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Sample records for replace oswer directive

  1. Directed Replacement

    CERN Document Server

    Karttunen, L

    1996-01-01

    This paper introduces to the finite-state calculus a family of directed replace operators. In contrast to the simple replace expression, UPPER -> LOWER, defined in Karttunen (ACL-95), the new directed version, UPPER @-> LOWER, yields an unambiguous transducer if the lower language consists of a single string. It transduces the input string from left to right, making only the longest possible replacement at each point. A new type of replacement expression, UPPER @-> PREFIX ... SUFFIX, yields a transducer that inserts text around strings that are instances of UPPER. The symbol ... denotes the matching part of the input which itself remains unchanged. PREFIX and SUFFIX are regular expressions describing the insertions. Expressions of the type UPPER @-> PREFIX ... SUFFIX may be used to compose a deterministic parser for a ``local grammar'' in the sense of Gross (1989). Other useful applications of directed replacement include tokenization and filtering of text streams.

  2. Replacement

    Directory of Open Access Journals (Sweden)

    S. Radhakrishnan

    2014-03-01

    Full Text Available The fishmeal replaced with Spirulina platensis, Chlorella vulgaris and Azolla pinnata and the formulated diet fed to Macrobrachium rosenbergii postlarvae to assess the enhancement ability of non-enzymatic antioxidants (vitamin C and E, enzymatic antioxidants (superoxide dismutase (SOD and catalase (CAT and lipid peroxidation (LPx were analysed. In the present study, the S. platensis, C. vulgaris and A. pinnata inclusion diet fed groups had significant (P < 0.05 improvement in the levels of vitamins C and E in the hepatopancreas and muscle tissue. Among all the diets, the replacement materials in 50% incorporated feed fed groups showed better performance when compared with the control group in non-enzymatic antioxidant activity. The 50% fishmeal replacement (best performance diet fed groups taken for enzymatic antioxidant study, in SOD, CAT and LPx showed no significant increases when compared with the control group. Hence, the present results revealed that the formulated feed enhanced the vitamins C and E, the result of decreased level of enzymatic antioxidants (SOD, CAT and LPx revealed that these feeds are non-toxic and do not produce any stress to postlarvae. These ingredients can be used as an alternative protein source for sustainable Macrobrachium culture.

  3. Directional cultural change by modification and replacement of memes.

    Science.gov (United States)

    Cardoso, Gonçalo C; Atwell, Jonathan W

    2011-01-01

    Evolutionary approaches to culture remain contentious. A source of contention is that cultural mutation may be substantial and, if it drives cultural change, then current evolutionary models are not adequate. But we lack studies quantifying the contribution of mutations to directional cultural change. We estimated the contribution of one type of cultural mutations--modification of memes--to directional cultural change using an amenable study system: learned birdsongs in a species that recently entered an urban habitat. Many songbirds have higher minimum song frequency in cities, to alleviate masking by low-frequency noise. We estimated that the input of meme modifications in an urban songbird population explains about half the extent of the population divergence in song frequency. This contribution of cultural mutations is large, but insufficient to explain the entire population divergence. The remaining divergence is due to selection of memes or creation of new memes. We conclude that the input of cultural mutations can be quantitatively important, unlike in genetic evolution, and that it operates together with other mechanisms of cultural evolution. For this and other traits, in which the input of cultural mutations might be important, quantitative studies of cultural mutation are necessary to calibrate realistic models of cultural evolution.

  4. DIRECTIONAL CULTURAL CHANGE BY MODIFICATION AND REPLACEMENT OF MEMES

    Science.gov (United States)

    Cardoso, Gonçalo C.; Atwell, Jonathan W.

    2017-01-01

    Evolutionary approaches to culture remain contentious. A source of contention is that cultural mutation may be substantial and, if it drives cultural change, then current evolutionary models are not adequate. But we lack studies quantifying the contribution of mutations to directional cultural change. We estimated the contribution of one type of cultural mutations—modification of memes—to directional cultural change using an amenable study system: learned birdsongs in a species that recently entered an urban habitat. Many songbirds have higher minimum song frequency in cities, to alleviate masking by low-frequency noise. We estimated that the input of meme modifications in an urban songbird population explains about half the extent of the population divergence in song frequency. This contribution of cultural mutations is large, but insufficient to explain the entire population divergence. The remaining divergence is due to selection of memes or creation of new memes. We conclude that the input of cultural mutations can be quantitatively important, unlike in genetic evolution, and that it operates together with other mechanisms of cultural evolution. For this and other traits, in which the input of cultural mutations might be important, quantitative studies of cultural mutation are necessary to calibrate realistic models of cultural evolution. PMID:20722726

  5. Factors affecting the placement or replacement of direct restorations in a dental school

    Directory of Open Access Journals (Sweden)

    Samara Silvani

    2014-01-01

    Full Text Available Context: The knowledge of the reasons for the placement of direct restorations makes possible to trace an epidemiological profile of a specific population and to direct the teaching of dentistry to techniques that are commonly used today and will be continued performed in the future. Purpose: The aim of this study was to verify the reasons for placement and replacement of direct restorations in patients treated in the Dental Clinic of the Uberaba University - Brazil. Materials and Methods: This study evaluated 306 restorative procedures carried out on 60 patients. During the treatment planning, a form that contained information about the patient′s gender, tooth number, the classification of restorations, the reasons for placement and replacement of amalgam and tooth-colored restorations, the material that had to be removed and the new material used to fill the cavities was filled for each patient. Statistical analysis was carried out using Chi-square test (α = 0.05. Results: The data showed that most of the patients were female (66.7%. Of all the restorations placed, 60.45% were 1 st -time placements, while 39.55% were replacements. For 1 st -time restorations, the main reason for placement was primary caries (76.76%, followed by non-carious cervical lesions (15.14%. The amalgam restorations were replaced more frequently (67.77%. The primary reason for replacements was the presence of secondary caries (for both previous amalgam (42.68% and composite (66.67% restorations (P < 0.05. The resin composite was the most indicated material for the new restorations (98.04% (P < 0.05. Conclusions: The main reason for placement of direct restorations was primary caries, while secondary caries was the main reason for replacements. In almost all cases, the material used to fill the cavities was the resin composite.

  6. Repair vs replacement of direct composite restorations: a survey of teaching and operative techniques in Oceania.

    Science.gov (United States)

    Brunton, Paul A; Ghazali, Amna; Tarif, Zahidah H; Loch, Carolina; Lynch, Christopher; Wilson, Nairn; Blum, Igor R

    2017-04-01

    To evaluate the teaching and operative techniques for the repair and/or replacement of direct resin-based composite restorations (DCRs) in dental schools in Oceania. A 14-item questionnaire was mailed to the heads of operative dentistry in 16 dental schools in Oceania (Australia, New Zealand, Fiji and Papua New Guinea). The survey asked whether the repair of DCRs was taught within the curriculum; the rationale behind the teaching; how techniques were taught, indications for repair, operative techniques, materials used, patient acceptability, expected longevity and recall systems. All 16 schools participated in the study. Thirteen (81%) reported the teaching of composite repairs as an alternative to replacement. Most schools taught the theoretical and practical aspects of repair at a clinical level only. All 13 schools (100%) agreed on tooth substance preservation being the main reason for teaching repair. The main indications for repair were marginal defects (100%), followed by secondary caries (69%). All 13 schools that performed repairs reported high patient acceptability, and considered it a definitive measure. Only three schools (23%) claimed to have a recall system in place following repair of DCRs. Most respondents either did not know or did not answer when asked about the longevity of DCRs. Repair of DCRs seems to be a viable alternative to replacement, which is actively taught within Oceania. Advantages include it being minimally invasive, preserving tooth structure, and time and money saving. However, standardised guidelines need to be developed and further clinical long-term studies need to be carried out. The decision between replacing or repairing a defective composite restoration tends to be based on what clinicians have been taught, tempered by experience and judgement. This study investigated the current status of teaching and operative techniques of repair of direct composite restorations in dental schools in Oceania. Copyright © 2017 Elsevier Ltd

  7. Development of Therapeutic Chimeric Uricase by Exon Replacement/Restoration and Site-Directed Mutagenesis

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    Guangrong Xie

    2016-05-01

    Full Text Available The activity of urate oxidase was lost during hominoid evolution, resulting in high susceptibility to hyperuricemia and gout in humans. In order to develop a more “human-like” uricase for therapeutic use, exon replacement/restoration and site-directed mutagenesis were performed to obtain porcine–human uricase with higher homology to deduced human uricase (dHU and increased uricolytic activity. In an exon replacement study, substitution of exon 6 in wild porcine uricase (wPU gene with corresponding exon in dhu totally abolished its activity. Substitutions of exon 5, 3, and 1–2 led to 85%, 60%, and 45% loss of activity, respectively. However, replacement of exon 4 and 7–8 did not significantly change the enzyme activity. When exon 5, 6, and 3 in dhu were replaced by their counterparts in wpu, the resulting chimera H1-2P3H4P5-6H7-8 was active, but only about 28% of wPU. Multiple sequence alignment and homology modeling predicted that mutations of E24D and E83G in H1-2P3H4P5-6H7-8 were favorable for further increase of its activity. After site-directed mutagenesis, H1-2P3H4P5-6H7-8 (E24D & E83G with increased homology (91.45% with dHU and higher activity and catalytic efficiency than the FDA-approved porcine–baboon chimera (PBC was obtained. It showed optimum activity at pH 8.5 and 35 °C and was stable in a pH range of 6.5–11.0 and temperature range of 20–40 °C.

  8. Sapien XT Transcatheter Mitral Valve Replacement Under Direct Vision in the Setting of Significant Mitral Annular Calcification.

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    Murashita, Takashi; Suri, Rakesh M; Daly, Richard C

    2016-03-01

    Mitral valve replacement carries a high risk in patients with extensive mitral annular calcification. We report the case of a 71-year-old woman with severely calcified mitral valve stenosis and extensive annular calcification. We approached the mitral valve through a left atriotomy using cardiopulmonary bypass and cardiac arrest. We successfully deployed a 29-mm Sapien XT valve under direct visualization with satisfactory positioning. We further balloon-expanded the device to diminish the likelihood of periprosthetic regurgitation. Open mitral valve replacement with a transcatheter valve can be performed without the need for decalcification of the mitral annulus and is a good alternative to conventional mitral valve replacement.

  9. High-efficiency microstructured semiconductor neutron detectors for direct {sup 3}He replacement

    Energy Technology Data Exchange (ETDEWEB)

    Fronk, R.G., E-mail: rfronk@ksu.edu [S.M.A.R.T. Laboratory, Department of Mechanical and Nuclear Engineering, Kansas State University, Manhattan, KS 66506 (United States); Bellinger, S.L.; Henson, L.C. [S.M.A.R.T. Laboratory, Department of Mechanical and Nuclear Engineering, Kansas State University, Manhattan, KS 66506 (United States); Huddleston, D.E. [Electronics Design Laboratory, Kansas State University, Manhattan, KS 66506 (United States); Ochs, T.R. [S.M.A.R.T. Laboratory, Department of Mechanical and Nuclear Engineering, Kansas State University, Manhattan, KS 66506 (United States); Sobering, T.J. [Electronics Design Laboratory, Kansas State University, Manhattan, KS 66506 (United States); McGregor, D.S. [S.M.A.R.T. Laboratory, Department of Mechanical and Nuclear Engineering, Kansas State University, Manhattan, KS 66506 (United States)

    2015-04-11

    High-efficiency Microstructured Semiconductor Neutron Detectors (MSNDs) have been tiled and arranged in a cylindrical form factor in order to serve as a direct replacement to aging and increasingly expensive {sup 3}He gas-filled proportional neutron detectors. Two 6-in long by 2-in diameter cylinders were constructed and populated with MSNDs which were then directly compared to a 4 atm Reuter Stokes {sup 3}He detector of the same dimensions. The Generation 1 MSND-based {sup 3}Helium-Replacement (HeRep Mk I) device contained sixty-four 1-cm{sup 2} active-area MSNDs, each with an intrinsic neutron detection efficiency of approximately 7%. A Generation 2 device (the HeRep Mk II) was populated with thirty 4-cm{sup 2} active-area MSNDs, with an intrinsic thermal neutron detection efficiency of approximately 30%. The MSNDs of each HeRep were integrated to count as a single device. The {sup 3}He proportional counter and the HeRep devices were tested while encased in a cylinder of high-density polyethylene measuring a total of 6-in by 9-in. The {sup 3}He counter and the HeRep Mk II were each placed 1 m from a 54-ng {sup 252}Cf source and tested for efficiency. The {sup 3}He proportional counter had a net count rate of 17.13±0.10 cps at 1 m. The HeRep Mk II device had a net count rate of 17.60±0.10 cps, amounting to 102.71±2.65% of the {sup 3}He gas counter while inside of the moderator. Outside of moderator, the {sup 3}He tube had a count rate of 3.35±0.05 cps and the HeRep Mk II device reported 3.19±05, amounting to 95.15±9.04% of the {sup 3}He neutron detector.

  10. Clinical longevity of extensive direct composite restorations in amalgam replacement : Up to 3.5 years follow-up

    NARCIS (Netherlands)

    Scholtanus, Johannes D.; Ozcan, Mutlu

    2014-01-01

    Objectives: This prospective clinical trial evaluated the longevity of direct resin composite (DRC) restorations made on stained dentin that is exposed upon removal of existing amalgam restorations in extensive cavities with severely reduced macro-mechanical retention for amalgam replacement. Method

  11. Some Direct and Generalized Effects of Replacing an Autistic Man's Echolalia with Correct Responses to Questions.

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    McMorrow, Martin J.; Foxx, R. M.

    1986-01-01

    The use of operant procedures was extended to decrease immediate echolalia and increase appropriate responding to questions of a 21-year-old autistic man. Multiple baseline designs demonstrated that echolalia was rapidly replaced with correct stimulus-specific responses. A variety of generalized improvements were observed in verbal responses to…

  12. Direct monophasic replacement of fatty acid by DMSA on SPION surface

    Energy Technology Data Exchange (ETDEWEB)

    Gogoi, M. [Department of Physics, Tezpur University (Central University), Tezpur 784028 (India); Deb, P., E-mail: pdeb@tezu.ernet.in [Department of Physics, Tezpur University (Central University), Tezpur 784028 (India); Interface Chemistry and Surface Engineering, Max-Planck-Institut fuer Eisenforschung GmbH, Max-Planck-Strasse 1, 40237 Duesseldorf (Germany); Vasan, G.; Keil, P.; Kostka, A.; Erbe, A. [Interface Chemistry and Surface Engineering, Max-Planck-Institut fuer Eisenforschung GmbH, Max-Planck-Strasse 1, 40237 Duesseldorf (Germany)

    2012-10-01

    Highlights: Black-Right-Pointing-Pointer Monophasic replacement of fatty acid coating. Black-Right-Pointing-Pointer Ultrastable dispersion of hydrophilic SPION in a wide pH range. Black-Right-Pointing-Pointer Unaltered microstructure and property on surface modification. - Abstract: Tailoring the surface and understanding the surface characteristics is necessary for biomedical applications of superparamagnetic nanoparticles. In this paper, superparamagnetic iron oxide nanoparticles (SPIONs) were prepared by thermal decomposition of iron nitrate in presence of stearic acid as surfactant. Due to the multilayer organization of surfactant molecules over the nanoparticle surface, the surface potential can be tuned by pH changes and hence the nanoparticles can be made dispersible in nonpolar as well as in polar solvents. We have presented a simple, facile procedure for controlled replacement of stearic acid from maghemite surface and subsequent derivatization by biocompatible dimercaptosuccinic acid (DMSA) to obtain ultrastable hydrophilic nanoparticles with unaltered morphology, phase and properties. The surface chemistry of the functionalized SPIONs was analyzed by Fourier transform infrared spectroscopy (FTIR), thermogravimetric analysis (TGA) and X-ray photoelectron spectroscopy (XPS) revealing the presence of bound and unbound thiol groups and disulfides, leading to its prolonged stability in aqueous medium. The consequence of spatially selective functionalization on the stability and solubility of surface hydrophilic SPION has also been realized.

  13. Direct monophasic replacement of fatty acid by DMSA on SPION surface

    Science.gov (United States)

    Gogoi, M.; Deb, P.; Vasan, G.; Keil, P.; Kostka, A.; Erbe, A.

    2012-10-01

    Tailoring the surface and understanding the surface characteristics is necessary for biomedical applications of superparamagnetic nanoparticles. In this paper, superparamagnetic iron oxide nanoparticles (SPIONs) were prepared by thermal decomposition of iron nitrate in presence of stearic acid as surfactant. Due to the multilayer organization of surfactant molecules over the nanoparticle surface, the surface potential can be tuned by pH changes and hence the nanoparticles can be made dispersible in nonpolar as well as in polar solvents. We have presented a simple, facile procedure for controlled replacement of stearic acid from maghemite surface and subsequent derivatization by biocompatible dimercaptosuccinic acid (DMSA) to obtain ultrastable hydrophilic nanoparticles with unaltered morphology, phase and properties. The surface chemistry of the functionalized SPIONs was analyzed by Fourier transform infrared spectroscopy (FTIR), thermogravimetric analysis (TGA) and X-ray photoelectron spectroscopy (XPS) revealing the presence of bound and unbound thiol groups and disulfides, leading to its prolonged stability in aqueous medium. The consequence of spatially selective functionalization on the stability and solubility of surface hydrophilic SPION has also been realized.

  14. Short communication: Effects of increasing protein and energy in the milk replacer with or without direct-fed microbial supplementation on growth and performance of preweaned Holstein calves.

    Science.gov (United States)

    Geiger, A J; Ward, S H; Williams, C C; Rude, B J; Cabrera, C J; Kalestch, K N; Voelz, B E

    2014-11-01

    Forty-four Holstein calves were fed a direct-fed microbial (DFM) and 1 of 2 milk replacers to evaluate calf performance and growth. Treatments were (1) a control milk replacer [22:20; 22% crude protein (CP) and 20% fat], (2) an accelerated milk replacer (27:10; 27% CP and 10% fat), (3) the control milk replacer with added DFM (22:20+D), and (4) the accelerated milk replacer with added DFM (27:10+D). Dry matter intake, rectal temperatures, respiration scores and rates, and fecal scores were collected daily. Body weight, hip and withers height, heart girth, blood, and rumen fluid samples were collected weekly. Effects of treatment, sex, week, and their interactions were analyzed. Calves fed an accelerated milk replacer, regardless of DFM supplementation, consumed more CP and metabolizable energy in the milk replacer. No treatment differences were found for starter intake or intake of neutral detergent fiber or acid detergent fiber in the starter. Calves fed the accelerated milk replacer had greater preweaning and weaning body weight compared with calves fed the control milk replacer. Average daily gain was greater during the preweaning period for calves fed the accelerated milk replacer, but the same pattern did not hold true during the postweaning period. Feed efficiency did not differ among treatments. Hip height tended to be and withers height and heart girth were greater at weaning for calves fed the accelerated milk replacer compared with calves fed the control milk replacer. Fecal scores were greatest in calves fed DFM. Overall acetate, propionate, butyrate, and n-valerate concentrations were lower in calves fed the accelerated milk replacer, but DFM did not have an effect. Rumen pH was not different. Blood metabolites were unaffected by DFM supplementation, but calves fed the accelerated milk replacer had increased partial pressure of CO2, bicarbonate, and total bicarbonate in the blood. Direct-fed microbial supplementation did not appear to benefit the calf

  15. Direct evidence for redundant segmental replacement between multiple 18S rRNA genes in a single Prototheca strain.

    Science.gov (United States)

    Ueno, Ryohei; Huss, Volker A R; Urano, Naoto; Watabe, Shugo

    2007-11-01

    Informational genes such as those encoding rRNAs are related to transcription and translation, and are thus considered to be rarely subject to lateral gene transfer (LGT) between different organisms, compared to operational genes having metabolic functions. However, several lines of evidence have suggested or confirmed the occurrence of LGT of DNA segments encoding evolutionarily variable regions of rRNA genes between different organisms. In the present paper, we show, for the first time to our knowledge, that variable regions of the 18S rRNA gene are segmentally replaced by multiple copies of different sequences in a single strain of the green microalga Prototheca wickerhamii, resulting in at least 17 genotypes, nine of which were actually transcribed. Recombination between different 18S rRNA genes occurred in seven out of eight variable regions (V1-V5 and V7-V9) of eukaryotic small subunit (SSU) rRNAs. While no recombination was observed in V1, one to three different recombination loci were demonstrated for the other regions. Such segmental replacement was also implicated for helix H37, which is defined as V6 of prokaryotic SSU rRNAs. Our observations provide direct evidence for redundant recombination of an informational gene, which encodes a component of mature ribosomes, in a single strain of one organism.

  16. Final OSWER Vapor Intrusion Guidance

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    EPA is preparing to finalize its guidance on assessing and addressing vapor intrusion, which is defined as migration of volatile constituents from contaminated media in the subsurface (soil or groundwater) into the indoor environment. In November 2002, EPA issued draft guidance o...

  17. Characterization of Site-Directed Mutants in the lac Permease of Escherichia coli. 1. Replacement of Histidine Residues

    NARCIS (Netherlands)

    Püttner, Irene B.; Sarkar, Hemanta K.; Padan, Etana; Lolkema, Julius S.; Kaback, H. Ronald

    1989-01-01

    Wild-type lac permease from Escherichia coli and two site-directed mutant permeases containing Arg in place of His35 and His39 or His322 were purified and reconstituted into proteoliposomes. H35-39R permease is indistinguishable from wild type with regard to all modes of translocation. In contrast,

  18. A Distinct Subpopulation of Bone Marrow Mesenchymal Stem Cells, Muse Cells, Directly Commit to the Replacement of Liver Components.

    Science.gov (United States)

    Katagiri, H; Kushida, Y; Nojima, M; Kuroda, Y; Wakao, S; Ishida, K; Endo, F; Kume, K; Takahara, T; Nitta, H; Tsuda, H; Dezawa, M; Nishizuka, S S

    2016-02-01

    Genotyping graft livers by short tandem repeats after human living-donor liver transplantation (n = 20) revealed the presence of recipient or chimeric genotype cases in hepatocytes (6 of 17, 35.3%), sinusoidal cells (18 of 18, 100%), cholangiocytes (15 of 17, 88.2%) and cells in the periportal areas (7 of 8, 87.5%), suggesting extrahepatic cell involvement in liver regeneration. Regarding extrahepatic origin, bone marrow mesenchymal stem cells (BM-MSCs) have been suggested to contribute to liver regeneration but compose a heterogeneous population. We focused on a more specific subpopulation (1-2% of BM-MSCs), called multilineage-differentiating stress-enduring (Muse) cells, for their ability to differentiate into liver-lineage cells and repair tissue. We generated a physical partial hepatectomy model in immunodeficient mice and injected green fluorescent protein (GFP)-labeled human BM-MSC Muse cells intravenously (n = 20). Immunohistochemistry, fluorescence in situ hybridization and species-specific polymerase chain reaction revealed that they integrated into regenerating areas and expressed liver progenitor markers during the early phase and then differentiated spontaneously into major liver components, including hepatocytes (≈74.3% of GFP-positive integrated Muse cells), cholangiocytes (≈17.7%), sinusoidal endothelial cells (≈2.0%), and Kupffer cells (≈6.0%). In contrast, the remaining cells in the BM-MSCs were not detected in the liver for up to 4 weeks. These results suggest that Muse cells are the predominant population of BM-MSCs that are capable of replacing major liver components during liver regeneration.

  19. Using a magnetite/thermoplastic composite in 3D printing of direct replacements for commercially available flow sensors

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    Leigh, S. J.; Purssell, C. P.; Billson, D. R.; Hutchins, D. A.

    2014-09-01

    Flow sensing is an essential technique required for a wide range of application environments ranging from liquid dispensing to utility monitoring. A number of different methodologies and deployment strategies have been devised to cover the diverse range of potential application areas. The ability to easily create new bespoke sensors for new applications is therefore of natural interest. Fused deposition modelling is a 3D printing technology based upon the fabrication of 3D structures in a layer-by-layer fashion using extruded strands of molten thermoplastic. The technology was developed in the late 1980s but has only recently come to more wide-scale attention outside of specialist applications and rapid prototyping due to the advent of low-cost 3D printing platforms such as the RepRap. Due to the relatively low-cost of the printers and feedstock materials, these printers are ideal candidates for wide-scale installation as localized manufacturing platforms to quickly produce replacement parts when components fail. One of the current limitations with the technology is the availability of functional printing materials to facilitate production of complex functional 3D objects and devices beyond mere concept prototypes. This paper presents the formulation of a simple magnetite nanoparticle-loaded thermoplastic composite and its incorporation into a 3D printed flow-sensor in order to mimic the function of a commercially available flow-sensing device. Using the multi-material printing capability of the 3D printer allows a much smaller amount of functional material to be used in comparison to the commercial flow sensor by only placing the material where it is specifically required. Analysis of the printed sensor also revealed a much more linear response to increasing flow rate of water showing that 3D printed devices have the potential to at least perform as well as a conventionally produced sensor.

  20. Ankle replacement

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    Ankle arthroplasty - total; Total ankle arthroplasty; Endoprosthetic ankle replacement; Ankle surgery ... You may not be able to have a total ankle replacement if you have had ankle joint infections in ...

  1. Knee Replacement

    Science.gov (United States)

    Knee replacement is surgery for people with severe knee damage. Knee replacement can relieve pain and allow you to ... Your doctor may recommend it if you have knee pain and medicine and other treatments are not ...

  2. Replacing surrogate measures by direct quantification of ultraviolet radiation exposure in registry-based analyses of seasonality of melanoma diagnoses.

    Science.gov (United States)

    Keller, Andrea K; Uter, Wolfgang; Pfahlberg, Annette B; Radespiel-Tröger, Martin; Mayer, Ingo; Gefeller, Olaf

    2015-12-01

    Seasonal variation in melanoma diagnoses has been observed in numerous studies that used calendar time indicators. Depending on the latitude (and altitude) of the study region, the magnitude of seasonal and year-to-year variation of ultraviolet radiation (UVR) is neglected in these studies. An alternative approach comprises the direct incorporation of UVR measurements into such analyses. The aim of this investigation is a comparative evaluation of these approaches. The population-based Bavarian cancer registry recorded 11 901 incident melanoma cases between 2003 and 2008 that were used for the analysis. UVR intensity data for the same period were available from the solar radiation station at Munich-Neuherberg. Negative binomial regression modelling yielded adjusted relative risks (RR) controlled for year of diagnosis and age in 16 subgroups defined by sex, Breslow thickness and localization. Overall, the analyses showed slightly differing yet consistent results for exposure effects in subgroups. Melanoma evolving on the extremities showed the most pronounced association with increasing level of the UV index among men [e.g. RR=1.086, 95% confidence interval (CI) 1.054-1.119, and RR=1.102, 95% CI 1.046-1.161, for thin and thick melanoma on the upper limbs, respectively] and women (e.g. RR=1.088, 95% CI 1.058-1.119, and RR=1.056, 95% CI 1.010-1.103, for thin and thick melanoma on the lower limbs, respectively). Our analysis provides a benchmark for international comparisons and synthesis of epidemiologic evidence of seasonal variability in melanoma diagnoses. Future studies should use direct UVR measures to enable pooling of risk estimates and resolve remaining inconsistencies potentially resulting from latitudinal differences in exposure between international studies.

  3. Knee Replacement

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    ... need knee replacement surgery usually have problems walking, climbing stairs, and getting in and out of chairs. Some ... a total living space on one floor since climbing stairs can be difficult. Install safety bars or a ...

  4. Replacing penalties

    Directory of Open Access Journals (Sweden)

    Vitaly Stepashin

    2017-01-01

    Full Text Available УДК 343.24The subject. The article deals with the problem of the use of "substitute" penalties.The purpose of the article is to identify criminal and legal criteria for: selecting the replacement punishment; proportionality replacement leave punishment to others (the formalization of replacement; actually increasing the punishment (worsening of legal situation of the convicted.Methodology.The author uses the method of analysis and synthesis, formal legal method.Results. Replacing the punishment more severe as a result of malicious evasion from serving accused designated penalty requires the optimization of the following areas: 1 the selection of a substitute punishment; 2 replacement of proportionality is serving a sentence other (formalization of replacement; 3 ensuring the actual toughening penalties (deterioration of the legal status of the convict. It is important that the first two requirements pro-vide savings of repression in the implementation of the replacement of one form of punishment to others.Replacement of punishment on their own do not have any specifics. However, it is necessary to compare them with the contents of the punishment, which the convict from serving maliciously evaded. First, substitute the punishment should assume a more significant range of restrictions and deprivation of certain rights of the convict. Second, the perfor-mance characteristics of order substitute the punishment should assume guarantee imple-mentation of the new measures.With regard to replacing all forms of punishment are set significant limitations in the application that, in some cases, eliminates the possibility of replacement of the sentence, from serving where there has been willful evasion, a stricter measure of state coercion. It is important in the context of the topic and the possibility of a sentence of imprisonment as a substitute punishment in cases where the original purpose of the strict measures excluded. It is noteworthy that the

  5. Esophageal replacement.

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    Kunisaki, Shaun M; Coran, Arnold G

    2017-04-01

    This article focuses on esophageal replacement as a surgical option for pediatric patients with end-stage esophageal disease. While it is obvious that the patient׳s own esophagus is the best esophagus, persisting with attempts to retain a native esophagus with no function and at all costs are futile and usually detrimental to the overall well-being of the child. In such cases, the esophagus should be abandoned, and the appropriate esophageal replacement is chosen for definitive reconstruction. We review the various types of conduits used for esophageal replacement and discuss the unique advantages and disadvantages that are relevant for clinical decision-making. Copyright © 2017 Elsevier Inc. All rights reserved.

  6. 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

  7. Directly replaces of a minors and “exemplary” of a disability person: The patrimony of a persons with disability or minors 14 years old

    Directory of Open Access Journals (Sweden)

    Mª Fernanda Moretón Sanz

    2015-04-01

    Full Text Available This research study the law, the jurisprudence and the law literatury of aspects of replaces of a minors and “exemplary” of a disability persons. It is fact that used by the testator, have different impact about the patrimony of de minors and persons whit disability. In the substitution or replaces, the object will depend on the means the testator deciding on the disposal heritage. Specifically, despite certain resistance from legal thought and case-law, in the substitution of a minor and in exemplary replace, the substitute (parent or legal representative may dispose of all the of the person substituted (child under 14 years of age or legal incapacitated person. Therefore, both types of substitution affect to the persons substituted and the patrimony of them

  8. Solving the replacement paths problem for planar directed graphs in O(logn) time

    DEFF Research Database (Denmark)

    Wulff-Nilsen, Christian

    2010-01-01

    In a graph G with non-negative edge lengths, let P be a shortest path from a vertex s to a vertex t. We consider the problem of computing, for each edge e on P, the length of a shortest path in G from s to t that avoids e. This is known as the replacement paths problem. We give a linearspace algo...

  9. [Estrogen replacement].

    Science.gov (United States)

    Søgaard, A J; Berntsen, G K; Magnus, J H; Tollan, A

    1998-02-10

    Recent research on long-term postmenopausal hormone replacement therapy (HRT) indicates a positive effect on both total mortality and morbidity. This has raised the question of widespread preventive long-term use of HRT. Possible side-effects and ideological issues related to preventive HRT have led to debate and uncertainty among health professionals, in the media, and in the population at large. In order to evaluate the level of knowledge about and attitudes towards HRT, a randomly selected group of 737 Norwegian women aged 16-79 was interviewed by the Central Bureau of Statistics. One in three women had received information about HRT in the last two years, mainly through weekly magazines and physicians. The proportion who answered the questions on knowledge correctly varied from 36% to 47%. Those who had been given information by a physician possessed accurate knowledge, had more positive attitudes towards HRT and were more willing to use HRT than women who had reviewed information through other channels. Women with a higher level of education were better informed and more knowledgeable than others, but were nevertheless more reluctant to use HRT than those who were less educated. The limited number of women who actually receive information on HRT, the low level of knowledge and the ambivalent attitudes toward HRT are a major challenge to the public health service.

  10. Site-directed in vitro replacement of nucleosides in the anticodon loop of tRNA: application to the study of structural requirements for queuine insertase activity.

    Science.gov (United States)

    Carbon, P; Haumont, E; Fournier, M; de Henau, S; Grosjean, H

    1983-01-01

    We have investigated the specificity of the enzymes Q-insertase and mannosyl-Q transferase that replace the guanosine at position 34 (wobble base) in the anticodon of several tRNAs by Q or mannosyl-Q derivatives. We have restructured in vitro the normal anticodon of yeast tRNA-Asp-GUC, yeast tRNAArgICG and yeast tRNALeuUAG. With yeast tRNA-Asp-GUC, we have replaced one or several nucleotides in the vicinity of G34 by one of the four canonical nucleotides or by pseudouridylic acid; we have also constructed a tRNAAsp with eight bases instead of seven in the anticodon loop. With yeast tRNAArgICG and yeast tRNALeuUAG, we have replaced their anticodon by the trinucleotide GUC, coding for aspartic acid. The chimerical tRNAs were microinjected into the cytoplasm of Xenopus laevis oocytes and after 72 h the amount of Q34 and mannosyl-Q34 incorporated was measured. Our results show that the U33G34U35 sequence, within an anticodon loop of seven bases in chimerical yeast tRNA-Asp-GUC, tRNAArgGUC or tRNALeuGUC, is the main determinant for Q-insertase activity at position 34; the rest of the tRNA sequence has only a slight influence. For mannosyl-Q transferase, however, a much broader structural feature of the tRNA than just the U33G34U35 sequence is important for the efficiency of Q34 transformation into mannosyl-Q34.

  11. Faster Replacement Paths

    CERN Document Server

    Williams, Virginia Vassilevska

    2010-01-01

    The replacement paths problem for directed graphs is to find for given nodes s and t and every edge e on the shortest path between them, the shortest path between s and t which avoids e. For unweighted directed graphs on n vertices, the best known algorithm runtime was \\tilde{O}(n^{2.5}) by Roditty and Zwick. For graphs with integer weights in {-M,...,M}, Weimann and Yuster recently showed that one can use fast matrix multiplication and solve the problem in O(Mn^{2.584}) time, a runtime which would be O(Mn^{2.33}) if the exponent \\omega of matrix multiplication is 2. We improve both of these algorithms. Our new algorithm also relies on fast matrix multiplication and runs in O(M n^{\\omega} polylog(n)) time if \\omega>2 and O(n^{2+\\eps}) for any \\eps>0 if \\omega=2. Our result shows that, at least for small integer weights, the replacement paths problem in directed graphs may be easier than the related all pairs shortest paths problem in directed graphs, as the current best runtime for the latter is \\Omega(n^{2.5...

  12. Testosterone replacement effectively inhibits the development of experimental autoimmune orchitis in rats: evidence for a direct role of testosterone on regulatory T cell expansion.

    Science.gov (United States)

    Fijak, Monika; Schneider, Eva; Klug, Jörg; Bhushan, Sudhanshu; Hackstein, Holger; Schuler, Gerhard; Wygrecka, Malgorzata; Gromoll, Jörg; Meinhardt, Andreas

    2011-05-01

    Despite the immune-privileged status of the male genital tract, infection and inflammation of the male genital tract are important etiological factors in male infertility. A common observation in clinical and experimental orchitis as well as in systemic infection and inflammation are decreased levels of testosterone. Emerging data point to an immunosuppressive role of testosterone. In our study, we substituted testosterone levels in experimental autoimmune orchitis (EAO) in rat by s.c. testosterone implants. EAO development was reduced to 17% when animals were treated with low-dose testosterone implants (3 cm long, EAO+T3) and to 33% when rats were supplied with high-dose testosterone implants (24 cm, EAO+T24) compared with 80% of animals developing disease in the EAO control group. In the testis, testosterone replacement in EAO animals prevented the accumulation of macrophages and significantly reduced the number of CD4(+) T cells with a strong concomitant increase in the number of regulatory T cells (CD4(+)CD25(+)Foxp3(+)) compared with EAO control. In vitro testosterone treatment of naive T cells led to an expansion of the regulatory T cell subset with suppressive activity and ameliorated MCP-1-stimulated chemotaxis of T lymphocytes in a Transwell assay. Moreover, expression of proinflammatory mediators such as MCP-1, TNF-α, and IL-6 in the testis and secretion of Th1 cytokines such as IFN-γ and IL-2 by mononuclear cells isolated from testicular draining lymph nodes were decreased in the EAO+T3 and EAO+T24 groups. Thus, our study shows an immunomodulatory and protective effect of testosterone substitution in the pathogenesis of EAO and suggests androgens as a new factor in the differentiation of regulatory T cells.

  13. Replacement of diesel oil by hydrous ethyl alcohol in direct burning: a comparison; Substituicao do oleo diesel por alcool etilico hidratado na queima direta: uma comparacao

    Energy Technology Data Exchange (ETDEWEB)

    Perez, Edgar Paz; Carvalho Junior, Joao Andrade de; Carrocci, Luiz Roberto [Universidade Estadual Paulista (FEG/UNESP), Guaratingueta, SP (Brazil). Fac. de Engenharia], Emails: edgarpaz@feg.unesp.br, joao@feg.unesp.br, carrocci@feg.unesp.br

    2006-07-01

    This article presents a study of the substitution of diesel fuel by ethyl alcohol in direct burning. The investigation is concentrated in the physical-chemical properties of the fuels, the combustion thermodynamics, the atomization, and the pollutants formation. Results show that hydrated ethyl alcohol can be an attractive alternative for diesel fuel, mainly by the benefits in the combustion process and the pollutants formation. Nevertheless, care must be taken in the substitution to prevent losses by evaporation, fire risks and material damage by corrosion. (author)

  14. Shoulder Joint Replacement

    Science.gov (United States)

    ... Shoulder Replacement Options Shoulder replacement surgery is highly technical. It should be performed by a surgical team ... area and will meet a doctor from the anesthesia department. You, your anesthesiologist, and your surgeon will ...

  15. Partial knee replacement - slideshow

    Science.gov (United States)

    ... page: //medlineplus.gov/ency/presentations/100225.htm Partial knee replacement - series—Normal anatomy To use the sharing ... A.M. Editorial team. Related MedlinePlus Health Topics Knee Replacement A.D.A.M., Inc. is accredited ...

  16. Direct Methanol Fuel Cell Battery Replacement Program

    Science.gov (United States)

    2011-04-11

    Electrochemical Society Meeting, ABS#1089, Oct. 16th 2008, Hawaii, USA. 2. Hall, T.D.; Grice, C.R.; Swenson, L.R.; Smotkin, E.S., “Reversible and irreversible...degradation modes of DMFC anode catalysts”, 212th Electrochemical Society Meeting, ABS#819, Oct. 14th 2008, Hawaii, USA. 3. Yuan Zhang, James Cooper...Paul McGinn “Combinatorial Screening of Fuel Cell Catalysts” 211th Electrochemical Society Meeting, Phoenix, AZ, May, 2008 4. Hall, T.D.; Grice, Corey

  17. [Mitral valve replacement after previous coronary artery bypass grafting with functioning left internal thoracic artery graft: effectiveness of the method using a direct vision retrosternal approach; report of a case].

    Science.gov (United States)

    Sakata, Junichi; Saito, Tatsuya; Fujii, Akira; Tsukamoto, Masaru; Date, Osamu; Yokoyama, Hideo; Abe, Tomio; Nakase, Atsunobu; Ohori, Katsumi

    2014-08-01

    Performing a redo-sternotomy when a mammary artery graft is patent can be rather difficult. We previously reported a redo-sternotomy technique involving direct visualization with a retrosternal dissection (DR) method using a Kent's retractor. The DR method in detail is as follows: 1) A midline skin incision is extended to the abdomen about 5 cm. 2) The bilateral costal arches are divided from the rectal muscle. 3). A pair of retractors is placed under the costal arch. 4) A stainless steel wire is applied to the previous sternal wire at the center of the sternum. 5) The retractor and sternal wire are lifted up using the Kent's retractor to widen the retrosternal space. 6) The sternum and sub-sternal tissue are carefully divided using an electronic scalpel or metal retractor with an entirely sternal length. 7) Routine sternotomy is performed using a Stryker. Herein, we report a patient who had undergone cardiac surgery, coronary artery bypass grafting (CABG), using a left internal mammary artery and mitral annuloplasty 2 years previously, and then developed mitral regurgitation caused by infectious endocarditis. He successfully underwent redo-sternotomy and mitral valve replacement using the DR method. In a patient with a patent internal mammary artery, the DR method greatly reduces the risk of graft injury.

  18. Aeronautical Information System Replacement -

    Data.gov (United States)

    Department of Transportation — Aeronautical Information System Replacement is a web-enabled, automation means for the collection and distribution of Service B messages, weather information, flight...

  19. Radiation Source Replacement Workshop

    Energy Technology Data Exchange (ETDEWEB)

    Griffin, Jeffrey W.; Moran, Traci L.; Bond, Leonard J.

    2010-12-01

    This report summarizes a Radiation Source Replacement Workshop in Houston Texas on October 27-28, 2010, which provided a forum for industry and researchers to exchange information and to discuss the issues relating to replacement of AmBe, and potentially other isotope sources used in well logging.

  20. In-frame amber stop codon replacement mutagenesis for the directed evolution of proteins containing non-canonical amino acids: identification of residues open to bio-orthogonal modification.

    Directory of Open Access Journals (Sweden)

    James A J Arpino

    Full Text Available Expanded genetic code approaches are a powerful means to add new and useful chemistry to proteins at defined residues positions. One such use is the introduction of non-biological reactive chemical handles for site-specific biocompatible orthogonal conjugation of proteins. Due to our currently limited information on the impact of non-canonical amino acids (nAAs on the protein structure-function relationship, rational protein engineering is a "hit and miss" approach to selecting suitable sites. Furthermore, dogma suggests surface exposed native residues should be the primary focus for introducing new conjugation chemistry. Here we describe a directed evolution approach to introduce and select for in-frame codon replacement to facilitate engineering proteins with nAAs. To demonstrate the approach, the commonly reprogrammed amber stop codon (TAG was randomly introduced in-frame in two different proteins: the bionanotechnologically important cyt b(562 and therapeutic protein KGF. The target protein is linked at the gene level to sfGFP via a TEV protease site. In absence of a nAA, an in-frame TAG will terminate translation resulting in a non-fluorescent cell phenotype. In the presence of a nAA, TAG will encode for nAA incorporation so instilling a green fluorescence phenotype on E. coli. The presence of endogenously expressed TEV proteases separates in vivo target protein from its fusion to sfGFP if expressed as a soluble fusion product. Using this approach, we incorporated an azide reactive handle and identified residue positions amenable to conjugation with a fluorescence dye via strain-promoted azide-alkyne cycloaddition (SPAAC. Interestingly, best positions for efficient conjugation via SPAAC were residues whose native side chain were buried through analysis of their determined 3D structures and thus may not have been chosen through rational protein engineering. Molecular modeling suggests these buried native residues could become partially

  1. Replacing a Missing Tooth

    Science.gov (United States)

    ... vessels in the tooth pulps are rather large. Drilling down these teeth for crowns may expose the ... porcelain replacement tooth is held in place by metal extensions cemented to the backs of the adjacent ...

  2. Hormone Replacement Therapy

    Science.gov (United States)

    ... before and during menopause, the levels of female hormones can go up and down. This can cause ... hot flashes and vaginal dryness. Some women take hormone replacement therapy (HRT), also called menopausal hormone therapy, ...

  3. Knee joint replacement

    Science.gov (United States)

    ... of your kneecap. Your kneecap is called the patella. The replacement part is usually made from a ... long. Then your surgeon will: Move your kneecap (patella) out of the way, then cut the ends ...

  4. Knee joint replacement - slideshow

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/presentations/100088.htm Knee joint replacement - series—Normal anatomy To use the ... to slide 4 out of 4 Overview The knee is a complex joint. It contains the distal ...

  5. Product Platform Replacements

    DEFF Research Database (Denmark)

    Sköld, Martin; Karlsson, Christer

    2012-01-01

    Purpose – It is argued in this article that too little is known about product platforms and how to deal with them from a manager's point of view. Specifically, little information exists regarding when old established platforms are replaced by new generations in R&D and production environments...... originality and value is achieved by focusing on product platform replacements believed to represent a growing management challenge....

  6. Robotic mitral valve replacement.

    Science.gov (United States)

    Senay, Sahin; Gullu, Ahmet Umit; Kocyigit, Muharrem; Degirmencioglu, Aleks; Karabulut, Hasan; Alhan, Cem

    2014-01-01

    Robotic surgical techniques allow surgeons to perform mitral valve surgery. This procedure has gained acceptance, particularly for mitral valve repair in degenerative mitral disease. However, mitral repair may not always be possible, especially in severely calcified mitral valve of rheumatic origin. This study demonstrates the basic concepts and technique of robotic mitral valve replacement for valve pathologies that are not suitable for repair.

  7. Replacing America's Job Bank

    Science.gov (United States)

    Vollman, Jim

    2009-01-01

    The Job Central National Labor Exchange (www.jobcentral.com) has become the effective replacement for America's Job Bank with state workforce agencies and, increasingly, with community colleges throughout the country. The American Association of Community Colleges (AACC) has formed a partnership with Job Central to promote its use throughout the…

  8. Replacing America's Job Bank

    Science.gov (United States)

    Vollman, Jim

    2009-01-01

    The Job Central National Labor Exchange (www.jobcentral.com) has become the effective replacement for America's Job Bank with state workforce agencies and, increasingly, with community colleges throughout the country. The American Association of Community Colleges (AACC) has formed a partnership with Job Central to promote its use throughout the…

  9. Total ankle replacement - surgical treatment and rehabilitation.

    Science.gov (United States)

    Prusinowska, Agnieszka; Krogulec, Zbigniew; Turski, Piotr; Przepiórski, Emil; Małdyk, Paweł; Księżopolska-Orłowska, Krystyna

    2015-01-01

    Functions of the ankle joint are closely connected with the gait and ability to maintain an upright position. Degenerative lesions of the joint directly contribute to postural disorders and greatly restrict propulsion of the foot, thus leading to abnormal gait. Development of total ankle replacement is connected with the use of the method as an efficient treatment of joint injuries and continuation of achievements in hip and knee surgery. The total ankle replacement technique was introduced as an alternative to arthrodesis, i.e. surgical fixation, which made it possible to preserve joint mobility and to improve gait. Total ankle replacement is indicated in post-traumatic degenerative joint disease and joint destruction secondary to rheumatoid arthritis. In this paper, total ankle replacement and various types of currently used endoprostheses are discussed. The authors also describe principles of early postoperative rehabilitation as well as rehabilitation in the outpatient setting.

  10. Ulnar head replacement.

    Science.gov (United States)

    Herbert, Timothy J; van Schoonhoven, Joerg

    2007-03-01

    Recent years have seen an increasing awareness of the anatomical and biomechanical significance of the distal radioulnar joint (DRUJ). With this has come a more critical approach to surgical management of DRUJ disorders and a realization that all forms of "excision arthroplasty" can only restore forearm rotation at the expense of forearm stability. This, in turn, has led to renewed interest in prosthetic replacement of the ulnar head, a procedure that had previously fallen into disrepute because of material failures with early implants, in particular, the Swanson silicone ulnar head replacement. In response to these early failures, a new prosthesis was developed in the early 1990s, using materials designed to withstand the loads across the DRUJ associated with normal functional use of the upper limb. Released onto the market in 1995 (Herbert ulnar head prosthesis), clinical experience during the last 10 years has shown that this prosthesis is able to restore forearm function after ulnar head excision and that the materials (ceramic head and noncemented titanium stem), even with normal use of the limb, are showing no signs of failure in the medium to long term. As experience with the use of an ulnar head prosthesis grows, so does its acceptance as a viable and attractive alternative to more traditional operations, such as the Darrach and Sauve-Kapandji procedures. This article discusses the current indications and contraindications for ulnar head replacement and details the surgical procedure, rehabilitation, and likely outcomes.

  11. Aortic valve replacement

    DEFF Research Database (Denmark)

    Kapetanakis, Emmanouil I; Athanasiou, Thanos; Mestres, Carlos A

    2008-01-01

    BACKGROUND AND AIMS OF THE STUDY: Prompted by anecdotal evidence and observations by surgeons, an investigation was undertaken into the potential differences in implanted aortic valve prosthesis sizes, during aortic valve replacement (AVR) procedures, between northern and southern European...... countries. METHODS: A multi-institutional, non-randomized, retrospective analysis was conducted among 2,932 patients who underwent AVR surgery at seven tertiary cardiac surgery centers throughout Europe. Demographic and perioperative variables including valve size and type, body surface area (BSA) and early...

  12. Total ankle joint replacement.

    Science.gov (United States)

    2016-02-01

    Ankle arthritis results in a stiff and painful ankle and can be a major cause of disability. For people with end-stage ankle arthritis, arthrodesis (ankle fusion) is effective at reducing pain in the shorter term, but results in a fixed joint, and over time the loss of mobility places stress on other joints in the foot that may lead to arthritis, pain and dysfunction. Another option is to perform a total ankle joint replacement, with the aim of giving the patient a mobile and pain-free ankle. In this article we review the efficacy of this procedure, including how it compares to ankle arthrodesis, and consider the indications and complications.

  13. The Optimum Replacement of Weapon

    Institute of Scientific and Technical Information of China (English)

    ZHANG Xiao; ZHANG Jin-chun

    2002-01-01

    The theory of LCC (Life Cycle Cost) is applied in this paper. The relation between the economic life of weapon and the optimum replacement is analyzed. The method to define the optimum replacement time of weapon is discussed.

  14. Power Plant Replacement Study

    Energy Technology Data Exchange (ETDEWEB)

    Reed, Gary

    2010-09-30

    This report represents the final report for the Eastern Illinois University power plant replacement study. It contains all related documentation from consideration of possible solutions to the final recommended option. Included are the economic justifications associated with the chosen solution along with application for environmental permitting for the selected project for construction. This final report will summarize the results of execution of an EPC (energy performance contract) investment grade audit (IGA) which lead to an energy services agreement (ESA). The project includes scope of work to design and install energy conservation measures which are guaranteed by the contractor to be self‐funding over its twenty year contract duration. The cost recovery is derived from systems performance improvements leading to energy savings. The prime focus of this EPC effort is to provide a replacement solution for Eastern Illinois University’s aging and failing circa 1925 central steam production plant. Twenty‐three ECMs were considered viable whose net impact will provide sufficient savings to successfully support the overall project objectives.

  15. Total disc replacement.

    Science.gov (United States)

    Vital, J-M; Boissière, L

    2014-02-01

    Total disc replacement (TDR) (partial disc replacement will not be described) has been used in the lumbar spine since the 1980s, and more recently in the cervical spine. Although the biomechanical concepts are the same and both are inserted through an anterior approach, lumbar TDR is conventionally indicated for chronic low back pain, whereas cervical TDR is used for soft discal hernia resulting in cervicobrachial neuralgia. The insertion technique must be rigorous, with precise centering in the disc space, taking account of vascular anatomy, which is more complex in the lumbar region, particularly proximally to L5-S1. All of the numerous studies, including prospective randomized comparative trials, have demonstrated non-inferiority to fusion, or even short-term superiority regarding speed of improvement. The main implant-related complication is bridging heterotopic ossification with resulting loss of range of motion and increased rates of adjacent segment degeneration, although with an incidence lower than after arthrodesis. A sufficiently long follow-up, which has not yet been reached, will be necessary to establish definitively an advantage for TDR, particularly in the cervical spine. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

  16. REPLACEMENT OF FRENCH CARDS

    CERN Multimedia

    HR/SOC

    2001-01-01

    The French Ministry of Foreign Affairs has informed the Organization that it is shortly to replace all diplomatic cards, special cards and employment permits ('attestations de fonctions') now held by members of the personnel and their families. Between 2 July and 31 December 2001, these cards are to be replaced by secure, computerized equivalents. The old cards may continue to be used until 31 December 2001. For the purposes of the handover, members of the personnel must go personally to the cards office (33/1-015), in order to fill in a 'fiche individuelle' form, taking the following documents for themselves and members of their families already in possession of a French card : A recent identity photograph in 4.5 cm x 3.5 cm format. The French card in their possession. An A4 photocopy of the same French card, certified by the cards office as being a true copy. Those members of the personnel whose cards (and/or cards belonging to members of their families) are shortly due to expire, or have recently done...

  17. REPLACEMENT OF FRENCH CARDS

    CERN Multimedia

    Human Resources Division; Cards.Service@cern.ch

    2001-01-01

    The French Ministry of Foreign Affairs is currently replacing all diplomatic cards, special cards and employment permits («attestations de fonctions») held by members of the personnel and their families. These cards are replaced by secure, computerized equivalents. The old cards may no longer be used after 31 December 2001. For the purposes of the handover, members of the personnel must go personally to the cards office (33/1-015) between 8h30 and 12h30, in order to fill in a «fiche individuelle» form, taking the following documents for themselves and members of their families already in possession of a French card : A recent identity photograph in 4.5 cm x 3.5 cm format, the French card in their possession, an A4 photocopy of the same French card, certified by the cards office as being a true copy. Those members of the personnel whose cards (and/or cards belonging to members of their families) are shortly due to expire, or have recently done so, are also requested...

  18. REPLACEMENT OF FRENCH CARDS

    CERN Multimedia

    Human Resources Division

    2001-01-01

    The French Ministry of Foreign Affairs has informed the Organization that it is shortly to replace all diplomatic cards, special cards and employment permits ('attestations de fonctions') now held by members of the personnel and their families. Between 2 July and 31 December 2001, these cards are to be replaced by secure, computerized equivalents. The old cards may continue to be used until 31 December 2001. For the purposes of the handover, members of the personnel are asked to go to the cards office (33/1-015), taking the following documents for themselves and members of their families already in possession of a French card : A recent identity photograph in 4.5 cm x 3.5 cm format, The French card in their possession, an A4 photocopy of the same French card, certified by the cards office as being a true copy. Those members of the personnel whose cards (and/or cards belonging to members of their families) are shortly due to expire, or have recently done so, are also requested to take these items to the c...

  19. REPLACEMENT OF FRENCH CARDS

    CERN Multimedia

    Human Resources Division

    2001-01-01

    The French Ministry of Foreign Affairs has informed the Organization that it is shortly to replace all diplomatic cards, special cards and employment permits ('attestations de fonctions') now held by members of the personnel and their families. Between 2 July and 31 December 2001, these cards are to be replaced by secure, computerized equivalents. A 'personnel office' stamped photocopy of the old cards may continue to be used until 31 December 2001. For the purposes of the handover, members of the personnel must go personally to the cards office (33/1-015), between 8:30 and 12:30, in order to fill a 'fiche individuelle' form (in black ink only), which has to be personally signed by themselves and another separately signed by members of their family, taking the following documents for themselves and members of their families already in possession of a French card : A recent identity photograph in 4.5 cm x 3.5 cm format (signed on the back) The French card in their possession an A4 photocopy of the same Fre...

  20. Power Plant Replacement Study

    Energy Technology Data Exchange (ETDEWEB)

    Reed, Gary

    2010-09-30

    This report represents the final report for the Eastern Illinois University power plant replacement study. It contains all related documentation from consideration of possible solutions to the final recommended option. Included are the economic justifications associated with the chosen solution along with application for environmental permitting for the selected project for construction. This final report will summarize the results of execution of an EPC (energy performance contract) investment grade audit (IGA) which lead to an energy services agreement (ESA). The project includes scope of work to design and install energy conservation measures which are guaranteed by the contractor to be self-funding over its twenty year contract duration. The cost recovery is derived from systems performance improvements leading to energy savings. The prime focus of this EPC effort is to provide a replacement solution for Eastern Illinois University's aging and failing circa 1925 central steam production plant. Twenty-three ECMs were considered viable whose net impact will provide sufficient savings to successfully support the overall project objectives.

  1. Power Plant Replacement Study

    Energy Technology Data Exchange (ETDEWEB)

    Reed, Gary

    2010-09-30

    This report represents the final report for the Eastern Illinois University power plant replacement study. It contains all related documentation from consideration of possible solutions to the final recommended option. Included are the economic justifications associated with the chosen solution along with application for environmental permitting for the selected project for construction. This final report will summarize the results of execution of an EPC (energy performance contract) investment grade audit (IGA) which lead to an energy services agreement (ESA). The project includes scope of work to design and install energy conservation measures which are guaranteed by the contractor to be self-funding over its twenty year contract duration. The cost recovery is derived from systems performance improvements leading to energy savings. The prime focus of this EPC effort is to provide a replacement solution for Eastern Illinois University’s aging and failing circa 1925 central steam production plant. Twenty-three ECMs were considered viable whose net impact will provide sufficient savings to successfully support the overall project objectives.

  2. Toleration, Synthesis or Replacement?

    DEFF Research Database (Denmark)

    Holtermann, Jakob v. H.; Madsen, Mikael Rask

    2016-01-01

    to have considerable problems keeping a clear focus on the key question: What are the implications of this empirical turn in terms of philosophy of legal science, of the social understanding of IL, and, not least, of the place of doctrinal scholarship after the alleged Wende? What is needed, we argue......, in order to answer is not yet another partisan suggestion, but rather an attempt at making intelligible both the oppositions and the possibilities of synthesis between normative and empirical approaches to law. Based on our assessment and rational reconstruction of current arguments and positions, we...... therefore outline a taxonomy consisting of the following three basic, ideal-types in terms of the epistemological understanding of the interface of law and empirical studies: toleration, synthesis and replacement. This tripartite model proves useful with a view to teasing out and better articulating...

  3. Recent progress and future directions for reduction, refinement, and replacement of animal use in veterinary vaccine potency and safety testing: a report from the 2010 NICEATM-ICCVAM International Vaccine Workshop.

    Science.gov (United States)

    Stokes, W S; Kulpa-Eddy, J; Brown, K; Srinivas, G; McFarland, R

    2012-01-01

    Veterinary vaccines contribute to improved animal and human health and welfare by preventing infectious diseases. However, testing necessary to ensure vaccine effectiveness and safety can involve large numbers of animals and significant pain and distress. NICEATM and ICCVAM recently convened an international workshop to review the state of the science of human and veterinary vaccine potency and safety testing, and to identify priority activities to advance new and improved methods that can further reduce, refine and replace animal use. Rabies, Clostridium sp., and Leptospira sp. vaccines were identified as the highest priorities, while tests requiring live viruses and bacteria hazardous to laboratory workers, livestock, pets, and wildlife were also considered high priorities. Priority research, development and validation activities to address critical knowledge and data gaps were identified, including opportunities to apply new science and technology. Enhanced international harmonization and cooperation and closer collaborations between human and veterinary researchers were recommended to expedite progress. Implementation of the workshop recommendations is expected to advance new methods for vaccine testing that will benefit animal welfare and ensure continued and improved protection of human and animal health.

  4. Laboratory Evaluation of LED T8 Replacement Lamp Products

    Energy Technology Data Exchange (ETDEWEB)

    Richman, Eric E.; Kinzey, Bruce R.; Miller, Naomi J.

    2011-05-23

    A report on a lab setting analysis involving LED lamps intended to directly replace T8 fluorescent lamps (4') showing light output, power, and economic comparisons with other fluorescent options.

  5. Iron replacement therapy

    DEFF Research Database (Denmark)

    Nielsen, Ole Haagen; Coskun, Mehmet; Weiss, Günter

    2016-01-01

    PURPOSE OF REVIEW: Approximately, one-third of the world's population suffers from anemia, and at least half of these cases are because of iron deficiency. With the introduction of new intravenous iron preparations over the last decade, uncertainty has arisen when these compounds should be admini...... treatment, when to follow-up for relapse, which dosage and type of therapy should be recommended or not recommended, and if some patients should not be treated....... be administered and under which circumstances oral therapy is still an appropriate and effective treatment. RECENT FINDINGS: Numerous guidelines are available, but none go into detail about therapeutic start and end points or how iron-deficiency anemia should be best treated depending on the underlying cause...... of iron deficiency or in regard to concomitant underlying or additional diseases. SUMMARY: The study points to major issues to be considered in revisions of future guidelines for the true optimal iron replacement therapy, including how to assess the need for treatment, when to start and when to stop...

  6. Mineralogical correlation between primary and replacement dolomites

    Institute of Scientific and Technical Information of China (English)

    黄志诚; 杨守业; 陈智娜

    1997-01-01

    Primary dolostones occur in the Upper Sinian Dengying Formation. Based on mineralogieal study the indicators for correlation between the primary dolomites which are not influenced by the diagenesis and the replacement dolomites of different periods have been obtained. It is shown that the primary dolomites are characterized by crystal forms precipitated and deposited directly from sea water, stable and homogeneous distribution of Mg and Ca, ideal chemical composition, regular modulated microstructures, low positive δ13C and low negative δ18O.

  7. Using your shoulder after replacement surgery

    Science.gov (United States)

    Joint replacement surgery - using your shoulder; Shoulder replacement surgery - after ... You have had shoulder replacement surgery to replace the bones of your shoulder joint with artificial parts. The parts include a stem made of metal and a ...

  8. Educating My Replacement

    Science.gov (United States)

    Tarter, Jill

    , in partnership with the dedicated teachers out there, I think I can help promote the critical thinking skills and scientific literacy of the next generation of voters. Hopefully, I can also help train my replacement to be a better scientist, capable of seizing all the opportunities generated by advances in technology and our improved understanding of the universe to craft search strategies with greater probability of success than those I have initiated.

  9. [Ascending aorta replacement late after aortic valve replacement].

    Science.gov (United States)

    Hayashi, Yasunari; Ito, Toshiaki; Maekawa, Atsuo; Sawaki, Sadanari; Fujii, Genyo; Hoshino, Satoshi; Tokoro, Masayoshi; Yanagisawa, Junji

    2013-07-01

    Replacement of the asceding aorta is indicated in patients undergoing aortic valve replacement( AVR), if the diameter of the ascending aorta is greater than 5.0 cm. If the diameter of the asceding aorta is from 4.0 to 5.0 cm, it was arguable whether replacement of the ascending aorta should be performed. Nine patients who underwent reoperative ascending aorta replacement after AVR were reviewed retrospectively. Reoperation on the asending aorta replacement was performed 11.8±7.2 years (range 1y5m~23y3m) after AVR. Mean patient age was 69.9±6.3 (range 60~81). In 2 cases, reoperations were performed early year after AVR. Although ascending aorta was dilated at the 1st operation, replacement wasn't performed for the age and minimally invasive cardiac surgery (MICS). In 3 cases, reoperations were performed more than 10 years later. On these cases, ascending aorta aneurysm and dissection occurred with no pain and were pointed out by computed tomography(CT) or ultrasonic cardiogram(UCG). We think that patients with dilatation of the ascending aorta should undergo AVR and aorta replacement at the 1st operation regardness of age. It is important that patients who underwent AVR should undergo a regular checkup on the ascending aorta.

  10. Electrocatalysts Prepared by Galvanic Replacement

    OpenAIRE

    Athanasios Papaderakis; Ioanna Mintsouli; Jenia Georgieva; Sotiris Sotiropoulos

    2017-01-01

    Galvanic replacement is the spontaneous replacement of surface layers of a metal, M, by a more noble metal, Mnoble, when the former is treated with a solution containing the latter in ionic form, according to the general replacement reaction: nM + mMnoblen+ → nMm+ + mMnoble. The reaction is driven by the difference in the equilibrium potential of the two metal/metal ion redox couples and, to avoid parasitic cathodic processes such as oxygen reduction and (in some cases) hydrogen evolution too...

  11. Minimally invasive aortic valve replacement

    DEFF Research Database (Denmark)

    Foghsgaard, Signe; Schmidt, Thomas Andersen; Kjaergard, Henrik K

    2009-01-01

    In this descriptive prospective study, we evaluate the outcomes of surgery in 98 patients who were scheduled to undergo minimally invasive aortic valve replacement. These patients were compared with a group of 50 patients who underwent scheduled aortic valve replacement through a full sternotomy....... The 30-day mortality rate for the 98 patients was zero, although 14 of the 98 mini-sternotomies had to be converted to complete sternotomies intraoperatively due to technical problems. Such conversion doubled the operative time over that of the planned full sternotomies. In the group of patients whose...... is an excellent operation in selected patients, but its true advantages over conventional aortic valve replacement (other than a smaller scar) await evaluation by means of randomized clinical trial. The "extended mini-aortic valve replacement" operation, on the other hand, is a risky procedure that should...

  12. Experimental replacement of an obligate insect symbiont.

    Science.gov (United States)

    Moran, Nancy A; Yun, Yueli

    2015-02-17

    Symbiosis, the close association of unrelated organisms, has been pivotal in biological diversification. In the obligate symbioses found in many insect hosts, organisms that were once independent are permanently and intimately associated, resulting in expanded ecological capabilities. The primary model for this kind of symbiosis is the association between the bacterium Buchnera and the pea aphid (Acyrthosiphon pisum). A longstanding obstacle to efforts to illuminate genetic changes underlying obligate symbioses has been the inability to experimentally disrupt and reconstitute symbiont-host partnerships. Our experiments show that Buchnera can be experimentally transferred between aphid matrilines and, furthermore, that Buchnera replacement has a massive effect on host fitness. Using a recipient pea aphid matriline containing Buchnera that are heat sensitive because of an allele eliminating the heat shock response of a small chaperone, we reduced native Buchnera through heat exposure and introduced a genetically distinct Buchnera from another matriline, achieving complete replacement and stable inheritance. This transfer disrupted 100 million years (∼ 1 billion generations) of continuous maternal transmission of Buchnera in its host aphids. Furthermore, aphids with the Buchnera replacement enjoyed a dramatic increase in heat tolerance, directly demonstrating a strong effect of symbiont genotype on host ecology.

  13. Knee Replacement: What you can Expect

    Science.gov (United States)

    ... improves function lessen with each additional surgery. Artificial knees can wear out Another risk of knee replacement ... replacement surgery to last about two hours. After knee replacement surgery After surgery, you're wheeled to ...

  14. Homologous gene replacement in Physarum

    Energy Technology Data Exchange (ETDEWEB)

    Burland, T.G. [Univ. of Wisconsin, Madison, WI (United States); Pallotta, D. [Laval Univ., Quebec (Canada)

    1995-01-01

    The protist Physarum polycephalum is useful for analysis of several aspects of cellular and developmental biology. To expand the opportunities for experimental analysis of this organism, we have developed a method for gene replacement. We transformed Physarum amoebae with plasmid DNA carrying a mutant allele, ardD{Delta}1, of the ardD actin gene; ardD{Delta}1 mutates the critical carboxy-terminal region of the gene product. Because ardD is not expressed in the amoeba, replacement of ardD{sup +} with ardD{Delta}1 should not be lethal for this cell type. Transformants were obtained only when linear plasmid DNA was used. Most transformants carried one copy of ardD{Delta}1 in addition to ardD{sup +}, but in two (5%), ardD{sup +} was replaced by a single copy of ardD{Delta}1. This is the first example of homologous gene replacement in Physarum. ardD{Delta}1 was stably maintained in the genome through growth, development and meiosis. We found no effect of ardD{Delta}l on viability, growth, or development of any of the various cell types of Physarum. Thus, the carboxy-terminal region of the ardD product appears not to perform a unique essential role in growth or development. Nevertheless, this method for homologous gene replacement can be applied to analyze the function of any cloned gene. 38 refs., 6 figs., 1 tab.

  15. Direct Methanol Fuel Cell (DMFC) Battery Replacement Program

    Science.gov (United States)

    2013-01-29

    required for maximum performance of electrochemical flow reactors . A reactant stream will favor the path of least resistance, potentially starving re...gions of the electrode assembly and lowering reactor efficiency. Array fuel cells are ideal for evaluation of catalytic layers, gas diffusion...layers, solid electrolytes , electrode fabrica- tion methods and flow uniformity. The coupling of Array fuel cell analysis with a modular flow-field

  16. Cobra Probes Containing Replaceable Thermocouples

    Science.gov (United States)

    Jones, John; Redding, Adam

    2007-01-01

    A modification of the basic design of cobra probes provides for relatively easy replacement of broken thermocouples. Cobra probes are standard tube-type pressure probes that may also contain thermocouples and that are routinely used in wind tunnels and aeronautical hardware. They are so named because in side views, they resemble a cobra poised to attack. Heretofore, there has been no easy way to replace a broken thermocouple in a cobra probe: instead, it has been necessary to break the probe apart and then rebuild it, typically at a cost between $2,000 and $4,000 (2004 prices). The modified design makes it possible to replace the thermocouple, in minimal time and at relatively low cost, by inserting new thermocouple wire in a tube.

  17. Renal replacement therapy in ICU

    Directory of Open Access Journals (Sweden)

    C Deepa

    2012-01-01

    Full Text Available Diagnosing and managing critically ill patients with renal dysfunction is a part of the daily routine of an intensivist. Acute kidney insufficiency substantially contributes to the morbidity and mortality of critically ill patients. Renal replacement therapy (RRT not only does play a significant role in the treatment of patients with renal failure, acute as well as chronic, but also has spread its domains to the treatment of many other disease conditions such as myaesthenia gravis, septic shock and acute on chronic liver failure. This article briefly outlines the role of renal replacement therapy in ICU.

  18. Prioritization methodology for chemical replacement

    Science.gov (United States)

    Goldberg, Ben; Cruit, Wendy; Schutzenhofer, Scott

    1995-01-01

    This methodology serves to define a system for effective prioritization of efforts required to develop replacement technologies mandated by imposed and forecast legislation. The methodology used is a semi quantitative approach derived from quality function deployment techniques (QFD Matrix). QFD is a conceptual map that provides a method of transforming customer wants and needs into quantitative engineering terms. This methodology aims to weight the full environmental, cost, safety, reliability, and programmatic implications of replacement technology development to allow appropriate identification of viable candidates and programmatic alternatives.

  19. Wafer Replacement Cluster Tool (Presentation);

    Energy Technology Data Exchange (ETDEWEB)

    Branz, H. M.

    2008-04-01

    This presentation on wafer replacement cluster tool discusses: (1) Platform for advanced R and D toward SAI 2015 cost goal--crystal silicon PV at area costs closer to amorphous Si PV, it's 15% efficiency, inexpensive substrate, and moderate temperature processing (<800 C); (2) Why silicon?--industrial and knowledge base, abundant and environmentally benign, market acceptance, and good efficiency; and (3) Why replace wafers?--expensive, high embedded energy content, and uses 50-100 times more silicon than needed.

  20. Double emulsions as fat replacers

    NARCIS (Netherlands)

    Oppermann, Anika

    2017-01-01

    The use of double (w1/o/w2) emulsions, in which part of the oil is replaced by small water droplets, is a promising strategy to reduce oil content in food products. For successful applications, (1) significant levels of fat reduction (i.e. significant amounts of water inside the oil droplets) have

  1. Replacement policies for dairy cows

    DEFF Research Database (Denmark)

    Nielsen, Lars Relund

    In a recent paper a hierarchical Markov decision processes (MDP) with finite state and action space was formulated for the dairy cow replacement problem with stage lengths of 1 d. Bayesian updating was used to predict the performance of each cow in the herd and economic decisions were based...

  2. Electrocatalysts Prepared by Galvanic Replacement

    Directory of Open Access Journals (Sweden)

    Athanasios Papaderakis

    2017-03-01

    Full Text Available Galvanic replacement is the spontaneous replacement of surface layers of a metal, M, by a more noble metal, Mnoble, when the former is treated with a solution containing the latter in ionic form, according to the general replacement reaction: nM + mMnoblen+ → nMm+ + mMnoble. The reaction is driven by the difference in the equilibrium potential of the two metal/metal ion redox couples and, to avoid parasitic cathodic processes such as oxygen reduction and (in some cases hydrogen evolution too, both oxygen levels and the pH must be optimized. The resulting bimetallic material can in principle have a Mnoble-rich shell and M-rich core (denoted as Mnoble(M leading to a possible decrease in noble metal loading and the modification of its properties by the underlying metal M. This paper reviews a number of bimetallic or ternary electrocatalytic materials prepared by galvanic replacement for fuel cell, electrolysis and electrosynthesis reactions. These include oxygen reduction, methanol, formic acid and ethanol oxidation, hydrogen evolution and oxidation, oxygen evolution, borohydride oxidation, and halide reduction. Methods for depositing the precursor metal M on the support material (electrodeposition, electroless deposition, photodeposition as well as the various options for the support are also reviewed.

  3. Total ankle replacement – surgical treatment and rehabilitation

    Science.gov (United States)

    Krogulec, Zbigniew; Turski, Piotr; Przepiórski, Emil; Małdyk, Paweł; Księżopolska-Orłowska, Krystyna

    2015-01-01

    Functions of the ankle joint are closely connected with the gait and ability to maintain an upright position. Degenerative lesions of the joint directly contribute to postural disorders and greatly restrict propulsion of the foot, thus leading to abnormal gait. Development of total ankle replacement is connected with the use of the method as an efficient treatment of joint injuries and continuation of achievements in hip and knee surgery. The total ankle replacement technique was introduced as an alternative to arthrodesis, i.e. surgical fixation, which made it possible to preserve joint mobility and to improve gait. Total ankle replacement is indicated in post-traumatic degenerative joint disease and joint destruction secondary to rheumatoid arthritis. In this paper, total ankle replacement and various types of currently used endoprostheses are discussed. The authors also describe principles of early postoperative rehabilitation as well as rehabilitation in the outpatient setting. PMID:27407223

  4. Bonding over Dentin Replacement Materials.

    Science.gov (United States)

    Meraji, Naghmeh; Camilleri, Josette

    2017-08-01

    Dentin replacement materials are necessary in large cavities to protect the pulp and reduce the bulk of filling material. These materials are layered with a composite resin restorative material. Microleakage caused by poor bonding of composite resin to underlying dentin replacement material will result in pulp damage. The aim of this study was to characterize the interface between dentin replacement materials and composite resin and to measure the shear bond strength after dynamic aging. Biodentine (Septodont, Saint Maur-des-Fosses, France), Theracal LC (Bisco, Schaumburg, IL), and Fuji IX (GC, Tokyo, Japan) were used as dentin replacement materials. They were then overlaid with a total-etch and bonding agent or a self-etch primer and composite resin or a glass ionomer cement. All combinations were thermocycled for 3000 cycles. The interface was characterized using scanning electron microscopy and elemental mapping. Furthermore, the shear bond strength was assessed. The Biodentine surface was modified by etching. The Theracal LC and Fuji IX microstructure was unchanged upon the application of acid etch. The Biodentine and glass ionomer interface showed an evident wide open space, and glass particles from the glass ionomer adhered to the Biodentine surface. Elemental migration was shown with aluminum, barium, fluorine, and ytterbium present in Biodentine from the overlying composite resin. Calcium was more stable. The bond strength between Theracal LC and composite using a total-etch technique followed by self-etch primer achieved the best bond strength values. Biodentine exhibited the weakest bond with complete failure of bonding shown after demolding and thermocycling. Dynamic aging is necessary to have clinically valid data. Bonding composite resin to water-based dentin replacement materials is still challenging, and further alternatives for restoration of teeth using such materials need to be developed. Copyright © 2017 American Association of Endodontists

  5. A study on the changes of atrial septal motion speed after mitral valve replacement using omni-directional M-mode echocardiography%应用全方向M型超声研究二尖瓣置换术后房间隔运动速度变化

    Institute of Scientific and Technical Information of China (English)

    熊丽燕; 郭薇

    2012-01-01

    目的 应用全方向M型超声心动图测量二尖瓣置换术前、术后房间隔运动速度变化,评估左心房功能.方法 选择行二尖瓣置换术患者49例,年龄34~69岁,平均(54.27±9.30)岁,其中男23例,女26例.分别于手术中术前、术后对所有患者进行经食管超声心动图监测,应用全方向M型超声心动图测量收缩期和舒张期房间隔运动峰值速度.应用经胸超声心动图测量左心房容积变化率、左心房前后径、左心室舒张末容积、左心室射血分数.结果 二尖瓣置换术后,房间隔运动峰值速度、左心房容积变化率、左心室舒张末容积及左心室射血分数较术前升高(P<0.05).术前、术后房间隔运动峰值速度与左心房容积变化率存在相关性(r =0.389、0.354,P<0.05).结论 全方向M型超声心动图测量的房间隔运动峰值速度能够评价二尖瓣置换术前、术后左心房功能变化.%Objective To assess left atrium function by measured atrial septal motion speed changes using omni-directional M-mode echocardiography (OME) before and after mitral valve replacement. Methods Forty-nine patients underwent mitral valve replacement surgery were enrolled with the age 34-69 years; mean age(54.27 ± 9.30)years;23 men,26 women. Examed all patients by traneesophageal echocardiography pre- and post-operation immediately. Systolic and diaslolic atrial septum motion peak speed was measured by OME. Left atrial volume change fraction,left atrial diameter,end-diastolic volume and left ventricular ejection fraction were measured by transthoracic echocardiography. Results After mitral valve replacement surgery, atrial septum motion peak speed, left atrial volume change fraction, end-diastolic volume and left ventricular ejection fraction were higher than pre-operation( P < 0.05). There were correlation between atrial septal motion peak speed and left atrial volume change fraction pre- and post-operation( r = 0. 389,0. 354, P < 0

  6. Urbanization, Ikization, and Replacement Dynamics

    CERN Document Server

    Chen, Yanguang

    2015-01-01

    The phenomenon of Iks was first found by anthropologists and biologists, but it is actually a problem of human geography. However, it has not yet drawn extensive attention of geographers. In this paper, a hypothesis of ikization is presented that sudden and violent change of geographical environments results in dismantling of traditional culture, which then result in collective depravity of a nationality. By quantitative analysis and mathematical modeling, the causality between urbanization and ikization is discussed, and the theory of replacement dynamics is employed to interpret the process of ikization. Urbanization is in essence a nonlinear process of population replacement. Urbanization may result in ikization because that the migration of population from rural regions to urban regions always give rise to abrupt changes of geographical environments and traditional culture. It is necessary to protect the geographical environment against disruption, and to inherit and develop traditional culture in order t...

  7. [MINIMALLY INVASIVE AORTIC VALVE REPLACEMENT].

    Science.gov (United States)

    Tabata, Minoru

    2016-03-01

    Minimally invasive aortic valve replacement (MIAVR) is defined as aortic valve replacement avoiding full sternotomy. Common approaches include a partial sternotomy right thoracotomy, and a parasternal approach. MIAVR has been shown to have advantages over conventional AVR such as shorter length of stay and smaller amount of blood transfusion and better cosmesis. However, it is also known to have disadvantages such as longer cardiopulmonary bypass and aortic cross-clamp times and potential complications related to peripheral cannulation. Appropriate patient selection is very important. Since the procedure is more complex than conventional AVR, more intensive teamwork in the operating room is essential. Additionally, a team approach during postoperative management is critical to maximize the benefits of MIAVR.

  8. Mitochondrial Replacement: Ethics And Identity

    OpenAIRE

    Wrigley, Anthony; Wilkinson, Stephen; Appleby, John B

    2015-01-01

    Mitochondrial replacement techniques (MRTs) have the potential to allow prospective parents who are at risk of passing on debilitating or even life-threatening mitochondrial disorders to have healthy children to whom they are genetically related. Ethical concerns have however been raised about these techniques. This article focuses on one aspect of the ethical debate, the question of whether there is any moral difference between the two types of MRT proposed: Pronuclear Transfer (PNT) and Mat...

  9. Replacing magnets at the LHC

    CERN Multimedia

    LHC, LSI2, Point 4

    2013-01-01

    CERN engineers have been working through the night this week to move the final replacement dipole magnets into position on the Large Hadron Collider (LHC). Though there are several still to go, the teams expect to have completed the task by the end of this month. Dipole magnets bend the paths of particles as they travel around the circular accelerator. Of the LHC's 1232 dipoles – each 15 metres long and weighing 35 tonnes – 15 are being replaced as part of the long shutdown of CERN's accelerator complex. These 15 magnets suffered wear and tear during the LHC's first 4-year run. Three quadrupole-magnet assemblies – which help to focus particles into a tight beam – have also been replaced. Moving such heavy magnets requires specially adapted cranes and trailers both above and below ground. There are several access points on the LHC. Some, such as the 100-metre vertical access shaft down to the ALICE experiment, are equipped with lifts to allow technical personnel and visitors down to the caverns. Other ...

  10. Results of Austin Moore replacement.

    Directory of Open Access Journals (Sweden)

    Jadhav A

    1996-04-01

    Full Text Available Forty cases of Austin Moore Replacement done for transcervical fractures of the femur in patients were reviewed after a period of 12 to 48 months postoperatively (mean 26 mth. 30 cases (75% had mild to severe pain of non-infective origin, starting as early as 6 months postoperatively. This was irrespective of the make, size or position (varus/valgus of the prosthesis. Though the Aufranc and Sweet clinical scoring was satisfactory in 65% cases, radiological evidence of complications like sinking, protrusion, etc. were seen in majority of the cases. Calcar resorption was seen in 34 cases (85% as early as 4 months postoperatively. Results of THR and bipolar replacement done for transcervical fractures in recent literature show 85% pain-free cases at 5 years. We feel that Austin Moore Replacement should be reserved for patients more than 65 years of age and those who are less active or debilitated because of other factors, because of increased acetabular wear with time in the younger individual. This is corroborated by unsatisfactory results in patients less than 65 years of age (p < 0.05.

  11. The caudal septum replacement graft.

    Science.gov (United States)

    Foda, Hossam M T

    2008-01-01

    To describe a technique for reconstructing the lost tip support in cases involving caudal septal and premaxillary deficiencies. The study included 120 patients with aesthetic and functional nasal problems resulting from the loss of caudal septal and premaxillary support. An external rhinoplasty approach was performed to reconstruct the lost support using a cartilaginous caudal septum replacement graft and premaxillary augmentation with Mersilene mesh. The majority of cases (75%) involved revisions in patients who had previously undergone 1 or more nasal surgical procedures. A caudal septum replacement graft was combined with premaxillary augmentation in 93 patients (77.5%). The mean follow-up period was 3 years (range, 1-12 years). The technique succeeded in correcting the external nasal deformities in all patients and resulted in a significant improvement in breathing in 74 patients (86%) with preoperative nasal obstruction. There were no cases of infection, displacement, or extrusion. The caudal septum replacement graft proved to be very effective in restoring the lost tip support in patients with caudal septal deficiency. Combining the graft with premaxillary augmentation using Mersilene mesh helped increase support and stability over long-term follow-up.

  12. Fusion following failed total ankle replacement.

    Science.gov (United States)

    Wünschel, Markus; Leichtle, Ulf G; Leichtle, Carmen I; Walter, Christian; Mittag, Falk; Arlt, Eva; Suckel, Andreas

    2013-04-01

    Although mid- to long-term results after total ankle replacement have improved because of available second- and third-generation devices, failure of total ankle replacement is still more common compared with total hip replacement and total knee replacement. The portfolio of available total ankle replacement revision component options is small. Furthermore, the bone stock of the tibiotalar region is scarce making it difficult and in some situations impossible to perform revision total ankle replacement. In these cases tibiotalar and tibiotalocalcaneal fusions are valuable options. This article describes which surgical procedures should be performed depending on the initial situation and gives detailed advice on surgical technique, postoperative care, and clinical results.

  13. Strategies for Revision Total Ankle Replacement

    Directory of Open Access Journals (Sweden)

    Thomas S. Roukis, DPM, PhD, FACFAS

    2014-12-01

    Full Text Available As the frequency of primary total ankle replacement (TAR continues to build, revision will become more commonplace. At present there are no “standard principles” associated with revision TAR. What is clear is that the current approaches are technically complex, fraught with complications and no one approach represents the only answer. Exchange of TAR metallic components to the same system standard or dedicated revision components are viable options with limited occurrence of complications. Explantation and conversion to custom-design long stemmed components has limited availability. Explantation and conversion to another TAR system is high-risk and has strong potential for complications. The use of metal reinforced polymethylmethacrylate cement augmentation of failed TAR systems and tibio-talo-calcaneal arthrodesis should be reserved for very select situations where other options are not possible. There is a real need for long-term survivorship following revision TAR and future efforts ought to be directed in this area.

  14. Replacement collision sequence studies in iron

    CERN Document Server

    Hou, M; Becquart, C S

    2002-01-01

    The properties of replacement collision sequences (RCS) in iron and their contribution to radiation damage are studied as they are generated in atomic collision cascades with the binary collision approximation Marlowe. Length distributions of RCS in collision cascades generated by primaries with a couple of ten keV kinetic energies are predicted short. Whatever the interatomic potential employed, at least 90% of the generated RCS have a length of no more than three successive collisions, whatever the directions. This property was found for all the known phases of iron at standard pressure (bcc and fcc). The RCS length distributions are not significantly influenced by the temperature nor by the accurate form of the model describing the energy loss in RCS. Close to 50% of the stable Frenkel pairs (FP) created result from RCS that are shorter than the vacancy-interstitial recombination distance estimated on the basis of molecular dynamics calculations. The other half results from longer RCS (about five successiv...

  15. Radiology of total hip replacement

    Energy Technology Data Exchange (ETDEWEB)

    Griffiths, H.J.; Lovelock, J.E.; McCollister Evarts, C.; Geyer, D.

    1984-06-01

    The radiology of total hip replacement (THR) and its complications is reviewed in conjunction with a long-term follow-up study on 402 patients with 501 prostheses. The indications, contraindications, biomechanics, and operative management of these patients is discussed. Clinical complications such as deep vein thrombosis, pulmonary embolism, and hemorrhage are mentioned. Postoperative infections including granulomatous pseudotumors, dislocations and fractures, true loosening of the prosthesis, and heterotopic bone formation (HBF) are discussed and illustrated. The importance of differentiating the lucent line from true loosening is stressed. Mechanical and other clinical complications which are largely ignored by radiologists are also discussed. The uses of arthrography and bone scanning are included.

  16. [Proximal and total femur replacement].

    Science.gov (United States)

    Pennekamp, P H; Wirtz, D C; Dürr, H R

    2012-07-01

    Reconstruction of segmental bone defects of the proximal femur following wide tumor resection or revision arthroplasty. Aggressive benign or primary malignant bone tumors of the proximal femur; destructive metastases; massive segmental bone defects of the proximal femur; periprosthetic fractures. Local infection; very short life expectancy (acetabular bone stock. Anterolateral approach. Exposure and detachment of the iliopsoas and gluteus medius muscle from the proximal femur with a sufficient safety margin to the bone; distal transsection of the vastus lateralis/intermedius and rectus femoris muscle according to the extraosseous tumor extension; distal femur osteotomy al least 3 cm beyond the farthest point of tumor extension; in case of total femur replacement, additional lateral arthrotomy of the knee with resection of the ligaments and menisci; reaming of the medullary canal after securing the shaft with a Verbrugge clamp; trial assembly and reduction followed by the definitive implantation of the prosthesis with adjustment of the femoral neck anteversion in 5° increments; soft tissue reconstruction and fixation to an attachment tube covering the prosthesis; in case of total femur replacement, the preparation of the tibia is followed by the coupling of the tibial and femoral components. Infection prophylaxis, 20 kg partial weight bearing, continuous passive motion. A total of 20  patients with proximal femur replacement and 2 patients with total femur replacement implanted between June 2007 and December 2011 were retrospectively reviewed. Three patients had primary malignant bone tumors, while 19 patients underwent resection for metastatic disease. The mean age at surgery was 62.0 ± 18.1 years (18-82 years). Fifteen patients with a mean follow-up of 20.3 ± 17.2 months (4-51 months) were studied. Among the 22 cases, periprosthetic infection occurred in 3 patients (13.6%), dislocation in 2 patients (9.1%). Evaluation of the functional

  17. B Plant process piping replacement feasibility study

    Energy Technology Data Exchange (ETDEWEB)

    Howden, G.F.

    1996-02-07

    Reports on the feasibility of replacing existing embedded process piping with new more corrosion resistant piping between cells and between cells and a hot pipe trench of a Hanford Site style canyon facility. Provides concepts for replacement piping installation, and use of robotics to replace the use of the canyon crane as the primary means of performing/supporting facility modifications (eg, cell lining, pipe replacement, equipment reinstallation) and operational maintenenace.

  18. REMINDER REPLACEMENT OF FRENCH CARDS

    CERN Multimedia

    Human Resources Division; Cards.Service@cern.ch

    2001-01-01

    The French Ministry of Foreign Affairs is currently replacing all diplomatic cards, special cards and employment permits («attestations de fonctions») held by members of the personnel and their families. These cards are replaced by secure, computerized equivalents. The old cards may no longer be used after 31 December 2001. For the purposes of the handover, members of the personnel must go personally to the cards office (33/1-015) between 8h30 and 12h30, in order to fill in a «fiche individuelle» form, taking the following documents for themselves and members of their families already in possession of a French card : A recent identity photograph in 4.5 cm x 3.5 cm format, the French card in their possession, an A4 photocopy of the same French card, certified by the cards office as being a true copy. Those members of the personnel whose cards (and/or cards belonging to members of their families) are shortly due to expire, or have recently done so, are also requested...

  19. Total hip replacement in dancers.

    Science.gov (United States)

    Buyls, Inge R A E; Rietveld, A B M Boni; Ourila, Tiia; Emerton, Mark E; Bird, H A

    2013-04-01

    A case report of a professional contemporary dancer who successfully returned to the stage after bilateral total hip replacements (THR) for osteoarthritis is presented, together with her own commentary and a retrospective cohort study of total hip replacements in dancers. In the presented cohort, there were no post-operative dislocations or infections, the original pain had been relieved, rehabilitation was objectively normal and all resumed their dance (teaching) activities. Nevertheless, they were disappointed about the prolonged rehabilitation. Due to their high demands as professional dancers, post-operative expectations were too optimistic in view of the usual quick and favourable results of THR in the older and less physically active, general population. In all dancers with unilateral osteoarthritis, the left hip was involved, which may reflect the tendency to use the left leg as standing leg and be suggestive that strenuous physical activity may lead to osteoarthritis. Better rehabilitation guidelines are needed for dancer patients undergoing THR, especially drawing their attention to realistic post-operative expectations.

  20. OPTIMUM ORDERING POLICY FOR PREVENTIVE AGE REPLACEMENT

    Institute of Scientific and Technical Information of China (English)

    Young T.PARK; Jing SUN

    2009-01-01

    Most of the spare ordering policies treated up to now have assumed that preventive and corrective replacement costs are equal, which implies in essential that there is no significant need for preventive replacement. This paper presents an ordering policy for preventive age replacement with minimal repair. Introducing the replacement, repair, inventory holding and shortage costs, the expected cost rate is derived. A procedure to determine jointly the ordering time for a spare and the preventive replacement time for the operating unit so as to minimize the expected cost rate is proposed. To explain the ordering policy and the optimization procedure, a numerical example is also included.

  1. ORO. The physical developer replacement?

    Science.gov (United States)

    Wood, Michael A; James, Tim

    2009-12-01

    In the process of fingerprint development Physical Developer has been largely the method of choice on porous surfaces after coming into contact with wet environments. It is only recently that a new technique has been identified which could replace this standard technique. This study aims to build on previous research and expand knowledge regarding the technique. The study built on previous research and compared Physical Developer to Oil Red O, testing both on four paper types, while being placed in three different water types and an accelerant for various amounts of time. Marks were placed with both heavily 'loaded' sebaceous fingers and 'normal' un-washed fingers. Results show that Oil Red O consistently produced clearer more detailed marks from the 'loaded' fingers, but neither technique proved to work better on the 'normal' marks. Neither technique developed any prints from the accelerant.

  2. Optimal randomized scheduling by replacement

    Energy Technology Data Exchange (ETDEWEB)

    Saias, I.

    1996-05-01

    In the replacement scheduling problem, a system is composed of n processors drawn from a pool of p. The processors can become faulty while in operation and faulty processors never recover. A report is issued whenever a fault occurs. This report states only the existence of a fault but does not indicate its location. Based on this report, the scheduler can reconfigure the system and choose another set of n processors. The system operates satisfactorily as long as, upon report of a fault, the scheduler chooses n non-faulty processors. We provide a randomized protocol maximizing the expected number of faults the system can sustain before the occurrence of a crash. The optimality of the protocol is established by considering a closely related dual optimization problem. The game-theoretic technical difficulties that we solve in this paper are very general and encountered whenever proving the optimality of a randomized algorithm in parallel and distributed computation.

  3. Controversies in hormone replacement therapy

    Directory of Open Access Journals (Sweden)

    A. Baziad

    2001-09-01

    Full Text Available Deficiency of estrogen hormone will result in either long-term or short-term health problems which may reduce the quality of life. There are numerous methods by which the quality of female life can be achieved. Since the problems occuring are due to the deficiency of estrogen hormone, the appropriate method to tackle the problem is by administration of estrogen hormone. The administration of hormone replacement therapy (HRT with estrogen may eliminate climacteric complaints, prevent osteoporosis, coronary heart disease, dementia, and colon cancer. Although HRT has a great deal of advantage, its use is still low and may result in controversies. These controversies are due to fact that both doctor and patient still hold on to the old, outmoded views which are not supported by numerous studies. Currently, the use of HRT is not only based on experience, or temporary observation, but more on evidence based medicine. (Med J Indones 2001; 10: 182-6Keywords: controversies, HRT

  4. Replacement reactor to revolutionise magnets

    CERN Document Server

    Atkins, G

    2002-01-01

    Electric motors, hearing aids and magnetic resonance imaging are only some of the applications that will benefit from the first advances in magnets in a quarter of a century. Magnets achieve their characteristics when electrons align themselves to produce a unified magnetic field. Neutrons can probe these magnetic structures. The focus is not just on making more powerful magnets, but also identifying the characteristics that make magnets cheaper and easier for industry to manufacture. Staff from the ANSTO's Neutron Scattering Group have already performed a number of studies on the properties of magnets using using HIFAR, but the Replacement Research Reactor that will produce cold neutrons would allow scientists to investigate the atomic properties of materials with large molecules. A suite of equipment will enable studies at different temperatures, pressures and magnetic fields

  5. Renal replacement therapy in Europe

    DEFF Research Database (Denmark)

    Noordzij, Marlies; Kramer, Anneke; Abad Diez, José M

    2014-01-01

    BACKGROUND: This article provides a summary of the 2011 ERA-EDTA Registry Annual Report (available at www.era-edta-reg.org). METHODS: Data on renal replacement therapy (RRT) for end-stage renal disease (ESRD) from national and regional renal registries in 30 countries in Europe and bordering the .......6-47.0], and on dialysis 39.3% (95% CI 39.2-39.4). The unadjusted 5-year patient survival after the first renal transplantation performed between 2002 and 2006 was 86.7% (95% CI 86.2-87.2) for kidneys from deceased donors and 94.3% (95% CI 93.6-95.0) for kidneys from living donors....

  6. Leptin replacement improves cognitive development.

    Directory of Open Access Journals (Sweden)

    Gilberto J Paz-Filho

    Full Text Available BACKGROUND: Leptin changes brain structure, neuron excitability and synaptic plasticity. It also regulates the development and function of feeding circuits. However, the effects of leptin on neurocognitive development are unknown. OBJECTIVE: To evaluate the effect of leptin on neurocognitive development. METHODOLOGY: A 5-year-old boy with a nonconservative missense leptin gene mutation (Cys-to-Thr in codon 105 was treated with recombinant methionyl human leptin (r-metHuLeptin at physiologic replacement doses of 0.03 mg/kg/day. Cognitive development was assessed using the Differential Ability Scales (DAS, a measure of general verbal and nonverbal functioning; and selected subtests from the NEPSY, a measure of neuropsychological functioning in children. PRINCIPAL FINDINGS: Prior to treatment, the patient was morbidly obese, hypertensive, dyslipidemic, and hyperinsulinemic. Baseline neurocognitive tests revealed slower than expected rates of development (developmental age lower than chronological age in a majority of the areas assessed. After two years, substantial increases in the rates of development in most neurocognitive domains were apparent, with some skills at or exceeding expectations based on chronological age. We also observed marked weight loss and resolution of hypertension, dyslipidemia and hyperinsulinemia. CONCLUSIONS: We concluded that replacement with r-metHuLeptin is associated with weight loss and changes in rates of development in many neurocognitive domains, which lends support to the hypothesis that, in addition to its role in metabolism, leptin may have a cognitive enhancing role in the developing central nervous system. TRIAL REGISTRATION: ClinicalTrials.gov NCT00659828.

  7. Transcatheter Aortic Valve Replacement: A Review Article

    Directory of Open Access Journals (Sweden)

    Juan A Siordia

    2016-06-01

    Full Text Available Transcatheter aortic valve replacement (TAVR is a novel therapeutic intervention for the replacement of severely stenotic aortic valves in high-risk patients for standard surgical procedures. Since the initial PARTNER trial results, use of TAVR has been on the rise each year. New delivery methods and different valves have been developed and modified in order to promote the minimally invasive procedure and reduce common complications, such as stroke. This review article focuses on the current data on the indications, risks, benefits, and future directions of TAVR. Recently, TAVR has been considered as a standard-of-care procedure. While this technique is used frequently in high-risk surgical candidates, studies have been focusing on the application of this method for younger patients with lower surgical risk. Moreover, several studies have proposed promising results regarding the use of valve-in-valve technique or the procedure in which the valve is placed within a previously implemented bioprosthetic valve. However, ischemic strokes and paravalvular leak remain a matter of debate in these surgeries. New methods and devices have been developed to reduce the incidence of post-procedural stroke. While the third generation of TAVR valves (i.e., Edwards Sapien 3 and Medtronic Evolut R addresses the issue of paravalvular leak structurally, results on their efficacy in reducing the risk of paravalvular leak are yet to be obtained. Furthermore, TAVR enters the field of hybrid methods in the treatment of cardiac issues via both surgical and catheter-based approaches. Finally, while TAVR is primarily performed on cases with aortic stenosis, new valves and methods have been proposed regarding the application of this technique in aortic regurgitation, as well as other aortic pathologies. TAVR is a suitable therapeutic approach for the treatment of aortic stenosis in high-risk patients. Considering the promising results in the current patient population

  8. Fracture After Total Hip Replacement

    Science.gov (United States)

    ... osteolysis. Symptoms The most common symptoms of periprosthetic hip fracture include: • Pain around the hip or thigh • Swelling ... o en very painful, someone with a periprosthetic hip fracture will most likely go directly to the emergency ...

  9. Gene replacement in Penicillium roqueforti.

    Science.gov (United States)

    Goarin, Anne; Silar, Philippe; Malagnac, Fabienne

    2015-05-01

    Most cheese-making filamentous fungi lack suitable molecular tools to improve their biotechnology potential. Penicillium roqueforti, a species of high industrial importance, would benefit from functional data yielded by molecular genetic approaches. This work provides the first example of gene replacement by homologous recombination in P. roqueforti, demonstrating that knockout experiments can be performed in this fungus. To do so, we improved the existing transformation method to integrate transgenes into P. roqueforti genome. In the meantime, we cloned the PrNiaD gene, which encodes a NADPH-dependent nitrate reductase that reduces nitrate to nitrite. Then, we performed a deletion of the PrNiaD gene from P. roqueforti strain AGO. The ΔPrNiaD mutant strain is more resistant to chlorate-containing medium than the wild-type strain, but did not grow on nitrate-containing medium. Because genomic data are now available, we believe that generating selective deletions of candidate genes will be a key step to open the way for a comprehensive exploration of gene function in P. roqueforti.

  10. VNR CMS Pixel detector replacement

    CERN Document Server

    2017-01-01

    Joel Butler, spokesperson of the CMS collaboration explains how a team from many different partner institutes installed a new detector in CMS. This detector is the silicon pixel detector and they’ve been working on it for about five years, to replace one of our existing detectors. This detectors measures particles closer to the beam than any of the other components of this huge detector behind me. It gives us the most precise picture of tracks as they come out of the collisions and expand and travel through the detector. This particular device has twice as many pixels, 120 million, as opposed to about 68 million in the old detector and it can take data faster and pump it out to the analysis more quickly. 00’53’’ Images of the descent, insertion and installation of first piece of the Pixel detector on Tue Feb 28. Images of the descent, insertion and installation of second piece of the Pixel and the two cylinders being joined.

  11. Orthogonal Matching Pursuit with Replacement

    CERN Document Server

    Jain, Prateek; Dhillon, Inderjit S

    2011-01-01

    In this paper, we consider the problem of compressed sensing where the goal is to recover almost all the sparse vectors using a small number of fixed linear measurements. For this problem, we propose a novel partial hard-thresholding operator that leads to a general family of iterative algorithms. While one extreme of the family yields well known hard thresholding algorithms like ITI (Iterative Thresholding with Inversion) and HTP (Hard Thresholding Pursuit), the other end of the spectrum leads to a novel algorithm that we call Orthogonal Matching Pursuit with Replacement (OMPR). OMPR, like the classic greedy algorithm OMP, adds exactly one coordinate to the support at each iteration, based on the correlation with the current residual. However, unlike OMP, OMPR also removes one coordinate from the support. This simple change allows us to prove that OMPR has the best known guarantees for sparse recovery in terms of the Restricted Isometry Property (a condition on the measurement matrix). In contrast, OMP is kn...

  12. Visual Image Sensor Organ Replacement

    Science.gov (United States)

    Maluf, David A.

    2014-01-01

    This innovation is a system that augments human vision through a technique called "Sensing Super-position" using a Visual Instrument Sensory Organ Replacement (VISOR) device. The VISOR device translates visual and other sensors (i.e., thermal) into sounds to enable very difficult sensing tasks. Three-dimensional spatial brightness and multi-spectral maps of a sensed image are processed using real-time image processing techniques (e.g. histogram normalization) and transformed into a two-dimensional map of an audio signal as a function of frequency and time. Because the human hearing system is capable of learning to process and interpret extremely complicated and rapidly changing auditory patterns, the translation of images into sounds reduces the risk of accidentally filtering out important clues. The VISOR device was developed to augment the current state-of-the-art head-mounted (helmet) display systems. It provides the ability to sense beyond the human visible light range, to increase human sensing resolution, to use wider angle visual perception, and to improve the ability to sense distances. It also allows compensation for movement by the human or changes in the scene being viewed.

  13. [Animal experiment, can we replace?

    Science.gov (United States)

    Combrisson, H

    2017-09-01

    Animal experiment is a subject of controversies. Some people, defenders of animals, think that it is not acceptable to use for scientific purposes at the risk of making them suffer or assert that the results obtained with animals are not transposable in the human beings. Others, in particular researchers in biology or medicine, think that the animal models are essential for the biomedical search. This confrontation of the opinions bases largely on an evolution of the place of animals in our society. The regulations authorize the use of animals for scientific purposes but oblige to make it under restrictive conditions. The application of 3Rs - replacement, reduction, and refinement - expressed in 1959 by Russel and Burch is an ethical guide to improve the welfare of animals in research. The alternative methods do not allow, in the present state of the knowledge, to answer all the scientific questions in biology and medicine research. They are, most of the time, complementary methods of the in vivo methods. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  14. Flow-induced vibration testing of replacement thermowell designs

    Science.gov (United States)

    Haslinger, K. H.

    2003-09-01

    Inconel 600 Primary Water Stress Corrosion Cracking (PWSCC) in Nuclear Pressurized Water Reactors (PWRs) has necessitated the repair/replacement of various small bore nozzles. These repairs/replacements must be designed to avoid unwanted vibrations. So, to this end, new RTD-Thermowell-Nozzle replacement designs were developed and subjected to flow testing over a velocity range from 9.14 to 33.53m/s (30-110ft/s), and temperatures ranging from 121°C to 316°C (250-600°F). The replacement nozzles are welded on the pipe OD, rather than on the pipe ID. A split, tapered ferrule is used to support the nozzle tip inside the pipe bore. This maintains high thermowell tip-resonance frequencies with the objective of avoiding self-excitation from vortex shedding that is believed to have caused failures in an earlier design during initial, precritical plant startup testing. The flow testing was complicated by the small size of the thermowell tips (5.08mm or 0.2in ID), which necessitated use of a complement of low temperature and high temperature instrumentation. Since the high temperature device had an internal resonance (750Hz) within the frequency range of interest (0-2500Hz), adequate sensor correlations had to be derived from low temperature tests. The current nozzle/thermowell design was tested concurrently with two slight variations of the replacement design. The acceleration signals were acquired during incremental and continuous flow sweeps, nominally at 5kHz sampling rates and for time domain processing as high as 25kHz. Whereas vortex-shedding frequencies were predicted to prevail between 400 and 1500Hz, no such response was observed at these frequencies. Rather, the thermowell tips responded due to turbulent buffeting with a peak response that was related directly to flow velocity. Lift direction response was always larger than drag direction response. The thermowell tips also responded at their natural tip frequencies in a narrow band random fashion. At the higher

  15. Biology of tooth replacement in amniotes

    Institute of Scientific and Technical Information of China (English)

    John A Whitlock; Joy M Richman

    2013-01-01

    Tooth replacement is a common trait to most vertebrates, including mammals. Mammals, however, have lost the capacity for continuous tooth renewal seen in most other vertebrates, and typically have only 1–2 generations of teeth. Here, we review the mechanisms of tooth replacement in reptiles and mammals, and discuss in detail the current and historical theories on control of timing and pattern of tooth replacement and development.

  16. Intraoperative Radiation Exposure During Revision Total Ankle Replacement.

    Science.gov (United States)

    Roukis, Thomas S; Iceman, Kelli; Elliott, Andrew D

    2016-01-01

    Intraoperative C-arm image intensification is required for primary total ankle replacement implantation. Significant radiation exposure has been linked to these procedures; however, the radiation exposure during revision total ankle replacement remains unknown. Therefore, we sought to evaluate the radiation exposure encountered during revision total ankle replacement. The data from 41 patients were retrospectively analyzed from a prospective database: 19 Agility(™) to Agility(™); 4 Agility(™) to Custom Agility(™); 9 Agility(™) to INBONE(®) II; 5 Agility(™) to Salto Talaris(®) XT; 2 Scandinavian Total Ankle Replacement Prosthesis to Salto Talaris(®) XT; and 2 INBONE(®) I to INBONE(®) II revision total ankle replacements were performed. Two broad categories were identified: partial revision (Agility(™) to Agility(™), Agility(™) to Custom Agility(™), INBONE(®) I to INBONE(®) II) and complete conversion (Agility(™) to INBONE(®) II, Agility(™) to Salto Talaris(®) XT, Scandinavian Total Ankle Replacement Prosthesis to Salto Talaris(®) XT). The mean radiation exposure per case was significant at 3.49 ± 2.21 mGy. Complete conversions, specifically Agility(™) to INBONE(®) II, exhibited the greatest radiation exposure and C-arm time. Revision implant selection and revision type (complete or partial) directly contributed to radiation exposure. Accordingly, revision systems requiring less radiation exposure are preferable. Surgeons should strive to minimize intraoperative complications and limit additional procedures to those necessary, because both lead to additional radiation exposure.

  17. Understanding Life Cycle Assessment: Applications for OSWER's Land and Materials Managment

    Science.gov (United States)

    The Office of Superfund Remediation and Technology Innovation (OSRTI) is hosting an informative webcast presentation by Jane Bare, expert on Life Cycle Impact Assessment (LCIA) in EPA's Office of Research and Development. Ms. Bare's presentation will provide an overview of LCIA, ...

  18. Aortic valve replacement in octogenarians

    Directory of Open Access Journals (Sweden)

    Dark John H

    2007-07-01

    Full Text Available Abstract Background and Aims As our population ages and life expectancy increases the number of people aged over 80 and more referred for cardiac surgery is growing. This study sought to identify the outcome of aortic valve replacement (AVR in octogenarians. Methods 68 patients aged 80 years or more underwent AVR at the Freeman Hospital, between April 2001 and April 2004. A retrospective review of the notes and outcomes from the patients' GP and the NHS strategic tracking service was performed. 54% (37 underwent isolated AVR whilst 46% (31 underwent combined AVR and CABG. Results Follow up was 100% complete. The mean age was 83.1 ± s.d. 2.9 years, a mean gradient of 83 ± s.d. 31 mmHg and mean AVA of 0.56 cm2. The mean additive EuroSCORE was 8.6 ± s.d. 1.2, the logistic EuroSCORE mean 12.0 ± s.d. 5.9. In hospital 30 day mortality was 13 %. Survival was 80% at 1 year and 78% at 2 years. Median follow up was for 712 days. Stepwise logistic regression identified chronic obstructive airways disease as an independent predictor of mortality (p Conclusion Our study demonstrates that the operative mortality for AVR in the over eighties is good, whilst the mid to long term outcome is excellent There is a very low attrition rate with those undergoing the procedure living as long than their age matched population. This study confirms AVR is a safe, acceptable treatment for octogenarians with excellent mid term outcomes.

  19. Menopause and hormone replacement therapy

    Directory of Open Access Journals (Sweden)

    Ali Baziad

    2001-12-01

    Full Text Available The global population in the 21st century has reached 6.2 billion people, by the year 2025 it is to be around 8.3-8.5 billion, and will increase further. Elderly people are expected to grow rapidly than other groups. The fastest increase in the elderly population will take place in Asia. Life expectancy is increasing steadily throughout developed and developing countries. For many  menopausal women, increased life expectancy will accompanied by many health problems. The consequences of estrogen deficiency are the menopausal symptoms. The treatment of menopause related complaints and diseases became an  important socioeconomic and medical issue. Long term symptoms, such as the increase in osteoporosis fractures, cardio and cerebrovascular disesses and dementia, created a large financial burden on individuals and society. All these health problems can be lreated or prevented by hormone replacement therapy (HRT. Natural HRT is usually prefened. Synthetic  estrogen in oral contraceptives (oc are not recommended for HRT. Many contra-indications for oc, but now it is widely usedfor HRT. The main reasons for discontinuing HRT are unwanted bleeding, fear of cancer, and negative side effects. Until now there are sill debates about the rebrtonship between HRT and the incidence of breast cancer. Many data showed that there were no clear relationship between the use of HRT and breast cancer. ThereÎore, nwny experts advocate the use of HRTfrom the first sign of climacteric complaints until death. (Med J Indones 2001;10: 242-51Keywords: estrogen deficiency, climacteric phases, tibolone.

  20. Total joint replacement preadmission programs.

    Science.gov (United States)

    Messer, B

    1998-01-01

    Patients begin to formulate their expectations of the postoperative hospitalization during the preadmission program. The challenge is to better understand the factors patients consider when formulating judgments about the quality of preadmission education. For example, it may be that perceptions of the preadmission program are influenced by what patients believe about their postoperative pain and functional abilities. Specific attention needs to be given both preoperatively and postoperatively to instructing patients on realistic expectations for recovery. One other method of measuring patient outcomes is with the Health Status Profile (SF-36) (Response Healthcare Information Management, 1995). The SF-36 approach emphasizes the outcome of medical care as the patient sees it, in addition to a clinical evaluation of successful health care. This form is currently initiated in the physician's office and returned for scanning at the preadmission class. The patient then completes another SF-36 at 6 months and every year thereafter to compare measurable outcomes. Patients intending to have elective total joint replacements experience anxiety and require much support and education. An effective preadmission program is a major investment in a patient's recovery, as well as a unique marketing tool to customers. Preadmission programs can be viewed as an opportunity to enhance customer satisfaction. Preadmission clinics are an excellent means for nurses to improve the quality of patient care through patient education. the overall goal of preadmission testing programs is to ensure patient preparedness while increasing quality health care and overall customer satisfaction. To enhance program effectiveness, health care providers must lead collaborative efforts to improve the efficiency of systems.

  1. Current concepts in total femoral replacement.

    Science.gov (United States)

    Ramanathan, Deepak; Siqueira, Marcelo Bp; Klika, Alison K; Higuera, Carlos A; Barsoum, Wael K; Joyce, Michael J

    2015-12-18

    Total femoral replacement (TFR) is a salvage arthroplasty procedure used as an alternative to lower limb amputation. Since its initial description in the mid-20(th) century, this procedure has been used in a variety of oncologic and non-oncologic indications. The most compelling advantage of TFR is the achievement of immediate fixation which permits early mobilization. It is anticipated that TFR will be increasingly performed as the rate of revision arthroplasty rises worldwide. The existing literature is mainly composed of a rather heterogeneous mix of retrospective case series and a wide assortment of case reports. Numerous TFR prostheses are currently available and the surgeon must understand the unique implications of each implant design. Long-term functional outcomes are dependent on adherence to proper technique and an appropriate physical therapy program for postoperative rehabilitation. Revision TFR is mainly performed for periprosthetic infection and the severe femoral bone loss associated with aseptic revisions. Depending on the likelihood of attaining infection clearance, it may sometimes be advisable to proceed directly to hip disarticulation without attempting salvage of the TFR. Other reported complications of TFR include hip joint instability, limb length discrepancy, device failure, component loosening, patellar maltracking and delayed wound healing. Further research is needed to better characterize the long-term functional outcomes and complications associated with this complex procedure.

  2. Process optimized minimally invasive total hip replacement

    Directory of Open Access Journals (Sweden)

    Philipp Gebel

    2012-02-01

    Full Text Available The purpose of this study was to analyse a new concept of using the the minimally invasive direct anterior approach (DAA in total hip replacement (THR in combination with the leg positioner (Rotex- Table and a modified retractor system (Condor. We evaluated retrospectively the first 100 primary THR operated with the new concept between 2009 and 2010, regarding operation data, radiological and clinical outcome (HOOS. All surgeries were perfomed in a standardized operation technique including navigation. The average age of the patients was 68 years (37 to 92 years, with a mean BMI of 26.5 (17 to 43. The mean time of surgery was 80 min. (55 to 130 min. The blood loss showed an average of 511.5 mL (200 to 1000 mL. No intra-operative complications occurred. The postoperative complication rate was 6%. The HOOS increased from 43 points pre-operatively to 90 (max 100 points 3 months after surgery. The radiological analysis showed an average cup inclination of 43° and a leg length discrepancy in a range of +/- 5 mm in 99%. The presented technique led to excellent clinic results, showed low complication rates and allowed correct implant positions although manpower was saved.

  3. Drug dosing during continuous renal replacement therapy.

    Science.gov (United States)

    Churchwell, Mariann D; Mueller, Bruce A

    2009-01-01

    Continuous renal replacement therapy (CRRT) has given clinicians an important option in the care of critically ill patients. The slow and continuous dialysate and ultrafiltrate flow rates that are employed with CRRT can yield drug clearances similar to an analogous glomerular filtration rate of the native kidneys. Advantages such as superior volume control, excellent metabolic control, and hemodynamic tolerance by critically ill patients are well documented, but an understanding of drug dosing for CRRT is still a bit of a mystery. Although some pharmaceutical companies have dedicated postmarket research in this direction, many pharmaceutical companies have chosen not to pursue this information as it is not mandated and represents a relatively small part of their market. This lack of valuable information has created many challenges in the care of the critically ill patient as intermittent hemodialysis drug dosing recommendations cannot be extrapolated to CRRT. This drug dosing review will highlight factors that clinicians should consider when determining a pharmacotherapy regimen for a patient receiving CRRT.

  4. Transcatheter Aortic Valve Replacement in Europe

    DEFF Research Database (Denmark)

    Mylotte, Darren; Osnabrugge, Ruben L J; Windecker, Stephan;

    2013-01-01

    The authors sought to examine the adoption of transcatheter aortic valve replacement (TAVR) in Western Europe and investigate factors that may influence the heterogeneous use of this therapy.......The authors sought to examine the adoption of transcatheter aortic valve replacement (TAVR) in Western Europe and investigate factors that may influence the heterogeneous use of this therapy....

  5. Replacing lactose from calf milk replacers : effects on digestion and post-absorptive metabolism

    NARCIS (Netherlands)

    Gilbert, M.S.

    2015-01-01

    Summary PhD thesis Myrthe S. Gilbert Replacing lactose from calf milk replacers – Effects on digestion and post-absorptive metabolism Veal calves are fed milk replacer (MR) and solid feed. The largest part of the energy provided to veal calves originates from

  6. Aortic valve replacement with the Nicks annulus enlargement procedure 12 years after mitral valve replacement.

    Science.gov (United States)

    Kazama, S; Kurata, A; Yamashita, Y

    1999-10-01

    An aortic valve replacement was successfully performed employing the Nicks annulus enlargement procedure in a case of aortic valve stenosis with small annulus 12 years after mitral valve replacement. Previous mitral valve replacement does not preclude feasibility of the Nicks procedure.

  7. Evaluation of mitral valve replacement anchoring in a phantom

    Science.gov (United States)

    McLeod, A. Jonathan; Moore, John; Lang, Pencilla; Bainbridge, Dan; Campbell, Gordon; Jones, Doug L.; Guiraudon, Gerard M.; Peters, Terry M.

    2012-02-01

    Conventional mitral valve replacement requires a median sternotomy and cardio-pulmonary bypass with aortic crossclamping and is associated with significant mortality and morbidity which could be reduced by performing the procedure off-pump. Replacing the mitral valve in the closed, off-pump, beating heart requires extensive development and validation of surgical and imaging techniques. Image guidance systems and surgical access for off-pump mitral valve replacement have been previously developed, allowing the prosthetic valve to be safely introduced into the left atrium and inserted into the mitral annulus. The major remaining challenge is to design a method of securely anchoring the prosthetic valve inside the beating heart. The development of anchoring techniques has been hampered by the expense and difficulty in conducting large animal studies. In this paper, we demonstrate how prosthetic valve anchoring may be evaluated in a dynamic phantom. The phantom provides a consistent testing environment where pressure measurements and Doppler ultrasound can be used to monitor and assess the valve anchoring procedures, detecting pararvalvular leak when valve anchoring is inadequate. Minimally invasive anchoring techniques may be directly compared to the current gold standard of valves sutured under direct vision, providing a useful tool for the validation of new surgical instruments.

  8. Cell replacement therapy for central nervous system diseases

    Institute of Scientific and Technical Information of China (English)

    Danju Tso; Randall D. McKinnon

    2015-01-01

    The brain and spinal cord can not replace neurons or supporting glia that are lost through trau-matic injury or disease. In pre-clinical studies, however, neural stem and progenitor cell transplants can promote functional recovery. Thus the central nervous system is repair competent but lacks endogenous stem cell resources. To make transplants clinically feasible, this ifeld needs a source of histocompatible, ethically acceptable and non-tumorgenic cells. One strategy to generate pa-tient-speciifc replacement cells is to reprogram autologous cells such as ifbroblasts into pluripotent stem cells which can then be differentiated into the required cell grafts. However, the utility of pluripotent cell derived grafts is limited since they can retain founder cells with intrinsic neoplastic potential. A recent extension of this technology directly reprograms ifbroblasts into the ifnal graft-able cells without an induced pluripotent stem cell intermediate, avoiding the pluripotent caveat. For both types of reprogramming the conversion efficiency is very low resulting in the need to amplify the cells in culture which can lead to chromosomal instability and neoplasia. Thus to make reprogramming biology clinically feasible, we must improve the efifciency. The ultimate source of replacement cells may reside in directly reprogramming accessible cells within the brain.

  9. Conceptual Design Plan SM-43 Replacement Project

    Energy Technology Data Exchange (ETDEWEB)

    University of California, Los Alamos National Laboratory, SCC Project Office

    2000-11-01

    The Los Alamos National Laboratory Conceptual Design Plan for the SM-43 Replacement Project outlines plans for replacing the SM-43 Administration Building. Topics include the reasons that replacement is considered a necessity; the roles of the various project sponsors; and descriptions of the proposed site and facilities. Also covered in this proposal is preliminary information on the project schedule, cost estimates, acquisition strategy, risk assessment, NEPA strategy, safety strategy, and safeguards and security. Spreadsheets provide further detail on space requirements, project schedules, and cost estimates.

  10. Percutaneous tricuspid valve replacement in childhood

    Directory of Open Access Journals (Sweden)

    Mathias Emmel

    2015-01-01

    Full Text Available Percutaneous replacement of the tricuspid valve with a bovine jugular venous valve (melody valve was successfully undertaken in a 9-year-old boy. The patient had a previous history of bacterial endocarditis of the native tricuspid valve in infancy. Initially, a pericardial patch valve was created, followed by surgical replacement of the valve using a biological tissue valve at 4 years of age. Progressive stenosis and regurgitation of the biological valve, with severe venous congestion and resulting hepatic dysfunction prompted percutaneous valve replacement.

  11. Trials and Tribulations with VH Replacement

    Directory of Open Access Journals (Sweden)

    Wenzhao eMeng

    2014-01-01

    Full Text Available VH replacement is a type of antibody gene rearrangement in which an upstream heavy chain variable gene segment (VH invades a pre-existing rearrangement (VDJ. In this Hypothesis and Theory article, we begin by reviewing the mechanism of VH replacement, its developmental timing and its potential biological consequences. Then we explore the hypothesis that specific sequence motifs called footprints reflect VH replacement vs. other processes. We provide a compilation of footprint sequences from different regions of the antibody heavy chain, include data from the literature and from a high throughput sequencing experiment to evaluate the significance of footprint sequences. We conclude by discussing the difficulties of attributing footprints to VH replacement.

  12. Gyrator-type circuits replace ungrounded inductors

    Science.gov (United States)

    Deboo, G. J.

    1968-01-01

    Gyrator circuits using only transistors, capacitors, and resistors which can replace both grounded and ungrounded inductors have been developed to permit complete microminiaturization of circuitry by integration of the components.

  13. Total ankle replacement. Design evolution and results.

    Science.gov (United States)

    van den Heuvel, Alexander; Van Bouwel, Saskia; Dereymaeker, Greta

    2010-04-01

    The ankle joint has unique anatomical, biomechanical and cartilaginous structural characteristics that allow the joint to withstand the very high mechanical stresses and strains over years. Any minor changes to any of these features predispose the joint to osteoarthritis. Total ankle replacement (TAR) is evolving as an alternative to ankle arthrodesis for the treatment of end-stage ankle osteoarthritis. Initial implant designs from the early 1970s had unacceptably high failure and complication rates. As a result many orthopaedic surgeons have restricted the use of TAR in favour of ankle arthrodesis. Long term follow-up studies following ankle arthrodesis show risks of developing adjacent joint osteoarthritis. Therefore research towards a successful ankle replacement continues. Newer designs and longer-term outcome studies have renewed the interest in ankle joint replacement. We present an overview of the evolution, results and current concepts of total ankle replacement.

  14. Minimally Invasive Transcatheter Aortic Valve Replacement (TAVR)

    Medline Plus

    Full Text Available Watch a Broward Health surgeon perform a minimally invasive Transcatheter Aortic Valve Replacement (TAVR) Click Here to view the BroadcastMed, Inc. Privacy Policy and Legal Notice © 2017 BroadcastMed, Inc. ...

  15. 47 CFR 13.17 - Replacement license.

    Science.gov (United States)

    2010-10-01

    ... Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL COMMERCIAL RADIO OPERATORS General § 13.17 Replacement... Operator License, Marine Radio Operator Permit, First Class Radiotelegraph Operator's Certificate, Second... Radio Operator's License, Restricted GMDSS Radio Operator License, GMDSS Radio Maintainer's License,...

  16. Renal replacement therapy for acute renal failure.

    Science.gov (United States)

    Macedo, E; Bouchard, J; Mehta, R L

    2009-09-01

    Renal replacement therapy became a common clinical tool to treat patients with severe acute kidney injury (AKI) since the 1960s. During this time dialytic options have expanded considerably; biocompatible membranes, bicarbonate dialysate and dialysis machines with volumetric ultrafiltration control have improved the treatment for acute kidney injury. Along with advances in methods of intermittent hemodialysis, continuous renal replacement therapies have gained widespread acceptance in the treatment of dialysis-requiring AKI. However, many of the fundamental aspects of the renal replacement treatment such as indication, timing of dialytic intervention, and choice of dialysis modality are still controversial and may influence AKI patient's outcomes. This review outlines current concepts in the use of dialysis techniques for AKI and suggests an approach for selecting the optimal method of renal replacement therapy.

  17. Minimally Invasive Transcatheter Aortic Valve Replacement (TAVR)

    Medline Plus

    Full Text Available Watch a Broward Health surgeon perform a minimally invasive Transcatheter Aortic Valve Replacement (TAVR) Click Here to view the BroadcastMed, Inc. Privacy Policy and Legal Notice © 2017 BroadcastMed, Inc. ...

  18. SYNERGISTIC WOOD PRESERVATIVES FOR REPLACEMENT OF CCA

    Science.gov (United States)

    The objective of this project was to evaluate the potential synergistic combinations of environmentally-safe biocides as wood preservatives. These wood preservatives could be potential replacements for the heavy-metal based CCA.Didecyldimethylammonium chloride [DDAC] was...

  19. Bone Marrow Transplantation (BMT) and Gene Replacement ...

    African Journals Online (AJOL)

    Bone Marrow Transplantation (BMT) and Gene Replacement Therapy (GRT) In Sickle Cell Anemia. ... manifesting clinical disease, while the heterozygoste(AS) are clinically ... medicine, we argue here the case for Bone marrow transplantation

  20. Infective endocarditis following percutaneous pulmonary valve replacement

    DEFF Research Database (Denmark)

    Cheung, Gary; Vejlstrup, Niels; Ihlemann, Nikolaj;

    2013-01-01

    Infective endocarditis (IE) following percutaneous pulmonary valve replacement (PPVR) with the Melody valve is rarely reported. Furthermore, there are challenges in this diagnosis; especially echocardiographic evidence of vegetation within the prosthesis may be difficult.......Infective endocarditis (IE) following percutaneous pulmonary valve replacement (PPVR) with the Melody valve is rarely reported. Furthermore, there are challenges in this diagnosis; especially echocardiographic evidence of vegetation within the prosthesis may be difficult....

  1. [Replacement of tracheo-esophageal Provox prosthesis].

    Science.gov (United States)

    Biacabe, B; Laccourreye, O; Ménard, M; Hans, S; Brasnu, D

    2000-02-01

    To compare anesthesic techniques used between 1992 and 1997 at Laënnec Hospital for replacement by tracheo-esophageal Provox prosthesis: local and general anesthesia. Theoretical financial cost for replacement was estimated according to anaesthetic techniques. Provox in situ lifetime was calculated in 58 patients who underwent 115 and 49 replacements under general and local anaesthesia respectively. Age, sex, surgical and radiotherapy backgrounds, complications and anaesthetic techniques were studied as potential factors correlated with Provox in situ lifetime. Theoretical financial cost for replacement was estimated according to anaesthetic techniques. In 1992, 12% of Provox prosthesis were inserted under local anaesthesia and 54% in 1997. Provox in situ lifetime was either not influenced by anaesthetic techniques or other factors under analysis. The theoretical financial cost was estimated at 14, 341 FFrs and 6,048 FFrs for replacement under general and local anaesthesia respectively. Due to increased control of health care costs, we advocated local anaesthesia for Provox prosthesis replacement if control endoscopy is not required.

  2. Strategic vehicle fleet management - the replacement problem

    Directory of Open Access Journals (Sweden)

    Adam Redmer

    2016-03-01

    Full Text Available Background: Fleets constitute the most important production means in transportation. Their appropriate management is crucial for all companies having transportation duties. The paper is the third one of a series of three papers that the author dedicates to the strategic vehicle fleet management topic. Material and methods: The paper discusses ways of building replacement strategies for companies' fleets of vehicles. It means deciding for how long to exploit particular vehicles in a fleet (the fleet replacement problem - FR. The essence of this problem lies in the minimization of vehicle / fleet exploitation costs by balancing ownership and utilization costs and taking into account budget limitations. In the paper an original mathematical model (an optimization method allowing for the FR analysis is proposed. Results: An application of the proposed optimization method in a real-life decision situation (the case study within the Polish environment and the obtained solution are presented. The solution shows that there exist optimal exploitation periods of particular vehicles in a fleet. However, combination of them gives a replacement plan for an entire fleet violating budget constraints. But it is possible to adjust individual age to replacement of particular vehicles to fulfill budget constraints without losing economical optimality of a developed replacement plan for an entire fleet. Conclusions: The paper is the last one of a series of three papers that the author dedicated to the strategic vehicle fleet management topic including the following managerial decision problems: MAKE-or-BUY, sizing / composition and replacement.

  3. Renal Replacement Therapy [version 1; referees: 4 approved

    Directory of Open Access Journals (Sweden)

    Zaccaria Ricci

    2016-01-01

    Full Text Available During the last few years, due to medical and surgical evolution, patients with increasingly severe diseases causing multiorgan dysfunction are frequently admitted to intensive care units. Therapeutic options, when organ failure occurs, are frequently nonspecific and mostly directed towards supporting vital function. In these scenarios, the kidneys are almost always involved and, therefore, renal replacement therapies have become a common routine practice in critically ill patients with acute kidney injury. Recent technological improvement has led to the production of safe, versatile and efficient dialysis machines. In addition, emerging evidence may allow better individualization of treatment with tailored prescription depending on the patients’ clinical picture (e.g. sepsis, fluid overload, pediatric. The aim of the present review is to give a general overview of current practice in renal replacement therapies for critically ill patients. The main clinical aspects, including dose prescription, modality of dialysis delivery, anticoagulation strategies and timing will be addressed. In addition, some technical issues on physical principles governing blood purification, filters characteristics, and vascular access, will be covered. Finally, a section on current standard nomenclature of renal replacement therapy is devoted to clarify the “Tower of Babel” of critical care nephrology.

  4. A randomized clinical trial of cusp-replacing resin composite restorations: efficiency and short-term effectiveness.

    NARCIS (Netherlands)

    Kuijs, R.H.; Fennis, W.M.M.; Kreulen, C.M.; Roeters, F.J.M.; Creugers, N.H.J.; Burgersdijk, R.C.W.

    2006-01-01

    PURPOSE: This study aimed to assess the efficacy and short-term effectiveness of the morphology and function of direct and indirect cusp-replacing resin composite restorations. MATERIALS AND METHODS: In 94 patients, 106 cusp-replacing restorations for maxillary premolars were fabricated to restore

  5. The Scandinavian Total Ankle Replacement and the ideal biomechanical requirements of ankle replacements.

    Science.gov (United States)

    Robati, Shibby; Salih, Alan; Ghosh, Koushik; Vinayakam, Parthiban

    2016-03-01

    The complex anatomy of the articular bone surfaces, ligaments, tendon attachments and muscles makes the ankle joint difficult to replicate in prosthetic replacements. Ever since the early 1970s, which saw the dawn of the first total ankle replacements, there have been numerous other attempts at replicating the joint, often with poor clinical outcomes. The anatomy of the ankle is discussed, followed by evidence of the normal ankle biomechanics and the ideal requirements of an ankle replacement. We focus on the Scandinavian Total Ankle Replacement and evaluate whether these requirements have been met.

  6. Posterior Ankle Structure Injury During Total Ankle Replacement.

    Science.gov (United States)

    Reb, Christopher W; McAlister, Jeffrey E; Hyer, Christopher F; Berlet, Gregory C

    2016-01-01

    Total ankle replacement studies have focused on reporting complications that are directly observed clinically or radiographically, including wound problems, technical errors, implant loosening, subsidence, infection, bone fractures, and heterotopic ossification. However, patients can still experience unresolved pain even when these problems have been ruled out. We initiated a study to more clearly define the relative risk of injury to the anatomic structures in the posterior ankle during total ankle replacement using a third-generation implant system. Ten fresh-frozen adult cadaveric below-the-knee specimens were positioned in the intraoperative positioning frame of an approved total ankle replacement system and adjusted to achieve proper foot alignment using fluoroscopic imaging. The relationship between the tibial cutting guide pins and the posterior neurovascular and tendon structures was measured using digital calipers. High rates of posterior structural injury were found. Nearly all proximal-medial pins encountered a posteromedial neurovascular structure, most commonly the tibial nerve. The distal-medial pins mainly encountered posteromedial tendinous structures, in particular, the flexor digitorum longus tendon. The proximal lateral pins were highly likely to encounter the Achilles tendon and the sural nerve. Our results support our hypothesis that the tibial neurovascular structures are at the greatest risk when preparing for and completing the bony resection, particularly with the medial and proximal cuts. Posterior ankle soft tissue structure injuries can occur during implantation but currently with unknown frequency and undetermined significance. Further study of posterior structural injuries could result in a more informed approach to post-total ankle replacement complications and management.

  7. Testosterone replacement therapy and prostate health.

    Science.gov (United States)

    Polackwich, A Scott; Ostrowski, Kevin A; Hedges, Jason C

    2012-12-01

    There is an emerging evolution in the understanding of the relationship between the prostate and testosterone. It has long been generally believed that with testosterone replacement therapy (TRT), increasing serum testosterone levels led to prostatic growth and worsening of voiding dysfunction and associated complications. A new theory, the Saturation Model of Testosterone and its effect on the Prostate has gained attention. This theory suggests that the prostate's response to increasing levels of serum testosterone reaches a limit beyond which there is minimal effect. This model predicts that testosterone replacement therapy occurs above this saturation point, and replacing testosterone to eugonadal levels should not worsen prostate related benign disease. We evaluated the recent published data, with an emphasis on clinical studies done within the last 3 years, for the effects of testosterone supplementation on benign prostatic disease.

  8. Postmenopausal hormone replacement therapy--clinical implications

    DEFF Research Database (Denmark)

    Ravn, S H; Rosenberg, J; Bostofte, E

    1994-01-01

    in the urogenital tract. Women at risk of osteoporosis will benefit from hormone replacement therapy. The treatment should start as soon after menopause as possible and it is possible that it should be maintained for life. The treatment may be supplemented with extra calcium intake, vitamin D, and maybe calcitonin....... Physical activity should be promoted, and cigarette smoking reduced if possible. Women at risk of cardiovascular disease will also benefit from hormone replacement therapy. There is overwhelming evidence that hormone therapy will protect against both coronary heart disease and stroke...... suggest that every woman showing any signs of hormone deprivation should be treated with hormone replacement therapy. This includes women with subjective or objective vaso-motor symptoms, genito-urinary symptoms, women at risk of osteoporosis (fast bone losers), and women at risk of cardiovascular...

  9. Double Valve Replacement for Lupus Valvulitis

    Science.gov (United States)

    Ferraris, Victor A.; Hawksley, Vaughn C.; Rabinowitz, Max; Coyne, Carolyn M.; Sullivan, Thomas J.; Sprague, Merle S.

    1990-01-01

    Hemodynamically significant lupus valvulitis, requiring valve replacement, is rare: 21 cases have been reported so far in the literature, and only 2 of these have involved double valve replacement. We describe an additional case of double valve replacement in a patient with systemic lupus erythematosus. The histopathologic and clinical features of this case suggest that valvular involvement resulted from both acute and chronic disease processes. Medical success in the treatment of systemic lupus erythematosus, especially that achieved through prolonged or high-dose steroid therapy, may cause chronic valvular disease to become a more common surgical problem. A review of the literature supports this contention. (Texas Heart Institute Journal 1990;17:56-60) Images PMID:15227191

  10. Renal function after elective total hip replacement

    DEFF Research Database (Denmark)

    Perregaard, Helene; Damholt, Mette B; Solgaard, Søren

    2016-01-01

    and the prevalence of chronic kidney disease (CKD) in an elective population of orthopedic patients undergoing primary total hip replacement, hypothesizing that chronic kidney disease predisposes to AKI. Patients and methods - This was a single-center, population-based, retrospective, registry-based cohort study...... involving all primary elective total hip replacements performed from January 2003 through December 2012. Patient demographics and creatinine values were registered. We evaluated the presence of CKD and AKI according to the international guidelines for kidney disease (KDIGO Acute Kidney Injury Workgroup 2013...... ). Results - 3,416 patients were included (2,064 females (60%)). AKI (according to KDIGO criteria) was seen in 75 patients (2.2%, 95% CI: 1.7-2.7) in the course of primary total hip replacement. Of these, 26 had pre-existing CKD of class 3-5. Pre-existing CKD of class 3-5, indicating moderately to severely...

  11. OPTIMAL MAINTENANCE AND REPLACEMENT OF EXTRACTION MACHINERY

    Institute of Scientific and Technical Information of China (English)

    Suresh P.SETHI; Hong-Mo YEH; Rong ZHANG; Andrew K.S.JARDINE

    2008-01-01

    This paper considers a problem of optimal preventive maintenance and replacement schedule ofequipment devoted to extracting resources from known deposits. Typical examples are oil drills, mine shovels, etc. At most one replacement of the existing machinery by a new one is allowed. The problem is formulated as an optimal control problem subject to the state constraint that the remaining deposit at any given time is nonnegative. We show that the optimal preventive maintenance, production rates, and the replacement and salvage times of the existing machinery and the new one, if required, can be obtained by solving sequentially a series of free-end-point optimal control problems. Moreover, an algorithm based on this result is developed and used to solve two illustrative examples.

  12. Dead pixel replacement in LWIR microgrid polarimeters.

    Science.gov (United States)

    Ratliff, Bradley M; Tyo, J Scott; Boger, James K; Black, Wiley T; Bowers, David L; Fetrow, Matthew P

    2007-06-11

    LWIR imaging arrays are often affected by nonresponsive pixels, or "dead pixels." These dead pixels can severely degrade the quality of imagery and often have to be replaced before subsequent image processing and display of the imagery data. For LWIR arrays that are integrated with arrays of micropolarizers, the problem of dead pixels is amplified. Conventional dead pixel replacement (DPR) strategies cannot be employed since neighboring pixels are of different polarizations. In this paper we present two DPR schemes. The first is a modified nearest-neighbor replacement method. The second is a method based on redundancy in the polarization measurements.We find that the redundancy-based DPR scheme provides an order-of-magnitude better performance for typical LWIR polarimetric data.

  13. Hip or knee replacement - after - what to ask your doctor

    Science.gov (United States)

    ... replacement Hip pain Knee joint replacement Knee pain Osteoarthritis ... Ma, MD, Assistant Professor, Chief, Sports Medicine and Shoulder Service, UCSF Department of Orthopaedic Surgery, San Francisco, ...

  14. Hip or knee replacement - before - what to ask your doctor

    Science.gov (United States)

    ... replacement Hip pain Knee joint replacement Knee pain Osteoarthritis ... Ma, MD, Assistant Professor, Chief, Sports Medicine and Shoulder Service, UCSF Department of Orthopaedic Surgery, San Francisco, ...

  15. The echocardiography of replacement heart valves

    Science.gov (United States)

    2016-01-01

    This is a practical description of how replacement valves are assessed using echocardiography. Normal transthoracic appearances including normal variants are described. The problem of differentiating normal function, patient–prosthesis mismatch and pathological obstruction in aortic replacement valves with high gradients is discussed. Obstruction and abnormal regurgitation is described for valves in the aortic, mitral and right-sided positions and when to use echocardiography in suspected infective endocarditis. The roles of transoesophageal and stress echocardiography are described and finally when other imaging techniques may be useful. PMID:27600454

  16. Upgrade or replace?: The effect of the EPBD on the choice between improvement or replacement

    NARCIS (Netherlands)

    Thomsen, A.F.; Van der Flier, C.L.

    2010-01-01

    What is better: improvement or replacement by new construction? The choice between life cycle extension and replacement of existing buildings is at itself a vital but very difficult decision, involving a wide range of different aspects and affecting several contrary and often conflicting interests.

  17. Direct Democracy

    DEFF Research Database (Denmark)

    Doerr, Nicole

    2013-01-01

    Direct democracy describes a theory of democracy and a form of collective decision-making in which sovereignty is directly exercised by the people. Democracy is direct if it is characterized by citizens making all decisions together with a maximum of equal participation. Direct democracy can...

  18. Direct Bonded Pontic (Laporan Kasus

    Directory of Open Access Journals (Sweden)

    Suhandi Sidjaja

    2015-10-01

    Full Text Available Advanced science and technology in dentistry enable dental practitioners to modified she bonding techniques in tooth replacement. A pontic made of composite resin bonded to etched enamel of the adjacent teeth can be used in the replacement of one missing anterior tooth with a virgin or sowed adpicent tooth. The advantages of this technique include a one visit treatment, cow cost, good esthetics, less side effects and easy repair or rebounding. Clinical evaluation showed a high success rate therefore with a proper diagnosis and a perfect skill of the direct bonded technique this treatment can be used as an alternative restoration.

  19. Potential of Microbubbles as Fat Replacer

    NARCIS (Netherlands)

    Rovers, T.A.M.; Sala, Guido; Linden, Van der Erik; Meinders, M.B.J.

    2016-01-01

    The potential of microbubbles as fat replacers and texture modifiers was assessed by comparison of the rheological and tribological properties of model food systems that contained (1) microbubbles, (2) emulsion droplets or (3) no added colloidal structures. We used (a) liquids with thickener, (b)

  20. Predictors of mortality after aortic valve replacement

    NARCIS (Netherlands)

    Tjang, Yanto Sandy; van Hees, Yvonne; Koerfer, Reiner; Grobbee, Diederick E.; van der Heijden, Geert J. M. G.

    Aortic valve replacement (AVR) is recommended as a standard surgical procedure for aortic valve disease. Still the evidence for commonly claimed predictors of post-AVR prognosis, in particular mortality, appears scant. This systematic review reports on the evidence for predictors of post-AVR

  1. Is physiological glucocorticoid replacement important in children?

    Science.gov (United States)

    Porter, John; Blair, Joanne; Ross, Richard J

    2017-01-01

    Cortisol has a distinct circadian rhythm with low concentrations at night, rising in the early hours of the morning, peaking on waking and declining over the day to low concentrations in the evening. Loss of this circadian rhythm, as seen in jetlag and shift work, is associated with fatigue in the short term and diabetes and obesity in the medium to long term. Patients with adrenal insufficiency on current glucocorticoid replacement with hydrocortisone have unphysiological cortisol concentrations being low on waking and high after each dose of hydrocortisone. Patients with adrenal insufficiency complain of fatigue, a poor quality of life and there is evidence of poor health outcomes including obesity potentially related to glucocorticoid replacement. New technologies are being developed that deliver more physiological glucocorticoid replacement including hydrocortisone by subcutaneous pump, Plenadren, a once-daily modified-release hydrocortisone and Chronocort, a delayed and sustained absorption hydrocortisone formulation that replicates the overnight profile of cortisol. In this review, we summarise the evidence regarding physiological glucocorticoid replacement with a focus on relevance to paediatrics. PMID:27582458

  2. 25 CFR 700.53 - Dwelling, replacement.

    Science.gov (United States)

    2010-04-01

    ... § 700.55. (b) May include existing dwellings for resale, new construction, modular homes, mobile homes... person if, after he receives a replacement housing payment and any available housing assistance payments... supplemental income payments received from public agencies. If the person's monthly income pattern is...

  3. Prosthesis infections after orthopedic joint replacement

    DEFF Research Database (Denmark)

    Song, Zhijun; Borgwardt, Lotte; Høiby, Niels

    2013-01-01

    Prosthesis-related infection is a serious complication for patients after orthopedic joint replacement, which is currently difficult to treat with antibiotic therapy. Consequently, in most cases, removal of the infected prosthesis is the only solution to cure the infection. It is, therefore...

  4. Criteria for the replacement of restorations

    DEFF Research Database (Denmark)

    Wilson, Nairn; Lynch, Christopher; Brunton, Paul Brunton

    2016-01-01

    The replacement of a restoration is one of the most common procedures in dentistry. However, the criteria for such intervention, excluding catastrophic failure and persistent discomfort and pain, continue to be the subject of considerable debate. The decision-making process remains subjective...

  5. Measure Guideline: Window Repair, Rehabilitation, and Replacement

    Energy Technology Data Exchange (ETDEWEB)

    Baker, P.

    2012-12-01

    This measure guideline provides information and guidance on rehabilitating, retrofitting, and replacing existing window assemblies in residential construction. The intent is to provide information regarding means and methods to improve the energy and comfort performance of existing wood window assemblies in a way that takes into consideration component durability, in-service operation, and long term performance of the strategies.

  6. Segmental blood pressure after total hip replacement

    DEFF Research Database (Denmark)

    Gebuhr, Peter Henrik; Soelberg, M; Henriksen, Jens Henrik Sahl

    1992-01-01

    Twenty-nine patients due to have a total hip replacement had their systemic systolic and segmental blood pressures measured prior to operation and 1 and 6 weeks postoperatively. No patients had signs of ischemia. The segmental blood pressure was measured at the ankle and at the toes. A significant...

  7. Method of replacing corrupted audio data

    NARCIS (Netherlands)

    Stemerdink, J.; Meijerink, Arjan

    2006-01-01

    A decoding method for coded data representing original data. Corrupted data is detected and replaced with buffered data. The buffered data is stored in the buffer a time interval corresponding to an estimated periodicity or an integer multiple thereof before the corrupted data was received. The esti

  8. Analogue Assessment of the Replacement Behavior

    Science.gov (United States)

    Cipani, Ennio

    2008-01-01

    The use of experimental analyses in determining behavioral function for problems behaviors is well established. Such analyses lead to functional treatment prescriptions for the target problem behavior. However, data indicative of the strength of the replacement behavior are often not collected during a functional behavioral assessment. I examine…

  9. Hormone replacement therapy and risk of glioma

    DEFF Research Database (Denmark)

    Andersen, Lene; Friis, Søren; Hallas, Jesper;

    2013-01-01

    Aim: Several studies indicate that use of hormone replacement therapy (HRT) is associated with an increased risk of intracranial meningioma, while associations between HRT use and risk of other brain tumors have been less explored. We investigated the influence of HRT use on the risk of glioma...

  10. Aggression Replacement Training and Childhood Trauma

    Science.gov (United States)

    Amendola, A. Mark; Oliver, Robert W.

    2013-01-01

    Aggression Replacement Training (ART) was developed by the late Arnold Goldstein of Syracuse University to teach positive alternatives to children and youth with emotional and behavioral problems (Glick & Gibbs, 2011; Goldstein, Glick, & Gibbs, 1998). ART provides cognitive, affective, and behavioral interventions to build competence in…

  11. Probability Issues in without Replacement Sampling

    Science.gov (United States)

    Joarder, A. H.; Al-Sabah, W. S.

    2007-01-01

    Sampling without replacement is an important aspect in teaching conditional probabilities in elementary statistics courses. Different methods proposed in different texts for calculating probabilities of events in this context are reviewed and their relative merits and limitations in applications are pinpointed. An alternative representation of…

  12. [Acute renal replacement therapy in pediatrics].

    Science.gov (United States)

    Gaillot, T; Ozanne, B; Bétrémieux, P; Tirel, O; Ecoffey, C

    2013-12-01

    In pediatric intensive care unit, the available modalities of acute renal replacement therapy include intermittent hemodialysis, peritoneal dialysis and continuous renal replacement therapies. No prospective studies have evaluated to date the effect of dialysis modality on the outcomes of children. The decision about dialysis modality should therefore be based on local expertise, resources available, and the patient's clinical status. Poor hemodynamic tolerance of intermittent hemodialysis is a common problem in critically ill patients. Moreover, many pediatric intensive care units are not equipped with dedicated water circuit. Peritoneal dialysis, a simple and inexpensive alternative, is the most widely available form of acute renal replacement therapy. However, its efficacy may be limited in critically ill patients. The use of continuous renal replacement therapy permits usually to reach a greater estimated dialysis dose, a better control of fluid balance, and additionally, to provide adequate nutrition. Copyright © 2013 Société française d’anesthésie et de réanimation (Sfar). Published by Elsevier SAS. All rights reserved.

  13. Revision Total Hip Replacement: A Case Report

    Directory of Open Access Journals (Sweden)

    Md Hafizur Rahman

    2013-07-01

    Full Text Available Total hip replacement is a reconstructive procedure that has improved the management of those diseases of the hip joint that have responded poorly to conventional medical therapy. Conventional, primary total hip replacement is a durable operation in the majority of patients. A hip replacement is a mechanical device with parts that are assembled before and during the operation. But the possible complications of total hip arthroplasty, and its clinical performance over time, is a challenging occasion to the surgeons, and such a challenge we faced with our presenting patient. A 68 year old lady with history of cemented bipolar hemiarthroplasty done in a tertiary care hospital, due to fracture neck of the left femur having the history of diabetes, chronic kidney disease, heart disease, anaemia, and mental disorders presented with loosened prosthesis, thinning of medial proximal cortex of the femur which had broken within few months after surgery. She complained of painful walking at left hip joint. There was also evidence of chronic infective and degenerative arthritis of acetabular component of the affected hip joint. Cemented revision total hip replacement surgery was performed with expert multidisciplinary involvement. On 2nd postoperative day the patient was allowed to walk on operated limb with the aid of walker. On 12th postoperative day all the stitches were removed and wound was found healthy.

  14. [Hormone replacement therapy: curse or blessing?].

    Science.gov (United States)

    Schmidt, M; Fink, D; Lang, U; Kimmig, R

    2006-01-01

    There is a controversial discussion on the risks and benefits of hormonal replacement therapy (HRT), and many women and doctors have revised their opinions of HRT over the last few years. Complementary and alternative therapies can be considered an option to treat menopausal symptoms. The following issue summarizes the actual knowledge of treatment options of menopausal symptoms.

  15. Enzyme replacement therapy for alpha-mannosidosis

    DEFF Research Database (Denmark)

    Borgwardt, Line Gutte; Dali, Christine I.; Fogh, J

    2013-01-01

    Alpha-mannosidosis (OMIM 248500) is a rare lysosomal storage disease (LSD) caused by alpha-mannosidase deficiency. Manifestations include intellectual disabilities, facial characteristics and hearing impairment. A recombinant human alpha-mannosidase (rhLAMAN) has been developed for weekly intrave...... intravenous enzyme replacement therapy (ERT). We present the preliminary data after 12 months of treatment....

  16. Esophageal tissue engineering: A new approach for esophageal replacement

    Institute of Scientific and Technical Information of China (English)

    Giorgia Totonelli; Panagiotis Maghsoudlou; Jonathan M Fishman; Giuseppe Orlando; Tahera Ansari; Paul Sibbons; Martin A Birchall

    2012-01-01

    A number of congenital and acquired disorders require esophageal tissue replacement.Various surgical techniques,such as gastric and colonic interposition,are standards of treatment,but frequently complicated by stenosis and other problems.Regenerative medicine approaches facilitate the use of biological constructs to replace or regenerate normal tissue function.We review the literature of esophageal tissue engineering,discuss its implications,compare the methodologies that have been employed and suggest possible directions for the future.Medline,Embase,the Cochrane Library,National Research Register and ClinicalTrials.gov databases were searched with the following search terms:stem cell and esophagus,esophageal replacement,esophageal tissue engineering,esophageal substitution.Reference lists of papers identified were also examined and experts in this field contacted for further information.All full-text articles in English of all potentially relevant abstracts were reviewed.Tissue engineering has involved acellular scaffolds that were either transplanted with the aim of being repopulated by host cells or seeded prior to transplantation.When acellular scaffolds were used to replace patch and short tubular defects they allowed epithelial and partial muscular migration whereas when employed for long tubular defects the results were poor leading to an increased rate of stenosis and mortality.Stenting has been shown as an effective means to reduce stenotic changes and promote cell migration,whilst omental wrapping to induce vascularization of the construct has an uncertain benefit.Decellularized matrices have been recently suggested as the optimal choice for scaffolds,but smart polymers that will incorporate signalling to promote cell-scaffold interaction may provide a more reproducible and available solution.Results in animal models that have used seeded scaffolds strongly suggest that seeding of both muscle and epithelial cells on scaffolds prior to implantation is a

  17. Influence of Total Knee Arthroplasty on Gait Mechanics of the Replaced and Non-Replaced Limb During Stair Negotiation.

    Science.gov (United States)

    Standifird, Tyler W; Saxton, Arnold M; Coe, Dawn P; Cates, Harold E; Reinbolt, Jeffrey A; Zhang, Songning

    2016-01-01

    This study compared biomechanics during stair ascent in replaced and non-replaced limbs of total knee arthroplasty (TKA) patients with control limbs of healthy participants. Thirteen TKA patients and fifteen controls performed stair ascent. Replaced and non-replaced knees of TKA patients were less flexed at contact compared to controls. The loading response peak knee extension moment was greater in control and non-replaced knees compared with replaced. The push-off peak knee abduction moment was elevated in replaced limbs compared to controls. Loading and push-off peak hip abduction moments were greater in replaced limbs compared to controls. The push-off peak hip abduction moment was greater in non-replaced limbs compared to controls. Future rehabilitation protocols should consider the replaced knee and also the non-replaced knee and surrounding joints.

  18. 25 CFR 700.183 - Determination of replacement housing benefit.

    Science.gov (United States)

    2010-04-01

    ... 25 Indians 2 2010-04-01 2010-04-01 false Determination of replacement housing benefit. 700.183... RELOCATION PROCEDURES Replacement Housing Payments § 700.183 Determination of replacement housing benefit. (a) Amount of benefit. The replacement housing benefit for a certified eligible head-of-household is...

  19. Directed homology

    DEFF Research Database (Denmark)

    Fahrenberg, Uli

    2004-01-01

    We introduce a new notion of directed homology for semicubical sets. We show that it respects directed homotopy and is functorial, and that it appears to enjoy some good algebraic properties. Our work has applications to higher-dimensional automata.......We introduce a new notion of directed homology for semicubical sets. We show that it respects directed homotopy and is functorial, and that it appears to enjoy some good algebraic properties. Our work has applications to higher-dimensional automata....

  20. [Direct biosynthesis of ethylene].

    Science.gov (United States)

    Sun, Zhilan; Chen, Yifeng

    2013-10-01

    Ethylene is the most widely used petrochemical feedstock globally. The development of bio-ethylene is essential due to limited fossil fuels and rising oil prices. Bio-ethylene is produced primarily by the dehydration of ethanol, but can alternatively be directly produced from ethylene biosynthesis pathways in plants, algae, or microorganisms by using cheap and renewable substrates. This review addressed the biosynthesis of ethylene in plants and microorganisms, the characterization of key enzymes, genetic engineering strategies for ethylene biosynthesis in microorganisms, and evaluated its perspective and successful cases toward the industrial application. The direct production of bio-ethylene from a biological process in situ is promising to supplement and even replace the petrochemical ethylene production.

  1. Effects of replacing lactose from milk replacer by glucose, fructose, or glycerol on energy partitioning in veal calves

    NARCIS (Netherlands)

    Gilbert, M. S.; Pantophlet, A. J.; van den Borne, J. J. G. C.; Hendriks, W. H.; Schols, H. A.; Gerrits, W. J. J.

    2016-01-01

    Calf milk replacers contain 40 to 50% lactose. Fluctuating dairy prices are a major economic incentive to replace lactose from milk replacers by alternative energy sources. Our objective was, therefore, to determine the effects of replacement of lactose with glucose, fructose, or glycerol on energy

  2. Effects of replacing lactose from milk replacer by glucose, fructose, or glycerol on energy partitioning in veal calves

    NARCIS (Netherlands)

    Gilbert, M.S.; Pantophlet, A.J.; Borne, van den J.J.G.C.; Hendriks, W.H.; Schols, H.A.; Gerrits, W.J.J.

    2016-01-01

    Calf milk replacers contain 40 to 50% lactose. Fluctuating dairy prices are a major economic incentive to replace lactose from milk replacers by alternative energy sources. Our objective was, therefore, to determine the effects of replacement of lactose with glucose, fructose, or glycerol on

  3. Effects of replacing lactose from milk replacer by glucose, fructose, or glycerol on energy partitioning in veal calves

    NARCIS (Netherlands)

    Gilbert, M. S.; Pantophlet, A. J.; van den Borne, J. J. G. C.; Hendriks, W. H.; Schols, H. A.; Gerrits, W. J. J.

    Calf milk replacers contain 40 to 50% lactose. Fluctuating dairy prices are a major economic incentive to replace lactose from milk replacers by alternative energy sources. Our objective was, therefore, to determine the effects of replacement of lactose with glucose, fructose, or glycerol on energy

  4. An improved cloning vector for construction of gene replacements in Listeria monocytogenes.

    Science.gov (United States)

    Li, Guojie; Kathariou, S

    2003-05-01

    Listeria monocytogenes is a gram-positive, facultative intracellular bacterium implicated in severe food-borne illness (listeriosis) in humans. The construction of well-defined gene replacements in the genome of L. monocytogenes has been instrumental to several genetic studies of the virulence and other attributes of the organism. Construction of such mutations by currently available procedures, however, tends to be labor intensive, and gene replacement mutants are sometimes difficult to recover due to lack of direct selection for the construct. In this study we describe the construction and use of plasmid vector pGF-EM, which can be conjugatively transferred from Escherichia coli S17-1 to L. monocytogenes and which provides the genetic means for direct selection of gene replacements.

  5. Transcatheter aortic valve replacement in elderly patients

    Institute of Scientific and Technical Information of China (English)

    Dimytri Siqueira; Alexandre Abizaid; Magaly Arrais J.; Eduardo Sousa

    2012-01-01

    Aortic stenosis is the most common native valve disease, affecting up to 5% of the elderly population. Surgical aortic valve replacement reduces symptoms and improves survival, and is the definitive therapy in patients with symptomatic severe aortic stenosis. However, despite the good results of classic surgery, risk is markedly increased in elderly patients with co-morbidities. Transcatheter aortic valve replacement (TAVR) allows implantation of a prosthetic heart valve within the diseased native aortic valve without the need for open heart surgery and cardiopulmonary bypass, offering a new therapeutic option to elderly patients considered at high surgical risk or with contraindications to surgery. To date, several multicenter registries and a randomized trial have confirmed the safety and efficacy of TAVR in those patients. In this chapter, we review the background and clinical applications of TAVR in elderly patients.

  6. Mitochondrial replacement therapy in reproductive medicine.

    Science.gov (United States)

    Wolf, Don P; Mitalipov, Nargiz; Mitalipov, Shoukhrat

    2015-02-01

    Mitochondrial dysfunction is implicated in disease and age-related infertility. Mitochondrial replacement therapies (MRT) in oocytes or zygotes, such as pronuclear (PNT), spindle (ST), or polar body (PBT) transfer, could prevent second-generation transmission of mitochondrial DNA (mtDNA) defects. PNT, associated with high levels of mtDNA carryover in mice but low levels in human embryos, carries ethical issues secondary to donor embryo destruction. ST, developed in primates, supports normal development to adults and low mtDNA carryover. PBT in mice, coupled with PN or ST, may increase the yield of reconstructed embryos with low mtDNA carryover. MRT also offers replacement of the deficient cytoplasm in oocytes from older patients, with the expectation of high pregnancy rates following in vitro fertilization.

  7. Nicotine replacement therapies: patient safety and persistence

    Directory of Open Access Journals (Sweden)

    Ferguson SG

    2011-06-01

    Full Text Available Stuart G Ferguson1,2, Saul Shiffman3,4, Joseph G Gitchell51School of Pharmacy, 2Menzies Research Institute Tasmania, University of Tasmania, Hobart, Australia; 3Pinney Associates, 4University of Pittsburgh, Pittsburgh, PA, USA; 5Pinney Associates, Bethesda, MD, USAAbstract: Nicotine replacement therapy (NRT has become a central part of the treatment of nicotine dependence. However, NRT’s potential efficacy is limited to some extent by patient adherence and persistence. Here we review the relationship between NRT compliance and adherence, and overall treatment outcome. We then examine the factors that likely impact on treatment compliance and persistence, with a special focus on users’ perceptions of treatment safety and efficacy as possible mediators. Potential clinical strategies for improving suboptimal medication use are also discussed.Keywords: nicotine replacement therapy, compliance, safety

  8. Replacements For Ozone-Depleting Foaming Agents

    Science.gov (United States)

    Blevins, Elana; Sharpe, Jon B.

    1995-01-01

    Fluorinated ethers used in place of chlorofluorocarbons and hydrochlorofluorocarbons. Replacement necessary because CFC's and HCFC's found to contribute to depletion of ozone from upper atmosphere, and manufacture and use of them by law phased out in near future. Two fluorinated ethers do not have ozone-depletion potential and used in existing foam-producing equipment, designed to handle liquid blowing agents soluble in chemical ingredients that mixed to make foam. Any polyurethane-based foams and several cellular plastics blown with these fluorinated ethers used in processes as diverse as small batch pours, large sprays, or double-band lamination to make insulation for private homes, commercial buildings, shipping containers, and storage tanks. Fluorinated ethers proved useful as replacements for CFC refrigerants and solvents.

  9. The pure relationship and below replacement fertility

    Directory of Open Access Journals (Sweden)

    David R. Hall

    2003-12-01

    interest from demographers. Despite the fact that researchers have extensively modeled recent demographic changes such as skyrocketing divorce rates, rising common-law union formation, delayed childbearing, and the decline to belowreplacement fertility levels, our understanding of the causes of these trends, and the possible connections between them remains theoretically fragmented and incomplete. The goal of this paper is to advance our understanding in this area by exploring the insights on modern family formation of prominent sociologist Anthony Giddens. Specifically, this study examines whether Giddens’ “pure relationship” concept can shed light on the trend toward very low fertility. The results of this inquiry suggest that couples in both marriages and common-law unions who conform to key aspects of Giddens pure relationship are more likely to have uncertain or below-replacement fertility intentions, and less likely to embrace above-replacement fertility goals.

  10. Autogenous Transplantation for Replacing a Hopeless Tooth

    Science.gov (United States)

    Zakershahrak, Mehrsa; Moshari, Amirabbas; Vatanpour, Mehdi; Khalilak, Zohreh; Jalali Ara, Afsoon

    2017-01-01

    Autogenous tooth transplantation (ATT) is a simple and reasonable choice for replacing the missing teeth when a proper donor tooth is available. This report presents a case of successful ATT of a maxillary right third molar for replacement of mandibular right second molar with a concomitant endodontic-periodontal disease. The mandibular second molar was believed to be hopeless due to a severe damage to coronal tooth structure, inappropriate root canal treatment and apical radiolucency. After extraction of mandibular second molar and maxillary third molar (the donor), the tooth was re-implanted into the extracted socket of second molar site. Root canal therapy was then performed. After 3 years, clinical and radiographic examinations revealed satisfying results, with no signs and symptoms. The patient is asymptomatic and the transplanted tooth is still functional with no signs of marginal periodontal pathosis. Radiographies showed bone regeneration in the site of previous extensive periapical lesion, normal periodontal ligament with no signs of root resorption. PMID:28179939

  11. Liver replacement for alpha1-antitrypsin deficiency

    Science.gov (United States)

    Putnam, Charles W.; Porter, Kendrick A.; Peters, Robert L.; Ashcavai, Mary; Redeker, Allan G.; Starzl, Thomas E.

    2010-01-01

    A 16-year-old girl with advanced cirrhosis and severe alpha1-antitrypsin deficiency of the homozygous PiZZ phenotype was treated by orthotopic liver transplantation. After replacement of the liver with a homograft from a donor with the normal PiMM phenotype, the alpha1-antitrypsin concentration in the recipient’s serum rose to normal; it had the PiMM phenotype. Two and a third years later, chronic rejection necessitated retransplantation. Insertion of a homograft from a heterozygous PiMZ donar was followed by the identification of that phenotype in the recipient’s serum. Neither liver graft developed the alpha1-antitrypsin glycoprotein deposits seen with the deficiency state. These observations confirm that this hepatic- based inborn error metabolism is metabolically cured by liver replacement. PMID:320694

  12. Current practice in primary total hip replacement: results from the National Hip Replacement Outcome Project

    OpenAIRE

    Best, A. J.; Fender, D.; Harper, W. M.; McCaskie, A. W.; Oliver, K; Gregg, P J

    1999-01-01

    As part of the National Study of Primary Hip Replacement Outcome, 402 consultant orthopaedic surgeons from three regions were contacted by postal questionnaire which covered all aspects of total hip replacement (THR). There was a 70% response rate of which 71 did not perform hip surgery, a further 33 refused to take part, leaving 181 valid responses. Preoperative assessment clinics were used by 89% of surgeons, but anaesthetists and rehabilitation services were rarely involved at this stage. ...

  13. Native species that can replace exotic species in landscaping

    Directory of Open Access Journals (Sweden)

    Elisabeth Regina Tempel Stumpf

    2015-08-01

    Full Text Available Beyond aesthetics, the contemporary landscaping intends to provide other benefits for humans and environment, especially related to the environmental quality of urban spaces and conservation of the species. A trend in this direction is the reduction in the use of exotic plants in their designs, since, over time, they can become agents of replacement of native flora, as it has occurred in Rio Grande do Sul with many species introduced by settlers. However, the use of exotic species is unjustifiable, because the flora diversity of the Bioma Pampa offers many native species with appropriate features to the ornamental use. The commercial cultivation and the implantation of native species in landscaped areas constitute innovations for plant nurseries and landscapers and can provide a positive reduction in extractivism, contributing to dissemination, exploitation and preservation of native flora, and also decrease the impact of chemical products on environment. So, this work intends to identify native species of Bioma Pampa with features and uses similar to the most used exotic species at Brazilian landscaping. The species were selected from consulting books about native plants of Bioma Pampa and plants used at Brazilian landscaping, considering the similarity on habit and architecture, as well as characteristics of leafs, flowers and/or fruits and environmental conditions of occurrence and cultivation. There were identified 34 native species able to properly replace exotic species commonly used. The results show that many native species of Bioma Pampa have interesting ornamental features to landscape gardening, allowing them to replace exotic species that are traditionally cultivated.

  14. Risks of testosterone replacement therapy in men

    Directory of Open Access Journals (Sweden)

    E Charles Osterberg

    2014-01-01

    Full Text Available Testosterone replacement therapy (TRT is a widely used treatment for men with symptomatic hypogonadism. The benefits seen with TRT, such as increased libido and energy level, beneficial effects on bone density, strength and muscle as well as cardioprotective effects, have been well-documented. TRT is contraindicated in men with untreated prostate and breast cancer. Men on TRT should be monitored for side-effects such as polycythemia, peripheral edema, cardiac and hepatic dysfunction.

  15. Alternatives to testosterone replacement: testosterone restoration.

    Science.gov (United States)

    McCullough, Andrew

    2015-01-01

    The European Male Aging Study has demonstrated that the hypogonadism of male aging is predominantly secondary. Theoretically with appropriate stimulation from the pituitary, the aging testis should be able to produce eugonadal levels of testosterone. The strategies for the treatment of late onset hypogonadism (LOH) have focused on replacement with exogenous testosterone versus restoration of endogenous production. The purpose of this article is to review existing peer-reviewed literature supporting the concept of restoration of endogenous testosterone in the treatment of LOH.

  16. Alternatives to testosterone replacement: testosterone restoration

    OpenAIRE

    Andrew McCullough

    2014-01-01

    The European Male Aging Study has demonstrated that the hypogonadism of male aging is predominantly secondary. Theoretically with appropriate stimulation from the pituitary, the aging testis should be able to produce eugonadal levels of testosterone. The strategies for the treatment of late onset hypogonadism (LOH) have focused on replacement with exogenous testosterone versus restoration of endogenous production. The purpose of this article is to review existing peer-reviewed literature supp...

  17. Current concepts in total femoral replacement

    OpenAIRE

    Ramanathan, Deepak; Siqueira, Marcelo BP; Klika, Alison K.; Higuera, Carlos A.; Barsoum, Wael K.; Joyce, Michael J

    2015-01-01

    Total femoral replacement (TFR) is a salvage arthroplasty procedure used as an alternative to lower limb amputation. Since its initial description in the mid-20th century, this procedure has been used in a variety of oncologic and non-oncologic indications. The most compelling advantage of TFR is the achievement of immediate fixation which permits early mobilization. It is anticipated that TFR will be increasingly performed as the rate of revision arthroplasty rises worldwide. The existing li...

  18. Mitochondrial Replacement Therapy in Reproductive Medicine

    OpenAIRE

    Wolf, Don P; Mitalipov, Nargiz; Mitalipov, Shoukhrat

    2014-01-01

    Mitochondrial dysfunction is implicated in disease and in age-related infertility. Mitochondrial replacement therapies (MRT) in oocytes or zygotes such as pronuclear (PNT), spindle (ST) or polar body (PBT) transfer could prevent second generation transmission of mitochondrial DNA (mtDNA) defects. PNT, associated with high levels of mtDNA carryover in mice but low levels in human embryos, carries ethical issues secondary to donor embryo destruction. ST, developed in primates, supports normal d...

  19. Drug Dosing During Continuous Renal Replacement Therapies

    OpenAIRE

    Thompson, A. Jill

    2008-01-01

    Continuous renal replacement therapies (CRRT) are used to manage fluid overload and/or renal failure. The continuous nature of the fluid and solute removal has less impact on hemodynamic variables in critically ill patients, making CRRT preferred over intermittent hemodialysis for some patients in the intensive care arena. The impact of CRRT on drug removal is variable depending on the CRRT modality, the ultrafiltrate and dialysate flow rates, the filter, and the patient's residual renal func...

  20. VH replacement in primary immunoglobulin repertoire diversification.

    Science.gov (United States)

    Sun, Amy; Novobrantseva, Tatiana I; Coffre, Maryaline; Hewitt, Susannah L; Jensen, Kari; Skok, Jane A; Rajewsky, Klaus; Koralov, Sergei B

    2015-02-01

    The genes encoding the variable (V) region of the B-cell antigen receptor (BCR) are assembled from V, D (diversity), and J (joining) elements through a RAG-mediated recombination process that relies on the recognition of recombination signal sequences (RSSs) flanking the individual elements. Secondary V(D)J rearrangement modifies the original Ig rearrangement if a nonproductive original joint is formed, as a response to inappropriate signaling from a self-reactive BCR, or as part of a stochastic mechanism to further diversify the Ig repertoire. VH replacement represents a RAG-mediated secondary rearrangement in which an upstream VH element recombines with a rearranged VHDHJH joint to generate a new BCR specificity. The rearrangement occurs between the cryptic RSS of the original VH element and the conventional RSS of the invading VH gene, leaving behind a footprint of up to five base pairs (bps) of the original VH gene that is often further obscured by exonuclease activity and N-nucleotide addition. We have previously demonstrated that VH replacement can efficiently rescue the development of B cells that have acquired two nonproductive heavy chain (IgH) rearrangements. Here we describe a novel knock-in mouse model in which the prerearranged IgH locus resembles an endogenously rearranged productive VHDHJH allele. Using this mouse model, we characterized the role of VH replacement in the diversification of the primary Ig repertoire through the modification of productive VHDHJH rearrangements. Our results indicate that VH replacement occurs before Ig light chain rearrangement and thus is not involved in the editing of self-reactive antibodies.

  1. Transdermal testosterone replacement therapy in men

    Directory of Open Access Journals (Sweden)

    Ullah MI

    2014-01-01

    Full Text Available M Iftekhar Ullah,1 Daniel M Riche,1,2 Christian A Koch1,31Department of Medicine, University of Mississippi Medical Center, 2Department of Pharmacy Practice, The University of Mississippi, 3GV (Sonny Montgomery VA Medical Center, Jackson, MS, USAAbstract: Androgen deficiency syndrome in men is a frequently diagnosed condition associated with clinical symptoms including fatigue, decreased libido, erectile dysfunction, and metabolic syndrome. Serum testosterone concentrations decline steadily with age. The prevalence of androgen deficiency syndrome in men varies depending on the age group, known and unknown comorbidities, and the respective study group. Reported prevalence rates may be underestimated, as not every man with symptoms of androgen deficiency seeks treatment. Additionally, men reporting symptoms of androgen deficiency may not be correctly diagnosed due to the vagueness of the symptom quality. The treatment of androgen deficiency syndrome or male hypogonadism may sometimes be difficult due to various reasons. There is no consensus as to when to start treating a respective man or with regards to the best treatment option for an individual patient. There is also lack of familiarity with treatment options among general practitioners. The formulations currently available on the market are generally expensive and dose adjustment protocols for each differ. All these factors add to the complexity of testosterone replacement therapy. In this article we will discuss the general indications of transdermal testosterone replacement therapy, available formulations, dosage, application sites, and recommended titration schedule.Keywords: hypogonadism, transdermal, testosterone, sexual function, testosterone replacement therapy, estradiol

  2. The pure relationship and below replacement fertility

    Directory of Open Access Journals (Sweden)

    Hall, David R.

    2003-01-01

    Full Text Available Of the many changes which have characterized the second demographic transition, shifts in fertility and union formation have attracted a great deal of interest from demographers. Despite the fact that researchers have extensively modeled recent demographic changes such as skyrocketing divorce rates, rising common-law union formation, delayed childbearing, and the decline to below-replacement fertility levels, our understanding of the causes of these trends, and the possible connections between them remains theoretically fragmented and incomplete. The goal of this paper is to advance our understanding in this area by exploring the insights on modern family formation of prominent sociologist Anthony Giddens. Specifically, this study examines whether Giddens' "pure relationship" concept can shed light on the trend toward very low fertility. The results of this inquiry suggest that couples in both marriages and common-law unions who conform to key aspects of Giddens pure relationship are morel likely to have uncertain or below-replacement fertility intentions, and less likely to embrace above-replacement fertility goals.

  3. Flow boiling test of GDP replacement coolants

    Energy Technology Data Exchange (ETDEWEB)

    Park, S.H. [comp.

    1995-08-01

    The tests were part of the CFC replacement program to identify and test alternate coolants to replace CFC-114 being used in the uranium enrichment plants at Paducah and Portsmouth. The coolants tested, C{sub 4}F{sub 10} and C{sub 4}F{sub 8}, were selected based on their compatibility with the uranium hexafluoride process gas and how well the boiling temperature and vapor pressure matched that of CFC-114. However, the heat of vaporization of both coolants is lower than that of CFC-114 requiring larger coolant mass flow than CFC-114 to remove the same amount of heat. The vapor pressure of these coolants is higher than CFC-114 within the cascade operational range, and each coolant can be used as a replacement coolant with some limitation at 3,300 hp operation. The results of the CFC-114/C{sub 4}F{sub 10} mixture tests show boiling heat transfer coefficient degraded to a minimum value with about 25% C{sub 4}F{sub 10} weight mixture in CFC-114 and the degree of degradation is about 20% from that of CFC-114 boiling heat transfer coefficient. This report consists of the final reports from Cudo Technologies, Ltd.

  4. Retention Benefit Based Intelligent Cache Replacement

    Institute of Scientific and Technical Information of China (English)

    李凌达; 陆俊林; 程旭

    2014-01-01

    The performance loss resulting from different cache misses is variable in modern systems for two reasons: 1) memory access latency is not uniform, and 2) the latency toleration ability of processor cores varies across different misses. Compared with parallel misses and store misses, isolated fetch and load misses are more costly. The variation of cache miss penalty suggests that the cache replacement policy should take it into account. To that end, first, we propose the notion of retention benefit. Retention benefits can evaluate not only the increment of processor stall cycles on cache misses, but also the reduction of processor stall cycles due to cache hits. Then, we propose Retention Benefit Based Replacement (RBR) which aims to maximize the aggregate retention benefits of blocks reserved in the cache. RBR keeps track of the total retention benefit for each block in the cache, and it preferentially evicts the block with the minimum total retention benefit on replacement. The evaluation shows that RBR can improve cache performance significantly in both single-core and multi-core environment while requiring a low storage overhead. It also outperforms other state-of-the-art techniques.

  5. Oral rivaroxaban for the prevention of symptomatic venous thromboembolism after elective hip and knee replacement

    DEFF Research Database (Denmark)

    Eriksson, B I; Kakkar, A K; Turpie, A G G;

    2009-01-01

    A once-daily dose of rivaroxaban 10 mg, an oral, direct Factor Xa inhibitor, was compared with enoxaparin 40 mg subcutaneously once daily for prevention of venous thromboembolism in three studies of patients undergoing elective hip and knee replacement (RECORD programme). A pooled analysis of dat...

  6. The replacement principle in networked economies with single-peaked preferences

    DEFF Research Database (Denmark)

    Szwagrzak, Karol

    2016-01-01

    ’s preferences affects all other agents in the same direction in terms of welfare. We find that the only Pareto-efficient, participation-compatible, replication-invariant, and envy-free rule satisfying an appropriate formulation of the replacement principle is the “egalitarian rule” introduced by Bochet et al...

  7. Direct Democracy

    DEFF Research Database (Denmark)

    Beramendi, Virginia; Ellis, Andrew; Kaufman, Bruno

    While many books on direct democracy have a regional or national approach, or simply focus on one of the many mechanisms associated with direct democracy, this Handbook delves into a global comparison of direct democracy mechanisms, including referendums, citizens' initiatives, agenda initiatives...... included as a chapter in the Handbook are possible measures for best practices of implementation, designed for those who wish to tailor direct democracy instruments to their specific needs. In order to further complement the best practices, a variety of global case studies detail the practical uses...... of direct democracy mechanisms in specific contexts. These country case studies allow for in depth discussion of particular issues, including signature collection and voter participation, campaign financing, media coverage, national variations in the usage of direct democracy procedures and national lessons...

  8. Competitive analysis of soybean and sudangrass using replacement series design

    Directory of Open Access Journals (Sweden)

    Mauro Antônio Rizzardi

    Full Text Available ABSTRACT Competition is the best known form of direct interference of weeds on agricultural crops. However, there is relatively little information on the competition of the weed sudangrass on soybean, which has been common in agricultural areas in the southern of Rio Grande do Sul. The objective of this study was to evaluate the competition between sudangrass and soybeans using replacement series experiments. The experiment was carried out in a greenhouse in a completely randomized design with four replications. The treatments consisted of soybean and sudangrass associations. The experimental units were 8-L plastic pots, in the proportions 0: 8, 2: 6, 4: 4, 6: 2, 8: 0, corresponding to 0, 25, 50, 75 and 100% of the crop and weed respectively. Shoot, root and total dry matter and plant height were analyzed through diagrams applied to replacement series and competitive indices. Soybean showed competitive superiority in coexistence with sudangrass in relation to shoot, root and total dry matter. The intraspecific competition was more significant for the crop and inter-specific competition was more important for the weed.

  9. Cardiac crossroads: deciding between mechanical or bioprosthetic heart valve replacement

    Directory of Open Access Journals (Sweden)

    Maggie N Tillquist

    2011-02-01

    Full Text Available Maggie N Tillquist1, Thomas M Maddox21School of Medicine, University of Colorado Denver, Denver, CO, USA; 2VA Eastern Colorado Health Care System, and Department of Medicine (Cardiology, University of Colorado Denver, Denver, CO, USAAbstract: Nearly 15 million people in the United States suffer from either aortic or mitral valvular disease. For patients with severe and symptomatic valvular heart disease, valve replacement surgery improves morbidity and mortality outcomes. In 2009, 90,000 valve replacement surgeries were performed in the United States. This review evaluates the advantages and disadvantages of mechanical and bioprosthetic prosthetic heart valves as well as the factors for consideration in deciding the appropriate valve type for an individual patient. Although many caveats exist, the general recommendation is for patients younger than 60 to 65 years to receive mechanical valves due to the valve's longer durability and for patients older than 60 to 65 years to receive a bioprosthetic valve to avoid complications with anticoagulants. Situations that warrant special consideration include patient co-morbidities, the need for anticoagulation, and the potential for pregnancy. Once these characteristics have been considered, patients' values, anxieties, and expectations for their lifestyle and quality of life should be incorporated into final valve selection. Decision aids can be useful in integrating preferences in the valve decision. Finally, future directions in valve technology, anticoagulation, and medical decision-making are discussed.Keywords: prosthetic heart valves, patient preference, valve type, anticoagulant, structural valve deterioration 

  10. A Cost Analysis of Kidney Replacement Therapy Options in Palestine

    Directory of Open Access Journals (Sweden)

    Mustafa Younis Ph.D.

    2015-03-01

    Full Text Available This study provides a cost analysis of kidney replacement therapy options in Palestine. It informs evidence-based resource allocation decisions for government-funded kidney disease services where transplant donors are limited, and some of the common modalities, i.e., peritoneal dialysis (PD and home hemodialysis (HD, are not widely available due to shortages of qualified staff, specialists, and centers to follow the patient cases, provide training, make home visits, or provide educational programs for patients. The average cost of kidney transplant was US$16 277 for the first year; the estimated cost of HD per patient averaged US$16 085 per year—nearly as much as a transplant. Consistent with prior literature and experience, while live, related kidney donors are scarce, we found that kidney transplant was more adequate and less expensive than HD. These results have direct resource allocation implications for government-funded kidney disease services under Palestinian Ministry of Health. Our findings strongly suggest that investing in sufficient qualified staff, equipment, and clinical infrastructure to replace HD services with transplantation whenever medically indicated and suitable kidney donors are available, as well as deploying PD programs and Home HD programs, will result in major overall cost savings. Our results provide a better understanding of the costs of kidney disease and will help to inform Ministry of Health and related policy makers as they develop short- and long-term strategies for the population, in terms of both cost savings and enhanced quality of life.

  11. Direct Democracy

    DEFF Research Database (Denmark)

    Beramendi, Virginia; Ellis, Andrew; Kaufman, Bruno

    While many books on direct democracy have a regional or national approach, or simply focus on one of the many mechanisms associated with direct democracy, this Handbook delves into a global comparison of direct democracy mechanisms, including referendums, citizens' initiatives, agenda initiatives...... valuable information regarding the binding or non-binding nature of referendums, as well as issues that can be brought forth to a referendum....

  12. Complex patterns of tooth replacement revealed in the fruit bat (Eidolon helvum).

    Science.gov (United States)

    Popa, Elena M; Anthwal, Neal; Tucker, Abigail S

    2016-12-01

    How teeth are replaced during normal growth and development has long been an important question for comparative and developmental anatomy. Non-standard model animals have become increasingly popular in this field due to the fact that the canonical model laboratory mammal, the mouse, develops only one generation of teeth (monophyodonty), whereas the majority of mammals possess two generations of teeth (diphyodonty). Here we used the straw-coloured fruit bat (Eidolon helvum), an Old World megabat, which has two generations of teeth, in order to observe the development and replacement of tooth germs from initiation up to mineralization stages. Our morphological study uses 3D reconstruction of histological sections to uncover differing arrangements of the first and second-generation tooth germs during the process of tooth replacement. We show that both tooth germ generations develop as part of the dental lamina, with the first generation detaching from the lamina, leaving the free edge to give rise to a second generation. This separation was particularly marked at the third premolar locus, where the primary and replacement teeth become positioned side by side, unconnected by a lamina. The position of the replacement tooth, with respect to the primary tooth, varied within the mouth, with replacements forming posterior to or directly lingual to the primary tooth. Development of replacement teeth was arrested at some tooth positions and this appeared to be linked to the timing of tooth initiation and the subsequent rate of development. This study adds an additional species to the growing body of non-model species used in the study of tooth replacement, and offers a new insight into the development of the diphyodont condition. © 2016 Anatomical Society.

  13. Hairline aesthetics and styling in hair replacement surgery.

    Science.gov (United States)

    Mayer, T G; Fleming, R W

    1985-01-01

    Punch grafting and flap surgery are proven methods of correcting baldness. Using either method, the location and shape of a new hairline on the frontal and temporal scalp is one of the most important aspects of hair replacement surgery. If the hairline is not aesthetic, the results can be unacceptable or even devastating for the patient and surgeon alike. The principles of planning the frontal and temporal hairline are presented using punch grafts as well as flaps. Postoperative styling of the "new" hair will vary depending upon the method used to transfer the hair (flaps or grafts), the local factors involved (texture, direction, density, tufting, etc.), as well as the patient's preference. The various advantages and disadvantages of styling possibilities with each method are presented. These factors should be discussed with the patient preoperatively.

  14. Transcatheter aortic valve replacement (TAVR): access planning and strategies.

    Science.gov (United States)

    Ramlawi, Basel; Anaya-Ayala, Javier E; Reardon, Michael J

    2012-01-01

    Transcatheter aortic valve replacement (TAVR) has proven to be a viable tool for the high-surgical-risk population with severe aortic valve stenosis. Vascular access complications are not uncommon with TAVR and may increase early and late mortality. Avoiding these serious complications is the goal. With experience and careful screening, we are now able to risk-stratify patients who may be at increased risk of vascular complications. While the traditional iliofemoral access site remains the most common for TAVR, alternate access sites that have proven to be viable and safe alternatives include the transapical, direct-aortic, and subclavian techniques. TAVR teams should be familiar and comfortable with these approaches as each of them has its own advantages and weaknesses. The best option is usually one in which the procedure is tailored to the patient. The present review examines our current access planning and strategies for TAVR.

  15. [Left Ventricular Rupture during Both Mitral and Aortic Valve Replacements].

    Science.gov (United States)

    Kurumisawa, Soki; Aizawa, Kei; Takazawa, Ippei; Sato, Hirotaka; Muraoka, Arata; Ohki, Shinnichi; Saito, Tsutomu; Kawahito, Koji; Misawa, Yoshio

    2015-05-01

    A 73-year-old woman on hemodialysis was transferred to our hospital for surgical treatment of heart valve disease. She required both mitral and aortic valve replacement with mechanical valves, associated with tricuspid annuloplasty. After aortic de-clamping, a massive hemorrhage from the posterior atrioventricular groove was observed. Under repeated cardiac arrest, the left atrium was reopened, the implanted mitral prosthetic valve was removed and a type I left ventricular rupture (Treasure classification) was diagnosed. The lesion was directly repaired with mattress stitches and running sutures, using reinforcement materials such as a glutaraldehyde-treated bovine pericardium. To avoid mechanical stress by the prosthetic valve on the repaired site, a mechanical valve was implanted using a translocation method. The patient suffered from aspiration pneumonia and disuse atrophy for 3 months. However, she was doing well at 1 year post-operation.

  16. Experimental replacement of aragonite by hydroxyapatite

    Science.gov (United States)

    Kasioptas, A.; Perdikouri, C.; Geisler, T.; Putnis, A.

    2009-04-01

    Hydrothermal treatment of aragonite with (NH4)2HPO4 solution has been shown to produce hydroxyapatite (HAP) with an overall identical and thus pre-determined morphology (Kasioptas et al, 2008). The preservation of the morphology is an outcome of the pseudomorphic nature of this particular reaction. We have investigated the mechanism of the replacement of aragonite by HAP using single, natural, inorganic aragonite crystals. Isothermal experiments were carried out with small crystals placed and sealed in autoclaves with (NH4)2HPO4 solution. After the experiments the aragonite crystals are partly replaced by a new phase. X-ray powder diffraction confirmed that the product phase is indeed HAP; however electron microprobe measurements revealed that the HAP is probably non-stoichiometric. Even when completely converted to HAP, scanning electron microscopy showed that the fine-structure of the aragonite has perfectly been retained. It was also observed that the HAP product phase exhibited a high porosity and was separated from the aragonite parent phase by a sharp interface (on the micrometer scale). The replacement of aragonite by HAP in an aqueous solution can be described in terms of a coupled dissolution-reprecipitation mechanism that takes place at an inward moving reaction front (Putnis& Putnis, 2007). The porosity in the HAP product phase allows the solution to reach the reaction interface. In addition, we have performed experiments with (NH4)2HPO4 solutions prepared with H2O enriched with 97 at.% 18O. The solutions were pre-heated separately to equilibrate the oxygen isotopes in the solution. Raman spectroscopy of the HAP product was used to identify the different vibration modes in the PO43-molecule due to the exchange of 16O with 18O atoms. Apart from the main ?1(PO4) band located near 962 cm-1, we observed four new bands near 945, 931, 919 and 908 cm-1. We have attributed the generation of these new bands to four different degrees of 18O atomic substitutions in

  17. Lower limb joint replacement in rheumatoid arthritis

    Directory of Open Access Journals (Sweden)

    Clement Nicholas D

    2012-06-01

    Full Text Available Abstract Introduction There is limited literature regarding the peri-operative and surgical management of patients with rheumatoid disease undergoing lower limb arthroplasty. This review article summarises factors involved in the peri-operative management of major lower limb arthroplasty surgery for patients with rheumatoid arthritis. Methods We performed a search of the medical literature, using the PubMed search engine (http://www.pubmed.gov. We used the following terms: ‘rheumatoid’ ‘replacement’ ‘arthroplasty’ and ‘outcome’. Findings The patient should be optimised pre-operatively using a multidisciplinary approach. The continued use of methotrexate does not increase infection risk, and aids recovery. Biologic agents should be stopped pre-operatively due the increased infection rate. Patients should be made aware of the increased risk of infection and periprosthetic fracture rates associated with their disease. The surgical sequence is commonly hip, knee and then ankle. Cemented total hip replacement (THR and total knee replacement (TKR have superior survival rates over uncemented components. The evidence is not clear regarding a cruciate sacrificing versus retaining in TKR, but a cruciate sacrificing component limits the risk early instability and potential revision. Patella resurfacing as part of a TKR is associated with improved outcomes. The results of total ankle replacement remain inferior to THR and TKR. RA patients achieve equivalent pain relief, but their rehabilitation is slower and their functional outcome is not as good. However, the key to managing these complicated patients is to work as part of a multidisciplinary team to optimise their outcome.

  18. Mactaquac intake tendons removal and replacement

    Energy Technology Data Exchange (ETDEWEB)

    Campbell, I. [NB Power Generation Corp., Mactaquac Generating Station, Keswick Ridge, NB (Canada); Mee, A. [Hatch Energy, Niagara Falls, ON (Canada)

    2007-07-01

    In 1988 and 1989, multi-strand tendons were installed in the intake structure of the Mactaquac generating station. In order to control displacements caused by alkali aggregate reaction (AAR), they were installed in preparation for a slot cutting program in the intake structure to guard against the possibility of a sliding failure of a section of the structure along a plane coincident with the bottom of the water passage. Unique problems for the designers were present in the expansion affect of AAR that were compounded by field conditions that resulted in further difficulties. For example, concrete expansion required the installation of a thick shim pack under the upper anchor head and the periodic testing of the tendons. Once tested, shims could be gradually removed to maintain the correct load over the life of the tendon. However, during the first round of testing and de-stressing five years after the original installation, it was found that some of the tendons had already failed. Over half of the tendons have been replaced in the 20 years since the installation. This paper discussed the original design considerations and examined the conditions that contributed to the premature failure of the tendons. It outlined the history of tendon testing procedures, tendon failure modes and tendon replacement methods. Specifically, the paper discussed the remedial techniques that were employed and the iterations that lead to the current repair approach, while considering the unique field conditions. The application of various corrosion protection schemes and installation and testing methodologies were discussed. It was concluded that tendons were successfully installed in numerous concrete dams around the world but have needed replacement for a variety of reasons. 1 ref., 10 figs.

  19. 75 FR 17086 - Airworthiness Directives; Bombardier, Inc. Model CL-600-2B19 (Regional Jet Series 100 & 440...

    Science.gov (United States)

    2010-04-05

    ... to mandating inspection, rework and/or replacement of the air supply ducts, Airworthiness Directive..., rework and/or replacement of the air supply ducts, Airworthiness Directive (AD) CF-2003-05 (subsequently... of an air supply duct. In addition to mandating inspection, rework and/or replacement of the...

  20. Alternatives to testosterone replacement: testosterone restoration

    Directory of Open Access Journals (Sweden)

    Andrew McCullough

    2015-04-01

    Full Text Available The European Male Aging Study has demonstrated that the hypogonadism of male aging is predominantly secondary. Theoretically with appropriate stimulation from the pituitary, the aging testis should be able to produce eugonadal levels of testosterone. The strategies for the treatment of late onset hypogonadism (LOH have focused on replacement with exogenous testosterone versus restoration of endogenous production. The purpose of this article is to review existing peer-reviewed literature supporting the concept of restoration of endogenous testosterone in the treatment of LOH.

  1. Sex hormone replacement in Turner syndrome

    DEFF Research Database (Denmark)

    Trolle, Christian; Hjerrild, Britta; Cleemann, Line Hartvig

    2012-01-01

    osteoporosis seen in Turner syndrome. But sex hormone insufficiency is also involved in the increased cardiovascular risk, state of physical fitness, insulin resistance, body composition, and may play a role in the increased incidence of autoimmunity. Severe morbidity and mortality affects females with Turner...... syndrome. Recent research emphasizes the need for proper sex hormone replacement therapy (HRT) during the entire lifespan of females with TS and new hypotheses concerning estrogen receptors, genetics and the timing of HRT offers valuable new information. In this review, we will discuss the effects...

  2. Immunoglobulin Replacement Therapy for Primary Immunodeficiency.

    Science.gov (United States)

    Sriaroon, Panida; Ballow, Mark

    2015-11-01

    Immunoglobulin replacement therapy has been standard treatment in patients with primary immunodeficiency diseases for the past 3 decades. The goal of therapy is to reduce serious bacterial infections in individuals with antibody function defects. Approximately one-third of patients receiving intravenous immunoglobulin treatment experience adverse reactions. Recent advances in manufacturing processes have resulted in products that are safer and better tolerated. Self-infusion by the subcutaneous route has become popular and resulted in better quality of life. This review summarizes the use of immunoglobulin therapy in primary immunodeficiency diseases including its properties, dosing, adverse effects, and different routes of administration.

  3. Segmental blood pressure after total hip replacement

    DEFF Research Database (Denmark)

    Gebuhr, Peter Henrik; Soelberg, M; Henriksen, Jens Henrik Sahl

    1992-01-01

    Twenty-nine patients due to have a total hip replacement had their systemic systolic and segmental blood pressures measured prior to operation and 1 and 6 weeks postoperatively. No patients had signs of ischemia. The segmental blood pressure was measured at the ankle and at the toes. A significant...... drop was found in all pressures 1 week postoperatively. The decrease followed the systemic pressure and was restored to normal after 6 weeks. In a group of six patients with preoperatively decreased ankle pressure, a significant transient further decrease in the ankle-toe gradient pressure was found...

  4. To learn more about BHT replacement

    CERN Document Server

    2002-01-01

    Following the article 'An improved financial tool to replace BHT' which appeared in Bulletin No 41/2002, dates of 4 general presentations were published. Please note that the time of the first presentation has changed from 16.00 hrs to 14.00 hrs. The dates/times are now as follows: Wednesday 16 October 14.00 hrs* IT Auditorium (English) *note change of time. Friday 18 October 16.00 hrs, SL Auditorium (French) Monday 21 October 10.00 hrs, LHC Auditorium (French) Wednesday 23 October 10.00 hrs, Council Chamber (English)

  5. Trials and Tribulations with VH Replacement.

    Science.gov (United States)

    Meng, Wenzhao; Jayaraman, Sahana; Zhang, Bochao; Schwartz, Gregory W; Daber, Robert D; Hershberg, Uri; Garfall, Alfred L; Carlson, Christopher S; Luning Prak, Eline T

    2014-01-01

    VH replacement (VHR) is a type of antibody gene rearrangement in which an upstream heavy chain variable gene segment (VH) invades a pre-existing rearrangement (VDJ). In this Hypothesis and Theory article, we begin by reviewing the mechanism of VHR, its developmental timing and its potential biological consequences. Then we explore the hypothesis that specific sequence motifs called footprints reflect VHR versus other processes. We provide a compilation of footprint sequences from different regions of the antibody heavy chain, and include data from the literature and from a high throughput sequencing experiment to evaluate the significance of footprint sequences. We conclude by discussing the difficulties of attributing footprints to VHR.

  6. Infective endocarditis following transcatheter aortic valve replacement-

    DEFF Research Database (Denmark)

    Loh, Poay Huan; Bundgaard, Henning; S�ndergaard, Lars

    2013-01-01

    Transcatheter aortic valve replacement (TAVR) can improve the symptoms and prognosis of patients with severe aortic stenosis who, due to a high expected operative risk, would not have otherwise been treated surgically. If these patients develop prosthetic valve endocarditis, their presentations may...... be atypical causing a delay in the diagnosis and treatment. The management is also complicated by their comorbidities, and surgical treatment may not be feasible leading to a significant morbidity and mortality. We describe a case of an 85-year-old man with TAVI prosthetic valve endocarditis successfully...

  7. Aortic Annular Enlargement during Aortic Valve Replacement

    Directory of Open Access Journals (Sweden)

    Selman Dumani

    2016-09-01

    Full Text Available In the surgery of aortic valve replacement is always attempted, as much as possible, to implant the larger prosthesis with the mains goals to enhance the potential benefits, to minimise transvalvular gradient, decrease left ventricular size and avoid the phenomenon of patient-prosthesis mismatch. Implantation of an ideal prosthesis often it is not possible, due to a small aortic annulus. A variety of aortic annulus enlargement techniques is reported to avoid patient-prosthesis mismatch. We present the case that has submitted four three times open heart surgery. We used Manouguian technique to enlarge aortic anulus with excellent results during the fourth time of surgery.

  8. Can electronic stability control replace studded tyres?

    Science.gov (United States)

    Elvik, Rune

    2015-12-01

    Based on recent studies, this paper examines whether an increased use of electronic stability control can replace studded tyres. A re-analysis of a study that evaluated the effects on accidents of changes in the use of studded tyres in major cities in Norway is presented. It is found that if all cars have electronic stability control, the use of studded tyres can be reduced to about 15 percent before any increase in the number of accidents occurs. Even if studded tyres were eliminated entirely, any increase in the number of accidents is likely to be considerably smaller than it would have been if electronic stability control had never been invented.

  9. Replacing the Beam Dump at the Booster

    CERN Multimedia

    2013-01-01

    The PS Booster Dump, designed in the 1960’s to cope with beam energies in the order of 800 MeV, has been dismantled and replaced with a new one, capable of withstanding the 2 GeV beam provided by the upcoming LINAC4 at CERN. This video shows the installation of that new dump core inside a one-metre diameter cavity, surrounded by five shielding rings made of concrete and steel. It is the culmination of months of preparation, an interdisciplinary work involving several teams from the Engineering, Beams and Technology Departments, as well as the collaboration and supervision of radio-protection experts.

  10. Replacing the Beam Dump at the Booster

    CERN Multimedia

    2013-01-01

    The PS Booster Dump, designed in the 1960’s to cope with beam energies in the order of 800 MeV, has been dismantled and replaced with a new one, capable of withstanding the 2 GeV beam provided by the upcoming LINAC4 at CERN. This video shows the installation of that new dump core inside a one-metre diameter cavity, surrounded by five shielding rings made of concrete and steel. It is the culmination of months of preparation, an interdisciplinary work involving several teams from the Engineering, Beams and Technology Departments, as well as the collaboration and supervision of radio-protection experts.

  11. On replacing Am-Be neutron sources in compensated porosity logging tools

    Energy Technology Data Exchange (ETDEWEB)

    Peeples, Cody R. [North Carolina State University (United States)], E-mail: crpeeple@ncsu.edu; Mickael, Medhat; Gardner, Robin P. [North Carolina State University (United States)

    2010-04-15

    Authors explored the direct replacement of Am-Be neutron sources in neutron porosity logging tools through Monte Carlo simulations using MCNP5. {sup 252}Cf and electronic accelerator neutron sources based on the Deuterium-Tritium fusion reaction were considered. Between the sources, a tradeoff was noted between sensitivity to the presence of hydrogen and uncertainty due to counting statistics. It was concluded that both replacement sources as well as accelerator sources based on the Deuterium-Deuterium fusion reaction warrant further consideration as porosity log sources.

  12. On replacing Am-Be neutron sources in compensated porosity logging tools.

    Science.gov (United States)

    Peeples, Cody R; Mickael, Medhat; Gardner, Robin P

    2010-01-01

    Authors explored the direct replacement of Am-Be neutron sources in neutron porosity logging tools through Monte Carlo simulations using MCNP5. (252)Cf and electronic accelerator neutron sources based on the Deuterium-Tritium fusion reaction were considered. Between the sources, a tradeoff was noted between sensitivity to the presence of hydrogen and uncertainty due to counting statistics. It was concluded that both replacement sources as well as accelerator sources based on the Deuterium-Deuterium fusion reaction warrant further consideration as porosity log sources.

  13. The effect of fat replacers on batter and cake properties.

    Science.gov (United States)

    Psimouli, Vassiliki; Oreopoulou, Vassiliki

    2013-10-01

    Fat was replaced at 35% to 100% in cakes by maltodextrin (dextrose equivalent = 3), inulin (high performance and granulated), oligofructose, citrus pectin, and microparticulated protein. Fat replacement by 35% did not induce significant differences in general. Above 65% fat replacement resulted in statistically significant (P < 0.05) decreased viscosity (except for pectin) that was followed by statistically significant decrease in air incorporation and broader bubble size distribution. The starch gelatinization temperature showed a statistically significant increase when fat was replaced by fructose oligosaccharides. The cakes presented statistically significant increase of hardness, elasticity, and decrease of volume development as fat replacement increased above 65%. Also cakes with increased fat replacement received lower scores on taste and flavor, whereas at total fat replacement they were evaluated as not acceptable. Nevertheless, at 65% fat replacement, the samples presented acceptable textural, physical, and sensorial attributes. © 2013 Institute of Food Technologists®

  14. The use of limestone powder as an alternative cement replacement ...

    African Journals Online (AJOL)

    The use of limestone powder as an alternative cement replacement material: An ... The laboratory test results revealed that up to 15% replacement of clinker by fine ... Early strength, Limestone filler, Loss on ignition, Portland limestone cement ...

  15. Protein Replacement Therapy Shows Promise in Treating Rare Skin Disorder

    Science.gov (United States)

    ... 1999 Spotlight on Research 2014 February 2014 (historical) Protein Replacement Therapy Shows Promise in Treating Rare Skin Disorder Replacing a protein that is crucial to ensuring that the skin’s ...

  16. Cardiovascular implantable electronic device replacement infections and prevention: results from the REPLACE Registry.

    Science.gov (United States)

    Uslan, Daniel Z; Gleva, Marye J; Warren, David K; Mela, Theofanie; Chung, Mina K; Gottipaty, Venkateshwar; Borge, Richard; Dan, Dan; Shinn, Timothy; Mitchell, Kevin; Holcomb, Richard G; Poole, Jeanne E

    2012-01-01

    Infection following cardiovascular implantable electronic device (CIED) replacement is a serious complication, and rates of infection have increased. Analysis of procedural and clinical data from device replacement procedures collected by the REPLACE Registry may provide insights into infection prevention strategies and outcomes. We prospectively evaluated procedural complications in patients undergoing CIED replacement over 6 months from 72 U.S. sites. Major and minor infections were predefined and adjudicated by an independent blinded clinical events committee. Data regarding infection prevention strategies and infectious outcomes were analyzed for their potential relationships. A total of 1,744 patients were included in REPLACE. All patients received preoperative intravenous antibiotics and 68.7% received postoperative systemic antibiotic therapy. CIED infection developed in 22 patients (1.3%), of which 14 cases were major (0.8%, 95% confidence interval [CI] 0.4%-1.3%) and eight were minor (0.5%, 95% CI 0.2%-0.9%). Patients with infections were more likely to have had postoperative hematomas (five of 22 [22.7%] vs 17 of 1,722 [0.98%], P = 0.002). Participating sites experiencing infection rates >5% were more likely to use povidone-iodine for topical antisepsis, had lower implantation volume, and had patients with higher Charlson Comorbidity Index (2.79 vs 2.32, 95% CI for difference 0.08-0.86, P = 0.019). In this multicenter prospective study with 6 months of follow-up, infections associated with CIED replacements were surprisingly infrequent, possibly due to the use of preoperative antibiotics. Patients with infections were more likely to have had a postoperative hematoma, and sites with higher infection rates had sicker patients and lower overall procedural volume. ©2011, The Authors. Journal compilation ©2011 Wiley Periodicals, Inc.

  17. Property Assessment of Sponge Cake Added with Egg Replacer

    OpenAIRE

    Yaqiang He; Linlin Wang; Qian Lu

    2015-01-01

    Chicken egg which is always used in sponge cake production is likely to deteriorate during storage or transportation. This weakness prevents the wide use of chicken egg in sponge cake making. In order to solve this problem, egg replacer has been developed. In this study, effect of egg replacer on the property of sponge cake was analyzed. The result indicated egg replacer could improve the yield rate and specific volume of sponge cake. However, high content of egg replacer would negatively imp...

  18. Transdermal testosterone replacement therapy in men.

    Science.gov (United States)

    Ullah, M Iftekhar; Riche, Daniel M; Koch, Christian A

    2014-01-01

    Androgen deficiency syndrome in men is a frequently diagnosed condition associated with clinical symptoms including fatigue, decreased libido, erectile dysfunction, and metabolic syndrome. Serum testosterone concentrations decline steadily with age. The prevalence of androgen deficiency syndrome in men varies depending on the age group, known and unknown comorbidities, and the respective study group. Reported prevalence rates may be underestimated, as not every man with symptoms of androgen deficiency seeks treatment. Additionally, men reporting symptoms of androgen deficiency may not be correctly diagnosed due to the vagueness of the symptom quality. The treatment of androgen deficiency syndrome or male hypogonadism may sometimes be difficult due to various reasons. There is no consensus as to when to start treating a respective man or with regards to the best treatment option for an individual patient. There is also lack of familiarity with treatment options among general practitioners. The formulations currently available on the market are generally expensive and dose adjustment protocols for each differ. All these factors add to the complexity of testosterone replacement therapy. In this article we will discuss the general indications of transdermal testosterone replacement therapy, available formulations, dosage, application sites, and recommended titration schedule.

  19. Testosterone replacement therapy in obese males.

    Science.gov (United States)

    Drewa, Tomasz; Olszewska-Słonina, Dorota; Chlosta, Piotr

    2011-01-01

    Controversy surrounds testosterone replacement therapy in obese ageing due to no generally accepted lower limits of normal testosterone level and high prevalence of hypogonadal symptoms in the ageing male population and the non-specific nature of these symptoms. Late onset hypogonadism is a clinical and biochemical syndrome associated with advancing age, often coexisting with obesity and metabolic syndrome. High fat and carbohydrates (fructose) consumption is responsible for development of obesity and metabolic syndrome which is one of risk factors for hypogonadism in older men. High fructose intake has been shown to cause dyslipidemia and to impair hepatic insulin sensitivity. Obesity and lack of physical activity negatively influence testosterone level. Low testosterone level should be regarded as an effect of obesity, but reverse relationship has not been proved yet. The management of late-onset hypogonadism symptoms has to be treated by a change of a life style and prevented with healthy nutrition and physical activity. The question related to rational indications for testosterone replacement therapy in obese males seems to be still actual.

  20. An improved financial tool to replace BHT

    CERN Multimedia

    2002-01-01

    In November, the BHT tool used to control financial data will be replaced by an improved and more powerful system, called CET for CERN Expenditure Tracking. The team in charge of CET. From left to right, sitting, Martyn Rankin, David McGlashan, standing, Per Gunnar Jonsson, James Purvis and Mikael Angberg. After 10 years of BHT at CERN, in order to face the challenges of the LHC era, and following the recommendations of the External Review Committee, the BHT application will be replaced by an improved and more powerful expenditure tracking tool called CET for CERN Expenditure Tracking. For those who are not familiar with it, the BHT, Budget Holders Toolkit, is a utility that provides a way to view CERN financial data. It is available for users who have access to at least one budget code. The new CET represents a tool that not only allows powerful analysis of the past, but also assists in forecasting the future. CET will offer significantly more functionality than BHT, including extended contract analysis, ...

  1. LS1 Report: Replacing an antique

    CERN Multimedia

    CERN Bulletin

    2013-01-01

    At the PS Booster, the old beam dump and the shielding blocks surrounding it have been removed (see here). Installation of the new beam dump is now under way (see video).   The new PSB beam dump during its installation. At the PS, replacement of the old cooling and ventilation system, which dated back to 1957, is progressing well. The dismantling phase has just been completed and the tunnel is being prepared to receive a brand new ventilation system offering more efficient aeration of radioactive areas. At the same time, testing of the newly installed access system is under way. At the SPS, all the equipment of the Long Straight Section 1 (LSS1) has been removed to make way for the campaign to replace the irradiated cables, which started this week. In the LHC, the Radiation to Electronics (R2E) campaign is still progressing at a good clip, especially at Point 1, where the teams are two and a half months ahead of schedule. The Superconducting Magnets and Circuits Consolidation (SMACC) proje...

  2. Toward replacement fertility in Egypt and Tunisia.

    Science.gov (United States)

    Eltigani, Eltigani E

    2009-09-01

    Egypt and Tunisia began their fertility transition at almost identical fertility levels and at roughly the same time period, yet the difference in the pace of decline has been such that the total fertility rate (TFR) in Tunisia reached replacement level by the year 2001, whereas the TFR in Egypt remains above three live births per woman. This article draws on the secondary literature and on several nationally representative surveys from the two countries between 1978 and 2005 to provide empirical evidence of the difference in the pace of fertility decline and to analyze the determinants of the differential. Findings include (a) variation across the two countries in the consistency of fertility decline among the segments of the population leading the transition; (b) that the success of each country's family planning program was influenced by the role of political leaders and the extent of the program's integration within socioeconomic development objectives; (c) that the impact of contraception on TFR decline became an important factor in the mid-1980s; and (d) that the greatest determinant of the discrepancy in the pace of fertility decline is the disparity in age at marriage, which rose more significantly in Tunisia than in Egypt. The latter finding indicates that reaching replacement fertility in Egypt hinges primarily on further declines in marital fertility, resulting from reduction of wanted fertility and from an expansion of family planning program coverage and improved efficiency of service delivery and use.

  3. Hypoparathyroidism: Replacement Therapy with Parathyroid Hormone

    Directory of Open Access Journals (Sweden)

    Lars Rejnmark

    2015-12-01

    Full Text Available Hypoparathyroidism (HypoPT is characterized by low serum calcium levels caused by an insufficient secretion of parathyroid hormone (PTH. Despite normalization of serum calcium levels by treatment with activated vitamin D analogues and calcium supplementation, patients are suffering from impaired quality of life (QoL and are at increased risk of a number of comorbidities. Thus, despite normalization of calcium levels in response to conventional therapy, this should only be considered as an apparent normalization, as patients are suffering from a number of complications and calcium-phosphate homeostasis is not normalized in a physiological manner. In a number of recent studies, replacement therapy with recombinant human PTH (rhPTH(1-84 as well as therapy with the N-terminal PTH fragment (rhPTH(1-34 have been investigated. Both drugs have been shown to normalize serum calcium while reducing needs for activated vitamin D and calcium supplements. However, once a day injections cause large fluctuations in serum calcium. Twice a day injections diminish fluctuations, but don't restore the normal physiology of calcium homeostasis. Recent studies using pump-delivery have shown promising results on maintaining normocalcemia with minimal fluctuations in calcium levels. Further studies are needed to determine whether this may improve QoL and lower risk of complications. Such data are needed before replacement with the missing hormone can be recommended as standard therapy.

  4. Concomitant aortic valve replacement and myocardial revascularization.

    Science.gov (United States)

    Craver, J M; Jones, E L; Hatcher, C R; Farmer, J H

    1977-01-01

    Twenty-six consecutive patients underwent combined aortic valve replacement and myocardial revascularization at the Emory University Affiliated Hospitals between May, 1973 and March, 1976. Acute myocardial infarction resulted in two operative deaths (8%). There have been four late deaths, all Class IV preoperative. The age range was 37 to 79 years with an average age of 60. Preoperatively all patients were Class IV or late Class III. Twenty-three patients had symptoms of angina pectoris; congestive heart failure was evident in 56%. Postoperatively, 70% are now Class 1 or II. Single coronary bypass was performed in 16 patients, double in 6, and triple in three. Double bypass plus mitral valve replacement was required in two with aneurysmectomy in one. The rate of intraoperative infarction was 27% for the series but only 7% in the last year. The methods of intraoperative myocardial preservation and the technical approach for the operative procedures were variable. Results with each method are correlated, and currently preferred techniques are presented and discussed. Best results were obtained in patients who presented early in their symptomatic course with isolated proximal coronary lesions and good renoff vessels. Excellent results could be achieved despite advanced age of patients, requirement for multiple bypass grafts, and correction of other associated cardiac lesions. Poorest results were obtained when long-standing ventricular failure was combined with poor vessels distal to coronary stenoses. PMID:860881

  5. BABAR IFR Replacement R and D

    CERN Document Server

    Berry, M

    2003-01-01

    The Instrumented Flux Return (IFR) of the BaBar detector will soon need to be replaced by a more robust muon detection system. Scintillator bars with embedded Wavelength Shifting (WLS) fibers and Limited Streamer Tubes are two replacement technology options. The scintillator bars are tested for attenuation length; and causes for the large width of the Photo Multiplier Tube (PMT) signal are analyzed by Monte Carlo simulation. Cooling techniques for Avalanche Photo Diodes (APD) are investigated. The fairly high attenuation length coupled with the narrow PMT signal make the scintillator a viable option for a muon detecting system. Continuing work will focus on increasing timing resolution using an APD to read the signal from the WLS fibers, and investigating the lifetime of the APD. The ability to read a signal from the LST on external copper strips is tested and signals are found to be clearly distinguishable from noise. The voltage is compared to count rate to find that the optimal operating voltage for the LS...

  6. Limitations to fluid replacement during exercise.

    Science.gov (United States)

    Maughan, R J; Leiper, J B

    1999-04-01

    Fluid replacement during exercise is essential for endurance exercise performance and reducing the risk of heat illness. Fluids supply water, which ameliorates dehydration, and also substrate for the working muscles. Absorption of water and nutrients occurs in the upper part of the small intestine, and replacement may be limited by the rate at which fluid is emptied from the stomach or absorbed in the intestine. Gastric emptying of liquids is influenced primarily by the volume of fluid in the stomach and by its energy density. Increasing the volume will speed emptying, but increasing the nutrient content will slow emptying. Osmolality, temperature, and pH of drinks, as well as exercise intensity, are of minor importance. Intestinal water absorption is a passive process: water follows osmotic gradients but will also follow the active absorption of nutrients, especially glucose, which is actively co-transported with sodium. Water transport is maximised by the presence in the intestine of hypotonic solutions of glucose and sodium. Hypertonic solutions promote net water secretion into the intestinal lumen, resulting in a temporary net loss of water from the body. The amount of fluid ingested by athletes is normally much less than can be tolerated, therefore issues such as palatability and practising drinking during training are important.

  7. Neutron scattering at Australia's replacement research reactor

    Science.gov (United States)

    Robinson, R. A.; Kennedy, S. J.

    2002-01-01

    On August 25 1999, the Australian government gave final approval to build a research reactor to replace the existing HIFAR reactor at Lucas Heights. The replacement reactor, which will commence operation in 2005, will be multipurpose in function, with capabilities for both neutron-beam research and radioisotope production. Regarding beams, cold and thermal neutron sources are to be installed and the intent is to use supermirror guides, with coatings with critical angles up to 3 times that of natural Ni, to transport cold and thermal neutron beams into a large modern guide hall. The reactor and all the associated infrastructure, with the exception of the neutron beam instruments, is to be built by INVAP, SE and subcontractors in a turnkey contract. The goal is to have at least eight leading-edge neutron-beam instruments ready in 2005, and they will be developed by ANSTO and other contracted organisations, in consultation with the Australian user community and interested overseas parties. A review of the planned scientific capabilities, a description of the facility and a status report on the activities so far is given.

  8. Postoperative Autologous Reinfusion in Total Knee Replacement

    Directory of Open Access Journals (Sweden)

    A. Crescibene

    2015-01-01

    Full Text Available Surgeries for total knee replacement (TKR are increasing and in this context there is a need to develop new protocols for management and use of blood transfusion therapy. Autologous blood reduces the need for allogeneic blood transfusion and the aim of the present study was to verify the safety and the clinical efficacy. An observational retrospective study has been conducted on 124 patients, undergoing cemented total knee prosthesis replacement. Observed population was stratified into two groups: the first group received reinfusion of autologous blood collected in the postoperative surgery and the second group did not receive autologous blood reinfusion. Analysis of data shows that patients undergoing autologous blood reinfusion received less homologous blood bags (10.6% versus 30%; p=0.08 and reduced days of hospitalization (7.88 ± 0.7 days versus 8.96 ± 2.47 days for the control group; p=0.03. Microbiological tests were negative in all postoperatively salvaged and reinfused units. Our results emphasize the effectiveness of this procedure and have the characteristics of simplicity, low cost (€97.53 versus €103.79; p<0.01, and easy reproducibility. Use of autologous drainage system postoperatively is a procedure that allows reducing transfusion of homologous blood bags in patients undergoing TKR.

  9. Recombinant Enzyme Replacement Therapy in Hypophosphatasia.

    Science.gov (United States)

    Hofmann, Christine; Jakob, Franz; Seefried, Lothar; Mentrup, Birgit; Graser, Stephanie; Plotkin, Horacio; Girschick, Hermann J; Liese, Johannes

    2015-01-01

    Hypophosphatasia (HPP) is a rare monogenetic and multisystemic disease with involvement of different organs, including bone, muscle, kidney, lung, gastrointestinal tract and the nervous system. The exact metabolic mechanisms of the effects of TNAP deficiency in different tissues are not understood in detail. There is no approved specific treatment for HPP; therefore symptomatic treatment in order to improve the clinical features is of major interest. Enzyme replacement therapy (ERT) is a relatively new type of treatment based on the principle of administering a medical treatment replacing a defective or absent enzyme. Recently ERT with a bone targeted recombinant human TNAP molecule has been reported to be efficient in ten severely affected patients and improved survival of life threatening forms. These results are very promising especially with regard to the skeletal phenotype but it is unclear whether ERT also has beneficial effects for craniosynostosis and in other affected tissues in HPP such as brain and kidney. Long-term data are not yet available and further systematic clinical trials are needed. It is also necessary to establish therapeutic approaches to help patients who are affected by less severe forms of HPP but also suffer from a significant reduction in quality of life. Further basic research on TNAP function and role in different tissues and on its physiological substrates is critical to gain a better insight in the pathogenesis in HPP. This and further experiences in new therapeutic strategies may improve the prognosis and quality of life of patients with all forms of HPP.

  10. Directing Creativity

    DEFF Research Database (Denmark)

    Darsø, Lotte; Ibbotson, Piers

    2008-01-01

    In this article we argue that leaders facing complex challenges can learn from the arts, specifically that leaders can learn by examining how theatre directors direct creativity through creative constraints. We suggest that perceiving creativity as a boundary phenomenon is helpful for directing it....... Like leaders, who are caught in paradoxical situations where they have to manage production and logistics simultaneously with making space for creativity and innovation, theatre directors need to find the delicate balance between on one hand renewal of perceptions, acting and interaction...... and on the other hand getting ready for the opening night. We conclude that the art of directing creativity is linked to developing competencies of conscious presence, attention and vigilance, whereas the craft of directing creativity concerns communication, framing and choice....

  11. Future directions.

    Science.gov (United States)

    Raffa, Robert B; Tallarida, Ronald J

    2010-01-01

    The chapters of this book summarize much of what has been done and reported regarding cancer chemotherapy-related cognitive impairment. In this chapter, we point out some future directions for investigation.

  12. 48 CFR 908.7101-4 - Replacement of motor vehicles.

    Science.gov (United States)

    2010-10-01

    ... 48 Federal Acquisition Regulations System 5 2010-10-01 2010-10-01 false Replacement of motor....7101-4 Replacement of motor vehicles. (a) The replacement of motor vehicles shall be in accordance with... Heads of Contracting Activities may arrange to sell, as exchange sales, used motor vehicles...

  13. 21 CFR 874.3450 - Partial ossicular replacement prosthesis.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Partial ossicular replacement prosthesis. 874.3450 Section 874.3450 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES... replacement prosthesis. (a) Identification. A partial ossicular replacement prosthesis is a device intended...

  14. 21 CFR 874.3495 - Total ossicular replacement prosthesis.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Total ossicular replacement prosthesis. 874.3495 Section 874.3495 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES... replacement prosthesis. (a) Identification. A total ossicular replacement prosthesis is a device intended...

  15. 21 CFR 870.3710 - Pacemaker repair or replacement material.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Pacemaker repair or replacement material. 870.3710... (CONTINUED) MEDICAL DEVICES CARDIOVASCULAR DEVICES Cardiovascular Prosthetic Devices § 870.3710 Pacemaker repair or replacement material. (a) Identification. A pacemaker repair or replacement material is an...

  16. 14 CFR 21.9 - Replacement and modification articles.

    Science.gov (United States)

    2010-01-01

    ... 14 Aeronautics and Space 1 2010-01-01 2010-01-01 false Replacement and modification articles. 21.9... CERTIFICATION PROCEDURES FOR PRODUCTS AND PARTS General § 21.9 Replacement and modification articles. (a) If a person knows, or should know, that a replacement or modification article is reasonably likely to...

  17. Effects of Home Exercise Programmes During Home Visits After Hip Replacement: A Systematic Review.

    Science.gov (United States)

    Ozdemir, Ozlem; Tosun, Bet Uuml L

    2017-01-01

    This study systematically reviews the research, focused on the effects of home exercise programmes implemented during home visits after hip replacement on patients. PubMed (MEDLINE), Wiley Online Library, EBSCOhost, Science Direct databases (between 2004 and June 2015) were searched with the keywords "hip replacement, home exercise programme and home visit". Eleven original articles were retrieved. Different parameters were used in the trials to assess the physical functions, mobility and quality of life of patients. In six trials, the intervention group achieved significantly better improvements statistically in all parameters after home exercise programmes. In three trials, the intervention group achieved better but not significant outcomes. Early recovery in daily living activities with home exercise programme was reported only in one trial. Reviewed studies suggest that home exercise programmes, implemented during home visits after hip replacement, improve patients' physical functions and life quality.

  18. Orthodontic retraction of autotransplanted premolar to replace ankylosed maxillary incisor with replacement resorption.

    Science.gov (United States)

    Choi, Yoon Jeong; Shin, Sujung; Kim, Kyung-Ho; Chung, Chooryung J

    2014-04-01

    This case report describes the successful treatment of an adult with lip protrusion and a previously traumatized maxillary central incisor that had experienced replacement root resorption. An extracted premolar was transplanted into the incisor space and retracted orthodontically. Autotransplantation was successful with complete root formation and, combined with orthodontic treatment, provided a satisfying esthetic outcome.

  19. Revision of the aseptic and septic total ankle replacement.

    Science.gov (United States)

    Espinosa, Norman; Wirth, Stephan Hermann

    2013-04-01

    Total ankle replacement has become a popular treatment of symptomatic end-stage ankle osteoarthritis. Contemporary total ankle replacement systems provide more anatomic and biomechanically sound function. However, longevity is still limited and long-term results of modern total ankle replacement designs are not available. In the case of failure, conversion into arthrodesis has remained the treatment of choice but at the cost of hindfoot function and potential degeneration of the adjacent joints. Thus, revision total ankle replacement by exchange of the prosthetic components represents an attractive solution. This article focuses on revision total ankle replacement and conversion to ankle arthrodesis.

  20. Testosterone replacement therapy following the diagnosis of prostate cancer: outcomes and utilization trends.

    Science.gov (United States)

    Kaplan, Alan L; Trinh, Quoc-Dien; Sun, Maxine; Carter, Stacey C; Nguyen, Paul L; Shih, Ya-Chen Tina; Marks, Leonard S; Hu, Jim C

    2014-04-01

    Late-onset hypogonadism may impair quality of life and contribute to metabolic and cardiovascular comorbidity in aging men. Testosterone replacement therapy is effective in treating hypogonadism. However, for the millions of men with a history of prostate cancer, exogenous testosterone has long been considered contraindicated, even though little data in such men are available. Clarification of this safety issue could allow treatment to be considered for a sizeable segment of the aging male population. The aim of this study is to examine population-based utilization and impact of testosterone replacement therapy in men with prostate cancer. Using linked Surveillance, Epidemiology, and End Results-Medicare data, we identified 149,354 men diagnosed with prostate cancer from 1992 to 2007. Of those, 1181 (0.79%) men received exogenous testosterone following their cancer diagnosis. We used propensity scoring analysis to examine the effect of testosterone replacement on the use of salvage hormone therapy and overall and prostate cancer-specific mortality. We assessed overall mortality, cancer-specific mortality, and the use of salvage hormone therapy. Following prostate cancer diagnosis, testosterone replacement was directly related to income and educational status and inversely related to age (all P testosterone (all P testosterone replacement therapy was not associated with overall or cancer-specific mortality or with the use of salvage hormone therapy. In this population-based observational study of testosterone replacement therapy in men with a history of prostate cancer, treatment was not associated with increased overall or cancer-specific mortality. These findings suggest testosterone replacement therapy may be considered in men with a history of prostate cancer, but confirmatory prospective studies are needed. © 2014 International Society for Sexual Medicine.

  1. Testosterone Replacement Therapy and the Cardiovascular System.

    Science.gov (United States)

    Naderi, Sahar

    2016-04-01

    As testosterone replacement therapy (TRT) has emerged as a commonly prescribed therapy for symptomatic low testosterone, conflicting data have been reported in terms of both its efficacy and potential adverse outcomes. One of the most controversial associations has been that of TRT and cardiovascular morbidity and mortality. This review briefly provides background on the history of TRT, the indications for TRT, and the data behind TRT for symptomatic low testosterone. It then specifically delves into the rather limited data for cardiovascular outcomes of those with low endogenous testosterone and those who receive TRT. The available body of literature strongly suggests that more work, by way of clinical trials, needs to be done to better understand the impact of testosterone and TRT on the cardiovascular system.

  2. Segmental blood pressure after total hip replacement

    DEFF Research Database (Denmark)

    Gebuhr, Peter Henrik; Soelberg, M; Henriksen, Jens Henrik

    1992-01-01

    drop was found in all pressures 1 week postoperatively. The decrease followed the systemic pressure and was restored to normal after 6 weeks. In a group of six patients with preoperatively decreased ankle pressure, a significant transient further decrease in the ankle-toe gradient pressure was found......Twenty-nine patients due to have a total hip replacement had their systemic systolic and segmental blood pressures measured prior to operation and 1 and 6 weeks postoperatively. No patients had signs of ischemia. The segmental blood pressure was measured at the ankle and at the toes. A significant...... on the operated side. None of the patients had symptoms from the lowered pressure. We conclude that in patients without signs of ischemia, the postoperative segmental pressure decrease is reversible and therefore not dangerous....

  3. [Interventional mitral valve replacement. Current status].

    Science.gov (United States)

    Lutter, G; Frank, D

    2016-02-01

    Approximately 30 % of patients suffering from severe valvular heart disease, such as mitral valve regurgitation are non-compliant to the gold standard of minimally invasive surgery, reconstruction or valve replacement. The number of these mostly old patients with severe comorbidities is increasing; therefore, transcatheter interventions have been developed to address an unmet clinical need and may be an alternative therapeutic option to the reference standard. Apart from the successful MitraClip therapy, alternative transcatheter reconstruction technologies are being developed. As with transcatheter aortic valve implantation (TAVI) procedures, the off-pump implantation of a valved stent into the mitral position mainly via a transapical approach will be of great benefit. Recently, the feasibility of transcatheter mitral valved stent implantation in high-risk patients has already been reported.

  4. The cost of standing strong for replacement.

    Science.gov (United States)

    Brown, Katy

    2015-03-01

    The testimonies of these individuals largely speak for themselves. The responses point to the importance of specific institutions or research groups that focus on the development and use of alternatives, and these should, of course, be better supported. Those who find themselves outside such institutions or teams, are more likely to feel stranded and isolated. Then again, Liz did have the support of a research group dedicated to replacement, but she has still had a significant struggle to find funding. The interviews with some of these particular young researchers indeed pointed toward a tangible ‘cost’ in terms of having to steer their career on the often difficult path toward the use of non-animal based methods.

  5. Stationary populations with below-replacement fertility

    Directory of Open Access Journals (Sweden)

    Carl Schmertmann

    2012-04-01

    Full Text Available BACKGROUND A population with sustained below-replacement fertility and constant immigration eventually becomes stationary. Stationary-through-immigration (SI populations have unusual age structures that depend on the distribution of immigrants' arrival ages. OBJECTIVE I summarize known formal relationships between the distribution of immigrants' entry ages and the long-run size and structure of SI populations. I clarify a previously published result about SI dependency ratios. RESULTS The long-run size and age structure of an SI population depend on the remaining life expectancies of arriving immigrants, but are also sensitive to the expected numbers of native children born after arrival. Numerical calculations with contemporary Austrian data show (1 contrary to previously published results, immigration flows need not be concentrated in early working ages in order to ensure low overall dependency, and (2 the SI dependency ratio is minimized when all immigrants are in their mid-30s.

  6. Replacement of Swiss "Attestations de fonctions"

    CERN Multimedia

    DG Unit

    2009-01-01

    The Swiss Permanent Mission has informed CERN that the "attestations de fonctions" issued to certain members of the personnel and the "attestations" issued to their family members will gradually be replaced by P-type "cartes de légitimation" (see specimen copies below). This card’s name, together with its more contemporary design compared with old-style "Attestations" issued in the 1970s, will make the holder’s daily life much easier, e.g. when crossing borders, renting accommodation or setting up a telephone line. The Users Office (PH Department) and the Cards Office (HR Department), which are responsible for handling requests for "cartes de légitimation", will provide information in due course on how they intend to organise the exchange of "attestations" (priority will be given to residents of Switzerland, in parti...

  7. The Research of Artificial Cervical Disc Replacement

    Institute of Scientific and Technical Information of China (English)

    Zhao Zhua; Qiang Shenb

    2008-01-01

    Cervical arthroplasty after anterior decompression with insertion of a prosthetic total disc replacement has been suggested as an alternate to anterior cervical fusion. It develops quickly during recent years. Currently there are several cervical arthroplasty devices. Each device varies in terms of materials, range of motion and constraint. Early studies suggest that in the short term, the complication rate and efficacy is no worse than fusion surgery. Long-term results have not yet been reported. This review examines the current prostheses as well as discussing issues regarding indications and technique. It is hoped that an improvement of cervical arthroplasty occurs in terms of materials and design as spinal surgeons enter a new dines of the management of cervical spine disease.

  8. Growth hormone replacement therapy in Costello syndrome.

    Science.gov (United States)

    Triantafyllou, Panagiota; Christoforidis, Athanasios; Vargiami, Euthymia; Zafeiriou, Dimitrios I

    2014-12-01

    Costello syndrome (CS) is considered an overgrowth disorder given the macrosomia that is present at birth .However, shortly after birth the weight drops dramatically and the patients are usually referred for failure to thrive. Subsequently, affected patients develop the distinctive coarse facial appearance and are at risk for cardiac anomalies and solid tumor malignancies. Various endocrine disorders, although not very often, have been reported in patients with CS, including growth hormone deficiency, hypoglycemia, ACTH deficiency, cryptorchidism and hypothyroidism. We report a case of Costello syndrome with hypothyroidism, cryptorchidism and growth hormone deficiency and we evaluate the long-term safety and efficacy of growth hormone replacement therapy. The index patient is a paradigm of successful and safe treatment with growth hormone for almost 7 years. Since patients with CS are at increased risk for cardiac myopathy and tumor development they deserve close monitoring during treatment.

  9. Renal Replacement Therapy in Austere Environments

    Directory of Open Access Journals (Sweden)

    Christina M. Yuan

    2011-01-01

    Full Text Available Myoglobinuric renal failure is the classically described acute renal event occurring in disaster environments—commonly after an earthquake—which most tests the ingenuity and flexibility of local and regional nephrology resources. In recent decades, several nephrology organizations have developed response teams and planning protocols to address disaster events, largely focusing on patients at risk for, or with, acute kidney injury (AKI. In this paper we briefly review the epidemiology and outcomes of patients with dialysis-requiring AKI after such events, while providing greater focus on the management of the end-stage renal disease population after a disaster which incapacitates a pre-existing nephrologic infrastructure (if it existed at all. “Austere” dialysis, as such, is defined as the provision of renal replacement therapy in any setting in which traditional, first-world therapies and resources are limited, incapacitated, or nonexistent.

  10. Testosterone replacement therapy for older men

    Directory of Open Access Journals (Sweden)

    Stephen E Borst

    2008-01-01

    Full Text Available Stephen E Borst, Thomas MulliganGeriatrics Research, Education, and Clinical Center, North Florida/South Georgia Veterans Health System, Gainesville, FL, USAAbstract: Despite intensive research on testosterone therapy for older men, important questions remain unanswered. The evidence clearly indicates that many older men display a partial androgen deficiency. In older men, low circulating testosterone is correlated with low muscle strength, with high adiposity, with insulin resistance and with poor cognitive performance. Testosterone replacement in older men has produced benefits, but not consistently so. The inconsistency may arise from differences in the dose and duration of testosterone treatment, as well as selection of the target population. Generally, studies reporting anabolic responses to testosterone have employed higher doses of testosterone for longer treatment periods and have targeted older men whose baseline circulating bioavailable testosterone levels were low. Most studies of testosterone replacement have reported anabolic that are modest compared to what can be achieved with resistance exercise training. However, several strategies currently under evaluation have the potential to produce greater anabolic effects and to do so in a safe manner. At this time, testosterone therapy can not be recommended for the general population of older men. Older men who are hypogonadal are at greater risk for the catabolic effects associated with a number of acute and chronic medical conditions. Future research is likely to reveal benefits of testosterone therapy for some of these special populations. Testosterone therapy produces a number of adverse effects, including worsening of sleep apnea, gynecomastia, polycythemia and elevation of PSA. Efficacy and adverse effects should be assessed frequently throughout the course of therapy.Keywords: aging, testosterone, hypogonadism, physical function

  11. Renal replacement therapy in Korea, 2012

    Directory of Open Access Journals (Sweden)

    Dong Chan Jin

    2014-03-01

    Full Text Available The Korean Society of Nephrology (KSN launched the official end-stage renal disease (ESRD patient registry in 1985, and an Internet online registry program was opened in 2001 and revised in 2013. The ESRD Registry Committee of KSN has collected data on dialysis therapy in Korea through the online registry program in the KSN Internet website. The status of renal replacement therapy in Korea at the end of 2012 is described in the following. The total number of ESRD patients was 70,211 at the end of 2012, which included 48,531 hemodialysis (HD patients, 7,552 peritoneal dialysis (PD patients, and 14,128 functioning kidney transplant (KT patients. The prevalence of ESRD was 1,353.3 patients per million population (PMP, and the distribution of renal replacement therapy among ESRD patients was as follows: HD, 69.1%; PD, 10.8%; and KT, 20.2%. The number of new ESRD patients in 2012 was 11,742 (HD, 8,811; PD, 923; and KT, 1,738; the incidence rate was 221.1 PMP. The primary causes of ESRD were diabetic nephropathy (50.6%, hypertensive nephrosclerosis (18.5%, and chronic glomerulonephritis (18.1%. The mean urea reduction ratio was 67.9% in male and 74.1% in female HD patients. The mean Kt/V was 1.382 in male and 1.652 in female HD patients. The 5-year survival rates of male and female dialysis patients were 70.6% and 73.5%, respectively.

  12. Neonatal varicella pneumonia, surfactant replacement therapy

    Directory of Open Access Journals (Sweden)

    Mousa Ahmadpour-kacho

    2015-12-01

    Full Text Available Background: Chickenpox is a very contagious viral disease that caused by varicella-zoster virus, which appears in the first week of life secondary to transplacental transmission of infection from the affected mother. When mother catches the disease five days before and up to two days after the delivery, the chance of varicella in neonate in first week of life is 17%. A generalized papulovesicular lesion is the most common clinical feature. Respiratory involvement may lead to giant cell pneumonia and respiratory failure. The mortality rate is up to 30% in the case of no treatment, often due to pneumonia. Treatment includes hospitalization, isolation and administration of intravenous acyclovir. The aim of this case report is to introduce the exogenous surfactant replacement therapy after intubation and mechanical ventilation for respiratory failure in neonatal chickenpox pneumonia and respiratory distress. Case Presentation: A seven-day-old neonate boy was admitted to the Neonatal Intensive Care Unit at Amirkola Children’s Hospital, Babol, north of Iran, with generalized papulovesicular lesions and respiratory distress. His mother has had a history of Varicella 4 days before delivery. He was isolated and given supportive care, intravenous acyclovir and antibiotics. On the second day, he was intubated and connected to mechanical ventilator due to severe pneumonia and respiratory failure. Because of sever pulmonary involvement evidenced by Chest X-Ray and high ventilators set-up requirement, intratracheal surfactant was administered in two doses separated by 12 hours. He was discharged after 14 days without any complication with good general condition. Conclusion: Exogenous surfactant replacement therapy can be useful as an adjunctive therapy for the treatment of respiratory failure due to neonatal chickenpox.

  13. Directing Creativity

    DEFF Research Database (Denmark)

    Darsø, Lotte; Ibbotson, Piers

    2008-01-01

    In this article we argue that leaders facing complex challenges can learn from the arts, specifically that leaders can learn by examining how theatre directors direct creativity through creative constraints. We suggest that perceiving creativity as a boundary phenomenon is helpful for directing it....... Like leaders, who are caught in paradoxical situations where they have to manage production and logistics simultaneously with making space for creativity and innovation, theatre directors need to find the delicate balance between on one hand renewal of perceptions, acting and interaction...

  14. Reduction of the reversible circuits gate complexity without using the equivalent replacement tables for the gate compositions

    Directory of Open Access Journals (Sweden)

    D. V. Zakablukov

    2014-01-01

    Full Text Available The subject of study of this paper is reversible logic circuits. The irreversibility of computation can lead in the future to significant energy loss during the calculation process. Reversible circuits can be widely used in devices operating under conditions of limited computational resources.Presently, the problem of reversible logic synthesis is widely studied. The task a synthesis algorithm can face with is to reduce the gate complexity of synthesized circuit. One way to solve this problem is to use equivalent replacement tables for the gate compositions. The disadvantage of this approach is that it is necessary to build replacement tables, it takes a long time to find the replacement in the table, and there is no way to build an appropriate universal replacement table for arbitrary reversible circuit. The aim of this paper is to develop the solution for the problem of gate complexity reduction for the reversible circuits without using equivalent replacement tables for the gate compositions.This paper makes a generalization of the k-CNOT gate for the case of zero value at some of the gate control inputs. To describe such gates it suggests using a set of direct control inputs and a set of inverted ones. A definition of the independence of two reversible gates is introduced. Two independent gates standing next to each other in the circuit can be swapped without changing the circuit result transformation. Various conditions of the independence of two reversible gates are considered including conditions imposed to the set of direct control inputs and the set of inverted ones. It is proved that two gates are independent if there is, at least, one common control input, which differs only by the type (direct or inverted.Various equivalent replacements of two k-CNOT gates compositions and its conditions imposed to the set of direct control inputs and to the set of inverted ones are considered. The proof of correctness for such replacements is

  15. Urban chaos and replacement dynamics in nature and society

    Science.gov (United States)

    Chen, Yanguang

    2014-11-01

    Replacements resulting from competition are ubiquitous phenomena in both nature and society. The evolution of a self-organized system is always a physical process substituting one type of components for another type of components. A logistic model of replacement dynamics has been proposed in terms of technical innovation and urbanization, but it fails to arouse widespread attention in the academia. This paper is devoted to laying the foundations of general replacement principle by using analogy and induction. The empirical base of this study is urban replacement, including urbanization and urban growth. The sigmoid functions can be employed to model various processes of replacement. Many mathematical methods such as allometric scaling and head/tail breaks can be applied to analyzing the processes and patterns of replacement. Among varied sigmoid functions, the logistic function is the basic and the simplest model of replacement dynamics. A new finding is that replacement can be associated with chaos in a nonlinear system, e.g., urban chaos is just a part of replacement dynamics. The aim of developing replacement theory is at understanding complex interaction and conversion. This theory provides a new way of looking at urbanization, technological innovation and diffusion, Volterra-Lotka’s predator-prey interaction, man-land relation, and dynastic changes resulting from peasant uprising, and all that. Especially, the periodic oscillations and chaos of replacement dynamics can be used to explain and predict the catastrophic occurrences in the physical and human systems.

  16. Advances in Rosetta structure prediction for difficult molecular-replacement problems

    Energy Technology Data Exchange (ETDEWEB)

    DiMaio, Frank, E-mail: dimaio@u.washington.edu [University of Washington, UW Box 357350, Seattle, WA 98195 (United States)

    2013-11-01

    Modeling advances using Rosetta structure prediction to aid in solving difficult molecular-replacement problems are discussed. Recent work has shown the effectiveness of structure-prediction methods in solving difficult molecular-replacement problems. The Rosetta protein structure modeling suite can aid in the solution of difficult molecular-replacement problems using templates from 15 to 25% sequence identity; Rosetta refinement guided by noisy density has consistently led to solved structures where other methods fail. In this paper, an overview of the use of Rosetta for these difficult molecular-replacement problems is provided and new modeling developments that further improve model quality are described. Several variations to the method are introduced that significantly reduce the time needed to generate a model and the sampling required to improve the starting template. The improvements are benchmarked on a set of nine difficult cases and it is shown that this improved method obtains consistently better models in less running time. Finally, strategies for best using Rosetta to solve difficult molecular-replacement problems are presented and future directions for the role of structure-prediction methods in crystallography are discussed.

  17. Property Assessment of Sponge Cake Added with Egg Replacer

    Directory of Open Access Journals (Sweden)

    Yaqiang He

    2015-08-01

    Full Text Available Chicken egg which is always used in sponge cake production is likely to deteriorate during storage or transportation. This weakness prevents the wide use of chicken egg in sponge cake making. In order to solve this problem, egg replacer has been developed. In this study, effect of egg replacer on the property of sponge cake was analyzed. The result indicated egg replacer could improve the yield rate and specific volume of sponge cake. However, high content of egg replacer would negatively impact the internal structure and sensory property of sponge cake. Based on the result of this research, optimum content of egg replacer in sponge cake is 3.6 g. In the industrial production of sponge cake, different types of wheat flour and additives would be used. The optimum content of egg replacer may be different from the result of this research. Therefore, in the industrial production, the optimum content of egg replacer should be determined based on experiment.

  18. DEVELOPMENT OF REMOTE HANFORD CONNECTOR GASKET REPLACEMENT TOOLING FOR DWPF

    Energy Technology Data Exchange (ETDEWEB)

    Krementz, D.; Coughlin, Jeffrey

    2009-05-05

    The Defense Waste Processing Facility (DWPF) requested the Savannah River National Laboratory (SRNL) to develop tooling and equipment to remotely replace gaskets in mechanical Hanford connectors to reduce personnel radiation exposure as compared to the current hands-on method. It is also expected that radiation levels will continually increase with future waste streams. The equipment is operated in the Remote Equipment Decontamination Cell (REDC), which is equipped with compressed air, two master-slave manipulators (MSM's) and an electro-mechanical manipulator (EMM) arm for operation of the remote tools. The REDC does not provide access to electrical power, so the equipment must be manually or pneumatically operated. The MSM's have a load limit at full extension of ten pounds, which limited the weight of the installation tool. In order to remotely replace Hanford connector gaskets several operations must be performed remotely, these include: removal of the spent gasket and retaining ring (retaining ring is also called snap ring), loading the new snap ring and gasket into the installation tool and installation of the new gasket into the Hanford connector. SRNL developed and tested tools that successfully perform all of the necessary tasks. Removal of snap rings from horizontal and vertical connectors is performed by separate air actuated retaining ring removal tools and is manipulated in the cell by the MSM. In order install a new gasket, the snap ring loader is used to load a new snap ring into a groove in the gasket installation tool. A new gasket is placed on the installation tool and retained by custom springs. An MSM lifts the installation tool and presses the mounted gasket against the connector block. Once the installation tool is in position, the gasket and snap ring are installed onto the connector by pneumatic actuation. All of the tools are located on a custom work table with a pneumatic valve station that directs compressed air to the desired

  19. Two different techniques of manufacturing TMJ replacements - A technical report.

    Science.gov (United States)

    Kozakiewicz, Marcin; Wach, Tomasz; Szymor, Piotr; Zieliński, Rafał

    2017-09-01

    Presently, during the surgical treatment of the patients in maxillofacial surgery, one can use various medical implants. Moreover custom made implants are being used. Replacements may be fitted to the structure and shape of the human skull owing to CAD/CAM (custom aided design/manufacture) called customized implants. This study was aimed to report for the first time clinical material from which custom implants, using two different techniques, were manufactured to reconstruct the temporomandibular joint (TMJ). In this study, eleven patients with an average age of 54 years were included. All of the patients underwent TMJ reconstruction using direct metal laser sintering (DMLS) or computer numerical control milling (CNC) techniques for implant manufacture. Four of the eleven patients had a malignancy diagnosis, and seven had a benign diagnosis. Patients complained of hypomobility of the TMJ, facial asymmetry, pain and swelling of the preauricular region. Treatment included 7 CNC milled implants and 4 implants in DMLS. More metallic implant parts with a rough surface were associated with the DMLS technique. Post operational, uneventful healing was observed in all clinical cases during an average of 26.8 months of follow-up. Three months post-operation, facial nerve palsy, swallowing disturbances and pain were not observed. Infections, allergic reactions to materials and re-ankylosis were also not observed. Replacements received correct forms and functions owing to the CAM techniques. Post-operational maximal interincisal opening improved (p < 0.01) and was not significantly related to preoperational opening, age, sex, diagnosis or adjuvant radiotherapy. Considering both methods, the feature that differentiates the manufacture technique is the more subtractive surface finishing required for the DMLS implant than the CNC implant. Both techniques resulted the same clinical outcomes and can be used successfully in patients with neoplastic lesions and other TMJ disorders

  20. Evolution of high tooth replacement rates in sauropod dinosaurs.

    Directory of Open Access Journals (Sweden)

    Michael D D'Emic

    Full Text Available BACKGROUND: Tooth replacement rate can be calculated in extinct animals by counting incremental lines of deposition in tooth dentin. Calculating this rate in several taxa allows for the study of the evolution of tooth replacement rate. Sauropod dinosaurs, the largest terrestrial animals that ever evolved, exhibited a diversity of tooth sizes and shapes, but little is known about their tooth replacement rates. METHODOLOGY/PRINCIPAL FINDINGS: We present tooth replacement rate, formation time, crown volume, total dentition volume, and enamel thickness for two coexisting but distantly related and morphologically disparate sauropod dinosaurs Camarasaurus and Diplodocus. Individual tooth formation time was determined by counting daily incremental lines in dentin. Tooth replacement rate is calculated as the difference between the number of days recorded in successive replacement teeth. Each tooth family in Camarasaurus has a maximum of three replacement teeth, whereas each Diplodocus tooth family has up to five. Tooth formation times are about 1.7 times longer in Camarasaurus than in Diplodocus (315 vs. 185 days. Average tooth replacement rate in Camarasaurus is about one tooth every 62 days versus about one tooth every 35 days in Diplodocus. Despite slower tooth replacement rates in Camarasaurus, the volumetric rate of Camarasaurus tooth replacement is 10 times faster than in Diplodocus because of its substantially greater tooth volumes. A novel method to estimate replacement rate was developed and applied to several other sauropodomorphs that we were not able to thin section. CONCLUSIONS/SIGNIFICANCE: Differences in tooth replacement rate among sauropodomorphs likely reflect disparate feeding strategies and/or food choices, which would have facilitated the coexistence of these gigantic herbivores in one ecosystem. Early neosauropods are characterized by high tooth replacement rates (despite their large tooth size, and derived titanosaurs and

  1. Direct marketing

    Directory of Open Access Journals (Sweden)

    Čičić Muris

    2002-01-01

    Full Text Available Direct Marketing (DM is usually treated as unworthy activity, with actions at the edge of legality and activities minded cheating. Despite obvious problems regarding ethics and privacy threat, DM with its size, importance and role in a concept of integrated marketing communication deserves respect and sufficient analysis and review

  2. 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

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

    Science.gov (United States)

    Chong, Elaine W; Wang, Yuanyuan; Robman, Liubov D; Aung, Khin Zaw; Makeyeva, Galina A; Giles, Graham G; Graves, Stephen; Cicuttini, Flavia M; Guymer, Robyn H

    2015-01-01

    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 neck of femur may be

  4. Direct ELISA.

    Science.gov (United States)

    Lin, Alice V

    2015-01-01

    First described by Engvall and Perlmann, the enzyme-linked immunosorbent assay (ELISA) is a rapid and sensitive method for detection and quantitation of an antigen using an enzyme-labeled antibody. Besides routine laboratory usage, ELISA has been utilized in medical field and food industry as diagnostic and quality control tools. Traditionally performed in 96-well or 384-well polystyrene plates, the technology has expanded to other platforms with increase in automation. Depending on the antigen epitope and availability of specific antibody, there are variations in ELISA setup. The four basic formats are direct, indirect, sandwich, and competitive ELISAs. Direct ELISA is the simplest format requiring an antigen and an enzyme-conjugated antibody specific to the antigen. This chapter describes the individual steps for detection of a plate-bound antigen using a horseradish peroxidase (HRP)-conjugated antibody and luminol-based enhanced chemiluminescence (ECL) substrate. The methodological approach to optimize the assay by chessboard titration is also provided.

  5. Directing Lives

    Institute of Scientific and Technical Information of China (English)

    1999-01-01

    YANG Yang is he director of China Television PlayCenter.Before the arrival of the series Holding Hands,she filmed television plays reflecting women and marriage.Examples of her work include Niu Yuqin and Her Trees and theMidnight Trolley.The artistry and sympathy towards women inthese programmes make it obvious that they were directed by awoman.Holding Hands especially cements this connection.

  6. Surfactant replacement therapy--economic impact.

    Science.gov (United States)

    Pejaver, R K; al Hifzi, I; Aldussari, S

    2001-06-01

    Surfactant replacement is an effective treatment for neonatal respiratory distress syndrome. (RDS). As widespread use of surfactant is becoming a reality, it is important to assess the economic implications of this new form of therapy. A comparison study was carried out at the Neonatal Intensive Care Unit (NICU) of Northwest Armed Forces Hospital, Saudi Arabia. Among 75 infants who received surfactant for RDS and similar number who were managed during time period just before the surfactant was available, but by set criteria would have made them eligible for surfactant. All other management modalities except surfactant were the same for all these babies. Based on the intensity of monitoring and nursing care required by the baby, the level of care was divided as: Level IIIA, IIIB, Level II, Level I. The cost per day per bed for each level was calculated, taking into account the use of hospital immovable equipment, personal salaries of nursing, medical, ancillary staff, overheads and maintenance, depreciation and replacement costs. Medications used, procedures done, TPN, oxygen, were all added to individual patient's total expenditure. 75 infants in the Surfactant group had 62 survivors. They spent a total of 4300 days in hospital. (av 69.35) Out of which 970 d (av 15.65 per patient) were ventilated days. There were 56 survivors in the non-surfactant group of 75. They had spent a total of 5023 days in the hospital (av 89.69/patient) out of which 1490 were ventilated days (av 26.60 d). Including the cost of surfactant (two doses), cost of hospital stay for each infant taking the average figures of stay would be SR 118, 009.75 per surfactant treated baby and SR 164, 070.70 per non-surfactant treated baby. The difference of 46,061 SR is 39.03% more in non-surfactant group. One Saudi rial = 8 Rs (approx at the time study was carried out.) Medical care cost varies from place to place. However, it is definitely cost-effective where surfactant is concerned. Quality adjusted

  7. Mineral replacement reactions and element mobilization

    Science.gov (United States)

    Putnis, Christine V.; Ruiz-Agudo, Encarnacion; King, Helen E.; Hövelmann, Jörn; Renard, François

    2016-04-01

    When a mineral is out of equilibrium with an aqueous fluid, reactions will take place in an attempt to reach a new equilibrium. Commonly in the Earth dissolution at a mineral-fluid interface initiates a coupled reaction involving dissolution and precipitation (Ruiz-Agudo et al., 2014). This is a ubiquitous reaction during such processes as metamorphism, metasomatism and weathering. When rock-forming minerals such as feldspars, olivine, pyroxenes are in contact with aqueous fluids (typically NaCl-rich) resultant new phases are formed and elements present in the parent mineral are released to the fluid and therefore mobilized for transport elsewhere. This has been shown in a number of systems such as the albitisation of feldspars (Hövelmann et al., 2010) when a Ca-bearing plagioclase is replaced by albite (NaAlSi3O8). However during this reaction not only is Ca released to the fluid but most other minor elements, such as Mg, Pb, rare earth elements amongst others, are almost totally mobilized and removed in solution. This interface-coupled dissolution-precipitation reaction has many implications for the redistributon of elements in the crust of the Earth. It is also of note that albitisation occurs often in areas of high mineralization, such as in the Curnamona Province in S. Australia (Au-Cu and Ag-Pb-Zn deposits) and the Bamble District of S. Norway. Secondly atomic force microscopy (AFM) has been used to image these reactions at a nanoscale, especially at the calcite-fluid interface, such as the formation of apatite from phosphate-bearing solutions, and the sequestration of toxic elements, eg., Se and As. References Ruiz-Agudo E., Putnis C.V., Putnis A. (2014) Coupled dissolution and precipitation at mineral-fluid interfaces. Chemical Geology, 383, 132-146. Putnis C.V. and Ruiz-Agudo E. (2013) The mineral-water interface: where minerals react with the environment. Elements, 9, 177-182. Hövelmann J., Putnis A., Geisler T., Schmidt B.C., Golla-Schindler U. (2009

  8. Analytical Protocol (GC/ECNIMS) for OSWER's Response to OIG Report (2005-P-00022) on Toxaphene Analysis

    Science.gov (United States)

    The research approached the large number and complexity of the analytes as four separate groups: technical toxaphene, toxaphene congeners (eight in number), chlordane, and organochlorine pesticides. This approach was advantageous because it eliminated potential interferences amon...

  9. Direct Production of Copper

    Science.gov (United States)

    Victorovich, G. S.; Bell, M. C.; Diaz, C. M.; Bell, J. A. E.

    1987-09-01

    The use of commercially pure oxygen in flash smelting a typical chalcopyrite concentrate or a low grade comminuted matte directly to copper produces a large excess of heat. The heat balance is controlled by adjusting the calorific value of the solid feed. A portion of the sulfide material is roasted to produce a calcine which is blended with unroasted material, and the blend is then autogeneously smelted with oxygen and flux directly to copper. Either iron silicate or iron calcareous slags are produced, both being subject to a slag cleaning treatment. Practically all of the sulfur is contained in a continuous stream of SO2 gas, most of which is strong enough for liquefaction. A particularly attractive feature of these technologies is that no radically new metallurgical equipment needs to be developed. The oxygen smelting can be carried out not only in the Inco type flash furnace but in other suitable smelters such as cyclone furnaces. Another major advantage stems from abolishion of the ever-troublesome converter aisle, which is replaced with continuous roasting of a fraction of the copper sulfide feed.

  10. Delivering enhanced testosterone replacement therapy through nanochannels.

    Science.gov (United States)

    Ferrati, Silvia; Nicolov, Eugenia; Bansal, Shyam; Zabre, Erika; Geninatti, Thomas; Ziemys, Arturas; Hudson, Lee; Ferrari, Mauro; Goodall, Randal; Khera, Mohit; Palapattu, Ganesh; Grattoni, Alessandro

    2015-02-18

    Primary or secondary hypogonadism results in a range of signs and symptoms that compromise quality of life and requires life-long testosterone replacement therapy. In this study, an implantable nanochannel system is investigated as an alternative delivery strategy for the long-term sustained and constant release of testosterone. In vitro release tests are performed using a dissolution set up, with testosterone and testosterone:2-hydroxypropyl-β-cyclodextrin (TES:HPCD) 1:1 and 1:2 molar ratio complexes release from the implantable nanochannel system and quantify by HPLC. 1:2 TES:HPCD complex stably achieve 10-15 times higher testosterone solubility with 25-30 times higher in vitro release. Bioactivity of delivered testosterone is verified by LNCaP/LUC cell luminescence. In vivo evaluation of testosterone, luteinizing hormone (LH), and follicle stimulating hormone (FSH) levels by liquid chromatography mass spectrometry (LC/MS) and multiplex assay is performed in castrated Sprague-Dawley rats over 30 d. Animals are treated with the nanochannel implants or degradable testosterone pellets. The 1:2 TES:HPCD nanochannel implant exhibits sustained and clinically relevant in vivo release kinetics and attains physiologically stable plasma levels of testosterone, LH, and FSH. In conclusion, it is demonstrated that by providing long-term steady release 1:2 TES:HPCD nanochannel implants may represent a major breakthrough for the treatment of male hypogonadism.

  11. Acute Renal Replacement Therapy in Pediatrics

    Directory of Open Access Journals (Sweden)

    Rajit K. Basu

    2011-01-01

    Full Text Available Acute kidney injury (AKI independently increases morbidity and mortality in children admitted to the hospital. Renal replacement therapy (RRT is an essential therapy in the setting of AKI and fluid overload. The decision to initiate RRT is complex and often complicated by concerns related to patient hemodynamic and thermodynamic instability. The choice of which RRT modality to use depends on numerous criteria that are both patient and treatment center specific. Surprisingly, despite decades of use, no randomized, controlled trial study involving RRT in pediatrics has been performed. Because of these factors, clear-cut consensus is lacking regarding key questions surrounding RRT delivery. In this paper, we will summarize existing data concerning RRT use in children. We discuss the major modalities and the data-driven specifics of each, followed by controversies in RRT. As no standard of care is in widespread use for RRT in AKI or in multiorgan disease, we conclude in this paper that prospective studies of RRT are needed to identify best practice guidelines.

  12. Can Smartwatches Replace Smartphones for Posture Tracking?

    Directory of Open Access Journals (Sweden)

    Bobak Mortazavi

    2015-10-01

    Full Text Available This paper introduces a human posture tracking platform to identify the human postures of sitting, standing or lying down, based on a smartwatch. This work develops such a system as a proof-of-concept study to investigate a smartwatch’s ability to be used in future remote health monitoring systems and applications. This work validates the smartwatches’ ability to track the posture of users accurately in a laboratory setting while reducing the sampling rate to potentially improve battery life, the first steps in verifying that such a system would work in future clinical settings. The algorithm developed classifies the transitions between three posture states of sitting, standing and lying down, by identifying these transition movements, as well as other movements that might be mistaken for these transitions. The system is trained and developed on a Samsung Galaxy Gear smartwatch, and the algorithm was validated through a leave-one-subject-out cross-validation of 20 subjects. The system can identify the appropriate transitions at only 10 Hz with an F-score of 0.930, indicating its ability to effectively replace smart phones, if needed.

  13. Can smartwatches replace smartphones for posture tracking?

    Science.gov (United States)

    Mortazavi, Bobak; Nemati, Ebrahim; VanderWall, Kristina; Flores-Rodriguez, Hector G; Cai, Jun Yu Jacinta; Lucier, Jessica; Naeim, Arash; Sarrafzadeh, Majid

    2015-10-22

    This paper introduces a human posture tracking platform to identify the human postures of sitting, standing or lying down, based on a smartwatch. This work develops such a system as a proof-of-concept study to investigate a smartwatch's ability to be used in future remote health monitoring systems and applications. This work validates the smartwatches' ability to track the posture of users accurately in a laboratory setting while reducing the sampling rate to potentially improve battery life, the first steps in verifying that such a system would work in future clinical settings. The algorithm developed classifies the transitions between three posture states of sitting, standing and lying down, by identifying these transition movements, as well as other movements that might be mistaken for these transitions. The system is trained and developed on a Samsung Galaxy Gear smartwatch, and the algorithm was validated through a leave-one-subject-out cross-validation of 20 subjects. The system can identify the appropriate transitions at only 10 Hz with an F-score of 0.930, indicating its ability to effectively replace smart phones, if needed.

  14. TOTAL ANKLE REPLACEMENT: WHY, WHEN AND HOW?

    Science.gov (United States)

    Bonasia, Davide Edoardo; Dettoni, Federico; Femino, John E; Phisitkul, Phinit; Germano, Margherita; Amendola, Annunziato

    2010-01-01

    Total ankle replacement (TAR) was first attempted in the 1970s, but poor results led to its being considered inferior to ankle fusion until the late 1980s and early 1990s. By that time, newer designs which more closely replicated the natural anatomy of the ankle, showed improved clinical outcomes.1 Currently, even though controversy still exists about the effectiveness of TAR compared to ankle fusion, TAR has shown promising mid-term results and should no longer be considered an experimental procedure. Factors related to improved TAR outcomes include: 1) better patient selection, 2) more precise knowledge and replication of ankle biomechanics, 3) the introduction of less-constrained designs with reduced bone resection and no need for cementation, and 4) greater awareness of soft-tissue balance and component alignment. When TAR is performed, a thorough knowledge of ankle anatomy, pathologic anatomy and biomechanics is needed along with a careful pre-operative plan. These are fundamental in obtaining durable and predictable outcomes. The aim of this paper is to outline these aspects through a literature review. PMID:21045984

  15. Total ankle replacement for posttraumatic arthritis

    Science.gov (United States)

    Weme, Rebecca A Nieuwe; van Solinge, Guido; N Doornberg, Job; Sierevelt, Inger; Haverkamp, Daniël; Doets, H Cornelis

    2015-01-01

    Background and purpose Most studies on total ankle replacement (TAR) have used a case mix of patients. We evaluated the outcome of TAR performed for end-stage arthritis either because of fracture or ligamentous injury. Patients and methods We prospectively followed 88 consecutive patients (50 postfracture ankles and 40 ankles with instability arthritis (2 bilateral)) who underwent TAR between 2001 and 2009. Mean follow-up for both groups was 5 years. Results Preoperative varus deformity of 10° or more was present in 23 ankles in the instability group. At 6 years, survival with revision or salvage fusion as an endpoint was 87% (95% CI: 74–99) in the postfracture group and 79% (95% CI: 63–94) in the instability group. Progressive periprosthetic osteolysis was seen in 23 ankles, and required salvage fusion in 6. The number of reoperations was similar in both groups. Clinical outcome, as assessed with 2 ankle scores and 2 questionnaires, showed good results and was similar at the latest follow-up. Interpretation The outcome was similar in the postfracture and instability groups and also similar to that reported in series including a case mix of patients. In contrast to earlier reports, preoperative frontal plane deformity in this series was not identified as a risk factor for failure. PMID:25772269

  16. Ulnar Head Replacement and Related Biomechanics

    Science.gov (United States)

    Sauerbier, Michael; Arsalan-Werner, Annika; Enderle, Elena; Vetter, Miriam; Vonier, Daniel

    2013-01-01

    A stable distal radioulnar joint (DRUJ) is mandatory for the function and load transmission in the wrist and forearm. Resectional salvage procedures such as the Darrach procedure, Bowers arthroplasty, and Sauvé-Kapandji procedure include the potential risk of radioulnar instability and impingement, which can lead to pain and weakness. Soft tissue stabilizing techniques have only limited success rates in solving these problems. In an attempt to stabilize the distal forearm mechanically following ulnar head resection, various endoprostheses have been developed to replace the ulnar head. The prostheses can be used for secondary treatment of failed ulnar head resection, but they can also achieve good results in the primary treatment of osteoarthritis of the DRUJ. Our experience consists of twenty-five patients (follow-up 30 months) with DRUJ osteoarthritis who were treated with an ulnar head prosthesis, with improvement in pain, range of motion, and grip strength. An ulnar head prosthesis should be considered as a treatment option for a painful DRUJ. PMID:24436786

  17. The quest for physiologic insulin replacement.

    Science.gov (United States)

    Owens, David R

    2004-11-01

    Historically, the objective of insulin replacement has been to simulate the 2 major components of insulin secretion in individuals without diabetes mellitus: the low-level basal secretion during the night and periods of fasting, and the prandial secretion in response to food intake. The variable pharmacokinetic and pharmacodynamic characteristics of conventional insulin preparations have made mimicking these physiologic profiles virtually impossible. Balancing the effects of diet, exercise, and the numerous factors contributing to intra- and inter-individual variations in insulin absorption and action, such as type, site of injection, and dosage of insulin, while avoiding the very serious side effect of hypoglycemia in seeking normoglycemia, presents a further challenge. Recently, these limitations have been addressed by recombinant DNA-mediated development of insulin analogues, such as rapid-acting insulin lispro, aspart and glulisine, and the long-acting insulin preparations, insulin glargine and detemir. The molecular structures of these analogues have produced time-action profiles that better approach prandial and basal insulin secretion, thus allowing for easier, safer, and more flexible treatment regimens.

  18. MRI after patellofemoral replacement: The preserved compartments

    Energy Technology Data Exchange (ETDEWEB)

    Heyse, Thomas J., E-mail: heyse@med.uni-marburg.de [Department of Orthopedics and Rheumatology, University Hospital Marburg, Baldingerstrasse, 35043 Marburg (Germany); Figiel, Jens [Department of Radiology, University Hospital Marburg, Marburg (Germany); Hähnlein, Ulrike [Department of Orthopedics and Rheumatology, University Hospital Marburg, Baldingerstrasse, 35043 Marburg (Germany); Timmesfeld, Nina [Institute for Medical Biometry and Epidemiology, Marburg (Germany); Lakemeier, Stefan; Schofer, Markus D.; Fuchs-Winkelmann, Susanne; Efe, Turgay [Department of Orthopedics and Rheumatology, University Hospital Marburg, Baldingerstrasse, 35043 Marburg (Germany)

    2012-09-15

    Introduction: The aim of this study was to assess the reproducibility of magnet resonance imaging (MRI) analysis of preserved anatomic structures of the knee after patellofemoral replacement (PFR). It was hypothesized that evaluation of cartilage, ligaments, meniscus and tendons would result in high inter-observer reliability after PFR. Material and methods: MRI, tailored to reduce metallic artefacts of the knee, after PFR was performed in seven patients. Two independent investigators evaluated cartilage, menisci, collateral and cruciate ligaments, the quadriceps and patellar tendons and the presence of joint effusion. The reviewers used a five-point scale to give a degree of confidence to their evaluation of each parameter. Inter-observer reliability was determined by calculation of Cohen's Kappas. Results: Artefact provoked by the implants was not observed. For all assessed structures, there was excellent inter-observer reliability, with high Cohen's Kappas. There were also high levels of inter-observer agreement and observer confidence in the evaluation of cartilage, meniscus, tendons, ligaments and joint effusion. Conclusion: Tailored MRI allows reproducible analysis of the preserved knee joint structures after PFR. It might prove helpful in assessment of painful knee joints after PFR.

  19. MMIC Replacement for Gunn Diode Oscillators

    Science.gov (United States)

    Crowe, Thomas W.; Porterfield, David

    2011-01-01

    An all-solid-state replacement for high-frequency Gunn diode oscillators (GDOs) has been proposed for use in NASA s millimeter- and submillimeter-wave sensing instruments. Highly developed microwave oscillators are used to achieve a low-noise and highly stable reference signal in the 10-40-GHz band. Compact amplifiers and high-power frequency multipliers extend the signal to the 100-500-GHz band with minimal added phase noise and output power sufficient for NASA missions. This technology can achieve improved output power and frequency agility, while maintaining phase noise and stability comparable to other GDOs. Additional developments of the technology include: a frequency quadrupler to 145 GHz with 18 percent efficiency and 15 percent fixed tuned bandwidth; frequency doublers featuring 124, 240, and 480 GHz; an integrated 874-GHz subharmonic mixer with a mixer noise temperature of 3,000 K DSB (double sideband) and mixer conversion loss of 11.8 dB DSB; a high-efficiency frequency tripler design with peak output power of 23 mW and 14 mW, and efficiency of 16 and 13 percent, respectively; millimeter-wave integrated circuit (MMIC) power amplifiers to the 30-40 GHz band with high DC power efficiency; and an 874-GHz radiometer suitable for airborne observation with state-of-the-art sensitivity at room temperature and less than 5 W of total power consumption.

  20. Nonclinical Development of BCG Replacement Vaccine Candidates

    Directory of Open Access Journals (Sweden)

    Bernd Eisele

    2013-04-01

    Full Text Available The failure of current Mycobacterium bovis bacille Calmette–Guérin (BCG vaccines, given to neonates to protect against adult tuberculosis and the risk of using these live vaccines in HIV-infected infants, has emphasized the need for generating new, more efficacious and safer replacement vaccines. With the availability of genetic techniques for constructing recombinant BCG (rBCG strains containing well-defined gene deletions or insertions, new vaccine candidates are under evaluation at both the preclinical and clinical stages of development. Since most BCG vaccines in use today were evaluated in clinical trials decades ago and are produced by outdated processes, the development of new BCG vaccines offers a number of advantages that include a modern well-defined manufacturing process along with state-of-the-art evaluation of safety and efficacy in target populations. We provide a description of the preclinical development of two novel rBCGs, VPM1002 that was constructed by adding a modified hly gene coding for the protein listeriolysin O (LLO from Listeria monocytogenes and AERAS-422, which carries a modified pfoA gene coding for the protein perfringolysin O (PFO from Clostridium perfringens, and three genes from Mycobacterium tuberculosis. Novel approaches like these should be helpful in generating stable and effective rBCG vaccine candidates that can be better characterized than traditional BCG vaccines.

  1. [Renal replacement therapy for refractory heart failure].

    Science.gov (United States)

    Schwenger, V; Remppis, A B

    2012-07-01

    After broad cardiological and nephrological evaluation and consideration of optimal conservative options according to national and international guidelines, renal replacement therapy might be helpful in patients with refractory heart failure even if they are not dialysis-dependent. This is even more important as renal failure is a strong predictor for mortality in patients with severe congestive heart failure (CHF) and CHF is one of the fastest growing morbidities in western countries. Although peritoneal dialysis (PD) is frequently used in patients with CHF its role remains unclear. Acute chronic volume overload in refractory CHF is still an unresolved clinical problem. In patients with acute heart and renal failure with need of management in an intensive care unit, extracorporeal ultrafiltration or a dialysis modality should be preferred. In patients with chronic refractory CHF, volume overload and renal failure, peritoneal dialysis should be the therapy of choice. Due to the limited data available, treatment and outcome parameters should be recorded in the registry of the German Society of Nephrology (http://www.herz-niere.de).

  2. Replacement of Swiss "Attestations de fonctions"

    CERN Multimedia

    DG Unit

    2009-01-01

    The Swiss Permanent Mission has informed CERN that the "attestations de fonctions" issued to certain members of the personnel and the "attestations" issued to their family members will gradually be replaced by P-type "cartes de légitimation" (see specimen copies in the printed Bulletin). This card’s name, together with its more contemporary design compared with old-style "Attestations" issued in the 1970s, will make the holder’s daily life much easier, e.g. when crossing borders, renting accommodation or setting up a telephone line. The Users Office (PH Department) and the Cards Office (HR Department), which are responsible for handling requests for "cartes de légitimation", will provide information in due course on how they intend to organise the exchange of "attestations" (priority will be given to residents of Switzerland, in particular those requiring a visa for the Schengen area). In this context, we remind you that the Swiss Permanent Mission is systematically in...

  3. Cortical bone total ossicular replacement prosthesis

    Directory of Open Access Journals (Sweden)

    Manu Malhotra

    2014-01-01

    Full Text Available Objectives: Evaluate an autologous cortical bone total ossicular replacement prosthesis (B TORP made of cortical bone for cost effective and sustainable hearing results. Materials and Methods: A prospective study was undertaken in the patients who underwent tympanoplasty with new B-TORP from January 2011 to December 2011. All patients had an absent superstructure of the stapes and long process of the incus due to chronic otitis media. Totally 40 patients were evaluated. Hearing results were evaluated using four-frequency average pure tone air conduction and air-bone gap (ABG measured at 0.5, 1, 2, and 3 kHz after a period of 12 months. Pre- and post-operative continuous variables were compared using a paired t-test and data from unequal groups were assessed for significant differences using unpaired t-test. Results: Successful rehabilitation of the ABG to 20 dB or less was achieved in 95% of patients. Overall mean improvement in ABG was 25.8 ± 5.6 dB, which was statistically significant (t = 26.8, P 0.5. Conclusion: The new autologous B-TORP provides sustainable hearing improvement and is bio-compatible, stable, and magnetic resonance imaging compatible.

  4. Flash-Aware Page Replacement Algorithm

    Directory of Open Access Journals (Sweden)

    Guangxia Xu

    2014-01-01

    Full Text Available Due to the limited main memory resource of consumer electronics equipped with NAND flash memory as storage device, an efficient page replacement algorithm called FAPRA is proposed for NAND flash memory in the light of its inherent characteristics. FAPRA introduces an efficient victim page selection scheme taking into account the benefit-to-cost ratio for evicting each victim page candidate and the combined recency and frequency value, as well as the erase count of the block to which each page belongs. Since the dirty victim page often contains clean data that exist in both the main memory and the NAND flash memory based storage device, FAPRA only writes the dirty data within the victim page back to the NAND flash memory based storage device in order to reduce the redundant write operations. We conduct a series of trace-driven simulations and experimental results show that our proposed FAPRA algorithm outperforms the state-of-the-art algorithms in terms of page hit ratio, the number of write operations, runtime, and the degree of wear leveling.

  5. Testosterone Replacement Therapy: The Emperor's New Clothes.

    Science.gov (United States)

    Sansone, Andrea; Sansone, Massimiliano; Lenzi, Andrea; Romanelli, Francesco

    2017-02-01

    The mean age of the world population has steadily increased in the last decades, as a result of increased life expectancy and reduced birth rate. Global aging has led to a greater worldwide cost for healthcare: hormonal alterations contribute to the pathogenesis of several conditions and might cause a significant reduction in the perceived sense of well-being. Menopause is archetypal of hormonal alterations occurring during aging: in males, sex hormones do not decrease abruptly, yet testosterone levels decrease steadily and continuously during aging, ultimately resulting in late-onset hypogonadism. Treatment of this condition might mitigate most symptoms; however, testosterone replacement therapy (TRT) should be prescribed only in selected patients and it should not be considered as an antiaging treatment. In recent years, different authors have questioned health risks associated with testosterone treatment; while position statements from many scientific societies seem to be reassuring, the Food and Drug Administration has issued a warning in regard to the possible side effects of this therapy. We aim to review recent controversies and discoveries in regard to TRT.

  6. Licensing of the Australian replacement research reactor

    Energy Technology Data Exchange (ETDEWEB)

    Garea, Veronica B. [INVAP S.E., San Carlos de Bariloche (Argentina)

    2002-07-01

    The Australian Nuclear Science and Technology Organisation (ANSTO)'s Replacement Research Reactor has been submitted to a comprehensive licensing process of which peer review has been a fundamental part. Following Australian Regulation, an application for a site licence was the first step supported by an Environmental Impact Statement approved by The Minister for the Environment and Heritage, and a Reference Accident Analysis. After the site licence had been granted and the contract awarded to the Designer and Constructor, INVAP S.E:, a 2500 page Preliminary Safety Analysis Report was submitted by ANSTO to the Australian Radiation Protection and Nuclear Safety Agency (ARPANSA), which conducted its review. ARPANSA requested that the PSAR be also reviewed by an experts mission from the International Atomic Energy Agency. The PSAR was also reviewed by the Argentine Regulatory Body, it was submitted to public examination in Australia and it was reviewed by international experts hired as consultants by several Australian organisations. A public forum was also held in Sydney. The Regulator, the applicant and the Designer-Constructor maintained constant interaction during the whole process, so that questions, comments and observations that arose from the review of the PSAR were fed back to the designers. This process allowed for a robust, safe design enriched by the results of the safety analysis and review process. (author)

  7. Antimicrobial dosing in acute renal replacement.

    Science.gov (United States)

    Fissell, William H

    2013-01-01

    Acute kidney injury (AKI) is a common problem in hospitalized patients and is associated with significant morbidity and mortality. Two large trials showed no benefit from increased doses of renal replacement therapy (RRT) despite previous clinical data suggesting that increased clearance from RRT has beneficial effects. Since infection is the leading cause of death in AKI, my group and others hypothesized that increased RRT antibiotic clearance might create a competing morbidity. The data from my group, as well as those of other groups, show that many patients are underdosed when routine "1 size fits all" antibiotic dosing is used in patients with AKI receiving continuous RRT (CRRT). Here, concepts of drug distribution and clearance in AKI are briefly discussed and then 1 antibiotic (piperacillin) is discussed in depth to illustrate the challenges in applying the medical literature to clinical practice. The fact that published data on drug dosing in AKI and dialysis reflect the evolution of practice patterns and often do not apply to present prescribing habits is also discussed. A more general approach to drug dosing facilitates situation-specific prescribing by the nephrologist and critical care specialist. Copyright © 2013 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.

  8. Drug dosing during continuous renal replacement therapies.

    Science.gov (United States)

    Thompson, A Jill

    2008-04-01

    Continuous renal replacement therapies (CRRT) are used to manage fluid overload and/or renal failure. The continuous nature of the fluid and solute removal has less impact on hemodynamic variables in critically ill patients, making CRRT preferred over intermittent hemodialysis for some patients in the intensive care arena. The impact of CRRT on drug removal is variable depending on the CRRT modality, the ultrafiltrate and dialysate flow rates, the filter, and the patient's residual renal function; all of these may change from patient to patient or even in the same patient depending on the clinical status. However, CRRT modalities are generally more efficient than intermittent hemodialysis at drug removal, in some cases approximating or even exceeding normal renal function, resulting in a significant risk of subtherapeutic dosing if conventional hemodialysis dosing recommendations are followed. This annotated bibliography provides a summary of publications analyzing drug removal during CRRT, including CRRT settings and drug clearance values found in each study. Caution is warranted as findings from one study may not be generalizable to all patients due to the many factors that influence drug removal. Serum drug concentrations should be monitored when available, and patient clinical status is exceedingly important for following expected and unexpected responses to drug therapies. Reviews on general drug dosing calculations in CRRT are available elsewhere.

  9. Efficient four fragment cloning for the construction of vectors for targeted gene replacement in filamentous fungi

    DEFF Research Database (Denmark)

    Frandsen, Rasmus John Normand; Andersson, Jens A.; Kristensen, Matilde Bylov

    2008-01-01

    Background: The rapid increase in whole genome fungal sequence information allows large scale functional analyses of target genes. Efficient transformation methods to obtain site-directed gene replacement, targeted over-expression by promoter replacement, in-frame epitope tagging or fusion...... of coding sequences with fluorescent markers such as GFP are essential for this process. Construction of vectors for these experiments depends on the directional cloning of two homologous recombination sequences on each side of a selection marker gene. Results: Here, we present a USER Friendly cloning based...... technique that allows single step cloning of the two required homologous recombination sequences into different sites of a recipient vector. The advantages are: A simple experimental design, free choice of target sequence, few procedures and user convenience. The vectors are intented for Agrobacterium...

  10. Hydrothermal replacement of calcite by Mg-carbonates

    Science.gov (United States)

    Jonas, Laura; Mueller, Thomas; Dohmen, Ralf

    2014-05-01

    The transport of heat and mass through the Earth's crust is coupled to mineral reactions and the exchange of isotopes and elements between different phases. Carbonate minerals are a major constituent of the Earth's crust and play an important role in different physical, chemical and even biological processes. In this experimental study, the element exchange reaction between calcite (CaCO3) and a Mg-rich fluid phase is investigated under hydrothermal conditions. Single crystals of calcite (2x2x2 mm) react with 1 ml of a 1 M MgCl2 solution at 200° C in a Teflon-lined steel autoclave for different times between one day and four weeks. The reaction leads to the formation of a porous reaction front and the pseudomorphic replacement of calcite by dolomite [CaMg(CO3)2] and magnesite (MgCO3). Scanning electron microscopy revealed that the reaction rim consists of small Mg-carbonate rhombs closely attached to each other, suggesting that the replacement reaction takes place by a dissolution-precipitation mechanism. Typically, the observed reaction front can be divided into two different domains. The outer part of the reaction rim, i.e. from the mineral surface in contact to the fluid inwards, consists of magnesite, whereas the inner part of the rim surrounding the unreacted calcite core consists of Ca-rich dolomite. The formation of a porous microstructure that varies in different parts of the reaction rim is a direct result of the large molar volume change induced by the replacement of calcite by magnesite and dolomite. The developing porosity therefore creates fluid pathways that promote the progress of the reaction front towards the unreacted core of the single crystal. Compositional profiles measured perpendicular to the mineral surface across the reactions rims using electron microprobe (EMPA) further revealed a compositional gradient within the reaction rim with regard to the structure-forming elements Mg and Ca. Here, the amount of Mg incorporated in both product

  11. Principles of Human Joint Replacement Design and Clinical Application

    CERN Document Server

    Buechel, Frederick F

    2012-01-01

    Drs. Buechel, an orthopaedic surgeon, and Pappas, a professor of Mechanical Engineering, are the designers of several successful joint replacement systems. The most well-known of these is the pioneering LCS knee replacement. They have written this book for the users and designers of joint replacements. It is an attempt to convey to the reader the knowledge accumulated by the authors during their thirty five year effort on the development of replacement devices for the lower limb for the purpose of aiding the reader in their design and evaluation of joint replacement devices. The early chapters describe the engineering, scientific and medical principles needed for replacement joint evaluation. One must understand the nature and performance of the materials involved and their characteristics in vivo, i.e. the response of the body to implant materials. It is also essential to understand the response of the implants to applied loading and motion, particularly in the hostile physiological environment. A chapter de...

  12. Principles of human joint replacement design and clinical application

    CERN Document Server

    Buechel, Frederick F

    2015-01-01

    This book is written for the users and designers of joint replacements. In its second extended edition it conveys to the reader the knowledge accumulated by the authors during their forty year effort on the development of replacement devices for the lower limb for the purpose of aiding the reader in their design and evaluation of joint replacement devices. The early chapters describe the engineering, scientific and medical principles needed for replacement joint evaluation. One must understand the nature and performance of the materials involved and their characteristics in vivo, i.e. the response of the body to implant materials. It is also essential to understand the response of the implants to applied loading and motion, particularly in the hostile physiological environment. A chapter describes the design methodology now required for joint replacement in the USA and EU countries. The remaining chapters provide a history of joint replacement, an evaluation of earlier and current devices and sample case hist...

  13. Dual mobility total hip replacement in a high risk population

    Science.gov (United States)

    Luthra, Jatinder Singh; Al Riyami, Amur; Allami, Mohamad Kasim

    2016-01-01

    Objective: The purpose of the study was to evaluate results of dual mobility total replacement in a high risk population who take hip into hyperflexed position while sitting and praying on the floor. Method: The study included 65 (35 primary total replacement and 30 complex total hip replacement) cases of total hip replacement using avantage privilege dual mobility cup system from biomet. A cemented acetabular component and on femoral side a bimetric stem, either cemented or uncemented used depending on the canal type. Ten cases were examined fluoroscopically in follow up. Result: There was dislocation in one patient undergoing complex hip replacement. Fluoroscopy study showed no impingement between the neck of prosthesis and acetabular shell at extremes of all movements. Conclusion: The prevalence of dislocation is low in our high risk population and we consider it preferred concept for patients undergoing complex total hip replacement. PMID:27924742

  14. Dual mobility total hip replacement in a high risk population

    Directory of Open Access Journals (Sweden)

    Luthra Jatinder Singh

    2016-01-01

    Full Text Available Objective: The purpose of the study was to evaluate results of dual mobility total replacement in a high risk population who take hip into hyperflexed position while sitting and praying on the floor. Method: The study included 65 (35 primary total replacement and 30 complex total hip replacement cases of total hip replacement using avantage privilege dual mobility cup system from biomet. A cemented acetabular component and on femoral side a bimetric stem, either cemented or uncemented used depending on the canal type. Ten cases were examined fluoroscopically in follow up. Result: There was dislocation in one patient undergoing complex hip replacement. Fluoroscopy study showed no impingement between the neck of prosthesis and acetabular shell at extremes of all movements. Conclusion: The prevalence of dislocation is low in our high risk population and we consider it preferred concept for patients undergoing complex total hip replacement.

  15. New Firm Performance and the Replacement of Founder-CEOs

    DEFF Research Database (Denmark)

    Chen, Jing; Thompson, Peter

    2015-01-01

    We study the causes and consequences of the replacement of founder-CEOs in a sample of 4,172 Danish start-ups. We propose that founder-CEO replacement is driven in part by mismatches between business quality and founder ability. Our framework suggests that replacements are more likely among the w...... considerably faster. Our empirical results are consistent with these proposed predictions. Copyright © 2015 Strategic Management Society....... the worst- and best-performing firms, with low (high)-ability founders replaced by manager with higher (lower) ability. Replacement is not unambiguously associated with better subsequent performance. Firms that replaced the founder were much more likely to fail, but the surviving firms among them grew...

  16. The Comparative study of Automated Face replacement Techniques for Video

    Directory of Open Access Journals (Sweden)

    Harmesh Sanghvi

    2014-03-01

    Full Text Available For entertaining purposes, a computerized special effect referred to as “morphing” has enlarged huge attention and face replacement is one of the interesting tasks. Face replacement in video is a useful application in the amusement and special effect industries. Though various techniques for face replacement have been developed for single image and generally applied in animation and morphing, there are few mechanisms to spread out these techniques to handle videos automatically. Face replacement in video automatically is not only a fascinating application, but a challenging problem. For face replacement in video, the frame-by-frame manipulation process using the software is often time consuming and labor-intensive. Hence, the paper compares numerous latest Automatic face replacement techniques in video to understand the various problems to be solved, their shortcomings and benefits over others.

  17. THE REPLACEMENT-RENEWAL OF INDUSTRIAL EQUIPMENTS. THE MAPI FORMULAS

    Directory of Open Access Journals (Sweden)

    Meo Colombo Carlotta

    2010-07-01

    Full Text Available Since the production has been found to be an economical means for satisfying human wants, this process requires a complex industrial organization together with a large investment in equipments, plants and productive systems. These productive systems are employed to alter the physical environment and create consumer goods. As a result, they are consumed or become obsolete, inadequate, or otherwise candidates for replacement. When replacement is being considered, two assets must be evaluated: the present asset, the defender and its potential replacement, the challenger. Since the success of an industrial organization depends upon profit, replacement should generally occur if an economic advantage will result. Whatever the reason leading to the consideration of replacement, the analysis and decisions must be based upon estimates of what will occur in the future. In this paper we present the Mapi algorithm as a procedure for evaluating investments or for analyzing replacement opportunities.

  18. Unusual redo mitral valve replacement for bleeding in Glanzmann thrombasthenia.

    Science.gov (United States)

    Garcia-Villarreal, Ovidio A; Fernández-Ceseña, Ernesto; Solano-Ricardi, Mercedes; Aguilar-García, Alma L; Vega-Hernández, Raquel; Del Angel-Soto, Gustavo

    2016-01-01

    We report the case of 23-year-old man with mitral valve regurgitation and Glanzmann thrombasthenia, who underwent mechanical mitral valve replacement. Warfarin therapy was devastating, causing bilateral hemothorax, pericardial effusion, gastrointestinal bleeding, and hematuria. Redo mitral valve replacement with a biological prosthesis was required to resolve this critical situation. To our knowledge, this is the first report of mitral valve replacement in Glanzmann thrombasthenia, highlighting the danger of oral anticoagulation in this pathology.

  19. UK annuity rates and pension replacement ratios 1957-2002

    OpenAIRE

    Cannon, Edmund; Tonks, Ian

    2003-01-01

    This paper constructs a time series of annuity rates in the UK for 1957-2002, and examines the pricing of UK annuities, and the relationship between the accumulation and decumulation phases of a defined contribution pension scheme by focusing on the properties of the pension replacement ratio. Using data on annuity returns and the returns on other financial assets, the paper simulates replacement ratios, to build up a frequency distribution of the pension replacement ratio for a UK individual...

  20. Measuring biomarkers of acute kidney injury during renal replacement therapy: wisdom or folly?

    Science.gov (United States)

    Ostermann, Marlies; Forni, Lui G

    2014-06-19

    Early data are now appearing relating to the measurement of biomarkers of acute kidney injury during renal replacement therapy. These data go some way in describing the clearance of these molecules during renal support. Understanding the potential clearance, or otherwise, of these proteins may lead to directing our therapies in the future particularly with regard to cessation of renal support. We describe a recent study which has provided data that may aid in addressing this issue.

  1. The efficiency of functional mitochondrial replacement in Saccharomyces species has directional character

    DEFF Research Database (Denmark)

    Sulo, P.; Spirek, M.; Soltesova, A.;

    2003-01-01

    Optimal interactions among nuclear and mitochondria-coded proteins are required to assemble functional complexes of mitochondrial oxidative phosphorylation. The communication between the nuclear and mitochondrial genomes has been studied by transplacement of mitochondria from related species...... into mutants devoid of mitochondrial DNA (rho(0)). Recently we have reported that the mitochondria transferred from Saccharomyces paradoxus restored partially the respiration in Saccharomyces cerevisiae rho(0) mutants. Here we present evidence that the S. cerevisiae mitochondria completely salvage from...

  2. Thermodynamics and time-directional invariance

    OpenAIRE

    Klimenko, A. Y.; Maas, U.

    2012-01-01

    Time directions are not invariant in conventional thermodynamics. We broadly follow ideas of Ludwig Boltzmann and investigate implications of postulating time-directional invariance in thermodynamics. In this investigation, we require that thermodynamic descriptions are not changed under time reversal accompanied by replacement of matter by antimatter (i.e. CPT-invariant thermodynamics). The matter and antimatter are defined as thermodynamic concepts without detailing their physical structure...

  3. Right ventricular Hemodynamic Alteration after Pulmonary Valve Replacement in Children with Congenital Heart Disease

    Directory of Open Access Journals (Sweden)

    Hamid Bigdelian

    2015-03-01

    Full Text Available Introduction:  In patients who underwent surgery to repair Tetralogy of Fallot, right ventricular dilation from pulmonary regurgitation may be result in right ventricular failure, arrhythmias and cardiac arrest. Hence, pulmonary valve replacement may be necessary to reduce right ventricular volume overload. The aim of present study was to assess the effects of pulmonary valve replacement on right ventricular function after repair of Tetralogy of Fallot.   Materials and  Method:  This retrospective study was carried out between July 2011 and October 2013 on 21 consecutive patients in Chamran Heart Center (Esfahan. The study included 13 male (61.9% and 8 female (38.1%. Cardiac magnetic resonance was performed before, 6 and 12 months after pulmonary valve replacement in all patients (Babak Imaging Center, Tehran with the 1.5 Tesla system. The main reason for surgery at Tetralogy of Fallot repaired time was Tetralogy of Fallot + Pulmonary insufficiency (17 cases and Tetralogy of Fallot + Pulmonary atresia (4 cases. Right ventricular function was assessed before and after pulmonary valve replacement with Two-dimensional echocardiography and ttest was used to evaluate follow-up data.   Results:  Right ventricular end-diastolic volume, right ventricular end- systolic volume significantly decreased (P value ˂ 0.05.Right ventricular ejection fraction had a significant increase (P value ˂ 0.05. Right ventricular mass substantially shrank after pulmonary valve replacement. Moreover, pulmonary regurgitation noticeably decreased in patients. The other hemodynamic parameter such as left ventricular ejection fraction improved but was not significant (P value= 0.79. Conclusion:  Pulmonary valve replacement can successfully restores the impaired hemodynamic function of right ventricle which is caused by direct consequence of volume unloading in patient. Pulmonary valve surgery in children with Tetralogy of Fallot who have moderate to severe pulmonary

  4. Short-term hunger intensity changes following ingestion of a meal replacement bar for weight control.

    Science.gov (United States)

    Rothacker, Dana Q; Watemberg, Salo

    2004-05-01

    Meal replacement products for weight loss are popular and safe for most unsupervised consumers desiring to lose weight. Previously we reported that the thickness of meal replacement diet shakes had a direct and significant effect on hunger intensity during the first 2 h and that hunger intensity scores for liquid meal replacements were significantly below baseline for 3 h following consumption (Mattes & Rothacker, 2001) This study uses the same protocol to investigate meal replacement bars designed for overweight consumers. Subjects were prescreened to include only those that normally ate breakfast and liked chocolate. The bar used in this study contained 250 calories (about 30 more than most liquid diet shakes), 4 g dietary fiber, 14 g protein and 8 g fat. Subjects were instructed to consume the entire bar with a glass of water following an overnight fast when they would normally consume their first meal of the day and to assess their hunger on a 1 (not hungry at all) to 9 (as hungry as I have ever felt) scale before consumption, immediately after and hourly for 6 h (only on typical weekdays). Similar assessments were made for the perception of stomach fullness (1=empty, 9=extremely full), strength of the desire to eat (1=no desire, 9=extremely strong) and thirst (1=not at all thirsty, 9=extremely thirsty). One-hundred and eight subjects (23 male and 85 female) completed the study. No gender satiety differences were found. Hunger ratings and desire to eat remained significantly below baseline for 5 h following consumption. Stomach fullness scores were significantly above baseline for 5 h. Thirst scores were significantly below baseline for 3 h. In conclusion, although the meal replacement diet bars contained only 30 additional calories than liquids, they provided an additional 2 h of hunger suppression from baseline that may have an impact on overall weightloss success. These results support superior short-term hunger control with solid meal replacements.

  5. Economics of Chlorofluorocarbon (CFC) Machine Replacement

    Science.gov (United States)

    1994-09-01

    if no further releases of halocarbons took place, ozone layer depletion would increase to 2 percent due to the time required for diffusion into the... ozone layer depletion . It also directed the President to enter into international agreements for research and for the development of standards and

  6. Arthroscopic Management of Complications Following Total Ankle Replacement.

    Science.gov (United States)

    Lui, Tun Hing; Roukis, Thomas S

    2015-10-01

    There is great potential of managing the complications of total ankle replacement arthroscopically and endoscopically, and these procedures can be summarized into 3 groups. Group 1 includes procedures of the ankle joint proper with close proximity to the articular components of the total ankle replacement. Group 2 includes procedures of the tibia and talus with close proximity to the nonarticular parts of the total ankle replacement. Group 3 includes procedures that are away from the total ankle replacement. However, these remain master arthroscopist procedures and should be performed by foot and ankle surgeons who perform them with regularity.

  7. Total hip and total knee replacement: preoperative nursing management.

    Science.gov (United States)

    Lucas, Brian

    Total hip replacement (THR) and total knee replacement (TKR) surgery are carried out for the relief of hip or knee pain, usually caused by osteoarthritis. This is the first of two articles on THR and TKR. It will outline the different types of replacement used in lower limb joint replacement surgery. Preparation of patients for surgery requires attention to physical, psychological and social factors and these are explored in detail. The organization of services along the patient pathway to ensure comprehensive preparation is considered and the nursing role highlighted. The second article, to be published in the next issue, will discuss recovery and rehabilitation from THR and TKR surgery.

  8. Mitochondrial replacement techniques: egg donation, genealogy and eugenics.

    Science.gov (United States)

    Palacios-González, César

    2016-03-01

    Several objections against the morality of researching or employing mitochondrial replacement techniques have been advanced recently. In this paper, I examine three of these objections and show that they are found wanting. First I examine whether mitochondrial replacement techniques, research and clinical practice, should not be carried out because of possible harms to egg donors. Next I assess whether mitochondrial replacement techniques should be banned because they could affect the study of genealogical ancestry. Finally, I examine the claim that mitochondrial replacement techniques are not transferring mitochondrial DNA but nuclear DNA, and that this should be prohibited on ethical grounds.

  9. Volume of Requests for Internet Medicare Replacement Cards

    Data.gov (United States)

    Social Security Administration — This dataset provides monthly volumes at the national level from federal fiscal year 2008 onwards for Internet Medicare Replacement Card. The dataset includes only...

  10. Polar Direct Drive

    Science.gov (United States)

    Skupsky, S.

    2003-10-01

    Direct drive offers the potential of higher target gain on the National Ignition Facility (NIF) than x-ray drive: The initial direct-drive target design had a 1-D gain of 45 and consisted primarily of a pure cryogenic DT shell. Using the expected levels of target and laser nonuniformities for the NIF, two-dimensional (2-D) hydrodynamic simulations predicted target gains around 30.(P.W. McKenty et al.), Phys. Plasmas 8, 2315 (2001). More-recent designs have shown that higher target gains could be obtained by replacing a portion of the DT shell with ``wetted'' CH foam and by using adiabat shaping: (1) Higher-Z material (C) in the foam increases laser absorption by about 40% (from 60% absorption to 85%).(S. Skupsky et al.), in Inertial Fusion Sciences and Applications 2001, edited by K. Tanaka et al. (Elsevier, Paris, 2002), p. 240. (2) Adiabat shaping allows the main portion of the fuel to be placed on a lower adiabat without compromising target stability.(V.N. Goncharov et al.), Phys. Plasmas 10, 1906 (2003). These direct-drive concepts can be tested on the NIF, long before that facility is converted to a direct-drive (spherically symmetric) irradiation configuration. Using the NIF x-ray-drive beam configuration, some of the near-polar beams could be pointed to better illuminate the target's equator. These more-oblique, equatorial beams will have lower absorption and reduced drive efficiency than the polar beams. One strategy to compensate for the difference in polar and equatorial drive is to reduce the irradiation at the poles and employ different pulse shapes to accommodate the time-dependent variations in drive and absorption. This concept of polar direct drive (PDD) has been studied using the 2-D hydrocode DRACO to determine the requirements for achieving ignition and moderate target gain for the NIF. Experiments on the OMEGA laser will examine the effects of oblique irradiation on target drive. Results of simulations for different direct-drive target designs

  11. Replacing fallow by cover crops: economic sustainability

    Science.gov (United States)

    Gabriel, José Luis; Garrido, Alberto; Quemada, Miguel

    2013-04-01

    Replacing fallow by cover crops in intensive fertilized systems has been demonstrated as an efficient tool for reducing nitrate leaching. However, despite the evident environmental services provided and the range of agronomic benefits documented in the literature, farmers' adoption of this new technology is still limited because they are either unwilling or unable, although adoption reluctance is frequently rooted in low economic profitability, low water se efficiency or poor knowledge. Economic analyses permit a comparison between the profit that farmers obtain from agricultural products and the cost of adopting specific agricultural techniques. The goal of this study was to evaluate the economic impact of replacing the usual winter fallow with cover crops (barley (Hordeum vulgare L., cv. Vanessa), vetch (Vicia villosa L., cv. Vereda) and rapeseed (Brassica napus L., cv. Licapo)) in irrigated maize systems and variable Mediterranean weather conditions using stochastic Monte-Carlo simulations of key farms' financial performance indicators. The three scenarios studied for each cover crop were: i) just leaving the cover crop residue in the ground, ii) leaving the cover crop residue but reduce following maize fertilization according to the N available from the previous cover crop and iii) selling the cover crop residue for animal feeding. All the scenarios were compared with respect to a typical maize-fallow rotation. With observed data from six different years and in various field trials, looking for different weather conditions, probability distribution functions of maize yield, cover crop biomass production and N fertilizer saving was fitted. Based in statistical sources maize grain price, different forage prices and the cost of fertilizer were fitted to probability distribution functions too. As result, introducing a cover crop involved extra costs with respect to fallow as the initial investment, because new seed, herbicide or extra field operations. Additional

  12. Can postmortem fetal MR imaging replace autopsy?

    Energy Technology Data Exchange (ETDEWEB)

    Cho, Jeong Yeon; Song, Mi Jin [Sungkyunkwan Univ. School of Medicine, Seoul (Korea, Republic of); Kim, Seoung Hyup [Seoul National Univ. College of Medicine, Seoul (Korea, Republic of)

    2001-02-01

    The purposes of this study were to compare postmortem fetal MRI findings with autopsy findings and to assess whether postmortem MRI can replace autopsy. The study group consisted of 13 stillborn fetuses, seven that died immediately after birth, and five terminated because of anomalies seen on prenatal sonograms. A total 17 were male, and eight were female, and their gestational ages were from 20 to 41 (average;28.2) weeks. Spin-echo T1-and T2-weighted axial, sagittal, and coronal MR images were obtained, and autopsy findings were divided into major and minor. A major finding was defined as an anomaly or syndrome which caused fetal death or termination of the pregnancy: minor findings were classified, on the basis of gross inspection, as internal or external. MR images were retrospectively analyzed by two radiologists unaware of the autopsy findings, and by comparison with these, the postmortem MRI detection rates for major and minor findings was then determined. In seven of 25 fetuses, MR imaging revealed major findings, a dietction rate of 100%. There were two cases of anencephaly, two of trisomy-18, and one each of hydrops fetalis with large cystic hygroma, diaphragmatic hernia, and Dandy-Walker malformation. Twenty-three of 60 minor findings (38.3%) were detected by MRI. The detection rates for external and internal findings were 29.6%(8/27) and 45.5%(15/33), respectively. Although a limitation of our study is the low detection rate for minor findings, postmortem fetal MRI may help diagnose the major cause of fetal death.

  13. Why Lumbar Artificial Disk Replacements (LADRs) Fail.

    Science.gov (United States)

    Pettine, Kenneth; Ryu, Robert; Techy, Fernando

    2017-07-01

    A retrospective review of prospectively collected data. To determine why artificial disk replacements (ADRs) fail by examining results of 91 patients in FDA studies performed at a single investigational device exemption (IDE) site with minimum 2-year follow-up. Patients following lumbar ADR generally achieve their 24-month follow-up results at 3 months postoperatively. Every patient undergoing ADR at 1 IDE site by 2 surgeons was evaluated for clinical success. Failure was defined as Maverick, 25 patients; Charité, 31 patients; and Kineflex, 35 patients. All procedures were 1-level operations performed at L4-L5 or L5-S1. Demographics and inclusion/exclusion criteria were similar and will be discussed. Overall clinical failure occurred in 26% (24 of 91 patients) at 2-year follow-up. Clinical failure occurred in: 28% (Maverick) (7 of 25 patients), 39% (Charité) (12 of 31 patients), and 14% (Kineflex) (5 of 35 patients). Causes of failure included facet pathology, 50% of failure patients (12 of 24). Implant complications occurred in 5% of total patients and 21% of failure patients (5 of 24). Only 5 patients went from a success to failure after 3 months. Only 1 patient went from a failure to success after a facet rhizotomy 1 year after ADR. Seventy-four percent of patients after ADR met strict clinical success after 2-year follow-up. The clinical success versus failure rate did not change from their 3-month follow-up in 85 of the 91 patients (93%). Overall clinical success may be improved most by patient selection and implant type.

  14. Investigation of Biodentine as dentine replacement material.

    Science.gov (United States)

    Camilleri, Josette

    2013-07-01

    Biodentine was compared to glass ionomer and resin modified cements in an "open sandwich" restoration. Fuji IX, Vitrebond and Biodentine were characterised using various techniques. The effect of etching with 35% phosphoric acid was investigated by assessment of surface topography, Fourier transform infrared (FT-IR) spectroscopy, surface micro-hardness and micro-leakage using tagged carboxylated-modified fluorescent microspheres and tracing the presence of these particles with a confocal microscope. Acid etching resulted in erosion of the material surface with exposure of the glass particles in the glass ionomer-based materials. Biodentine exhibited a reduction in the chlorine peak and the calcium-silicon ratio. There was no difference in the micro-hardness in etched and un-etched materials. The FT-IR plots did not show any chemical changes caused by etching for all the materials investigated. Both Vitrebond and Fuji IX exhibited no leakage at the dentine to material interface while Biodentine exhibited leakage both when it was etched and also when the surface was left unprepared. The sandwich technique was effective and prevented micro-leakage with glass ionomer-based materials but micro-leakage occurred with Biodentine. Biodentine demonstrated both structural and chemical changes when etched with 37% phosphoric acid. Biodentine exhibited a lower calcium to silicon ratio and a reduction in the chloride peak height when etched. When used as a dentine replacement material in the sandwich technique overlayed with composite, significant leakage occurred at the dentine to material interface. On the other hand materials based on glass ionomer cement were etched successfully and no chemical and physical changes or micro-leakage were detected when the materials were used as bases under composite restorations. The micro-hardness of all the materials was unaffected by etching. Copyright © 2013 Elsevier Ltd. All rights reserved.

  15. Hormone Replacement Therapy After Breast Cancer

    Directory of Open Access Journals (Sweden)

    Mueck AO

    2008-01-01

    Full Text Available So far, patient samples in all studies investigating hormone replacement therapy (HRT after breast cancer have been small.Therefore, HRT should only be used if alternatives such as specifically not contraindicated phytopreparations or selective sero-tonin reuptake inhibitors (SSRIs are not effective. This is primarily due to forensic reasons since clinical data on the risk ofalternatives (based on present evidence are even more sparse. Regarding HRT, four prospective randomized studies and at least15 observational studies after breast cancer are available. Only the HABITS study shows an increased risk of relapse. The authorssuggest that this is probably associated with the relatively high number of patients with HRT treatment after ER-positive cancersas well as due to the preferred use of estrogen/progestin-combined preparations. Based on the results of the randomized pla-cebo-controlled study Women’s Health Initiative (WHI as well as of at least 12 observational studies, the progestin componentseems to be mainly responsible for the probability of increased diagnosis frequency of primary breast cancer. However, no dataare available on the impact of progestin on the use of combined HRT after breast cancer. However, also with estrogen only anincreased risk of relapse must be expected and patients should be informed about it. This has to be concluded due to biologicalplausibility and observational studies although the estrogen-only arm in WHI did not show any increased primary risk. Thus, anyform of HRT should only be performed in exceptional cases, and treatment duration should be as short as possible with thelowest effective dose.

  16. Activation of Complement Following Total Hip Replacement.

    Science.gov (United States)

    Thordardottir, S; Vikingsdottir, T; Bjarnadottir, H; Jonsson, H; Gudbjornsson, B

    2016-03-01

    The aim of this study was to investigate whether complement activation, via the classical and alternative pathways, occurs following a cemented total hip replacement (THR) surgery due to osteoarthritis. Blood samples were collected systematically from 12 patients - six male and six women, with a median age of 75 (range: 59-90 years) - preoperatively, 6 h post-operatively and on the first, second and third post-operative day. Total function of classical (CH50) and alternative pathways (AH50) was evaluated, along with the determination of serum concentrations of the complement proteins C3, C4, C3d, the soluble terminal complement complex (sTCC) sC5b-9, as well as C-reactive protein (CRP) and albumin. Measurements of CRP and albumin levels elucidated a marked inflammatory response following the operation. The CH50, AH50 and C3 and C4 levels were significantly lower 6 h after the surgery compared with the preoperative levels, but elevated above the preoperative levels during the following 3 days. The complement activation product C3d levels increased continually during the whole observation period, from 13.5 AU/ml (range: 8-19 AU/ml) preoperative to 20 AU/ml (range: 12-34 AU/ml) on the third post-operative day. Furthermore, we observed an increase in the sC5b-9 levels between the preoperative and the third post-operative day. These results demonstrate a significant activation of the complement system following cemented THR. Further studies are needed to elucidate the time frame and the pathogenic role of this observed complement activation.

  17. Blood donation and testosterone replacement therapy.

    Science.gov (United States)

    Chin-Yee, Benjamin; Lazo-Langner, Alejandro; Butler-Foster, Terrie; Hsia, Cyrus; Chin-Yee, Ian

    2017-03-01

    Polycythemia is the most common adverse effect of testosterone replacement therapy (TRT) and may predispose patients to adverse vascular events. Current Canadian guidelines recommend regular laboratory monitoring and discontinuing TRT or reducing the dose if the hematocrit exceeds 54% (hemoglobin ≥180 g/L). This threshold has been interpreted by some physicians and patients to indicate the need for phlebotomy or blood donation while on TRT. We reviewed all male blood donors in Southwestern Ontario at Canadian Blood Services from December 2013 to March 2016 who self-identified or were found on donor screening to be on TRT. Hemoglobin concentration was measured at the time of donation or clinic visit and with each subsequent appointment in repeat donors. We identified 39 patients on TRT who presented for blood donation over a 2-year period. The mean hemoglobin level at all clinic visits was 173 g/L (range, 134-205 g/L; n = 108). Hemoglobin concentrations of 180 g/L or more (calculated hematocrit, ≥54%) were measured at 25% of appointments. Of the 27 repeat donors, 12 (44%) had persistently elevated hemoglobin levels (≥180 g/L) at subsequent donations. Hemoglobin concentrations were elevated in donors on TRT, and significant numbers had hemoglobin levels above those recommended by current guidelines. These data also suggest that repeat blood donation was insufficient to maintain a hematocrit below 54%. Our findings raise concerns about the persistent risk of vascular events in these donors, particularly when coupled with the misperception by patients and health care providers that donation has reduced or eliminated the risks of TRT-induced polycythemia. © 2017 AABB.

  18. Replacing standard galaxy profiles with mixtures of Gaussians

    CERN Document Server

    Hogg, David W

    2012-01-01

    Exponential, de Vaucouleurs, and S\\'ersic profiles are simple and successful models for fitting two-dimensional images of galaxies. One numerical issue encountered in this kind of fitting is the pixel rendering and convolution (or correlation) of the models with the telescope point-spread function (PSF); these operations are slow, and easy to get slightly wrong at small radii. Here we exploit the realization that these models can be approximated to arbitrary accuracy with a mixture (linear superposition) of two-dimensional Gaussians (MoGs). MoGs are fast to render and fast to affine-transform. Most importantly, if you have a MoG model for the pixel-convolved PSF, the PSF-convolved, affine-transformed galaxy models are themselves MoGs and therefore very fast to compute, integrate, and render precisely. We present worked examples that can be directly used in image fitting; we are using them ourselves. The MoG profiles we provide can be swapped in to replace the standard models in any image-fitting code; they sp...

  19. Levodopa therapy: consequences of the nonphysiologic replacement of dopamine.

    Science.gov (United States)

    Chase, T N

    1998-05-01

    Normal motor function is dependent on the highly regulated synthesis and release of the transmitter dopamine by neurons projecting from the substantia nigra to the corpus striatum. Parkinson's disease involves the progressive degeneration of these neurons. Its core symptoms are a direct consequence of a striatal insufficiency of intrasynaptic dopamine. Levodopa, the standard of care for the treatment of PD, acts after its conversion to dopamine by restoring striatal dopaminergic transmission. However, there are significant differences between the normally functioning dopamine system and the restoration of function provided by standard levodopa treatment. Increasing clinical and preclinical evidence suggests that the intermittent stimulation of dopamine receptors resulting from current therapeutic regimens contributes to the response complications that ultimately affect most parkinsonian patients. It now appears that chronic nonphysiologic stimulation of dopaminergic receptors on striatal GABAergic neurons activates characteristic signaling pathways, leading to a potentiation of the synaptic efficacy of adjacent glutamatergic receptors of the N-methyl-D-aspartate (NMDA) subtype. As a result, function of these GABAergic efferent neurons changes in ways that favor the appearance of motor complications. Conceivably, use of dopaminomimetic replacement strategies that provide more continuous dopamine receptor stimulation will act to prevent or alleviate these disabling complications. A number of promising approaches to achieving this goal are now under development.

  20. The Effects of Leptin Replacement on Neural Plasticity

    Directory of Open Access Journals (Sweden)

    Gilberto J. Paz-Filho

    2016-01-01

    Full Text Available Leptin, an adipokine synthesized and secreted mainly by the adipose tissue, has multiple effects on the regulation of food intake, energy expenditure, and metabolism. Its recently-approved analogue, metreleptin, has been evaluated in clinical trials for the treatment of patients with leptin deficiency due to mutations in the leptin gene, lipodystrophy syndromes, and hypothalamic amenorrhea. In such patients, leptin replacement therapy has led to changes in brain structure and function in intra- and extrahypothalamic areas, including the hippocampus. Furthermore, in one of those patients, improvements in neurocognitive development have been observed. In addition to this evidence linking leptin to neural plasticity and function, observational studies evaluating leptin-sufficient humans have also demonstrated direct correlation between blood leptin levels and brain volume and inverse associations between circulating leptin and risk for the development of dementia. This review summarizes the evidence in the literature on the role of leptin in neural plasticity (in leptin-deficient and in leptin-sufficient individuals and its effects on synaptic activity, glutamate receptor trafficking, neuronal morphology, neuronal development and survival, and microglial function.

  1. Fat Replacement of Paraspinal Muscles with Aging in Healthy Adults.

    Science.gov (United States)

    Dahlqvist, Julia R; Vissing, Christoffer R; Hedermann, Gitte; Thomsen, Carsten; Vissing, John

    2017-03-01

    The aims of this study were to investigate the age-related changes in fatty replacement and cross-sectional area (CSA) of cervical, thoracic, and lumbar paraspinal muscles versus leg muscles in healthy adults and to test for association between muscle fat fraction and lifestyle factors. Fifty-three healthy adults (24-76 yr) were included. Dixon magnetic resonance imaging technique was used to determine CSA and to quantify the fat fraction of paraspinal and leg muscles. Muscle CSA and fat fractions were tested for association with age and muscle strength. The fat fractions were also tested for association with sex, body mass index (BMI), physical activity, and lower back pain. Both paraspinal and leg fat fractions correlated directly with age (P fat fraction was higher in paraspinal than leg muscles. The age-related increase in fat fraction was higher in paraspinal muscles than leg muscles (P muscles did not correlate with age. Knee extension strength correlated with fat fraction (P muscle strength of hip muscles, thigh muscles, and anterior calf muscles correlated with CSA (P fat fraction (P fat fraction (P fat fraction and physical activity or lower back pain. The paraspinal muscles were more susceptible to age-related changes than leg muscles. Further, men had significantly lower fat fractions in lumbar paraspinal muscles, and BMI was positively associated with thigh, but not paraspinal, fat fraction.

  2. Estrogen replacement therapy and cardioprotection: mechanisms and controversies

    Directory of Open Access Journals (Sweden)

    M.T.R. Subbiah

    2002-03-01

    Full Text Available Epidemiological and case-controlled studies suggest that estrogen replacement therapy might be beneficial in terms of primary prevention of coronary heart disease (CHD. This beneficial effect of estrogens was initially considered to be due to the reduction of low density lipoproteins (LDL and to increases in high density lipoproteins (HDL. Recent studies have shown that estrogens protect against oxidative stress and decrease LDL oxidation. Estrogens have direct effects on the arterial tissue and modulate vascular reactivity through nitric oxide and prostaglandin synthesis. While many of the effects of estrogen on vascular tissue are believed to be mediated by estrogen receptors alpha and ß, there is evidence for `immediate non-genomic' effects. The role of HDL in interacting with 17ß-estradiol including its esterification and transfer of esterified estrogens to LDL is beginning to be elucidated. Despite the suggested positive effects of estrogens, two recent placebo-controlled clinical trials in women with CHD did not detect any beneficial effects on overall coronary events with estrogen therapy. In fact, there was an increase in CHD events in some women. Mutations in thrombogenic genes (factor V Leiden, prothrombin mutation, etc. in a subset of women may play a role in this unexpected finding. Thus, the cardioprotective effect of estrogens appears to be more complicated than originally thought and requires more research.

  3. Future direction of direct writing

    Science.gov (United States)

    Kim, Nam-Soo; Han, Kenneth N.

    2010-11-01

    Direct write technology using special inks consisting of finely dispersed metal nanoparticles in liquid is receiving an undivided attention in recent years for its wide range of applicability in modern electronic industry. The application of this technology covers radio frequency identification-tag (RFID-tag), flexible-electronics, organic light emitting diodes (OLED) display, e-paper, antenna, bumpers used in flip-chip, underfilling, frit, miniresistance applications and biological uses, artificial dental applications and many more. In this paper, the authors have reviewed various direct write technologies on the market and discussed their advantages and shortfalls. Emphasis has given on microdispensing deposition write (MDDW), maskless mesoscale materials deposition (M3D), and ink-jet technologies. All of these technologies allow printing various patterns without employing a mask or a resist with an enhanced speed with the aid of computer. MDDW and M3D are capable of drawing patterns in three-dimension and MDDW, in particular, is capable of writing nanoinks with high viscosity. However, it is still far away for direct write to be fully implemented in the commercial arena. One of the hurdles to overcome is in manufacturing conductive inks which are chemically and physically stable, capable of drawing patterns with acceptable conductivity, and also capable of drawing patterns with acceptable adhesiveness with the substrates. The authors have briefly discussed problems involved in manufacturing nanometal inks to be used in various writing devices. There are numerous factors to be considered in manufacturing such inks. They are reducing agents, concentrations, oxidation, compact ability allowing good conductivity, and stability in suspension.

  4. Effect of growth hormone replacement therapy on pituitary hormone secretion and hormone replacement therapies in GHD adults

    DEFF Research Database (Denmark)

    Hubina, Erika; Mersebach, Henriette; Rasmussen, Ase Krogh;

    2004-01-01

    We tested the impact of commencement of GH replacement therapy in GH-deficient (GHD) adults on the circulating levels of other anterior pituitary and peripheral hormones and the need for re-evaluation of other hormone replacement therapies, especially the need for dose changes.......We tested the impact of commencement of GH replacement therapy in GH-deficient (GHD) adults on the circulating levels of other anterior pituitary and peripheral hormones and the need for re-evaluation of other hormone replacement therapies, especially the need for dose changes....

  5. ISS EPS Orbital Replacement Unit Block Diagrams

    Science.gov (United States)

    Schmitz, Gregory V.

    2001-01-01

    The attached documents are being provided to Switching Power Magazine for information purposes. This magazine is writing a feature article on the International Space Station Electrical Power System, focusing on the switching power processors. These units include the DC-DC Converter Unit (DDCU), the Bi-directional Charge/Discharge Unit (BCDU), and the Sequential Shunt Unit (SSU). These diagrams are high-level schematics/block diagrams depicting the overall functionality of each unit.

  6. Advance care directives

    Science.gov (United States)

    ... advance directive; Do-not-resuscitate - advance directive; Durable power of attorney - advance care directive; POA - advance care directive; Health care agent - advance care directive; Health care proxy - ...

  7. Relapsing hypocupraemic myelopathy requiring high‐dose oral copper replacement

    OpenAIRE

    Prodan, C.I.; Bottomley, S S; Holland, N R; Lind, S. E.

    2006-01-01

    Adult‐onset copper deficiency with neurological manifestations is a newly recognised syndrome. Long‐term oral copper replacement therapy has been the mainstay of treatment in the literature. A case of relapsing hypocupraemic myelopathy responsive to increased doses of copper replacement is reported. Standard doses of copper may not be sufficient for all patients.

  8. Improving compliance with hormonal replacement therapy in primary osteoporosis prevention

    DEFF Research Database (Denmark)

    Vestergaard, P; Hermann, A P; Gram, J

    1997-01-01

    To evaluate whether introduction of treatment alternatives would improve compliance with hormonal replacement therapy (HRT) as primary osteoporosis prevention in women not tolerating the first line osteoporosis prevention schedule.......To evaluate whether introduction of treatment alternatives would improve compliance with hormonal replacement therapy (HRT) as primary osteoporosis prevention in women not tolerating the first line osteoporosis prevention schedule....

  9. Total joint replacement in multiplex congenita contractures: a case report

    OpenAIRE

    Cameron, Hugh U.

    1998-01-01

    A 34-year-old man with multiplex congenita contractures underwent replacement of 2 hips and 1 knee. Even though a good range of movement was achieved at surgery and intensive physiotherapy, his joints returned to their preoperative status within 2 years. This outcome suggests that total joint replacement has little to offer the patient with multiplex congenita contractures who has immobile joints.

  10. Synovial hypertrophy causing recurrent hemarthrosis after total knee replacement.

    Science.gov (United States)

    Gajjar, Shreyash M; Platts, Andrew; Dowd, George

    2010-03-01

    Recurrent hemarthrosis following total knee replacement is relatively uncommon and can result from causes that may not always be easy to diagnose. We report three patients with late-onset recurrent hemarthrosis following total knee replacement due to synovial hypertrophy and impingement, which were successfully treated by embolization.

  11. Studies on the replacement policies in dairy cattle

    NARCIS (Netherlands)

    Arendonk, van J.A.M.

    1985-01-01

    In The Netherlands dairy farmers replace on average 25-30% of their cows each year. The decision to replace instead of to keep a cow is based mainly on economic considerations rather than because a cow is no longer able to produce.

    The investigations described in this thesis were

  12. Renal replacement therapy after cardiac surgery; renal function recovers

    DEFF Research Database (Denmark)

    Steinthorsdottir, Kristin Julia; Kandler, Kristian; Agerlin Windeløv, Nis

    2013-01-01

    To assess renal outcome in patients discharged from hospital following cardiac surgery-associated acute kidney injury (CSA-AKI) with need for renal replacement therapy.......To assess renal outcome in patients discharged from hospital following cardiac surgery-associated acute kidney injury (CSA-AKI) with need for renal replacement therapy....

  13. Replacement corn for jackfruit silage in diets for feedlot lambs

    Directory of Open Access Journals (Sweden)

    José Augusto Gomes Azevêdo

    2015-06-01

    Full Text Available The objective was to evaluate the effects of replacement corn by jackfruit silage on intake, coefficient of apparent digestibility and performance in diets for feedlot confined lambs. Santa Inês crossbred castrated male lambs were used, in the completely randomized design. The replacement levels were 0. 333. 666. 1000 g kg-1 in dry matter (DM of corn as the concentrate component. The intake DM, crude protein (CP (g day-1, neutral detergent fiber (NDF in g kg-1 and g kg-1 body weight (BW increased linearly with replacement. The intake of organic matter (OM, ethereal extract (EE, total carbohydrates (TC and non-fiber carbohydrates (NFC decreased linearly, while for total digestible nutrients (TDN quadratic behavior with replacement. The coefficients of apparent digestibility of OM, TC and NFC decreased linearly with replacement, while the coefficient of digestibility of CP and TDN showed quadratic behavior with replacement. The BW and average daily gain decreased linearly with the replacement of corn for jackfruit silage. The jackfruit silage can be used to replace corn in diets of lambs and their use is dependent on economic factors, the availability of fruit and purpose of animal productivity to be reached

  14. 7 CFR 274.6 - Replacement issuances to households.

    Science.gov (United States)

    2010-01-01

    ... recipient's signature on the authorization document matches the signature on the ID card. In a Photo ID area... matches the serial number on the recipient's ID card; (3) Issue a replacement in accordance with... recipient's ID card. Any replacement which results in duplicate participation shall be considered...

  15. The metabolic consequences of thyroxine replacement in adult hypopituitary patients

    DEFF Research Database (Denmark)

    Filipsson Nyström, Helena; Feldt-Rasmussen, Ulla; Kourides, Ione;

    2012-01-01

    The metabolic consequences of thyroxine replacement in patients with central hypothyroidism (CH) need to be evaluated. The aim was to examine the outcome of thyroxine replacement in CH. Adult hypopituitary patients (n = 1595) with and without CH from KIMS (Pfizer International Metabolic Database...

  16. Dilatation of the aneurysmal sac after total arch replacement.

    Science.gov (United States)

    Watanuki, Hirotaka; Ogino, Hitoshi; Matsuda, Hitoshi; Minatoya, Kenji; Sasaki, Hiroaki; Fukuda, Tetsuya; Kitamura, Soichiro

    2008-02-01

    In our institution, total arch replacement for distal arch aneurysms is performed through a median sternotomy with antegrade selective cerebral perfusion. The distal anastomosis to the completely transected descending aorta is made through the aneurysmal sac. We report on three interesting cases presenting late dilatation of the aneurysmal sac due to collateral flow after total arch replacement.

  17. Functionality of Inulin as a Sucrose Replacer in Cookie Baking

    Science.gov (United States)

    Inulin was evaluated as a sucrose replacer for healthy cookie production with benefits of low glycemic impact and prebiotic soluble fiber. Sucrose (as a reference) and three inulin products of different concentrations (as soluble fibers) were used to explore the effects of sugar-replacer type on so...

  18. A.R.T. – Aggression Replacement Training

    DEFF Research Database (Denmark)

    Harbo, Lotte Junker; Domben, Eskil

    2015-01-01

    Artiklen indeholder en kort introduktion, eksemplificeret ved case, af det manualbaserede program til behandling af udadreagerende unge Aggression Replacement Training.......Artiklen indeholder en kort introduktion, eksemplificeret ved case, af det manualbaserede program til behandling af udadreagerende unge Aggression Replacement Training....

  19. Fat Reduction and Replacement in Dry-Cured Fermented Sausage by Using High Pressure Processing Meat as Fat Replacer and Olive Oil

    Directory of Open Access Journals (Sweden)

    Bolumar Tomas

    2015-09-01

    Full Text Available The present paper describes the modification of the lipid fraction of dry-cured fermented sausage through fat reduction (35% and fat replacement of animal fat with olive oil (up to 10%. High pressure processing (HPP treated meat was employed as a novel fat replacer to reduce the fat content and as a new strategy to enable a stable incorporation of olive oil in dry-cured fermented sausages. Chemical (proximate composition and fatty acid profile, physical (water retention, structure formation and colour and sensorial (appearance, texture and flavour properties were evaluated. It is concluded that 35% of fat reduction is possible without reduction of consumer acceptability. Moreover, the addition of HPP-treated meat as a fat replacer resulted in good mimic of the fat particles together with good physical and sensory properties. Therefore, it resulted in an effective and clean alternative (no added-additives for fat reduction. However, the incorporation of olive oil either by direct addition (4.3% oil or within a HPP-created protein network (10% oil resulted in unacceptable products since the oil was not properly retained inside the sausage matrix. Further studies are needed to find processing strategies that permit a stable incorporation of liquid plant oils to dry-cured fermented sausage for the development of healthier and more sustainable dry-cured fermented meat products.

  20. Inspection-replacement policy of system under predictive maintenance

    Institute of Scientific and Technical Information of China (English)

    LIU Bao-you; FANG You-tong; WEI Jin-xiang; WANG Yong-liang

    2007-01-01

    In general, every system is in one of the three states: normal, abnormal, or failure state. When the system is diagnosed as abnormal state, it needs predictive maintenance. If the system fails, an identical new one will replace it. The predictive maintenance cannot make the system "as good as new". Under these assumptions, the reliability index and the inspection-replacement policy of a system were studied. The explicit expression of the reliability index and the average income rate (i.e., the long-runaverage income per unit time) are derived by using probability analysis and vector Markov process method. The criterion of feasibility for the optimal inspection-replacement policy under the maximum average income rate is obtained. The numerical example shows the optimal inspection-replacement policy can raise the average income rate when the optimal inspection-replacement policy is feasible.

  1. REPLACEMENT CONTROL OF INNOVATION MANAGERS: ORGANIZATIONAL AND ECONOMIC ASPECTS

    Directory of Open Access Journals (Sweden)

    E. V. Gurina

    2011-01-01

    Full Text Available The paper substantiates phases of specialists’ replacement ensuring innovation development of the national economy in Belarus, i.e. managers of innovation activity. Realization of replacement phases is presented within the system consisting of four blocks – objective, managing, controllable and providing. Analysis results of the current state of the innovation activity managers replacement system reveal main problems in interaction of its basic agents. The paper considers solution of specified problems in the context of formation of organizational and economic approaches to managing the innovation activity managers replacement system which presupposes modernization of organizational interrelations between state- run public authorities in the managing block and micro-incentive structures in the controllable block as well as the usage of the process approach in every phase of the replacement process. 

  2. Replacing Electron Transport Cofactors with Hydrogenases

    KAUST Repository

    Laamarti, Rkia

    2016-12-01

    Enzymes have found applications in a broad range of industrial production processes. While high catalytic activity, selectivity and mild reaction conditions are attractive advantages of the biocatalysts, particularly costs arising from required cofactors pose a sever limitation. While cofactor-recycling systems are available, their use implies constraints for process set-up and conditions, which are a particular problem e.g. for solid-gas-phase reactions. Several oxidoreductases are able to directly exchange electrons with electrodes. Hence, the co-immobilization of both, an electron-utilizing and an electron-generating oxidoreductase on conductive nanoparticles should facilitate the direct electron flow from an enzymatic oxidation to a reduction reaction circumventing redox-cofactors requirements. In such a set-up, hydrogenases could generate and provide electrons directly form gaseous hydrogen. This thesis describes the co-immobilization of the oxygen tolerant hydrogenases from C. eutropha or C. metallidurans and cytochrome P450BM3 as test system. Conductive material in the form of carbon nanotubes (CNT) serves as a suitable support. A combination of the hydrogenase and the catalytic domain of P450BM3 immobilized on carbon nanotubes were tested for the oxidation of lauric acid in the presence of hydrogen instead of an electron-transport cofactor. The GC-MS analysis reveals the conversion of 4% of lauric acid (LA) into three products, which correspond to the hydroxylated lauric acid in three different positions with a total turnover (TON) of 34. The product distribution is similar to that obtained when using the wildtype P450BM3 with the nicotinamide adenine dinucleotide phosphate (NADPH) cofactor. Such electronic coupling couldn’t be achieved for the conversion of other substrates such as propane and cyclohexane, probably due to the high uncoupling rate within the heme-domain of cytochrome P450BM3 when unnatural substrates are introduced.

  3. Can Geothermal Power Replace Fossil Fuels?

    Science.gov (United States)

    Klenner, R.; Gosnold, W. D.

    2009-12-01

    is scaled up to produce power in the MW range. Values needed for these systems are temperatures of 92+ °C and flow rates of 140-1000 gpm. In a detailed analysis of the North Dakota part of the Williston Basin, we used heat flow, bottom-hole temperatures, and measured temperature gradients to calculate the energy contained within specific formations having temperatures in the range of 100 °C to 150 °C. We find that at a 2% recovery factor, approximately 4500 MW/hr can be recovered at depths of 3-4 km. North Dakota currently produces approximately 3100 MW/hr from non-renewable sources such as coal and petroleum. We conclude that the geothermal resource in the Williston Basin could completely replace fossil fuels as an electrical power supply for North Dakota.

  4. The role of cell replacement in benthic–pelagic coupling by suspension feeders

    Science.gov (United States)

    2016-01-01

    Benthic–pelagic coupling through suspension feeders and their detrital pathways is integral to carbon transport in oceans. In food-poor ecosystems however, a novel mechanism of carbon recycling has been proposed that involves direct uptake of dissolved carbon by suspension feeders followed by shedding of cells as particulate carbon. We studied cell replacement rates in a range of cold-water sponge species to determine how universal this mechanism might be. We show that cell replacement rates of feeding epithelia in explants vary from 30 hours up to 7 days, and change during different seasons and life-history stages. We also found that feeding epithelia are not replaced through direct replication but instead arise from a population of stem cells that differentiate and integrate into epithelial tissues. Our results reveal a surprising amount of complexity in the control of cell processes in sponges, with cell turnover depending on environmental conditions and using stem cells as rate-limiting mechanisms. Our results also suggest that for species in cold water with high particulate organic matter, cell turnover is not the mechanism delivering carbon flux to surrounding communities. PMID:28018632

  5. Do meal replacement drinks have a role in diabetes management?

    Science.gov (United States)

    Ditschuneit, Herwig H

    2006-01-01

    The poor effectiveness of conventional dietary treatment for weight loss and weight maintenance in patients with type-2 diabetes may be improved by a meal replacement strategy that provides a strong structured meal plan with reasonable opportunity for dietary variety. Typical meal replacement programs fix the intake of one or two meals per day with a calorie-controlled, nutritionally balanced commercial formulation, and allow prudent additional meals and snacks. In obese subjects, diets with meal replacements have proven to be more efficient than conventional diets. Patients on the meal replacement regimen lost 7.3 and 8.4% of initial body weight after 12 weeks and 4 years, respectively, whereas the patients on the conventional diet had lost 1.4% and 3.2% of initial body weight after 12 weeks and 4 years, respectively. The meal replacement plan has also proven to be effective in patients with type-2 diabetes. After 6 and 12 months, patients in the meal replacement group achieved on average a weight loss of 5.24 and 4.35% of their initial body weight, respectively. In contrast, after 6 and 12 months, patients on the individualized diet plan achieved on average a weight loss of 2.85 and 2.36% of their initial body weight, respectively. Meal replacements offer a promising strategy for treating obese patients with type-2 diabetes.

  6. Direct methods in protein crystallography.

    Science.gov (United States)

    Karle, J

    1989-11-01

    It is pointed out that the 'direct methods' of phase determination for small-structure crystallography do not have immediate applicability to macromolecular structures. The term 'direct methods in macromolecular crystallography' is suggested to categorize a spectrum of approaches to macromolecular structure determination in which the analyses are characterized by the use of two-phase and higher-order-phase invariants. The evaluation of the invariants is generally obtained by the use of heavy-atom techniques. The results of a number of the more recent algebraic and probabilistic studies involving isomorphous replacement and anomalous dispersion thus become valid subjects for discussion here. These studies are described and suggestions are also presented concerning future applicability. Additional discussion concerns the special techniques of filtering, the use of non-crystallographic symmetry, some features of maximum entropy and attempts to apply phase-determining formulas to the refinement of macromolecular structure. It is noted that, in addition to the continuing remarkable progress in macromolecular crystallography based on the traditional applications of isomorphous replacement and anomalous dispersion, recent valuable advances have been made in the application of non-crystallographic symmetry, in particular, to virus structures and in applications of filtering. Good progress has also been reported in the application of exact linear algebra to multiple-wavelength anomalous-dispersion investigations of structures containing anomalous scatterers of only moderate scattering power.

  7. Registry data trends of total ankle replacement use.

    Science.gov (United States)

    Roukis, Thomas S; Prissel, Mark A

    2013-01-01

    Joint arthroplasty registry data are meaningful when evaluating the outcomes of total joint replacement, because they provide unbiased objective information regarding survivorship and incidence of use. Critical evaluation of the registry data information will benefit the surgeon, patient, and industry. However, the implementation and acceptance of registry data for total ankle replacement has lagged behind that of hip and knee implant arthroplasty. Currently, several countries have national joint arthroplasty registries, with only some procuring information for total ankle replacement. We performed an electronic search to identify publications and worldwide registry databanks with pertinent information specific to total ankle replacement to determine the type of prostheses used and usage trends over time. We identified worldwide registry data from 33 countries, with details pertinent to total ankle replacement identified in only 6 countries. The obtained information was arbitrarily stratified into 3 distinct periods: 2000 to 2006, 2007 to 2010, and 2011. Within these study periods, the data from 13 total ankle replacement systems involving 3,980 ankles were identified. The vast majority (97%) of the reported ankle replacements were 3-component, mobile-bearing, uncemented prostheses. Three usage trends were identified: initial robust embracement followed by abrupt disuse, minimal use, and initial embracement followed by sustained growth in implantation. Before the widespread acceptance of new total ankle replacements, the United States should scrutinize and learn from the international registry data and develop its own national joint registry that would include total ankle replacement. Caution against the adoption of newly released prostheses, especially those without readily available revision components, is recommended.

  8. Improving the efficiency of molecular replacement by utilizing a new iterative transform phasing algorithm

    Energy Technology Data Exchange (ETDEWEB)

    He, Hongxing; Fang, Hengrui [Department of Physics and Texas Center for Superconductivity, University of Houston, Houston, Texas 77204 (United States); Miller, Mitchell D. [Department of BioSciences, Rice University, Houston, Texas 77005 (United States); Phillips, George N. Jr [Department of BioSciences, Rice University, Houston, Texas 77005 (United States); Department of Chemistry, Rice University, Houston, Texas 77005 (United States); Department of Biochemistry, University of Wisconsin-Madison, Madison, Wisconsin 53706 (United States); Su, Wu-Pei, E-mail: wpsu@uh.edu [Department of Physics and Texas Center for Superconductivity, University of Houston, Houston, Texas 77204 (United States)

    2016-07-15

    An iterative transform algorithm is proposed to improve the conventional molecular-replacement method for solving the phase problem in X-ray crystallography. Several examples of successful trial calculations carried out with real diffraction data are presented. An iterative transform method proposed previously for direct phasing of high-solvent-content protein crystals is employed for enhancing the molecular-replacement (MR) algorithm in protein crystallography. Target structures that are resistant to conventional MR due to insufficient similarity between the template and target structures might be tractable with this modified phasing method. Trial calculations involving three different structures are described to test and illustrate the methodology. The relationship of the approach to PHENIX Phaser-MR and MR-Rosetta is discussed.

  9. Initiating Heavy-atom Based Phasing by Multi-Dimensional Molecular Replacement

    DEFF Research Database (Denmark)

    Pedersen, Bjørn Panyella; Gourdon, Pontus Emanuel; Liu, Xiangyu

    2014-01-01

    approaches, which however may fail when only poorly diffracting derivative crystals are available, as often the case for e.g. membrane proteins. Here we present an approach for heavy atom site identification based on a Molecular Replacement Parameter Matrix (MRPM) search. It involves an n-dimensional search......To obtain an electron-density map from a macromolecular crystal the phase-problem needs to be solved, which often involves the use of heavy-atom derivative crystals and concomitantly the determination of the heavy atom substructure. This is customarily done by direct methods or Patterson-based...... to test a wide spectrum of molecular replacement parameters, such as clusters of different conformations. The result is scored by the ability to identify heavy-atom positions, from anomalous difference Fourier maps, that allow meaningful phases to be determined. The strategy was successfully applied...

  10. Evaluation of replacement thread lubricants for red lead and graphite in mineral oil

    Energy Technology Data Exchange (ETDEWEB)

    Jungling, T.L.; Rauth, D.R.; Goldberg, D.

    1998-04-30

    Eight commercially available thread lubricants were evaluated to determine the best replacement for Red Lead and Graphite in Mineral Oil (RLGMO). The evaluation included coefficient of friction testing, high temperature anti-seizing testing, room temperature anti-galling testing, chemical analysis for detrimental impurities, corrosion testing, off-gas testing, and a review of health and environmental factors. The coefficient of friction testing covered a wide variety of factors including stud, nut, and washer materials, sizes, manufacturing methods, surface coatings, surface finishes, applied loads, run-in cycles, and relubrication. Only one lubricant, Dow Corning Molykote P37, met all the criteria established for a replacement lubricant. It has a coefficient of friction range similar to RLGMO. Therefore, it can be substituted directly for RLGMO without changing the currently specified fastener torque values for the sizes, materials and conditions evaluated. Other lubricants did not perform as well as Molykote P37 in one or more test or evaluation categories.

  11. Minimally Invasive Transaortic Mitral Decalcification During Aortic Valve Replacement.

    Science.gov (United States)

    Totsugawa, Toshinori; Sakaguchi, Taichi; Hiraoka, Arudo; Matsushita, Hiroshi; Hirai, Yuki; Yoshitaka, Hidenori

    2015-01-01

    Mitral annular calcification accompanied by aortic stenosis is hazardous for both double-valve replacement and transcatheter aortic valve implantation. Less invasive mitral procedure is required in this condition, and minimally invasive approach may further reduce the operative risk in high-risk patients. Here, we report minimally invasive transaortic mitral decalcification during aortic valve replacement through minithoracotomy. We believe that this option is feasible in patients who are at prohibitive risk for double-valve replacement or transcatheter aortic valve implantation because of severe mitral annular calcification.

  12. DETERMINATION OF REPLACEMENT EFFICIENCY OF TRANSFORMERS WITH LONG SERVICE LIFE

    Directory of Open Access Journals (Sweden)

    M. I. Fursanov

    2014-01-01

    Full Text Available The paper shows non-efficient application of the existing economical models for determination of replacement time for transformers with long service life because these models do not take into account real changes in transformer parameters during its operational period. An improved mathematical model for estimation of replacement efficiency of power transformers which are used at substations of power distribution networks has been developed in the paper. The model makes it possible to determine an optimum replacement time and economically justified operational service life of the transformers.

  13. 78 FR 54561 - Airworthiness Directives; Piper Aircraft, Inc. Airplanes

    Science.gov (United States)

    2013-09-05

    ...-17457; AD 2013-10-04] RIN 2120-AA64 Airworthiness Directives; Piper Aircraft, Inc. Airplanes AGENCY... an airworthiness directive (AD) that published in the Federal Register. That AD applies to all Piper... airplane exhaust system, and repair or replacement of parts as necessary for all Piper Aircraft,...

  14. Should dehydroepiandrosterone replacement therapy be provided with glucocorticoids?

    Science.gov (United States)

    Robinzon, B; Cutolo, M

    1999-06-01

    Adrenocorticotrophic hormone (ACTH) induces the concomitant secretion of glucocorticoids (GC) and dehydroepiandrosterone (DHEA) from the adrenal cortex. Whereas GC are catabolic, DHEA is anabolic. Long-term GC administration may result in some deleterious side-effects, such as muscular weakness, atrophy and necrosis, diabetes, fattiness, osteopenia, osteoporosis and avascular necrosis and susceptibility to infections. DHEA ameliorates some deleterious effects of GC, such as diabetes, amino acid deamination, fattiness, hypertension and susceptibility to viraemia. By its anabolic effects in muscles, bones and endothelium, DHEA may diminish the severity of GC-induced myopathy, osteopenia, osteoporosis and avascular necrosis. The natural concomitant secretion of DHEA with GC probably enables the latter to protect the body from ill-effects of stress without exerting their deleterious potency. DHEA secretion diminishes during aging and severe or chronic diseases such as rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE). Anti-inflammatory and immunosuppressive effects of GC and androgens, including DHEA, are now well established. On the other hand, administration of GC inhibits ACTH secretion, involutes the adrenal cortex and results in further DHEA deficiency, particularly harmful in chronic autoimmune diseases (i.e. RA, SLE). Therefore, the deleterious side-effects of chronic administration of GC emerges from both their direct catabolic activity and the suppression of DHEA production. Whereas, in males, most androgens come from the testes, in females, under GC supplementation, DHEA deficiency leads to nullification of the androgen-dependent anabolism, leaving them exposed to the GC-catabolic effects to a larger extent. The viewpoint presented here claims that under chronic GC supplementation, DHEA replacement therapy may reduce damage caused by GC administration.

  15. Effect of curd suppression in a milk replacer on physiological ...

    African Journals Online (AJOL)

    ... to determine the effect of abomasal curd suppression on selected blood profiles. ... Fasting (0 h) plasma free essential amino acid (EAA) concentration tended to be ... Keywords: Blood profiles, calves, casein curd formation, milk replacers, ...

  16. Macronutrient replacement options for saturated fat: effects on cardiovascular health.

    Science.gov (United States)

    Flock, Michael R; Fleming, Jennifer A; Kris-Etherton, Penny M

    2014-02-01

    The purpose of this review is to discuss macronutrient replacement options for saturated fatty acids (SFAs) to optimize cardiovascular disease (CVD) risk reduction. Dietary recommendations advise decreasing SFAs. There is convincing evidence that replacing SFAs with unsaturated fat, both omega-6 and omega-3 polyunsaturated fatty acids, reduces CVD risk. Monounsaturated fatty acid substitution for SFAs also decreases CVD risk. Replacing SFAs with refined carbohydrate does little to alter CVD risk, whereas whole-grain CHO or lean protein substitutions beneficially affect CVD risk. Modifying the macronutrient composition of the diet by replacing SFAs with unsaturated fatty acids, as well as lean protein and carbohydrate from whole grains, all lower CVD risk. Research is needed to identify food sources of macronutrients that optimize CVD risk reduction.

  17. Prosthetic valve thrombosis in a patient with mitral valve replacement.

    Science.gov (United States)

    Bilal, Muhammad; Khan, Muhammad Shahzeb; Haseeb, Abdul; Khan, Abdul Bari

    2015-07-01

    Prosthetic valve thrombosis within one year after mitral valve replacement is rarely seen in patients on warfarin therapy and without any risk factor. Here, we describe a case of a 39-year- old female, who presented with dyspnoea and shortness of breath 11 months after mitral valve replacement. The echocardiogram revealed severe valvular stenosis due to presence of clots on the mitral valve and restricted motion of the mitral leaflets. As a result of deterioration of general condition and haemodynamic un-stability, plan was made to re-operate for her valve replacement surgery. This case report highlights the diagnosis, prevention and management of patients with prosthetic valve thrombosis following mitral valve replacement.

  18. Hormone replacement for osteoporosis in women with primary biliary cirrhosis

    DEFF Research Database (Denmark)

    Rudic, Jelena S; Poropat, Goran; Krstic, Miodrag N

    2011-01-01

    Women with primary biliary cirrhosis often suffer from postmenopausal osteoporosis due to their age, or osteoporosis secondary to their liver disease, or treatments provided for their liver disease. Hormone replacement increases bone mineral density and reduces fractures in postmenopausal women...

  19. the influence of replacing maize with chrysophyllum albidum seed ...

    African Journals Online (AJOL)

    AGROSEARCH UIL

    Production Technology, Moor Plantation, PMB 5029, Ibadan ... including; Coffee pulp (Fagbenro and Arowosoge, 1991a); plantain peel and yam peel (Fagbenro .... Aderolu et al (2011) fed biscuit waste as a replacer of maize to Clarias ...

  20. Performance and economic effects of partially replacing soybean ...

    African Journals Online (AJOL)

    Performance and economic effects of partially replacing soybean meal with palm kernel ... to determine the optimal level of inclusion for maximum production in broilers. ... while no PKC was used in treatment I, which also served as the control.

  1. A new bread improver to replace traditional gluten fortifier

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

    @@ Scientists with the CAS Changchun Institute for Applied Chemistry recently developed a new plant derivative of polysaccharide to replace the traditional agent of gluten fortifier in the bread-baking industry.

  2. Comprehensive Care For Joint Replacement Model - Provider Data

    Data.gov (United States)

    U.S. Department of Health & Human Services — Comprehensive Care for Joint Replacement Model - provider data. This data set includes provider data for two quality measures tracked during an episode of care:...

  3. Set Covering with Ordered Replacement -- Additive and Multiplicative Gaps

    CERN Document Server

    Eisenbrand, Friedrich; Rothvoß, Thomas; Sanità, Laura

    2010-01-01

    We consider set covering problems where the underlying set system satisfies a particular replacement property w.r.t. a given partial order on the elements: Whenever a set is in the set system then a set stemming from it via the replacement of an element by a smaller element is also in the set system. Many variants of BIN PACKING that have appeared in the literature are such set covering problems with ordered replacement. We provide a rigorous account on the additive and multiplicative integrality gap and approximability of set covering with replacement. In particular we provide a polylogarithmic upper bound on the additive integrality gap that also yields a polynomial time additive approximation algorithm if the linear programming relaxation can be efficiently solved. We furthermore present an extensive list of covering problems that fall into our framework and consequently have polylogarithmic additive gaps as well.

  4. evaluation of early calves' weaning diet as milk replacer for ...

    African Journals Online (AJOL)

    ACSS

    This results in depressed calves' growth rates, high calf mortality rates, late ... additive can be an effective milk- replacer in smallholder dairy production systems to wean dairy calves at 28-35 ... consumption, but also increases cash income for.

  5. An all MMIC Replacement for Gunn Diode Oscillators Project

    Data.gov (United States)

    National Aeronautics and Space Administration — We propose to replace the Gunn Diode Oscillators (GDOs) in NASA?s millimeter- and submillimeter-wave sensing instruments. Our new solution will rely on modern and...

  6. 39 CFR 777.24 - Replacement housing payments.

    Science.gov (United States)

    2010-07-01

    ... replacement dwelling). They include: (1) Legal, closing, and related costs, including those for title search... assurance of title. (7) Escrow agent's fee. (8) State revenue or documentary stamps, sales or transfer...

  7. Knee Replacement for Women with Patient-Specific Instructions

    Medline Plus

    Full Text Available Knee Replacement for Women with Patient-Specific Instructions Click Here to view the BroadcastMed, Inc. Privacy Policy and Legal Notice © 2017 BroadcastMed, Inc. All rights reserved.

  8. Hormone Replacement Therapy: Can It Cause Vaginal Bleeding?

    Science.gov (United States)

    Hormone replacement therapy: Can it cause vaginal bleeding? I'm taking hormone therapy for menopause symptoms, and my monthly menstrual periods have returned. Is this normal? Answers from Shannon K. Laughlin- ...

  9. performance of concrete with partial replacement of fine aggregates ...

    African Journals Online (AJOL)

    user

    Key Words: compressive strength, concrete, crushed waste glass, flexural strength, setting time, water absorption and workability. ... powder as partial replacement of fine aggregates up to ... water in cement paste and reactive silica in the WG.

  10. Knee Replacement for Women with Patient-Specific Instructions

    Medline Plus

    Full Text Available Knee Replacement for Women with Patient-Specific Instructions Click Here to view the BroadcastMed, Inc. Privacy Policy and Legal Notice © 2017 BroadcastMed, Inc. All rights reserved.

  11. Implications of human evolution and admixture for mitochondrial replacement therapy

    National Research Council Canada - National Science Library

    Rishishwar, Lavanya; Jordan, I. King

    2017-01-01

    Mitochondrial replacement (MR) therapy is a new assisted reproductive technology that allows women with mitochondrial disorders to give birth to healthy children by combining their nuclei with mitochondria from unaffected egg donors...

  12. Rescue Surgery 19 Years after Composite Root and Hemiarch Replacement

    Directory of Open Access Journals (Sweden)

    Konstantin von Aspern

    2013-01-01

    Full Text Available A 59-year-old male patient with Marfan's syndrome was referred to our clinic due to acute chest pain. His medical history contains complex surgery for type A aortic dissection 19 years ago including composite root replacement using a mechanical aortic valve. Immediate computed tomography indicated perforation at the distal ascending aortic anastomosis plus complete avulsion of both coronary ostia. The patient underwent successful rescue surgery with ascending aortic and arch replacement using a modified Cabrol technique.

  13. Transvalvular mitral regurgitation following mitral valve replacement a diagnostic dilemma

    OpenAIRE

    U S Dinesh Kumar; Umesh Nareppa; Shyam Prasad Shetty; Murugesh Wali

    2015-01-01

    After mitral valve replacement with a prosthetic valve, the valve should be competent and there should not be any residual prosthetic valve regurgitation. Transvalvular residual prosthetic valve regurgitation are difficult to diagnose and quantify. we are reporting interesting TEE images as a diagnostic dilemma in a case of transvalvular mitral regurgitation following mitral valve replacement secondary to entrapment of sub-valvular apparatus in a Chitra mechanical heart valve.

  14. The Business of Bundling: Joining Forces on Joint Replacement.

    Science.gov (United States)

    Kaldy, Joanne

    2016-03-01

    A mandated bundled-payment program for joint replacement is in place in several regions across the country, and practitioners such as pharmacists are still sorting out their roles in this federal initiative. To get involved, pharmacists need to establish connections with area hospitals and physician groups to promote and document their ability to manage medications, reduce and eliminate medication-related problems and rehospitalizations, and work with patients to maximize adherence and improve communication for those undergoing hip and knee replacement.

  15. Spontaneous Coronary Artery Dissection following Topical Hormone Replacement Therapy

    OpenAIRE

    2012-01-01

    Spontaneous coronary artery dissection is a rare condition, usually presenting as an acute coronary syndrome, and is often seen in states associated with high systemic estrogen levels such as pregnancy or oral contraceptive use. While topical hormonal replacement therapy may result in increased estrogen levels similar to those documented with oral contraceptive use, there are no reported cases of spontaneous coronary dissection with topical hormonal replacement therapy. We describe a 53-year...

  16. SERDP-ESTCP Depot Cd/Chromate Replacement Initiative

    Science.gov (United States)

    2014-11-18

    ESTCP SERDP Environmental Technology Development Process Office of the Deputy Under Secretary of Defense - Installations and Environment 4...SERDP-ESTCP Depot Cd/ Chromate Replacement Initiative Robin Nissan Weapons Systems and Platforms Program Manager ASETSDefense 18 November 2014...NOV 2014 2. REPORT TYPE 3. DATES COVERED 00-00-2014 to 00-00-2014 4. TITLE AND SUBTITLE SERDP-ESTCP Depot Cd/ Chromate Replacement Initiative 5a

  17. Transcatheter aortic valve prosthesis surgically replaced 4 months after implantation

    DEFF Research Database (Denmark)

    Thyregod, Hans Gustav; Lund, Jens Teglgaard; Engstrøm, Thomas;

    2010-01-01

    Transcatheter aortic valve implantation is a new and rapidly evolving treatment option for high-risk surgical patients with degenerative aortic valve stenosis. Long-term results with these new valve prostheses are lacking, and potential valve dysfunction and failure would require valve replacement....... We report the first case of surgical valve replacement in a patient with a dysfunctional transcatheter-implanted aortic valve prosthesis 4 months after implantation....

  18. Transcatheter aortic valve replacement: techniques, complications, and bailout strategies.

    Science.gov (United States)

    Singh, Vikas; Macon, Conrad J; Scot Shaw, Eric; Londoño, Juan C; Martinez, Claudia A

    2013-09-01

    Transcatheter aortic valve replacement has emerged as an alternative option for inoperable or very high-risk patients with severe aortic stenosis-however, there are serious complications associated with the procedure, such as patient mortality, stroke, conduction disturbances, paravalvular regurgitation, and vascular concerns. Our review focuses on the most common complications related to transcatheter aortic valve replacement procedures and potential bailout strategies and techniques.

  19. Nursing procedures during continuous renal replacement therapies: a national survey

    OpenAIRE

    Ricci, Zaccaria; Benelli, Sonia; Barbarigo, Fabio; Cocozza, Giulia; Pettinelli, Noemi; Di Luca, Emanuela; Mettifogo, Mariangela; Toniolo, Andrea; Ronco, Claudio

    2015-01-01

    Introduction The current role of nurses in the management of critically ill patients needing continuous renal replacement therapies is clearly fundamental. The care of these complex patients is typically shared by critical care and dialysis nurses: their precise duties may vary from country to country. Methods To clarify this issue we conducted a national-level survey at a recent Italian course on nursing practices during continuous renal replacement therapies. Results A total of 119 question...

  20. Renal Replacement Therapy in Support of Combat Operations

    Science.gov (United States)

    2008-07-01

    was used to create viable sets; pediatric chest tubes were used as PD catheters and dialysate was made using either intravenous saline solution with...important logistic factor in performing RRT is the volume of fluid required for dialysate (for hemodi- alysis and peritoneal dialysis) or replace- ment...treatment may range on the order of 100 to 1000 L per day per patient. Both the dialysate and replacement fluid must be sterile, and no approach for

  1. Optimization criteria for the design of orbital replacement units (ORUs)

    Science.gov (United States)

    Schulze, Manfred W.

    A reduction of life cycle costs of spacecraft or Space Station elements can be achieved by a modular build up which allows an in orbit replacement, maintenance, and service of functional units named Orbital Replacement Units (ORUs). The criteria for an optimal design for an ORU is presented. Requirements involving the user spacecraft configuration, the servicing vehicle, the handling by astronauts and remote manipulator system are considered.

  2. Midterm Results of Aortic Valve Replacement with Cryopreserved Homografts

    Directory of Open Access Journals (Sweden)

    Emre Özker

    2012-06-01

    Full Text Available Objective: The aim of this study was to analyze the midterm clinical results of aortic valve replacement with cryopreserved homografts.Materials and Methods: Aortic valve replacement was performed in 40 patients with cryopreserved homograft. The indications were aortic valve endocarditis in 20 patients (50%, truncus arteriosus in 6 patients (15%, and re-stenosis or regurtitation after aortic valve reconstruction in 14 (35% patients. The valve sizes ranged from 10 to 27mm. A full root replacement technique was used for homograft replacement in all patients.Results: The 30-day postoperative mortality rate was 12.5% (5 patients. There were four late deaths. Only one of them was related to cardiac events. Overall mortality was 22.5%. Thirty-three patients were followed up for 67±26 months. Two patients needed reoperation due to aortic aneurysm caused by endocarditis. The mean transvalvular gradient significantly decreased after valve replacement (p<0.003. The last follow up showed that the 27 (82% patients had a normal left ventricular function.Conclusion: Cryopreserved homografts are safe alternatives to mechanical valves that can be used when there are proper indications. Although it has a high perioperative mortality rate, cryopreserved homograft implantation is an alternative for valve replacement, particularly in younger patients and for complex surgical problems such as endocarditis that must be minimalized.

  3. Urban chaos and replacement dynamics in nature and society

    CERN Document Server

    Chen, Yanguang

    2011-01-01

    Many growing phenomena in both nature and society can be predicted with sigmoid function. The growth curve of the level of urbanization is a typical S-shaped one, and can be described by using logistic function. The logistic model implies a replacement process, and the logistic substitution suggests non-linear dynamical behaviors such as bifurcation and chaos. Using mathematical transform and numerical computation, we can demonstrate that the 1-dimensional map comes from a 2-dimensional two-group interaction map. By analogy with urbanization, a general theory of replacement dynamics is presented in this paper, and the replacement process can be simulated with the 2-dimansional map. If the rate of replacement is too high, periodic oscillations and chaos will arise, and the system maybe breaks down. The replacement theory can be used to interpret various complex interaction and conversion in physical and human systems. The replacement dynamics provides a new way of looking at Volterra-Lotka's predator-prey inte...

  4. Controversy in mitral valve repair, resection or chordal replacement?

    Science.gov (United States)

    Sawazaki, Masaru; Tomari, Shiro; Zaikokuji, Kenta; Imaeda, Yusuke

    2014-10-01

    Mitral valve plasty has superseded valve replacement as the standard technique for treating degenerative mitral valve prolapse. Quadrangular resection is considered the gold standard for posterior leaflet prolapse. Chordal replacement was first developed to treat the anterior leaflet and subsequently became widely used for the posterior leaflet, after which a new version of posterior leaflet resection was developed that did not involve local annular plication. In the era of the mini-thoracotomy, the premeasured loop technique is simple to adopt and is as durable as quadrangular resection. However, there is controversy surrounding whether resection or chordal replacement is the optimal technique. The resection technique is curative because it removes the main pathologic lesion. The disadvantage of the resection is that it can be complicated and often requires advanced surgical skills. In contrast, chordal replacement is not pathologically curative because it leaves behind a redundant leaflet. However, the long-term results appear to be equivalent in many reports. Functionally, chordal replacement retains greater posterior leaflet motion with a lower trans-mitral pressure gradient than quadrangular resection. Moreover, chordal replacement is simple and yields uniform results. The optimal technique depends on whether the anterior leaflet or posterior leaflet is involved, the Barlow or non-Barlow disease state, and whether a mini-thoracotomy or standard sternotomy approach is used. For mitral valve repair, the most superior and reliable technique for the posterior leaflet is resection using the newer resection technique with a sternotomy approach, which requires a skilled surgeon.

  5. Mechanism and Correlated Factors of SAM Phenomenon after Aortic Valve Replacement

    Institute of Scientific and Technical Information of China (English)

    XU Jing; WEN Jianguo; SHU Liliang; LIU Chao; ZHANG Jingchao; ZHAO Wenzeng

    2007-01-01

    To investigate the mechanism and correlated factors of systolic anterior motion (SAM) phenomenon after aortic valve replacement, 48 patients with severe aortic valvular stenosis were studied. Tested by echo-Doppler one week after aortic valve replacement, the patients were divided into two groups: SAM group and non-SAM group. The data of the left ventricular end-diastolic diameters, the left ventricular end-systolic diameters, the left ventricular outflow diameters, the thickness of the interventricular septum, the posterior wall of left ventricle, the blood velocities of left ventricular outflow and intra-cavitary gradients were recorded and compared. The results showed that no patients died during or after the operation. The blood velocities of left ventricular outflow was increased significantly in 9 patients (>2.5 m/s), and 6 of them developed SAM phenomenon. There was significant difference in all indexes (P<0.05 or P<0.01) except the posterior wall of left ventricle (P>0.05) between two groups. These indicated that the present of SAM phenomenon after aortic valve replacement may be directly related to the increase of blood velocities of left ventricular outflow and intra-cavitary gradients. It is also suggested that smaller left ventricular diastolic diameters, left ventricular systolic diameters, left ventricular outflow diameters and hypertrophy of interventricular septum may be the anatomy basis of SAM phenomenon.

  6. GATE REPLACEMENT TECHNIQUE FOR REDUCING LEAKAGE CURRENT IN WALLACE TREE MULTIPLIER

    Directory of Open Access Journals (Sweden)

    Naveen Raman

    2013-01-01

    Full Text Available Leakage power has become more significant in the power dissipation of today’s CMOS circuits. This affects the portable battery operated devices directly. The multipliers are the main key for designing an energy efficient processor, where the multiplier design decides the digital signal processors efficiency. In this study gate replacement technique is used to reduce the leakage power in 4×4 Wallace tree multiplier architecture which has been designed by using one bit full adders. This technique replaces the gate which is at worst leakage state by a library gate .In this technique the actual output logic state is maintained in active mode. The main objective of our study is to calculate leakage power in 4×4 Wallace tree multiplier by applied gate replacement technique and it is compared with 4×4 Wallace tree full adder multiplier. The proposed method reduces 43% of leakage power in 4×4 Wallace tree multiplier.

  7. Technology management: a perspective on system support, procurement, and replacement planning.

    Science.gov (United States)

    Dickerson, M L; Jackson, M E

    1992-01-01

    The escalating costs associated with medical technology present a host of challenges for the hospital clinical engineering department. As service and support costs comprise ever larger portions of a system's life cycle cost, innovative management of service provider mix and mechanisms can provide substantial savings in operating expenses. In addition to full-service contracts, the use of demand service and independents has become commonplace. Medical equipment maintenance insurance programs provide yet another service alternative, combining the flexibility of demand service with the safety of a capped budget. These programs have gained acceptance among hospitals as their providers have become more focused on the healthcare market and its many needs. In view of the long-term cost impact surrounding technology procurement, the authors recommend that hospitals refine system evaluation methodologies and develop more comprehensive techniques directed at capital equipment replacement planning. One replacement planning approach, based on an estimation of system value changes, is described and illustrated using data collected through client consultations. Although the validity of this method has not been demonstrated, it represents a simplified approach to life cycle cost analysis and is intended to provide a standard method by which system replacement planning may be quantified. As a departure from system devaluation based solely on depreciation, this method estimates prospective system values derived from anticipated operations and maintenance costs, projected revenue, and the availability of new technology.

  8. Stable gene replacement in barley by targeted double-strand break induction.

    Science.gov (United States)

    Watanabe, Koichi; Breier, Ulrike; Hensel, Götz; Kumlehn, Jochen; Schubert, Ingo; Reiss, Bernd

    2016-03-01

    Gene targeting is becoming an important tool for precision genome engineering in plants. During gene replacement, a variant of gene targeting, transformed DNA integrates into the genome by homologous recombination (HR) to replace resident sequences. We have analysed gene targeting in barley (Hordeum vulgare) using a model system based on double-strand break (DSB) induction by the meganuclease I-SceI and a transgenic, artificial target locus. In the plants we obtained, the donor construct was inserted at the target locus by homology-directed DNA integration in at least two transformants obtained in a single experiment and was stably inherited as a single Mendelian trait. Both events were produced by one-sided integration. Our data suggest that gene replacement can be achieved in barley with a frequency suitable for routine application. The use of a codon-optimized nuclease and co-transfer of the nuclease gene together with the donor construct are probably the components important for efficient gene targeting. Such an approach, employing the recently developed synthetic nucleases/nickases that allow DSB induction at almost any sequence of a genome of interest, sets the stage for precision genome engineering as a routine tool even for important crops such as barley.

  9. An opposite view data replacement approach for reducing artifacts due to metallic dental objects

    Energy Technology Data Exchange (ETDEWEB)

    Yazdi, Mehran; Lari, Meghdad Asadi; Bernier, Gaston; Beaulieu, Luc [Department of Electrical Engineering, School of Engineering, Shiraz University, Shiraz 7134851154 (Iran, Islamic Republic of) and Departement de Radio-Oncologie, Ho circumflex tel-Dieu de Quebec, Centre Hospitalier Universitaire de Quebec, 11 Cote du Palais, Quebec, Quebec G1R 2J6 (Canada); Department of Electrical Engineering, School of Engineering, Shiraz University, Shiraz 7134851154 (Iran, Islamic Republic of); Departement de Radio-Oncologie, Ho circumflex tel-Dieu de Quebec, Centre Hospitalier Universitaire de Quebec, 11 Cote du Palais, Quebec, Quebec G1R 2J6 (Canada); Departement de Physique, de Genie Physique et D' optique, Universite Laval, Quebec, Quebec (Canada) and Departement de Radio-Oncologie, Hotel-Dieu de Quebec, Centre Hospitalier Universitaire de Quebec, 11 Cote du Palais, Quebec, Quebec G1R 2J6 (Canada)

    2011-04-15

    Purpose: To present a conceptually new method for metal artifact reduction (MAR) that can be used on patients with multiple objects within the scan plane that are also of small sized along the longitudinal (scanning) direction, such as dental fillings. Methods: The proposed algorithm, named opposite view replacement, achieves MAR by first detecting the projection data affected by metal objects and then replacing the affected projections by the corresponding opposite view projections, which are not affected by metal objects. The authors also applied a fading process to avoid producing any discontinuities in the boundary of the affected projection areas in the sinogram. A skull phantom with and without a variety of dental metal inserts was made to extract the performance metric of the algorithm. A head and neck case, typical of IMRT planning, was also tested. Results: The reconstructed CT images based on this new replacement scheme show a significant improvement in image quality for patients with metallic dental objects compared to the MAR algorithms based on the interpolation scheme. For the phantom, the authors showed that the artifact reduction algorithm can efficiently recover the CT numbers in the area next to the metallic objects. Conclusions: The authors presented a new and efficient method for artifact reduction due to multiple small metallic objects. The obtained results from phantoms and clinical cases fully validate the proposed approach.

  10. Nonhatching Decapsulated Artemia Cysts As a Replacement to Artemia Nauplii in Juvenile and Adult Zebrafish Culture.

    Science.gov (United States)

    Tye, Marc; Rider, Dana; Duffy, Elizabeth A; Seubert, Adam; Lothert, Brogen; Schimmenti, Lisa A

    2015-12-01

    Feeding Artemia nauplii as the main nutrition source for zebrafish is a common practice for many research facilities. Culturing live feed can be time-consuming and requires additional equipment to be purchased, maintained, and cleaned. Nonhatching decapsulated Artemia cysts (decaps) are a commercially available product that can be fed directly to fish. Several other ornamental fish species have been successfully cultured using decaps. Replacing Artemia nauplii with decaps could reduce the overall time and costs associated with the operation of a zebrafish facility. The objective of this study was to determine if decaps could be a suitable replacement to Artemia nauplii in juvenile and adult zebrafish culture. Wild-type zebrafish were fed one of three dietary treatments: decaps only, nauplii only, or a standard consisting of nauplii plus a commercially prepared pellet food. Survival, growth (length and weight), and embryo production were analyzed between the treatments. Fish receiving the decap diet demonstrated a significantly higher growth and embryo production when compared to the fish receiving the nauplii-only diet. When comparing the decap fish to the standard fish, no significant difference was found in mean survival, mean weight at 90 days postfertilization, or mean embryo production. It was determined that nonhatching decapsulated Artemia cysts can be used as a suitable replacement to Artemia nauplii in juvenile and adult zebrafish culture.

  11. Functional tooth regeneration using a bioengineered tooth unit as a mature organ replacement regenerative therapy.

    Science.gov (United States)

    Oshima, Masamitsu; Mizuno, Mitsumasa; Imamura, Aya; Ogawa, Miho; Yasukawa, Masato; Yamazaki, Hiromichi; Morita, Ritsuko; Ikeda, Etsuko; Nakao, Kazuhisa; Takano-Yamamoto, Teruko; Kasugai, Shohei; Saito, Masahiro; Tsuji, Takashi

    2011-01-01

    Donor organ transplantation is currently an essential therapeutic approach to the replacement of a dysfunctional organ as a result of disease, injury or aging in vivo. Recent progress in the area of regenerative therapy has the potential to lead to bioengineered mature organ replacement in the future. In this proof of concept study, we here report a further development in this regard in which a bioengineered tooth unit comprising mature tooth, periodontal ligament and alveolar bone, was successfully transplanted into a properly-sized bony hole in the alveolar bone through bone integration by recipient bone remodeling in a murine transplantation model system. The bioengineered tooth unit restored enough the alveolar bone in a vertical direction into an extensive bone defect of murine lower jaw. Engrafted bioengineered tooth displayed physiological tooth functions such as mastication, periodontal ligament function for bone remodeling and responsiveness to noxious stimulations. This study thus represents a substantial advance and demonstrates the real potential for bioengineered mature organ replacement as a next generation regenerative therapy.

  12. Effects of leptin replacement therapy on pancreatic β-cell function in patients with lipodystrophy.

    Science.gov (United States)

    Muniyappa, Ranganath; Brown, Rebecca J; Mari, Andrea; Joseph, Jalaja; Warren, Mary A; Cochran, Elaine K; Skarulis, Monica C; Gorden, Phillip

    2014-04-01

    OBJECTIVE Leptin administration is known to directly modulate pancreatic β-cell function in leptin-deficient rodent models. However, human studies examining the effects of leptin administration on β-cell function are lacking. In this study, we examined the effects (16-20 weeks) of leptin replacement on β-cell function in patients with lipodystrophy. RESEARCH DESIGN AND METHODS In a prospective, open-label, currently ongoing study, we studied the effects of leptin replacement on β-cell function in 13 patients with congenital or acquired lipodystrophy. Insulin secretory rate (ISR) was calculated by C-peptide deconvolution from plasma glucose and C-peptide levels measured during oral glucose tolerance tests (OGTTs) performed at baseline and after 16-20 weeks of leptin replacement. β-Cell glucose sensitivity and rate sensitivity were assessed by mathematical modeling of OGTT. RESULTS There was a significant decrease in triglycerides, free fatty acids, and glycosylated hemoglobin levels (A1C) after leptin therapy. Patients with lipodystrophy have high fasting and glucose-stimulated ISR. However, leptin therapy had no significant effect on fasting ISR, total insulin secretion during OGTT, β-cell glucose sensitivity, rate sensitivity, or insulin clearance. CONCLUSIONS In contrast to the suppressive effects of leptin on β-cell function in rodents, 16-20-week treatment with leptin in lipodystrophy patients did not significantly affect insulin secretion or β-cell function in leptin-deficient individuals with lipodystrophy.

  13. Initiating heavy-atom-based phasing by multi-dimensional molecular replacement.

    Science.gov (United States)

    Pedersen, Bjørn Panyella; Gourdon, Pontus; Liu, Xiangyu; Karlsen, Jesper Lykkegaard; Nissen, Poul

    2016-03-01

    To obtain an electron-density map from a macromolecular crystal the phase problem needs to be solved, which often involves the use of heavy-atom derivative crystals and concomitant heavy-atom substructure determination. This is typically performed by dual-space methods, direct methods or Patterson-based approaches, which however may fail when only poorly diffracting derivative crystals are available. This is often the case for, for example, membrane proteins. Here, an approach for heavy-atom site identification based on a molecular-replacement parameter matrix (MRPM) is presented. It involves an n-dimensional search to test a wide spectrum of molecular-replacement parameters, such as different data sets and search models with different conformations. Results are scored by the ability to identify heavy-atom positions from anomalous difference Fourier maps. The strategy was successfully applied in the determination of a membrane-protein structure, the copper-transporting P-type ATPase CopA, when other methods had failed to determine the heavy-atom substructure. MRPM is well suited to proteins undergoing large conformational changes where multiple search models should be considered, and it enables the identification of weak but correct molecular-replacement solutions with maximum contrast to prime experimental phasing efforts.

  14. Durability and acoustics of concrete with slag of cupola furnace as fine aggregate replacement

    Directory of Open Access Journals (Sweden)

    Ricardo Alfredo Cruz Hernández

    2015-01-01

    Full Text Available In this paper, it was evaluated the performance of concrete with crushed slag of cupola furnace (SCF as sand replacement in percentages of 0 %, 10 %, 15 % and 20 %, subjected to accelerated chemical attacks of carbonation, sulfation and alkali-aggregate reaction (AAR. The sound absorption characteristics of the material were determined through the sound absorption coefficient (α, and the noise reduction coefficient (NRC. Carbonation was evaluated through a closed camera with the 70 % concentration of carbon dioxide and conditions of relative humidity between 50 % and 70 %. The results indicated that the penetration depth of CO2 is lower when greater the percentage of substitution is. To accelerate the attack by sulfates, specimens were immersed in aqueous solution of sodium sulfate anhydrous (Na2SO4 1N with cycles of wetting and drying. It determined that the impairment presented in concrete paste is directly proportional to the percentage of sand replacement. The acceleration of the AAR in the concrete was carried out by immersing specimens in an aqueous solution of sodium hydroxide (NaOH for 16 days. The test concluded that the inclusion of SCF is not favorable for AAR. The measurement of sound absorption coefficient was taken by the method of impedance tube, relating minimum and maximum values of stationary wave amplitude. The results showed that SCF with higher sand replacement are favorable for the noise absorption in buildings.

  15. Stem cells for cell replacement therapy: a therapeutic strategy for HD?

    Science.gov (United States)

    Rosser, Anne; Svendsen, Clive N

    2014-09-15

    Much interest has been expressed over the last couple of decades in the potential application of stem cells to medicine, both for research and diagnostic tools and as a source of donor cells for therapeutic purposes. Potential therapeutic applications include replacement of cells in many body organs where the capacity for intrinsic repair is limited, including the pancreas, heart, and brain. A key challenge is to generate the relevant donor cell types, and this is particularly challenging in the brain where the number of different neuronal subtypes is so great. Although dopamine neuron replacement in Parkinson's disease has been the focus of most clinical studies, great interest has been shown in this approach for other disorders, including Huntington's disease. Replacing complete neural circuits in the adult brain is clearly challenging, and there are many other complexities with regard to both donor cells and host. This article presents the pros and cons of taking a cell therapy approach in Huntington's disease. It considers the implantation both of cells that are already of the same neural subtype as those lost in the disease process (ie, primary fetal cells derived from the developing striatum) and those derived from stem cells, which require "directing" toward that phenotype.

  16. Testosterone Replacement Therapy and BPH/LUTS. What is the Evidence?

    Science.gov (United States)

    Baas, Wesley; Köhler, Tobias S

    2016-06-01

    Contrary to the previous dogma that prostatic growth is directly proportional to testosterone levels, emerging research has suggested a lack of testosterone may be a risk factor for lower urinary tract symptoms (LUTS) and benign prostatic hyperplasia (BPH). Within this review article, we have demonstrated the current understanding of the physiology of hypogonadism and its interplay with prostatic and lower urinary tract physiology. The current evidence suggests that not only does testosterone replacement therapy (TRT) not worsen LUTS, but that hypogonadism itself is an important risk factor for LUTS/BPH.

  17. The use of Xenopus oocytes and embryos as a route towards cell replacement

    Indian Academy of Sciences (India)

    J B Gurdon

    2005-02-01

    When nuclei of somatic cells are transplanted to enucleated eggs of Xenopus, a complete reprogramming of nuclear function can take place. To identify mechanisms of nuclear reprogramming, somatic nuclei can be transplanted to growing meiotic oocytes of Xenopus, and stem cell genes activated without DNA replication. The combination of somatic cell nuclear transfer with morphogen signalling and the community effect may lead towards the possibility of cell replacement therapy. When mechanisms of nuclear reprogramming are understood, it may eventually be possible to directly reprogramme human somatic cell nuclei without the use of eggs.

  18. Directing the Flow

    Institute of Scientific and Technical Information of China (English)

    2011-01-01

    Severe droughts and floods inrecent years are forcing the Chinese Government to replace outdated water conservation systems Local governments at all levels have put irrigation and water conservation tasks at

  19. An alternative strategy for targeted gene replacement in plants using a dual-sgRNA/Cas9 design.

    Science.gov (United States)

    Zhao, Yongping; Zhang, Congsheng; Liu, Wenwen; Gao, Wei; Liu, Changlin; Song, Gaoyuan; Li, Wen-Xue; Mao, Long; Chen, Beijiu; Xu, Yunbi; Li, Xinhai; Xie, Chuanxiao

    2016-04-01

    Precision DNA/gene replacement is a promising genome-editing tool that is highly desirable for molecular engineering and breeding by design. Although the CRISPR/Cas9 system works well as a tool for gene knockout in plants, gene replacement has rarely been reported. Towards this end, we first designed a combinatory dual-sgRNA/Cas9 vector (construct #1) that successfully deleted miRNA gene regions (MIR169a and MIR827a). The deletions were confirmed by PCR and subsequent sequencing, yielding deletion efficiencies of 20% and 24% on MIR169a and MIR827a loci, respectively. We designed a second structure (construct #2) that contains sites homologous to Arabidopsis TERMINAL FLOWER 1 (TFL1) for homology-directed repair (HDR) with regions corresponding to the two sgRNAs on the modified construct #1. The two constructs were co-transformed into Arabidopsis plants to provide both targeted deletion and donor repair for targeted gene replacement by HDR. Four of 500 stably transformed T0 transgenic plants (0.8%) contained replaced fragments. The presence of the expected recombination sites was further confirmed by sequencing. Therefore, we successfully established a gene deletion/replacement system in stably transformed plants that can potentially be utilized to introduce genes of interest for targeted crop improvement.

  20. Valve replacement in pediatric patients:a single center experience

    Institute of Scientific and Technical Information of China (English)

    YU Jian-hua; GUO Hong-wei; ZHANG Gong; WU Shu-ming; SONG Guang-min; SUN Wen-yu

    2011-01-01

    Background Reconstructive surgery is the primary goal in pediatric patients with valve disease.However,in cases with irreparable valve lesions,valve replacement is the only option.This study aimed to retrospectively analyze the clinical experience of heart valve prosthesis replacement in children.Methods Between January 1990 and July 2009,35 pediatric patients (16 boys,19 girls) underwent mechanical valve replacement in Shandong University Qilu Hospital.The ages ranged from 2.5 to 14 years (mean,(8.8±3.8) years) and body weight varied from 11 to 37 kg (mean,(22.1±5.2) kg).Mechanical valve replacement was performed because of congenital heart disease in 23 patients,rheumatic disease in ten patients and infective endocarditis in two patients.St.Jude bileaflet mechanical valves were implanted in all the 35 patients including mitral valve replacement (MVR) in 18,aortic valve replacement (AVR) in 12,tricuspid valve replacement (TVR) in two,AVR and MVR in two and MVR and TVR in one.The size of the prostheses ranged between 19 and 27 mm.All patients received long-term anticoagulation treatment with sodium warfarin,aiming to maintain an international normalized ratio between 1.5 to 2.0.Follow-up was performed in all the patients with a total follow-up of 119.4 patient-years.Results The operative mortality was 8.57% (3/35).One patient,who underwent cardiac debridement and AVR,died 2 hours after being admitted to the intensive care unit because of severe low cardiac output syndrome and ventricular fibrillation.Two patients died of cardiogenic shock and renal failure during initial hospitalization after the operation.One patient who received replacement of a tricuspid valve developed complete heart block requiring temporary pacing and recovered sinus rhythm 4 days later.Thirty-two patients survived and their cardiac function was in New York Heart Association (NYHA) class Ⅰ to class Ⅱ when discharged.Late events included hemorrhage and endocarditis.Two patients required

  1. Immunoglobulin Replacement Therapy: When You Need It -- and When You Don't

    Science.gov (United States)

    ... Videos Lists Search Patient Resources Immunoglobulin Replacement Therapy Immunoglobulin Replacement Therapy When you need it—and when ... enough germ-fighting antibodies. A treatment known as immunoglobulin replacement (IgG) therapy can be a lifesaver for ...

  2. Menopausal depression:comparison of hormone replacement therapy and hormone replacement therapy plus fiuoxetine

    Institute of Scientific and Technical Information of China (English)

    刘平; 何方方; 白文佩; 郁琦; 史蔚; 吴宜勇; 贺丹军; 肖计划; 郑晔; 廖秦平

    2004-01-01

    Background To compare the efficacy and safety of hormone replacement therapy (HRT) combined with fluoxetine, with HRT alone, in post-menopausal women suffering from depression.Methods A randomized, open-label, parallel trial was applied. HRT was administered to all patients for 2 cycles, with ]4 days of estrogen therapy and 14 days of estrogen plus progesterone. Patients who were randomly assigned to the HRT plus fluoxetine group were given fluoxetine in combination with HRT. Hamilton Depression Rating Scale (HAMD), Kupperman Menopausal Index (KMI), and Clinical Global Impressions scale were used to measure the efficacy. Results One hundred and twenty-three post-menopausal patients with depression were enrolled in the study. Among them, 120 had at least one post-treatment visit and entered into the statistical analysis. The mean total HAMD scores were significantly lower, and the percentages of HAMD score reductions were higher in the HRT plus fluoxetine Group compared with the HRT Group, after at least 3 weeks of treatment, with an average difference of 5 points at the endpoint. The Clinical Global Impression-Severity and Clinical Global Impression-Improvement scores were significantly different in the 2 groups, in favor of the combination therapy. The mean total KMI was significantly lower in the Combination Group compared with the HRT Group, after at least 6 weeks of treatment, with an average 4. 5-point difference between the groups. No statistically significant differences were found in most of the adverse events reported in the Combination Group compared with the HRT group, with the exception of 3 symptoms, i. e., dry mouth, loss of appetite, and abdominal distention. They were mild to moderate in severity. Two patients in the HRT group, but none in the combination group, dropped out due to adverse events. Conclusion HRT plus fluoxetine therapy was effective in the treatment of menopausal depression with a satisfactory safety profile.

  3. A general approach to total repair cost limit replacement policies

    Directory of Open Access Journals (Sweden)

    F. Beichelt

    2014-01-01

    Full Text Available A common replacement policy for technical systems consists in replacing a system by a new one after its economic lifetime, i.e. at that moment when its long-run maintenance cost rate is minimal. However, the strict application of the economic lifetime does not take into account the individual deviations of maintenance cost rates of single systems from the average cost development. Hence, Beichet proposed the total repair cost limit replacement policy: the system is replaced by a new one as soon as its total repair cost reaches or exceeds a given level. He modelled the repair cost development by functions of the Wiener process with drift. Here the same policy is considered under the assumption that the one-dimensional probability distribution of the process describing the repair cost development is given. In the examples analysed, applying the total repair cost limit replacement policy instead of the economic life-time leads to cost savings of between 4% and 30%. Finally, it is illustrated how to include the reliability aspect into the policy.

  4. Transcatheter Aortic Valve Replacement: Comprehensive Review and Present Status

    Science.gov (United States)

    Misenheimer, Jacob A.; Ramaraj, Radhakrishnan

    2017-01-01

    Aortic stenosis is the most common valvular heart disease in the developed world. About 7% of the population over age 65 years suffers from degenerative aortic stenosis. The prognosis of patients with symptomatic severe aortic stenosis is dismal without valve replacement. Even though the American College of Cardiology recommends aortic valve replacement to treat this condition as a class I recommendation, approximately one third of these patients over the age of 75 years are not referred for surgery. Typically, this is from concern about prohibitive surgical risk associated with patient frailty, comorbidities, age, and severe left ventricular dysfunction. The advent in France of transcatheter aortic valve replacement has raised the hope in the United States for an alternative, less invasive treatment for aortic stenosis. Two recent trials—the Placement of AoRTic TraNscathetER Valve Trial Edwards SAPIEN Transcatheter Heart Valve (Partner) and the CoreValve US Pivotal—have established transcatheter aortic valve replacement as the preferred approach in patients who are at high or prohibitive surgical risk. The more recently published Partner 2 trial has shown the feasibility of transcatheter aortic valve replacement in intermediate-surgical-risk patients as well. With a profile that promises easier use and better valve performance and delivery, newer-generation valves have shown their potential for further improvement in safety profile and overall outcomes. We review the history and status of this topic. PMID:28265210

  5. Continuous Renal Replacement Therapy for Severe Obstetric Sepsis

    Directory of Open Access Journals (Sweden)

    D. L. Shukevich

    2010-01-01

    Full Text Available Objective: to improve the results of treatment for severe obstetric sepsis by pathogenetically founded continuous renal replacement therapies as extracorporeal homeostatic correction. Subjects and methods. Forty-two women with severe abdominal sepsis were divided into 3 groups: 1 14 women with severe extragenital abdominal sepsis who received standard intensive care (a control group; 2 12 women with severe obstetric sepsis who had standard intensive care (a study group; 3 16 with severe obstetric sepsis who had the standard intensive care supplemented with continuous renal replacement therapy (an intervention group. Results. In Group 2, endogenous intoxication and multiple organ dysfunction were controlled later than in Group 1, mortality rates being 41.7 and 7.1%, respectively. Clinical laboratory differences were due to gestosis recorded in 100% of the patients with severe obstetric sepsis. When continuous renal replacement therapy was incorporated into the complex therapy of severe obstetric sepsis, there was a prompter regression of endogenous intoxication and multiple organ dysfunction, mortality was decreased by an average of 35% as compared with that during standard therapy. Conclusion. The inclusion of continuous renal replacement therapy into the complex treatment program for severe obstetric sepsis made it possible to reduce control time _ for endogenous intoxication and multiple organ dysfunction and to decrease mortality by an average of 35% as compared with that during standard intensive care. Key words: obstetric sepsis, abdominal sepsis, gestosis, endogenous intoxication, multiple organ dysfunction, renal replacement therapy.

  6. PERFORMANCE OF PRIVATE CACHE REPLACEMENT POLICIES FOR MULTICORE PROCESSORS

    Directory of Open Access Journals (Sweden)

    Matthew Lentz

    2014-07-01

    Full Text Available Multicore processors have become ubiquitous, both in general-purpose and special-purpose applications. With the number of transistors in a chip continuing to increase, the number of cores in a processor is also expected to increase. Cache replacement policy is an important design parameter of a cache hierarchy. As most of the processor designs have become multicore, there is a need to study cache replacement policies for multi-core systems. Previous studies have focused on the shared levels of the multicore cache hierarchy. In this study, we focus on the top level of the hierarchy, which bears the brunt of the memory requests emanating from each processor core. We measure the miss rates of various cache replacement policies, as the number of cores is steadily increased from 1 to 16. The study was done by modifying the publicly available SESC simulator, which models in detail a multicore processor with a multilevel cache hierarchy. Our experimental results show that for the private L1 caches, the LRU (Least Recently Used replacement policy outperforms all of the other replacement policies. This is in contrast to what was observed in previous studies for the shared L2 cache. The results presented in this paper are useful for hardware designers to optimize their cache designs or the program codes.

  7. Face-specific Replacement of Calcite by Amorphous Silica Nanoparticles

    Science.gov (United States)

    Liesegang, M.; Milke, R.; Neusser, G.; Mizaikoff, B.

    2016-12-01

    Amorphous silica, composed of nanoscale spheres, is an important biomineral, alteration product of silicate rocks on the Earth's surface, and precursor material for stable silicate minerals. Despite constant progress in silica sphere synthesis, fundamental knowledge of natural silica particle interaction and ordering processes leading to colloidal crystals is absent so far. To understand the formation pathways of silica spheres in a geologic environment, we investigated silicified Cretaceous mollusk shell pseudomorphs from Coober Pedy (South Australia) using focused ion beam (FIB)-SEM tomography, petrographic microscopy, µ-XRD, and EMPA. The shells consist of replaced calcite crystals (product, the advancement of synchronized dissolution and precipitation fronts along lattice planes is essential. We assume that the volume-preserving replacement process proceeds via a face-specific dissolution-precipitation mechanism with intermediate subparticle aggregation and subsequent layer-by-layer deposition of spheres along a planar surface. Porosity created during the replacement reaction allows permanent fluid access to the propagating reaction interface. Fluid pH and ionic strength remain constant throughout the replacement process, permitting continuous silica nanoparticle formation and diffusion-limited colloid aggregation. Our study provides a natural example of the transformation of an atomic crystal to an amorphous, mesoscale ordered material; thus, links the research fields of natural colloidal crystal formation, carbonate-silica replacement, and crystallization by oriented particle aggregation (CPA).

  8. Synthetic Versus Tissue-Engineered Implants for Joint Replacement

    Directory of Open Access Journals (Sweden)

    Duncan E. T. Shepherd

    2007-01-01

    Full Text Available Human synovial joints are remarkable as they can last for a lifetime. However, they can be affected by disease that may lead to destruction of the joint surface. The most common treatment in the advanced stages of joint disease is artificial joint replacement, where the diseased synovial joint is replaced with an artificial implant made from synthetic materials, such as metals and polymers. A new technique for repairing diseased synovial joints is tissue engineering where cells are used to grow replacement tissue. This paper explores the relative merits of synthetic and tissue-engineered implants, using joint replacement as an example. Synthetic joint replacement is a well-established procedure with the advantages of early mobilisation, pain relief and high patient satisfaction. However, synthetic implants are not natural tissues; they can cause adverse reactions to the body and there could be a mismatch in mechanical properties compared to natural tissues. Tissue-engineered implants offer great potential and have major advantages over synthetic implants as they are natural tissue, which should ensure that they are totally biocompatible, have the correct mechanical properties and integrate well with the existing tissue. However, there are still many limitations to be addressed in tissue engineering such as scaling up for production, bioreactor design, appropriate regulation and the potential for disease to attack the new tissue-engineered implant.

  9. Impact of prosthesis-patient mismatch on survival after mitral valve replacement: a systematic review

    Institute of Scientific and Technical Information of China (English)

    ZHANG Jian-feng; WU Yi-cheng; SHEN Wei-feng; KONG Ye

    2013-01-01

    Objective To determine whether the prosthesis-patient mismatch has a deleterious impact on survival after mitral valve replacement.Data sources A comprehensive literature search of PubMed,Embase,and ScienceDirect was carried out.References and cited papers of relevant articles were also checked.Study selection All articles published after January 1980 was initially considered.Non-English and non-human studies,case reports,and reviews were excluded from the initial search.References and cited papers of relevant articles were also checked.Results A total of 8 retrospective cohort studies were identified for this review.The overall incidence of prosthesis-patient mismatch (<1.3 to <1.2 cm2/m2) after mitral valve replacement ranged from 3.7% to 85.9% (moderate prosthesis-patient mismatch (0.9 to 1.2 cm2/m2) in 37.4% to 69.5%,severe prosthesis-patient mismatch (<0.9 cm2/m2) in 8.7% to 16.4%).Four studies demonstrated an association of prosthesis-patient mismatch with reduced long-term survival,but the other four studies found no significant deleterious impact of prosthesis-patient mismatch after mitral valve replacement.No definite conclusion could be derived from these conflicting results.Conclusions Current evidence is insufficient to derive a definite conclusion whether mitral prosthesis-patient mismatch affects long-term survival because of the biases and confounding factors that interfere with late clinical outcomes.Good-quality prospective studies are warranted to evaluate the impact of mitral prosthesis-patient mismatch after mitral valve replacement in the future.

  10. Total ankle replacement. Early experiences with STAR prosthesis.

    Science.gov (United States)

    Murnaghan, J. M.; Warnock, D. S.; Henderson, S. A.

    2005-01-01

    Early designs of Total Ankle Replacement (TAR) had a high failure rate. More recent experience with the 3-piece, meniscal bearing, total ankle replacement has been more promising. We report a review of the early results of our first 22 prostheses in 20 patients undergoing Scandinavian Total Ankle Replacement (STAR) in Northern Ireland. There was a mean follow-up time of 26 months. Seventeen patients are pain-free at the ankle joint during normal daily activities. Two of the early cases have required revision surgery due to technical errors. Other complications have included malleolar fractures, poor wound healing and postoperative stiffness. These early results show high levels of patient satisfaction, and we are encouraged to continue with total ankle arthroplasty. There is a steep initial learning curve and use of TAR should be restricted to foot and ankle surgeons. Images Fig 1 Figs 2a and b Figs 2 c and d PMID:16022128

  11. SERUM MAGNESIUM LEVELS IN AORTIC AND MITRAL VALVE REPLACEMENT SURGERIES

    Directory of Open Access Journals (Sweden)

    Srinivasa Rao

    2015-08-01

    Full Text Available BACKGROUND : The purpose of the study was to analyze serum magnesium concentration in patients undergoing Aortic and Mitral Valve replacement surgeries. METHODS: This prospective study was conducted in 60 patients who underwent elective Aortic and Mitral va lve replacement surgeries. Blood samples from radial artery were collected just before induction of anesthesia and three days post - operatively for estimation of serum magnesium. RESULTS: Magnesium level was 2.02mg/dl at baseline, 2.28mg/dl, 2.08mg/dl and 1 .90mg/dl respectively on three consecutive days post - operatively. CONCLUSION: The lowering of serum magnesium in Aortic and Mitral valve replacement surgeries postoperatively recommends the use of routine serum magnesium determination and administration to prevent post - operative arrhythmias.

  12. Salto Talaris fixed-bearing total ankle replacement system.

    Science.gov (United States)

    Rush, Shannon M; Todd, Nicholas

    2013-01-01

    The Salto Talaris total ankle replacement is an anatomically designed fixed bearing prosthesis available in the United States based on the successful design of the mobile-bearing Salto prosthesis available outside the United States. The original mobile-bearing design was modified and the mobile-bearing was transferred to the precision instrumentation at the trial phase evaluation. Instrumentation and technique allow the surgeon to determine the functional joint axis before final implantation. The Salto Talaris total ankle replacement design blends minimal bone resection and optimizes surface area, cortical contact, and ultra-high molecular weight polyethylene conformity. The authors present an overview of the Salto Talaris total ankle replacement surgical technique and pearls for successful application.

  13. Stresses in the ankle joint and total ankle replacement design.

    Science.gov (United States)

    Kakkar, Rahul; Siddique, M S

    2011-06-01

    The ankle is a highly congruent joint with a surface area of 11-13 cm(2). Total ankle replacements have been attempted since the early 1970s and design has continually evolved as the early designs were a failure. This was because the stresses involved and the mutiaxial motion of the ankle has not been understood until recently. It has been shown that the talus slides as well as rolls during the ankle arc of motion from plantarflexion to dorsiflexion. Furthermore, the articular surfaces and the calcaneofibular and tibiocalcaneal ligaments have been shown to form a four bar linkage dictating ankle motion. A new design ankle replacement has been suggested recently which allows multiaxial motion at the ankle while maintaining congruency throughout the arc of motion. The early results of this ankle replacement have been encouraging without any reported failures due to mechanical loosening.

  14. Applications of molecular replacement to G protein-coupled receptors

    Energy Technology Data Exchange (ETDEWEB)

    Kruse, Andrew C.; Manglik, Aashish; Kobilka, Brian K., E-mail: kobilka@stanford.edu [Stanford University, 279 Campus Drive, Stanford, CA 94305 (United States); Weis, William I., E-mail: kobilka@stanford.edu [Stanford University, 279 Campus Drive, Stanford, CA 94305 (United States); Stanford University, Fairchild Building, Stanford, CA 94305 (United States)

    2013-11-01

    The use of molecular replacement in solving the structures of G protein-coupled receptors is discussed, with specific examples being described in detail. G protein-coupled receptors (GPCRs) are a large class of integral membrane proteins involved in regulating virtually every aspect of human physiology. Despite their profound importance in human health and disease, structural information regarding GPCRs has been extremely limited until recently. With the advent of a variety of new biochemical and crystallographic techniques, the structural biology of GPCRs has advanced rapidly, offering key molecular insights into GPCR activation and signal transduction. To date, almost all GPCR structures have been solved using molecular-replacement techniques. Here, the unique aspects of molecular replacement as applied to individual GPCRs and to signaling complexes of these important proteins are discussed.

  15. Respondent-Driven Sampling – Testing Assumptions: Sampling with Replacement

    Directory of Open Access Journals (Sweden)

    Barash Vladimir D.

    2016-03-01

    Full Text Available Classical Respondent-Driven Sampling (RDS estimators are based on a Markov Process model in which sampling occurs with replacement. Given that respondents generally cannot be interviewed more than once, this assumption is counterfactual. We join recent work by Gile and Handcock in exploring the implications of the sampling-with-replacement assumption for bias of RDS estimators. We differ from previous studies in examining a wider range of sampling fractions and in using not only simulations but also formal proofs. One key finding is that RDS estimates are surprisingly stable even in the presence of substantial sampling fractions. Our analyses show that the sampling-with-replacement assumption is a minor contributor to bias for sampling fractions under 40%, and bias is negligible for the 20% or smaller sampling fractions typical of field applications of RDS.

  16. Greedy feature replacement for online value function approximation

    Institute of Scientific and Technical Information of China (English)

    Feng-fei ZHAO; Zheng QIN; Zhuo SHAO; Jun FANG; Bo-yan REN

    2014-01-01

    Reinforcement learning (RL) in real-world problems requires function approximations that depend on selecting the appropriate feature representations. Representational expansion techniques can make linear approximators represent value functions more effectively;however, most of these techniques function well only for low dimensional problems. In this paper, we present the greedy feature replacement (GFR), a novel online expansion technique, for value-based RL algorithms that use binary features. Given a simple initial representation, the feature representation is expanded incrementally. New feature dependencies are added automatically to the current representation and conjunctive features are used to replace current features greedily. The virtual temporal difference (TD) error is recorded for each conjunctive feature to judge whether the replacement can improve the approximation. Correctness guarantees and computational complexity analysis are provided for GFR. Experimental results in two domains show that GFR achieves much faster learning and has the capability to handle large-scale problems.

  17. Spontaneous Coronary Artery Dissection following Topical Hormone Replacement Therapy

    Directory of Open Access Journals (Sweden)

    Alexander L. Pan

    2012-01-01

    Full Text Available Spontaneous coronary artery dissection is a rare condition, usually presenting as an acute coronary syndrome, and is often seen in states associated with high systemic estrogen levels such as pregnancy or oral contraceptive use. While topical hormonal replacement therapy may result in increased estrogen levels similar to those documented with oral contraceptive use, there are no reported cases of spontaneous coronary dissection with topical hormonal replacement therapy. We describe a 53-year-old female who developed two spontaneous coronary dissections while on topical hormonal replacement therapy. The patient had no other risk factors for coronary dissection. After withdrawal from topical hormonal therapy, our patient has done well and has not had recurrent coronary artery dissections over a one-year follow-up period. The potential contributory role of topical hormonal therapy as a cause of spontaneous coronary dissection should be recognized.

  18. Failure rate of cemented and uncemented total hip replacements

    DEFF Research Database (Denmark)

    Makela, K. T.; Matilainen, M.; Pulkkinen, P.

    2014-01-01

    Objective To assess the failure rate of cemented, uncemented, hybrid, and reverse hybrid total hip replacements in patients aged 55 years or older. Design Register study. Setting Nordic Arthroplasty Register Association database (combined data from Sweden, Norway, Denmark, and Finland......). Participants 347 899 total hip replacements performed during 1995-2011. Main outcome measures Probability of implant survival (Kaplan-Meier analysis) along with implant survival with revision for any reason as endpoint (Cox multiple regression) adjusted for age, sex, and diagnosis in age groups 55-64, 65......-74, and 75 years or older. Results The proportion of total hip replacements using uncemented implants increased rapidly towards the end of the study period. The 10 year survival of cemented implants in patients aged 65 to 74 and 75 or older (93.8%, 95% confidence interval 93.6% to 94.0% and 95.9%, 95...

  19. Recent patents and designs on hip replacement prostheses.

    Science.gov (United States)

    Derar, H; Shahinpoor, M

    2015-01-01

    Hip replacement surgery has gone through tremendous evolution since the first procedure in 1840. In the past five decades the advances that have been made in technology, advanced and smart materials innovations, surgical techniques, robotic surgery and methods of fixations and sterilization, facilitated hip implants that undergo multiple design revolutions seeking the least problematic implants and a longer survivorship. Hip surgery has become a solution for many in need of hip joint remedy and replacement across the globe. Nevertheless, there are still long-term problems that are essential to search and resolve to find the optimum implant. This paper reviews several recent patents on hip replacement surgery. The patents present various designs of prostheses, different materials as well as methods of fixation. Each of the patents presents a new design as a solution to different issues ranging from the longevity of the hip prostheses to discomfort and inconvenience experienced by patients in the long-term.

  20. Replacement Attack: A New Zero Text Watermarking Attack

    Science.gov (United States)

    Bashardoost, Morteza; Mohd Rahim, Mohd Shafry; Saba, Tanzila; Rehman, Amjad

    2017-03-01

    The main objective of zero watermarking methods that are suggested for the authentication of textual properties is to increase the fragility of produced watermarks against tampering attacks. On the other hand, zero watermarking attacks intend to alter the contents of document without changing the watermark. In this paper, the Replacement attack is proposed, which focuses on maintaining the location of the words in the document. The proposed text watermarking attack is specifically effective on watermarking approaches that exploit words' transition in the document. The evaluation outcomes prove that tested word-based method are unable to detect the existence of replacement attack in the document. Moreover, the comparison results show that the size of Replacement attack is estimated less accurate than other common types of zero text watermarking attacks.

  1. The replacement of serum by hormones in cell culture media.

    Science.gov (United States)

    Sato, G; Hayashi, I

    1976-12-01

    The replacement of serum by hormones in cell culture media. (Reemplazo del suero por hormonas en el medio de cultivo de células). Arch. Biol. Med. Exper. 10: 120-121, 1976. The serum used in cell culture media can be replaced by a mixture of hormones and some accesory blood factors. The pituitary cell line GH3 can be grown in a medium in which serum is replaced by triiodothyronine, transferrin, parathormone, tyrotrophin releasing hormone and somatomedins. Hela and BHK cell strains can also be grown in serum free medium supplemented with hormones. Each cell type appears to have different hormonal requirements yet it may found that some hormones are required for most cell types.

  2. Prospects for replacement of auditory neurons by stem cells.

    Science.gov (United States)

    Shi, Fuxin; Edge, Albert S B

    2013-03-01

    Sensorineural hearing loss is caused by degeneration of hair cells or auditory neurons. Spiral ganglion cells, the primary afferent neurons of the auditory system, are patterned during development and send out projections to hair cells and to the brainstem under the control of largely unknown guidance molecules. The neurons do not regenerate after loss and even damage to their projections tends to be permanent. The genesis of spiral ganglion neurons and their synapses forms a basis for regenerative approaches. In this review we critically present the current experimental findings on auditory neuron replacement. We discuss the latest advances with a focus on (a) exogenous stem cell transplantation into the cochlea for neural replacement, (b) expression of local guidance signals in the cochlea after loss of auditory neurons, (c) the possibility of neural replacement from an endogenous cell source, and (d) functional changes from cell engraftment. Copyright © 2013 Elsevier B.V. All rights reserved.

  3. In this issue: Time to replace doctors’ judgement with computers

    Directory of Open Access Journals (Sweden)

    Simon de Lusignan

    2015-11-01

    Full Text Available Informaticians continue to rise to the challenge, set by the English Health Minister, of trying to replace doctors’ judgement with computers. This issue describes successes and where there are barriers. However, whilst there is progress this tends to be incremental and there are grand challenges to be overcome before computers can replace clinician. These grand challenges include: (1 improving usability so it is possible to more readily incorporate technology into clinical workflow; (2 rigorous new analytic methods that make use of the mass of available data, ‘Big data’, to create real-world evidence; (3 faster ways of meeting regulatory and legal requirements including ensuring privacy; (4 provision of reimbursement models to fund innovative technology that can substitute for clinical time and (5 recognition that innovations that improve quality also often increase cost. Informatics more is likely to support and augment clinical decision making rather than replace clinicians.

  4. Supervised neuromuscular exercise prior to hip and knee replacement

    DEFF Research Database (Denmark)

    Fernandes, Linda; Roos, Ewa M; Overgaard, Søren

    2017-01-01

    BACKGROUND: There are indications of beneficial short-term effect of pre-operative exercise in reducing pain and improving activity of daily living after total hip replacement (THR) and total knee replacement (TKR) surgery. Though, information from studies conducting longer follow-ups and economic...... evaluations of exercise prior to THR and TKR is needed. The aim of the study was to analyse 12-month clinical effect and cost-utility of supervised neuromuscular exercise prior to THR and TKR surgery. METHODS: The study was conducted alongside a randomised controlled trial including 165 patients scheduled...... for standard THR or TKR at a hospital located in a rural area of Denmark. The patients were randomised to replacement surgery with or without an 8-week preoperative supervised neuromuscular exercise program (Clinical Trials registration no.: NCT01003756). Clinical effect was measured with Hip disability...

  5. Meal Replacement Mass Reduction and Integration Acceptability Study

    Science.gov (United States)

    Sirmons, T.; Barrett, A.; Richardson, M.; Arias, D.; Schneiderman, J.; Slack, K.; Williams, T.; Douglas, G.

    2017-01-01

    NASA, in planning for long-duration missions, has an imperative to provide a food system with the necessary nutrition, acceptability, and safety to ensure sustainment of crew health and performance. The Orion Multi-Purpose Crew Vehicle (MPCV) and future exploration missions are mass constrained; therefore the team is challenged to reduce the mass of the food system by 10% while maintaining product safety, nutrition, and acceptability. Commercially available products do not meet the nutritional requirements for a full meal replacement in the spaceflight food system, and it is currently unknown if daily meal replacements will impact crew food intake and psychosocial health over time. The purpose of this study was to develop a variety of nutritionally balanced breakfast replacement bars that meet spaceflight nutritional, microbiological, sensorial, and shelf-life requirements, while enabling a 10% savings in food mass. To date, six nutrient-dense meal replacement bars (approximately 700 calories per bar) have been developed, using traditional methods of compression as well as novel ultrasonic compression technologies developed by Creative Resonance Inc. (Phoenix, AZ). The four highest rated bars were evaluated in the Human Exploration Research Analog (HERA) to assess the frequency with which actual meal replacement options may be implemented. Specifically, overall impact of bars on mood, satiety, digestive discomfort, and satisfaction with food. These factors are currently being analyzed to inform successful implementation strategies where crew maintain adequate food intake. In addition, these bars are currently undergoing shelf-life testing to determine long-term sensory acceptability, nutritional stability, qualitative stability of analytical measurements (i.e. water activity and texture), and microbiological compliance over two years of storage at room temperature and potential temperature abuse conditions to predict long-term acceptability. It is expected that

  6. Tricuspid Valve Replacement, Mechnical vs. Biological Valve, Which Is Better?

    Directory of Open Access Journals (Sweden)

    Haitham Akram Altaani

    2013-06-01

    Full Text Available Background: The initial trial in tricuspid surgery is repair; however, replacement is done whenever the valve is badly diseased. Tricuspid valve replacement comprises 1.7% of all tricuspid valve surgeries. Materials and Methods: The present retrospective study was performed using the medical records of 21 cases who underwent tricuspid valve replacement from January 2002 until the end of December 2010. The mean age of the participants was 52.3±8.8 years and 66.7% were females. In addition, tricuspid valve replacement was associated with mitral valve surgery, aortic valve surgery, and both in 14.3%, 4.8%, and 33.3% of the cases, respectively. Yet, isolated tricuspid valve replacement and redo surgery were performed in 10 cases (47.6% and 8 cases (38.1%, respectively. Besides, trial of repair was done in 14 cases (66.7%. Moreover, biological and mechanical valves were used in 76.2% and 23.8% of the patients, respectively. Results: According to the results, early mortality was 23.8% and one year survival was 66.7%. Moreover, early mortality was caused by right ventricular failure, multiorgan failure, medistinitis, and intracerbral bleeding in 42%, 28.6%, 14.3%, and 14.3% of the cases, respectively. In addition, 57.1% of the deaths had occurred in the cases where the biological valve was used, while 42.9% of the deaths had taken place where the mechanical one was utilized. Conclusions: The patients who require tricuspid valve replacement are usually high risk surgical candidates with early and long term mortality. The findings of the current study showed no significant hemodynamic difference between mechanical and biological valves.

  7. Proximal femoral replacement for the treatment of periprosthetic fractures.

    Science.gov (United States)

    Klein, Gregg R; Parvizi, Javad; Rapuri, Venkat; Wolf, Christopher F; Hozack, William J; Sharkey, Peter F; Purtill, James J

    2005-08-01

    A periprosthetic fracture around the femoral component is a rare but potentially problematic complication after total hip arthroplasty. Reconstruction can be challenging, especially when severe bone stock deficiency is encountered. Proximal femoral replacement is one method of treating the severely deficient proximal part of the femur. The present report describes the outcomes of revision total hip arthroplasty with use of a proximal femoral replacement in a cohort of patients who had a Vancouver type-B3 periprosthetic fracture. With use of a computerized institutional database, all patients in whom a Vancouver type-B3 fracture (characterized by severe proximal bone deficiency and a loose femoral stem) had been treated with a proximal femoral replacement were identified. A modular femoral replacement with proximal porous coating had been used in all cases. The twenty-one patients who were identified had had a mean age of 78.3 years (range, fifty-two to ninety years) at the time of the index operation. The clinical and radiographic records of these patients were reviewed. At the time of the latest follow-up (mean, 3.2 years), all but one of the patients were able to walk and had minimal to no pain. Complications included persistent wound drainage that was treated with incision and drainage (two hips), dislocation (two hips), refracture of the femur distal to the stem (one hip), and acetabular cage failure (one hip). Despite a relatively high complication rate, we believe that proximal femoral replacement is a viable option for the treatment of periprosthetic fractures in older patients with severe bone deficiency. If a proximal femoral replacement is used, the stability of the hip must be tested diligently intraoperatively and a constrained acetabular liner should be utilized if instability is encountered. In order to enhance the bone stock, the proximal part of the femur, however poor in quality, should be retained for reapproximation onto the implant.

  8. Minimally Invasive Mitral Valve Replacement and Transfemoral Aortic Valve Implantation.

    Science.gov (United States)

    Rustenbach, Christian; Baumbach, Hardy; Hill, Stephan; Franke, Ulrich F W

    2015-01-01

    The case is reported of a symptomatic elderly patient with severe mitral regurgitation, severe aortic valve stenosis, and coronary heart disease. The coronary artery disease had been interventionally treated four years previously with stent implantation into the right coronary artery. Published studies have shown that a combination of mitral and aortic valve surgery is associated with a significantly increased risk of mortality and morbidity, particularly in elderly patients. In the present patient, both valvular malformations were successfully treated with a single-step interdisciplinary approach, namely an initial surgical mitral valve replacement followed by transfemoral transcatheter aortic valve replacement.

  9. Application of ionizing radiation in sterilization of Selasan milk replacer

    Energy Technology Data Exchange (ETDEWEB)

    Olbrichova, D.; Zouharova, A.; Buriankova, E. (Statni Vyzkumny Ustav Textilni, Veverska Bityska (Czechoslovakia). Centrum Radiacnich Technologii)

    1984-08-01

    The effect of eight ascending doses of radiation within the range of 3 to 30 kGy on isolated microflora was observed in the milk replacer Selasan with initial contamination 4.9x10/sup 4/ germs per 1 gram of preparation. Microorganisms which survived the said radiation dose were evaluated micro and macroscopically. The level of resistance of isolates was determined on the basis of parameters of inactivation curves Nsub(D)=N/sub 0/.esup(-kD). The obtained data served as the basis for determining the minimum sterilization dose 25 kGy for the Selasan replacer.

  10. Replacing a battery by a nanogenerator with 20 V output

    Energy Technology Data Exchange (ETDEWEB)

    Hu, Youfan; Lin, Long; Zhang, Yan; Wang, Zhong Lin [School of Material Science and Engineering, Georgia Institute of Technology, Atlanta, Georgia (United States)

    2012-01-03

    Replacing batteries by nanogenerators (NGs) in small consumer electronics is one of the goals in the emerging field of self-powered nanotechnology. We show that the maximum measured output voltage of an NG optimized with pretreatments on the as-grown ZnO nanowire films reaches 20 V and the output current exceeds 6 {mu}A, which corresponds to a power density of 0.2 W cm{sup -3}. The NG is also demonstrated to replace a battery for driving a electronic watch. (Copyright copyright 2012 WILEY-VCH Verlag GmbH and Co. KGaA, Weinheim)

  11. Atrioventricular valve replacement in functional single-ventricle patients

    Institute of Scientific and Technical Information of China (English)

    ZHANG Zhong; CEN Jian-zheng; XU Gang; WEN Shu-sheng; CHEN Ji-mei

    2016-01-01

    Background This article summarized the experience of atrioventricular valve replacement operation for functional single ventricle patients whose atrioventricular valve was insufficiency.The follow-up time of operation was arranged from early-to medium-term.Methods From July 2009 to July 2015,there were 40 patients of functional single ventricle receiving the operation of atrioventricular valve replacement,including 23 male and 17 female patients.The age at A-Ⅴ valve replacement was ranged from 6 days to 32 years (the medium age of 9 years),and the body weight ranged from 2.7 to 57 kg (the medium body weight of 21.5 kg).Moreover,the atrioventricular valve replacement was performed on all patients under extracorporeal circulation.Results Atrioventricular valve replacement was performed on 40 patients with function single ventricle in hospital,of which eight (20.0%) died in hospital including two neonate and infant (age range:6 days-2 years old) accounting for 25% (2/8),Among them,seven patients died of low cardiac output syndrome two patients with repeated hypoxemia concurrent infection after operation,and one with bilateral diaphragmatic paralysis and malignant arrhythmia.For the patients suffering the severe perivalvular leakage,there was a reoperation,and the cardiac function before the first operation was class Ⅳ.One patient received heart transplantation finally for severe heart failure after AV valve replacement.For the rest of patients,their cardiac function recovered to class Ⅰ-Ⅱ after operation.Conclusions For function single ventricle patients with atrioventricular valve regurgitation,the mortality rate of atrioventricular valve replacement can be accepted if the operation was indicated.For patients with severe atrioventricular value regurgitation,the result of the operation in the early and medium term was satisfying.Thus,the atrioventricular valve replacement served as a useful treatment for patients diagnosed of A-Ⅴ valve regurgitation and

  12. Replacing the Irreplaceable: Fast Algorithms for Team Member Recommendation

    OpenAIRE

    Li, Liangyue; Tong, Hanghang; Cao, Nan; Ehrlich, Kate; Lin, Yu-Ru; Buchler, Norbou

    2014-01-01

    In this paper, we study the problem of Team Member Replacement: given a team of people embedded in a social network working on the same task, find a good candidate who can fit in the team after one team member becomes unavailable. We conjecture that a good team member replacement should have good skill matching as well as good structure matching. We formulate this problem using the concept of graph kernel. To tackle the computational challenges, we propose a family of fast algorithms by (a) d...

  13. Chaos identification based on CMAC with replacing eligibility learning

    Institute of Scientific and Technical Information of China (English)

    SUN Yan-zhong

    2009-01-01

    In the conventional CMAC learning scheme, the correcting amounts of errors are equally distributed into all addressed weight, regardless the temporal credibility of those weights. In order to solve the temporal credit assignment problem of the CMAC, an improved CMAC neural network based on replacing eligibility learning concept was designed. The proposed improved leaning approach uses the replacing eligibility learning concept of the reinforcement learning to improve the prediction capability. The simulations for chaotic system identification show that the improved CMAC neural network is effective.

  14. Who should have knee joint replacement surgery for osteoarthritis?

    DEFF Research Database (Denmark)

    Dieppe, Paul; Lim, Keith; Lohmander, Stefan

    2011-01-01

    Knee joint replacement is an effective and cost-effective intervention for severe symptomatic osteoarthritis of the knee joint. However, utilisation rates vary hugely, there are no indications, it is difficult to know when (in the course of arthritis) it is best to operate, and some 10-20% of peo......Knee joint replacement is an effective and cost-effective intervention for severe symptomatic osteoarthritis of the knee joint. However, utilisation rates vary hugely, there are no indications, it is difficult to know when (in the course of arthritis) it is best to operate, and some 10...

  15. New protein involved in the replacement of cell molecules

    DEFF Research Database (Denmark)

    Poulsen, Jesper Buchhave

    2011-01-01

    In collaboration with colleagues from La Trobe University, Australia, scientists at Aarhus University have discovered and defined a novel enzyme involved in the replacement and renewal of cell molecules. The enzyme exerts its function within the so-called mitochondria - small “enclosed” compartme......In collaboration with colleagues from La Trobe University, Australia, scientists at Aarhus University have discovered and defined a novel enzyme involved in the replacement and renewal of cell molecules. The enzyme exerts its function within the so-called mitochondria - small “enclosed...

  16. The instability of wrist joint and total wrist replacement

    Institute of Scientific and Technical Information of China (English)

    Jin-xing Ma; Yong-Qing Xu

    2016-01-01

    Total wrist arthroplasty are not used as widely as total knee and hip replacement.The functional hands are requiring surgeons to design a durable and functional satisfying prosthesis.This article will list the main reasons that cause the failure of the prosthesis.Some remarkable and representative prostheses are listed to show the devolvement of total wrist prosthesis and their individual special innovations to fix the problems,And the second part we will discuss the part that biomechanical elements act in the total wrist replacement (TWA).Summarize and find out what the real problem is and how we can find a way to fix it.

  17. Supervised neuromuscular exercise prior to hip and knee replacement

    DEFF Research Database (Denmark)

    Fernandes, Linda; Roos, Ewa M; Overgaard, Søren

    2017-01-01

    BACKGROUND: There are indications of beneficial short-term effect of pre-operative exercise in reducing pain and improving activity of daily living after total hip replacement (THR) and total knee replacement (TKR) surgery. Though, information from studies conducting longer follow-ups and economic...... and Osteoarthritis Outcome Score (HOOS) and Knee injury and Osteoarthritis Outcome Score (KOOS). Quality adjusted life years (QALYs) were based on EQ-5D-3L and Danish preference weights. Resource use was extracted from national registries and valued using standard tariffs (2012-EUR). Incremental net benefit...

  18. Fluid replacement following dehydration reduces oxidative stress during recovery.

    Science.gov (United States)

    Paik, Il-Young; Jeong, Myung-Hyun; Jin, Hwa-Eun; Kim, Young-Il; Suh, Ah-Ram; Cho, Su-Youn; Roh, Hee-Tae; Jin, Chan-Ho; Suh, Sang-Hoon

    2009-05-22

    To investigate the effects of hydration status on oxidative DNA damage and exercise performance, 10 subjects ran on a treadmill until exhaustion at 80% VO(2max) during four different trials [control (C), 3% dehydration (D), 3% dehydration+water (W) or 3% dehydration+sports drink (S)]. Dehydration significantly decreased exercise time to exhaustion (DDehydration significantly increased oxidative DNA damage during exercise, but fluid replacement with water or sports drink alleviated it equally. These results suggest that (1) dehydration impairs exercise performance and increases DNA damage during exercise to exhaustion; and (2) fluid replacement prolongs exercise endurance and attenuates DNA damage.

  19. Therapy of hypoparathyroidism by replacement with parathyroid hormone

    DEFF Research Database (Denmark)

    Rejnmark, Lars; Underbjerg, Line; Sikjaer, Tanja

    2014-01-01

    Hypoparathyroidism (HypoPT) is a state of hypocalcemia due to inappropriate low levels of parathyroid hormone (PTH). HypoPT is normally treated by calcium supplements and activated vitamin D analogues. Although plasma calcium is normalized in response to conventional therapy, quality of life (Qo......L) seems impaired and patients are at increased risk of renal complications. A number of studies have suggested subcutaneous injections with PTH as an alternative therapy. By replacement with the missing hormone, urinary calcium may be lowered and QoL may improve. PTH replacement therapy (PTH-RT) possesses...

  20. Chimney technique for mitral valve replacement in children.

    Science.gov (United States)

    González Rocafort, Álvaro; Aroca, Ángel; Polo, Luz; Rey, Juvenal; Villagrá, Fernando

    2013-11-01

    Severe mitral stenosis is unusual in children, but it represents an important challenge for surgeons because of the scarcity of solutions. Several mitral percutaneous and surgical valvuloplasties are performed repetitively to delay mitral valve replacement. Most of the time these procedures show discouraging results. When mitral valve replacement is performed, the annulus may not be large enough to fit a substitute. We present, to our best knowledge, a new technique to implant a large prosthesis in a small annulus without negatively affecting the opening of the leaflets.

  1. Primary extra-cranial meningioma following total hip replacement

    Energy Technology Data Exchange (ETDEWEB)

    Campbell, T.J.; Beggs, I. [Royal Infirmary, Department of Radiology, Edinburgh (United Kingdom); Patton, J.T.; Porter, D. [Royal Infirmary, Department of Orthopaedics, Edinburgh (United Kingdom); Salter, D.M.; Al-Nafussi, A. [Royal Infirmary, Department of Pathology, Edinburgh (United Kingdom)

    2009-01-15

    A 61-year-old man presented with pain at the left hip and decreased mobility 10 years after total hip replacement. Imaging demonstrated a large destructive expansile mass adjacent to the prosthesis. Histological analysis confirmed the presence of an extra-cranial meningioma. Primary tumours after total hip replacement are rare and include soft tissue sarcomas, bone sarcomas and lymphomas. To our knowledge, no previous cases of primary extracranial meningioma have been identified. The imaging features, histology, pathogenesis and differential diagnosis are discussed. (orig.)

  2. Political Participation Online: The Replacement and the Mobilisation Hypotheses Revisited

    DEFF Research Database (Denmark)

    Jensen, Jakob Linaa

    2013-01-01

    of the Internet. The pure replacement hypothesis is rejected. Instead, it is found that the Internet still supplements rather than replaces other media, even among heavy Internet users. The Internet is one among several media used by ‘media omnivores’, and political participation online supplements rather than...... participation, efficacy and social capital seem to have less impact on online political participation. In the end, these findings are related to more overall discussions on the democratising potential of the Internet....

  3. Fatty replacement of lower paraspinal muscles: normal and neuromuscular disorders

    Energy Technology Data Exchange (ETDEWEB)

    Hader, H.; Gadoth, N.; Heifetz, H.

    1983-11-01

    The physiologic replacement of the lower paraspinal muscles by fat was evaluated in 157 patients undergoing computed tomography for reasons unrelated to abnormalities of the locomotor system. Five patients with neuromuscular disorders were similarly evaluated. The changes were graded according to severity at three spinal levels: lower thoracic-upper lumbar, midlumbar, and lumbosacral. The results were analyzed in relation to age and gender. It was found that fatty replacement of paraspinal muscles is a normal age-progressive phenomenon most prominent in females. It progresses down the spine, being most advanced in the lumbosacral region. The severest changes in the five patients with neuromuscular disorders (three with poliomyelitis and two with progressive muscular dystrophy) consisted of complete muscle group replacement by fat. In postpoliomyelitis atrophy, the distribution was typically asymmetric and sometimes lacked clinical correlation. In muscular dystrophy, fatty replacement was symmetric, showing relative sparing of the psoas and multifidus muscles. In patients with neuromuscular diseases, computed tomography of muscles may be helpful in planning a better rehabilitation regimen.

  4. Quantitative image analysis for planning of aortic valve replacement

    NARCIS (Netherlands)

    Elattar, M.A.I.M.

    2016-01-01

    Aortic stenosis is the most common and frequent cause of sudden death among all valvular heart diseases. Symptomatic aortic stenosis is considered to be a fatal disease if left untreated. Aortic valve replacement is the mainstay of treatment of symptomatic aortic stenosis. Traditional treatment of s

  5. Quantitative image analysis for planning of aortic valve replacement

    NARCIS (Netherlands)

    Elattar, M.A.I.M.

    2016-01-01

    Aortic stenosis is the most common and frequent cause of sudden death among all valvular heart diseases. Symptomatic aortic stenosis is considered to be a fatal disease if left untreated. Aortic valve replacement is the mainstay of treatment of symptomatic aortic stenosis. Traditional treatment of

  6. Replacing Copper with Aluminum” Looms Large

    Institute of Scientific and Technical Information of China (English)

    2012-01-01

    <正>It is said that Yunnan Aluminum has completed China’s first proprietary production line of high-strength aluminum alloy round bars with annual capacity of 40,000 tons. The topic of "replacing copper with aluminum" has heated up again.

  7. Environmental Assessment and (FONSI) Winnett School District Boiler Replacement Project.

    Science.gov (United States)

    Department of Energy, Washington, DC.

    An analysis is presented of the environmental impacts of replacing the Winnett School District's existing oil-fired heating system with a new coal-fired heating system with funds provided from a grant under the Institutional Conservation Program. The report first covers the background and need for action, along with the alternative actions…

  8. Soybean meal, distillers grains replace fishmeal in experimental shrimp diets

    Science.gov (United States)

    The objective of this study was to evaluate inclusion of distiller’s dried grains with solubles (DDGS) as partial replacement of commercial, solvent-extracted soybean meal (SBM) in fish meal-free diets for Pacific white shrimp, Litopenaeus vannamei. Aquaria connected to a recirculating biofiltratio...

  9. Mitochondrial gene replacement in primate offspring and embryonic stem cells.

    Science.gov (United States)

    Tachibana, Masahito; Sparman, Michelle; Sritanaudomchai, Hathaitip; Ma, Hong; Clepper, Lisa; Woodward, Joy; Li, Ying; Ramsey, Cathy; Kolotushkina, Olena; Mitalipov, Shoukhrat

    2009-09-17

    Mitochondria are found in all eukaryotic cells and contain their own genome (mitochondrial DNA or mtDNA). Unlike the nuclear genome, which is derived from both the egg and sperm at fertilization, the mtDNA in the embryo is derived almost exclusively from the egg; that is, it is of maternal origin. Mutations in mtDNA contribute to a diverse range of currently incurable human diseases and disorders. To establish preclinical models for new therapeutic approaches, we demonstrate here that the mitochondrial genome can be efficiently replaced in mature non-human primate oocytes (Macaca mulatta) by spindle-chromosomal complex transfer from one egg to an enucleated, mitochondrial-replete egg. The reconstructed oocytes with the mitochondrial replacement were capable of supporting normal fertilization, embryo development and produced healthy offspring. Genetic analysis confirmed that nuclear DNA in the three infants born so far originated from the spindle donors whereas mtDNA came from the cytoplast donors. No contribution of spindle donor mtDNA was detected in offspring. Spindle replacement is shown here as an efficient protocol replacing the full complement of mitochondria in newly generated embryonic stem cell lines. This approach may offer a reproductive option to prevent mtDNA disease transmission in affected families.

  10. CALiPER Special Summary Report: Retail Replacement Lamp Testing

    Energy Technology Data Exchange (ETDEWEB)

    None

    2011-04-01

    CALiPER testing has evaluated many products for commercial lighting markets and found some excellent performers. However, many of these are not available on the retail market. This special testing was undertaken to identify and test solid-state lighting (SSL) replacement lamp products that are available to the general public through retail stores and websites.

  11. Early micromovement of the Articular Surface Replacement (ASR) femoral component

    DEFF Research Database (Denmark)

    Penny, J O; Ding, M; Varmarken, J E;

    2012-01-01

    Radiostereometric analysis (RSA) can detect early micromovement in unstable implant designs which are likely subsequently to have a high failure rate. In 2010, the Articular Surface Replacement (ASR) was withdrawn because of a high failure rate. In 19 ASR femoral components, the mean micromovemen...

  12. Simultaneous bilateral total ankle replacement using a 3-component prosthesis

    Science.gov (United States)

    2011-01-01

    Background and purpose Total ankle replacement is an established surgical procedure in patients with end-stage ankle osteoarthritis. We analyzed complications and medium-term results in patients with simultaneous bilateral total ankle replacement. Patients and methods 10 women and 16 men, mean age 60 (SD 13) years, were followed for a median of 5 (2–10) years. Results There were no intraoperative or perioperative complications, with the exception of 1 patient with prolonged wound healing. Major revision surgery was necessary in 6 of the 52 ankles, including 4 revisions of prosthetic components. The average pain score decreased from 6.9 (4−10) to 1.8 (0−4) points. The American Orthopaedic Foot and Ankle Society hindfoot score increased from 32 (SD 14) points preoperatively to 74 (SD 12) points postoperatively. The average range of motion increased from 28° (SD 12) preoperatively to 38° (SD 9) postoperatively. All 8 categories of SF-36 score improved. Interpretation Simultaneous bilateral total ankle replacement is a suitable method for restoration of function and attainment of pain relief in patients with bilateral end-stage ankle osteoarthritis. The results of this procedure, including complication rates, revision rates, and functional outcome, are comparable to those reported in patients with unilateral total ankle replacement. PMID:21999622

  13. Analgesia after total hip replacement: epidural versus psoas ...

    African Journals Online (AJOL)

    cessfully for hip replacement surgery.7 They were the first to call this approach the ... block is the technique of choice due to a better risk profile.13 In a later study .... necessitating treatment by the nursing staff occurred in three of the patients in ...

  14. Medium term results of Avon patellofemoral joint replacement

    Directory of Open Access Journals (Sweden)

    Praveen K Sarda

    2011-01-01

    Conclusion: The Avon patellofemoral joint replacement provides predictably good results and excellent survivorship in the medium term, for isolated patellofemoral arthritis. However, progression of tibiofemoral arthritis remains unpredictable and therefore patient selection is crucial to ensure success. Clicking remains a potential problem and can compromise the postoperative results in upto 15% of the cases.

  15. 9 CFR 82.15 - Replacement birds and poultry.

    Science.gov (United States)

    2010-01-01

    ... 9 Animals and Animal Products 1 2010-01-01 2010-01-01 false Replacement birds and poultry. 82.15 Section 82.15 Animals and Animal Products ANIMAL AND PLANT HEALTH INSPECTION SERVICE, DEPARTMENT OF AGRICULTURE INTERSTATE TRANSPORTATION OF ANIMALS (INCLUDING POULTRY) AND ANIMAL PRODUCTS EXOTIC NEWCASTLE DIS- EASE (END) AND CHLAMYDIOSIS Exotic...

  16. Simulation Gaming in Construction: ER, The Equipment Replacement Game.

    Science.gov (United States)

    Nassar, Khaled

    2002-01-01

    The Equipment Replacement simulation game can be used to explain the different effects of various equipment buy/sell strategies on the economic performance of construction companies. The probabilistic aspect of demand in the construction market is incorporated. The game is implemented using Excel and Visual Basic for Applications. (Author/SK)

  17. Wear prediction on total ankle replacement effect of design parameters

    CERN Document Server

    Saad, Amir Putra Bin Md; Harun, Muhamad Noor; Kadir, Mohammed Rafiq Abdul

    2016-01-01

    This book develops and analyses computational wear simulations of the total ankle replacement for the stance phase of gait cycle. The emphasis is put on the relevant design parameters. The book presents a model consisting of three components; tibial, bearing and talar representing their physiological functions.

  18. Aggression Replacement Training: Putting Theory and Research to Work

    Science.gov (United States)

    Hollin, Clive R.

    2003-01-01

    There are many problems posed by aggressive youth, the harm to victims and the loss of young people into the criminal justice system and penal confinement. Aggression Replacement Training (ART) was developed by Arnold Goldstein and his colleagues as a means of working with aggressive young people to help them learn new, prosocial ways of behaving.…

  19. Digestive Enzyme Replacement Therapy: Pancreatic Enzymes and Lactase.

    Science.gov (United States)

    Felicilda-Reynaldo, Rhea Faye D; Kenneally, Maria

    2016-01-01

    Maldigestion occurs when digestive enzymes are lacking to help break complex food components into absorbable nutrients within the gastrointestinal tract. Education is needed to help patients manage the intricacies of digestive enzyme replacement therapies and ensure their effectiveness in reducing symptoms of maldigestion.

  20. Transcending the replacement paradigm of solid-state lighting.

    Science.gov (United States)

    Kim, Jong Kyu; Schubert, E Fred

    2008-12-22

    The field of photonics starts with the efficient generation of light. The generation of efficient yet highly controllable light can indeed be accomplished with light-emitting diodes (LEDs), which are, in principle, capable of generating white light with a 20 times greater efficiency than conventional light bulbs. Deployed on a global scale to replace conventional sources, such solid-state light sources will result in enormous benefits that, over a period of 10 years, include (1) gigantic energy savings of 1.9 x 1020 joule, (2) a very substantial reduction in global-warming CO2 emissions, (3) a strong reduction in the emission of pollutants such as acid-rain-causing SO2, mercury (Hg), and uranium (U), and (4) financial savings exceeding a trillion (10(12)) US$. These benefits can be accomplished by the "replacement paradigm" in which conventional light sources are replaced by more energy efficient, more durable, and non-toxic light sources. However, it will be shown that solid-state light sources can go beyond the replacement paradigm, by providing new capabilities including the control of spectrum, color temperature, polarization, temporal modulation, and spatial emission pattern. We will show that such future, "smart" light sources, can harness the huge potential of LEDs by offering multi-dimensional controllability that will enhance the functionality and performance of light sources in a wide range of applications. These applications include optical microscopy, imaging, display technologies, communications, networking, and transportation systems.

  1. Diverse modalities of gingival replacement: A report of three cases

    Directory of Open Access Journals (Sweden)

    Dileep N Vinnakota

    2012-01-01

    Full Text Available Gingival replacement is often a component of comprehensive prosthodontics. Gingival prostheses may be fixed or removable. It can be made from acrylics, composite resins, silicones or porcelain-based materials.This paper describes different clinical situations in which three types of gingival prostheses, removable acrylic veneer with melanin pigmentation, fixed ceramic veneer and flexible nylon based veneer, were used effectively.

  2. Flight Hour Reductions in Fleet Replacement Pilot Training through Simulation.

    Science.gov (United States)

    Smode, Alfred F.

    A project was undertaken to integrate the 2F87F operational flight trainer into the program for training replacement patrol plane pilots. The objectives were to determine the potential of the simulator as a substitute environment for learning aircraft tasks and to effectively utilize the simulator in pilot training. The students involved in the…

  3. Properties of Cement Mortar Containing Rubber Ash as Sand Replacement

    Science.gov (United States)

    Syamir Senin, Mohamad; Shahidan, Shahiron; Syazani Leman, Alif; Izzati Raihan Ramzi Hannan, Nurul

    2016-11-01

    Discarded scrap tyres have become one of the major environmental problems nowadays. There has been increasing public worry about the mining of natural resources in recent years. In order to minimize the consumption of natural resources, rubber ash has been postulated as a potential material for partial replacement of sand in concrete materials especially for applications which are subjected to impact and vibration such as road and bridge construction. Thus, it contributes to the development of the construction industry in a sustainable way. This paper mainly emphasizes on the use of rubber ash from waste tyres in cement mortar. 100mm cubic specimens were produced by adding rubber ash volume ratios of 0%, 3%, 5% and 7% as sand replacement in M30 quality cement mortar. A compressive stress test and a density test were conducted at the end of 7, 14, and 28 days. The result shows that 5% is the optimum value for sand replacement in the cement mortar. Therefore, rubber ash is acceptable to be used as sand replacement.

  4. Factors Influencing Mortality after Bioprosthetic Valve Replacement; A Midterm Outcome

    Directory of Open Access Journals (Sweden)

    Hassan Javadzadegan

    2013-12-01

    Conclusion: Our study shows that using biprosthetic valve could reduce the risk of morbidity occurrence in patient who needs valve replacement. However, if medical treatments fail, patients should be referred for surgery. This would reduce the risk of mortality because of lower incident of complications such as atrial fibrillation and morbidities due to younger patients’ population.

  5. Final Environmental Assessment: Replace Hanscom AFB Middle School

    Science.gov (United States)

    2012-04-01

    Middle Schools are one story masonry veneer buildings originally constructed in 1958 with multiple subsequent additions. A major renovation addition to...installed on Kirtland Street to the club and temporary housing facilities. The Base is continuing to replace older cement asbestos pipes with ductile iron

  6. Philosophies of stem designs in cemented total hip replacement.

    NARCIS (Netherlands)

    Verdonschot, N.J.J.

    2005-01-01

    Stem designs, which have different design features, may produce similar clinical survival curves. Alteratively, some designs that are considered to be similar in design produce different survival rates. In this paper, design aspects of cemented femoral total hip replacement stems, how they can be gr

  7. Measure Guideline. Wood Window Repair, Rehabilitation, and Replacement

    Energy Technology Data Exchange (ETDEWEB)

    Baker, P. [Building Science Corporation, Somerville, MA (United States); Eng, P. [Building Science Corporation, Somerville, MA (United States)

    2012-12-01

    This measure guideline provides information and guidance on rehabilitating, retrofitting, and replacing existing window assemblies in residential construction. The intent is to provide information regarding means and methods to improve the energy and comfort performance of existing wood window assemblies in a way that takes into consideration component durability, in-service operation, and long term performance of the strategies.

  8. Replacement-cost depreciation: monopoly versus competitive business

    Energy Technology Data Exchange (ETDEWEB)

    Matulich, S.; Hensley, S.

    1982-06-24

    The purpose of this article is to clarify some of the arguments for and against the use of replacement-cost depreciation in setting rates for public-utility companies. It does so by examining some simplified examples, which enable the reader to focus upon the logic and basic merits of each argument, pro or con.

  9. Interdisciplinary approach to a total knee replacement program.

    Science.gov (United States)

    Seemann, S

    2000-06-01

    An orthopedic clinical nurse specialist facilitated an interdisciplinary evaluation, design, and implementation of best practice initiatives for the total knee replacement patient population using the Center for Advanced Nursing Practice's Evidence-Based Practice Model. The interdisciplinary team approach enhanced the total joint program by achieving positive patient outcomes, demonstrating financial stewardship of resources, and facilitating inter- and intradisciplinary communication.

  10. Apixaban versus enoxaparin for thromboprophylaxis after hip replacement

    DEFF Research Database (Denmark)

    Lassen, Michael Rud; Gallus, Alexander; Raskob, Gary E

    2010-01-01

    There are various regimens for thromboprophylaxis after hip replacement. Low-molecular-weight heparins such as enoxaparin predominantly inhibit factor Xa but also inhibit thrombin to some degree. Orally active, specific factor Xa inhibitors such as apixaban may provide effective thromboprophylaxis...

  11. Maximum fossil fuel feedstock replacement potential of petrochemicals via biorefineries

    NARCIS (Netherlands)

    Brehmer, B.; Boom, R.M.; Sanders, J.P.M.

    2009-01-01

    The search for feedstock replacement options within the petrochemical industry should logically be based upon non-fossil resources. Retaining the functionality of the biochemicals in biomass for use as chemical products and precursors can lead to a sizeable reduction of fossil fuel consumption. This

  12. Trends in Renal Replacement Therapy in Turkey, 1996-2008

    NARCIS (Netherlands)

    G. Suleymanlar; K. Serdengecti; M.R. Altiparmak; K. Jager; N. Seyahi; E. Erek

    2011-01-01

    Background: National renal registry studies providing data for incidence, prevalence, and characteristics of end-stage renal disease and renal replacement therapy (RRT) serve as a basis to determine national strategies for the prevention and treatment of these diseases and identify new areas for spe

  13. Optimizing model. 1. Insemination, replacement, seasonal production and cash flow.

    NARCIS (Netherlands)

    Delorenzo, M.A.; Spreen, T.H.; Bryan, G.R.; Beede, D.K.; Arendonk, van J.A.M.

    1992-01-01

    Dynamic programming to solve the Markov decision process problem of optimal insemination and replacement decisions was adapted to address large dairy herd management decision problems in the US. Expected net present values of cow states (151,200) were used to determine the optimal policy. States

  14. A consumer-oriented classification system for home meal replacements

    NARCIS (Netherlands)

    Costa, A.I.A.; Dekker, M.; Beumer, R.R.; Rombouts, F.M.; Jongen, W.M.F.

    2001-01-01

    This paper introduces a new definition and classification system for home meal replacements (HMR), based on convenience attributes as viewed by consumers. An overview of other food classifications, focusing on methodological aspects, is also presented. The classifying criteria chosen (shelf-life and

  15. Apixaban versus enoxaparin for thromboprophylaxis after hip replacement

    DEFF Research Database (Denmark)

    Lassen, Michael Rud; Gallus, Alexander; Raskob, Gary E

    2010-01-01

    There are various regimens for thromboprophylaxis after hip replacement. Low-molecular-weight heparins such as enoxaparin predominantly inhibit factor Xa but also inhibit thrombin to some degree. Orally active, specific factor Xa inhibitors such as apixaban may provide effective thromboprophylaxi...

  16. 49 CFR 24.404 - Replacement housing of last resort.

    Science.gov (United States)

    2010-10-01

    ... circumstances of the displaced person, or (2) By a determination that: (i) There is little, if any, comparable replacement housing available to displaced persons within an entire program or project area; and, therefore..., which contribute to total program or project costs. (b) Basic rights of persons to be...

  17. TOTAL HIP REPLACEMENT IN LEGG-CALVÉ-PERTHES DISEASE

    DEFF Research Database (Denmark)

    Froberg, Lonnie; Christensen, Finn; Pedersen, Niels Wisbech;

    2009-01-01

    INTRODUCTION Poor long-time results in patients with Legg-Calvé-Perthes disease (LCP) are most often due to degenerative hip disease. The purpose of this study was to investigate if patients with LCP have an increased rate of total hip replacement (THR) compared to sex- and age-matched persons...

  18. A review of national shoulder and elbow joint replacement registries

    DEFF Research Database (Denmark)

    Rasmussen, Jeppe V; Olsen, Bo S; Fevang, Bjørg-Tilde S

    2012-01-01

    The aim was to review the funding, organization, data handling, outcome measurements, and findings from existing national shoulder and elbow joint replacement registries; to consider the possibility of pooling data between registries; and to consider wether a pan european registry might be feasible....

  19. AFLCMC Cd and Cr Replacement/Elimination Strategy

    Science.gov (United States)

    2014-11-18

    elimination of Cd/Cr on Weapon Systems • Gain PEO /Program Office buy-in to implement qualified products • Use Airworthiness (AW) Process for...plating, ensuring the safety and cost effectiveness of the novel brush plating technology • Cd replacement on Low and High Strength Steel Fasteners

  20. Maximum fossil fuel feedstock replacement potential of petrochemicals via biorefineries

    NARCIS (Netherlands)

    Brehmer, B.; Boom, R.M.; Sanders, J.P.M.

    2009-01-01

    The search for feedstock replacement options within the petrochemical industry should logically be based upon non-fossil resources. Retaining the functionality of the biochemicals in biomass for use as chemical products and precursors can lead to a sizeable reduction of fossil fuel consumption. This