewed videos on YouTube related to infertility and (2) identify video characteristics that relate to viewer preference. Using the search term "infertility," the 80 top-viewed YouTube videos and their viewing statistics (eg, views, likes, and comments) were collected. Videos that were non-English, unrelated to infertility, or had age restrictions were excluded. Content analysis was used to examine videos, employing a coding rubric that measured the presence or absence of video codes related to purpose, tone, and demographic and fertility characteristics (eg, sex, parity, stage of fertility treatment). A total of 59 videos, with a median of 156,103 views, met the inclusion criteria and were categorized into 35 personal videos (35/59, 59%) and 24 informational-educational videos (24/59, 41%). Personal videos did not differ significantly from informational-educational videos on number of views, dislikes, subscriptions driven, or shares. However, personal videos had significantly more likes (PYouTube is a source of both technical and personal experience-based information about infertility. However, videos that include personal experiences may elicit greater viewer engagement. Positive videos and stories of treatment success may provide hope to viewers but could also create and perpetuate unrealistic expectations about the success rates of fertility treatment. ©Margot Kelly-Hedrick, Paul H Grunberg, Felicia Brochu, Phyllis Zelkowitz. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 23.05.2018.

  11. Determining Health-Related Quality-of-Life Outcomes Using the SF-6D Following Total Hip Arthroplasty.

    Science.gov (United States)

    Elmallah, Randa K; Chughtai, Morad; Adib, Farshad; Bozic, Kevin J; Kurtz, Steven M; Mont, Michael A

    2017-03-15

    Following total hip arthroplasty, patients' perception of their postoperative improvement and health plays a large role in satisfaction with and success of the surgical procedure. The Short Form-6D (SF-6D) is a health-related quality-of-life measure that assigns numerical value to the perception of patients' own health. The purpose was to determine SF-6D values of patients after total hip arthroplasty, to determine whether score changes were clinically relevant, and to compare these with postoperative functional improvements. We evaluated 188 patients who underwent primary total hip arthroplasty at 7 institutions and who had a mean age of 69 years (range, 47 to 88 years) and a mean body mass index of 28.8 kg/m (range, 19.8 to 38.9 kg/m). The SF-6D values were obtained from patients' SF-36 scores, and clinical relevance of value changes was determined using effect size. Using previous research, effect sizes were considered small between 0.2 and 0.5, moderate between 0.6 to 0.8, and large at >0.8. Clinical correlation was assessed using the Lower-Extremity Activity Scale and Harris hip scores. Patients were assessed preoperatively and postoperatively at 6 months and 1, 2, 3, and 5 years. The SF-6D scores improved from preoperatively and achieved significance (p < 0.05) at all points. The effect size demonstrated good clinical relevance up to the latest follow-up: 1.27 at 6 months, 1.30 at 1 year, 1.07 at 2 years, 1.08 at 3 years, and 1.05 at 5 years. The Lower-Extremity Activity Scale improved at all follow-up points from preoperatively to 1.8 at 6 months, 2.0 at 1 year, 1.8 at 2 years, 1.5 at 3 years, and 1.6 points at 5 years. The Harris hip score improved to 38 points at 6 months, 40 points at 1 year, 38 points at 2 years, 39 points at 3 years, and 41 points at 5 years postoperatively. The improvements in the Lower-Extremity Activity Scale and the Harris hip score significantly positively correlated (p < 0.01) with the SF-6D scores at all time points. SF-6D scores

  12. Radiographic cup position following posterior and lateral approach to total hip arthroplasty. An explorative randomized controlled trial.

    Science.gov (United States)

    Kruse, Christine; Rosenlund, Signe; Broeng, Leif; Overgaard, Søren

    2018-01-01

    The two most common surgical approaches to total hip arthroplasty are the posterior approach and lateral approach. The surgical approach may influence cup positioning and restoration of the offset, which may affect the biomechanical properties of the hip joint. The primary aim was to compare cup position between posterior approach and lateral approach. Secondary aims were to compare femoral offset, abductor moment arm and leg length discrepancy between the two approaches. Eighty patients with primary hip osteoarthritis were included in a randomized controlled trial and assigned to total hip arthroplasty using posterior approach or lateral approach. Postoperative radiographs from 38 patients in each group were included in this study for measurement of cup anteversion and inclination. Femoral offset, cup offset, total offset, abductor moment arm and leg length discrepancy were measured on preoperative and postoperative radiographs in 28 patients in each group. We found that mean anteversion was 5° larger in the posterior approach group (95% CI, -8.1 to -1.4; p = 0.006), while mean inclination was 5° less steep (95% CI, 2.7 to 7.2; pcup anteversion but less steep cup inclination in the posterior approach group compared with the lateral approach group. Femoral offset and abductor moment arm were restored after total hip arthroplasty using lateral approach but significantly increased when using posterior approach.

  13. Factors associated with health related quality of life after a hip or knee total replacement, according to a gender approach

    Directory of Open Access Journals (Sweden)

    Sergio R. López Alonso

    2010-07-01

    Full Text Available Objective: To identify the factors associated with Health Related Quality of Life (HRQL, and Symptoms and Physical Functional Disability (S&PFD after a Hip or Knee Total Replacement, according to a gender approach. A longitudinal cohort study design is performed at “La Merced” (Osuna. Sevilla and “Torrecárdenas” (Almería Hospitals, via telephone interview since October 2004 to November 2006. The study included all people who underwent a hip or knee total replacement. The dependent variables were HRQL and S&PFD, both measured via short versions of the COOP/WONCA and WOMAC questionnaires.Results: 311 people were included, who were mostly women (82,63% and 70 years old (average. The hip and knee replacement obtained an statistically significant improvement on HRQL (20,5% and S&PFD (28,2%, with no gender difference. Five variables were associated to HRQL for Women: HRQL previous to surgery, hospital, local infection as a complication, autonomy for daily living, and marital status. All of them were associated to men, except the last two ones. About S&PFD, six variables were associated for women: HRQL and S&PFD previous to surgery, hospital, local infection as a complication, body mass index and marital status. All of them were associated to men, except the last two ones.Factors associated to improve on HRQL and S&PFD in male population are few, though they find a great explanation of the improvement. Different situation arise on female population because more factors obtained a substantially inferior explanation.

  14. Comparison of topical and intravenous administration of tranexamic acid for blood loss control during total joint replacement: Review of literature

    Directory of Open Access Journals (Sweden)

    Georgi P. Georgiev

    2018-04-01

    Full Text Available Purpose: Many randomised controlled trials and meta-analysis studies have presented the efficacy of tranexamic acid (TXA without an increase of complications. However, questions still remain about the type of administration, optimal dose and secondary outcomes of TXA in total hip arthroplasty and total knee arthroplasty. The aim of this review is to summarise the existing information in literature concerning the pharmacological characteristics of TXA, forms, doses, types of application and contraindications for its use. Methods: A literature review containing 63 articles from the PubMed data starting from the first description of tranexamic acid until now was made in trying to present the existing information in a simple and effective way. Results: TXA leads to statistically significant reduction of peri and postoperative bleeding and in that way decreases blood transfusion rates and the infection risk. Topical and intravenous (IV use of TXA revealed similar results, with no increase of deep venous thrombosis. Therefore, topical TXA could be a reasonable alternative in patients with contraindications for IV application of TXA. Conclusions: Blood loss control with TXA, a synthetic analogue of the amino acid lysine, may be an excellent and safe alternative to allogeneic blood transfusion after total hip arthroplasty and total knee arthroplasty. Further studies are needed to establish the efficacy of combined IV and topical administration of TXA with regard to diminishing blood loss and reducing hospital stay. The Translational Potential of this Article: This review briefly presents the pharmacological characteristics of TXA, forms, doses, types of application and contraindications for its use with regard to diminishing blood loss and reducing hospital stay for better therapeutic strategies in orthopaedics. Keywords: Arthroplasty, Review, Tranexamic acid

  15. No difference in terms of radiostereometric analysis between fixed- and mobile-bearing total knee arthroplasty: a randomized, single-blind, controlled trial.

    Science.gov (United States)

    Schotanus, M G M; Pilot, P; Kaptein, B L; Draijer, W F; Tilman, P B J; Vos, R; Kort, N P

    2017-09-01

    A concern that arises with any new prosthesis is whether it will achieve satisfactory long-term implant stability. The gold standard of assessing the quality of fixation in a new or relatively new implant is to undertake a randomized controlled trial using radiostereometric analysis. It was hypothesized that both mobile-bearing total knee arthroplasty and fixed-bearing total knee arthroplasty have comparable migration patterns at 2-year follow-up. This study investigated two types of cemented total knee arthroplasty, the mobile- or fixed-bearing variant from the same family with use of radiostereometric analysis. This prospective, patient-blinded, randomized, controlled trial was designed to investigate early migration of the tibia component after two years of follow-up with use of radiostereometric analysis. A total of 50 patients were randomized to receive a mobile- or fixed-bearing TKA from the same family. Patients were evaluated during 2-year follow-up, including radiostereometric analysis, physical and clinical examination and patient reported outcome measures (PROMs). At two-year follow-up, the mean (±SD) maximum total point motion (MTPM) in the fixed-bearing group was 0.82 (±1.16) versus 0.92 mm (±0.64) in the mobile-bearing group (p = n.s) with the largest migration seen during the first 6 weeks (0.45 ± 0.32 vs. 0.54 ± 0.30). The clinical outcome and PROMs significantly improved within each group, not between both groups. Measuring early micromotion is useful for predicting clinical loosening that can lead to revision. The results of this study demonstrate that early migration of the mobile-bearing is similar to that of the fixed-bearing component at two years and was mainly seen in the first weeks after implantation. Randomized, single-blind, controlled trial, Level I.

  16. Research report of fiscal 1997. Study on total energy and material control (feasibility study on circulating society); 1997 nendo chosa hokokusho. Total energy and material control ni kansuru chosa (junkangata shakai kochiku kanosei chosa) chosa hokokusho

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1998-03-01

    In order to construct real sustainable global environment and human society in the 21st century called the century of environment, not only the innovation of manufacturing processes technically supporting such the construction but also the conception including the innovation of the whole society from a wide viewpoint are essential. As a total energy and material control system (TEMCOS) concept, the view of an energy-saving circulating society is attempted which minimizes a total energy and material flow in Japan, and the role and issue of manufacturing industry, in particular, material industry are extracted. As one of the targets of such a concept, the conception of an eco-town is also described. Paying attention on some important material industries including a mass material flow and consuming a large amount of energy such as metal, plastics and automobile industries, the study result on a material flow for every industry is arranged, and some effective issues contributing to minimize a material flow and control energy consumption and CO2 emission are extracted. 80 refs., 67 figs., 30 tabs.

  17. Effectiveness of Bupivacaine Liposome Injectable Suspension for Postoperative Pain Control in Total Knee Arthroplasty: A Prospective, Randomized, Double Blind, Controlled Study.

    Science.gov (United States)

    DeClaire, Jeffrey H; Aiello, Paige M; Warritay, Olayinka K; Freeman, Dwight C

    2017-09-01

    We compared the effectiveness of liposomal bupivacaine to ropivacaine, each as part of multimodal pain management, in total knee arthroplasty (TKA) postoperative pain control. This prospective, double blind study randomized 96 TKA patients into a control group (periarticular injection of ropivacaine, ketorolac, morphine, and epinephrine in saline; 100cc) or an experimental group (periarticular injection of bupivacaine, ketorolac, morphine, and epinephrine in saline; 80cc plus 1.3% liposomal bupivacaine 20cc; total injection 100cc). The postoperative use of narcotics, visual analog pain scores, hours to ambulate 100 feet, and length of hospital stay were recorded. There was no significant difference between the two groups (control N = 49, experiment N = 47) in mean narcotic use per hour, total narcotic use during hospital stay, time to ambulate 100 feet, length of hospital stay, or visual analog score for pain postoperatively. There is no benefit in the use of liposomal bupivacaine compared with ropivacaine for postoperative pain control in TKA. Copyright © 2017 Elsevier Inc. All rights reserved.

  18. Stability and alignment do not improve by using patient-specific instrumentation in total knee arthroplasty: a randomized controlled trial.

    Science.gov (United States)

    Kosse, Nienke M; Heesterbeek, Petra J C; Schimmel, Janneke J P; van Hellemondt, Gijs G; Wymenga, Ate B; Defoort, Koen C

    2018-06-01

    The primary aim of the study was to examine stability and alignment after total knee arthroplasty (TKA) using patient-specific instrumentation (PSI) and conventional instrumentation (CI). The hypothesis was that stability and alignment would be better using PSI than CI, 12 months postoperatively. The secondary aim included the evaluation of clinical outcomes after TKA. In this prospective randomized controlled trial, 42 patients with knee osteoarthritis received a Genesis II PS prosthesis with either PSI or CI. Patients visited the hospital preoperatively and postoperatively after 6 weeks and 3 and 12 months. To evaluate stability, varus-valgus laxity was determined in extension and flexion using stress radiographs 12 months postoperatively. Three months postoperatively, a long-leg radiograph and CT scan were obtained to measure hip-knee-ankle (HKA) alignment and component rotation. Furthermore, frontal and sagittal alignment of the components, the Knee Society Score, VAS Pain, VAS Satisfaction, Knee injury and Osteoarthritis Outcome score, Patella score (Kujala), University of California Los Angeles activity score, anterior-posterior laxity, (serious) adverse device-related events, and intraoperative complications were reported. The clinical outcomes were compared using independent t tests or non-parametric alternatives, and repeated measurements ANOVA with a significance level of p stability, HKA angle, and rotational alignment. In four patients, the PSI did not fit correctly on the tibia and/or femur requiring intraoperative modifications. Both groups improved significantly over time on all clinical outcomes, with no significant differences between the groups 12 months postoperatively. The PSI group showed less tibial slope than the patients in the CI group [PSI 2.6° versus CI 4.8° (p = 0.02)]. Finally, the PSI group more frequently received a thinner insert size than the CI group (p = 0.03). Patients operated with PSI did not differ from CI in

  19. Preliminary evaluation of Community-Led Total Sanitation for the control of Taenia solium cysticercosis in Katete District of Zambia.

    Science.gov (United States)

    Bulaya, Carol; Mwape, Kabemba E; Michelo, Charles; Sikasunge, Chummy S; Makungu, Chitwambi; Gabriel, Sarah; Dorny, Pierre; Phiri, Isaac K

    2015-01-30

    Taenia solium taeniasis/cysticercosis is a zoonotic disease endemic in sub-Saharan Africa. It is associated with poor sanitary practices, free-range pig husbandry and lack of disease awareness in endemic communities. A comparative research was conducted with pre and post-intervention assessments in nine villages to evaluate Community-Led Total Sanitation (CLTS) as an intervention measure for the control of porcine cysticercosis in Katete District in the Eastern Province of Zambia. Blood samples were collected from pigs for circulating antigen detection and a questionnaire focused on the household was administered to a total of 153 respondents whose pigs were examined (64 pre-intervention, 89 post-intervention), in order to obtain information on general demographic characteristics, pig husbandry practices, sanitation practices and associated knowledge and awareness of T. solium infections. The first sampling was conducted prior to the implementation of the CLTS and second sampling eight months after triggering of CLTS in the selected villages. A total of 379 pig serum samples were examined using the B158/B60 Ag-ELISA to detect T. solium cysticercosis, 104 pre-intervention and 275 post-intervention, of which 14 (13.5%) and 45 (16.4%) were positive, respectively. Wald test p-values were computed to assess significant differences in the variables of interest mentioned above for the pre and post CLTS. The research revealed that CLTS as a control measure did not significantly improve T. solium infections in pigs. The research also revealed that the sanitation practices and awareness of cysticercosis did not change. It is recommended that a longer term evaluation be undertaken when the villages have been declared open defaecation free. In addition, the research recommends that health education, mass drug treatment and pig vaccination be incorporated, as an essential component of prevention and control programmes for T. solium infections. Copyright © 2014 Elsevier B

  20. Combined versus single application of tranexamic acid in total knee and hip arthroplasty: A meta-analysis of randomized controlled trials.

    Science.gov (United States)

    Peng Zhang, M M; Jifeng Li, M M; Xiao Wang, M M

    2017-07-01

    To compare the efficacy and safety of the combined application of both intravenous and topical tranexamic acid versus the single use of either application in patients with total knee and hip arthroplasty. Potentially relevant studies were identified from electronic databases including Medline, PubMed, Embase, ScienceDirect and the Cochrane Library. Patients undergoing primary total knee and hip arthroplasty were included in our studies, with an experimental group that received combined intravenous and topical application of tranexamic acid and a control group that received a single application of tranexamic acid or normal saline. The primary outcomes were total blood loss, hemoglobin decline and transfusion requirements. The secondary outcomes were length of stay, operation time and tranexamic acid-related adverse effects, such as superficial infection, deep vein thrombosis or pulmonary embolism. Modified Jadad scores were used to assess the quality of the included randomized controlled trials (RCTs). The data was pooled using RevMan 5.3. After testing for heterogeneity across studies, the data were aggregated using random-effects modeling when appropriate. We have registered the trial at http://www.researchregistry.com. Six RCTs that included 704 patients met the inclusion criteria. The present meta-analysis indicated significant differences existed in the total blood loss (MD = -134.65, 95% CI: -191.66 to -77.64, P tranexamic acid in total knee and hip arthroplasty was associated with significantly reduced total blood loss, postoperative hemoglobin decline, drainage volume, and transfusion requirements. Based on the limitations of current meta-analysis, well-designed, high-quality RCTs with long-term follow-up are still required. Copyright © 2017 IJS Publishing Group Ltd. Published by Elsevier Ltd. All rights reserved.

  1. Cognitive control training for emotion-related impulsivity.

    Science.gov (United States)

    Peckham, Andrew D; Johnson, Sheri L

    2018-06-01

    Many forms of psychopathology are tied to a heightened tendency to respond impulsively to strong emotions, and this tendency, in turn, is closely tied to problems with cognitive control. The goal of the present study was to test whether a two-week, six-session cognitive control training program is efficacious in reducing emotion-related impulsivity. Participants (N = 52) reporting elevated scores on an emotion-related impulsivity measure completed cognitive control training targeting working memory and response inhibition. A subset of participants were randomized to a waitlist control group. Impulsivity, emotion regulation, and performance on near and far-transfer cognitive tasks were assessed at baseline and after completion of training. Emotion-related impulsivity declined significantly from pre-training to post-training and at two-week follow-up; improvements were not observed in the waitlist control group. A decrease in brooding rumination and an increase in reappraisal were also observed. Participants showed significant improvements on trained versions of the working memory and inhibition tasks as well as improvements on an inhibition transfer task. In sum, these preliminary findings show that cognitive training appears to be well-tolerated for people with significant emotion-driven impulsivity. Results provide preliminary support for the efficacy of cognitive training interventions as a way to reduce emotion-related impulsivity. Copyright © 2018 Elsevier Ltd. All rights reserved.

  2. [Total artificial heart].

    Science.gov (United States)

    Antretter, H; Dumfarth, J; Höfer, D

    2015-09-01

    To date the CardioWest™ total artificial heart is the only clinically available implantable biventricular mechanical replacement for irreversible cardiac failure. This article presents the indications, contraindications, implantation procedere and postoperative treatment. In addition to a overview of the applications of the total artificial heart this article gives a brief presentation of the two patients treated in our department with the CardioWest™. The clinical course, postoperative rehabilitation, device-related complications and control mechanisms are presented. The total artificial heart is a reliable implant for treating critically ill patients with irreversible cardiogenic shock. A bridge to transplantation is feasible with excellent results.

  3. US-Russian relations: the arms control agenda

    Energy Technology Data Exchange (ETDEWEB)

    Potter, W

    2001-07-01

    At a time when US-Russian relations are widely regarded to be in a state of flux, it is appropriate to examine the degree of continuity and change in the sphere of nuclear arms control. More specifically, this brief essay identifies a number of propositions about nuclear weapons, arms control, and nonproliferation that increasingly reflect the conventional wisdom in Washington, although these propositions may be neither true nor wise; and assesses the prospects for arms control progress in the areas of strategic and non-strategic nuclear weapons and nonproliferation in light of these prevailing views. (author)

  4. US-Russian relations: the arms control agenda

    International Nuclear Information System (INIS)

    Potter, W.

    2001-01-01

    At a time when US-Russian relations are widely regarded to be in a state of flux, it is appropriate to examine the degree of continuity and change in the sphere of nuclear arms control. More specifically, this brief essay identifies a number of propositions about nuclear weapons, arms control, and nonproliferation that increasingly reflect the conventional wisdom in Washington, although these propositions may be neither true nor wise; and assesses the prospects for arms control progress in the areas of strategic and non-strategic nuclear weapons and nonproliferation in light of these prevailing views. (author)

  5. In vitro fermentation of total mixed diets differing in concentrate proportion: relative effects of inocula and substrates.

    Science.gov (United States)

    Serment, Amélie; Giger-Reverdin, Sylvie; Schmidely, Philippe; Dhumez, Ophélie; Broudiscou, Laurent P; Sauvant, Daniel

    2016-01-15

    In vitro techniques are used to predict ruminant feedstuff values or characterise rumen fermentation. As the results are influenced by several factors, such as the relative effects of inocula and substrates, this study aimed to examine in vitro incubation of two total mixed rations (substrates) differing in their proportion of concentrate [low (L): 350 g kg(-1) vs. high (H): 700 g kg(-1)] incubated in inocula provided by goats fed either a L or a H diet. Gas production and composition in carbon dioxide (CO2), methane (CH4 ) and hydrogen (H2), volatile fatty acids (VFAs), soluble carbohydrates (SCs) and ammonia (NH3) concentrations, and pH of the fermentation fluid were measured. In comparison with the L inoculum and L substrate, the H ones produced more CO2 and CH4 gas, which led to higher SCs and VFA concentrations, and lower acetate-to-propionate ratio and NH3 concentration, with a predominant effect of the inoculum. The effects of the inocula and of the substrates were additive using donor animals adapted to the diets. © 2015 Society of Chemical Industry.

  6. Computer-assisted total knee arthroplasty marketing and patient education: an evaluation of quality, content and accuracy of related websites.

    Science.gov (United States)

    Shemesh, Shai S; Bronson, Michael J; Moucha, Calin S

    2016-10-01

    The internet is increasingly being used as a resource for health-related information by the general public. We sought to establish the authorship, content and accuracy of the information available online regarding computer-assisted total knee arthroplasty (CA-TKA). One hundred fifty search results from three leading search engines available online (Google, Yahoo!, Bing) from ten different countries worldwide were reviewed. While private physicians/groups authored 50.7 % of the websites, only 17.3 % were authored by a hospital/university. As compared to traditional TKA, 59.3 % of the websites claimed that navigated TKA offers better longevity, 46.6 % claimed accelerated recovery and 26 % claimed fewer complications. Only 11.3 % mentioned the prolonged operating room time required, and only 15.3 % noted the current lack of long-term evidence in support of this technology. Patients seeking information regarding CA-TKA through the major search engines are likely to encounter websites presenting a narrow, unscientific, viewpoint of the present technology, putting emphasis on unsubstantiated benefits while disregarding potential drawbacks. Survey of Materials-Internet.

  7. Inhibitory effects and related molecular mechanisms of total flavonoids in Mosla chinensis Maxim against H1N1 influenza virus.

    Science.gov (United States)

    Zhang, Xiao-Xia; Wu, Qiao-Feng; Yan, Yun-Liang; Zhang, Feng-Ling

    2018-02-01

    The Shixiangru (Mosla chinensis Maxim) total flavonoids (STF) mainly contain luteolin and apigenin. The study aims to examine the inhibitory effects of STF on anti-H1N1 influenza virus and its related molecular mechanisms in pneumonia mice. The viral pneumonia mice were treated with Ribavirin or various doses of STF. We observed histological changes of lung by immunohistochemistry and measured lung index to value anti-influenza virus effects of STF. The concentrations of inflammatory cytokines and anti-oxidant factors were detected by ELISA. RT-PCR and western blot assays were used to determine the expression level of TLR pathway's key genes and proteins in lung tissues. We found that the pathological changes of lung in the viral pneumonia mice obviously alleviated by STF treatments and the STF (288 or 576 mg/kg) could significantly decrease lung indices. Moreover, the up-regulation (IL-6, TNF-α, IFN-γ, and NO) and down-regulation (IL-2, SOD and GSH) of inflammatory cytokines and anti-oxidant factors were associated with higher clearance of virus and reduction of inflammatory lung tissue damage. Meanwhile, the expression levels of TLR3, TLR7, MyD88, TRAF3 and NF-κB p65 of the TLR pathway were reduced by STF treatment. This study suggested that STF may be a promising candidate for treating H1N1 influenza and subsequent viral pneumonia.

  8. Impulse control and related disorders in Mexican Parkinson's disease patients.

    Science.gov (United States)

    Rodríguez-Violante, Mayela; González-Latapi, Paulina; Cervantes-Arriaga, Amin; Camacho-Ordoñez, Azyadeh; Weintraub, Daniel

    2014-08-01

    Impulse control disorders (ICDs) are a relatively recent addition to the behavioral spectrum of PD-related non-motor symptoms. Social and economic factors may play a role on the ICD phenotype of PD patients. The aim of this study is to determine the prevalence and characterize the clinical profile of ICDs in a sample of low-income, low-education PD patients with no social security benefits from a Latin American country. We included 300 consecutive PD patients and 150 control subjects. The presence of ICD and related disorders was assessed using a structured interview. After the interview and neurological evaluation were concluded, all subjects completed the Questionnaire for Impulsive-compulsive Disorders in Parkinson's Disease-Rating Scale (QUIP-RS). Regarding ICDs and related disorders (hobbyism-punding), 25.6% (n = 77) of patients in the PD group and 16.6% (n = 25) in the control group fulfilled criteria for at least one ICD or related disorder (p = 0.032). There was a statistically significant difference in the QUIP-RS mean score between PD and control subjects (5.6 ± 9.7 and 2.7 ± 4.21, p = 0.001). The most common ICD was compulsive eating for both PD (8.6%) and control (2.6%) groups. The results of this study confirm that for this population, symptoms of an ICD are significantly more frequent in PD subjects than in control subjects. Nevertheless, socioeconomic differences may contribute to a lower overall frequency and distinct pattern of ICDs in PD patients compared with what has been reported in other countries. Copyright © 2014 Elsevier Ltd. All rights reserved.

  9. Relations between Parental Psychological Control and Childhood Relational Aggression: Reciprocal in Nature?

    Science.gov (United States)

    Kuppens, Sofie; Grietens, Hans; Onghena, Patrick; Michiels, Daisy

    2009-01-01

    Using a cross-lagged panel design, this study examined the directionality of relations between parental psychological control and child relational aggression. Data were collected from a proportionally stratified sample of 600 Flemish 8- to 10-year-old children at 3 measurement points with 1-year intervals. Reciprocal effects were evident in…

  10. Relations Between Parental Psychological Control and Childhood Relational Aggression : Reciprocal in Nature?

    NARCIS (Netherlands)

    Kuppens, Sofie; Grietens, Hans; Onghena, Patrick; Michiels, Daisy

    2009-01-01

    Using a cross-lagged panel design, this study examined the directionality of relations between parental psychological control and child relational aggression. Data were collected from a proportionally stratified sample of 600 Flemish 8- to 10-year-old children at 3 measurement points with 1-year

  11. Who Do You Think Is in Control in Addiction? A Pilot Study on Drug-related Locus of Control Beliefs.

    Science.gov (United States)

    Ersche, Karen D; Turton, Abigail J; Croudace, Tim; Stochl, Jan

    2012-12-01

    The drug-related locus of control scale (DR-LOC) is a new instrument for assessing a person's belief of "being in control" in situations involving drug abuse. It consists of 16-item pairs presented in a forced-choice format, based on the conceptual model outlined by Rotter. The model characterizes the extent to which a person believes that the outcome of an event is under their personal control (internal locus of control) or the influence of external circumstances (external locus of control). A total of 592 volunteers completed the DR-LOC and the Rotter's I-E scale. Approximately half of the respondents were enrolled in a drug treatment program for opiates, stimulants and/or alcohol dependence (n = 282), and the remainder (n = 310) had no history of drug dependence. Factor analysis of DR-LOC items revealed 2 factors reflecting control beliefs regarding (i) the successful recovery from addiction, and (ii) decisions to use drugs. The extent to which a person attributes control in drug-related situations is significantly influenced by their personal or professional experiences with drug addiction. Drug-dependent individuals have a greater internal sense of control with regard to addiction recovery or drug-taking behaviors than health professionals and/or non-dependent control volunteers. The DR-LOC has shown to effectively translate generalized expectancies of control into a measure of control expectancies for drug-related situations, making it more sensitive for drug-dependent individuals than Rotter's I-E scale. Further research is needed to demonstrate its performance at discriminating between heterogeneous clinical groups such as between treatment-seeking versus non-treatment-seeking drug users.

  12. The effects of transversus abdominis plane block on analgesic and anesthetic consumption during total abdominal hysterectomy: a randomized controlled study

    Directory of Open Access Journals (Sweden)

    Tugba Karaman

    Full Text Available Abstract Background and objectives: A transversus abdominis plane block is a peripheral block method that has been used successfully for pain relief after total abdominal hysterectomy. However, the effects of the combination of the transversus abdominis plane block and general anesthesia on analgesic and anesthetic requirements remain unclear. This randomized placebo-controlled study is aimed to evaluate the effects of transversus abdominis plane block on analgesic and anesthetic consumption during total abdominal hysterectomy under general anesthesia. Methods: Sixty-six women undergoing total abdominal hysterectomy were randomized into two groups to receive general anesthesia alone (control group or with transversus abdominis plane block using 20 mL of 0.25% bupivacaine (transversus abdominis plane group. Intraoperative remifentanil and sevoflurane consumption were recorded. We also evaluated the postoperative pain, nausea, quality of recovery scores and rescue analgesic requirement during postoperative 24 hours. Results: The total remifentanil and sevoflurane consumption is significantly lower in transversus abdominis plane group; respectively mean (SD 0.130 (0.25 vs. 0.094 (0.02 mcg.kg-1.min-1; p < 0.01 and 0.295 (0.05 vs. 0.243 (0.06 mL.min-1; p < 0.01. In the postoperative period, pain scores were significantly reduced in transversus abdominis plane group soon after surgery; median (range 6 (2-10 vs. 3 (0-5; p < 0.001, at 2 h (5 [3-9] vs. 2.5 [0-6]; p < 0.001, at 6 h (4 [2-7] vs. 3[0-6], p < 0.001, at 12 h (3.5 [1-6] vs. 2 [1-5]; p = 0.003. The patients in the transversus abdominis plane group had significantly higher QoR-40 scores 190.5 (175-197 vs. 176.5 (141-187; p < 0.001. Conclusion: Combining transversus abdominis plane block with general anesthesia can provide reduced opioid and anesthetic consumption and can improve postoperative pain and quality of recovery scores in patients undergoing total abdominal hysterectomy.

  13. Influences of peer relations and locus of control on students ...

    African Journals Online (AJOL)

    Effort to checkmate extravagance and maximize gain is the focus of all organizations more in this period of global financial crisis. There is need therefore to checkmate unnecessary financial spending. This study examines the influence of the variables, peer relations and locus of control, on such spending among University ...

  14. International note: Maternal warmth, behavioral control, and psychological control: Relations to adjustment of Ghanaian early adolescents.

    Science.gov (United States)

    Salaam, Braima; Mounts, Nina S

    2016-06-01

    This investigation addressed the relation between maternal warmth, behavioral control, psychological control, and psychological adjustment in a sample of 119 Ghanaian adolescents (42% boys) living in an urban area (mean age = 14.19). Adolescents in the sample reported clinically elevated levels of depression and anxiety. Significant associations were found between warmth, behavioral control, and psychological control and adolescents' anxiety, physical aggression, relational aggression, positive friendship quality, and conflict with friends. Warmth moderated the effect of behavioral control on anxiety, physical aggression, and relational aggression such that higher levels of warmth in combination with higher levels of behavioral control were related to more positive adjustment. Higher levels of warmth in conjunction with higher psychological control were related to higher levels of anxiety. Boys who reported lower levels of warmth in combination with higher behavioral control reported higher levels of physical aggression. For boys reporting higher levels of warmth, higher behavioral control was associated with lower physical aggression. Copyright © 2016 The Foundation for Professionals in Services for Adolescents. Published by Elsevier Ltd. All rights reserved.

  15. Exercising self-control increases relative left frontal cortical activation.

    Science.gov (United States)

    Schmeichel, Brandon J; Crowell, Adrienne; Harmon-Jones, Eddie

    2016-02-01

    Self-control refers to the capacity to override or alter a predominant response tendency. The current experiment tested the hypothesis that exercising self-control temporarily increases approach motivation, as revealed by patterns of electrical activity in the prefrontal cortex. Participants completed a writing task that did vs did not require them to exercise self-control. Then they viewed pictures known to evoke positive, negative or neutral affect. We assessed electroencephalographic (EEG) activity while participants viewed the pictures, and participants reported their trait levels of behavioral inhibition system (BIS) and behavioral activation system (BAS) sensitivity at the end of the study. We found that exercising (vs not exercising) self-control increased relative left frontal cortical activity during picture viewing, particularly among individuals with relatively higher BAS than BIS, and particularly during positive picture viewing. A similar but weaker pattern emerged during negative picture viewing. The results suggest that exercising self-control temporarily increases approach motivation, which may help to explain the aftereffects of self-control (i.e. ego depletion). © The Author (2015). Published by Oxford University Press. For Permissions, please email: journals.permissions@oup.com.

  16. Control beliefs are related to smoking prevention in prenatal care.

    Science.gov (United States)

    Lemola, Sakari; Meyer-Leu, Yvonne; Samochowiec, Jakub; Grob, Alexander

    2013-10-01

    Smoking during pregnancy is one of the most important avoidable health risks for the unborn child. Gynaecologists and midwives play a fundamental role in the prevention of smoking during pregnancy. However, a large number of health care practitioners still do not address smoking in pregnant patients. We examined whether gynaecologists and midwives engage in screening and counselling of pregnant women and conducting interventions to prevent smoking during pregnancy. Further, we examined the role of gynaecologists' and midwives' control beliefs. Control beliefs involve efficacy expectations--the practitioner's confidence in his capacity to conduct prevention efforts adequately--and outcome expectations--the practitioner's expectation that such prevention efforts are successful in general. A total of 486 gynaecologists and 366 midwives completed a questionnaire on screening of smoking, counselling and other interventions they conduct to prevent smoking during pregnancy. Moreover, gynaecologists and midwives rated their control beliefs regarding their influence on pregnant patients' smoking habits. The majority of gynaecologists and midwives reported screening all pregnant patients regarding smoking, explaining the risks and recommending smoking cessation. By contrast, only a minority engages in more extensive prevention efforts. Strong control beliefs were predictive of a higher likelihood of screening and counselling, as well as of engaging in more extensive interventions. The findings point to the importance of strengthening gynaecologists' and midwives' control beliefs by professional education and training on smoking prevention. © 2012 John Wiley & Sons Ltd.

  17. Xerostomia relates to the degree of asthma control.

    Science.gov (United States)

    Alcázar Navarrete, Bernardino; Gómez-Moreno, Gerardo; Aguilar-Salvatierra, Antonio; Guardia, Javier; Romero Palacios, Pedro José

    2015-04-01

    Few studies have assessed the relationships between xerostomia and the use of inhaled corticosteroids (ICS). The main objective of this study was to investigate the prevalence of xerostomia in a respiratory outpatient clinic and its relationship with bronchial asthma and ICS use. A cross-sectional observational study of patients recruited in an outpatient setting divided them according to previous diagnoses of bronchial asthma. Data about pulmonary function, concomitant medication, medical comorbidities, Xerostomia Inventory test (XI test), and the degree of asthma control by ACT (asthma control test) were collected for each patient. A linear regression model was applied, using the XI score as dependent variable and the ACT score as independent variable. The 57 patients were divided into asthmatics (40 patients, 70.2%) and control group without asthma (17, 29.8%). The prevalence of xerostomia was 87.7% (50 patients), with no differences between the study groups or current dose of ICS. In the asthmatic group, patients with uncontrolled asthma had worse XI scores than those with partially or totally controlled asthma (30.43 ± 8.71 vs. 24.92 ± 8.08; P Xerostomia is a common symptom in the ambulatory setting. There is a moderate relationship between the degree of asthma control and the severity of xerostomia. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  18. Effects of extracted soy isoflavones alone on blood total and LDL cholesterol: Meta-analysis of randomized controlled trials

    Directory of Open Access Journals (Sweden)

    Kyoko Taku

    2008-07-01

    Full Text Available Kyoko Taku1, Keizo Umegaki1, Yoshiko Ishimi2, Shaw Watanabe31Information Center, National Institute of Health and Nutrition, Tokyo, Japan; 2Nutritional Epidemiology Program, National Institute of Health and Nutrition, Tokyo, Japan; 3Nutritional Education Program, National Institute of Health and Nutrition, Tokyo, JapanAbstract: When provided concurrently with soy protein for 1–3 months, soy isoflavones exert synergistic or additive cholesterol-lowering effects. This meta-analysis was performed to evaluate the effects of extracted soy isoflavones alone (not ingested concurrently with soy protein on total and low density lipoprotein (LDL cholesterol. MEDLINE (1966–2007, EMBASE (1966–2007, CENTRAL (1966–2007, ICHUSHI (1983–2008, and CNKI (1979–2007 were searched for randomized placebo-controlled trials published in English, Japanese, and Chinese, describing the changes in lipid profiles in adult humans resulting from ingestion of extracted soy isoflavones for 1–3 months. Reference lists of relevant systematic reviews and meta-analyses were hand-searched. Meta-analysis of 10 and 9 trials with usable information using REVMAN found that an average of 70 mg soy isoflavones/day (27–132 mg, as the aglycone form alone had a nonsignificant effect on total (0.01 mmol/L [95% CI: –0.12, 0.14]; P = 0.86 and LDL (0.03 mmol/L [95% CI: –0.11, 0.16]; P = 0.71 cholesterol in menopausal women, respectively. It is concluded that ingestion of about 70 mg extracted soy isoflavones/day alone for 1–3 months does not improve total and LDL cholesterol levels in normocholesterolemic menopausal women; further studies are needed to verify the effects of extracted soy isoflavones.Keywords: extracted soy isoflavones, lipid, total cholesterol, LDL cholesterol

  19. Foetal proglucagon processing in relation to adult appetite control

    DEFF Research Database (Denmark)

    Jensen, P B; Larsen, P J; Karlsen, C

    2011-01-01

    with a foetal processing pattern of proglucagon to both glucagon and GLP-1 (7-36amide), and is due to taste aversion. The sudden onset is characterized by a dramatic increase in circulating levels of biologically active GLP-1 (7-36amide), suggesting eventual saturation of proteolytic inactivation of its N-terminus....... neuropeptide Y (NPY) mRNA levels in the nucleus arcuatus. We now show that circulating levels of bioactive glucagon-like peptide-1 (GLP-1) (7-36amide) start to increase above control levels exactly at the time of onset of anorexia. At this time-point, bioactive glucagon as well as total glucagon precursors...

  20. Physical activity level, leisure activities and related quality of life 1 year after lumbar decompression or total hip arthroplasty.

    Science.gov (United States)

    Rolving, Nanna; Obling, Kirstine H; Christensen, Finn B; Fonager, Kirsten

    2013-04-01

    Lumbar decompression surgery (LDS) and total hip arthroplasty (THA) are frequently performed in the elderly population, but very little is known about their subsequent physical capacity and participation in leisure activities. Despite similar demographics and comorbidities, it is questionable whether LDS patients achieve equally high levels of physical capacity and quality of life postoperatively as do THA patients. The aim was to compare the physical activity level, participation in leisure activities and related quality of life 1 year after an LDS and THA procedure. Data from 95 THA patients and 83 LDS patients were gathered from questionnaires on self-reported physical activity level, leisure activities and quality of life. LDS and THA patients reported equally moderate levels of physical activity. The median score was 42.3 METs/day (IQR 37.9; 47.7) for the LDS group and 41.0 METs/day (IQR 38.5; 48.5) for the THA group (p = 0.79). Weekly time consumption for leisure activities in the LDS group was a median of 420 min/week (IQR 210; 660) compared to a median of 480 min/week (IQR 240; 870) in the THA group (p = 0.16). Regarding quality of life, LDS patients reported significantly worse Euroqol Five Dimensions scores with a median value of 0.740 (IQR 0.68; 0.82) compared to THA patients' median of 0.824 (IQR 0.72; 1.0), p leisure activities, LDS patients did not achieve a quality of life comparable to that of THA patients 1 year postoperatively.

  1. Economical Evaluation of Faba bean (Vicia faba and Maize (Zea mays L. Intercropping Based on Total Relative Value Index and Weeds Growth Reduction

    Directory of Open Access Journals (Sweden)

    J. Hamzei

    2016-05-01

    Full Text Available The chemical control of weeds raises serious concerns about food safety and environmental quality, which have necessitated the need for non chemical weed management techniques such as intercropping. Intercropping can suppress weeds and reduce the use of herbicides in production systems. Therefore, the objective of this work was to evaluate the effects of intercropping of faba bean and maize, as well as hand-weeding on maize grain yield and total grain yield. The experiment was carried out during growing season of 2010 as a randomized complete block design with three replications at the Agricultural Research Station, Faculty of Agriculture, Bu-Ali Sina University, Hamedan, Iran. Sole cropping of maize with weed control (MWF, sole cropping of maize without weed control (MWI, intercropping of 15% faba bean+maize (M+15%F, 30% faba bean+maize (M+30%F, 45% faba bean+maize (M+45%F  and sole cropping of faba bean were the experimental treatments. Weed biomass and density were affected by treatments. With increasing faba bean density in the intercropping treatments, weed biomass and density decreased significantly from 85 plants and 310 g m-2 for MWI treatment to 22 plants and 63 g m-2 for M+45%F treatment, respectively. The greatest number of seed row per ear, seed number per ear and grain and biological yields (8033 and 17933 kg ha-1, respectively were achieved at MWF treatment and the smallest values for these attributes were revealed at MWI treatment. There was no significant difference between MWF and M+45%F treatments for total grain yield (i.e. grain yield of maize + faba bean. Sole cropping of faba bean led to the greatest yield components and grain and biological yields. With increasing faba bean density in intercropping treatments, above mentioned traits (except number of pods per plant were increased significantly. The great values for weed control efficiency (73% and total relative value (1.14 were achieved at M+45%F treatment. Results of

  2. Perceived Sexual Control, Sex-Related Alcohol Expectancies and Behavior Predict Substance-Related Sexual Revictimization

    Science.gov (United States)

    Walsh, Kate; Messman-Moore, Terri; Zerubavel, Noga; Chandley, Rachel B.; DeNardi, Kathleen A.; Walker, Dave P.

    2013-01-01

    Objectives Although numerous studies have documented linkages between childhood sexual abuse (CSA) and later sexual revictimization, mechanisms underlying revictimization, particularly assaults occurring in the context of substance use, are not well-understood. Consistent with Traumagenic Dynamics theory, the present study tested a path model positing that lowered perceptions of sexual control resulting from CSA may be associated with increased sex-related alcohol expectancies and heightened likelihood of risky sexual behavior, which in turn, may predict adult substance-related rape. Methods Participants were 546 female college students who completed anonymous surveys regarding CSA and adult rape, perceptions of sexual control, sex-related alcohol expectancies, and likelihood of engaging in risky sexual behavior. Results The data fit the hypothesized model well and all hypothesized path coefficients were significant and in the expected directions. As expected, sex-related alcohol expectancies and likelihood of risky sexual behavior only predicted substance-related rape, not forcible rape. Conclusions Findings suggested that low perceived sexual control stemming from CSA is associated with increased sex-related alcohol expectancies and a higher likelihood of engaging in sexual behavior in the context of alcohol use. In turn these proximal risk factors heighten vulnerability to substance-related rape. Programs which aim to reduce risk for substance-related rape could be improved by addressing expectancies and motivations for risky sexual behavior in the context of substance use. Implications and future directions are discussed. PMID:23312991

  3. A Flexible Job Shop Scheduling Problem with Controllable Processing Times to Optimize Total Cost of Delay and Processing

    Directory of Open Access Journals (Sweden)

    Hadi Mokhtari

    2015-11-01

    Full Text Available In this paper, the flexible job shop scheduling problem with machine flexibility and controllable process times is studied. The main idea is that the processing times of operations may be controlled by consumptions of additional resources. The purpose of this paper to find the best trade-off between processing cost and delay cost in order to minimize the total costs. The proposed model, flexible job shop scheduling with controllable processing times (FJCPT, is formulated as an integer non-linear programming (INLP model and then it is converted into an integer linear programming (ILP model. Due to NP-hardness of FJCPT, conventional analytic optimization methods are not efficient. Hence, in order to solve the problem, a Scatter Search (SS, as an efficient metaheuristic method, is developed. To show the effectiveness of the proposed method, numerical experiments are conducted. The efficiency of the proposed algorithm is compared with that of a genetic algorithm (GA available in the literature for solving FJSP problem. The results showed that the proposed SS provide better solutions than the existing GA.

  4. Uniform-related infection control practices of dental students

    Directory of Open Access Journals (Sweden)

    Aljohani Y

    2017-04-01

    Full Text Available Yazan Aljohani,1 Mohammed Almutadares,1 Khalid Alfaifi,1 Mona El Madhoun,1 Maysoon H Albahiti,2 Nadia Al-Hazmi3 1Internship Program, Faculty of dentistry, King Abdulaziz University, 2Department of Endodontics, King Abdulaziz University, 3Department of Oral Biology, King Abdulaziz University, Faculty of Dentistry, Jeddah, Saudi Arabia Background: Uniform-related infection control practices are sometimes overlooked and underemphasized. In Saudi Arabia, personal protective equipment must meet global standards for infection control, but the country’s Islamic legislature also needs to be taken into account. Aim: To assess uniform-related infection control practices of a group of dental students in a dental school in Saudi Arabia and compare the results with existing literature related to cross-contamination through uniforms in the dental field. Method: A questionnaire was formulated and distributed to dental students at King Abdulaziz University Faculty of Dentistry in Jeddah, Saudi Arabia, which queried the students about their uniform-related infection control practices and their methods and frequency of laundering and sanitizing their uniforms, footwear, and name tags. Results: There is a significant difference between genders with regard to daily uniform habits. The frequency of uniform washing was below the standard and almost 30% of students were not aware of how their uniforms are washed. Added to this, there is no consensus on a unified uniform for male and female students. Conclusion: Information on preventing cross-contamination through wearing uniforms must be supplied, reinforced, and emphasized while taking into consideration the cultural needs of the Saudi society. Keywords: cross-contamination, infection control, dental students, uniforms

  5. Some optimal considerations in attitude control systems. [evaluation of value of relative weighting between time and fuel for relay control law

    Science.gov (United States)

    Boland, J. S., III

    1973-01-01

    The conventional six-engine reaction control jet relay attitude control law with deadband is shown to be a good linear approximation to a weighted time-fuel optimal control law. Techniques for evaluating the value of the relative weighting between time and fuel for a particular relay control law is studied along with techniques to interrelate other parameters for the two control laws. Vehicle attitude control laws employing control moment gyros are then investigated. Steering laws obtained from the expression for the reaction torque of the gyro configuration are compared to a total optimal attitude control law that is derived from optimal linear regulator theory. This total optimal attitude control law has computational disadvantages in the solving of the matrix Riccati equation. Several computational algorithms for solving the matrix Riccati equation are investigated with respect to accuracy, computational storage requirements, and computational speed.

  6. A feasibility randomised controlled trial of pre-operative occupational therapy to optimise recovery for patients undergoing primary total hip replacement for osteoarthritis (PROOF-THR).

    Science.gov (United States)

    Jepson, Paul; Sands, Gina; Beswick, Andrew D; Davis, Edward T; Blom, Ashley W; Sackley, Catherine M

    2016-02-01

    To assess the feasibility of a pre-operative occupational therapy intervention for patients undergoing primary total hip replacement. Single blinded feasibility randomised controlled trial, with data collection prior to the intervention, and at 4, 12, and 26 weeks following surgery. Recruitment from two NHS orthopaedic outpatient centres in the West Midlands, UK. Patients awaiting primary total hip replacement due to osteoarthritis were recruited. Following pre-operative assessment, patients were individually randomised to intervention or control by a computer-generated block randomisation algorithm stratified by age and centre. The intervention group received a pre-surgery home visit by an occupational therapist who discussed expectations, assessed home safety, and provided appropriate adaptive equipment. The control group received treatment as usual. The study assessed the feasibility of recruitment procedures, delivery of the intervention, appropriateness of outcome measures and data collection methods. Health related quality of life and resource use were recorded at 4, 12 and 26 weeks. Forty-four participants were recruited, 21 were randomised to the occupational therapy intervention and 23 to usual care. Analysis of 26 week data included 18 participants in the intervention group and 21 in the control. The intervention was delivered successfully with no withdrawals or crossovers; 5/44 were lost to follow-up with further missing data for participation and resource use. The feasibility study provided the information required to conduct a definitive trial. Burden of assessment would need to be addressed. A total of 219 patients would be required in an efficacy trial. © The Author(s) 2015.

  7. The effects of transversus abdominis plane block on analgesic and anesthetic consumption during total abdominal hysterectomy: a randomized controlled study

    Directory of Open Access Journals (Sweden)

    Tugba Karaman

    2018-05-01

    Full Text Available Background and objectives: A transversus abdominis plane block is a peripheral block method that has been used successfully for pain relief after total abdominal hysterectomy. However, the effects of the combination of the transversus abdominis plane block and general anesthesia on analgesic and anesthetic requirements remain unclear. This randomized placebo-controlled study is aimed to evaluate the effects of transversus abdominis plane block on analgesic and anesthetic consumption during total abdominal hysterectomy under general anesthesia. Methods: Sixty-six women undergoing total abdominal hysterectomy were randomized into two groups to receive general anesthesia alone (control group or with transversus abdominis plane block using 20 mL of 0.25% bupivacaine (transversus abdominis plane group. Intraoperative remifentanil and sevoflurane consumption were recorded. We also evaluated the postoperative pain, nausea, quality of recovery scores and rescue analgesic requirement during postoperative 24 hours. Results: The total remifentanil and sevoflurane consumption is significantly lower in transversus abdominis plane group; respectively mean (SD 0.130 (0.25 vs. 0.094 (0.02 mcg.kg−1.min−1; p < 0.01 and 0.295 (0.05 vs. 0.243 (0.06 mL.min−1; p < 0.01. In the postoperative period, pain scores were significantly reduced in transversus abdominis plane group soon after surgery; median (range 6 (2–10 vs. 3 (0–5; p < 0.001, at 2 h (5 [3–9] vs. 2.5 [0–6]; p < 0.001, at 6 h (4 [2–7] vs. 3[0–6], p < 0.001, at 12 h (3.5 [1–6] vs. 2 [1–5]; p = 0.003. The patients in the transversus abdominis plane group had significantly higher QoR-40 scores 190.5 (175–197 vs. 176.5 (141–187; p < 0.001. Conclusion: Combining transversus abdominis plane block with general anesthesia can provide reduced opioid and anesthetic consumption and can improve postoperative pain and quality of recovery scores in patients undergoing total

  8. Inflammation and post-operative recovery in patients undergoing total knee arthroplasty-secondary analysis of a randomized controlled trial

    DEFF Research Database (Denmark)

    Langkilde, A; Jakobsen, T L; Bandholm, T Q

    2017-01-01

    OBJECTIVE: Reduced function persists for many patients after total knee arthroplasty (TKA). Inflammation is part of osteoarthritis' pathophysiology, and surgery induces a marked inflammatory response. We therefore wanted to explore the role of inflammation in long-term recovery after TKA, and thus...... conducted this secondary analysis of our randomized controlled trial (RCT) of physical rehabilitation ± progressive strength training (PST). We aimed to investigate whether (1) inflammation is associated with functional performance, knee-extension strength, and knee pain before TKA; (2) PST affects...... factor (TNF)-α at baseline; day 1, week 4, 8, and 26 after TKA. RESULTS: At baseline, suPAR (P = 006) was negatively associated with 6MWT. Neither baseline nor surgery-induced inflammation modified the response to rehabilitation ± PST. Only surgery-induced IL-10 was associated with Δ6MWT26 weeks...

  9. Tantalum acetabular augments in one-stage exchange of infected total hip arthroplasty: a case-control study.

    Science.gov (United States)

    Klatte, Till Orla; Kendoff, Daniel; Sabihi, Reza; Kamath, Atul F; Rueger, Johannes M; Gehrke, Thorsten

    2014-07-01

    During the one-stage exchange procedure for periprosthetic joint infection (PJI) after total hip arthroplasty (THA), acetabular defects challenge reconstructive options. Porous tantalum augments are an established tool for addressing acetabular destruction in aseptic cases, but their utility in septic exchange is unknown. This retrospective case-control study presents the initial results of tantalum augmentation during one-stage exchange for PJI. Primary endpoints were rates of re-infection and short-term complications associated with this technique. Study patients had no higher risk of re-infection with equivalent durability at early follow-up with a re-infection rate in both groups of 4%. In conclusion, tantalum augments are a viable option for addressing acetabular defects in one-stage exchange for septic THA. Further study is necessary to assess long-term durability when compared to traditional techniques for acetabular reconstruction. Copyright © 2014 Elsevier Inc. All rights reserved.

  10. Is Electrocautery of Patella Useful in Patella Non-Resurfacing Total Knee Arthroplasty?: A Prospective Randomized Controlled Study.

    Science.gov (United States)

    Kwon, Sae Kwang; Nguku, Levis; Han, Chang Dong; Koh, Yong-Gon; Kim, Dong-Wook; Park, Kwan Kyu

    2015-12-01

    There is controversy over the need for electrocauterization of the patella in non-resurfacing total knee arthroplasty (TKA). We investigated whether this procedure is beneficial through a prospective randomized controlled trial. Fifty patients who underwent electrocautery were compared with 50 patients who did not undergo this procedure. We determined cartilage status, preoperative and postoperative American Knee Society (AKS) score, the Western Ontario and McMaster Universities score (WOMAC) and the Patellofemoral (PF) scores for a minimum of 5 years. The two groups did not differ significantly in demographics, intraoperative cartilage status, or preoperative or postoperative outcomes. No complications were detected in either group. We found no benefits of electrocautery of the patella in patellar non-resurfacing TKA up to 5 years. Copyright © 2015 Elsevier Inc. All rights reserved.

  11. Cognitive control reduces sensitivity to relational aggression among adolescent girls.

    Science.gov (United States)

    Baird, Abigail A; Silver, Shari H; Veague, Heather B

    2010-01-01

    Relational aggression is a type of aggression that aims to hurt others through relationships and includes behaviors such as gossip and ostracism. This type of aggression is very common among adolescent girls, and in its more intense forms has been linked with poor psychosocial outcomes, including depression and suicide. In the present study we investigated whether individual differences in sensitivity to relational aggression among adolescent girls predicted recruitment of neural networks associated with executive function and cognitive control. Neural response was measured using functional magnetic resonance imaging during an affect recognition task that included unfamiliar peer faces. A finding of relatively fewer reports of being victimized by relational aggression was associated with increased recruitment of bilateral dorsolateral prefrontal cortices as well as anterior and posterior cingulate cortices in response to the affect recognition task, as well as with greater competence on behavioral measures of executive function. Our results suggest that girls who are able to recruit specific frontal networks to improve cognitive and executive control are less sensitive to relational aggression. © 2010 Psychology Press

  12. Effect of an e-Learning Tool on Expectations and Satisfaction Following Total Knee Arthroplasty: A Randomized Controlled Trial.

    Science.gov (United States)

    Culliton, Sharon E; Bryant, Dianne M; MacDonald, Steven J; Hibbert, Kathy M; Chesworth, Bert M

    2018-07-01

    Orthopedic surgeons recognize patient expectations of total knee arthroplasty (TKA) can be managed through education. E-learning is the application of educational technology. The objective of this study was to evaluate whether an e-learning tool could affect whether patients' expectations were met and they were satisfied 1 year following TKA. Patients with osteoarthritis from the London Health Sciences Centre, Canada, were randomly assigned to either a control group (n = 207) receiving standard patient education or an intervention group (n = 209) using the e-learning tool in addition to the standard. We used a web-based system with permuted block sizes, stratified by surgeon and first or second TKA. Preoperative measures were completed following the patients' preadmission clinic visit. Postoperative patient-reported outcome measures were completed at 6 weeks, 3 months, and 1 year after TKA. One year after TKA, risk difference was used to determine between-group differences for patient satisfaction and expectations being met. One year postoperatively, the risk that expectations of patients were not met was 21.8% in the control group and 21.4% in the intervention group for an adjusted risk difference of 1.3% (95% confidence interval, -7.8% to 10.4%, P = .78). The proportion of patients satisfied with their TKA at 1 year postoperative was 78.6% in the intervention and 78.2% in the control groups. There was no between-group difference at 1 year between intervention and control groups for either the risk that expectations of patients were not met or the proportion of patients who were dissatisfied with their TKA. Copyright © 2018 Elsevier Inc. All rights reserved.

  13. The relation of mothers' controlling vocalizations to children's intrinsic motivation.

    Science.gov (United States)

    Deci, E L; Driver, R E; Hotchkiss, L; Robbins, R J; Wilson, I M

    1993-04-01

    Twenty-six mother-child dyads played together in a laboratory setting. Play sessions were surreptitiously videotaped (with mothers' permission), and each maternal vocalization was transcribed and coded, first into 1 of 24 categories and then ipso facto into one of three supercategories--namely, controlling, autonomy supportive, and neutral. The degree of mothers' controllingness was calculated as the percentage of vocalizations coded as controlling. This index was correlated with the intrinsic motivation of their 6- or 7-year-old children, as assessed primarily by the free-choice behavioral measure and secondarily by a child self-report measure of interest and liking for the task. Both correlations were significantly negative, thereby suggesting that the robust laboratory findings of a negative relation between controlling contexts and individuals' intrinsic motivation are directly generalizable to the domain of parenting. Results are discussed in terms of the processes that undermine intrinsic motivation and the means through which parental controllingness is communicated.

  14. Obesity-related differences in neural correlates of force control.

    Science.gov (United States)

    Mehta, Ranjana K; Shortz, Ashley E

    2014-01-01

    Greater body segment mass due to obesity has shown to impair gross and fine motor functions and reduce balance control. While recent studies suggest that obesity may be linked with altered brain functions involved in fine motor tasks, this association is not well investigated. The purpose of this study was to examine the neural correlates of motor performance in non-obese and obese adults during force control of two upper extremity muscles. Nine non-obese and eight obese young adults performed intermittent handgrip and elbow flexion exertions at 30% of their respective muscle strengths for 4 min. Functional near infrared spectroscopy was employed to measure neural activity in the prefrontal cortex bilaterally, joint steadiness was computed using force fluctuations, and ratings of perceived exertions (RPEs) were obtained to assess perceived effort. Obesity was associated with higher force fluctuations and lower prefrontal cortex activation during handgrip exertions, while RPE scores remained similar across both groups. No obesity-related differences in neural activity, force fluctuation, or RPE scores were observed during elbow flexion exertions. The study is one of the first to examine obesity-related differences on prefrontal cortex activation during force control of the upper extremity musculature. The study findings indicate that the neural correlates of motor activity in the obese may be muscle-specific. Future work is warranted to extend the investigation to monitoring multiple motor-function related cortical regions and examining obesity differences with different task parameters (e.g., longer duration, increased precision demands, larger muscles, etc.).

  15. Outcomes of total knee arthroplasty in relation to preoperative patient-reported and radiographic measures: data from the osteoarthritis initiative.

    Science.gov (United States)

    Kahn, Timothy L; Soheili, Aydin; Schwarzkopf, Ran

    2013-12-01

    Total knee arthroplasty (TKA) is the preferred surgical treatment for end-stage osteoarthritis. However, substantial numbers of patients still experience poor outcomes. Consequently, it is important to identify which patient characteristics are predictive of outcomes in order to guide clinical decisions. Our hypothesis is that preoperative patient-reported outcome measures and radiographic measures may help to predict TKA outcomes. Using cohort data from the Osteoarthritis Initiative, we studied 172 patients who underwent TKA. For each patient, we compiled pre- and postoperative Western Ontario and McMaster University Arthritis Index (WOMAC) scores. Radiographs were measured for knee joint angles, femorotibial angles, anatomical lateral distal femoral angles, and anatomical medial proximal tibial angles; Kellgren and Lawrence (KL) grades were assigned to each compartment of the knee. All studied measurements were compared to WOMAC outcomes. Preoperative WOMAC disability, pain, and total scores were positively associated with postoperative WOMAC total scores (P = .010, P = .010, and P = .009, respectively) and were associated with improvement in WOMAC total scores (P < .001, P < .001, and P < .001, respectively). For radiographic measurements, preoperative joint angles were positively associated with improvements in postoperative WOMAC total scores (P = .044). Combined KL grades (medial and lateral compartments) were negatively correlated with postoperative WOMAC disability and pain scores (P = .045 and P = .044) and were positively correlated with improvements in WOMAC total scores (P = .001). All preoperative WOMAC scores demonstrated positive associations with postoperative WOMAC scores, while among the preoperative radiographic measurements only combined KL grades and joint angles showed any correlation with postoperative WOMAC scores. Higher preoperative KL grades and joint angles were associated with better (lower) postoperative WOMAC scores, demonstrating an

  16. Randomized controlled trial on postoperative pulmonary humidification after total laryngectomy: external humidifier versus heat and moisture exchanger.

    Science.gov (United States)

    Mérol, Jean-Claude; Charpiot, Anne; Langagne, Thibault; Hémar, Patrick; Ackerstaff, Annemieke H; Hilgers, Frans J M

    2012-02-01

    Assessment of immediate postoperative airway humidification after total laryngectomy (TLE), comparing the use of an external humidifier (EH) with humidification through a heat and moisture exchanger (HME). Randomized controlled trial (RCT). Fifty-three patients were randomized into the standard (control) EH (N = 26) or the experimental HME arm (N = 27). Compliance, pulmonary and sleeping problems, patients' and nursing staff satisfaction, nursing time, and cost-effectiveness were assessed with trial-specific structured questionnaires and tally sheets. In the EH arm data were available for all patients, whereas in the HME arm data were incomplete for four patients. The 24/7 compliance rate in the EH arm was 12% and in the HME arm 87% (77% if the four nonevaluable patients are considered noncompliant). Compliance and patients' satisfaction were significantly better, and the number of coughing episodes, mucus expectoration for clearing the trachea, and sleeping disturbances were significantly less in the HME arm (P humidification by means of an HME over the use of an EH after TLE. This study therefore underlines that HMEs presently can be considered the better option for early postoperative airway humidification after TLE. Copyright © 2011 The American Laryngological, Rhinological, and Otological Society, Inc.

  17. Burden of total and cause-specific mortality related to tobacco smoking among adults aged ≥ 45 years in Asia: a pooled analysis of 21 cohorts.

    Directory of Open Access Journals (Sweden)

    Wei Zheng

    2014-04-01

    Full Text Available Tobacco smoking is a major risk factor for many diseases. We sought to quantify the burden of tobacco-smoking-related deaths in Asia, in parts of which men's smoking prevalence is among the world's highest.We performed pooled analyses of data from 1,049,929 participants in 21 cohorts in Asia to quantify the risks of total and cause-specific mortality associated with tobacco smoking using adjusted hazard ratios and their 95% confidence intervals. We then estimated smoking-related deaths among adults aged ≥45 y in 2004 in Bangladesh, India, mainland China, Japan, Republic of Korea, Singapore, and Taiwan-accounting for ∼71% of Asia's total population. An approximately 1.44-fold (95% CI = 1.37-1.51 and 1.48-fold (1.38-1.58 elevated risk of death from any cause was found in male and female ever-smokers, respectively. In 2004, active tobacco smoking accounted for approximately 15.8% (95% CI = 14.3%-17.2% and 3.3% (2.6%-4.0% of deaths, respectively, in men and women aged ≥45 y in the seven countries/regions combined, with a total number of estimated deaths of ∼1,575,500 (95% CI = 1,398,000-1,744,700. Among men, approximately 11.4%, 30.5%, and 19.8% of deaths due to cardiovascular diseases, cancer, and respiratory diseases, respectively, were attributable to tobacco smoking. Corresponding proportions for East Asian women were 3.7%, 4.6%, and 1.7%, respectively. The strongest association with tobacco smoking was found for lung cancer: a 3- to 4-fold elevated risk, accounting for 60.5% and 16.7% of lung cancer deaths, respectively, in Asian men and East Asian women aged ≥45 y.Tobacco smoking is associated with a substantially elevated risk of mortality, accounting for approximately 2 million deaths in adults aged ≥45 y throughout Asia in 2004. It is likely that smoking-related deaths in Asia will continue to rise over the next few decades if no effective smoking control programs are implemented. Please see later in the article for

  18. Quality Control Activities Related to Mechanical Maintenance of Safety Related Components at Krsko NPP

    International Nuclear Information System (INIS)

    Djakovic, D.

    2016-01-01

    For successful, safe and reliable operation of nuclear power plant, maintenance processes have to be systematically controlled and procedures for quality control of maintenance activities shall be established. This is requested by the quality assurance program, which shall provide control over activities affecting the quality of structures, systems, and components, considering their importance to safety. As a part of Quality and Nuclear Oversight Division (QNOD; SKV), the Quality Control Department (QC) provides quality control activities, which are deeply involved in maintenance processes at Krsko NPP, both on safety related and non-safety related (non-nuclear safety) components. QC activities on safety related components have to fulfil all requirements, which will enable the components to perform their intended safety functions. This paper describes quality control activities related to mechanical maintenance of safety related components at Krsko NPP and significant role of the Krsko plant QC Department in three particular maintenance cases connected with safety related components. In these three specific cases, the QC has confirmed its importance in compliance with quality assurance program and presented its significant added value in providing safe and reliable operation of the plant. The first maintenance activity was installation of nozzle check valves in the scope of a modification for improving regulation of spent fuel pit pumps. The QC Department performed receipt inspection of the valves. Using non-destructive examination methods and X-ray spectrometry, it was found out that the valve diffuser was made of improper material, which could cause progressive corrosion of the valve diffuser in borated water and consequently a loss of safety function of the valves followed by long-term consequences. The second one was the receipt inspection of containment ventilation fan coolers. The coolers were claimed and sent back to the supplier because the QC Department

  19. Clinical outcome of increased flexion gap after total knee arthroplasty. Can controlled gap imbalance improve knee flexion?

    Science.gov (United States)

    Ismailidis, P; Kuster, M S; Jost, B; Giesinger, K; Behrend, H

    2017-06-01

    Increased range of motion (ROM) while maintaining joint stability is the goal of modern total knee arthroplasty (TKA). A biomechanical study has shown that small increases in flexion gap result in decreased tibiofemoral force beyond 90° flexion. The purpose of this paper was to investigate clinical implications of controlled increased flexion gap. Four hundred and four TKAs were allocated into one of two groups and analysed retrospectively. In the first group (n = 352), flexion gap exceeded extension gap by 2.5 mm, while in the second group (n = 52) flexion gap was equal to the extension gap. The procedures were performed from 2008 to 2012. The patients were reviewed 12 months postoperatively. Objective clinical results were assessed for ROM, mediolateral and sagittal stability. Patient-reported outcome measures were the WOMAC score and the Forgotten Joint Score (FJS-12). After categorizing postoperative flexion into three groups (poor < 90°, satisfactory 91°-119°, good ≥ 120°) significantly more patients in group 1 achieved satisfactory or good ROM (p = 0.006). Group 1 also showed a significantly higher mean FJS-12 (group 1: 73, group 2: 61, p = 0.02). The mean WOMAC score was 11 in the first and 14 in the second group (n.s.). Increase in flexion gap did not influence knee stability. The clinical relevance of this study is that a controlled flexion gap increase of 2.5 mm may have a positive effect on postoperative flexion and patient satisfaction after TKA. Neither knee stability in the coronal and sagittal planes nor complications were influenced by a controlled increase in flexion gap. III.

  20. Endocrine factors related to changes in total peripheral vascular resistance after treatment of thyrotoxic and hypothyroid patients

    NARCIS (Netherlands)

    Diekman, M. J.; Harms, M. P.; Endert, E.; Wieling, W.; Wiersinga, W. M.

    2001-01-01

    Total peripheral vascular resistance (TPR) decreases in thyrotoxicosis and increases in hypothyroidism. Several mechanisms may be involved, including adaptation to changes in heat production and direct non-genomic effects of tri-iodothyronine (T3) on vascular smooth muscle cells. The aim of this

  1. Fall-related admissions after fast-track total hip and knee arthroplasty - cause of concern or consequence of success?

    DEFF Research Database (Denmark)

    Jørgensen, Christoffer Calov; Kehlet, Henrik; Hip, Lundbeck Foundation Centre for Fast-track

    2013-01-01

    Total hip (THA) and knee arthroplasty (TKA) are common procedures in elderly persons, who are at potential increased risk of postoperative fall due to loss of muscle strength and impaired balance. Fast-track surgery with early mobilization and opioid-sparing analgesia have improved outcomes after...

  2. How well are the climate indices related to the GRACE-observed total water storage changes in China?

    Science.gov (United States)

    Devaraju, B.; Vishwakarma, B.; Sneeuw, N. J.

    2017-12-01

    The fresh water availability over land masses is changing rapidly under the influence of climate change and human intervention. In order to manage our water resources and plan for a better future, we need to demarcate the role of climate change. The total water storage change in a region can be obtained from the GRACE satellite mission. On the other hand, many climate change indicators, for example ENSO, are derived from sea surface temperature. In this contribution we investigate the relationship between the total water storage change over China with the climate indices using statistical time-series decomposition techniques, such as Seasonal and Trend decomposition using Loess (STL), Principal Component Analysis (PCA) and Canonical Correlation Analysis (CCA). The anomalies in climate variables, such as sea surface temperature, are responsible for anomalous precipitation and thus an anomalous total water storage change over land. Therefore, it is imperative that we use a GRACE product that can capture anomalous water storage changes with unprecedented accuracy. Since filtering decreases the sensitivity of GRACE products substantially, we use the data-driven method of deviation for recovering the signal lost due to filtering. To this end, we are able to obtain the spatial fingerprint of individual climate index on total water storage change observed over China.

  3. Comparably improved health-related quality of life after total arterial revascularization versus conventional coronary surgery--Copenhagen arterial revascularization randomized patency and outcome trial

    DEFF Research Database (Denmark)

    Damgaard, Sune; Lund, Jens T; Lilleør, Nikolaj B

    2011-01-01

    OBJECTIVE: We compared health-related quality of life up to 11 months after coronary artery bypass grafting using total arterial revascularization versus conventional coronary surgery. METHODS: In this randomized single-center trial, 161 patients underwent total arterial revascularization using.......01). For total arterial revascularization, there were also not statistically significant improvements for 'physical component summary' (P=0.09), 'bodily pain' (P=0.07) and 'vitality' (P=0.08). CONCLUSION: Health-related quality of life up to 1 year after total arterial revascularization is equal or slightly...... of the general Danish population. On all scales of the SF-36, there was statistically significant improvement at 3 and 11 months in both groups. For 'social functioning', the improvement following total arterial revascularization was significantly higher than following conventional revascularization (P=0...

  4. Synergistic effects of intravenous and intra-articular tranexamic acid on reducing hemoglobin loss in revision total knee arthroplasty: a prospective, randomized, controlled study.

    Science.gov (United States)

    Yuan, Xiangwei; Wang, Jiaxing; Wang, Qiaojie; Zhang, Xianlong

    2018-04-01

    Tranexamic acid decreases blood loss in primary total knee arthroplasty, and no related prospective randomized clinical trials have been conducted to evaluate the effectiveness and safety of tranexamic acid in revision total knee arthroplasty. Thus, we conducted this work to evaluate the synergistic effects of intravenous plus intra-articular tranexamic acid on reducing hemoglobin loss compared with intra-articular tranexamic acid alone in revision total knee arthroplasty. This prospective, controlled study randomized 96 patients undergoing revision total knee arthroplasty into two groups: an intravenous plus intra-articular tranexamic acid group (48 patients who received 20 mg/kg intravenous tranexamic acid and 3.0 g intra-articular tranexamic acid); and an intra-articular tranexamic acid alone group (48 patients who received the same intravenous volume of normal saline and 3.0 g intra-articular tranexamic acid). The primary outcome was hemoglobin loss. Secondary outcomes included the volume of drain output, the percentage of patients who received transfusions, the number of units transfused, and thromboembolic events. The baseline data, preoperative hemoglobin, and tourniquet time were similar in both groups. There was significantly less hemoglobin loss in the intravenous plus intra-articular tranexamic acid group compared with the intra-articular tranexamic acid alone group (2.7 ± 0.6 g/dL and 3.7 ± 0.7 g/dL; p tranexamic acid alone group, the intravenous plus intra-articular tranexamic acid group also had significantly less drain output, fewer patients who received transfusions, and fewer units transfused (all p tranexamic acid alone, combined intravenous plus intra-articular tranexamic acid significantly reduced hemoglobin loss and the need for transfusion without an apparent increase in thromboembolic events in patients who underwent revision total knee arthroplasty. © 2018 AABB.

  5. Weed control in young coffee plantations through post emergence herbicide application onto total area Controle de plantas daninhas em cafezais recém-implantados, com herbicidas aplicados em pós-emergência em área total

    Directory of Open Access Journals (Sweden)

    C.P. Ronchi

    2004-12-01

    at doses recommended for bean crop, these herbicides may be applied to control weeds in coffee and bean intercropping systems by spraying the entire area.Este trabalho foi realizado com o objetivo de investigar, em campo, a eficiência de vários herbicidas aplicados em pós-emergência em área total no controle de plantas daninhas, em cafezais recém-implantados e no consórcio de café e feijão, assim como seus efeitos sobre essas culturas. Mudas de Coffea arabica, cultivar Catuaí Vermelho, com quatro a seis pares de folhas foram transplantadas para o campo e cultivadas segundo práticas agronômicas usuais. O consórcio de café e feijão foi obtido por meio do plantio de três linhas de feijão nas entrelinhas do cafezal. Quando os herbicidas foram aplicados sobre as culturas, as plantas de café estavam com seis a dez pares de folhas, as de feijão com três folíolos e as plantas daninhas no estádio inicial de desenvolvimento. Fluazifop-p-butil e clethodim foram seletivos às plantas de café e controlaram eficientemente Brachiaria plantaginea e Digitaria horizontalis. Plantas daninhas dicotiledôneas (Amaranthus retroflexus, Bidens pilosa, Coronopus didymus, Emilia sonchifolia, Galinsoga parviflora, Ipomoea grandifolia, Lepidium virginicum e Raphanus raphanistrum foram controladas eficientemente por aplicações isoladas de fomesafen, flazasulfuron e oxyfluorfen, com exceção de B. pilosa, C. didymus e R. raphanistrum para o oxyfluorfen. Aplicações seqüenciais com intervalos de sete dias de fomesafen + fluazifop-p-butil ou clethodim, e as duas misturas comerciais de fomesafen + fluazifop-p-butil controlaram simultaneamente ambos os tipos de plantas daninhas. Cyperus rotundus foi controlada apenas por flazasulfuron. Com exceção de fluazifop-p-butil e clethodim todos os demais tratamentos herbicidas provocaram apenas leves injúrias às folhas mais novas das plantas de café. Contudo, o crescimento das plantas não foi prejudicado, de forma que tanto a

  6. Individual differences in executive control relate to metaphor processing: an eye movement study of sentence reading.

    Science.gov (United States)

    Columbus, Georgie; Sheikh, Naveed A; Côté-Lecaldare, Marilena; Häuser, Katja; Baum, Shari R; Titone, Debra

    2014-01-01

    Metaphors are common elements of language that allow us to creatively stretch the limits of word meaning. However, metaphors vary in their degree of novelty, which determines whether people must create new meanings on-line or retrieve previously known metaphorical meanings from memory. Such variations affect the degree to which general cognitive capacities such as executive control are required for successful comprehension. We investigated whether individual differences in executive control relate to metaphor processing using eye movement measures of reading. Thirty-nine participants read sentences including metaphors or idioms, another form of figurative language that is more likely to rely on meaning retrieval. They also completed the AX-CPT, a domain-general executive control task. In Experiment 1, we examined sentences containing metaphorical or literal uses of verbs, presented with or without prior context. In Experiment 2, we examined sentences containing idioms or literal phrases for the same participants to determine whether the link to executive control was qualitatively similar or different to Experiment 1. When metaphors were low familiar, all people read verbs used as metaphors more slowly than verbs used literally (this difference was smaller for high familiar metaphors). Executive control capacity modulated this pattern in that high executive control readers spent more time reading verbs when a prior context forced a particular interpretation (metaphorical or literal), and they had faster total metaphor reading times when there was a prior context. Interestingly, executive control did not relate to idiom processing for the same readers. Here, all readers had faster total reading times for high familiar idioms than literal phrases. Thus, executive control relates to metaphor but not idiom processing for these readers, and for the particular metaphor and idiom reading manipulations presented.

  7. Individual Differences in Executive Control Relate to Metaphor Processing: An Eye Movement Study of Sentence Reading

    Directory of Open Access Journals (Sweden)

    Georgie eColumbus

    2015-01-01

    Full Text Available Metaphors are common elements of language that allow us to creatively stretch the limits of word meaning. However, metaphors vary in their degree of novelty, which determines whether people must create new meanings on-line or retrieve previously known metaphorical meanings from memory. Such variations affect the degree to which general cognitive capacities such as executive control are required for successful comprehension.We investigated whether individual differences in executive control relate to metaphor processing using eye movement measures of reading. Thirty-nine participants read sentences including metaphors or idioms, another form of figurative language that is more likely to rely on meaning retrieval. They also completed the AX-CPT, a domain-general executive control task. In Experiment 1, we examined sentences containing metaphorical or literal uses of verbs, presented with or without prior context. In Experiment 2, we examined sentences containing idioms or literal phrases for the same participants to determine whether the link to executive control was qualitatively similar or different to Experiment 1.When metaphors were low familiar, all people read verbs used as metaphors more slowly than verbs used literally (this difference was smaller for high familiar metaphors. Executive control capacity modulated this pattern in that high executive control readers spent more time reading verbs when a prior context forced a particular interpretation (metaphorical or literal, and they had faster total metaphor reading times when there was a prior context. Interestingly, executive control did not relate to idiom processing for the same readers. Here, all readers had faster total reading times for high familiar idioms than literal phrases. Thus, executive control relates to metaphor but not idiom processing for these readers, and for the particular metaphor and idiom reading manipulations presented.

  8. Comparison of Customized Cutting Block and Conventional Cutting Instrument in Total Knee Arthroplasty: A Randomized Controlled Trial.

    Science.gov (United States)

    Tammachote, Nattapol; Panichkul, Phonthakorn; Kanitnate, Supakit

    2018-03-01

    Customized cutting block (CCB) was designed to ensure the accurate alignment of knee prostheses during total knee arthroplasty. Given the paucity of CCB efficacy data, we compare CCB with conventional cutting guide using a randomized controlled trial. One hundred eight osteoarthritic knee patients underwent total knee arthroplasty by one experienced surgeon were randomized to receive CCB (n = 54) or conventional cutting instrument (CCI) surgery (n = 54). The primary outcomes were limb alignment, prostheses position, and operative time. The secondary outcomes were hemodynamic alteration after surgery, functional outcomes (modified Western Ontario and McMaster University Osteoarthritis Index) and range of motion at 2 years after surgery. Mean hip-knee-ankle angle in the CCB group was 179.4° ± 1.8° vs 179.1° ± 2.4° in the CCI group, Δ = 0 (95% confidence interval [CI] -0.6 to 1.1, P = .55). Mean operative time was faster in the CCB arm: 93 ± 12 vs 104 ± 12 minutes, Δ = 11 (95% CI -16.7 to -7.2, P < .0001). There were no differences in hemodynamic parameters, mean blood loss (446 [CCB] vs 514 mL [CCI], Δ = -68 [95% CI -138 to 31 mL, P = .21]), postoperative hemoglobin changes, incidence of hypotension (systolic <90 mm Hg), oliguria, and rates of blood transfusion. Functional outcomes and range of motion were also similar. There was no improvement in alignment, hemodynamic changes, blood loss, and knee functional outcomes. CCB reduced surgical time by 11 minutes in our population. CCB cost-effectiveness should be further investigated. Copyright © 2017 Elsevier Inc. All rights reserved.

  9. Retention of the posterior cruciate ligament versus the posterior stabilized design in total knee arthroplasty: a prospective randomized controlled clinical trial

    Directory of Open Access Journals (Sweden)

    van den Akker-Scheek Inge

    2009-09-01

    Full Text Available Abstract Background Prosthetic design for the use in primary total knee arthroplasty has evolved into designs that preserve the posterior cruciate ligament (PCL and those in which the ligament is routinely sacrificed (posterior stabilized. In patients with a functional PCL the decision which design is chosen depends largely on the favour and training of the surgeon. The objective of this study is to determine whether the patient's perceived outcome and speed of recovery differs between a posterior cruciate retaining total knee arthroplasty and a posterior stabilized total knee arthroplasty. Methods/Design A randomized controlled trial will be conducted. Patients who are admitted for primary unilateral TKA due to primary osteoarthrosis are included when the following inclusion criteria are met: non-fixed fixed varus or valgus deformity less than 10 degrees, age between 55 and 85 years, body mass index less than 35 kg/m2 and ASA score (American Society of Anaesthesiologists I or II. Patients are randomized in 2 groups. Patients in the posterior cruciate retaining group will receive a prosthesis with a posterior cut-out for the posterior cruciate ligament and relatively flat topography. In patients allocated to the posterior stabilized group, in which the posterior cruciate ligament is excised, the design may substitute for this function by an intercondylar tibial prominence that articulates with the femur in flexion. Measurements will take place preoperatively and 6 weeks, 3 months, 6 months and 1 year postoperatively. At all measurement points patient's perceived outcome will be assessed using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC. Secondary outcome measures are quality of life (SF-36 and physician reported functional status and range of motion as determined with the Knee Society Clinical Rating System (KSS. Discussion In the current practice both posterior cruciate retaining and posterior stabilized designs

  10. Early Statin Use and the Progression of Alzheimer Disease: A Total Population-Based Case-Control Study.

    Science.gov (United States)

    Lin, Feng-Cheng; Chuang, Yun-Shiuan; Hsieh, Hui-Min; Lee, Tzu-Chi; Chiu, Kuei-Fen; Liu, Ching-Kuan; Wu, Ming-Tsang

    2015-11-01

    The protective effect of statin on Alzheimer disease (AD) is still controversial, probably due to the debate about when to start the use of statin and the lack of any large-scale randomized evidence that actually supports the hypothesis. The purpose of this study was to examine the protective effect of early statin use on mild-to-moderate AD in the total Taiwanese population.This was a total population-based case-control study, using the total population of Taiwanese citizens seen in general medical practice; therefore, the findings can be applied to the general population. The study patients were those with newly diagnosed dementia (ICD-9 290.x) and prescribed any acetylcholinesterase inhibitors (AChEI) from the Taiwan National Health Insurance dataset in 1997 to 2008. The newly diagnosed eligible mild-to-moderate AD patients were traced from the dates of their index dates, which was defined as the first day to receive any AChEI treatment, back to 1 year (exposure period) to categorize them into AD with early statin use and without early statin use. Early statin use was defined as patients using statin before AChEI treatment. Alzheimer disease patients with early statin use were those receiving any statin treatment during the exposure period. Then, we used propensity-score-matched strategy to match these 2 groups as 1:1. The matched study patients were followed-up from their index dates. The primary outcome was the discontinuation of AChEI treatment, indicating AD progression.There were 719 mild-to-moderate AD-paired patients with early statin use and without early statin use for analyses. Alzheimer disease progression was statistically lower in AD patients with early statin use than those without (P = 0.00054). After adjusting for other covariates, mild-to-moderate AD patients with early stain use exhibited a 0.85-risk (95% CI = 0.76-0.95, P = 0.0066) to have AD progression than those without.Early statin use was significantly associated with a reduction in AD

  11. Bioaccumulation behaviour of transplants of the lichen Flavoparmelia caperata in relation to total deposition at a polluted location in Portugal

    International Nuclear Information System (INIS)

    Godinho, R.M.; Wolterbeek, H.Th.; Verburg, T.; Freitas, M.C.

    2008-01-01

    This experiment compares the short and long time element accumulation behaviour of transplants of Flavoparmelia caperata lichen thalli and total deposition in an atmospheric polluted area. It was found that lichens exposed for a short time behaved differently from lichens in cumulative exposition suggesting the presence of acclimatization behaviour. The lichen transplant elemental content does not unequivocally represent the average or cumulative environmental availability of the exposure period. Reflection characteristics depend on the element and the lichen physiological conditions. Good correlations between lichen elemental contents and total deposition were obtained when a physiological lichen parameter was introduced in a mathematical model, suggesting that metabolically mediated accumulation is important. - The length of the foregoing atmospheric availability period reflected by lichen elemental contents is element-specific and depends on lichen physiological conditions

  12. Total lymphocyte count and subpopulation lymphocyte counts in relation to dietary intake and nutritional status of peritoneal dialysis patients.

    Science.gov (United States)

    Grzegorzewska, Alicja E; Leander, Magdalena

    2005-01-01

    Dietary deficiency causes abnormalities in circulating lymphocyte counts. For the present paper, we evaluated correlations between total and subpopulation lymphocyte counts (TLC, SLCs) and parameters of nutrition in peritoneal dialysis (PD) patients. Studies were carried out in 55 patients treated with PD for 22.2 +/- 11.4 months. Parameters of nutritional status included total body mass, lean body mass (LBM), body mass index (BMI), and laboratory indices [total protein, albumin, iron, ferritin, and total iron binding capacity (TIBC)]. The SLCs were evaluated using flow cytometry. Positive correlations were seen between TLC and dietary intake of niacin; TLC and CD8 and CD16+56 counts and energy delivered from protein; CD4 count and beta-carotene and monounsaturated fatty acids 17:1 intake; and CD19 count and potassium, copper, vitamin A, and beta-carotene intake. Anorexia negatively influenced CD19 count. Serum albumin showed correlations with CD4 and CD19 counts, and LBM with CD19 count. A higher CD19 count was connected with a higher red blood cell count, hemoglobin, and hematocrit. Correlations were observed between TIBC and TLC and CD3 and CD8 counts, and between serum Fe and TLC and CD3 and CD4 counts. Patients with a higher CD19 count showed a better clinical-laboratory score, especially less weakness. Patients with a higher CD4 count had less expressed insomnia. Quantities of ingested vitamins and minerals influence lymphocyte counts in the peripheral blood of PD patients. Evaluation of TLC and SLCs is helpful in monitoring the effectiveness of nutrition in these patients.

  13. Epigenomics of Total Acute Sleep Deprivation in Relation to Genome-Wide DNA Methylation Profiles and RNA Expression

    OpenAIRE

    Nilsson, Emil K.; Bostr?m, Adrian E.; Mwinyi, Jessica; Schi?th, Helgi B.

    2016-01-01

    Abstract Despite an established link between sleep deprivation and epigenetic processes in humans, it remains unclear to what extent sleep deprivation modulates DNA methylation. We performed a within-subject randomized blinded study with 16 healthy subjects to examine the effect of one night of total sleep deprivation (TSD) on the genome-wide methylation profile in blood compared with that in normal sleep. Genome-wide differences in methylation between both conditions were assessed by applyin...

  14. Total Effective Xenoestrogen Burden in Serum Samples and Risk for Breast Cancer in a Population-Based Multicase–Control Study in Spain

    Science.gov (United States)

    Pastor-Barriuso, Roberto; Fernández, Mariana F.; Castaño-Vinyals, Gemma; Whelan, Denis; Pérez-Gómez, Beatriz; Llorca, Javier; Villanueva, Cristina M.; Guevara, Marcela; Molina-Molina, José-Manuel; Artacho-Cordón, Francisco; Barriuso-Lapresa, Laura; Tusquets, Ignasi; Dierssen-Sotos, Trinidad; Aragonés, Nuria; Olea, Nicolás; Kogevinas, Manolis; Pollán, Marina

    2016-01-01

    Background: Most studies on endocrine-disrupting chemicals and breast cancer have focused on single compounds and have produced inconclusive findings. Objectives: We assessed the combined estrogenic effects of mixtures of xenoestrogens in serum and their relationship to breast cancer risk. Methods: A total of 186 incident pretreatment breast cancer cases and 196 frequency-matched controls were randomly sampled from a large population-based multicase–control study in Spain. The total effective xenoestrogen burden attributable to organohalogenated xenoestrogens (TEXB-α) and endogenous hormones and more polar xenoestrogens (TEXB-β) was determined in serum samples using high-performance liquid chromatography and E-Screen bioassay. Odds ratios for breast cancer comparing tertiles of serum TEXB-α and TEXB-β were estimated using logistic models, and smooth risk trends were obtained using spline models. Results: Cases had higher geometric mean TEXB-α and TEXB-β levels (8.32 and 9.94 Eeq pM/mL, respectively) than controls (2.99 and 5.96 Eeq pM/mL, respectively). The fully adjusted odds ratios for breast cancer (95% confidence intervals) comparing the second and third tertiles of TEXB-α with the first tertile were 1.77 (0.76, 4.10) and 3.45 (1.50, 7.97), respectively, and those for TEXB-β were 2.35 (1.10, 5.03) and 4.01 (1.88, 8.56), respectively. A steady increase in risk was evident across all detected TEXB-α levels and a sigmoidal trend was observed for TEXB-β. Individual xenoestrogens showed weak and opposing associations with breast cancer risk. Conclusions: This is the first study to show a strong positive association between serum total xenoestrogen burden and breast cancer risk, highlighting the importance of evaluating xenoestrogen mixtures, rather than single compounds, when studying hormone-related cancers. Citation: Pastor-Barriuso R, Fernández MF, Castaño-Vinyals G, Whelan D, Pérez-Gómez B, Llorca J, Villanueva CM, Guevara M, Molina-Molina JM

  15. Does a thrombin-based topical haemostatic agent reduce blood loss and transfusion requirements after total knee revision surgery? A randomized, controlled trial.

    Science.gov (United States)

    Romanò, Carlo L; Monti, Lorenzo; Logoluso, Nicola; Romanò, Delia; Drago, Lorenzo

    2015-11-01

    The aim of the present study was to assess the efficacy of a thrombin-based topical haemostatic in reducing blood requirements after total knee replacement (TKR) revision surgery. This prospective, randomized, controlled study was designed to evaluate the haemostatic efficacy and safety of a thrombin-based topical haemostatic (Floseal) versus standard treatment in patients receiving total knee revision arthroplasty. The decrease in haemoglobin values postsurgery and the blood units transfused were recorded. The decision to transfuse was made by a surgeon blinded to the patient's group allocation. Forty-eight patients were enroled in the study; twenty-four patients each were randomized to the treatment and control groups, respectively. The median decrease in haemoglobin concentration on the first postoperative day was 2.2 g/dL in the treatment group and 2.7 g/dL in the control group. A significant reduction in units of blood transfused was also observed in the treatment group compared with the control group [1.1 ± 1.13 (range 0-4) vs. 1.9 ± 1.41 (range 0-5) blood units; P = 0.04]. No major treatment-related adverse events were recorded in the study. This study shows that a thrombin-based topical haemostatic reduces the need for blood transfusion in TKR revision surgery. A thrombin-based topical haemostatic agent can be an appropriate solution to enhance haemostasis and vessel sealing at the operative site in TKR revision surgery, in order to reduce the need for blood transfusion after surgery. II.

  16. Comparative evaluation of serum and salivary immunoglobulin G and A levels with total serum protein in oral submucous fibrosis patients: A case control study

    Directory of Open Access Journals (Sweden)

    M Kandasamy

    2016-01-01

    Full Text Available Aim and Objective: The objective of this study is to estimate and compare the serum and salivary immunoglobulin G and A (IgG, IgA levels in various stages of oral submucous fibrosis (OSMF patients and relate it to total serum protein (TSP and hemoglobin (Hb levels. Materials and Methods: The sample for the present study comprised a total of 20 healthy controls, 20 OSMF patients. About 5 ml of blood and 2 ml of saliva were collected. Quantitative analysis of serum and salivary IgG, IgA was done by turbidometric immunoassay. TSP and Hb were estimated by Biuret and cyanmethemoglobin methods, respectively. Results: Serum and salivary IgA and IgG levels were statistically significantly increased (P < 0.001 in OSMF patients when compared to controls. Also serum and salivary IgG and IgA levels showed significantly increased (P < 0.01 in all the three staging of OSMF when compared to control group. Hb levels and TSP levels were significantly decreased (P < 0.001 in OSMF patients when compared to controls. One-way ANOVA, Pearson's correlation, and unpaired t -test were used for statistical analysis. Conclusion: The elevated levels of IgG and IgA are also in favor of polygammapathy, which are nonspecific and nondiagnostic objective reflections of an underlying disease. Decreased TSP is a result of host response and Hb, acts as an indicator of nutritional status plays an important role. It is also observed from the present study that the severity of OSMF was directly proportional to the estimated elevated levels of the major IgG and IgA. A need is also felt for the knowledge of immunoprofile estimation in etiology and pathogenesis that would prove a great asset in the proper assessment of this condition.

  17. Comparative evaluation of serum and salivary immunoglobulin G and A levels with total serum protein in oral submucous fibrosis patients: A case control study.

    Science.gov (United States)

    Kandasamy, M; Jaisanghar, N; Austin, Ravi David; Srivastava, Kumar Chandan; Anusuya, G Sai; Anisa, N

    2016-10-01

    The objective of this study is to estimate and compare the serum and salivary immunoglobulin G and A (IgG, IgA) levels in various stages of oral submucous fibrosis (OSMF) patients and relate it to total serum protein (TSP) and hemoglobin (Hb) levels. The sample for the present study comprised a total of 20 healthy controls, 20 OSMF patients. About 5 ml of blood and 2 ml of saliva were collected. Quantitative analysis of serum and salivary IgG, IgA was done by turbidometric immunoassay. TSP and Hb were estimated by Biuret and cyanmethemoglobin methods, respectively. Serum and salivary IgA and IgG levels were statistically significantly increased ( P < 0.001) in OSMF patients when compared to controls. Also serum and salivary IgG and IgA levels showed significantly increased ( P < 0.01) in all the three staging of OSMF when compared to control group. Hb levels and TSP levels were significantly decreased ( P < 0.001) in OSMF patients when compared to controls. One-way ANOVA, Pearson's correlation, and unpaired t -test were used for statistical analysis. The elevated levels of IgG and IgA are also in favor of polygammapathy, which are nonspecific and nondiagnostic objective reflections of an underlying disease. Decreased TSP is a result of host response and Hb, acts as an indicator of nutritional status plays an important role. It is also observed from the present study that the severity of OSMF was directly proportional to the estimated elevated levels of the major IgG and IgA. A need is also felt for the knowledge of immunoprofile estimation in etiology and pathogenesis that would prove a great asset in the proper assessment of this condition.

  18. The success of assisted reproduction technologies in relation to composition of the total regulatory T cell (Treg) pool and different Treg subsets.

    Science.gov (United States)

    Schlossberger, V; Schober, L; Rehnitz, J; Schaier, M; Zeier, M; Meuer, S; Schmitt, E; Toth, B; Strowitzki, T; Steinborn, A

    2013-11-01

    Are there differences in composition of the total regulatory T cell (Treg) pool and distinct Treg subsets (naïve CD45RA(+)-Tregs, HLA-DR(-)- and HLA-DR(+)-memory Tregs) between successfully and non-successfully IVF/ICSI-treated women? Non-successfully IVF/ICSI-treated women have a decreased percentage of naïve CD45RA(+)-Tregs and an increased percentage of HLA-DR(-)-memory Tregs within the total Treg pool. Immunosuppressive Tregs play a significant role in human reproduction and studies have shown that their number and function are reduced in reproductive failure and complications of pregnancy such as pre-eclampsia and preterm labor. However, no data exist concerning the importance of Tregs for a successful outcome following assisted reproduction technologies. Blood samples were obtained from 210 women undergoing IVF/ICSI treatment, where 14 patients were excluded due to biochemical pregnancy or missed abortion. Age control blood samples were collected from 20 neonates and 176 healthy female volunteers. The study was performed between October 2010 and March 2012. In this study, we determined prospectively the quantity and composition of the total CD4(+)CD127(low+/-)CD25(+)FoxP3(+)-Treg pool and three different Treg subsets (naïve CD45RA(+)-Tregs, HLA-DR(-)- and HLA-DR(+)-memory Tregs) in all women undergoing IVF/ICSI treatment. We examined whether there were differences between those who became pregnant (n = 36) and those who did not (n = 160). The blood samples were collected within 1 h before the embryo transfer and analyzed by six-color flow cytometry. In order to evaluate these results with regard to the normal age-related changes in composition of the total Treg pool, the same analysis was performed using samples of umbilical cord blood and from healthy female volunteers aged between 17 and 76 years. The composition of the total Treg pool was documented for successfully IVF/ICSI-treated women (n = 5) throughout their pregnancy and we assessed the

  19. Visual search by chimpanzees (Pan): assessment of controlling relations.

    Science.gov (United States)

    Tomonaga, M

    1995-03-01

    Three experimentally sophisticated chimpanzees (Pan), Akira, Chloe, and Ai, were trained on visual search performance using a modified multiple-alternative matching-to-sample task in which a sample stimulus was followed by the search display containing one target identical to the sample and several uniform distractors (i.e., negative comparison stimuli were identical to each other). After they acquired this task, they were tested for transfer of visual search performance to trials in which the sample was not followed by the uniform search display (odd-item search). Akira showed positive transfer of visual search performance to odd-item search even when the display size (the number of stimulus items in the search display) was small, whereas Chloe and Ai showed a transfer only when the display size was large. Chloe and Ai used some nonrelational cues such as perceptual isolation of the target among uniform distractors (so-called pop-out). In addition to the odd-item search test, various types of probe trials were presented to clarify the controlling relations in multiple-alternative matching to sample. Akira showed a decrement of accuracy as a function of the display size when the search display was nonuniform (i.e., each "distractor" stimulus was not the same), whereas Chloe and Ai showed perfect performance. Furthermore, when the sample was identical to the uniform distractors in the search display, Chloe and Ai never selected an odd-item target, but Akira selected it when the display size was large. These results indicated that Akira's behavior was controlled mainly by relational cues of target-distractor oddity, whereas an identity relation between the sample and the target strongly controlled the performance of Chloe and Ai.

  20. Configuration control during maintenance of safety related equipment

    International Nuclear Information System (INIS)

    Irish, C.S.

    2001-01-01

    Possibly the most important aspect of performing maintenance of safety related equipment is maintaining the component's original design basis. Assuring that the repaired item will perform the same safety function within the original performance and equipment qualification parameters is commonly referred to as configuration control. Maintaining configuration control of a technologically current well documented item is easy. Unfortunately, this does not describe most safety related items requiring maintenance within the global nuclear industry. Items such as motors, transformers, metal clad switchgear (low and medium voltage circuit breakers), refrigeration compressors, and electronic components (i.e. circuit boards, power supplies, regulators, etc.) which routinely require repair have been in service for twenty plus years. As a result, finding replacement parts and or material to repair the items to the original condition is becoming more and more difficult. An added difficulty is the lack of original technical documentation available on the item which is being repaired. The lack of technical documentation makes it difficult to identify replacement material and parts when the original part or material is not available. The lack of documentation also makes it difficult to test the repaired item to make sure that the original configuration has been maintained after the repair. The presentation will discuss the details of repairing various items including motors, metal clad switchgear, refrigeration compressors and power supplies and the controls which are necessary to maintain the configuration of the original item. The discussion will include the Quality Assurance and engineering necessary to identify and evaluate replacement material and parts necessary to perform repairs on safety related equipment when the original material or part is not available. Examples of repairs which required different parts or materials than the original to be used in the repair will be

  1. Configuration control during maintenance of safety related equipment

    International Nuclear Information System (INIS)

    Irish, C.S.

    2003-01-01

    Possibly the most important aspect of performing maintenance of safety related equipment is maintaining the component's original design basis. Assuring that the repaired item will perform the same safety function within the original performance and equipment qualification parameters is commonly referred to as configuration control. Maintaining configuration control of a technologically current well documented item is easy. Unfortunately, this does not describe most safety related items requiring maintenance within the global nuclear industry. Items such as motors, transformers, metal clad switchgear (low and medium voltage circuit breakers), refrigeration compressors, and electronic components (i.e. circuit boards, power supplies, regulators, etc.) which routinely require repair have been in service for twenty plus years. As a result, finding replacement parts and or material to repair the items to the original condition is becoming more and more difficult. An added difficulty is the lack of original technical documentation available on the item which is being repaired. The lack of technical documentation makes it difficult to identify replacement material and parts when the original part or material is not available. The lack of documentation also makes it difficult to test the repaired item to make sure that the original configuration has been maintained after the repair. The presentation will discuss the details of repairing various items including motors, metal clad switchgear, refrigeration compressors and power supplies and the controls which are necessary to maintain the configuration of the original item. The discussion will include the Quality Assurance and engineering necessary to identify and evaluate replacement material and parts necessary to perform repairs on safety related equipment when the original material or part is not available. Examples of repairs which required different parts or materials than the original to be used in the repair will be

  2. Quality of life in cancer survivors 5 years or more after total gastrectomy: a case-control study.

    Science.gov (United States)

    Lee, Seung Soo; Chung, Ho Young; Kwon, Oh Kyoung; Yu, Wansik

    2014-01-01

    This study investigated how total gastrectomy (TG), along with memories of cancer, affect the subjective wellness of survivors long after surgery. Rational approaches for effectively improving the quality of life (QoL) of these survivors were suggested. Between 2008 and 2013, QoL data of gastric cancer patients who underwent a curative TG, were obtained at 5-year postoperative follow-up visits (5-year survivors) and at visits beyond 5 years (long-term survivors). The control groups for these survivor groups were constructed from volunteers who visited our health-examination center for annual medical checkups. The Korean versions of the European Organization for Research and Treatment (EORTC) Quality of Life Questionnaire Core 30 (QLQ-C30) and the gastric cancer specific module, the EORTC QLQ-STO22, were used to assess QoL. Five-year survivors showed worse QoL compared to the control group in role functioning, social functioning, nausea/vomiting, appetite loss, financial difficulties, reflux, eating restrictions, taste, and body image, and better QoL in the emotional and cognitive functioning scales. In long-term survivors, deterioration in QoL were still apparent in financial difficulties, reflux, and eating restrictions, while QoL differences in the remaining scales had diminished. Surviving 5 years after TG does not result in living in a carefree state in terms of QoL. After 5 postoperative years, survivors still need extended care for deteriorated QoL indicators due to symptomatic, behavioral, and financial consequences of surgery. While relevant clinical and institutional approaches are required for corresponding declines in QoL, such efforts must extend beyond 5 postoperative years. Copyright © 2014 Surgical Associates Ltd. Published by Elsevier Ltd. All rights reserved.

  3. Total control of chromium in tanneries - thermal decomposition of filtration cake from enzymatic hydrolysis of chrome shavings.

    Science.gov (United States)

    Kocurek, P; Kolomazník, K; Bařinová, M; Hendrych, J

    2017-04-01

    This paper deals with the problem of chromium recovery from chrome-tanned waste and thus with reducing the environmental impact of the leather industry. Chrome-tanned waste was transformed by alkaline enzymatic hydrolysis promoted by magnesium oxide into practically chromium-free, commercially applicable collagen hydrolysate and filtration cake containing a high portion of chromium. The crude and magnesium-deprived chromium cakes were subjected to a process of thermal decomposition at 650°C under oxygen-free conditions to reduce the amount of this waste and to study the effect of magnesium removal on the resulting products. Oxygen-free conditions were applied in order to prevent the oxidation of trivalent chromium into the hazardous hexavalent form. Thermal decomposition products from both crude and magnesium-deprived chrome cakes were characterized by high chromium content over 50%, which occurred as eskolaite (Cr 2 O 3 ) and magnesiochromite (MgCr 2 O 4 ) crystal phases, respectively. Thermal decomposition decreased the amount of chrome cake dry feed by 90%. Based on the performed experiments, a scheme for the total control of chromium in the leather industry was designed.

  4. La administración financiera y el control total de la calidad: algunos elementos de importancia

    Directory of Open Access Journals (Sweden)

    Mario Kaffury Silva

    2015-05-01

    Full Text Available RESUMEN El presente resumen tiene por objeto analizar la función que cumple el control total de la calidad en la administración financiera. Ha sido uno de los modelos aplicados a nuestro sistema colombiano, buscando mejores canales de comunicación dentro de la empresa, ajustando todo su proceso productivo de la manera más eficiente a los cambios en los gustos de los consumidores y a utilizar mejores sistemas para el avance y el encajonamiento en el mercado de dichas empresas. El esquema institucional de la normalización técnica en Colombia ha mostrado su eficiencia como modelo de concertación y ha contribuido a la formación de profesionales y técnicos en el campo general de la organización. Así, a través del desarrollo del trabajo se pretende ver y comprender la aplicación que ha tenido dicho sistema en los diferentes  campos tanto de contabilidad, costos y servicios.

  5. Total and allergen-specific IgE levels during and after pregnancy in relation to maternal allergy.

    Science.gov (United States)

    Sandberg, Martina; Frykman, Anne; Jonsson, Yvonne; Persson, Marie; Ernerudh, Jan; Berg, Göran; Matthiesen, Leif; Ekerfelt, Christina; Jenmalm, Maria C

    2009-07-01

    Type 2 T-helper cell (Th2)-skewed immunity is associated with successful pregnancy and the ability to easily direct immune responses to a Th2-polarised profile may be an evolutionary benefit. The Th2-like immunity associated with allergic disease might generate favourable effects for the maintenance of pregnancy, but could also promote development of Th2-like immune responses and allergic disease in the offspring. The aim of this study was to explore, by using IgE as a stable proxy for Th2, the Th1/Th2 balance in allergic and non-allergic women by measuring allergen-specific and total IgE antibody levels in plasma during pregnancy and after delivery. Specific and total IgE antibody levels were determined by ImmunoCAP technology at five occasions during pregnancy (gestational weeks 10-12, 15-16, 25, 35 and 39), as well as at 2 and 12 months after delivery. Thirty-six women without and 20 women with allergic symptoms were included, of whom 13 were sensitised with allergic symptoms and 30 were non-sensitised without allergic symptoms. The levels of total IgE, but not allergen-specific IgE, were increased during early pregnancy when compared to 12 months after delivery in the sensitised women with allergic symptoms, but not in the non-sensitised women without allergic symptoms (ppregnancy only in the sensitised women with allergic symptoms indicates that allergy is associated with an enhanced Th2 deviation during pregnancy.

  6. Total recall: Reconsolidation theory unifies cognitive psychology and neuroscience and creates new therapeutic options for memory-related disorders

    OpenAIRE

    Hunter, Philip

    2011-01-01

    New research reveals that long-term memory is not entirely stable and can be modified or potentially erased. These insights open new therapeutic possibilities for a range of memory-related diseases and disorders.

  7. Fractional rate of degradation (kd) of starch in the rumen and its relation to in vivo rumen and total digestibility

    DEFF Research Database (Denmark)

    Hvelplund, Torben; Larsen, Mogens; Lund, Peter

    2009-01-01

    in different ways both chemically and physically. The starch sources were fed in mixed diets together with grass silage and soya bean meal and allocated ad libitum to fistulated dairy cows. The starch content varied between 13 and 35% in ration dry matter for the different starch sources. The design...... was a series of cross-over experiments with two cows and two periods. Ruminal starch pool was estimated from rumen evacuation and starch flow was estimated by duodenal and faeces sampling. Fractional rate of rumen degradation was estimated from the equation [kd = rumen degraded/rumen pool] and rumen and total...

  8. Control mechanisms for a nonlinear model of international relations

    Energy Technology Data Exchange (ETDEWEB)

    Pentek, A.; Kadtke, J. [Univ. of California, San Diego, La Jolla, CA (United States). Inst. for Pure and Applied Physical Sciences; Lenhart, S. [Univ. of Tennessee, Knoxville, TN (United States). Mathematics Dept.; Protopopescu, V. [Oak Ridge National Lab., TN (United States). Computer Science and Mathematics Div.

    1997-07-15

    Some issues of control in complex dynamical systems are considered. The authors discuss two control mechanisms, namely: a short range, reactive control based on the chaos control idea and a long-term strategic control based on an optimal control algorithm. They apply these control ideas to simple examples in a discrete nonlinear model of a multi-nation arms race.

  9. Combined impact of lifestyle-related factors on total and cause-specific mortality among Chinese women: prospective cohort study.

    OpenAIRE

    Sarah J Nechuta; Xiao-Ou Shu; Hong-Lan Li; Gong Yang; Yong-Bing Xiang; Hui Cai; Wong-Ho Chow; Butian Ji; Xianglan Zhang; Wanqing Wen; Yu-Tang Gao; Wei Zheng

    2010-01-01

    Editors' Summary Background It is well established that lifestyle-related factors, such as limited physical activity, unhealthy diets, excessive alcohol consumption, and exposure to tobacco smoke are linked to an increased risk of many chronic diseases and premature death. However, few studies have investigated the combined impact of lifestyle-related factors and mortality outcomes, and most of such studies of combinations of established lifestyle factors and mortality have been conducted in ...

  10. [Quality of Outcome after Primary Total Hip Replacement at a Maximum Care Hospital in Relation to Preoperative Influencing Factors].

    Science.gov (United States)

    Osmanski-Zenk, K; Steinig, N S; Glass, Ä; Mittelmeier, W; Bader, R

    2015-12-01

    As the need for joint replacements will continue to rise, the outcome of primary total hip replacement (THR) must be improved and stabilised at a high level. In this study, we investigated whether pre-operative risk factors, such as gender, age and body weight at the time of the surgery or a restricted physical status (ASA-Status > 2 or Kellgren and Lawrence grade > 2) have a negative influence on the post-operative results or on patient satisfaction. Retrospective data collection and a prospective interview were performed with 486 patients who underwent primary total hip replacement between January 2007 and December 2010 in our hospital. The patients' satisfaction and quality of life were surveyed with the WOMAC-Score, SF-36 and EuroQol-5. Differences between more than two independent spot tests were tested with the non-parametric Kruskal-Wallis test. Differences between two independent spot tests were tested with the non-parametric Mann-Whitney U test. The frequencies were reported and odds ratios calculated. The confidence interval was set at 95 %. The level of significance was p total score of the SF-36 was 66.9 points. The patients declared an average EuroQol Index of 0.81. Our data show that the patients' gender did not influence the duration of surgery or the scores. However, female patients tended to exhibit more postoperative complications. However, increased patient age at the time of surgery was associated with an increased OR for duration of surgery, length of stay and risk of complications. Patients who had a normal body weight at time of the surgery showed better peri- and post-operative results. We showed that the preoperative estimated Kellgren and Lawrence grade had a significant influence on the duration of surgery. The ASA classification influenced the duration of surgery as well the length of stay and the rate of complications. The quality of results after primary THR depends on preoperative factors. Existing comorbidities have a

  11. Methodology to quantify the role of the factors controlling the variation of rivers' total dissolved solids in Jiu Catchment (Romania)

    Science.gov (United States)

    Adina Morosanu, Gabriela; Zaharia, Liliana; Ioana-Toroimac, Gabriela; Belleudy, Philippe

    2017-04-01

    The total dissolved solids (TDS) is a river water quality parameter reflecting its concentration in solute ions. It is sensitive to many physical and anthropogenic features of the watershed. In this context, the objective of this work is to analyze the spatial variation of the TDS and to identify the role of the main controlling factors (e.g. geology, soils, land use) in Jiu River and some of its main tributaries, by using a methodology based on GIS and multivariate analysis. The Jiu watershed (10,000 kmp) is located in south-western Romania and it has a high diversity of physical and anthropogenic features influencing the water flow and its quality. The study is based on TDS measurements performed in August, 2016, during low flow conditions in the Jiu River and its tributaries. To measure in situ the TDS (ppm), an EC/TDS/Temperature Hand-held Tester was used in the 12 measuring points on Jiu River and in another 7 points on some of its tributaries. Across the hydrographic basin, the recorded TDS values ranged from 31 ppm to 607 ppm, while in the case of Jiu River, the TDS varied between 38 ppm at Lonea station (upper Jiu River) and 314 ppm at Išalniča (in the lower course). For each catchment corresponding to the sampling points, the influence of some contiguous features was defined on the basis of the lithology (marls, limestones, erodible bedrocks) and soils (clay textures), as well as the land cover/use influencing the solubility and solid content. This assessment was carried out in GIS through a set of spatial statistics analysis by calculating the percentages of the catchment coverage area for each determinant. In order to identify the contributions of different catchment features on the TDS variability, principal components analysis (PCA) was then applied. The results revealed the major role of the marls and clayey soils in the increase of TDS (on the Amaradia and Gilort rivers and some sections in the middle course of the Jiu River). In contrast

  12. Relative roughness controls on incipient sediment motion in steep channels

    Science.gov (United States)

    Prancevic, J.; Lamb, M. P.; Fuller, B. M.

    2012-12-01

    For over eight decades, researchers have noted an appreciable increase in the nondimensional shear stress (Shields number) at initiation of fluvial bedload transport with increasing bed slope. The precise cause of the trend, however, is obscured by the covariance of several factors with increased slope: a greater downstream component of the gravity acting on the grains and fluid, changes in bed morphology, increased grainsize relative to the channel width that may lead to grain bridging, and increased grainsize relative to flow depth (relative roughness) that may change flow hydraulics and particle buoyancy. Here, we report on ongoing laboratory experiments spanning a wide range of bed slopes (2% to 67%) designed to isolate these variables and determine the true cause of heightened critical Shields numbers on steep slopes. First, we eliminated bed morphology as a factor by using only planar beds. To investigate the effect of grain bridging, we used two different channel widths, representing width-to-grainsize ratios of 23:1 and 9:1. Finally, to separate the effects of slope from relative roughness, we compared incipient motion conditions for acrylic particles (submerged specific gravity of 0.15) to natural siliciclastic gravel (submerged specific gravity of 1.65). Different particle densities allowed us to explore incipient motion as a function of relative roughness, independent of channel slope, because lighter particles move at shallower flow depths than heavier ones of the same size. Results show that both materials exhibit a positive trend between bed slope and critical Shields number despite the existence of planar beds for all slopes. Furthermore, changing the grainsize-to-width ratio had a negligible effect on this trend. For all slopes, the critical Shields number for bedload transport was higher for the acrylic particles than for gravel, indicating that relative roughness has a strong control on incipient sediment motion independent of channel slope. These

  13. Total protein

    Science.gov (United States)

    ... page: //medlineplus.gov/ency/article/003483.htm Total protein To use the sharing features on this page, please enable JavaScript. The total protein test measures the total amount of two classes ...

  14. Randomized Clinical Trial of Periarticular Drug Injection used in combination Patient-Controlled Analgesia versus Patient-Controlled Analgesia Alone in Total Knee Arthroplasty

    Directory of Open Access Journals (Sweden)

    MN Sabran

    2008-11-01

    Full Text Available This is a prospective randomized clinical trial to compare use of a combination of periarticular drug injection with patient- controlled analgesia (PCA to PCA alone in post-total knee arthroplasty (TKA. Thirty patients who were admitted for unilateral total knee arthroplasty were selected randomly into an Injection group or a Standard group. The periarticular injection contained Ropivacaine, Ketorolac and Adrenaline, given intra-operatively. The mean amount of opioid used was 22.87 mmol/L in the Injection group as compared to 39.78 mmol/L in the Standard group (p = 0.026. The Injection group had lower pain score at rest and during exercise (p=0.021, p=0.041, respectively, as well as better return to function (p=0.026 and shorter hospital stay (6.1 days, Injection; 7.5 days, Standard, p=0.027. Overall, the group receiving periarticular drugs injection had less pain, less narcotic usage, earlier return to function, similar experience of adverse effects and shorter hospital stays.

  15. Building-Related Symptoms among Office Employees Associated with Indoor Carbon Dioxide and Total Volatile Organic Compounds

    Directory of Open Access Journals (Sweden)

    Chung-Yen Lu

    2015-05-01

    Full Text Available This study investigated whether sick building syndrome (SBS complaints among office workers were associated with the indoor air quality. With informed consent, 417 employees in 87 office rooms of eight high-rise buildings completed a self-reported questionnaire for symptoms experienced at work during the past month. Carbon dioxide (CO2, temperature, humidity and total volatile organic compounds (TVOCs in each office were simultaneously measured for eight office hours using portable monitors. Time-averaged workday difference between the indoor and the outdoor CO2 concentrations (dCO2 was calculated as a surrogate measure of ventilation efficiency for each office unit. The prevalence rates of SBS were 22.5% for eye syndrome, 15.3% for upper respiratory and 25.4% for non-specific syndromes. Tiredness (20.9%, difficulty in concentrating (14.6%, eye dryness (18.7% were also common complaints. The generalized estimating equations multivariate logistic regression analyses showed that adjusted odds ratios (aORs and 95% confidence interval (CI per 100 ppm increase in dCO2 were significantly associated with dry throat (1.10, 95% CI = (1.00–1.22, tiredness (1.16, 95% CI = (1.04–1.29 and dizziness (1.22, 95% CI = (1.08–1.37. The ORs for per 100 ppb increases in TVOCs were also associated with upper respiratory symptoms (1.06, 95% CI = (1.04–1.07, dry throat (1.06, 95% CI = (1.03–1.09 and irritability (1.02, 95% CI = (1.01–1.04. In conclusion, the association between some SBS symptoms and the exposure to CO2 and total VOCs are moderate but may be independently significant.

  16. Local tumor control and cosmetic outcome following breast-conserving surgery and radiation up to a total dose of 56 Gy without boost in breast cancer patients

    International Nuclear Information System (INIS)

    Bayerl, A.

    2001-01-01

    Purpose: To evaluate overall survival, local tumor control and cosmetic outcome after breast-conserving surgery followed by radiotherapy without boost irradiation. Patients and Methods: In a retrospective study 270 breast cancer patients were treated with breast conserving surgery combined with a homogenous radiation of the tumor bearing breast up to a total dose of 56 Gy without local boost irradiation. Mean follow-up was 48 months. Local tumor control, side effects, cosmetic results and contentment with treatment were assessed using physical examinations and interviews based on a standardized questionnaire. Results: Cause-specific survival at 5 years after treatment was 88.3%, actuarial disease-free survival at 5 years was 76.1%. Within 23 to 78 months after treatment 12 patients suffered from ipsilateral breast recurrence. The actuarial freedom from local recurrence (single tumor manifestation) was 96.8% at 5 years after treatment, 89% at 10 years. The occurrence of local failures was not significantly correlated to tumor size, margins, grading, nodal status, age or lymphangiosis. 15.6% of the patients developed distant metastases. In all patients treatment was performed without interruption. Side effects were predominantly of mild degree, no severe side effects were detected. 73% of physicians and 81% of patients scored their cosmetic outcome as excellent or good. 93% of patients would again decide in favor of this procedure. Whereas, use of adjuvant chemotherapy as well as subcutaneous reconstruction of breast tissue did not significantly affect breast cosmesis, analysis demonstrated impaired cosmetic results related to a larger breast size. Conclusion: The data of this study show that tumor control achieved by breast conserving surgery in combination with a radiation technique up to a total dose of 56 Gy which omits boost irradiation is within the range of literature data. Side effects of the therapy were tolerable. The treatment displayed a good

  17. Are parenting style and controlling feeding practices related?

    Science.gov (United States)

    Blissett, J; Haycraft, E

    2008-01-01

    This study examined the relationships between parenting styles, feeding practices and BMI in a non-clinical sample of mothers and fathers of UK preschool children. Ninety-six cohabiting parents of 48 children (19 male, 29 female, mean age 42 months) completed a series of self-report questionnaires assessing parenting style, feeding practices, eating psychopathology and a range of demographic information. There were no relationships between authoritarian parenting and controlling feeding practices. In both mothers and fathers, permissive parenting style was related to lower monitoring of children's unhealthy food intake. Permissive parenting was also associated with increased use of restriction by mothers and pressure to eat by fathers. Authoritative parenting style was also related to lower use of pressure to eat by fathers only. Parenting styles were not related to child BMI in this sample. Higher child BMI was best predicted by lower paternal application of pressure to eat and greater paternal reports of drive for thinness. Parenting style may not have a direct impact on child BMI until child food selection and consumption becomes more autonomous.

  18. Blood glucose control in healthy subject and patients receiving intravenous glucose infusion or total parenteral nutrition using glucagon-like peptide 1

    DEFF Research Database (Denmark)

    Nauck, Michael A; Walberg, Jörg; Vethacke, Arndt

    2004-01-01

    It was the aim of the study to examine whether the insulinotropic gut hormone GLP-1 is able to control or even normalise glycaemia in healthy subjects receiving intravenous glucose infusions and in severely ill patients hyperglycaemic during total parenteral nutrition.......It was the aim of the study to examine whether the insulinotropic gut hormone GLP-1 is able to control or even normalise glycaemia in healthy subjects receiving intravenous glucose infusions and in severely ill patients hyperglycaemic during total parenteral nutrition....

  19. Inflammation Related MicroRNAs Are Modulated in Total Plasma and in Extracellular Vesicles from Rats with Chronic Ingestion of Sucrose

    Directory of Open Access Journals (Sweden)

    Malinalli Brianza-Padilla

    2016-01-01

    Full Text Available Circulating microRNAs (miRNAs and the functional implications of miRNAs contained in extracellular vesicles (EVs have gained attention in the last decade. Little is known about the regulation of the abundance of plasma miRNAs in response to chronic ingestion of carbohydrates. Therefore, we explored the circulating levels of miR-21, miR-146a, miR-155, and miR-223 in rats consuming sucrose in drinking water. Weanling Wistar rats were 25 weeks with 30% sucrose in drinking water, and miRNAs expression was determined in total plasma and in microvesicles, by RT-qPCR with TaqMan probe based assays for miR-21, miR-146a, miR-155, and miR-223, using cel-miR-39 (as spike in control and reference. Endotoxemia was also measured. Sucrose-fed animals showed higher body weight and retroperitoneal adipose tissue as well as higher glucose and triglyceride plasma levels than controls. Plasma endotoxin levels were low and not different among groups. Plasma miR-21 and miR-223 were higher in the sucrose group (p<0.05, whereas miR-155 tended to be lower (p=0.0661, and miR-146a did not show significant differences. In the plasma EVs the same trend was found except for miR-146a that showed significantly higher levels (p<0.05. Overall, our results show that high carbohydrate ingestion modulates circulating miRNAs levels related to an inflammatory response.

  20. Effect of joint mobilization techniques for primary total knee arthroplasty: Study protocol for a randomized controlled trial.

    Science.gov (United States)

    Xu, Jiao; Zhang, Juan; Wang, Xue-Qiang; Wang, Xuan-Lin; Wu, Ya; Chen, Chan-Cheng; Zhang, Han-Yu; Zhang, Zhi-Wan; Fan, Kai-Yi; Zhu, Qiang; Deng, Zhi-Wei

    2017-12-01

    Total knee arthroplasty (TKA) has become the most preferred procedure by patients for the relief of pain caused by knee osteoarthritis. TKA patients aim a speedy recovery after the surgery. Joint mobilization techniques for rehabilitation have been widely used to relieve pain and improve joint mobility. However, relevant randomized controlled trials showing the curative effect of these techniques remain lacking to date. Accordingly, this study aims to investigate whether joint mobilization techniques are valid for primary TKA. We will manage a single-blind, prospective, randomized, controlled trial of 120 patients with unilateral TKA. Patients will be randomized into an intervention group, a physical modality therapy group, and a usual care group. The intervention group will undergo joint mobilization manipulation treatment once a day and regular training twice a day for a month. The physical modality therapy group will undergo physical therapy once a day and regular training twice a day for a month. The usual care group will perform regular training twice a day for a month. Primary outcome measures will be based on the visual analog scale, the knee joint Hospital for Special Surgery score, range of motion, surrounded degree, and adverse effect. Secondary indicators will include manual muscle testing, 36-Item Short Form Health Survey, Berg Balance Scale function evaluation, Pittsburgh Sleep Quality Index, proprioception, and muscle morphology. We will direct intention-to-treat analysis if a subject withdraws from the trial. The important features of this trial for joint mobilization techniques in primary TKA are randomization procedures, single-blind, large sample size, and standardized protocol. This study aims to investigate whether joint mobilization techniques are effective for early TKA patients. The result of this study may serve as a guide for TKA patients, medical personnel, and healthcare decision makers. It has been registered at http

  1. Effect of Transcutaneous Electric Nerve Stimulation on Pain after Total Knee Arthroplasty: A Blind Randomized Controlled Trial.

    Science.gov (United States)

    Beckwée, David; Bautmans, Ivan; Lefeber, Nina; Lievens, Pierre; Scheerlinck, Thierry; Vaes, Peter

    2018-02-01

    Transcutaneous electric nerve stimulation (TENS) has proven to be effective for postsurgical pain relief. However, there is a lack of well-constructed clinical trials investigating the effect of TENS after total knee arthroplasty (TKA). In addition, previous investigations reported that low- and high-frequency TENSs produced analgesic tolerance after 4 or 5 days of treatment. The aim of this study is to explore the effect of burst TENS on pain during hospitalization after TKA and to investigate whether burst TENS produces analgesic tolerance after 4 or 5 days of treatment. This stratified, triple blind, randomized controlled trial was approved by the University Hospital Brussels. Sixty-eight subjects were screened for eligibility before surgery; 54 were found eligible and 53 were included in the analyses. Patients were allocated to either a burst TENS or sham burst TENS group. TENS was applied daily during continuous passive mobilization. Knee pain intensity, knee range of motion, and analgesic consumption were assessed daily. Patients received burst TENS ( N  = 25) or sham burst TENS ( N  = 28). No significant differences in knee pain intensity were found between the groups ( p  > 0.05). Within the TENS and the sham TENS groups, the difference in knee pain before and after treatment did not evolve over time ( p  > 0.05). This study found no effects of burst TENS compared with sham burst TENS on pain during hospitalization after TKA. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  2. The percentage of nosocomial-related out of total hospitalizations for rotavirus gastroenteritis and its association with hand hygiene compliance.

    Science.gov (United States)

    Waisbourd-Zinman, Orith; Ben-Ziony, Shiri; Solter, Ester; Chodick, Gabriel; Ashkenazi, Shai; Livni, Gilat

    2011-03-01

    Because the absolute numbers of both community-acquired and nosocomial rotavirus gastroenteritis (RVGE) vary, we studied the percentage of hospitalizations for RVGE that were transmitted nosocomially as an indicator of in-hospital acquisition of the infection. In a 4-year prospective study, the percentage of nosocomial RVGE declined steadily, from 20.3% in 2003 to 12.7% in 2006 (P = .001). Concomitantly, the rate of compliance with hand hygiene increased from 33.7% to 49% (P = .012), with a significant (P Infection Control and Epidemiology, Inc. Published by Mosby, Inc. All rights reserved.

  3. Performance on a Clinical Quadriceps Activation Battery Is Related to a Laboratory Measure of Activation and Recovery After Total Knee Arthroplasty.

    Science.gov (United States)

    Bade, Michael; Struessel, Tamara; Paxton, Roger; Winters, Joshua; Baym, Carol; Stevens-Lapsley, Jennifer

    2018-01-01

    To determine the relation between performance on a clinical quadriceps activation battery with (1) activation measured by doublet interpolation and (2) recovery of quadriceps strength and functional performance after total knee arthroplasty (TKA). Planned secondary analysis of a randomized controlled trial. University research laboratory. Patients (N=162; mean age, 63±7y; 89 women) undergoing TKA. Patients were classified as high (quadriceps activation battery ≥4/6) or low (quadriceps activation battery ≤3/6) based on performance on the quadriceps activation battery measured 4 days after TKA. Differences between groups in activation and recovery at 1, 2, 3, 6, and 12 months after TKA were compared using a repeated-measures maximum likelihood model. The low quadriceps activation battery group demonstrated poorer quadriceps activation via doublet interpolation (P=.01), greater quadriceps strength loss (P=.01), and greater functional performance decline (all Pbattery group. Differences between low and high quadriceps activation battery groups on all measures did not persist at 3 and 12 months (all P>.05). Poor performance on the quadriceps activation battery early after TKA is related to poor quadriceps activation and poor recovery in the early postoperative period. Patients in the low quadriceps activation battery group took 3 months to recover to the same level as the high quadriceps activation battery group. The quadriceps activation battery may be useful in identifying individuals who need specific interventions to target activation deficits or different care pathways in the early postoperative period to speed recovery after TKA. Copyright © 2017 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  4. Relation between preoperative autonomic function and blood pressure change after tourniquet deflation during total knee replacement arthroplasty.

    Science.gov (United States)

    Huh, In Young; Kim, Dae-Young; Lee, Ji-Hyeon; Shin, Soo Jin; Cho, Young Woo; Park, Soon Eun

    2012-02-01

    Tourniquets are used to provide a bloodless surgical field for extremities. Hypotension due to vasodilation and bleeding after tourniquet deflation is a common event. Hemodynamic stability is modulated by the autonomic nervous system (ANS). Heart rate variability (HRV) is a sensitive method for detecting individuals who may be at risk of hemodynamic instability during general anesthesia. The purpose of this study was to investigate ANS function to predict hypotension after tourniquet deflation. Eighty-six patients who underwent total knee replacement arthroplasty (TKRA) were studied. HRV, systolic blood pressure variability (SBPV) and baroreflex sensitivity (BRS) were analyzed. We assigned two groups depending on the lowest systolic blood pressure (SBP) or mean BP (MBP) after tourniquet release (Group H; SBP 80 mmHg and MBP > 60 mmHg). Fifteen patients developed severe hypotension and ten patients were treated with ephedrine. Of the parameters of HRV, SBPV, and BRS, only BRS(SEQ) was significant being low in Group H. BRS and high-frequency SBPV were correlated with the degree of MBP change after tourniquet deflation. Preoperative low BRS is associated with hypotension after tourniquet deflation, suggesting the importance of baroreflex regulation for intraoperative hemodynamic stability.

  5. Beliefs, Behaviors, and Perceptions of Community-Led Total Sanitation and Their Relation to Improved Sanitation in Rural Zambia

    Science.gov (United States)

    Joseph Lawrence, J.; Yeboah-Antwi, Kojo; Biemba, Godfrey; Ram, Pavani K.; Osbert, Nicolas; Sabin, Lora L.; Hamer, Davidson H.

    2016-01-01

    Inadequate hygiene and sanitation remain leading global contributors to morbidity and mortality in children and adults. One strategy for improving sanitation access is community-led total sanitation (CLTS), in which participants are guided into self-realization of the importance of sanitation through activities called “triggering.” This qualitative study explored community members' and stakeholders' sanitation, knowledge, perceptions, and behaviors during early CLTS implementation in Zambia. We conducted 67 in-depth interviews and 24 focus group discussions in six districts in Zambia 12–18 months after CLTS implementation. Triggering activities elicited strong emotions, including shame, disgust, and peer pressure, which persuaded individuals and families to build and use latrines and handwashing stations. New sanitation behaviors were also encouraged by the hierarchical influences of traditional leaders and sanitation action groups and by children's opinions. Poor soil conditions were identified as barriers to latrine construction. Taboos, including prohibition of different generations of family members, in-laws, and opposite genders from using the same toilet, were barriers for using sanitation facilities. CLTS, through community empowerment and ownership, produced powerful responses that encouraged construction and use of latrines and handwashing practices. These qualitative data suggest that CLTS is effective for improving sanitation beliefs and behaviors in Zambia. PMID:26787149

  6. Case-related factors affecting cutting errors of the proximal tibia in total knee arthroplasty assessed by computer navigation.

    Science.gov (United States)

    Tsukeoka, Tadashi; Tsuneizumi, Yoshikazu; Yoshino, Kensuke; Suzuki, Mashiko

    2018-05-01

    The aim of this study was to determine factors that contribute to bone cutting errors of conventional instrumentation for tibial resection in total knee arthroplasty (TKA) as assessed by an image-free navigation system. The hypothesis is that preoperative varus alignment is a significant contributory factor to tibial bone cutting errors. This was a prospective study of a consecutive series of 72 TKAs. The amount of the tibial first-cut errors with reference to the planned cutting plane in both coronal and sagittal planes was measured by an image-free computer navigation system. Multiple regression models were developed with the amount of tibial cutting error in the coronal and sagittal planes as dependent variables and sex, age, disease, height, body mass index, preoperative alignment, patellar height (Insall-Salvati ratio) and preoperative flexion angle as independent variables. Multiple regression analysis showed that sex (male gender) (R = 0.25 p = 0.047) and preoperative varus alignment (R = 0.42, p = 0.001) were positively associated with varus tibial cutting errors in the coronal plane. In the sagittal plane, none of the independent variables was significant. When performing TKA in varus deformity, careful confirmation of the bone cutting surface should be performed to avoid varus alignment. The results of this study suggest technical considerations that can help a surgeon achieve more accurate component placement. IV.

  7. Comprehensive Control of Human Papillomavirus Infections and Related Diseases

    Science.gov (United States)

    Bosch, F. Xavier; Broker, Thomas R.; Forman, David; Moscicki, Anna-Barbara; Gillison, Maura L.; Doorbar, John; Stern, Peter L.; Stanley, Margaret; Arbyn, Marc; Poljak, Mario; Cuzick, Jack; Castle, Philip E.; Schiller, John T.; Markowitz, Lauri E.; Fisher, William A.; Canfell, Karen; Denny, Lynette A.; Franco, Eduardo L.; Steben, Marc; Kane, Mark A.; Schiffman, Mark; Meijer, Chris J.L.M.; Sankaranarayanan, Rengaswamy; Castellsagué, Xavier; Kim, Jane J.; Brotons, Maria; Alemany, Laia; Albero, Ginesa; Diaz, Mireia; de Sanjosé, Silvia

    2014-01-01

    Infection with human papillomavirus (HPV) is recognized as one of the major causes of infection-related cancer worldwide, as well as the causal factor in other diseases. Strong evidence for a causal etiology with HPV has been stated by the International Agency for Research on Cancer for cancers of the cervix uteri, penis, vulva, vagina, anus and oropharynx (including base of the tongue and tonsils). Of the estimated 12.7 million new cancers occurring in 2008 worldwide, 4.8% were attributable to HPV infection, with substantially higher incidence and mortality rates seen in developing versus developed countries. In recent years, we have gained tremendous knowledge about HPVs and their interactions with host cells, tissues and the immune system; have validated and implemented strategies for safe and efficacious prophylactic vaccination against HPV infections; have developed increasingly sensitive and specific molecular diagnostic tools for HPV detection for use in cervical cancer screening; and have substantially increased global awareness of HPV and its many associated diseases in women, men, and children. While these achievements exemplify the success of biomedical research in generating important public health interventions, they also generate new and daunting challenges: costs of HPV prevention and medical care, the implementation of what is technically possible, socio-political resistance to prevention opportunities, and the very wide ranges of national economic capabilities and health care systems. Gains and challenges faced in the quest for comprehensive control of HPV infection and HPV-related cancers and other disease are summarized in this review. The information presented may be viewed in terms of a reframed paradigm of prevention of cervical cancer and other HPV-related diseases that will include strategic combinations of at least four major components: 1) routine introduction of HPV vaccines to women in all countries, 2) extension and simplification of

  8. Comparison of liposomal bupivacaine infiltration versus interscalene nerve block for pain control in total shoulder arthroplasty: A meta-analysis of randomized control trails.

    Science.gov (United States)

    Cao, Xiuling; Pan, Fang

    2017-09-01

    This meta-analysis aimed to compare the efficiency and safety of liposomal bupivacaine infiltration and interscalene nerve block for pain control after total shoulder arthroplasty. A systematic search was performed in Medline (1966 to May 2017), PubMed (1966 to May 2017), Embase (1980 to May 2017), ScienceDirect (1985 to May 2017) and the Cochrane Library. Only randomized controlled trials (RCTs) were included. Reported surgical outcomes, including visual analogue scale (VAS) scores, opioid consumption, length of stay, and postoperative adverse effects including the risk of nausea and vomiting. Meta-analysis was performed using Stata 11.0 software. Four RCTs including 510 patients met the inclusion criteria. The present meta-analysis indicated that there were no significant differences between groups in terms of VAS score at 12 hours (standard mean difference [SMD] = 0.272, 95% CI: -0.150 to 0.695, P = .207), 24 hours (SMD = -0.056, 95% CI: -0.458 to 0.346, P = 0.785), and 48 hours (SMD = 0.183, 95% CI: -0.148 to 0.513, P = .278). Liposomal bupivacaine infiltration groups required an equivalent amount of opioids at postoperative 12 hours (SMD = -0.039, 95% CI: -0.222 to 0.143, P = .672), 24 hours (SMD = 0.046, 95% CI: -0.136 to 0.228, P = .618) and 48 hours (SMD = -0.025, 95% CI: -0.207 to 0.157, P = .785). Liposomal bupivacaine infiltration provides equivalent postoperative pain control compared with interscalene nerve block following total shoulder arthroplasty. Both of them can reduce the consumption of opioids without severe adverse effects. More high-quality RCTs with long follow-up period are necessary for proper comparisons of the efficacy and safety of liposomal bupivacaine infiltration with interscalene nerve block.

  9. Anxiety and assertiveness in the relatives of alcoholics and controls.

    Science.gov (United States)

    Schuckit, M A

    1982-06-01

    The Rathus Assertiveness Schedule (RAS) and the Spielberger State-Trait Anxiety Inventory A-Trait Scale (STAI) were administered to male university students and nonacademic staff. Subjects classified as "at-risk" on the basis of a history of alcoholism in a first-degree relative (N = 30) were compared to controls with no such family histories (N = 30). The two groups were matched on demographic variables and drinking history. No significant differences were found between the groups on the traits of anxiety or assertiveness, although the subjects hypothesized to be at higher risk for alcoholism showed a trend toward higher assertiveness scores. These findings are not consistent with the hypothesis that higher levels of anxiety and/or lower levels of assertiveness predispose an individual toward the development of alcoholism.

  10. Relative dynamics and motion control of nanosatellite formation flying

    Science.gov (United States)

    Pimnoo, Ammarin; Hiraki, Koju

    2016-04-01

    Orbit selection is a necessary factor in nanosatellite formation mission design/meanwhile, to keep the formation, it is necessary to consume fuel. Therefore, the best orbit design for nanosatellite formation flying should be one that requires the minimum fuel consumption. The purpose of this paper is to analyse orbit selection with respect to the minimum fuel consumption, to provide a convenient way to estimate the fuel consumption for keeping nanosatellite formation flying and to present a simplified method of formation control. The formation structure is disturbed by J2 gravitational perturbation and other perturbing accelerations such as atmospheric drag. First, Gauss' Variation Equations (GVE) are used to estimate the essential ΔV due to the J2 perturbation and atmospheric drag. The essential ΔV presents information on which orbit is good with respect to the minimum fuel consumption. Then, the linear equations which account for J2 gravitational perturbation of Schweighart-Sedwick are presented and used to estimate the fuel consumption to maintain the formation structure. Finally, the relative dynamics motion is presented as well as a simplified motion control of formation structure by using GVE.

  11. Using discrete choice experiments as a decision aid in total knee arthroplasty: study protocol for a randomised controlled trial.

    Science.gov (United States)

    Dowsey, Michelle M; Scott, Anthony; Nelson, Elizabeth A; Li, Jinhu; Sundararajan, Vijaya; Nikpour, Mandana; Choong, Peter F M

    2016-08-19

    Osteoarthritis (OA) is a leading cause of disability in developed nations. Total knee arthroplasty (TKA) is a clinically effective treatment for people with end-stage knee OA, and represents one of the highest volume medical interventions globally. However, up to one in three patients remain dissatisfied following TKA. Research indicates that the strongest predictor of patient dissatisfaction following TKA is unmet expectations. This study will use a discrete choice experiment (DCE) provided to patients to improve knowledge of the expected outcomes of TKA. This increased knowledge is based on actual outcome data and is hypothesised to optimise patient expectations of TKA outcomes, thereby increasing their satisfaction and self-reported health outcomes. One hundred and thirty-two people with end-stage OA on the waiting list for TKA will be recruited and randomly allocated to one of two groups using computer-generated block randomisation. A randomised controlled trial (RCT) adhering to SPIRIT and CONSORT guidelines will evaluate the effect of administering a DCE prior to surgery on patient-reported pain and function and satisfaction following TKA. Patients in the intervention arm will complete a survey containing the DCE, compared to the control group who will complete a modified survey that does not contain the DCE activity. The DCE contains information on actual risks of postoperative complications, as well as health status after TKA. The DCE encourages patients to actively make trade-offs between risks and health outcomes to elicit their preferences. Participants in both groups will be required to complete the survey after consenting to have the procedure, but prior to surgery during their routine preadmission appointment at St. Vincent's Hospital, Melbourne, Australia (SVHM). Patients in both the intervention and control groups will also be required to complete a brief patient expectation survey 1 week prior to scheduled TKA. In addition, orthopaedic surgeons

  12. Switching the Fermilab Accelerator Control System to a relational database

    International Nuclear Information System (INIS)

    Shtirbu, S.

    1993-01-01

    The accelerator control system (open-quotes ACNETclose quotes) at Fermilab is using a made-in-house, Assembly language, database. The database holds device information, which is mostly used for finding out how to read/set devices and how to interpret alarms. This is a very efficient implementation, but it lacks the needed flexibility and forces applications to store data in private/shared files. This database is being replaced by an off-the-shelf relational database (Sybase 2 ). The major constraints on switching are the necessity to maintain/improve response time and to minimize changes to existing applications. Innovative methods are used to help achieve the required performance, and a layer seven gateway simulates the old database for existing programs. The new database is running on a DEC ALPHA/VMS platform, and provides better performance. The switch is also exposing problems with the data currently stored in the database, and is helping in cleaning up erroneous data. The flexibility of the new relational database is going to facilitate many new applications in the future (e.g. a 3D presentation of device location). The new database is expected to fully replace the old database during this summer's shutdown

  13. Relative null controllability of linear systems with multiple delays in ...

    African Journals Online (AJOL)

    varying multiple delays in state and control are developed. If the uncontrolled system is uniformly asymptotically stable, and if the linear system is controllable, then the linear system is null controllable. Journal of the Nigerian Association of ...

  14. Radiation control report on intermediate heat exchanger replacement and related works

    International Nuclear Information System (INIS)

    Kanou, Y.; Yamanaka, T.; Sasajima, T.; Hoshiba, H.; Emori, S.; Shindou, K.

    2002-03-01

    The 13th periodical inspection of the experimental fast reactor JOYO is being made from Jun. 2000 to Jan. 2003. While this inspection, from the end of Oct. 2000 to Nov. 2001, the MK-III modification work on heat transport system was made in lower region of the reactor containment vessel in the reactor facility (under floor area). In the MK-III modification work, the works important to radiation control were the replacement of intermediate heat exchangers (IHXs) and fixtures, and the picking out of the surveillance material from primary heat transport piping carried out in the maintenance building. Because the working areas of these works were executed in small space around the complicated primary heat transport piping, workability was bad and dose rate from the corrosion products (CP) in piping or fixtures was high. In such condition, radiation control was performed mainly concerned about external exposure. The planted total external exposure of the IHX replacement and related works was 7135 man-mSv (target of total dose control: less than 5708 man-mSv, 80% of the plan), derived from special radiation work plants for segmental works, concerned about work procedure, number of workers, period of work, dose rate of working area and surface dose rate of equipments. The special radiation control organization was established for such long and large-scale work. The spatial organization held detailed discussion about radiation control of this work with the execution section and contractors appropriately, performance careful external/internal exposure control and surface contamination control and made efforts to reduce te external exposure thoroughly. As a result of these action, the total external exposure was 2386 man·mSv (≅33% of the plan, ≅42% of the target) and the maximum individual exposure were 24.7 mSv for staffs and 21.7mSv for contractors. The dose rate, surface contamination and air contamination while the works were kept under the control level with the

  15. Evolution of magnetotelluric, total magnetic field, and VLF field parameters in Central Italy. Relations to local seismic activity

    Energy Technology Data Exchange (ETDEWEB)

    Meloni, A.; Di Mauro, D.; Mele, G.; Palangio, P. [Istituto Nazionale di Geofisica e Vulcanologia, Rome (Italy); Ernst, T.; Teisseyre, R. [Institute of Geophysics, Warszawa (Poland)

    2001-04-01

    Magnetotelluric data were collected at Collemeluccio (41.72{sup 0}N, 14.37{sup 0}E) in Central Italy from summer 1991 to spring 1998. Analyzed by means of tensor decomposition on the geoelectric potential and robust estimation on the geomagnetic field, this set of data allowed the investigation of the electromagnetic induction, is presented here in its time evolution and compared to local and regional seismic activity. Tecto magnetic field observations from absolute magnetic field level in Central Italy were also made on data simultaneously recorded at four magnetometer stations, using L'Aquila Geomagnetic Observatory as a reference for differentiation. Recent results gathered from a system of two VLF search coil wide-band antennas, installed in the L'Aquila Observatory, are also discussed in relation to local seismic activity.

  16. Allometric relations of total volumes of prolactin cells and corticotropic cells to body length in the annual cyprinodont Cynolebias whitei: effects of environmental salinity, stress and ageing

    NARCIS (Netherlands)

    Ruijter, J. M.; Wendelaar Bonga, S. E.

    1987-01-01

    An analysis of the allometric relations of the total volumes occupied by prolactin (PRL) and corticotropic (ACTH) cells (PRL volume and ACTH volume, respectively) to body length and a study of the immunocytochemical staining intensity of PRL and ACTH cells were used to determine the differences in

  17. Predictors of fecal incontinence and related quality of life after a total mesorectal excision with primary anastomosis for patients with rectal cancer

    NARCIS (Netherlands)

    Walma, Marieke S; Kornmann, Verena N N; Boerma, Djamila; de Roos, Marnix A J; van Westreenen, Henderik L

    PURPOSE: After total mesorectal excision (TME) with primary anastomosis for patients with rectal cancer, the quality of life (QoL) may be decreased due to fecal incontinence. This study aimed to identify predictors of fecal incontinence and related QoL. METHODS: Patients who underwent TME with

  18. Total working period and other risk factors related to eating protein foods habits among civil pilots in Indonesia

    Directory of Open Access Journals (Sweden)

    Indah Imelda Hutabarat

    2017-07-01

    pilots in Indonesia. Methods: A cross-sectional study using secondary data from the survey of eating, drinking and physical exercise habits among civilian pilots in Indonesia 2016. Data collected were demographic characteristics, physical exercise habits, smoking habits, knowledge, body mass index and flight characteristics. Cox regression analysis was used to analyze the dominant factors associated with protein eating habits. Results: Among 528 pilots aged 19-64 years, 194 (36.74% pilots had excessive protein eating habits . Long working period and body mass index were the dominant risk factors associated with protein eating habit in pilots. Compared to pilots with 1-9 years working period, pilots with 10-40 years working period had 35% lower risk of excessive protein eating habits (RRA = 0.65; 95% CI 0:49 - 0.87. Compared to pilots with normal body mass index, overweight pilots had 34% lower risk of excessive protein eating habits (RRA = 0.66; 95% CI 0:47 - 0.93. Conclusion: Long working period and overweight were protective factors from the risk of excessive protein eating habits Keywords: protein eating habits, total working periode, body mass index, civilian pilots Indonesia

  19. Emergency Diesel: Safety-related instrumentation and control with programmable logic controllers

    International Nuclear Information System (INIS)

    Breidenich, G.; Luedtke, M.

    2004-01-01

    This report presents a new concept for the design of emergency diesel equipment protection circuits as a part of the safety related instrumentation in the nuclear power plant Biblis, units A and B. The concept was implemented with state of the art SIMATIC S7/316 programmable logic controllers (PLCs) and can be adapted to any system with high availability requirements (e.g. power plant turbines, aircraft engines, mining pumps etc). (orig.)

  20. Estimating the proportion of groundwater recharge from flood events in relation to total annual recharge in a karst aquifer

    Science.gov (United States)

    Dvory, N. Z.; Ronen, A.; Livshitz, Y.; Adar, E.; Kuznetsov, M.; Yakirevich, A.

    2017-12-01

    Sustainable groundwater production from karstic aquifers is primarily dictated by its recharge rate. Therefore, in order to limit over-exploitation, it is essential to accurately quantify groundwater recharge. Infiltration during erratic floods in karstic basins may contribute substantial amount to aquifer recharge. However, the complicated nature of karst systems, which are characterized in part by multiple springs, sinkholes, and losing/gaining streams, present a large obstacle to accurately assess the actual contribution of flood water to groundwater recharge. In this study, we aim to quantify the proportion of groundwater recharge during flood events in relation to the annual recharge for karst aquifers. The role of karst conduits on flash flood infiltration was examined during four flood and artificial runoff events in the Sorek creek near Jerusalem, Israel. The events were monitored in short time steps (four minutes). This high resolution analysis is essential to accurately estimating surface flow volumes, which are of particular importance in arid and semi-arid climate where ephemeral flows may provide a substantial contribution to the groundwater reservoirs. For the present investigation, we distinguished between direct infiltration, percolation through karst conduits and diffused infiltration, which is most affected by evapotranspiration. A water balance was then calculated for the 2014/15 hydrologic year using the Hydrologic Engineering Center - Hydrologic Modelling System (HEC-HMS). Simulations show that an additional 8% to 24% of the annual recharge volume is added from runoff losses along the creek that infiltrate through the karst system into the aquifer. The results improve the understanding of recharge processes and support the use of the proposed methodology for quantifying groundwater recharge.

  1. Asthma-related health services and asthma control among women in Puerto Rico

    Science.gov (United States)

    Ortiz-Rivera, María Calixta

    2018-01-01

    Objectives: This study evaluates social, behavioral, and environmental determinants to differentiate between active and inactive asthma and how predisposing, enabling, and need factors elucidate asthma-related health services and asthma control among women in Puerto Rico. Methods: This study analyzed secondary cross-sectional data from a subsample of 625 adult females who participated in the Asthma Call Back Survey in Puerto Rico. Logistic and multinomial regression analyses were conducted to examine associations between explanatory variables and asthma outcomes. Results: In total, 63% of women reported active asthma, from which 37.9% have not well controlled or very poorly controlled asthma. Women with active asthma were significantly more likely to be out of work, have middle income (US$25,000–controlled asthma were significantly associated with increased units of physician urgent visits and emergency room visits. Conclusion: The findings confirmed significant determinants for active asthma and adds information on odds ratio for sensitive subgroups that utilize asthma-related health services in higher proportion than their counterparts. These associations suggest a development of asthma management plan targeting women to control the condition and reduce health-care utilization.

  2. Patient-related barriers to hypertension control in a Nigerian population

    Science.gov (United States)

    Okwuonu, Chimezie Godswill; Ojimadu, Nnamdi Ezekiel; Okaka, Enajite Ibiene; Akemokwe, Fatai Momodu

    2014-01-01

    Background Hypertension control is a challenge globally. Barriers to optimal control exist at the patient, physician, and health system levels. Patient-related barriers in our environment are not clear. The aim of this study was to identify patient-related barriers to control of hypertension among adults with hypertension in a semiurban community in South-East Nigeria. Methods This was a cross-sectional descriptive study of patients with a diagnosis of hypertension and on antihypertensive medication. Results A total of 252 participants were included in the survey, and comprised 143 males (56.7%) and 109 females (43.3%). The mean age of the participants was 56.6±12.7 years, with a diagnosis of hypertension for a mean duration of 6.1±3.3 years. Among these patients, 32.9% had controlled blood pressure, while 39.3% and 27.8%, respectively, had stage 1 and stage 2 hypertension according to the Seventh Report of the Joint National Committee on Prevention, Detection and Evaluation of High Blood Pressure. Only 23.4% knew the consequences of poor blood pressure control and 64% were expecting a cure from treatment even when the cause of hypertension was not known. Furthermore, 68.7% showed low adherence to medication, the reported reasons for which included forgetfulness (61.2%), financial constraints (56.6%), high pill burden (22.5%), side effects of medication (17.3%), and low measured blood pressure (12.1%). Finally, knowledge and practice of the lifestyle modifications necessary for blood pressure control was inadequate among the participants. Conclusion Poor knowledge regarding hypertension, unrealistic expectations of treatment, poor adherence with medication, unawareness of lifestyle modification, and failure to apply these were identified as patient-related barriers to blood pressure control in this study. PMID:25061335

  3. Quality control scheme for thyroid related hormones measured by radioimmunoassay

    International Nuclear Information System (INIS)

    Kamel, R.S.

    1989-09-01

    A regional quality control scheme for thyroid related hormones measured by radioimmunoassay is being established in the Middle East. The scheme started in January 1985, with eight laboratories which were all from Iraq. At the present nineteen laboratories from Iraq, Jordan, Kuwait, Saudi Arabia and United Arab Emirates (Dubai) are now participating in the scheme. The scheme was supported by the International Atomic Energy Agency. All participants received monthly three freeze dried quality control samples for assay. Results for T3, T4 and TSH received from participants are analysed statistically batch by batch and returned to the participants. Laboratories reporting quite marked bias results were contacted to check the assay performance for that particular batch and to define the weak points. Clinical interpretation for certain well defined samples were reported. A regular case study report is recently introduced to the scheme and will be distributed regularly as one of the guidelines in establishing a trouble shooting programme throughout the scheme. The overall mean between the laboratory performance showed a good result for the T4, moderate but acceptable for T3 and poor for TSH. The statistical analysis of the results based on the concept of a ''target'' value is derived from the believed correct value the ''Median''. The overall mean bias values (ignoring signs) for respectively low, normal and high concentration samples were for T4 18.0 ± 12.5, 11.2 ± 6.4 and 11.2 ± 6.4, for T3 28.8 ± 23.5, 11.2 ± 8.4 and 13.4 ± 9.0 and for TSH 46.3 ± 50.1, 37.2 ± 28.5 and 19.1 ± 12.1. The scheme proved to be effective not only in improving the overall performance but also it helped to develop awareness of the need for internal quality control programmes and gave confidence in the results of the participants. The scheme will continue and will be expanded to involve more laboratories in the region. Refs, fig and tabs

  4. Patient directed self management of pain (PaDSMaP compared to treatment as usual following total knee replacement: study protocol for a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Donell Simon

    2012-11-01

    Full Text Available Abstract Background In 2009, 665 patients underwent total knee replacements (TKRs at the Norfolk and Norwich University Hospitals NHS Foundation Trust (NNUH, representing nearly 1% of the national total. Pain control following the operation can be poor, and this can cause poor mobilization and potential long-term adverse events. Although high levels of pain are not associated with patient dissatisfaction, brief periods of pain may lead to neuronal remodeling and sensitization. Patient controlled oral analgesia (PCOA may improve pain relief; however, the evidence to date has been inconclusive. Patient directed self management of pain (PaDSMaP is a single center randomized controlled trial, which aims to establish if patient self-medication improves, or is equivalent to, treatment as usual and to create an educational package to allow implementation elsewhere. Methods/design Patients eligible for a TKR will be recruited and randomized in the outpatient clinic. All patients will undergo their operations according to normal clinical practice but will be randomized into two groups. Once oral medication has commenced, one group will have pain relief administered by nursing staff in the usual way (treatment as usual; TAU, whilst the second group will self manage their pain medication (patient directed self management of pain; PaDSMaP. Those recruited for self-medication will undergo a training program to teach the use of oral analgesics according to the World Health Organization (WHO pain cascade and how to complete the study documentation. The primary endpoint of the trial is the visual analogue scale (VAS pain score at 3 days or discharge, whichever is sooner. The follow-up time is 6 weeks with a planned trial period of 3 years. The secondary objectives are satisfaction with the management of patient pain post-operatively whilst an inpatient after primary TKR; overall pain levels and pain on mobilization; satisfaction with pain management information

  5. Total algorithms

    NARCIS (Netherlands)

    Tel, G.

    We define the notion of total algorithms for networks of processes. A total algorithm enforces that a "decision" is taken by a subset of the processes, and that participation of all processes is required to reach this decision. Total algorithms are an important building block in the design of

  6. Muscle-invasive bladder cancer treated with external beam radiation: influence of total dose, overall treatment time, and treatment interruption on local control

    International Nuclear Information System (INIS)

    Moonen, L.; Voet, H. van der; Nijs, R. de; Horenblas, S.; Hart, A.A.M.; Bartelink, H.

    1998-01-01

    Purpose: To evaluate and eventually quantify a possible influence of tumor proliferation during the external radiation course on local control in muscle invasive bladder cancer. Methods and Materials: The influence of total dose, overall treatment time, and treatment interruption has retrospectively been analyzed in a series of 379 patients with nonmetastasized, muscle-invasive transitional cell carcinoma of the urinary bladder. All patients received external beam radiotherapy at the Netherlands Cancer Institute between 1977 and 1990. Total dose varied between 50 and 75 Gy with a mean of 60.5 Gy and a median of 60.4 Gy. Overall treatment time varied between 20 and 270 days with a mean of 49 days and a median of 41 days. Number of fractions varied between 17 and 36 with a mean of 27 and a median of 26. Two hundred and forty-four patients had a continuous radiation course, whereas 135 had an intended split course or an unintended treatment interruption. Median follow-up was 22 months for all patients and 82 months for the 30 patients still alive at last follow-up. A stepwise procedure using proportional hazard regression has been used to identify prognostic treatment factors with respect to local recurrence as sole first recurrence. Results: One hundred and thirty-six patients experienced a local recurrence and 120 of these occurred before regional or distant metastases. The actuarial local control rate was 40.3% at 5 years and 32.3% at 10 years. In a multivariate analysis total dose showed a significant association with local control (p 0.0039), however in a markedly nonlinear way. In fact only those patients treated with a dose below 57.5 Gy had a significant higher bladder relapse rate, whereas no difference in relapse rate was found among patients treated with doses above 57.5 Gy. This remained the case even after adjustment for overall treatment time and all significant tumor and patient characteristics. The Normalized Tumor Dose (NTD) (α/β = 10) and NTD (

  7. Present status of standards relating to radiation control and protection

    International Nuclear Information System (INIS)

    Minami, Kentaro

    1996-01-01

    Japanese and international standards related to radiation control and radiation protective management are presented focusing on the forming condition, significance, current situation, and their relationship. Japanese Industrial Standards (JIS) is quite useful in the field of atomic energy as well as other fields in terms of optimization and rationalization of the management. JIS includes JIS Z 4001 Atomic Energy Terminology which corresponds to internationl standards ISO 921 Nuclear Glossary, and JIS Z 4005 Medical Radiation Terminology, covering about 500 articles, which corresponds to IEC 788 Medical Radiology-Terminology. The first standards regarding radiation protection was established in X-ray Film Badge, which is included in the field of personal dosimeter, in 1956. Currently, 36 JIS has been established in the field of radiation management dosimeter and 3 are under arrangement. As for radiation protective supplies, 9 JIS has been established so far. Before proposal of JIS, investigation had been conducted to improve, simplify, and standardize the standards of radiation dosimetric technique, dosimeters, dosimetric procedures, and improvement. In this article, the results of material surface contamination monitoring and body surface monitoring conducted in Atomic Energy Safety Association and Radiation Dosimetry Associationare reported, and ISO and IEC are also treated. (S.Y.)

  8. Sleep Quality Effects Recovery After Total Knee Arthroplasty (TKA)--A Randomized, Double-Blind, Controlled Study.

    Science.gov (United States)

    Gong, Long; Wang, ZhenHu; Fan, Dong

    2015-11-01

    This study examined the effects of sleep quality on early recovery after total knee arthroplasty. A total of 148 patients were randomized 1:1 to receive either zolpidem or placebo for 2 weeks. VAS pain scores (rest, ambulation and night), range of motion (ROM), total amount of opioid analgesics and antiemetics taken, postoperative nausea and vomiting (PONV), sleep efficacy and satisfaction were recorded. It was found that patients taking zolpidem achieved greater improvement in quality of life and reported better satisfaction. Patients in the intervention group had lower pain score and took less antiemetics. Moreover, a significant correlation between sleep quality and ROM was detected. These results demonstrated that improved sleep quality is beneficial to patients' post-TKA recovery. Copyright © 2015. Published by Elsevier Inc.

  9. Radiographic cup position following posterior and lateral approach to total hip arthroplasty. An explorative randomized controlled trial

    DEFF Research Database (Denmark)

    Kruse, Christine; Rosenlund, Signe; Broeng, Leif

    2018-01-01

    The two most common surgical approaches to total hip arthroplasty are the posterior approach and lateral approach. The surgical approach may influence cup positioning and restoration of the offset, which may affect the biomechanical properties of the hip joint. The primary aim was to compare cup...... arthroplasty using posterior approach or lateral approach. Postoperative radiographs from 38 patients in each group were included in this study for measurement of cup anteversion and inclination. Femoral offset, cup offset, total offset, abductor moment arm and leg length discrepancy were measured...... approach group had a larger mean femoral offset of 4.3mm (95% CI, -7.4 to -1.3, p = 0.006), mean total offset of 6.3mm (95% CI, -9.6 to -3; pcup anteversion but less...

  10. Quality Control of Gamma Irradiated Dwarf Mallow (Malva neglecta Wallr.) Based on Color, Organic Acids, Total Phenolics and Antioxidant Parameters.

    Science.gov (United States)

    Pinela, José; Barros, Lillian; Antonio, Amilcar L; Carvalho, Ana Maria; Oliveira, M Beatriz P P; Ferreira, Isabel C F R

    2016-04-08

    This study addresses the effects of gamma irradiation (1, 5 and 8 kGy) on color, organic acids, total phenolics, total flavonoids, and antioxidant activity of dwarf mallow (Malva neglecta Wallr.). Organic acids were analyzed by ultra fast liquid chromatography (UFLC) coupled to a photodiode array (PDA) detector. Total phenolics and flavonoids were measured by the Folin-Ciocalteu and aluminium chloride colorimetric methods, respectively. The antioxidant activity was evaluated based on the DPPH(•) scavenging activity, reducing power, β-carotene bleaching inhibition and thiobarbituric acid reactive substances (TBARS) formation inhibition. Analyses were performed in the non-irradiated and irradiated plant material, as well as in decoctions obtained from the same samples. The total amounts of organic acids and phenolics recorded in decocted extracts were always higher than those found in the plant material or hydromethanolic extracts, respectively. The DPPH(•) scavenging activity and reducing power were also higher in decocted extracts. The assayed irradiation doses affected differently the organic acids profile. The levels of total phenolics and flavonoids were lower in the hydromethanolic extracts prepared from samples irradiated at 1 kGy (dose that induced color changes) and in decocted extracts prepared from those irradiated at 8 kGy. The last samples also showed a lower antioxidant activity. In turn, irradiation at 5 kGy favored the amounts of total phenolics and flavonoids. Overall, this study contributes to the understanding of the effects of irradiation in indicators of dwarf mallow quality, and highlighted the decoctions for its antioxidant properties.

  11. Control of delay dominant systems with costs related to switching

    DEFF Research Database (Denmark)

    Deng, Honglian; Larsen, Lars Finn Sloth; Stoustrup, Jakob

    2010-01-01

    The objective of this paper is to extend a novel low complexity method for optimizing switch control developed by the authors earlier to work with delay dominant systems and demonstrate that the method works in practice with a refrigeration test system. The extended method solves switching problems...... controller with fixed bounds shows that the optimizing switch control outperforms the baseline....

  12. Total Thyroidectomy

    Directory of Open Access Journals (Sweden)

    Lopez Moris E

    2016-06-01

    Full Text Available Total thyroidectomy is a surgery that removes all the thyroid tissue from the patient. The suspect of cancer in a thyroid nodule is the most frequent indication and it is presume when previous fine needle puncture is positive or a goiter has significant volume increase or symptomes. Less frequent indications are hyperthyroidism when it is refractory to treatment with Iodine 131 or it is contraindicated, and in cases of symptomatic thyroiditis. The thyroid gland has an important anatomic relation whith the inferior laryngeal nerve and the parathyroid glands, for this reason it is imperative to perform extremely meticulous dissection to recognize each one of these elements and ensure their preservation. It is also essential to maintain strict hemostasis, in order to avoid any postoperative bleeding that could lead to a suffocating neck hematoma, feared complication that represents a surgical emergency and endangers the patient’s life.It is essential to run a formal technique, without skipping steps, and maintain prudence and patience that should rule any surgical act.

  13. Autologous re-transfusion drain compared with no drain in total knee arthroplasty : a randomised controlled trial

    NARCIS (Netherlands)

    Horstmann, Wieger; Kuipers, Bart; Ohanis, David; Slappendel, Robert; Kollen, Boudewijn; Verheyen, Cees

    Background. Post-operative anaemia following total knee arthroplasty is reported to impede functional mobility in the early period following surgery, whereas allogeneic blood transfusions, used to correct low post-operative haemoglobin levels, have concomitant disadvantages. The use of a

  14. [Asthma control status in children and related factors in 29 cities of China].

    Science.gov (United States)

    Zhao, Jing

    2013-02-01

    To investigate the status of asthma control in the city and severity of asthma in children and to identify related factors. This study was conducted in one children's hospital or tertiary hospital in each of the 29 provinces except Xinjiang and Xizang Autonomous Regions. Totally, 2960 parents with asthmatic children ages 0 to 14 years, and all had been diagnosed with asthma at least 3 months ago and the course was more than 12 months, who visited those hospitals were selected for the knowledge, attitude, and practice (KAP) questionnaire survey, and separated into the controlled asthma group and uncontrolled asthma group according to children's asthma conditions in the past 12 months. Multivariate analysis was carried out based on the answers to 28 tested factors; 2485 of 2960 questionnaires from 29 provinces were valid. Of the 2485 valid questionnaires, 66.0% asthmatic children had asthma attacks in the past 12 months, 26.8% asthmatic children had visited the emergency department, 16.2% asthmatic children had been hospitalized. The total cost was significantly higher in the uncontrolled group than in contro group (χ² = 23.14, P asthma control, knowledge of "3 or more times recurrent wheezing suggesting asthma", knowledge of "cough lasting for more than 4 weeks suggesting asthma", knowledge of "cough improved with bronchodilators suggesting asthma", knowledge of "awareness of using short-acting β₂ agonist for acute attack", avoiding contact with plush toys, adhere to use nasal steroid, inhaled corticosteroids/composite preparation, age of children and course of asthma in children are protective factors that affect asthma control and severity of asthma in children. Food allergies, eczema and family history of asthma are risk factors. Asthma in many children was poorly controlled. Factors that affect asthma control and severity include parents' knowledge about asthma, exposure to adverse environment, the compliance with medication and regular visits for asthma

  15. Dietary intake of nitrate relative to antioxidant vitamin in relation to breast cancer risk: a case-control study.

    Science.gov (United States)

    Yang, Yoon Jung; Hwang, Se Hee; Kim, Hyun Ja; Nam, Seok-Jin; Kong, Gu; Kim, Mi Kyung

    2010-01-01

    Nitrate is a precursor in the endogenous formation of N-nitroso compounds, which are potent animal carcinogens, whereas antioxidant vitamins have been suggested to protect against carcinogenesis. Interestingly, nitrate and antioxidant vitamins stem from the same dietary sources. We investigated whether the intake of nitrate relative to antioxidant vitamins is associated with the risk of breast cancer. A total of 362 breast cancer cases were matched to the 362 controls by age and menopausal status. Dietary intake was assessed using a quantitative food frequency questionnaire with 121 food items by trained interviewers. The nitrate to antioxidant vitamin consumption ratio was then calculated. Conditional logistic regression analysis was used to obtain odds ratios (ORs) and corresponding 95% confidence intervals (CI). Mean intakes of nitrate for cases and controls were 421 mg/day and 424 mg/day, respectively. Intakes of nitrate, nitrate/beta-carotene, nitrate/vitamin C, and nitrate/vitamin E were not associated with breast cancer risk. However, higher breast cancer risk was observed with higher intake of nitrate/folate (OR = 2.03, 95% CI = 1.16-3.54, P for trend = 0.052). Our results suggest that lowering the ratio of nitrate to folate intake may be effective in reducing breast cancer risk.

  16. Impulse Control and Related Disorders in Parkinson's Disease.

    Science.gov (United States)

    Weintraub, Daniel; Claassen, Daniel O

    2017-01-01

    Impulse control disorders (ICDs), such as compulsive gambling, buying, sexual, and eating behaviors, are a serious and increasingly recognized complication in Parkinson's disease (PD), occurring in up to 20% of PD patients over the course of their illness. Related behaviors include punding (stereotyped, repetitive, purposeless behaviors), dopamine dysregulation syndrome (DDS) (compulsive medication overuse), and hobbyism (e.g., compulsive internet use, artistic endeavors, and writing). These disorders have a significant impact on quality of life and function, strain interpersonal relationships, and worsen caregiver burden, and are associated with significant psychiatric comorbidity. ICDs have been most closely related to the use of dopamine agonists (DAs), while DDS is primarily associated with shorter acting, higher potency dopamine replacement therapy (DRT), such as levodopa. However, in preliminary research ICDs have also been reported to occur with monoamine oxidase inhibitor-B and amantadine treatment, and after deep brain stimulation (DBS) surgery. Other risk factors for ICDs may include sex (e.g., male sex for compulsive sexual behavior, and female sex for compulsive buying behavior); younger age overall at PD onset; a pre-PD history of an ICD; personal or family history of substance abuse, bipolar disorder, or gambling problems; and impulsive personality traits. Dysregulation of the mesocorticolimbic dopamine system is thought to be the major neurobiological substrate for ICDs in PD, but there is preliminary evidence for alterations in opiate and serotonin systems too. The primary treatment of ICDs in PD is discontinuation of the offending treatment, but not all patients can tolerate this due to worsening motor symptoms or DA withdrawal syndrome. While psychiatric medications and psychosocial treatments are frequently used to treat ICDs in the general population, there is limited empirical evidence for their use in PD, so it is critical for patients to be

  17. Women's perceived internal control of future pregnancy outcomes and its related factors.

    Science.gov (United States)

    Maleki, Azam; Mazloomzadeh, Saeideh

    2013-03-01

    With regards to the importance of women's beliefs in improving pregnancy outcomes, this study was performed to determine the perceived internal control on future pregnancy outcomes and its related factors in women who participated in pre-marital counseling. In a cross-sectional study, women's perceived internal control was investigated. The study population comprised the women in reproductive age of whom 400 were selected by random sampling. Data collection instrument was a questionnaire consisting of demographic, pre-conceptional care, and internal control questions. Two categories of favorite and not favorite levels of internal control were defined based on the total score. The validity of the questionnaire was determined via content validity method by use of experts' opinion and its reliability was evaluated through the calculation of Cronbach's alpha coefficient which was 0.76. Data were analyzed through frequency tables, correlation coefficient, and Chi-square test at the confidence level of 0.95. Two hundred sixty-five (65%) women had a good perceived internal control and it was significantly associated with the age, educational level, and hearing about pre-conceptional care. The internal control score also showed a positive and significant correlation with both age and the subject knowledge about folic acid (r = 0.19 and r = 0.15, respectively). The majority of women had a favorite perceived internal control. Since age and educational level were the affecting factors on the perceived internal control of women, promoting the level of internal control in young women and those with low education in pre-marital counseling classes seems necessary.

  18. A comparison of total amount of blood needed in patients taking autologous or homologous blood transfusion in coronary artery bypass grafting a clinical randomized case control trial

    International Nuclear Information System (INIS)

    Akhlagh, S.H.; Chohedri, A.H.; Bazojoo, A.; Nemati, M.H.

    2007-01-01

    The aim of this clinical case-control trial was to compare the total amount of blood needed in patients taking autologous or homologous blood transfusion in coronary artery bypass grafting (CABG) surgery. Sixty patients scheduled for CABG were randomly allocated to ANH (Acute Normovulemic Hemodynamic) group (A group) or control group (B group). Hematocrit before operation and 24 hours after the operation were checked. The amount of the total blood needed in each group was measured at the end of the operation. There was no significant difference between the two groups as regards post operational hematocrit. The mean total blood infused to the control and ANH group was 2010 ml and 1815 ml respectively. However there was significant difference between the two groups as regards the total amount of the blood needed during operation. Our randomized, double blinded case control study demonstrated that autologous blood, beside carrying lower risks for hemolytic and nonhemolytic transfusion reactions decrease the total amount of blood needed for CABG. However larger studies with more patients are needed to confirm the results. (author)

  19. TOTAL annual report 2003

    International Nuclear Information System (INIS)

    2004-01-01

    This 2003 annual report of the Group Total provides economical results and information of the society on the following topics: keys data, the corporate governance (Directors charter, board of directors, audit committee, nomination and remuneration committee, internal control procedures, compensation of directors and executive officers), the corporate social responsibility (environmental stewardship, the future of energy management, the safety enhancement, the human resources, ethics and local development), the investor relations, the management report, the upstream exploration and production, the downstream refining, marketing, trading and shipping, the chemicals and financial and legal information. (A.L.B.)

  20. Examination of the relation between periodontal health status and cardiovascular risk factors: serum total and high density lipoprotein cholesterol, C-reactive protein, and plasma fibrinogen.

    Science.gov (United States)

    Wu, T; Trevisan, M; Genco, R J; Falkner, K L; Dorn, J P; Sempos, C T

    2000-02-01

    Using data from the Third National Health and Nutrition Examination Survey (1988-1994), the authors examined the relation between periodontal health and cardiovascular risk factors: serum total and high density lipoprotein cholesterol, C-reactive protein, and plasma fibrinogen. A total of 10,146 participants were included in the analyses of cholesterol and C-reactive protein and 4,461 in the analyses of fibrinogen. Periodontal health indicators included the gingival bleeding index, calculus index, and periodontal disease status (defined by pocket depth and attachment loss). While cholesterol and fibrinogen were analyzed as continuous variables, C-reactive protein was dichotomized into two levels. The results show a significant relation between indicators of poor periodontal status and increased C-reactive protein and fibrinogen. The association between periodontal status and total cholesterol level is much weaker. No consistent association between periodontal status and high density lipoprotein cholesterol was detectable. Similar patterns of association were observed for participants aged 17-54 years and those 55 years and older. In conclusion, this study suggests that total cholesterol, C-reactive protein, and fibrinogen are possible intermediate factors that may link periodontal disease to elevated cardiovascular risk.

  1. Relative contributions of wind and water erosion to total soil loss and its effect on soil properties in sloping croplands of the Chinese Loess Plateau.

    Science.gov (United States)

    Tuo, Dengfeng; Xu, Mingxiang; Gao, Guangyao

    2018-08-15

    Wind and water erosion are two dominant types of erosion that lead to soil and nutrient losses. Wind and water erosion may occur simultaneously to varying extents in semi-arid regions. The contributions of wind and water erosion to total erosion and their effects on soil quality, however, remains elusive. We used cesium-137 ( 137 Cs) inventories to estimate the total soil erosion and used the Revised Universal Soil Loss Equation (RUSLE) to quantify water erosion in sloping croplands. Wind erosion was estimated from the subtraction of the two. We also used 137 Cs inventories to calculate total soil erosion and validate the relationships of the soil quality and erosion at different slope aspects and positions. The results showed that wind erosion (1460tkm -2 a -1 ) on northwest-facing slope was responsible for approximately 39.7% of the total soil loss, and water erosion (2216tkm -2 a -1 ) accounted for approximately 60.3%. The erosion rates were 58.8% higher on northwest- than on southeast-facing slopes. Northwest-facing slopes had lower soil organic carbon, total nitrogen, clay, and silt contents than southeast-facing slopes, and thus, the 137 Cs inventories were lower, and the total soil erosions were higher on the northwest-facing slopes. The variations in soil physicochemical properties were related to total soil erosion. The lowest 137 Cs inventories and nutrient contents were recorded at the upper positions on the northwest-facing slopes due to the successive occurrence of more severe wind and water erosion at the same site. The results indicated that wind and water could accelerate the spatial variability of erosion rate and soil properties and cause serious decreases in the nutrient contents in sloping fields. Our research could help researchers develop soil strategies to reduce soil erosion according to the dominant erosion type when it occurs in a hilly agricultural area. Copyright © 2018 Elsevier B.V. All rights reserved.

  2. The influence of selenium status on body composition, oxidative DNA damage and total antioxidant capacity in newly diagnosed type 2 diabetes mellitus: A case-control study.

    Science.gov (United States)

    Othman, Fatimah Binti; Mohamed, Hamid Jan Bin Jan; Sirajudeen, K N S; Noh, Mohd Fairulnizal B Md; Rajab, Nor Fadilah

    2017-09-01

    Selenium is involved in the complex system of defense against oxidative stress in diabetes through its biological function of selenoproteins and the antioxidant enzyme. A case-control study was carried out to determine the association of plasma selenium with oxidative stress and body composition status presented in Type 2 Diabetes Mellitus (T2DM) patient and healthy control. This study involved 82 newly diagnosed T2DM patients and 82 healthy controls. Plasma selenium status was determined with Graphite Furnace Atomic Absorption Spectrometry. Body Mass Index, total body fat and visceral fat was assessed for body composition using Body Composition Analyzer (TANITA). Oxidative DNA damage and total antioxidant capacity were determined for oxidative stress biomarker status. In age, gender and BMI adjustment, no significant difference of plasma selenium level between T2DM and healthy controls was observed. There was as a significant difference of Oxidative DNA damage and total antioxidant capacity between T2DM patients and healthy controls with tail DNA% 20.62 [95% CI: 19.71,21.49] (T2DM), 17.67 [95% CI: 16.87,18.56] (control); log tail moment 0.41[95% CI: 0.30,0.52] (T2DM), 0.41[95% CI: 0.30,0.52] (control); total antioxidant capacity 0.56 [95% CI: 0.54,0.58] (T2DM), 0.60 [95% CI: 0.57,0.62] (control). Waist circumference, BMI, visceral fat, body fat and oxidative DNA damage in the T2DM group were significantly lower in the first plasma selenium tertile (38.65-80.90μg/L) compared to the second (80.91-98.20μg/L) and the third selenium tertiles (98.21-158.20μg/L). A similar trend, but not statistically significant, was observed in the control group. Copyright © 2016 Elsevier GmbH. All rights reserved.

  3. Changes in lifestyle, biological risk factors and total homocysteine in relation to MTHFR C677T genotype: a 5-year follow-up study

    DEFF Research Database (Denmark)

    Husemoen, L L N; Linneberg, A; Fenger, M

    2009-01-01

    to increased tHcy in cross-sectional studies. In addition, the methylenetetrahydrofolate reductase (MTHFR) C677T gene variant is an important determinant of elevated tHcy. The main objective of the study was to examine the effect of changes in biological risk factors and lifestyle on tHcy in relation to MTHFR......, physical activity, smoking status, coffee, tea, total alcohol or wine consumption. An inverse relationship was observed between changes in tHcy and changes in the intake of beer in TT individuals but not in CC/CT individuals (P (interaction)=0.01). In addition, changes in tHcy were positively associated......BACKGROUND/OBJECTIVES: Total homocysteine (tHcy) has been associated with increased risk of several diseases in the general population. It is not clear whether these associations are causal. A less healthy lifestyle as well as a less favorable biological risk factor profile have been related...

  4. The Effect of India's Total Sanitation Campaign on Defecation Behaviors and Child Health in Rural Madhya Pradesh: A Cluster Randomized Controlled Trial

    Science.gov (United States)

    Patil, Sumeet R.; Arnold, Benjamin F.; Salvatore, Alicia L.; Briceno, Bertha; Ganguly, Sandipan; Colford, John M.; Gertler, Paul J.

    2014-01-01

    Background Poor sanitation is thought to be a major cause of enteric infections among young children. However, there are no previously published randomized trials to measure the health impacts of large-scale sanitation programs. India's Total Sanitation Campaign (TSC) is one such program that seeks to end the practice of open defecation by changing social norms and behaviors, and providing technical support and financial subsidies. The objective of this study was to measure the effect of the TSC implemented with capacity building support from the World Bank's Water and Sanitation Program in Madhya Pradesh on availability of individual household latrines (IHLs), defecation behaviors, and child health (diarrhea, highly credible gastrointestinal illness [HCGI], parasitic infections, anemia, growth). Methods and Findings We conducted a cluster-randomized, controlled trial in 80 rural villages. Field staff collected baseline measures of sanitation conditions, behaviors, and child health (May–July 2009), and revisited households 21 months later (February–April 2011) after the program was delivered. The study enrolled a random sample of 5,209 children <5 years old from 3,039 households that had at least one child <24 months at the beginning of the study. A random subsample of 1,150 children <24 months at enrollment were tested for soil transmitted helminth and protozoan infections in stool. The randomization successfully balanced intervention and control groups, and we estimated differences between groups in an intention to treat analysis. The intervention increased percentage of households in a village with improved sanitation facilities as defined by the WHO/UNICEF Joint Monitoring Programme by an average of 19% (95% CI for difference: 12%–26%; group means: 22% control versus 41% intervention), decreased open defecation among adults by an average of 10% (95% CI for difference: 4%–15%; group means: 73% intervention versus 84% control). However, the intervention

  5. The effect of India's total sanitation campaign on defecation behaviors and child health in rural Madhya Pradesh: a cluster randomized controlled trial.

    Directory of Open Access Journals (Sweden)

    Sumeet R Patil

    2014-08-01

    Full Text Available Poor sanitation is thought to be a major cause of enteric infections among young children. However, there are no previously published randomized trials to measure the health impacts of large-scale sanitation programs. India's Total Sanitation Campaign (TSC is one such program that seeks to end the practice of open defecation by changing social norms and behaviors, and providing technical support and financial subsidies. The objective of this study was to measure the effect of the TSC implemented with capacity building support from the World Bank's Water and Sanitation Program in Madhya Pradesh on availability of individual household latrines (IHLs, defecation behaviors, and child health (diarrhea, highly credible gastrointestinal illness [HCGI], parasitic infections, anemia, growth.We conducted a cluster-randomized, controlled trial in 80 rural villages. Field staff collected baseline measures of sanitation conditions, behaviors, and child health (May-July 2009, and revisited households 21 months later (February-April 2011 after the program was delivered. The study enrolled a random sample of 5,209 children <5 years old from 3,039 households that had at least one child <24 months at the beginning of the study. A random subsample of 1,150 children <24 months at enrollment were tested for soil transmitted helminth and protozoan infections in stool. The randomization successfully balanced intervention and control groups, and we estimated differences between groups in an intention to treat analysis. The intervention increased percentage of households in a village with improved sanitation facilities as defined by the WHO/UNICEF Joint Monitoring Programme by an average of 19% (95% CI for difference: 12%-26%; group means: 22% control versus 41% intervention, decreased open defecation among adults by an average of 10% (95% CI for difference: 4%-15%; group means: 73% intervention versus 84% control. However, the intervention did not improve child health

  6. Risk of colorectal cancer in relation to frequency and total amount of red meat consumption. Systematic review and meta-analysis

    OpenAIRE

    Smolińska, Katarzyna; Paluszkiewicz, Piotr

    2010-01-01

    Introduction The colon and rectum are common sites of food-related cancer in developed countries. Recent studies strongly suggest that red meat intake is associated with colon cancer, whereas for rectal cancer such an association still needs to be proved. The aim of the study was to assess the role of total amount and frequency of red meat intake in colorectal carcinogenesis based on published data using meta-analysis methods. Material and methods The literature published until 2009 was selec...

  7. Few Issues Related to an Electrodynamic Exciter Control

    OpenAIRE

    Čala, M.

    2015-01-01

    There are multiple problems to solve when controlling an electromagnetic exciter for vibrations generation. Main challenge is to straighten a frequency response of an exciter which is normally not uniform due to resonances resulting from the mechanical construction of an exciter, specimen to test, or mounting fixture. This paper describes number of aspects to consider, which arose during implementation of the control system for small electrodynamic exciter on the Department of Control and Ins...

  8. Intraoperative local infiltration analgesia for early analgesia after total hip arthroplasty: a randomized, double-blind, placebo-controlled trial

    DEFF Research Database (Denmark)

    Lunn, Troels H; Husted, Henrik; Solgaard, Søren

    2011-01-01

    : High-volume local infiltration analgesia (LIA) is widely applied as part of a multimodal pain management strategy in total hip arthroplasty (THA). However, methodological problems hinder the exact interpretation of previous trials, and the evidence for LIA in THA remains to be clarified....... Therefore, we evaluated whether intraoperative high-volume LIA, in addition to a multimodal oral analgesic regimen, would further reduce acute postoperative pain after THA....

  9. Ultrasound and nerve stimulator guided continuous femoral nerve block analgesia after total knee arthroplasty: a multicenter randomized controlled study

    Directory of Open Access Journals (Sweden)

    Fen Wang

    2015-02-01

    Full Text Available BACKGROUND AND OBJECTIVES: Postoperative analgesia is crucial for early functional excise after total knee arthroplasty. To investigate the clinical efficacy of ultrasound and nerve stimulator guided continuous femoral nerve block analgesia after total knee arthroplasty. METHODS: 46 patients with ASA grade I-III who underwent total knee arthroplasty received postoperative analgesia from October 2012 to January 2013. In 22 patients, ultrasound and nerve stimulator guided continuous femoral nerve block were performed for analgesia (CFNB group; in 24 patients, epidural analgesia was done (PCEA group. The analgesic effects, side effects, articular recovery and complications were compared between two groups. RESULTS: At 6 h and 12 h after surgery, the knee pain score (VAS score during functional tests after active exercise and after passive excise in CFNB were significantly reduced when compared with PCEA group. The amount of parecoxib used in CFNB patients was significantly reduced when compared with PCEA group. At 48 h after surgery, the muscle strength grade in CFNB group was significantly higher, and the time to ambulatory activity was shorter than those in PCEA group. The incidence of nausea and vomiting in CFNB patients was significantly reduced when compared with PCEA group. CONCLUSION: Ultrasound and nerve stimulator guided continuous femoral nerve block provide better analgesia at 6 h and 12 h, demonstrated by RVAS and PVAS. The amount of parecoxib also reduces, the incidence of nausea and vomiting decreased, the influence on muscle strength is compromised and patients can perform ambulatory activity under this condition.

  10. A randomised controlled trial of total hip arthroplasty versus resurfacing arthroplasty in the treatment of young patients with arthritis of the hip joint.

    Science.gov (United States)

    Achten, Juul; Parsons, Nick R; Edlin, Richard P; Griffin, Damian R; Costa, Matthew L

    2010-01-14

    Hip replacement (arthroplasty) surgery is a highly successful treatment for patients with severe symptomatic arthritis of the hip joint. For older patients, several designs of Total Hip Arthroplasty have shown excellent results in terms of both function and value for money. However, in younger more active patients, there is approximately a 50% failure rate at 25 years for traditional implants. Hip resurfacing is a relatively new arthroplasty technique. In a recent review of the literature on resurfacing arthroplasty it was concluded that the short-term functional results appear promising but some potential early disadvantages were identified, including the risk of femoral neck fracture and collapse of the head of the femur. The aim of the current study is to assess whether there is a difference in functional hip scores at one year post-operation between Total Hip Arthroplasty and Resurfacing Arthroplasty. Secondary aims include assessment of complication rates for both procedures as well cost effectiveness. All patients medically fit for surgery and deemed suitable for a resurfacing arthroplasty are eligible to take part in this study. A randomisation sequence will be produced and administered independently. After consenting, all patients will be clinically reviewed and hip function, quality of life and physical activity level will be assessed through questionnaires. The allocated surgery will then be performed with the preferred technique of the surgeon. Six weeks post-operation hip function will be assessed and complications recorded. Three, six and 12 months post-operation hip function, quality of life and physical activity level will be assessed. Additional information about patients' out-of-pocket expenses will also be collected. Current Controlled Trials ISRCTN33354155. UKCLRN portfolio ID 4093.

  11. Totally James

    Science.gov (United States)

    Owens, Tom

    2006-01-01

    This article presents an interview with James Howe, author of "The Misfits" and "Totally Joe". In this interview, Howe discusses tolerance, diversity and the parallels between his own life and his literature. Howe's four books in addition to "The Misfits" and "Totally Joe" and his list of recommended books with lesbian, gay, bisexual, transgender,…

  12. What are the risk factors for dislocation in primary total hip arthroplasty? A multicenter case-control study of 128 unstable and 438 stable hips.

    Science.gov (United States)

    Fessy, M H; Putman, S; Viste, A; Isida, R; Ramdane, N; Ferreira, A; Leglise, A; Rubens-Duval, B; Bonin, N; Bonnomet, F; Combes, A; Boisgard, S; Mainard, D; Leclercq, S; Migaud, H

    2017-09-01

    Dislocation after total hip arthroplasty (THA) is a leading reason for surgical revision. The risk factors for dislocation are controversial, particularly those related to the patient and to the surgical procedure itself. The differences in opinion on the impact of these factors stem from the fact they are often evaluated using retrospective studies or in limited patient populations. This led us to carry out a prospective case-control study on a large population to determine: 1) the risk factors for dislocation after THA, 2) the features of these dislocations, and 3) the contribution of patient-related factors and surgery-related factors. Risk factors for dislocation related to the patient and procedure can be identified using a large case-control study. A multicenter, prospective case-control study was performed between January 1 and December 31, 2013. Four patients with stable THAs were matched to each patient with a dislocated THA. This led to 566 primary THA cases being included: 128 unstable, 438 stable. The primary matching factors were sex, age, initial diagnosis, surgical approach, implantation date and type of implants (bearing size, standard or dual-mobility cup). The patients with unstable THAs were 67±12 [37-73]years old on average; there were 61 women (48%) and 67 men (52%). Hip osteoarthritis (OA) was the main reason for the THA procedure in 71% (91/128) of the unstable group. The dislocation was posterior in 84 cases and anterior in 44 cases. The dislocation occurred within 3 months of the primary surgery in 48 cases (38%), 3 to 12 months after in 23 cases (18%), 1 to 5years after in 20 cases (16%), 5 to 10years after in 17 cases (13%) and more than 10years later in 20 cases. The dislocation recurred within 6 months of the initial dislocation in 23 of the 128 cases (18%). The risk factors for instability were a high ASA score with an odds ratio (OR) of 1.93 (95% CI: 1.4-2.6), neurological disability (cognitive, motor or psychiatric disorders) with

  13. Associations between parental control and children's overt and relational aggression

    NARCIS (Netherlands)

    Kuppens, Sofie; Grietens, Hans; Onghena, Patrick; Michiels, Daisy

    The present study examined specialized associations between parental control and child aggression in a sample of 600 8- to 10-years old children. Parental control dimensions and aggression subtypes were assessed using multiple informants (i.e. children, mothers, fathers, peers, and teachers). In

  14. PET quantification with a histogram derived total activity metric: Superior quantitative consistency compared to total lesion glycolysis with absolute or relative SUV thresholds in phantoms and lung cancer patients

    International Nuclear Information System (INIS)

    Burger, Irene A.; Vargas, Hebert Alberto; Apte, Aditya; Beattie, Bradley J.; Humm, John L.; Gonen, Mithat; Larson, Steven M.; Ross Schmidtlein, C.

    2014-01-01

    Introduction: The increasing use of molecular imaging probes as biomarkers in oncology emphasizes the need for robust and stable methods for quantifying tracer uptake in PET imaging. The primary motivation for this research was to find an accurate method to quantify the total tumor uptake. Therefore we developed a histogram-based method to calculate the background subtracted lesion (BSL) activity and validated BSL by comparing the quantitative consistency with the total lesion glycolysis (TLG) in phantom and patient studies. Methods: A thorax phantom and a PET-ACR quality assurance phantom were scanned with increasing FDG concentrations. Volumes of interest (VOIs) were placed over each chamber. TLG was calculated with a fixed threshold at SUV 2.5 (TLG 2.5 ) and a relative threshold at 42% of SUV max (TLG 42% ). The histogram for each VOI was built and BSL was calculated. Comparison with the total injected FDG activity (TIA) was performed using concordance correlation coefficients (CCC) and the slope (a). Fifty consecutive patients with FDG-avid lung tumors were selected under an IRB waiver. TLG 42% , TLG 2.5 and BSL were compared to the reference standard calculating CCC and the slope. Results: In both phantoms, the CCC for lesions with a TIA ≤ 50 ml*SUV between TIA and BSL was higher and the slope closer to 1 (CCC = 0.933, a = 1.189), than for TLG 42% (CCC = 0.350, a = 0.731) or TLG 2.5 (CCC = 0.761, a = 0.727). In 50 lung lesions BSL had a slope closer to 1 compared to the reference activity than TLG 42% (a = 1.084 vs 0.618 – for high activity lesions) and also closer to 1 than TLG 2.5 (a = 1.117 vs 0.548 – for low activity lesions). Conclusion: The histogram based BSL correlated better with TIA in both phantom studies than TLG 2.5 or TLG 42% . Also in lung tumors, the BSL activity is overall more accurate in quantifying the lesion activity compared to the two most commonly applied TLG quantification methods

  15. Control de configuraciones peligrosas en instalaciones con riesgo asociado // Hazardous configurations control in risk related facilities

    Directory of Open Access Journals (Sweden)

    Antonio Torres - Valle

    2010-05-01

    Full Text Available ResumenEl control de configuraciones peligrosas en instalaciones con riesgo asociado es una aplicación delos Análisis Probabilistas de Seguridad (APS previos de las mismas. Una opción de mayor alcancees el uso de monitores de riesgo los que permiten la detección en tiempo real de talesconfiguraciones. Dada la complejidad de los APS y de los monitores de riesgo, esta tarea requiere depersonal experto. El documento presenta un método cualitativo de control de configuracionespeligrosas basado en matrices de dependencias. El algoritmo, informatizado en el códigoCONFIGURACION, puede ser aplicado sin necesidad de APS previos ni uso de monitores de riesgo.La sencillez del método justifica su extensión a instalaciones donde tales herramientas no se handesarrollado, permitiendo así la detección de las configuraciones peligrosas durante su explotación yelevando la seguridad de las plantas. Un sistema similar al descrito se utiliza como ayuda en laoperación de la central nuclear de Embalse. El artículo muestra el uso del método utilizando comobase un sistema de seguridad simplificado.Palabras claves: control de configuración, Análisis Probabilista de Seguridad (APS, matriz de___________________________________________________________________________AbstractThe hazardous configurations control in risk related facilities is an application of the previousProbabilistic Safety Analysis (PSA. A more complete option is the risk monitoring for the on-linedetection of these configurations. The expert personnel are required for this task take into account thecomplexity of the PSA and risk monitor. The paper presents a method of configuration control, basedon dependence matrixes. The algorithm is included in a computer code called CONFIGURACION, todetermine these situations in a qualitative way, without previous PSA results or using a Risk Monitor.The simplicity of the method warrants its application to facilities where these tools have not

  16. Local anesthetics after total knee arthroplasty: intraarticular or extraarticular administration? A randomized, double-blind, placebo-controlled study

    DEFF Research Database (Denmark)

    Andersen, L.O.; Kristensen, B.B.; Husted, H.

    2008-01-01

    evaluated. PATIENTS AND METHODS: 32 patients undergoing total knee replacement with high-volume (170 mL) 0.2% ropivacaine infiltration analgesia were randomized to receive injection of 20 mL ropivacaine (0.2%) intraarticularly plus 30 mL saline in the extraarticular wound space 24 hours postoperatively...... or to receive 20 mL ropivacaine (0.2%) intraarticularly plus 30 mL ropivacaine (0.2%) in the extraarticular wound space 24 hours postoperatively. Pain intensity at rest and with mobilization was recorded for 4 hours after administration of additional local anesthetics. RESULTS: Intensity of pain at rest, during...

  17. Developmental continuity in reward-related enhancement of cognitive control.

    Science.gov (United States)

    Strang, Nicole M; Pollak, Seth D

    2014-10-01

    Adolescents engage in more risky behavior than children or adults. The most prominent hypothesis for this phenomenon is that brain systems governing reward sensitivity and brain systems governing self-regulation mature at different rates. Those systems governing reward sensitivity mature in advance of those governing self-control. This hypothesis has substantial empirical support, however, the evidence supporting this theory has been exclusively derived from contexts where self-control systems are required to regulate reward sensitivity in order to promote adaptive behavior. In adults, reward promotes a shift to a proactive control strategy and better cognitive control performance. It is unclear whether children and adolescents will respond to reward in the same way. Using fMRI methodology, we explored whether children and adolescents would demonstrate a shift to proactive control in the context of reward. We tested 22 children, 20 adolescents, and 23 adults. In contrast to our hypothesis, children, adolescents, and adults all demonstrated a shift to proactive cognitive control in the context of reward. In light of the results, current neurobiological theories of adolescent behavior need to be refined to reflect that in certain contexts there is continuity in the manner reward and cognitive control systems interact across development. Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights reserved.

  18. Storage and stability of biochar-derived carbon and total organic carbon in relation to minerals in an acid forest soil of the Spanish Atlantic area.

    Science.gov (United States)

    Fernández-Ugalde, Oihane; Gartzia-Bengoetxea, Nahia; Arostegi, Javier; Moragues, Lur; Arias-González, Ander

    2017-06-01

    Biochar can largely contribute to enhance organic carbon (OC) stocks in soil and improve soil quality in forest and agricultural lands. Its contribution depends on its recalcitrance, but also on its interactions with minerals and other organic compounds in soil. Thus, it is important to study the link between minerals, natural organic matter and biochar in soil. In this study, we investigated the incorporation of biochar-derived carbon (biochar-C) into various particle-size fractions with contrasting mineralogy and the effect of biochar on the storage of total OC in the particle-size fractions in an acid loamy soil under Pinus radiata (C3 type) in the Spanish Atlantic area. We compared plots amended with biochar produced from Miscanthus sp. (C4 type) with control plots (not amended). We separated sand-, silt-, and clay-size fractions in samples collected from 0 to 20-cm depth. In each fraction, we analyzed clay minerals, metallic oxides and oxy-hydroxides, total OC and biochar-C. The results showed that 51% of the biochar-C was in fractions fractions (0.2-2μm, 0.05-0.2μm, fractions, as it occurred with the vermiculitic phases and metallic oxides and oxy-hydroxides. Biochar also affected to the distribution of total OC among particle-size fractions. Total OC concentration was greater in fractions 2-20μm, 0.2-2μm, 0.05-0.2μm in biochar-amended plots than in control plots. This may be explained by the adsorption of dissolved OC from fraction organic matter already occurred in the first year. Copyright © 2017 Elsevier B.V. All rights reserved.

  19. High-volume infiltration analgesia in total knee arthroplasty: a randomized, double-blind, placebo-controlled trial

    DEFF Research Database (Denmark)

    Andersen, L.O.; Husted, H.; Otte, K.S.

    2008-01-01

    with a detailed description of the infiltration technique. METHODS: In a randomized, double-blind, placebo-controlled trial in 12 patients undergoing bilateral knee arthroplasty, saline or high-volume (170 ml) ropivacaine (0.2%) with epinephrine was infiltrated around each knee, with repeated doses administered...

  20. Preoperative home-based physical therapy versus usual care to improve functional health of frail older adults scheduled for elective total hip arthroplasty: A pilot randomized controlled trial

    NARCIS (Netherlands)

    Oosting, E.; Jans, M.P.; Dronkers, J.J.; Naber, R.H.; Dronkers-Landman, C.M.; Appelman-De Vries, S.M.; Meeteren, N.L. van

    2012-01-01

    Preoperative home-based physical therapy versus usual care to improve functional health of frail older adults scheduled for elective total hip arthroplasty: a pilot randomized controlled trial. Objective: To investigate the feasibility and preliminary effectiveness of a home-based intensive exercise

  1. Economic Impacts of Total Water Use Control in the Heihe River Basin in Northwestern China—An Integrated CGE-BEM Modeling Approach

    Directory of Open Access Journals (Sweden)

    Na Li

    2015-03-01

    Full Text Available This paper develops an integrated modeling approach combined with a top-down dynamic computable general equilibrium (CGE model and a bottom-up bio-economic model (BEM to study the economic impact of a total water use control policy in the Heihe river basin, northwestern China. The integrated CGE-BEM model is regionally disaggregated with a variety of crops and livestock, and includes the responses of farmers and consequent feedback effects in the regional economic system. The results show that under the total water use control scenario, the water use structure is changed and water use efficiency is improved. The total water use control policy has limited negative impact on the regional economic growth with only a slightly lower growth rate of 13.38% compared with a growth rate of 14% by 2020 under a business as usual water use scenario. However, the total water use control policy has significant negative impacts on several sectors, especially agriculture and food processing. It is expected cropping systems will change through a replacement of water-intensive crops with water-efficient crops. Farmers’ incomes will decrease by 3.14%. In order to alleviate farmers’ income loss and deal with water use conflicts across different sectors and regions, the promotion of migration of surplus labor from agriculture to non-agricultural sectors and the improvement of water use efficiency in agriculture are needed.

  2. Plasma total anti-oxidant capacity correlates inversely with the extent of acute appendicitis: a case control study

    Directory of Open Access Journals (Sweden)

    Devay Seda

    2006-03-01

    Full Text Available Abstract Background The role of free oxygen radicals in inflammatory conditions is well known. Free radicals cause lipid peroxidation of cellular membranes resulting in cell death. The purpose of this study was to investigate the levels of total anti-oxidant status (TAS, as a marker of anti-oxidant defense system and malondialdehyde (MDA, as a marker of oxidative stress, in the plasma of patients with acute appendicitis. Methods Fifty-one adult patients with a median age of 31 years who underwent operations with a preoperative diagnosis of acute appendicitis were included in this prospective study. Blood samples for C-reactive protein (CRP, MDA and TAS were collected preoperatively. Groups were compared by using the Mann-Whitney U test. Results There were 27 patients with acute phlagmenous appendicitis and 19 patients with advanced appendicitis (10 gangrenous and 9 perforated appendicitis, while 5 negative explorations were documented. No significant differences in WBC counts and MDA levels between groups were encountered. Plasma CRP was significantly higher in patients with perforated appendicitis, but not in the other groups. In advanced appendicitis group, TAS level was significantly lower than the other groups. On the other hand, plasma TAS level in acute phlagmenous appendicitis group was significantly higher. Conclusion A decrease in plasma total anti-oxidant capacity might be a predictor of the progression of inflammation to the perforation in acute appendicitis.

  3. A randomised controlled trial of six weeks of home enteral nutrition versus standard care after oesophagectomy or total gastrectomy for cancer: report on a pilot and feasibility study.

    Science.gov (United States)

    Bowrey, David J; Baker, Melanie; Halliday, Vanessa; Thomas, Anne L; Pulikottil-Jacob, Ruth; Smith, Karen; Morris, Tom; Ring, Arne

    2015-11-21

    Poor nutrition in the first months after oesophago-gastric resection is a contributing factor to the reduced quality of life seen in these patients. The aim of this pilot and feasibility study was to ascertain the feasibility of conducting a multi-centre randomised controlled trial to evaluate routine home enteral nutrition in these patients. Patients undergoing oesophagectomy or total gastrectomy were randomised to either six weeks of home feeding through a jejunostomy (intervention), or treatment as usual (control). Intervention comprised overnight feeding, providing 50 % of energy and protein requirements, in addition to usual oral intake. Primary outcome measures were recruitment and retention rates at six weeks and six months. Nutritional intake, nutritional parameters, quality of life and healthcare costs were also collected. Interviews were conducted with a sample of participants, to ascertain patient and carer experiences. Fifty-four of 112 (48 %) eligible patients participated in the study over the 20 months. Study retention at six weeks was 41/54 patients (76 %) and at six months was 36/54 (67 %). At six weeks, participants in the control group had lost on average 3.9 kg more than participants in the intervention group (95 % confidence interval [CI] 1.6 to 6.2). These differences remained evident at three months (mean difference 2.5 kg, 95 % CI -0.5 to 5.6) and at six months (mean difference 2.5 kg, 95 % CI -1.2 to 6.1). The mean values observed in the intervention group for mid arm circumference, mid arm muscle circumference, triceps skin fold thickness and right hand grip strength were greater than for the control group at all post hospital discharge time points. The economic evaluation suggested that it was feasible to collect resource use and EQ-5D data for a full cost-effectiveness analysis. Thematic analysis of 15 interviews identified three main themes related to the intervention and the trial: 1) a positive experience, 2) the reasons for taking

  4. The effect of India's total sanitation campaign on defecation behaviors and child health in rural Madhya Pradesh: a cluster randomized controlled trial.

    Science.gov (United States)

    Patil, Sumeet R; Arnold, Benjamin F; Salvatore, Alicia L; Briceno, Bertha; Ganguly, Sandipan; Colford, John M; Gertler, Paul J

    2014-08-01

    Poor sanitation is thought to be a major cause of enteric infections among young children. However, there are no previously published randomized trials to measure the health impacts of large-scale sanitation programs. India's Total Sanitation Campaign (TSC) is one such program that seeks to end the practice of open defecation by changing social norms and behaviors, and providing technical support and financial subsidies. The objective of this study was to measure the effect of the TSC implemented with capacity building support from the World Bank's Water and Sanitation Program in Madhya Pradesh on availability of individual household latrines (IHLs), defecation behaviors, and child health (diarrhea, highly credible gastrointestinal illness [HCGI], parasitic infections, anemia, growth). We conducted a cluster-randomized, controlled trial in 80 rural villages. Field staff collected baseline measures of sanitation conditions, behaviors, and child health (May-July 2009), and revisited households 21 months later (February-April 2011) after the program was delivered. The study enrolled a random sample of 5,209 children village with improved sanitation facilities as defined by the WHO/UNICEF Joint Monitoring Programme by an average of 19% (95% CI for difference: 12%-26%; group means: 22% control versus 41% intervention), decreased open defecation among adults by an average of 10% (95% CI for difference: 4%-15%; group means: 73% intervention versus 84% control). However, the intervention did not improve child health measured in terms of multiple health outcomes (diarrhea, HCGI, helminth infections, anemia, growth). Limitations of the study included a relatively short follow-up period following implementation, evidence for contamination in ten of the 40 control villages, and bias possible in self-reported outcomes for diarrhea, HCGI, and open defecation behaviors. The intervention led to modest increases in availability of IHLs and even more modest reductions in open

  5. Incorporating quality control activities in scrum in relation to the ...

    Indian Academy of Sciences (India)

    Muhammad Aamir

    control activities in the scrum philosophy by introducing the concept of test backlog. ... Rapid application development; agile software development; extreme programming; scrum; ..... development team has a good problem solving approach.

  6. Classical Example of Total Kinetic and Thermodynamic Control: The Diels-Alder Reaction between DMAD and Bis-furyl Dienes.

    Science.gov (United States)

    Borisova, Kseniya K; Kvyatkovskaya, Elizaveta A; Nikitina, Eugeniya V; Aysin, Rinat R; Novikov, Roman A; Zubkov, Fedor I

    2018-04-20

    A rare example of chemospecificity in the tandem Diels-Alder reaction of activated alkynes and bis-dienes has been revealed. The reaction between bis-furyl dienes and DMAD occurs at 25-80 °C and leads to kinetically controlled "pincer" adducts, 4a,8a-disubstituted 1,4:5,8-diepoxynaphthalenes. On the contrary, only thermodynamically controlled "domino" adducts (2,3-disubstituted 1,4:5,8-diepoxynaphthalenes) are formed in the same reaction at 140 °C. The "pincer" adducts can be transformed to the "domino" adducts at heating. The rate constants for reactions of both types were calculated using dynamic 1 H NMR spectroscopy.

  7. Knee joint biomechanics and neuromuscular control during gait before and after total knee arthroplasty are sex-specific.

    Science.gov (United States)

    Astephen Wilson, Janie L; Dunbar, Michael J; Hubley-Kozey, Cheryl L

    2015-01-01

    The future of total knee arthroplasty (TKA) surgery will involve planning that incorporates more patient-specific characteristics. Despite known biological, morphological, and functional differences between men and women, there has been little investigation into knee joint biomechanical and neuromuscular differences between men and women with osteoarthritis, and none that have examined sex-specific biomechanical and neuromuscular responses to TKA surgery. The objective of this study was to examine sex-associated differences in knee kinematics, kinetics and neuromuscular patterns during gait before and after TKA. Fifty-two patients with end-stage knee OA (28 women, 24 men) underwent gait and neuromuscular analysis within the week prior to and one year after surgery. A number of sex-specific differences were identified which suggest a different manifestation of end-stage knee OA between the sexes. Copyright © 2014 Elsevier Inc. All rights reserved.

  8. The effect of tourniquet use on fixation quality in cemented total knee arthroplasty a prospective randomized clinical controlled RSA trial.

    Science.gov (United States)

    Molt, Mats; Harsten, Andreas; Toksvig-Larsen, Sören

    2014-03-01

    A concern that arises with any change in technique is whether it affects the long-term implant stability. The objective of this study was to evaluate the early migration, measured by radiostereometric analysis (RSA), and the functional outcome of the Triathlon™ cemented knee prosthesis, operated on with or without a tourniquet. During the last decades RSA has emerged as a way to assess prosthetic fixation and long time prognosis. The method has been used extensively in both hip and knee arthroplasty. This was a single centre prospective study including 60 patients randomized into two groups operated on either with or without tourniquet. RSA investigation was done within 2-3 days postoperatively after full weight bearing, and then at 3 months, 1 year and 2 years postoperatively. There were no differences between the groups regarding the translation along or rotation around the three coordinal axes, or in maximum total point motion (MTPM). At 2 years the mean MTPM (SD) was 0.71 mm (0.64) for the tourniquet-group and 0.53 mm (0.21) for the non-tourniquet-group. The tibial tray of the Triathlon™ cemented knee prosthesis showed similar early stability whether operated on with or without tourniquet. Level I. Article focus: A safety study for total knee replacement operated on with or without perioperative tourniquet regarding the prosthetic fixation. Strengths and limitations: Strength of this study is that it is a randomized prospective trial using an objective measuring tool. The sample size of 25-30 patients is reportedly sufficient for the screening of implants using RSA (1-3). Clinical trials NCT01604382, Ethics Committee approval D-nr: 144/20085. © 2013.

  9. Urinary Prothrombin Fragment 1+2 in relation to Development of Non-Symptomatic and Symptomatic Venous Thromboembolic Events following Total Knee Replacement

    DEFF Research Database (Denmark)

    Borris, Lars Carl; Breindahl, Morten; Rud-Lassen, Michael

    2011-01-01

    Prothrombin fragment 1+2 is excreted in urine (uF1+2) as a result of in vivo thrombin generation and can be a marker of coagulation status after an operative procedure. This study compared uF1+2 levels in patients with symptomatic and non-symptomatic venous thromboembolism (VTE) after total knee...... replacement (TKR) and in event-free sex- and age-matched controls. Significantly higher median uF1+2 levels were seen in the VTE patients on days 1, 3, and the day of venography (mostly day 7) after TKR compared with controls. The uF1+2 levels tended to be high in some patients with symptomatic VTE; however...

  10. Aerobic training for improved memory in patients with stress-related exhaustion: a randomized controlled trial.

    Science.gov (United States)

    Eskilsson, Therese; Slunga Järvholm, Lisbeth; Malmberg Gavelin, Hanna; Stigsdotter Neely, Anna; Boraxbekk, Carl-Johan

    2017-09-02

    Patients with stress-related exhaustion suffer from cognitive impairments, which often remain after psychological treatment or work place interventions. It is important to find effective treatments that can address this problem. Therefore, the aim of this study was to investigate the effects on cognitive performance and psychological variables of a 12-week aerobic training program performed at a moderate-vigorous intensity for patients with exhaustion disorder who participated in a multimodal rehabilitation program. In this open-label, parallel, randomized and controlled trial, 88 patients diagnosed with exhaustion disorder participated in a 24-week multimodal rehabilitation program. After 12 weeks in the program the patients were randomized to either a 12-week aerobic training intervention or to a control group with no additional training. Primary outcome measure was cognitive function, and secondary outcome measures were psychological health variables and aerobic capacity. In total, 51% patients in the aerobic training group and 78% patients in the control group completed the intervention period. The aerobic training group significantly improved in maximal oxygen uptake and episodic memory performance. No additional improvement in burnout, depression or anxiety was observed in the aerobic group compared with controls. Aerobic training at a moderate-vigorous intensity within a multimodal rehabilitation program for patients with exhaustion disorder facilitated episodic memory. A future challenge would be the clinical implementation of aerobic training and methods to increase feasibility in this patient group. ClinicalTrials.gov: NCT03073772 . Retrospectively registered 21 February 2017.

  11. Patient-specific guides do not improve accuracy in total knee arthroplasty: a prospective randomized controlled trial.

    Science.gov (United States)

    Victor, Jan; Dujardin, Jan; Vandenneucker, Hilde; Arnout, Nele; Bellemans, Johan

    2014-01-01

    Recently, patient-specific guides (PSGs) have been introduced, claiming a significant improvement in accuracy and reproducibility of component positioning in TKA. Despite intensive marketing by the manufacturers, this claim has not yet been confirmed in a controlled prospective trial. We (1) compared three-planar component alignment and overall coronal mechanical alignment between PSG and conventional instrumentation and (2) logged the need for applying changes in the suggested position of the PSG. In this randomized controlled trial, we enrolled 128 patients. In the PSG cohort, surgical navigation was used as an intraoperative control. When the suggested cut deviated more than 3° from target, the use of PSG was abandoned and marked as an outlier. When cranial-caudal position or size was adapted, the PSG was marked as modified. All patients underwent long-leg standing radiography and CT scan. Deviation of more than 3° from the target in any plane was defined as an outlier. The PSG and conventional cohorts showed similar numbers of outliers in overall coronal alignment (25% versus 28%; p = 0.69), femoral coronal alignment (7% versus 14%) (p = 0.24), and femoral axial alignment (23% versus 17%; p = 0.50). There were more outliers in tibial coronal (15% versus 3%; p = 0.03) and sagittal 21% versus 3%; p = 0.002) alignment in the PSG group than in the conventional group. PSGs were abandoned in 14 patients (22%) and modified in 18 (28%). PSGs do not improve accuracy in TKA and, in our experience, were somewhat impractical in that the procedure needed to be either modified or abandoned with some frequency.

  12. Technical note: validation of a motion analysis system for measuring the relative motion of the intermediate component of a tripolar total hip arthroplasty prosthesis.

    Science.gov (United States)

    Chen, Qingshan; Lazennec, Jean Yves; Guyen, Olivier; Kinbrum, Amy; Berry, Daniel J; An, Kai-Nan

    2005-07-01

    Tripolar total hip arthroplasty (THA) prosthesis had been suggested as a method to reduce the occurrence of hip dislocation and microseparation. Precisely measuring the motion of the intermediate component in vitro would provide fundamental knowledge for understanding its mechanism. The present study validates the accuracy and repeatability of a three-dimensional motion analysis system to quantitatively measure the relative motion of the intermediate component of tripolar total hip arthroplasty prostheses. Static and dynamic validations of the system were made by comparing the measurement to that of a potentiometer. Differences between the mean system-calculated angle and the angle measured by the potentiometer were within +/-1 degrees . The mean within-trial variability was less than 1 degrees . The mean slope was 0.9-1.02 for different angular velocities. The dynamic noise was within 1 degrees . The system was then applied to measure the relative motion of an eccentric THA prosthesis. The study shows that this motion analysis system provides an accurate and practical method for measuring the relative motion of the tripolar THA prosthesis in vitro, a necessary first step towards the understanding of its in vivo kinematics.

  13. Marine energy generation systems and related monitoring and control

    DEFF Research Database (Denmark)

    Blaabjerg, Frede; Liu, Hui; Loh, Poh Chiang

    2014-01-01

    Energy is very important to the world as a driver of the modern society. According to estimations done by the International Energy Agency (IEA), the total global energy consumption is about 17 500 TW·h/yr [1]. In the past, fossil fuels like coal, oil and natural gas supplied the biggest part...... of this global consumption, and they were far larger than those of the renewable energy sources as Fig. 1 shows for 1973 [2]. In 2011, the production of renewable energy and global energy consumption increased, even though renewable energy was still much smaller than fossil fuels as Fig. 1 shows. [2]....

  14. Ultrasound-guided genicular nerve block for pain control after total knee replacement: Preliminary case series and technical note.

    Science.gov (United States)

    González Sotelo, V; Maculé, F; Minguell, J; Bergé, R; Franco, C; Sala-Blanch, X

    2017-12-01

    Total knee arthroplasty (TKA) is an operation with moderate to severe postoperative pain. The Fast-Track models employ local infiltration techniques with anaesthetics at high volumes (100-150ml). We proposed a genicular nerve block with low volume of local anaesthetic. The aim of our study is to evaluate the periarticular distribution of these blocks in a fresh cadaver model and to describe the technique in a preliminary group of patients submitted to TKA. In the anatomical phase, 4 genicular nerves (superior medial, superior lateral, inferior medial and inferior lateral) were blocked with 4ml of local anaesthetic with iodinated contrast and methylene blue in each (16ml in total). It was performed on a fresh cadaver and the distribution of the injected medium was evaluated by means of a CT-scan and coronal anatomical sections on both knees. The clinical phase included 12 patients scheduled for TKA. Ultrasound-guided block of the 4 genicular nerves was performed preoperatively and their clinical efficacy evaluated by assessing pain after the reversal of the spinal block and at 12h after the block. Pain was measured using the numerical scale and the need for rescue analgesia was evaluated. A wide periarticular distribution of contrast was observed by CT-scan, which was later evaluated in the coronal sections. The distribution followed the joint capsule without entering the joint, both in the femur and in the tibia. The pain after the reversal of the subarachnoid block was 2±1, requiring rescue analgesia in 42% of the patients. At 12h, the pain according to the numerical scale was 4±1, 33% required rescue analgesia. The administration of 4ml of local anaesthetic at the level of the 4 genicular nerves of the knee produces a wide periarticular distribution. Our preliminary data in a series of 12 patients undergoing TKA seems to be clinically effective. Nevertheless, extensive case series and comparative studies with local infiltration techniques with anaesthetics are

  15. xGASS: total cold gas scaling relations and molecular-to-atomic gas ratios of galaxies in the local Universe

    Science.gov (United States)

    Catinella, Barbara; Saintonge, Amélie; Janowiecki, Steven; Cortese, Luca; Davé, Romeel; Lemonias, Jenna J.; Cooper, Andrew P.; Schiminovich, David; Hummels, Cameron B.; Fabello, Silvia; Geréb, Katinka; Kilborn, Virginia; Wang, Jing

    2018-05-01

    We present the extended GALEX Arecibo SDSS Survey (xGASS), a gas fraction-limited census of the atomic hydrogen (H I) gas content of 1179 galaxies selected only by stellar mass (M⋆ = 109-1011.5 M⊙) and redshift (0.01 new Arecibo observations of 208 galaxies, for which we release catalogues and H I spectra. In addition to extending the GASS H I scaling relations by one decade in stellar mass, we quantify total (atomic+molecular) cold gas fractions and molecular-to-atomic gas mass ratios, Rmol, for the subset of 477 galaxies observed with the IRAM 30 m telescope. We find that atomic gas fractions keep increasing with decreasing stellar mass, with no sign of a plateau down to log M⋆/M⊙ = 9. Total gas reservoirs remain H I-dominated across our full stellar mass range, hence total gas fraction scaling relations closely resemble atomic ones, but with a scatter that strongly correlates with Rmol, especially at fixed specific star formation rate. On average, Rmol weakly increases with stellar mass and stellar surface density μ⋆, but individual values vary by almost two orders of magnitude at fixed M⋆ or μ⋆. We show that, for galaxies on the star-forming sequence, variations of Rmol are mostly driven by changes of the H I reservoirs, with a clear dependence on μ⋆. Establishing if galaxy mass or structure plays the most important role in regulating the cold gas content of galaxies requires an accurate separation of bulge and disc components for the study of gas scaling relations.

  16. Mandatory and Location-Aware Access Control for Relational Databases

    Science.gov (United States)

    Decker, Michael

    Access control is concerned with determining which operations a particular user is allowed to perform on a particular electronic resource. For example, an access control decision could say that user Alice is allowed to perform the operation read (but not write) on the resource research report. With conventional access control this decision is based on the user's identity whereas the basic idea of Location-Aware Access Control (LAAC) is to evaluate also a user's current location when making the decision if a particular request should be granted or denied. LAAC is an interesting approach for mobile information systems because these systems are exposed to specific security threads like the loss of a device. Some data models for LAAC can be found in literature, but almost all of them are based on RBAC and none of them is designed especially for Database Management Systems (DBMS). In this paper we therefore propose a LAAC-approach for DMBS and describe a prototypical implementation of that approach that is based on database triggers.

  17. Delayed Stochastic Linear-Quadratic Control Problem and Related Applications

    Directory of Open Access Journals (Sweden)

    Li Chen

    2012-01-01

    stochastic differential equations (FBSDEs with Itô’s stochastic delay equations as forward equations and anticipated backward stochastic differential equations as backward equations. Especially, we present the optimal feedback regulator for the time delay system via a new type of Riccati equations and also apply to a population optimal control problem.

  18. Visual and Ocular Control Anomalies in Relation to Reading Difficulty.

    Science.gov (United States)

    Bedwell, C. H.; And Others

    1980-01-01

    The visual behavior under both static and dynamic viewing conditions was examined in a group of 13-year-old successful readers, compared with a group of the same age retarded in reading. Research supports the notion that problems of dynamic binocular vision and control while reading are important. (Author/KC)

  19. The Relations of Mothers' Controlling Vocalizations to Children's Intrinsic Motivation.

    Science.gov (United States)

    Deci, Edward L.; And Others

    1993-01-01

    Coded maternal vocalizations during videotaped play sessions of mothers and their six- or seven-year-old children. Children's intrinsic motivation was assessed by observing children's play when they were alone in a room. Found a negative relationship between maternal controlling vocalizations and children's intrinsic motivation. (MM)

  20. Factors Relating to Staff Attributions of Control over Challenging Behaviour

    Science.gov (United States)

    Dilworth, Jennifer A.; Phillips, Neil; Rose, John

    2011-01-01

    Background: Previous research has suggested that severity of intellectual disability (ID) and topography of behaviour may influence staff causal attributions regarding challenging behaviour. Subsequently, these causal attributions may influence helping behaviours. This study investigated the relationship between attributions of control over…

  1. Risk of colorectal cancer in relation to frequency and total amount of red meat consumption. Systematic review and meta-analysis.

    Science.gov (United States)

    Smolińska, Katarzyna; Paluszkiewicz, Piotr

    2010-08-30

    The colon and rectum are common sites of food-related cancer in developed countries. Recent studies strongly suggest that red meat intake is associated with colon cancer, whereas for rectal cancer such an association still needs to be proved. The aim of the study was to assess the role of total amount and frequency of red meat intake in colorectal carcinogenesis based on published data using meta-analysis methods. The literature published until 2009 was selected from: MEDLINE, PubMed, Scopus, Embase, CancerLit, Google Scholar and Cochrane Library databases. The used search terms were: colorectal cancer, colon cancer, rectal cancer, meat intake, red meat intake, red meat consumption, meat consumption, colorectal cancer risk, colon cancer risk, rectal cancer risk and lifestyle. Articles investigating red meat intake of more often than once a day or 50 g per day were reviewed and selected for further analysis. Twenty-two studies fulfilled the established criteria. A meta-analysis confirmed the carcinogenic effect of the consumption of over 50 g of red meat per day for the colon (relative risk 1.21, 1.07-1.37) but not for the rectum (relative risk 1.30, 0.90-1.89). Red meat intake more frequently than once a day can induce both colonic (relative risk 1.37, 1.09-1.71) and rectal cancer (relative risk 1.43, 1.24-1.64). Red meat intake is associated with elevated risk of developing colorectal cancer. The frequency of red meat consumption rather than total amount of consumed meat is associated with a higher risk of colorectal carcinogenesis.

  2. Effects of diabetes-related family stress on glycemic control in young patients with type 1 diabetes: Systematic review.

    Science.gov (United States)

    Tsiouli, Elina; Alexopoulos, Evangelos C; Stefanaki, Charikleia; Darviri, Christina; Chrousos, George P

    2013-02-01

    To investigate the way that family stress influences glycemic control among patients with diabetes who are younger than 18 years of age. PubMed and Scopus were searched for relevant studies published since 1990 using the following key words: diabetes type 1, glycemic control, family stress, family conflict, and family function. In total, 1478 papers were identified in the initial search. The final review included 6 cohort studies, 3 cross-sectional studies, and 1 qualitative review in which family stress was assessed using specific diabetes-related conflict measurement instruments, and glycemic control was evaluated by glycosylated hemoglobin measurement. In most studies family stress was negatively correlated with patients' glycemic control. Family function was strongly related to patients' glycemic control, while family conflict was adversely associated with glycemic control. Families of low socioeconomic status, those of adolescents with diabetes, and those of single parents were more prone to diabetes-related stress and thus more susceptible to worse glycemic control. Therapeutic psychological interventions and educational programs can help alleviate family diabetes-related stress and will likely improve glycemic control.

  3. Patient-related barriers to hypertension control in a Nigerian population

    Directory of Open Access Journals (Sweden)

    Okwuonu CG

    2014-07-01

    Full Text Available Chimezie Godswill Okwuonu,1 Nnamdi Ezekiel Ojimadu,2 Enajite Ibiene Okaka,3 Fatai Momodu Akemokwe41Nephrology Unit, Department of Internal Medicine, 2Department of Family Medicine, Federal Medical Center Umuahia, Abia State, 3Renal Unit, 4Neurology Unit, Department of Internal Medicine University of Benin Teaching Hospital, Benin City, NigeriaBackground: Hypertension control is a challenge globally. Barriers to optimal control exist at the patient, physician, and health system levels. Patient-related barriers in our environment are not clear. The aim of this study was to identify patient-related barriers to control of hypertension among adults with hypertension in a semiurban community in South-East Nigeria.Methods: This was a cross-sectional descriptive study of patients with a diagnosis of hypertension and on antihypertensive medication.Results: A total of 252 participants were included in the survey, and comprised 143 males (56.7% and 109 females (43.3%. The mean age of the participants was 56.6±12.7 years, with a diagnosis of hypertension for a mean duration of 6.1±3.3 years. Among these patients, 32.9% had controlled blood pressure, while 39.3% and 27.8%, respectively, had stage 1 and stage 2 hypertension according to the Seventh Report of the Joint National Committee on Prevention, Detection and Evaluation of High Blood Pressure. Only 23.4% knew the consequences of poor blood pressure control and 64% were expecting a cure from treatment even when the cause of hypertension was not known. Furthermore, 68.7% showed low adherence to medication, the reported reasons for which included forgetfulness (61.2%, financial constraints (56.6%, high pill burden (22.5%, side effects of medication (17.3%, and low measured blood pressure (12.1%. Finally, knowledge and practice of the lifestyle modifications necessary for blood pressure control was inadequate among the participants.Conclusion: Poor knowledge regarding hypertension, unrealistic

  4. Knee strength retention and analgesia with continuous perineural fentanyl infusion after total knee replacement: randomized controlled trial.

    Science.gov (United States)

    Mangar, Devanand; Karlnoski, Rachel A; Sprenker, Collin J; Downes, Katheryne L; Taffe, Narrene; Wainwright, Robert; Gustke, Kenneth; Bernasek, Thomas L; Camporesi, Enrico

    2014-04-01

    Despite providing adequate pain relief, a femoral nerve block can induce postoperative muscle weakness after total knee arthoplasty (TKA). Fentanyl has been shown to have peripheral effects but has not been used as a perineural infusate alone after TKA. Sixty patients scheduled for TKA were randomized to one of three blinded groups: a continuous 24 h infusion of either fentanyl 3 μg/ml, ropivacaine 0.1%, or 0.9% normal saline through a femoral nerve sheath catheter at 10 ml/h. The main outcome was maximum voluntary isometric contraction (MVIC) in the quadriceps femoris (knee extension), measured by a handheld dynamometer (Nm/kg). Other variables assessed were preoperative and postoperative visual analog scale (VAS) scores, hamstrings MVIC (knee flexion), active range of motion of the operative knee, distance ambulated, incidence of knee buckling, supplemental morphine usage, postoperative side effects, and serum fentanyl levels. Quadriceps MVIC values were significantly greater in the fentanyl group compared to the group that received ropivacaine (median values, 0.08 vs. 0.03 Nm/kg; p = 0.028). The incidence of postoperative knee buckling upon ambulation was higher in the ropivacaine group compared to the fentanyl group, although not statistically significant (40% vs. 15 %, respectively; p = 0.077). VAS scores while ambulating were not significantly different between the fentanyl group and the ropivacaine group (p = 0.270). Postoperative morphine consumption, nausea and vomiting, and resting VAS scores were similar among the three groups. A continuous perineural infusion of fentanyl produced greater strength retention than ropivacaine post-TKA.

  5. Age-related effects on postural control under multi-task conditions.

    Science.gov (United States)

    Granacher, Urs; Bridenbaugh, Stephanie A; Muehlbauer, Thomas; Wehrle, Anja; Kressig, Reto W

    2011-01-01

    Changes in postural sway and gait patterns due to simultaneously performed cognitive (CI) and/or motor interference (MI) tasks have previously been reported and are associated with an increased risk of falling in older adults. The objectives of this study were to investigate the effects of a CI and/or MI task on static and dynamic postural control in young and elderly subjects, and to find out whether there is an association between measures of static and dynamic postural control while concurrently performing the CI and/or MI task. A total of 36 healthy young (n = 18; age: 22.3 ± 3.0 years; BMI: 21.0 ± 1.6 kg/m(2)) and elderly adults (n = 18; age: 73.5 ± 5.5 years; BMI: 24.2 ± 2.9 kg/m(2)) participated in this study. Static postural control was measured during bipedal stance, and dynamic postural control was obtained while walking on an instrumented walkway. Irrespective of the task condition, i.e. single-task or multiple tasks, elderly participants showed larger center-of-pressure displacements and greater stride-to-stride variability than younger participants. Associations between measures of static and dynamic postural control were found only under the single-task condition in the elderly. Age-related deficits in the postural control system seem to be primarily responsible for the observed results. The weak correlations detected between static and dynamic measures could indicate that fall-risk assessment should incorporate dynamic measures under multi-task conditions, and that skills like erect standing and walking are independent of each other and may have to be trained complementarily. Copyright © 2010 S. Karger AG, Basel.

  6. Impact of postprandial glucose control on diabetes-related complications

    DEFF Research Database (Denmark)

    Madsbad, Sten

    2016-01-01

    Conflicting findings in the literature and lack of long-term definitive outcome studies have led to difficulty in drawing conclusions about the role of postprandial hyperglycemia in diabetes and its complications. Recent scientific publications support the role of postprandial glucose (PPG......) as a key contributor to overall glucose control and a predictor of microvascular and macrovascular events. However, the need remains for definitive evidence to support the precise relationship between PPG excursions and the development and progression of cardiovascular complications of diabetes. Drawing...... complications is unclarified and is one of the remaining unanswered questions in diabetes. Nevertheless, current evidence supports PPG control as an important strategy to consider in the comprehensive management plan of individuals with diabetes....

  7. Unethical practices relating to cattle freedom, care and control ...

    African Journals Online (AJOL)

    In animal care, 40.0%, 31.3%, 30.0%, 12.5%, 7.5% and 5.0% were of the opinion that cattle could be respectively tired, hungry, sick, heady, injured and being in a strange environment might be the reasons for their refusal to obey the instruction of the handlers. In controlling the cattle for a direction, 85.7%, 10.4% and 3.9% ...

  8. Total skin clearance results in improvements in health-related quality of life and reduced symptom severity among patients with moderate to severe psoriasis.

    Science.gov (United States)

    Viswanathan, Hema N; Chau, Dina; Milmont, Cassandra E; Yang, Wenjjing; Erondu, Ngozi; Revicki, Dennis A; Klekotka, Paul

    2015-06-01

    Newer therapies provide high levels of skin clearance in patients with moderate to severe psoriasis. However, insufficient evidence exists on the impact of total skin clearance from the patient's perspective. To examine effects of total skin clearance on health-related quality of life (HRQoL) and psoriasis symptom severity in subjects with moderate to severe psoriasis. Pooled data from a phase 2 dose-ranging trial in psoriasis using brodalumab (antibody to interleukin-17 receptor A) were used to compare subjects with static physician global assessment (sPGA) 1 versus sPGA 0 and subjects with Psoriasis Area and Severity Index (PASI) 75 to Quality Index (DLQI = 0) and no psoriasis symptoms (Psoriasis Symptom Inventory = 0). Of subjects with sPGA 0 (clear) and 1 (almost clear), 61.4% and 45.7% had a DLQI = 0 (p = 0.15), and 65.5% and 32.6% had a Psoriasis Symptom Inventory = 0 (p = 0.001), respectively. Significantly more subjects with sPGA 1 continued to report itching, redness, scaling, and flaking compared to subjects with sPGA 0. Similar results were observed based on PASI score. A higher proportion of subjects with total skin clearance reported no impairment in HRQoL and no psoriasis symptoms than those who were almost clear.

  9. The bone mass density in men aged over 50 and its relation to the concentration of free and total testosterone in the blood serum

    International Nuclear Information System (INIS)

    Purzycka-Jazdon, A.; Lasek, W.; Serafin, Z.; Manysiak, S.

    2003-01-01

    As the mean length of life increases, osteoporosis affects a growing number of men and women, thus becoming an important medical and socioeconomic problem in many countries. Pathogenesis and the prevalence of the osteoporosis in women are well established, however, in men, they are still controversial. In this study, the bone mass density (BMD) of the lumbar spine was determined in 100 healthy men age 50-83, using quantitative computed tomography (QCT). Also, the total serum and free testosterone was measured. The mean BMD was 123.1I39.3 mg/cm 3 , and the values below a fracture threshold were noted in 39% of subjects. The mean concentration of total and free serum testosterone was 4.3I1.7 ng/ml and 6.2I3.7 pg/ml, respectively. There was a significant (p 3 , respectively). There was no correlation found between total testosterone and BMD. Results indicate that reduced bone mass density in males over 50 is as frequent as recently reported in females. Moreover, sex hormones seem to be related to osteoporosis development in men as well. (author)

  10. Factors influencing health-related quality of life after total hip replacement - a comparison of data from the Swedish and Danish hip arthroplasty registers

    DEFF Research Database (Denmark)

    Gordon, Max; Paulsen, Aksel; Overgaard, Søren

    2013-01-01

    of PROs may present difficulties due to cultural differences and differences in the provision of health care. However, in order to understand how these differences affect PROs, common predictors for poor and good outcomes need to be investigated. This cross-sectional study investigates factors influencing......There is an increasing focus on measuring patient-reported outcomes (PROs) as part of routine medical practice, particularly in fields such as joint replacement surgery where pain relief and improvement in health-related quality of life (HRQoL) are primary outcomes. Between-country comparisons...... health-related quality of life (HRQoL) one year after total hip replacement (THR) surgery in Sweden and in Denmark....

  11. Nutrition-related risk indexes and long-term mortality in noncritically ill inpatients who receive total parenteral nutrition (prospective multicenter study).

    Science.gov (United States)

    Tapia, María José; Ocón, Julia; Cabrejas-Gómez, Carmen; Ballesteros-Pomar, María D; Vidal-Casariego, Alfonso; Arraiza-Irigoyen, Carmen; Olivares, Josefina; Conde-García, Ma Carmen; García-Manzanares, Álvaro; Botella-Romero, Francisco; Quílez-Toboso, Rosa P; Cabrerizo, Lucio; Rubio, Miguel A; Chicharro, Luisa; Burgos, Rosa; Pujante, Pedro; Ferrer, Mercedes; Zugasti, Ana; Petrina, Estrella; Manjón, Laura; Diéguez, Marta; Carrera, Ma José; Vila-Bundo, Anna; Urgelés, Juan Ramón; Aragón-Valera, Carmen; Sánchez-Vilar, Olga; Bretón, Irene; García-Peris, Pilar; Muñoz-Garach, Araceli; Márquez, Efren; del Olmo, Dolores; Pereira, José Luis; Tous, María C; Olveira, Gabriel

    2015-10-01

    Malnutrition in hospitalized patients is associated with an increased risk of death, in both the short and the long term. The purpose of this study was to determine which nutrition-related risk index predicts long-term mortality better (three years) in patients who receive total parenteral nutrition (TPN). This prospective, multicenter study involved noncritically ill patients who were prescribed TPN during hospitalization. Data were collected on Subjective Global Assessment (SGA), Nutritional Risk Index (NRI), Geriatric Nutritional Risk Index (GNRI), body mass index, albumin and prealbumin, as well as long-term mortality. Over the 1- and 3-year follow-up periods, 174 and 244 study subjects (28.8% and 40.3%) respectively, died. Based on the Cox proportional hazards survival model, the nutrition-related risk indexes most strongly associated with mortality were SGA and albumin (Nutrition and Metabolism. All rights reserved.

  12. Relations between total phosphorus and orthophosphorus concentrations and rainfall, surface-water discharge, and groundwater levels in Big Cypress Seminole Indian Reservation, Florida, 2014–16

    Science.gov (United States)

    McBride, W. Scott; Sifuentes, Dorothy F.

    2018-02-06

    The Seminole Tribe of Florida (the Tribe) is partnering with the U.S. Environmental Protection Agency to develop a numeric phosphorus criterion for the 52,000-acre Big Cypress Seminole Indian Reservation (BCSIR), which is located downgradient of the Everglades Agricultural Area, and of other public and private lands, in southeastern Hendry County and northwestern Broward County in southern Florida. The U.S. Geological Survey (USGS), in cooperation with the Tribe, used water-quality data collected between October 2014 and September 2016 by the Tribe and the South Florida Water Management District (SFWMD), along with data from rainfall gages, surface-water stage and discharge gages, and groundwater monitoring wells, to (1) examine the relations between local hydrology and measured total phosphorus (TP) and orthophosphorus (OP) concentrations and (2) identify explanatory variables for TP concentrations. Of particular concern were conditions when TP exceeded 10 parts per billion (ppb) (0.01 milligram per liter [mg/L]) given that the State of Florida and the Miccosukee Tribe of Indians Alligator Alley Reservation (located downstream of the BCSIR) have adopted a 10-ppb maximum TP criterion for surface waters.From October 2014 to September 2016, the Tribe collected 47–52 samples at each of nine water-quality sites for analysis of TP and OP, except at one site where 28 samples were collected. For all sites sampled, concentrations of TP (as phosphorus [P]) ranged from less than 0.002 mg/L (2 ppb) to a maximum of nearly 0.50 mg/L (500 ppb), whereas concentrations of OP (as P), the reactive form of inorganic phosphorus readily absorbed by plants and (or) abiotically absorbed, ranged from less than 0.003 mg/L (3 ppb) to a maximum of 0.24 mg/L (240 ppb). The median and interquartile ranges of concentrations of TP and OP in the samples collected in 2014–16 by the Tribe were similar to the median and interquartile ranges of concentrations in samples collected by the SFWMD at

  13. On Controlled Iterated GSM Mappings and Related Operations

    NARCIS (Netherlands)

    Asveld, P.R.J.

    1979-01-01

    In [17] G. Paun studied families of languages generated by iterated gsm mappings, iterated finite substitutions, and iterated homomorphisms. In this note we generalize some results in [17], and we discuss the relation between iterated finite substitutions (homomorphisms) and (deterministic) tabled

  14. On Controlled Iterated GSM Mappings and Related Operations

    NARCIS (Netherlands)

    Asveld, P.R.J.

    1980-01-01

    In [17] G. Paun studied families of languages generated by iterated gsm mappings, iterated finite substitutions, and iterated homomorphisms. In this note we generalize some results in [17], and we discuss the relation between iterated finite substitutions (homomorphisms) and (deterministic) tabled

  15. Patient related factors for optimal blood pressure control in patients ...

    African Journals Online (AJOL)

    EB

    2013-09-03

    Sep 3, 2013 ... e” 90 mm Hg.8. Interview questionnaires. The questionnaires during the interview were comprised of four categories. The first was in relation to formal .... high blood pressure in clinics and hospitals is a major cause. Our earlier study on a rural Australian population showed that 56.7% of the patients with.

  16. Relative versus Absolute Stimulus Control in the Temporal Bisection Task

    Science.gov (United States)

    de Carvalho, Marilia Pinhiero; Machado, Armando

    2012-01-01

    When subjects learn to associate two sample durations with two comparison keys, do they learn to associate the keys with the short and long samples (relational hypothesis), or with the specific sample durations (absolute hypothesis)? We exposed 16 pigeons to an ABA design in which phases A and B corresponded to tasks using samples of 1 s and 4 s,…

  17. Beyond total treatment effects in randomised controlled trials: Baseline measurement of intermediate outcomes needed to reduce confounding in mediation investigations.

    Science.gov (United States)

    Landau, Sabine; Emsley, Richard; Dunn, Graham

    2018-06-01

    Random allocation avoids confounding bias when estimating the average treatment effect. For continuous outcomes measured at post-treatment as well as prior to randomisation (baseline), analyses based on (A) post-treatment outcome alone, (B) change scores over the treatment phase or (C) conditioning on baseline values (analysis of covariance) provide unbiased estimators of the average treatment effect. The decision to include baseline values of the clinical outcome in the analysis is based on precision arguments, with analysis of covariance known to be most precise. Investigators increasingly carry out explanatory analyses to decompose total treatment effects into components that are mediated by an intermediate continuous outcome and a non-mediated part. Traditional mediation analysis might be performed based on (A) post-treatment values of the intermediate and clinical outcomes alone, (B) respective change scores or (C) conditioning on baseline measures of both intermediate and clinical outcomes. Using causal diagrams and Monte Carlo simulation, we investigated the performance of the three competing mediation approaches. We considered a data generating model that included three possible confounding processes involving baseline variables: The first two processes modelled baseline measures of the clinical variable or the intermediate variable as common causes of post-treatment measures of these two variables. The third process allowed the two baseline variables themselves to be correlated due to past common causes. We compared the analysis models implied by the competing mediation approaches with this data generating model to hypothesise likely biases in estimators, and tested these in a simulation study. We applied the methods to a randomised trial of pragmatic rehabilitation in patients with chronic fatigue syndrome, which examined the role of limiting activities as a mediator. Estimates of causal mediation effects derived by approach (A) will be biased if one of

  18. Relative abundance of total subgingival plaque-specific bacteria in salivary microbiota reflects the overall periodontal condition in patients with periodontitis.

    Science.gov (United States)

    Kageyama, Shinya; Takeshita, Toru; Asakawa, Mikari; Shibata, Yukie; Takeuchi, Kenji; Yamanaka, Wataru; Yamashita, Yoshihisa

    2017-01-01

    Increasing attention is being focused on evaluating the salivary microbiota as a promising method for monitoring oral health; however, its bacterial composition greatly differs from that of dental plaque microbiota, which is a dominant etiologic factor of oral diseases. This study evaluated the relative abundance of subgingival plaque-specific bacteria in the salivary microbiota and examined a relationship between the abundance and severity of periodontal condition in patients with periodontitis. Four samples (subgingival and supragingival plaques, saliva, and tongue coating) per each subject were collected from 14 patients with a broad range of severity of periodontitis before periodontal therapy. The bacterial composition was analyzed by 16S rRNA gene amplicon sequencing using Ion PGM. Of the 66 species-level operational taxonomic units (OTUs) representing the mean relative abundance of ≥ 1% in any of the four niches, 12 OTUs corresponding to known periodontal pathogens, including Porphyromonas gingivalis, were characteristically predominant in the subgingival plaque and constituted 37.3 ± 22.9% of the microbiota. The total relative abundance of these OTUs occupied only 1.6 ± 1.2% of the salivary microbiota, but significantly correlated with the percentage of diseased sites (periodontal pocket depth ≥ 4 mm; r = 0.78, P periodontal therapy, the total relative abundance of these 12 OTUs was evaluated as well as before periodontal therapy and reductions of the abundance through periodontal therapy were strongly correlated in saliva and subgingival plaque (r = 0.81, P bacteria representing the present condition of periodontal health.

  19. Total mercury levels in hair, toenail, and urine among women free from occupational exposure and their relations to renal tubular function

    International Nuclear Information System (INIS)

    Ohno, Tomoko; Sakamoto, Mineshi; Kurosawa, Tomoko; Dakeishi, Miwako; Iwata, Toyoto; Murata, Katsuyuki

    2007-01-01

    To investigate the relations among total mercury levels in hair, toenail, and urine, together with potential effects of methylmercury intake on renal tubular function, we determined their levels, and urinary N-acetyl-β-d-glucosaminidase activity (NAG) and α 1 -microglobulin (AMG) in 59 women free from occupational exposures, and estimated daily mercury intakes from fish and other seafood using a food frequency questionnaire. Mercury levels (mean+/-SD) in the women were 1.51+/-0.91μg/g in hair, 0.59+/-0.32μg/g in toenail, and 0.86+/-0.66μg/g creatinine in urine; and, there were positive correlations among them (P<0.001). The daily mercury intake of 9.15+/-7.84μg/day was significantly correlated with total mercury levels in hair, toenail, and urine (r=0.551, 0.537, and 0.604, P<0.001). Among the women, the NAG and AMG were positively correlated with both the daily mercury intake and mercury levels in hair, toenail, and urine (P<0.01); and, these relations were almost similar when using multiple regression analysis to adjust for possible confounders such as urinary cadmium (0.47+/-0.28μg/g creatinine) and smoking status. In conclusion, mercury resulting from fish consumption can explain total mercury levels in hair, toenail, and urine to some degree (about 30%), partly through the degradation into the inorganic form, and it may confound the renal tubular effect of other nephrotoxic agents. Also, the following equation may be applicable to the population neither with dental amalgam fillings nor with occupational exposures: [hair mercury (μg/g)]=2.44x[toenail mercury (μg/g)

  20. Nuclear and related techniques in the control of communicable diseases

    International Nuclear Information System (INIS)

    1991-07-01

    The IAEA has a programme component entitled ''Nuclear Techniques in Communicable Diseases'', the aims of which are to encourage research in the development of new methods of controlling communicable diseases and to transfer the technology to institutes in endemic regions. Implementation of the programme component includes information exchange through publications, symposiums and seminars. The two most recent seminars were held in Bombay in November 1988 and Belo Horizonte in November 1989, and a selection of the papers presented have been published in this Technical Document. Refs, figs and tabs

  1. Control Analysis Of Tobacco Raw Material Supplies Using Eoq Method Economic Order Quantity To Reach Efficiency Total Costs Of Raw Material In Pr. Sukun

    Directory of Open Access Journals (Sweden)

    Wiwik Sudarwati

    2017-07-01

    Full Text Available The raw material inventory control system determines and guarantees the availability of raw material stock in the right quantity quality and timing. The problem in this research is the procurement of raw materials of tobacco. PR. Sukun still often experiences the excess. This is related to the frequency of raw material purchases and the quantity of raw material purchases which can lead to waste of working capital embedded in raw material inventory raw material ordering costs and raw material storage costs. The purpose of this research is to know how to make an efficiency level in procurement of raw material inventory between EOQ method compared with policy of PR. Sukun. The type of research used is analytic descriptive type. Data analysis begins by analyzing raw material quantity comparison total raw material inventory cost and raw material cost between PR Sukun policy with EOQ method. Based on the results of research known that by using EOQ method can be much more efficient compared to policy of PR. Sukun. The quantity and frequency of purchasing raw materials is less but still take into account the safety stock and reorder point so the production process is not disturbed. In addition the cost of purchasing ordering costs and raw materials storage costs less so as to create efficiencies on the cost of raw materials inventory. PR. Sukun in the procurement of raw material inventory should use EOQ method to be more efficient and take into account the safety stock and reorder point to avoid the inventory excess of raw materials.

  2. Relative tracking control of constellation satellites considering inter-satellite link

    Science.gov (United States)

    Fakoor, M.; Amozegary, F.; Bakhtiari, M.; Daneshjou, K.

    2017-11-01

    In this article, two main issues related to the large-scale relative motion of satellites in the constellation are investigated to establish the Inter Satellite Link (ISL) which means the dynamic and control problems. In the section related to dynamic problems, a detailed and effective analytical solution is initially provided for the problem of satellite relative motion considering perturbations. The direct geometric method utilizing spherical coordinates is employed to achieve this solution. The evaluation of simulation shows that the solution obtained from the geometric method calculates the relative motion of the satellite with high accuracy. Thus, the proposed analytical solution will be applicable and effective. In the section related to control problems, the relative tracking control system between two satellites will be designed in order to establish a communication link between the satellites utilizing analytical solution for relative motion of satellites with respect to the reference trajectory. Sliding mode control approach is employed to develop the relative tracking control system for body to body and payload to payload tracking control. Efficiency of sliding mode control approach is compared with PID and LQR controllers. Two types of payload to payload tracking control considering with and without payload degree of freedom are designed and suitable one for practical ISL applications is introduced. Also, Fuzzy controller is utilized to eliminate the control input in the sliding mode controller.

  3. Relations of Control: Walkthroughs and the Structuring of Player Agency

    OpenAIRE

    James Newman; Daniel Ashton

    2010-01-01

    Videogame walkthroughs provide instructions on various elements of gameplay in relation to specific digital games, and exist as text-based documents and, to a lesser extent, as recorded moving image game footage. We focus here on written-walkthroughs for the purposes of depth, while recognising the specific and significant position that moving image walkthroughs hold (see Ashton, forthcoming). Player-produced walkthroughs, freely and widely distributed online, point to the broader social cont...

  4. Reducción de costo total de inventario aplicando un modelo de control de inventario del tipo (s,S).

    OpenAIRE

    Matos Quispe, Cesar Anibal; Matos Quispe, Cesar Anibal; Matos Quispe, Cesar Anibal

    2012-01-01

    El presente informe de suficiencia propone un modelo de control de inventario para minimizar los costos totales de inventario, aplicando una política de inventario de tipo (s, S) que es un modelo de control de inventario de clase estocástica. Explica cómo se desarrolla el modelo mediante el uso de la simulación Monte Cario tanto para simular el modelo de inventario, así como también la metodología de optimización para obtener los valores de decisión. Para el modelo de simulación se conside...

  5. Infectious disease-related laws: prevention and control measures

    Directory of Open Access Journals (Sweden)

    Mijeong Park

    2017-07-01

    Full Text Available OBJECTIVES This study examines recently revised Korean government legislation addressing global infectious disease control for public health emergency situations, with the aim of proposing more rational, effective and realistic interpretations and applications for improvement of law. METHODS The Korea reported its first laboratory-confirmed case of Middle East Respiratory Syndrome (MERS coronavirus on May 20, 2015. Since the first indexed case, Korean public health authorities enforced many public health measures that were not authorized in the law; the scope of the current law was too limited to cover MERS. Korea has three levels of government: the central government, special self-governing provinces, and si/gun/gu. Unfortunately, the Infectious Disease Control and Prevention Act does not designate the specific roles of each level of government, and does not state how these governmental branches should be vertically integrated in a state of emergency. RESULTS When thinking about these policy questions, we should be especially concerned about introducing a new act that deals with all matters relevant to emerging infectious diseases. The aim would be to develop a structure that specifies the roles of each level of government, and facilitates the close collaboration among them, then enacting this in law for the prevention and response of infectious disease. CONCLUSIONS To address this problem, after analyzing the national healthcare infrastructure along with the characteristics of emerging infectious diseases, we propose the revision of the relevant law(s in terms of governance aspects, emergency medical countermeasure aspects, and the human rights aspect.

  6. Dynamic and inertial controls on forest carbon-water relations

    Science.gov (United States)

    Maxwell, T.; Silva, L.; Horwath, W. R.

    2017-12-01

    This study fuses theory, empirical measurements, and statistical models to evaluate multiple processes controlling coupled carbon-water cycles in forest ecosystems. A series of latitudinal and altitudinal transects across the California Sierra Nevada was used to study the effects of climatic and edaphic gradients on intrinsic water-use efficiency (iWUE) - CO2 fixed per unit of water lost via transpiration - of nine dominant trees species. Transfer functions were determined between leaf, litter, and soil organic matter stable isotope ratios of carbon, oxygen, and nitrogen, revealing causal links between the physiological performance of tree species and stand-level estimations of productivity and water balance. Our results show that species iWUE is governed both by leaf traits (24% of the variation) and edaphic properties, such as parent material and soil development (3% and 12% of the variation, respectively). We show that soil properties combined with isotopic indicators can be used to explain constraints over iWUE by regulating water and nutrient availability across elevation gradients. Based on observed compositional shifts likely driven by changing climates in the region, encroachment of broad leaf trees could lead to an 80% increase in water loss via transpiration for each unit of CO2 fixed in Sierra mixed conifer zones. A combination of field-based, laboratory, and remote sensed data provide a useful framework for differentiating the effect of multiple controls of carbon and water cycles in temperate forest ecosystems.

  7. Exchanging a few commercial, regularly consumed food items with improved fat quality reduces total cholesterol and LDL-cholesterol: a double-blind, randomised controlled trial.

    Science.gov (United States)

    Ulven, Stine M; Leder, Lena; Elind, Elisabeth; Ottestad, Inger; Christensen, Jacob J; Telle-Hansen, Vibeke H; Skjetne, Anne J; Raael, Ellen; Sheikh, Navida A; Holck, Marianne; Torvik, Kristin; Lamglait, Amandine; Thyholt, Kari; Byfuglien, Marte G; Granlund, Linda; Andersen, Lene F; Holven, Kirsten B

    2016-10-01

    The healthy Nordic diet has been previously shown to have health beneficial effects among subjects at risk of CVD. However, the extent of food changes needed to achieve these effects is less explored. The aim of the present study was to investigate the effects of exchanging a few commercially available, regularly consumed key food items (e.g. spread on bread, fat for cooking, cheese, bread and cereals) with improved fat quality on total cholesterol, LDL-cholesterol and inflammatory markers in a double-blind randomised, controlled trial. In total, 115 moderately hypercholesterolaemic, non-statin-treated adults (25-70 years) were randomly assigned to an experimental diet group (Ex-diet group) or control diet group (C-diet group) for 8 weeks with commercially available food items with different fatty acid composition (replacing SFA with mostly n-6 PUFA). In the Ex-diet group, serum total cholesterol (PLDL-cholesterol (Pcholesterol and LDL-cholesterol, respectively. No difference in change in plasma levels of inflammatory markers (high-sensitive C-reactive protein, IL-6, soluble TNF receptor 1 and interferon-γ) was observed between the groups. In conclusion, exchanging a few regularly consumed food items with improved fat quality reduces total cholesterol, with no negative effect on levels of inflammatory markers. This shows that an exchange of a few commercially available food items was easy and manageable and led to clinically relevant cholesterol reduction, potentially affecting future CVD risk.

  8. The prevalence and control of Bacillus and related spore-forming bacteria in the dairy industry

    Directory of Open Access Journals (Sweden)

    Nidhi eGopal

    2015-12-01

    Full Text Available Milk produced in udder cells is sterile but due to its high nutrient content, it can be a good growth substrate for contaminating bacteria. The quality of milk is monitored via somatic cell counts and total bacterial counts, with prescribed regulatory limits to ensure quality and safety. Bacterial contaminants can cause disease, or spoilage of milk and its secondary products. Aerobic spore-forming bacteria, such as those from the genera Sporosarcina, Paenisporosarcina, Brevibacillus, Paenibacillus, Geobacillus and Bacillus, are a particular concern in this regard as they are able to survive industrial pasteurisation and form biofilms within pipes and stainless steel equipment. These single or multiple-species biofilms become a reservoir of spoilage microorganisms and a cycle of contamination can be initiated. Indeed, previous studies have highlighted that these microorganisms are highly prevalent in dead ends, corners, cracks, crevices, gaskets, valves and the joints of stainless steel equipment used in the dairy manufacturing plants. Hence, adequate monitoring and control measures are essential to prevent spoilage and ensure consumer safety. Common controlling approaches include specific cleaning-in-place processes, chemical and biological biocides and other novel methods. In this review, we highlight the problems caused by these microorganisms, and discuss issues relating to their prevalence, monitoring thereof and control with respect to the dairy industry.

  9. Prevention of low back pain in the military cluster randomized trial: effects of brief psychosocial education on total and low back pain-related health care costs.

    Science.gov (United States)

    Childs, John D; Wu, Samuel S; Teyhen, Deydre S; Robinson, Michael E; George, Steven Z

    2014-04-01

    Effective strategies for preventing low back pain (LBP) have remained elusive, despite annual direct health care costs exceeding $85 billion dollars annually. In our recently completed Prevention of Low Back Pain in the Military (POLM) trial, a brief psychosocial education program (PSEP) that reduced fear and threat of LBP reduced the incidence of health care-seeking for LBP. The purpose of this cost analysis was to determine if soldiers who received psychosocial education experienced lower health care costs compared with soldiers who did not receive psychosocial education. The POLM trial was a cluster randomized trial with four intervention arms and a 2-year follow-up. Consecutive subjects (n=4,295) entering a 16-week training program at Fort Sam Houston, TX, to become a combat medic in the U.S. Army were considered for participation. In addition to an assigned exercise program, soldiers were cluster randomized to receive or not receive a brief psychosocial education program delivered in a group setting. The Military Health System Management Analysis and Reporting Tool was used to extract total and LBP-related health care costs associated with LBP incidence over a 2-year follow-up period. After adjusting for postrandomization differences between the groups, the median total LBP-related health care costs for soldiers who received PSEP and incurred LBP-related costs during the 2-year follow-up period were $26 per soldier lower than for those who did not receive PSEP ($60 vs. $86, respectively, p=.034). The adjusted median total health care costs for soldiers who received PSEP and incurred at least some health care costs during the 2-year follow-up period were estimated at $2 per soldier lower than for those who did not receive PSEP ($2,439 vs. $2,441, respectively, p=.242). The results from this analysis demonstrate that a brief psychosocial education program was only marginally effective in reducing LBP-related health care costs and was not effective in reducing

  10. Elucidation and control of electronic properties related to organic semiconductors

    International Nuclear Information System (INIS)

    Yamane, Hiroyuki; Ueno, Nobuo; Seki, Kazuhiko

    2009-01-01

    The electronic structure of organic solids and interfaces plays a crucial role in the performance of optoelectronic devices using organic semiconductors such as light-emitting diodes, field-effect transistors, and photovoltaic cells. The functionality of these organic devices is seriously dominated by the geometric structure, which varies depending on the molecular structure and the sample preparation condition. Due to the rapid progress in sample preparation methods and surface science techniques, we can now discuss in detail the correlation of the electronic structure with the geometric structure of organic solids, films, and interfaces. This paper reviews the recent progress of studies in the geometric and electronic structures related to organic semiconductors. (author)

  11. Public policy for the control of tobacco-related disease.

    Science.gov (United States)

    Bierer, M F; Rigotti, N A

    1992-03-01

    Public policies concerning tobacco shape the environment of the smoker and nonsmoker alike. These policies use diverse means to achieve the common goal of reducing tobacco use and its attendant health consequences. Educational interventions such as warning labels, school curricula, and public service announcements serve to inform the public about the hazards of tobacco smoke. These are countered by the pervasive marketing of tobacco products by the tobacco industry, despite a ban on tobacco advertising on radio and television. Further restrictions on tobacco advertising and promotion have been proposed and await action. Cigarette excise taxes and smoker-nonsmoker insurance premium differentials discourage smoking by making it more costly to purchase cigarettes. Conversely, health insurance reimbursement for smoking cessation programs could reduce the cost of giving up the habit and might encourage cessation. Restricting or banning smoking in public places and workplaces decreases a smoker's opportunities to smoke, further inhibiting this behavior. Reducing the availability of cigarettes to children and adolescents may help to prevent them from starting to smoke. The environment of the smoker is conditioned by this pastiche of influences. Physicians who become involved in tobacco-control issues have the opportunity to alter the environmental influences on their patients. This is likely to be synergistic with physicians' efforts inside the office to encourage individual smokers to quit. As a first step toward advocacy outside the office, physicians can help to create a smoke-free health-care facility in their own institution. Beyond that, advocacy groups or the voluntary health organizations (e.g., American Lung Association) provide avenues for physicians to take a stand on community issues relevant to tobacco control. Physicians who take these steps to alter the environment of smokers beyond the office are likely to magnify the effect of their work with individual

  12. Controlling Relations in Baseline Conditional Discriminations as Determinants of Stimulus Equivalence

    Science.gov (United States)

    de Rose, Julio C.; Hidalgo, Matheus; Vasconcellos, Mariliz

    2013-01-01

    Variation in baseline controlling relations is suggested as one of the factors determining variability in stimulus equivalence outcomes. This study used single- comparison trials attempting to control such controlling relations. Four children learned AB, BC, and CD conditional discriminations, with 2 samples and 2 comparison stimuli. In Condition…

  13. Immediate total-body CT scanning versus conventional imaging and selective CT scanning in patients with severe trauma (REACT-2): a randomised controlled trial.

    Science.gov (United States)

    Sierink, Joanne C; Treskes, Kaij; Edwards, Michael J R; Beuker, Benn J A; den Hartog, Dennis; Hohmann, Joachim; Dijkgraaf, Marcel G W; Luitse, Jan S K; Beenen, Ludo F M; Hollmann, Markus W; Goslings, J Carel

    2016-08-13

    Published work suggests a survival benefit for patients with trauma who undergo total-body CT scanning during the initial trauma assessment; however, level 1 evidence is absent. We aimed to assess the effect of total-body CT scanning compared with the standard work-up on in-hospital mortality in patients with trauma. We undertook an international, multicentre, randomised controlled trial at four hospitals in the Netherlands and one in Switzerland. Patients aged 18 years or older with trauma with compromised vital parameters, clinical suspicion of life-threatening injuries, or severe injury were randomly assigned (1:1) by ALEA randomisation to immediate total-body CT scanning or to a standard work-up with conventional imaging supplemented with selective CT scanning. Neither doctors nor patients were masked to treatment allocation. The primary endpoint was in-hospital mortality, analysed in the intention-to-treat population and in subgroups of patients with polytrauma and those with traumatic brain injury. The χ(2) test was used to assess differences in mortality. This trial is registered with ClinicalTrials.gov, number NCT01523626. Between April 22, 2011, and Jan 1, 2014, 5475 patients were assessed for eligibility, 1403 of whom were randomly assigned: 702 to immediate total-body CT scanning and 701 to the standard work-up. 541 patients in the immediate total-body CT scanning group and 542 in the standard work-up group were included in the primary analysis. In-hospital mortality did not differ between groups (total-body CT 86 [16%] of 541 vs standard work-up 85 [16%] of 542; p=0.92). In-hospital mortality also did not differ between groups in subgroup analyses in patients with polytrauma (total-body CT 81 [22%] of 362 vs standard work-up 82 [25%] of 331; p=0.46) and traumatic brain injury (68 [38%] of 178 vs 66 [44%] of 151; p=0.31). Three serious adverse events were reported in patients in the total-body CT group (1%), one in the standard work-up group (<1%), and

  14. 'Stranger' child-murder: issues relating to causes and controls.

    Science.gov (United States)

    Wilson, P R

    1988-02-01

    Most industrialised countries are concerned with a perceived increase in the killing of children and adolescents by strangers. Though reliable statistics are lacking, the growth of serial murder suggests that more young persons may be at risk than ever before. Explanations, either of a psychological or sociological kind, of child murder by strangers are inadequately developed. Despite the tendency to see such killers as psychiatrically ill a number of studies suggest that the majority of offenders do not differ significantly, at least in psychological traits, from non-offenders. Subcultural and other sociological perspectives stressing "social disadvantage" have low levels of exploratory power and do not assist greatly in understanding child killings. Despite sketchy and contradictory evidence on the effects of the media on sexual and violent crime case study material supports the view that pornography, including popular music, may increase the propensity of individuals to commit atrocities. Counter-measures to control stranger child killing lie in more sophisticated law enforcement (profiling and computer links between police forces) long periods of incarceration of the offender and more sophisticated analyses of the crimes.

  15. Intraoperative and postoperative feasibility and safety of total tubeless, tubeless, small-bore tube, and standard percutaneous nephrolithotomy: a systematic review and network meta-analysis of 16 randomized controlled trials.

    Science.gov (United States)

    Lee, Joo Yong; Jeh, Seong Uk; Kim, Man Deuk; Kang, Dong Hyuk; Kwon, Jong Kyou; Ham, Won Sik; Choi, Young Deuk; Cho, Kang Su

    2017-06-27

    Percutaneous nephrolithotomy (PCNL) is performed to treat relatively large renal stones. Recent publications indicate that tubeless and total tubeless (stentless) PCNL is safe in selected patients. We performed a systematic review and network meta-analysis to evaluate the feasibility and safety of different PCNL procedures, including total tubeless, tubeless with stent, small-bore tube, and large-bore tube PCNLs. PubMed, Cochrane Central Register of Controlled Trials, and EMBASE™ databases were searched to identify randomized controlled trials published before December 30, 2013. One researcher examined all titles and abstracts found by the searches. Two investigators independently evaluated the full-text articles to determine whether those met the inclusion criteria. Qualities of included studies were rated with Cochrane's risk-of-bias assessment tool. Sixteen studies were included in the final syntheses including pairwise and network meta-analyses. Operation time, pain scores, and transfusion rates were not significantly different between PCNL procedures. Network meta-analyses demonstrated that for hemoglobin changes, total tubeless PCNL may be superior to standard PCNL (mean difference [MD] 0.65, 95% CI 0.14-1.13) and tubeless PCNLs with stent (MD -1.14, 95% CI -1.65--0.62), and small-bore PCNL may be superior to tubeless PCNL with stent (MD 1.30, 95% CI 0.27-2.26). Network meta-analyses also showed that for length of hospital stay, total tubeless (MD 1.33, 95% CI 0.23-2.43) and tubeless PCNLs with stent (MD 0.99, 95% CI 0.19-1.79) may be superior to standard PCNL. In rank probability tests, small-bore tube and total tubeless PCNLs were superior for operation time, pain scores, and hemoglobin changes. For hemoglobin changes, total tubeless and small-bore PCNLs may be superior to other methods. For hospital stay, total tubeless and tubeless PCNLs with stent may be superior to other procedures.

  16. The Intervening Role of Relational Aggression between Psychological Control and Friendship Quality

    Science.gov (United States)

    Soenens, Bart; Vansteenkiste, Maarten; Goossens, Luc; Duriez, Bart; Niemiec, Christopher P.

    2008-01-01

    This study investigated the associations among psychologically controlling parenting, relational aggression, friendship quality, and loneliness during adolescence. A model was proposed in which relational aggression plays an intervening role in the relations between both parental psychological control and friendship outcomes. In a sample comprised…

  17. Total body irradiation prior to bone marrow transplantation: efficacy and safety of granisetron in the prophylaxis and control of radiation-induced emesis

    International Nuclear Information System (INIS)

    Belkacemi, Yazid; Ozsahin, Mahmut; Pene, Francoise; Rio, Bernard; Sutton, Laurent; Laporte, Jean-Philippe; Touboul, Emmanuel; Gorin, Norbert-Claude; Laugier, Alain

    1996-01-01

    moderate nausea; S3 = severe nausea and/or single episode of vomiting; and S4 multiple episodes of vomiting. Results: During TBI, 18 (50%) patients were scored as complete responders (S1), 1 (3%) as a major responder (S2), 9 (25%) as minor responders (S3), and 8 (22%) as nonresponders (S4). During the following 12 h, 28 (78%) patients were free of severe nausea and vomiting (S1 or S2), whereas 8 (22%) vomited (S3 or S4). In univariate analyses, the 12-h probability of emesis was significantly higher in patients undergoing hyper diuresis (63% vs. 30%; p = 0.05), and in patients older than 45 years (65% for age >45 vs. 33% for age ≤45; p = 0.05). The probability of S3 or S4 emesis was 50% with Treatment A and 47% with Treatment B (p = 0.86). Sex, body weight, and type of conditioning chemotherapy did not influence the 12-h probability of emesis. Multivariate analysis revealed that hyper diuresis (p 0.02) and Treatment A (p = 0.04) were independently associated with radiation-induced emesis, whereas sex (p = 0.85), body weight (p = 0.13), age (p = 0.12), and type of conditioning chemotherapy (p = 0.92) were not. No early toxicity related to granisetron was observed. Conclusion: Granisetron is a well-tolerated and effective antiemetic agent that can be used as monotherapy during single-dose TBI. Good control of nausea and vomiting is obtained with this antiemetic drug, and its effect is increased when hyper diuresis is suspended during TBI

  18. Supporting the Delivery of Total Knee Replacements Care for Both Patients and Their Clinicians With a Mobile App and Web-Based Tool: Randomized Controlled Trial Protocol.

    Science.gov (United States)

    Hussain, M Sazzad; Li, Jane; Brindal, Emily; van Kasteren, Yasmin; Varnfield, Marlien; Reeson, Andrew; Berkovsky, Shlomo; Freyne, Jill

    2017-03-01

    Total knee replacement (TKR) surgeries have increased in recent years. Exercise programs and other interventions following surgery can facilitate the recovery process. With limited clinician contact time, patients with TKR have a substantial burden of self-management and limited communication with their care team, thus often fail to implement an effective rehabilitation plan. We have developed a digital orthopedic rehabilitation platform that comprises a mobile phone app, wearable activity tracker, and clinical Web portal in order to engage patients with self-management tasks for surgical preparation and recovery, thus addressing the challenges of adherence to and completion of TKR rehabilitation. The study will determine the efficacy of the TKR platform in delivering information and assistance to patients in their preparation and recovery from TKR surgery and a Web portal for clinician care teams (ie, surgeons and physiotherapists) to remotely support and monitor patient progress. The study will evaluate the TKR platform through a randomized controlled trial conducted at multiple sites (N=5) in a number of states in Australia with 320 patients undergoing TKR surgery; the trial will run for 13 months for each patient. Participants will be randomized to either a control group or an intervention group, both receiving usual care as provided by their hospital. The intervention group will receive the app and wearable activity tracker. Participants will be assessed at 4 different time points: 4 weeks before surgery, immediately before surgery, 12 weeks after surgery, and 52 weeks after surgery. The primary outcome measure is the Oxford Knee Score. Secondary outcome measures include quality of life (Short-Form Health Survey); depression, anxiety, and stress (Depression, Anxiety, and Stress Scales); self-motivation; self-determination; self-efficacy; and the level of satisfaction with the knee surgery and care delivery. The study will also collect quantitative usage data

  19. Quality of life following total mastectomy with and without reconstruction versus breast-conserving surgery for breast cancer: A case-controlled cohort study.

    Science.gov (United States)

    Howes, Benjamin H L; Watson, David I; Xu, Chris; Fosh, Beverley; Canepa, Maximiliano; Dean, Nicola R

    2016-09-01

    Patient-reported outcomes and quality of life following mastectomy are not well understood. This study evaluates the quality of life following surgery for breast cancer and compares outcomes following breast-conserving surgery versus total mastectomy with or without reconstruction. A case-controlled cross-sectional study was conducted using the validated BREAST-Q™ questionnaire and a study-specific questionnaire to determine patient's views about surgical outcomes. Questionnaires were completed by patients following breast-conserving surgery and total mastectomy with or without reconstruction and by controls without breast cancer. A one-way ANOVA was used to compare mean BREAST-Q™ scores between groups and post hoc analysis using Tukey's and Kruskal-Wallis tests. BREAST-Q™ questionnaires were completed by 400 women (123 controls, 97 breast conservations, 93 mastectomies without reconstruction, 87 mastectomies with reconstruction). Women who had undergone mastectomy and reconstruction had higher scores in satisfaction with breast and sexual well-being domains compared with women who had breast-conserving surgery, and women who had total mastectomy without reconstruction had the lowest scores in these two domains. There was no difference in psychosocial well-being between the groups. Women who had undergone breast-conserving surgery scored the lowest in the physical well-being chest domain and the majority reported breast asymmetry. Our study suggests that women who undergo total mastectomy and breast reconstruction for cancer achieve a quality-of-life outcome that is at least as good as that following breast-conserving surgery. Furthermore, breast conservation has been found to be associated with lower physical well-being (i.e., more pain and discomfort) in the chest area and poorer sexual well-being outcomes. Copyright © 2016 British Association of Plastic, Reconstructive and Aesthetic Surgeons. All rights reserved.

  20. Calyculins and Related Marine Natural Products as Serine- Threonine Protein Phosphatase PP1 and PP2A Inhibitors and Total Syntheses of Calyculin A, B, and C

    Directory of Open Access Journals (Sweden)

    Ari M. P. Koskinen

    2010-01-01

    Full Text Available Calyculins, highly cytotoxic polyketides, originally isolated from the marine sponge Discodermia calyx by Fusetani and co-workers, belong to the lithistid sponges group. These molecules have become interesting targets for cell biologists and synthetic organic chemists. The serine/threonine protein phosphatases play an essential role in the cellular signalling, metabolism, and cell cycle control. Calyculins express potent protein phosphatase 1 and 2A inhibitory activity, and have therefore become valuable tools for cellular biologists studying intracellular processes and their control by reversible phosphorylation. Calyculins might also play an important role in the development of several diseases such as cancer, neurodegenerative diseases, and type 2-diabetes mellitus. The fascinating structures of calyculins have inspired various groups of synthetic organic chemists to develop total syntheses of the most abundant calyculins A and C. However, with fifteen chiral centres, a cyano-capped tetraene unit, a phosphate-bearing spiroketal, an anti, anti, anti dipropionate segment, an α-chiral oxazole, and a trihydroxylated γ-amino acid, calyculins reach versatility that only few natural products can surpass, and truly challenge modern chemists’ asymmetric synthesis skills.

  1. What part of the total care consumed by type 2 diabetes patients is directly related to diabetes? Implications for disease management programs

    Directory of Open Access Journals (Sweden)

    Christel van Dijk

    2011-12-01

    Full Text Available Background: Disease management programs (DMP aim at improving coordination and quality of care and reducing healthcare costs for specific chronic diseases. This paper investigates to what extent total healthcare utilization of type 2 diabetes patients is actually related to diabetes and its implications for diabetes management programs.Research design and methods: Healthcare utilization for diabetes patients was analyzed using 2008 self-reported data (N=316 and data from electronic medical records (EMR (N=9023, and divided whether or not care was described in the Dutch type 2 diabetes multidisciplinary healthcare standard.Results: On average 4.3 different disciplines of healthcare providers were involved in the care for diabetes patients. 96% contacted a GP-practice and 63% an ophthalmologist, 24% an internist, 32% a physiotherapist and 23% a dietician. Diabetes patients had on average 9.3 contacts with GP-practice of which 53% were included in the healthcare standard. Only a limited part of total healthcare utilization of diabetes patients was included in the healthcare standard and therefore theoretically included in DMPs.Conclusion: Organizing the care for diabetics in a DMP might harm the coordination and quality of all healthcare for diabetics. DMPs should be integrated in the overall organization of care.

  2. Robust fault detection of turbofan engines subject to adaptive controllers via a Total Measurable Fault Information Residual (ToMFIR) technique.

    Science.gov (United States)

    Chen, Wen; Chowdhury, Fahmida N; Djuric, Ana; Yeh, Chih-Ping

    2014-09-01

    This paper provides a new design of robust fault detection for turbofan engines with adaptive controllers. The critical issue is that the adaptive controllers can depress the faulty effects such that the actual system outputs remain the pre-specified values, making it difficult to detect faults/failures. To solve this problem, a Total Measurable Fault Information Residual (ToMFIR) technique with the aid of system transformation is adopted to detect faults in turbofan engines with adaptive controllers. This design is a ToMFIR-redundancy-based robust fault detection. The ToMFIR is first introduced and existing results are also summarized. The Detailed design process of the ToMFIRs is presented and a turbofan engine model is simulated to verify the effectiveness of the proposed ToMFIR-based fault-detection strategy. Copyright © 2013 ISA. Published by Elsevier Ltd. All rights reserved.

  3. Comparison of extended-release epidural morphine with femoral nerve block to patient-controlled epidural analgesia for postoperative pain control of total knee arthroplasty: a case-controlled study.

    Science.gov (United States)

    Sugar, Scott L; Hutson, Larry R; Shannon, Patrick; Thomas, Leslie C; Nossaman, Bobby D

    2011-01-01

    Because newer anticoagulation strategies for total knee replacement present potentially increased risk of neuraxial analgesia, there is movement away from using patient-controlled epidural analgesia (PCEA) for pain control. This concern opens the door for other regional modalities in postoperative analgesia, including the use of extended-release epidural morphine (EREM) combined with a femoral nerve block (FNB). This study was a prospective observational chart review with the use of recent historical controls in patients undergoing unilateral total knee replacement. Outcomes of interest were 0-, 24-, and 48-hour postoperative pain scores using the visual analog scale (VAS); incidence of side effects; and time spent in the postanesthesia care unit (PACU). Postoperative pain scores at 24 and 48 hours in the EREM and FNB group (n  =  14; 2.6 ± 0.6 and 5.0 ± 0.9, respectively) were comparable to the PCEA group (n  =  14; 3.8 ± 0.6 and 4.2 ± 0.9). The PACU time was shorter in the EREM and FNB group (2.4 ± 0.3 hours) compared with PCEA (3.6 ± 0.3 hours, P  =  .02). No statistically significant difference was found in the incidence of side effects between the 2 groups. The VAS scores at 24 and 48 hours indicate that EREM and FNB provide comparable analgesia to PCEA. The trend toward shorter PACU times represents an opportunity for cost-identification analysis. The study data are limited by their observational nature and the small number of patients involved; nevertheless, this study demonstrates a therapeutic equivalence to PCEA that may be more cost effective.

  4. Exercise therapy for Stress-related mental disorder, a randomised controlled trial in primary care

    Directory of Open Access Journals (Sweden)

    Donker Marieke

    2011-07-01

    Full Text Available Abstract Background to investigate whether a structured physical exercise programme (PEP improves the recovery of general health in patients suffering from Stress-related Mental Disorder (SMD. Method Study design: randomised open trial in general practice. Patients from two regions in the Netherlands were included between September 2003 and December 2005, and followed up for 12 weeks. Intervention: the patients were referred to a physical therapist for instruction in and monitoring of physical exercise of an intermediate intensity. Following the Dutch Guidelines for Healthy Physical Exercise, the patients were instructed to exercise at least five times a week, for at least 30 minutes per day. Control group: usual care from the GP Outcome Primary: improvement of general health after 6 weeks according to the 'general health' dimension of the Short-Form 36. Secondary: total days off work, percentage that resumed work after 6 and 12 weeks, change in distress score and change in remaining SF36 dimensions after 6 and 12 weeks. Results out of 102 randomised patients (mean age 43, 60 (59% female, 70 (68% completed the trial, of whom 31 were in the intervention group. After 6 weeks, the mean (SD general health score was 54.6 (22.1 for the intervention group and 57.5 (19.2 for the controls. The corresponding effect size (Cohen's d with 95% confidence interval from analysis of covariance was -0.06 (-0.41, 0.30 indicating no effect on general health. No significant effects of the intervention were detected for any secondary outcome parameter either. Conclusion Notwithstanding the relatively high drop-out rate, our results suggest that referral to a physical therapist for structured physical exercise is not likely to be very effective in improving recovery from SMD. Trial registry Current Controlled Trials ISRCTN15609105

  5. Hot topic: apparent total-tract nutrient digestibilities measured commercially using 120-hour in vitro indigestible neutral detergent fiber as a marker are related to commercial dairy cattle performance.

    Science.gov (United States)

    Schalla, A; Meyer, L; Meyer, Z; Onetti, S; Schultz, A; Goeser, J

    2012-09-01

    Measuring individual feed nutrient concentration is common practice for field dairy nutritionists. However, accurately measuring nutrient digestibility and using digestion values in total digestible nutrients models is more challenging. Our objective was to determine if in vivo apparent total-tract nutrient digestibility measured with a practical approach was related to commercial milk production parameters. Total mixed ration and fecal samples were collected from high-producing cows in pens on 39 commercial dairies and analyzed at a commercial feed and forage testing laboratory for nutrient concentration and 120-h indigestible NDF (iNDF) content using the Combs-Goeser in vitro digestion technique. The 120-h iNDF was used as an internal marker to calculate in vivo apparent nutrient digestibilities. Two samples were taken from each dairy and were separated in time by at least 3 wk. Samples were targeted to be taken within 7d of Dairy Herd Improvement (DHI) herd testing. Approved DHI testers measured individual cow milk weights as well as fat and protein concentrations. Individual cow records were averaged by pen corresponding to the total mixed ration and fecal samples. Formulated diet and dry matter intake (DMI) records for each respective pen were also collected. Mixed model regression analysis with dairy specified as a random effect was used to relate explanatory variables (diet nutrient concentrations, formulated DMI, in vivo apparent nutrient digestibilities, and fecal nutrient concentrations) to milk production measures. Dry matter intake, organic matter (OM) digestibility, fecal crude protein (CP) concentration, and fecal ether extract concentration were related to milk, energy-corrected milk, and fat yields. Milk protein concentration was related to CP digestibility, and milk protein yield was related to DMI, OM digestibility, CP digestibility, and ether extract digestibility. Although many studies have related DMI and OM digestibility to milk production

  6. Role of the judge in defending tobacco control measures in Colombia: total ban on advertising, promotion and sponsorship of tobacco products case

    Directory of Open Access Journals (Sweden)

    Lorena Viviana Calderón Pinzón

    2018-03-01

    Colombia, has established a total ban on all forms of advertising, promotion and sponsorship of tobacco, as a result of the harmonization process between internal rules, mainly related to measures to protect the right to health of the population. In view of the adverse consequences of tobacco consumption and exposure to tobacco smoke and the international obligations set out in the first legally binding public health treaty within the United Nations System: WHO´s FCTC.

  7. A prospective study of the association of patient expectations with changes in health-related quality of life outcomes, following total joint replacement.

    Science.gov (United States)

    Gonzalez Saenz de Tejada, Marta; Escobar, Antonio; Bilbao, Amaia; Herrera-Espiñeira, Carmen; García-Perez, Lidia; Aizpuru, Felipe; Sarasqueta, Cristina

    2014-07-23

    Patient expectations regarding surgery may be related to outcomes in total joint replacement (TJR). The aim of this study was to determine the association of patient expectations with health related quality of life (HRQoL) outcomes measured by Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and Short Form 12 (SF-12) and satisfaction with current symptoms measured on a 4-point Likert scale, one year after surgery, adjusting for Body Mass Index (BMI), age, gender, joint, education, previous intervention and baseline scores. Consecutive patients preparing for TJR of the knee or hip due to primary osteoarthritis (OA) in 15 hospitals in Spain were recruited for the study. Patients completed questionnaires before surgery and 12 months afterwards: five questions about expectations before surgery; an item to measure satisfaction; two HRQoL instruments-WOMAC and SF-12; as well as questions about sociodemographic information. To determine the association of patient expectations at baseline, with changes in HRQoL 12 months after surgery and with satisfaction, general linear models and logistic regression analysis were performed. A total of 892 patients took part in the study. Patients who had higher pain relief or ability to walk expectations improved more in HRQoL at 12 months. Moreover, patients with high daily activity expectations were more satisfied. Patients with higher baseline expectations for TJR, improved more in HRQoL at one year and had more likelihood to be satisfied than patients with lower expectations, adjusted for BMI, age, gender, joint, education, previous intervention and HRQoL baseline scores.

  8. Aspect ratio control of Au nanorods via covariation of the total amount of HAuCl{sub 4} and ascorbic acid

    Energy Technology Data Exchange (ETDEWEB)

    Ma, Xiao [State Key Laboratory of Silicate Materials for Architectures, Wuhan University of Technology, 122 Luoshi Road, Hongshan District, Wuhan 430070, Hubei (China); Wang, Moo-Chin, E-mail: mcwang@kmu.edu.tw [Department of Fragrance and Cosmetic Science, Kaohsiung Medical University, 100 Shih-Chuan 1st Road, Kaohsiung 80708, Taiwan (China); Feng, Jinyang [State Key Laboratory of Silicate Materials for Architectures, Wuhan University of Technology, 122 Luoshi Road, Hongshan District, Wuhan 430070, Hubei (China); Zhao, Xiujian, E-mail: opluse@whut.edu.cn [State Key Laboratory of Silicate Materials for Architectures, Wuhan University of Technology, 122 Luoshi Road, Hongshan District, Wuhan 430070, Hubei (China)

    2015-07-15

    Highlights: • The AR value decreased as the total amount of [HAuCl{sub 4}] and [AA] increasing. • The UV–vis absorption spectra showed the peak wavelength of TSPR at around 530 nm. • The wavelength of LSPR had a red-shifted effect. - Abstract: Controlling the aspect ratio (AR) of gold nanorods (GNRs) via covariation of the total concentrations of HAuCl{sub 4} ([HAuCl{sub 4}]) and ascorbic acid ([AA]) has been studied. Characteristics of GNRs were examined by transmission electron microscopy (TEM) and ultraviolet–visible (UV–vis) absorption spectrophotometry. TEM results showed that single crystalline GNRs grew along an elongated growth direction of [100]. TEM results also revealed that the quantity of plate shaped and nearly spherical nanoparticles increased as the total amount of [HAuCl{sub 4}] and [AA] decreased. The AR value measured from TEM images decreased from 4.74 to 2.41 as the total amount of [HAuCl{sub 4}] and [AA] was increased from 0.305 to 2.44 mM. The UV–vis absorption spectra of all samples showed that the wavelength of transverse surface plasmon resonance (TSPR) peak appeared at around 530 nm for all samples. The wavelength of longitudinal surface plasmon resonance (LSPR) peak increased from 640 to 894 nm as the total amount of [HAuCl{sub 4}] and [AA] decreased from 2.44 to 0.305 mM. The wavelength of LSPR peak shows a red-shifted effect except when the total amount of [HAuCl{sub 4}] and [AA] was 0.122 mM.

  9. Early self-managed focal sensorimotor rehabilitative training enhances functional mobility and sensorimotor function in patients following total knee replacement: a controlled clinical trial.

    Science.gov (United States)

    Moutzouri, Maria; Gleeson, Nigel; Coutts, Fiona; Tsepis, Elias; John, Gliatis

    2018-02-01

    To assess the effects of early self-managed focal sensorimotor training compared to functional exercise training after total knee replacement on functional mobility and sensorimotor function. A single-blind controlled clinical trial. University Hospital of Rion, Greece. A total of 52 participants following total knee replacement. The primary outcome was the Timed Up and Go Test and the secondary outcomes were balance, joint position error, the Knee Outcome Survey Activities of Daily Living Scale, and pain. Patients were assessed on three separate occasions (presurgery, 8 weeks post surgery, and 14 weeks post surgery). Participants were randomized to either focal sensorimotor exercise training (experimental group) or functional exercise training (control group). Both groups received a 12-week home-based programme prescribed for 3-5 sessions/week (35-45 minutes). Consistently greater improvements ( F 2,98  = 4.3 to 24.8; P effect size range of 1.3-6.5. Overall, the magnitude of improvements in functional mobility and sensorimotor function endorses using focal sensorimotor training as an effective mode of rehabilitation following knee replacement.

  10. Relations of Control: Walkthroughs and the Structuring of Player Agency

    Directory of Open Access Journals (Sweden)

    James Newman

    2010-07-01

    Full Text Available Videogame walkthroughs provide instructions on various elements of gameplay in relation to specific digital games, and exist as text-based documents and, to a lesser extent, as recorded moving image game footage. We focus here on written-walkthroughs for the purposes of depth, while recognising the specific and significant position that moving image walkthroughs hold (see Ashton, forthcoming. Player-produced walkthroughs, freely and widely distributed online, point to the broader social contexts that inform and structure player agency. In this article, we emphasize three perspectives on these documents. First, walkthroughs can be approached as a means of recording and codifying playing styles, thereby legitimising specific approaches or strategies. Accordingly, we highlight glitch hunting and the Pokémon series to illustrate the diversity of these playing styles and the significance of the walkthrough as a form of ludic archival document. Second, walkthroughs as textual codifications of gameplay potential can encourage new styles of engagement with authors and performers by outlining opportunities for play, and illuminating strategies and techniques previously unknown to the reader. Importantly, as we shall demonstrate, walkthroughs not only investigate and interrogate game texts – exploring their every narrative turn and spatial aspects in minute detail – but also frequently present techniques that take advantage of weaknesses and flaws in the ruleset or code of the game in order to offer new gameplay options. In this respect, as James Newman (2008 suggests, walkthroughs can be understood as a form of reverse-engineering that renegotiates the player-designer relationship and encourages (perhaps even demands deliberately investigative, resistant and deviant strategies of gameplay. These modes of engagement frequently involve playing beyond performative norms and technical limits. The walkthrough, then, is both a document of the game as

  11. Fitness-related differences in the rate of whole-body total heat loss in exercising young healthy women are heat-load dependent.

    Science.gov (United States)

    Lamarche, Dallon T; Notley, Sean R; Poirier, Martin P; Kenny, Glen P

    2018-03-01

    What is the central question of this study? Aerobic fitness modulates heat loss, albeit the heat load at which fitness-related differences occur in young healthy women remains unclear. What is the main finding and its importance? We demonstrate using direct calorimetry that fitness modulates heat loss in a heat-load dependent manner, with differences occurring between young women of low and high fitness and matched physical characteristics when the metabolic heat load is at least 400 W in hot, dry conditions. Although fitness has been known for some time to modulate heat loss, our findings define the metabolic heat load at which fitness-related differences occur. Aerobic fitness has recently been shown to alter heat loss capacity in a heat-load dependent manner in young men. However, given that sex-related differences in heat loss capacity exist, it is unclear whether this response is consistent in women. We therefore assessed whole-body total heat loss in young (21 ± 3 years old) healthy women matched for physical characteristics, but with low (low-fit; 35.8 ± 4.5 ml O 2  kg -1  min -1 ) or high aerobic fitness (high-fit; 53.1 ± 5.1 ml O 2  kg -1  min -1 ; both n = 8; indexed by peak oxygen consumption), during three 30 min bouts of cycling performed at increasing rates of metabolic heat production of 250 (Ex1), 325 (Ex2) and 400 W (Ex3), each separated by a 15 min recovery, in hot, dry conditions (40°C, 11% relative humidity). Whole-body total heat loss (evaporative ± dry heat exchange) and metabolic heat production were measured using direct and indirect calorimetry, respectively. Body heat content was measured as the temporal summation of heat production and loss. Total heat loss did not differ during Ex1 (low-fit, 215 ± 16 W; high-fit, 231 ± 20 W; P > 0.05) and Ex2 (low-fit, 278 ± 15 W; high-fit, 301 ± 20 W; P > 0.05), but was lower in the low-fit (316 ± 21 W) compared with the high-fit women (359 ± 32

  12. Interest of active posturography to detect age-related and early Parkinson's disease-related impairments in mediolateral postural control.

    Science.gov (United States)

    Bonnet, Cédrick T; Delval, Arnaud; Defebvre, Luc

    2014-11-15

    Patients with Parkinson's disease display impairments of postural control most particularly in active, challenging conditions. The objective of the present study was to analyze early signs of disease-related and also age-related impairments in mediolateral body extension and postural control. Fifty-five participants (18 Hoehn and Yahr stage 2 patients in the off-drug condition, 18 healthy elderly control subjects, and 19 young adults) were included in the study. The participants performed a quiet stance task and two active tasks that analyzed the performance in mediolateral body motion: a limit of stability and a rhythmic weight shift task. As expected, the patients displayed significantly lower and slower body displacement (head, neck, lower back, center of pressure) than elderly control subjects when performing the two body excursion tasks. However, the behavioral variability in both tasks was similar between the groups. Under these active conditions, the patients showed significantly lower contribution of the hip postural control mechanisms compared with the elderly control subjects. Overall, the patients seemed to lower their performance in order to prevent a mediolateral postural instability. However, these patients, at an early stage of their disease, were not unstable in quiet stance. Complementarily, elderly control subjects displayed slower body performance than young adults, which therefore showed an additional age-related impairment in mediolateral postural control. Overall, the study illustrated markers of age-related and Parkinson's disease impairments in mediolateral postural control that may constrain everyday activities in elderly adults and even more in patients with Parkinson's disease. Copyright © 2014 the American Physiological Society.

  13. Comparison of topical versus intravenous tranexamic acid in primary total knee arthroplasty: a meta-analysis of randomized controlled and prospective cohort trials.

    Science.gov (United States)

    Wang, Hao; Shen, Bin; Zeng, Yi

    2014-12-01

    There has been much debate and controversy about the optimal regimen of tranexamic acid in primary total knee arthroplasty. The purpose of this study was to undertake a meta-analysis to compare the efficacy of topical and intravenous regimen of tranexamic acid in primary total knee arthroplasty. A systematic review of the electronic databases PubMed, CENTRAL, Web of Science, and Embase was undertaken. All randomized controlled trials and prospective cohort studies evaluating the effectiveness of topical and intravenous tranexamic acid during primary total knee arthroplasty were included. The focus of the analysis was on the outcomes of blood loss, transfusion rate, and thromboembolic complications. Subgroup analysis was performed when possible. Of 328 papers identified, six trials were eligible for data extraction and meta-analysis comprising 679 patients (739 knees). We found no statistically significant difference between topical and intravenous administration of tranexamic acid in terms of blood loss, transfusion requirements and thromboembolic complications. Topical tranexamic acid has a similar efficacy to intravenous tranexamic acid in reducing both blood loss and transfusion rate without sacrificing safety in primary total knee arthroplasty. II. Copyright © 2014 Elsevier B.V. All rights reserved.

  14. Relationship of nocturnal concentrations of melatonin, gamma-aminobutyric acid and total antioxidants in peripheral blood with insomnia after stroke: study protocol for a prospective non-randomized controlled trial

    Institute of Scientific and Technical Information of China (English)

    Wei Zhang; Fang Li; Tong Zhang

    2017-01-01

    Melatonin and gamma-aminobutyric acid (GABA) have been shown to regulate sleep. The nocturnal concentrations of melatonin, GABA and total antioxidants may relate to insomnia in stroke patients. In this prospective single-center non-randomized controlled clinical trial performed in the China Rehabilitation Research Center, we analyzed the relationship of nocturnal concentrations of melatonin, GABA and total antioxidants with insomnia after stroke. Patients during rehabilitation of stroke were recruited and assigned to the insomnia group or non-insomnia group. Simultaneously, persons without stroke or insomnia served as normal controls. Each group contained 25 cases. The primary outcome was nocturnal concentrations of melatonin, GABA and total antioxidants in peripheral blood. The secondary outcomes were Pittsburgh Sleep Quality Index, Insomnia Severity Index, Epworth Sleepiness Scale, Fatigue Severity Scale, Morningness-Eveningness Questionnaire (Chinese version), and National Institute of Health Stroke Scale. The relationship of nocturnal concentrations of melatonin, GABA and total antioxidants with insomnia after stroke was analyzed and showed that they were lower in the insomnia group than in the non-insomnia group. The severity of stroke was higher in the insomnia group than in the non-insomnia group. Correlation analysis demonstrated that the nocturnal concentrations of melatonin and GABA were associated with insomnia after stroke. This trial was regis-tered at ClinicalTrials.gov, identifier: NCT03202121.

  15. Continuous Femoral Nerve Block versus Intravenous Patient Controlled Analgesia for Knee Mobility and Long-Term Pain in Patients Receiving Total Knee Replacement: A Randomized Controlled Trial

    Directory of Open Access Journals (Sweden)

    Lihua Peng

    2014-01-01

    Full Text Available Objectives. To evaluate the comparative analgesia effectiveness and safety of postoperative continuous femoral nerve block (CFNB with patient controlled intravenous analgesia (PCIA and their impact on knee function and chronic postoperative pain. Methods. Participants were randomly allocated to receive postoperative continuous femoral nerve block (group CFNB or intravenous patient controlled analgesia (group PCIA. Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC scores for knee and incidence of chronic postoperative pain at 3, 6, and 12 months postoperatively were compared. postoperative pain and salvage medication at rest or during mobilization 24 hours, 48 hours, and 7 days postoperatively were also recorded. Results. After discharge from the hospital and rehabilitation of joint function, patients in group CFNB reported significantly improved knee flexion and less incidence of chronic postoperative pain at 3 months and 6 months postoperatively (P<0.05. Analgesic rescue medications were significantly reduced in patients receiving CFNB (P<0.001 and P=0.031, resp.. Conclusion. With standardized rehabilitation therapy, continuous femoral nerve block analgesia reduced the incidence of chronic postoperative pain, improved motility of replaced joints, and reduced the dosages of rescue analgesic medications, suggesting a recovery-enhancing effect of peripheral nerve block analgesia.

  16. Major and minor arsenic compounds accounting for the total urinary excretion of arsenic following intake of blue mussels (Mytilus edulis): A controlled human study

    DEFF Research Database (Denmark)

    Molin, M.; Ydersbond, T.A.; Ulven, S.M.

    2012-01-01

    Blue mussels (Mytilus edulis) accumulate and biotransform arsenic (As) to a larger variety of arsenicals than most seafood. Eight volunteers ingested a test meal consisting of 150g blue mussel (680μg As), followed by 72h with an identical, low As controlled diet and full urine sampling. We provide...... a complete speciation, with individual patterns, of urinary As excretion. Total As (tAs) urinary excretion was 328±47μg, whereof arsenobetaine (AB) and dimethylarsinate (DMA) accounted for 66% and 21%, respectively. Fifteen minor urinary arsenicals were quantified with inductively coupled plasma mass...... spectrometry (ICPMS) coupled to reverse-phase, anion and cation-exchange high performance liquid chromatography (HPLC). Thio-arsenicals and non-thio minor arsenicals (including inorganic As (iAs) and methylarsonate (MA)) contributed 10% and 7% of the total sum of species excretion, respectively, but there were...

  17. The relative contribution of waves, tides, and nontidal residuals to extreme total water levels on U.S. West Coast sandy beaches

    Science.gov (United States)

    Serafin, Katherine A.; Ruggiero, Peter; Stockdon, Hilary F.

    2017-01-01

    To better understand how individual processes combine to cause flooding and erosion events, we investigate the relative contribution of tides, waves, and nontidal residuals to extreme total water levels (TWLs) at the shoreline of U.S. West Coast sandy beaches. Extreme TWLs, defined as the observed annual maximum event and the simulated 100 year return level event, peak in Washington, and are on average larger in Washington and Oregon than in California. The relative contribution of wave-induced and still water levels (SWL) to the 100 year TWL event is similar to that of the annual maximum event; however, the contribution of storm surge to the SWL doubles across events. Understanding the regional variability of TWLs will lead to a better understanding of how sea level rise, changes in storminess, and possible changes in the frequency of major El Niños may impact future coastal flooding and erosion along the U.S. West Coast and elsewhere.

  18. Body composition of adult cystic fibrosis patients and control subjects as determined by densitometry, bioelectrical impedance, total-body electrical conductivity, skinfold measurements, and deuterium oxide dilution

    International Nuclear Information System (INIS)

    Newby, M.J.; Keim, N.L.; Brown, D.L.

    1990-01-01

    This study contrasts body compositions (by six methods) of eight cystic fibrosis (CF) subjects with those of eight control subjects matched for age, height, and sex. CF subjects weighed 84% as much as control subjects. Densitometry and two bioelectrical impedance-analysis methods suggested that reduced CF weights were due to less lean tissue (10.7, 9.5, and 10.4 kg). Total-body electrical conductivity (TOBEC) and skinfold-thickness measurements indicated that CF subjects were leaner than control subjects and had less fat (5.4 and 3.6 kg) and less lean (5.2 and 7 kg) tissue. D2O dilution showed a pattern similar to TOBEC (8.3 kg less lean, 2.7 kg less fat tissue). Densitometry estimates of fat (mass and percent) were not correlated (r less than 0.74, p greater than 0.05) with any other method for CF subjects but were correlated with all other methods for control subjects. CF subjects contained less fat and lean tissue than did control subjects. Densitometry by underwater weighing is unsuitable for assessing body composition of CF patients

  19. Transcutaneous Electrical Nerve Stimulation (TENS) for the Control of Pain during Rehabilitation Following Total Knee Arthroplasty (TKA): A Randomized, Blinded, Placebo-Controlled Trial

    Science.gov (United States)

    Rakel, Barbara; Zimmerman, M. Bridget; Geasland, Katharine; Embree, Jennie; Clark, Charles R; Noiseux, Nicolas O; Callaghan, John J; Herr, Keela; Walsh, Deirdre; Sluka, Kathleen A

    2014-01-01

    This study evaluated the efficacy of TENS in reducing pain and hyperalgesia and increasing function following total knee arthroplasty (TKA). We hypothesized participants using TENS during rehabilitation exercises would: 1) report significantly lower pain during range-of-motion (ROM) and fast walking but not at rest; 2) have less hyperalgesia; and, 3) have better function than participants receiving Placebo-TENS or Standard Care. We also hypothesized that change in ROM pain would differ based on psychological characteristics (trait anxiety, pain catastrophizing and depression) and treatment group. This prospective, randomized study used intent-to-treat analyses on 317 subjects after primary, unilateral TKA. Assessors, blinded to treatment allocation, measured pain, function (ROM and gait speed), and hyperalgesia (quantitative sensory tests) postoperatively and 6 weeks after surgery. Analgesic intake, anxiety, depression, and pain catastrophizing were also assessed. TENS participants used it 1–2 times/day at 42 mA (on average) and had less pain postoperatively during active knee extension (p=0.019) and fast walking (p=0.006) than Standard Care participants. TENS and Placebo-TENS were not significantly different. TENS participants who scored low on anxiety and pain catastrophizing had a greater reduction in ROM pain at 6 weeks than those scoring high on these factors (p=0.002 and 0.03). Both TENS and Placebo-TENS participants had less postoperative mechanical hyperalgesia (p=0.03 – 0.01) than Standard Care participants. Supplementing pharmacologic analgesia with TENS during rehabilitation exercises reduces movement pain postoperatively but a placebo influence exists and the effect is gone by 6 weeks. Patients with low anxiety and pain catastrophizing may benefit most from TENS. PMID:25270585

  20. Periarticular Liposomal Bupivacaine Injection Versus Intra-Articular Bupivacaine Infusion Catheter for Analgesia After Total Knee Arthroplasty: A Double-Blinded, Randomized Controlled Trial.

    Science.gov (United States)

    Smith, Eric B; Kazarian, Gregory S; Maltenfort, Mitchell G; Lonner, Jess H; Sharkey, Peter F; Good, Robert P

    2017-08-16

    Intra-articular bupivacaine hydrochloride (HCl) infusion catheters and periarticular injections of liposomal bupivacaine are often used as postoperative local anesthetics. The purpose of this study was to compare the efficacies of these local anesthetics following total knee arthroplasty. This study was a superiority trial with a randomized, controlled, double-blinded design. Patients were randomly assigned to either delivery of bupivacaine HCl by the ON-Q* Pain Relief System pump (n = 96) or by an injection of Exparel (liposomal bupivacaine) (n = 104). The primary outcome of this study was cumulative narcotic consumption on postoperative days 0 through 3. Narcotic consumption data were collected retrospectively from in-hospital records while patients were in the hospital. Following discharge, narcotic consumption data were gathered from patient surveys, as were secondary outcomes measures. We did not identify greater narcotic use in the ON-Q* group compared with the Exparel group (p = 0.641). The mean difference between the groups was 0.5 morphine equivalent (95% confidence interval [CI] = -1.7 to +2.8), with the ON-Q* group consuming an average 10.4 morphine equivalents (95% CI = 8.7 to 12.0) compared with 10.9 (95% CI = 9.3 to 12.5) in the Exparel group. There were no significant differences between groups with regard to any of the secondary measures of pain with the exception of pain while walking and pain with physical therapy (p = 0.019 and p = 0.010, respectively), both of which showed an approximately 1-point difference in favor of the ON-Q* group on a visual analog scale (VAS). There were also no differences in the postoperative side effects, including nausea, constipation, or vomiting, or in the rates of study-related complications, patient satisfaction, or length of hospital stay. Exparel did not have superior efficacy compared with the ON-Q* Pain Relief System as reflected by narcotic consumption, our primary outcome. There were small significant

  1. Minimally invasive computer-navigated total hip arthroplasty, following the concept of femur first and combined anteversion: design of a blinded randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Woerner Michael

    2011-08-01

    Full Text Available Abstract Background Impingement can be a serious complication after total hip arthroplasty (THA, and is one of the major causes of postoperative pain, dislocation, aseptic loosening, and implant breakage. Minimally invasive THA and computer-navigated surgery were introduced several years ago. We have developed a novel, computer-assisted operation method for THA following the concept of "femur first"/"combined anteversion", which incorporates various aspects of performing a functional optimization of the cup position, and comprehensively addresses range of motion (ROM as well as cup containment and alignment parameters. Hence, the purpose of this study is to assess whether the artificial joint's ROM can be improved by this computer-assisted operation method. Second, the clinical and radiological outcome will be evaluated. Methods/Design A registered patient- and observer-blinded randomized controlled trial will be conducted. Patients between the ages of 50 and 75 admitted for primary unilateral THA will be included. Patients will be randomly allocated to either receive minimally invasive computer-navigated "femur first" THA or the conventional minimally invasive THA procedure. Self-reported functional status and health-related quality of life (questionnaires will be assessed both preoperatively and postoperatively. Perioperative complications will be registered. Radiographic evaluation will take place up to 6 weeks postoperatively with a computed tomography (CT scan. Component position will be evaluated by an independent external institute on a 3D reconstruction of the femur/pelvis using image-processing software. Postoperative ROM will be calculated by an algorithm which automatically determines bony and prosthetic impingements. Discussion In the past, computer navigation has improved the accuracy of component positioning. So far, there are only few objective data quantifying the risks and benefits of computer navigated THA. Therefore, this

  2. Comparison of group-based outpatient physiotherapy with usual care after total knee replacement: a feasibility study for a randomized controlled trial.

    Science.gov (United States)

    Artz, Neil; Dixon, Samantha; Wylde, Vikki; Marques, Elsa; Beswick, Andrew D; Lenguerrand, Erik; Blom, Ashley W; Gooberman-Hill, Rachael

    2017-04-01

    To evaluate the feasibility of conducting a randomized controlled trial comparing group-based outpatient physiotherapy with usual care in patients following total knee replacement. A feasibility study for a randomized controlled trial. One secondary-care hospital orthopaedic centre, Bristol, UK. A total of 46 participants undergoing primary total knee replacement. The intervention group were offered six group-based exercise sessions after surgery. The usual care group received standard postoperative care. Participants were not blinded to group allocation. Feasibility was assessed by recruitment, reasons for non-participation, attendance, and completion rates of study questionnaires that included the Lower Extremity Functional Scale and Knee Injury and Osteoarthritis Outcome Score. Recruitment rate was 37%. Five patients withdrew or were no longer eligible to participate. Intervention attendance was high (73%) and 84% of group participants reported they were 'very satisfied' with the exercises. Return of study questionnaires at six months was lower in the usual care (75%) than in the intervention group (100%). Mean (standard deviation) Lower Extremity Functional Scale scores at six months were 45.0 (20.8) in the usual care and 57.8 (15.2) in the intervention groups. Recruitment and retention of participants in this feasibility study was good. Group-based physiotherapy was acceptable to participants. Questionnaire return rates were lower in the usual care group, but might be enhanced by telephone follow-up. The Lower Extremity Functional Scale had high responsiveness and completion rates. Using this outcome measure, 256 participants would be required in a full-scale randomized controlled trial.

  3. A randomised, controlled trial of circumpatellar electrocautery in total knee replacement without patellar resurfacing: a concise follow-up at a mean of 3.7 years.

    Science.gov (United States)

    van Jonbergen, H P W; Scholtes, V A B; Poolman, R W

    2014-04-01

    In the absence of patellar resurfacing, we have previously shown that the use of electrocautery around the margin of the patella improved the one-year clinical outcome of total knee replacement (TKR). In this prospective randomised study we compared the mean 3.7 year (1.1 to 4.2) clinical outcomes of 300 TKRs performed with and without electrocautery of the patellar rim: this is an update of a previous report. The overall prevalence of anterior knee pain was 32% (95% confidence intervals [CI] 26 to 39), and 26% (95% CI 18 to 35) in the intervention group compared with 38% (95% CI 29 to 48) in the control group (chi-squared test; p = 0.06). The overall prevalence of anterior knee pain remained unchanged between the one-year and 3.7 year follow-up (chi-squared test; p = 0.12). The mean total Western Ontario McMasters Universities Osteoarthritis Indices and the American Knee Society knee and function scores at 3.7 years' follow-up were similar in the intervention and control groups (repeated measures analysis of variance p = 0.43, p = 0.09 and p = 0.59, respectively). There were no complications. A total of ten patients (intervention group three, control group seven) required secondary patellar resurfacing after the first year. Our study suggests that the improved clinical outcome with electrocautery denervation compared with no electrocautery is not maintained at a mean of 3.7 years' follow-up.

  4. Data set on the effects of conifer control and slash burning on soil carbon, total N, organic matter and extractable micro-nutrients

    Directory of Open Access Journals (Sweden)

    Jonathan D. Bates

    2017-10-01

    Full Text Available Conifer control in sagebrush steppe of the western United States causes various levels of site disturbance influencing vegetation recovery and resource availability. The data set presented in this article include growing season availability of soil micronutrients and levels of total soil carbon, organic matter, and N spanning a six year period following western juniper (Juniperus occidentalis spp. occidentalis reduction by mechanical cutting and prescribed fire of western juniper woodlands in southeast Oregon. These data can be useful to further evaluate the impacts of conifer woodland reduction to soil resources in sagebrush steppe plant communities.

  5. Short-term hypertension management in community is associated with long-term risk of stroke and total death in China: A community controlled trial.

    Science.gov (United States)

    Wang, Zengwu; Hao, Guang; Wang, Xin; Wang, Wen; Chen, Weiwei; Zhu, Manlu

    2016-11-01

    It is not fully clear whether the effect of short-term management in community can reduce the long-term risk of stroke OBJECTIVES:: To evaluate whether short-term hypertension management is associated with long-term incidence of stroke and total death in community health centers in China. Community controlled trail. Six community health centers (4 active, 2 control) in China, patients with hypertension. Patients were treated with normally therapy method. Patients were treated oriented by the Guideline for hypertension management. Two centers (Hebei and Zhejiang) from the Hypertension Control in Community (HCC) Project, which was conducted from 2005 to 2008, were randomly selected for this study. Four thousand hypertensive patients from these centers, who were under management for one year in the baseline, were followed up in 2013. The electronic health record system (2005-2008) was used to identify 2000 hypertensive patients, who were not included in HCC but lived in comparable community health center in the same province, as the control group. All baseline and follow-up data were collected using standardized questionnaires for stroke outcomes. Stroke. Of the 6000 participants, 3787 (63.1%) were eligible for analysis. At the time of follow-up, the average BP was kept in the lower level than that in baseline, and the control rate was 59.3%. After propensity-score matching, 110 strokes (2.0% vs 4.6%) and 141 deaths (1.4% vs 3.8%) were noted in the matched intervention and control groups (1078 pairs), respectively. Patients in the intervention group were less likely to experience a stroke or die than those in the control group (hazard ratio [HR] = 0.40, 95% confidence interval [CI]: 0.26-0.62, P stroke in hypertensive patients.

  6. No Effect of a Bipolar Sealer on Total Blood Loss or Blood Transfusion in Nonseptic Revision Knee Arthroplasty-A Prospective Study With Matched Retrospective Controls

    DEFF Research Database (Denmark)

    Nielsen, Christian Skovgaard; Gromov, Kirill; Jans, Øivind

    2017-01-01

    deviation, ± 452) mL in the bipolar sealer group vs 1452 (SD, ± 530) mL in the control group (P = .66), nor for blood transfusion rates of 53% and 46% (P = .89), respectively. Four controls were readmitted within 90 days follow-up. CONCLUSION: The use of a bipolar sealer in a TKA revision setting without......BACKGROUND: Postoperative anemia is frequent after revision of total knee arthroplasty (TKA) with reported transfusion rates up to 83%. Despite increased efforts of reducing blood loss and enhancing fast recovery within the fast-track setup, a considerable transfusion rate is still evident. The aim......-five prospectively enrolled patients received treatment with both a bipolar sealer and electrocautery, whereas 26 patients had received treatment with a conventional electrocautery only in the retrospective group. RESULTS: No significant differences were found neither for calculated blood loss, with 1397 (standard...

  7. Direct hospital costs of total laparoscopic hysterectomy compared with fast-track open hysterectomy at a tertiary hospital: a retrospective case-controlled study.

    Science.gov (United States)

    Rhou, Yoon J J; Pather, Selvan; Loadsman, John A; Campbell, Neil; Philp, Shannon; Carter, Jonathan

    2015-12-01

    To assess the direct intraoperative and postoperative costs in women undergoing total laparoscopic hysterectomy and fast-track open hysterectomy. A retrospective review of the direct hospital-related costs in a matched cohort of women undergoing total laparoscopic hysterectomy (TLH) and fast-track open hysterectomy (FTOH) at a tertiary hospital. All costs were calculated, including the cost of advanced high-energy laparoscopic devices. The effect of the learning curve on cost in laparoscopic hysterectomy was also assessed, as was the hospital case-weighted cost, which was compared with the actual cost. Fifty women were included in each arm of the study. TLH had a higher intraoperative cost, but a lower postoperative cost than FTOH (AUD$3877 vs AUD$2776 P funding model in our hospital is inaccurate when compared to directly calculated hospital costs. © 2013 The Authors ANZJOG © 2013 The Royal Australian and New Zealand College of Obstetricians and Gynaecologists.

  8. Differences in cannabis-related experiences between patients with a first episode of psychosis and controls.

    Science.gov (United States)

    Bianconi, F; Bonomo, M; Marconi, A; Kolliakou, A; Stilo, S A; Iyegbe, C; Gurillo Muñoz, P; Homayoun, S; Mondelli, V; Luzi, S; Dazzan, P; Prata, D; La Cascia, C; O'Connor, J; David, A; Morgan, C; Murray, R M; Lynskey, M; Di Forti, M

    2016-04-01

    Many studies have reported that cannabis use increases the risk of a first episode of psychosis (FEP). However, only a few studies have investigated the nature of cannabis-related experiences in FEP patients, and none has examined whether these experiences are similar in FEP and general populations. The aim of this study was to explore differences in self-reported cannabis experiences between FEP and non-psychotic populations. A total of 252 subjects, who met International Classification of Diseases (ICD)-10 criteria for FEP, and 217 controls who reported cannabis use were selected from the Genetics and Psychosis (GAP) study. The Medical Research Council Social Schedule and the Cannabis Experience Questionnaire were used to collect sociodemographic data and cannabis use information, respectively. Both 'bad' and 'enjoyable' experiences were more commonly reported by FEP subjects than controls. Principal components factor analysis identified four components which explained 62.3% of the variance. Linear regression analysis on the whole sample showed that the type of cannabis used and beliefs about the effect of cannabis on health all contributed to determining the intensity and frequency of experiences. Linear regression analysis on FEP subjects showed that the duration of cannabis use and amount of money spent on cannabis were strongly related to the intensity and frequency of enjoyable experiences in this population. These results suggest a higher sensitivity to cannabis effects among people who have suffered their first psychotic episode; this hypersensitivity results in them reporting both more 'bad' and 'enjoyable' experiences. The greater enjoyment experienced may provide an explanation of why FEP patients are more likely to use cannabis and to continue to use it despite experiencing an exacerbation of their psychotic symptoms.

  9. Relations among Perceived Parental Control, Warmth, Indulgence, and Family Harmony of Chinese in Mainland China.

    Science.gov (United States)

    Lau, Sing; And Others

    1990-01-01

    Results of a study of 925 educated Chinese who recalled child-rearing patterns of their parents indicated that greater perceived parental dominating control was related to less perceived parental warmth and that greater parental warmth and less parental control were related to greater perceived family harmony. (RH)

  10. Relative contribution of different altered motor unit control to muscle weakness in stroke: a simulation study

    Science.gov (United States)

    Shin, Henry; Suresh, Nina L.; Zev Rymer, William; Hu, Xiaogang

    2018-02-01

    Objective. Chronic muscle weakness impacts the majority of individuals after a stroke. The origins of this hemiparesis is multifaceted, and an altered spinal control of the motor unit (MU) pool can lead to muscle weakness. However, the relative contribution of different MU recruitment and discharge organization is not well understood. In this study, we sought to examine these different effects by utilizing a MU simulation with variations set to mimic the changes of MU control in stroke. Approach. Using a well-established model of the MU pool, this study quantified the changes in force output caused by changes in MU recruitment range and recruitment order, as well as MU firing rate organization at the population level. We additionally expanded the original model to include a fatigue component, which variably decreased the output force with increasing length of contraction. Differences in the force output at both the peak and fatigued time points across different excitation levels were quantified and compared across different sets of MU parameters. Main results. Across the different simulation parameters, we found that the main driving factor of the reduced force output was due to the compressed range of MU recruitment. Recruitment compression caused a decrease in total force across all excitation levels. Additionally, a compression of the range of MU firing rates also demonstrated a decrease in the force output mainly at the higher excitation levels. Lastly, changes to the recruitment order of MUs appeared to minimally impact the force output. Significance. We found that altered control of MUs alone, as simulated in this study, can lead to a substantial reduction in muscle force generation in stroke survivors. These findings may provide valuable insight for both clinicians and researchers in prescribing and developing different types of therapies for the rehabilitation and restoration of lost strength after stroke.

  11. Regionally differentiated air pollution control regulations in the installation-related emission control law of the Federal Republic of Germany

    International Nuclear Information System (INIS)

    Buettner, T.W.

    1992-01-01

    The volume treats an issue from the boundary zone between environmental law and environmental economics, namely the regionalization of air pollution control standards in installation-related emission control law. In order to examine the question of whether this proposal, which originates in the field of environmental economics, can be adopted and is purposeful, the author initially performs a complete inventorization of applicable norms, this covering emission control law, the law of regional planning, and the provisions of international law. This status quo is then reviewed using conformity and optimization criteria developed by the political sciences. The assessment comes to the conclusion that the introduction of regionally differentiated air pollution control standards is not desirable. The author further submits proposals for the streamlining of the law of installation-related air pollution control in the Federal Republic of Germany. (orig.) [de

  12. Brightest group galaxies - II: the relative contribution of BGGs to the total baryon content of groups at z < 1.3

    Science.gov (United States)

    Gozaliasl, Ghassem; Finoguenov, Alexis; Khosroshahi, Habib G.; Henriques, Bruno M. B.; Tanaka, Masayuki; Ilbert, Olivier; Wuyts, Stijn; McCracken, Henry J.; Montanari, Francesco

    2018-04-01

    We performed a detailed study of the evolution of the star formation rate (SFR) and stellar mass of the brightest group galaxies (BGGs) and their relative contribution to the total baryon budget within R200 (f^{BGG}_{b,200}). The sample comprises 407 BGGs selected from X-ray groups (M200 = 1012.8-1014 M⊙) out to z ˜ 1.3 identified in the Cosmic Evolution Survey (COSMOS), XMM Large-Scale Structure survey (XMM-LSS), and the All-Wavelength Extended Groth strip International Survey (AEGIS) fields. We find that BGGs constitute two distinct populations of quiescent and star-forming galaxies and their mean SFR is ˜2 dex higher than the median SFR at z 2 dex. We take into account the halo mass growth of groups in selecting the sample of BGGs and find that the mean (median) stellar mass of BGGs has grown by 0.3 dex since z = 1.3 to the present day. We show that up to ˜ 45 per cent of the stellar mass growth in a star-forming BGG can be due to its star formation activity. With respect to f^{BGG}_{b,200}, we find it to increase with decreasing redshift by ˜0.35 dex, while decreasing with halo mass in a redshift-dependent manner. We show that the slope of the relation between f^{BGG}_{b,200} and halo mass increases negatively with decreasing redshift. This trend is driven by an insufficient star formation in BGGs, compared to the halo growth rate. We separately show the BGGs with the 20 per cent highest f^{BGG}_{b,200} are generally non-star-forming galaxies and grow in mass by processes not related to star formation (e.g. dry mergers and tidal striping). We present the M⋆-Mh and M⋆/Mh-Mh relations and compare them with semi-analytic model predictions and a number of results from the literature. We quantify the intrinsic scatter in stellar mass of BGGs at