Severe protein-calorie malnutrition in two brothers due to abuse by starvation.

Science.gov (United States)

Barroso, Marcela Montenegro Braga; Salvador, Luiza Martins; Fagundes Neto, Ulysses

2016-12-01

To describe the case of two siblings with severe protein-calorie malnutrition due to abuse by starvation. The two patients were simultaneously referred from the Municipal Hospital, where they were admitted to the Pediatric Gastroenterology clinic of a university hospital for diagnostic investigation of the cause of severe malnutrition and screening tests for Celiac Disease, Cystic Fibrosis and Environmental enteropathy among others. The exams were all normal, and after detailed research on the interactions of this family, we reached the conclusion that the malnutrition was due to abuse by starvation. The children spent approximately two months in the hospital, receiving a high-protein and high-calorie diet, with significant nutritional recovery. Abuse by starvation, although rare, should always be considered of as one of the causes of child malnutrition and pediatrician should be aware of the child's development, as well as the family interactions, to prevent more severe nutritional and emotional consequences in the future. Copyright © 2016. Publicado por Elsevier Editora Ltda.

Quantifying the Limitation to World Cereal Production Due To Soil Phosphorus Status

Science.gov (United States)

Kvakić, Marko; Pellerin, Sylvain; Ciais, Philippe; Achat, David L.; Augusto, Laurent; Denoroy, Pascal; Gerber, James S.; Goll, Daniel; Mollier, Alain; Mueller, Nathaniel D.; Wang, Xuhui; Ringeval, Bruno

2018-01-01

Phosphorus (P) is an essential element for plant growth. Low P availability in soils is likely to limit crop yields in many parts of the world, but this effect has never been quantified at the global scale by process-based models. Here we attempt to estimate P limitation in three major cereals worldwide for the year 2000 by combining information on soil P distribution in croplands and a generic crop model, while accounting for the nature of soil-plant P transport. As a global average, the diffusion-limited soil P supply meets the crop's P demand corresponding to the climatic yield potential, due to the legacy soil P in highly fertilized areas. However, when focusing on the spatial distribution of P supply versus demand, we found strong limitation in regions like North and South America, Africa, and Eastern Europe. Averaged over grid cells where P supply is lower than demand, the global yield gap due to soil P is estimated at 22, 55, and 26% in winter wheat, maize, and rice. Assuming that a fraction (20%) of the annual P applied in fertilizers is directly available to the plant, the global P yield gap lowers by only 5-10%, underlying the importance of the existing soil P supply in sustaining crop yields. The study offers a base for exploring P limitation in crops worldwide but with certain limitations remaining. These could be better accounted for by describing the agricultural P cycle with a fully coupled and mechanistic soil-crop model.

Fundamental limitations on V/STOL terminal guidance due to aircraft characteristics

Science.gov (United States)

Wolkovitch, J.; Lamont, C. W.; Lochtie, D. W.

1971-01-01

A review is given of limitations on approach flight paths of V/STOL aircraft, including limits on descent angle due to maximum drag/lift ratio. A method of calculating maximum drag/lift ratio of tilt-wing and deflected slipstream aircraft is presented. Derivatives and transfer functions for the CL-84 tilt-wing and X-22A tilt-duct aircraft are presented. For the unaugmented CL-84 in steep descents the transfer function relating descent angle to thrust contains a right-half plane zero. Using optimal control theory, it is shown that this zero causes a serious degradation in the accuracy with which steep flight paths can be followed in the presence of gusts.

Tricuspid valve repair for severe tricuspid regurgitation due to pacemaker leads.

Science.gov (United States)

Uehara, Kyokun; Minakata, Kenji; Watanabe, Kentaro; Sakaguchi, Hisashi; Yamazaki, Kazuhiro; Ikeda, Tadashi; Sakata, Ryuzo

2016-07-01

Tricuspid valve regurgitation due to pacemaker leads is a well-known complication. Although some reports have suggested that pacemaker leads should be surgically explanted, strongly adhered leads cannot always be removed. The aim of this study was to describe our tricuspid valve repair techniques with pacemaker leads left in situ. Our retrospective study investigated 6 consecutive patients who required tricuspid valve surgery for severe regurgitation induced by pacemaker leads. From the operative findings, we identified 3 patterns of tricuspid valve and pacemaker lead involvement. In 3 patients, the leads were caught in the chordae, in 2 patients, tricuspid regurgitation was caused by lead impingement on the septal leaflet, and in 3 patients, tricuspid valve leaflets had been perforated by the pacemaker leads. During surgery, all leads were left in situ after being separated from the leaflet or valvular apparatus. In addition, suture annuloplasty was performed for annular dilatation in all cases. In one patient, the lead was reaffixed to the annulus after the posterior leaflet was cut back towards the annulus, and the leaflet was then closed. There was one hospital death due to sepsis. The degree of tricuspid regurgitation was trivial in all surviving patients at discharge. During a mean follow-up of 21 months, one patient died from pneumonia 20 months after tricuspid valve repair. In patients undergoing tricuspid valve surgery due to severe tricuspid regurgitation caused by pacemaker leads, the leads can be left in situ after proper repair with annuloplasty. © The Author(s) 2016.

Anorexia Nervosa Presented with Fever and Pancytopenia Due to Severe Constipation

Directory of Open Access Journals (Sweden)

Senay Akbay

2014-06-01

Full Text Available The prevalence of eating disorders is on the increase in adolescence and childhood. The peak age of onset occurs between 14 and 19 years. Anorexia nervosa is diagnosed approximately nine times more often in females than in males. Anorexia nervosa is a eating disorder that occurs mainly in female adolescents and young women. Eating disorders are associated with severe and sometimes life-threatening medical and psychiatric comorbidities. Hematological abnormalities are common in anorexia nervosa. But severe bone marrow supression has rarely been reported. To our knowledge, there is not any publication in the literature about bone marrow supression due to constipation.We reported here a 17 years old girl diagnosed as anorexia nervosa who was not wasted yet, presented with constipation and developed fever and pancytopenia.

Recurrent severe vomiting due to hyperthyroidism

OpenAIRE

Chen, Li-ying; Zhou, Bo; Chen, Zhou-wen; Fang, Li-zheng

2010-01-01

Thyrotoxicosis may present in many ways; severe vomiting as a prominent symptom of thyrotoxicosis is uncommon. In this paper, we report a 24-year-old Chinese male with hyperthyroidism who presented with recurrent severe vomiting. The patient had had intermittent vomiting for seven years and had lost approximately 15 kg of weight. Gastroscopic examinations revealed chronic gastritis and one occasion peptic ulcer. He was treated with antacid and proton pump inhibitors, but his symptoms had no r...

Limits to co-combustion of coal and eucalyptus due to water availability in the state of Rio Grande do Sul, Brazil

International Nuclear Information System (INIS)

Hoffmann, Bettina Susanne; Szklo, Alexandre; Schaeffer, Roberto

2014-01-01

Highlights: • Brazil holds reserves of high ash coal that can only be used in mine-mouth plants. • Water scarcity requires the use of wet or dry cooling systems in several regions. • The co-firing of 30 wt% eucalyptus is possible regarding the biomass availability. • Biomass cultivation would aggravate the water scarcity in several regions. - Abstract: Brazil has favorable edaphoclimatic conditions for the cultivation of biomass for energy. On the other hand, the country plans to expand its thermal power park using fossil fuels, including Brazil’s high ash coal. This study estimates the potential of co-firing biomass from energy forests in power plants fired with Brazilian coal in the state of Rio Grande do Sul, Brazil, focusing on the limits given by biomass and water availability. Results show that the state holds coal reserves that could support a potential of approximately 8 GW. Referring to limits due to water availability, different outcomes were found for the various coal fields in Rio Grande do Sul. The Candiota coal field, which represents the most important coal field, holding a capacity of 4 GW, shows severe restrictions for water availability that would be aggravated by intense eucalyptus cultivation

Orthodontic-surgical management of a case of severe mandibular deficiency due to condylar ankylosis

Directory of Open Access Journals (Sweden)

Sridevi Padmanabhan

2014-01-01

Full Text Available Dentofacial deformities involve deviations from the normal facial proportions and dental relationships and can range from mild to being severe enough to be severely handicapping.The term handicapping malocclusions though not a term commonly used, involves a fortunately small section (2-4% of patients who can suffer from esthetic,psychological and functional problems. Craniofacial Orthodontics is the area of orthodontics that treats patients with congenital and acquired deformities of the integument and it′s underlying musculoskeletal system within the craniofacial area and associated structures.This case report of a young woman with severe mandibular deficiency and facial asymmetry due to condylar ankylosis highlights the importance of team work in rehabilitation of such severe craniofacial deformities.

Prevalence, Co-Occurrence and Associations with Self-Perceived Health and Limitations Due To Physical Health - A Danish Population-Based Study

DEFF Research Database (Denmark)

Eliasen, Marie; Kreiner, Svend; Ebstrup, Jeanette F

2016-01-01

) the associations between the symptoms, and 3) the associations between the somatic symptoms, self-perceived health and limitations due to physical health accounting for the co-occurrence of symptoms. Information on 19 somatic symptoms, self-perceived health and limitations due to physical health was achieved from...... a population-based questionnaire survey of 36,163 randomly selected adults in the Capital Region of Denmark in 2006/07. Chain graph models were used to transparently identify and describe the associations between symptoms, self-perceived health and limitations due to physical health. In total, 94...... all strongly directly associated with both of the outcomes (γ>0.30). Chest pain was strongly associated with self-perceived health, and other musculoskeletal symptoms and urinary retention were strongly associated with limitations due to physical health. Other symptoms were either moderate...

Vertical diplopia and oscillopsia due to midbrain keyhole aqueduct syndrome associated with severe cough.

Science.gov (United States)

Oh, Angela Jinsook; Lanzman, Bryan Alexander; Liao, Yaping Joyce

2018-06-01

Midline structural defects in the neural axis can give rise to neuro-ophthalmic symptoms. We report a rare case of keyhole aqueduct syndrome presenting after two years of severe cough due to gastroesophageal reflux disease. A 58-year-old woman with a 2-year history of daily, severe cough presented to the neuro-ophthalmology clinic with progressive diplopia and oscillopsia. Examination revealed a 1-2 Hz down-beating nystagmus in primary gaze that worsened with left, right, and down gazes. Gaze evoked nystagmus and mild paresis were also seen with up gaze. There was an incomitant left hypertropia due to skew deviation that worsened with right and up gazes and improved with down gaze. She also had a right-sided ptosis and a 3 mm anisocoria not due to cranial nerve 3 paresis or Horner's syndrome. Brain magnetic resonance imaging showed a 1.5 mm × 11.7 mm × 6 mm midline cleft in the ventral midbrain communicating with the cerebral aqueduct, consistent with keyhole aqueduct syndrome. Her nystagmus and diplopia improved with oral acetazolamide treatment, at high doses of 2500-3000 mg per day. We report the first case of midbrain keyhole aqueduct syndrome with ocular motor and other neuro-ophthalmic manifestations associated with severe cough. Although her cough was effectively treated and intracranial pressure measurement was normal, her ophthalmic symptoms continued to progress, which is common in previous cases reported. Treatment with acetazolamide led to significant improvement, supporting the use of acetazolamide in this rare condition.

The limits of adaptation of functional protein synthesis to severe undernutrition

International Nuclear Information System (INIS)

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

1996-01-01

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

Hypovolemic shock due to severe gastrointestinal bleeding in a child taking an herbal syrup

Directory of Open Access Journals (Sweden)

Paola Angela Moro

2011-01-01

Full Text Available We report the case of a 4-years-old boy who was admitted with hypovolemic shock due to a severe gastrointestinal bleeding. The esophagogastroduodenoscopy (EGDS showed hiatus hernia, erosions and ulcerations of the lower esophagus, possibly due to a gastroesophageal reflux, and a small duodenal erosion. The child was previously healthy and he had never shown any symptoms related to this condition. The only product taken by the child in the previous days was a syrup containing several herbs, among which Filipendula ulmaria (L. Maxim. and Salix spp. (known to contain salicylates, marketed as food and prescribed by his paediatrician to treat a mild cold accompanied by fever. Quali-quantitative analysis confirmed the presence of salicylates in the syrup. Naranjo algorithm showed a probable correlation between the onset of symptoms and the consumption of the herbal remedy. The child recovered after receiving intensive care. The product was withdrawn from Italian market.

Two cases of severe tracheal stenosis due to advanced adenoid cystic carcinoma of the trachea

Energy Technology Data Exchange (ETDEWEB)

Yuasa, Hiroshi; Akaogi, Eiichi; Morita, Riichiro; Onizuka, Masataka; Mitsui, Kiyofumi [Tsukuba Univ., Ibaraki (Japan). Inst. of Clinical Medicine; Tsuji, Hirohiko

1991-12-01

Two cases of severe tracheal stenosis due to advanced nonresectable adenoid cystic carcinoma of the trachea were reported. Case 1 was a 38-year-old male who underwent emergency {sup 60}Co irradiation following endoscopic YAG laser irradiation. This approach was quite effective. Proton irradiation was effective against tumor recurrence. Case 2 was a 28-year-old female in whom emergency treatment for tracheal obstruction due to edema after laser therapy necessitated transient tracheal intubation. The tracheal stenosis due to recurrent tumor after {sup 60}Co irradiation was improved by insertion of an intraluminal permanent stent. (author).

Severe hypertension due to renal polar artery stenosis in an adolescent treated with coil embolization

Energy Technology Data Exchange (ETDEWEB)

Docx, Martine K. [Koningin Paola Kinderziekenhuis, Department of Paediatrics, Chronic Diseases and Hypertension, Antwerp (Belgium); Vandenberghe, Philippe [Koningin Paola Kinderziekenhuis, Department of Paediatric Cardiology, Antwerp (Belgium); Maleux, Geert [University Hospitals Leuven, Department of Radiology, Leuven (Belgium); Gewillig, Marc [University Hospitals Leuven, Department of Paediatric Cardiology, Leuven (Belgium); Mertens, Luc [Hospital for Sick Children, Paediatric Cardiology, Toronto (Canada)

2009-11-15

A 12-year-old boy presented with severe arterial hypertension due to a severe subsegmental renal artery stenosis. Treatment consisted of selective embolization of the stenosed polar artery, which resulted in near normalization of the arterial pressures. Renal artery stenosis should always be considered, even in young adolescents, as a cause for arterial hypertension. Only selective angiography was able to demonstrate the subsegmental artery stenosis in this patient. (orig.)

Severe hypertension due to renal polar artery stenosis in an adolescent treated with coil embolization

International Nuclear Information System (INIS)

Docx, Martine K.; Vandenberghe, Philippe; Maleux, Geert; Gewillig, Marc; Mertens, Luc

2009-01-01

A 12-year-old boy presented with severe arterial hypertension due to a severe subsegmental renal artery stenosis. Treatment consisted of selective embolization of the stenosed polar artery, which resulted in near normalization of the arterial pressures. Renal artery stenosis should always be considered, even in young adolescents, as a cause for arterial hypertension. Only selective angiography was able to demonstrate the subsegmental artery stenosis in this patient. (orig.)

Recurrent severe vomiting due to hyperthyroidism

Science.gov (United States)

Chen, Li-ying; Zhou, Bo; Chen, Zhou-wen; Fang, Li-zheng

2010-01-01

Thyrotoxicosis may present in many ways; severe vomiting as a prominent symptom of thyrotoxicosis is uncommon. In this paper, we report a 24-year-old Chinese male with hyperthyroidism who presented with recurrent severe vomiting. The patient had had intermittent vomiting for seven years and had lost approximately 15 kg of weight. Gastroscopic examinations revealed chronic gastritis and one occasion peptic ulcer. He was treated with antacid and proton pump inhibitors, but his symptoms had no relief. His presenting symptoms suggested hyperthyroidism and were confirmed by laboratory data. After a month of propylthiouracil therapy, his symptoms were relieved. It should be noted that hyperthyroidism patients can have unexplained vomiting, and that hyperthyroidism may coexist with peptic ulcer in rare cases. Awareness of such atypical presentations of hyperthyroidism may help to make a correct diagnosis. PMID:20205308

Limitations in distance and frequency due to chromatic dispersion in fibre-optic microwave and millimeter-wave links

DEFF Research Database (Denmark)

Gliese, Ulrik Bo; Nielsen, Søren Nørskov; Nielsen, Søren Nørskov

1996-01-01

Chromatic dispersion significantly limits the distance and/or frequency in fibre-optic microwave and millimeter-wave links based on direct detection due to a decrease of the carrier to noise ratio. The limitations in links based on coherent remote heterodyne detection, however, are far less...

Vertical diplopia and oscillopsia due to midbrain keyhole aqueduct syndrome associated with severe cough

Directory of Open Access Journals (Sweden)

Angela Jinsook Oh

2018-06-01

Full Text Available Purpose: Midline structural defects in the neural axis can give rise to neuro-ophthalmic symptoms. We report a rare case of keyhole aqueduct syndrome presenting after two years of severe cough due to gastroesophageal reflux disease. Observations: A 58-year-old woman with a 2-year history of daily, severe cough presented to the neuro-ophthalmology clinic with progressive diplopia and oscillopsia. Examination revealed a 1–2 Hz down-beating nystagmus in primary gaze that worsened with left, right, and down gazes. Gaze evoked nystagmus and mild paresis were also seen with up gaze. There was an incomitant left hypertropia due to skew deviation that worsened with right and up gazes and improved with down gaze. She also had a right-sided ptosis and a 3 mm anisocoria not due to cranial nerve 3 paresis or Horner's syndrome. Brain magnetic resonance imaging showed a 1.5 mm × 11.7 mm × 6 mm midline cleft in the ventral midbrain communicating with the cerebral aqueduct, consistent with keyhole aqueduct syndrome. Her nystagmus and diplopia improved with oral acetazolamide treatment, at high doses of 2500–3000 mg per day. Conclusions and importance: We report the first case of midbrain keyhole aqueduct syndrome with ocular motor and other neuro-ophthalmic manifestations associated with severe cough. Although her cough was effectively treated and intracranial pressure measurement was normal, her ophthalmic symptoms continued to progress, which is common in previous cases reported. Treatment with acetazolamide led to significant improvement, supporting the use of acetazolamide in this rare condition. Keywords: Keyhole aqueduct syndrome, Midbrain cleft, Mesencephalic cleft, Syrinx, Syringobulbia, Down-beating nystagmus, Cerebrospinal fluid

Prediction of Severe Disease in Children with Diarrhea in a Resource-Limited Setting

Science.gov (United States)

Levine, Adam C.; Munyaneza, Richard M.; Glavis-Bloom, Justin; Redditt, Vanessa; Cockrell, Hannah C.; Kalimba, Bantu; Kabemba, Valentin; Musavuli, Juvenal; Gakwerere, Mathias; Umurungi, Jean Paul de Charles; Shah, Sachita P.; Drobac, Peter C.

2013-01-01

Objective To investigate the accuracy of three clinical scales for predicting severe disease (severe dehydration or death) in children with diarrhea in a resource-limited setting. Methods Participants included 178 children admitted to three Rwandan hospitals with diarrhea. A local physician or nurse assessed each child on arrival using the World Health Organization (WHO) severe dehydration scale and the Centers for Disease Control (CDC) scale. Children were weighed on arrival and daily until they achieved a stable weight, with a 10% increase between admission weight and stable weight considered severe dehydration. The Clinical Dehydration Scale was then constructed post-hoc using the data collected for the other two scales. Receiver Operator Characteristic (ROC) curves were constructed for each scale compared to the composite outcome of severe dehydration or death. Results The WHO severe dehydration scale, CDC scale, and Clinical Dehydration Scale had areas under the ROC curves (AUCs) of 0.72 (95% CI 0.60, 0.85), 0.73 (95% CI 0.62, 0.84), and 0.80 (95% CI 0.71, 0.89), respectively, in the full cohort. Only the Clinical Dehydration Scale was a significant predictor of severe disease when used in infants, with an AUC of 0.77 (95% CI 0.61, 0.93), and when used by nurses, with an AUC of 0.78 (95% CI 0.63, 0.93). Conclusions While all three scales were moderate predictors of severe disease in children with diarrhea, scale accuracy varied based on provider training and age of the child. Future research should focus on developing or validating clinical tools that can be used accurately by nurses and other less-skilled providers to assess all children with diarrhea in resource-limited settings. PMID:24349271

Rib fixation for severe chest deformity due to multiple rib fractures.

Science.gov (United States)

Igai, Hitoshi; Kamiyoshihara, Mitsuhiro; Nagashima, Toshiteru; Ohtaki, Yoichi

2012-01-01

The operative indications for rib fracture repair have been a matter of debate. However, several reports have suggested that flail chest, pain on respiration, and chest deformity/defect are potential conditions for rib fracture repair. We describe our experience of rib fixation in a patient with severe chest deformity due to multiple rib fractures. A 70-year-old woman was admitted with right-sided multiple rib fractures (2nd to 7th) and marked chest wall deformity without flailing caused by an automobile accident. Collapse of the chest wall was observed along the middle anterior axillary line. At 11 days after the injury, surgery was performed to repair the chest deformity, as it was considered to pose a risk of restrictive impairment of pulmonary function or chronic intercostal pain in the future. Operative findings revealed marked displacement of the superior 4 ribs, from the 2nd to the 5th, and collapse of the osseous chest wall towards the thoracic cavity. After exposure of the fracture regions, ribs fixations were performed using rib staplers. The total operation time was 90 minutes, and the collapsed portion of the chest wall along the middle anterior axillary line was reconstructed successfully.

Pineal melatonin level disruption in humans due to electromagnetic fields and ICNIRP limits

International Nuclear Information System (INIS)

Halgamuge, Malka N.

2013-01-01

The International Agency for Research on Cancer (IARC) classifies electromagnetic fields (EMFs) as 'possibly carcinogenic' to humans that might transform normal cells into cancer cells. Owing to high utilisation of electricity in day-to-day life, exposure to power-frequency (50 or 60 Hz) EMFs is unavoidable. Melatonin is a natural hormone produced by pineal gland activity in the brain that regulates the body's sleep-wake cycle. How man-made EMFs may influence the pineal gland is still unsolved. The pineal gland is likely to sense EMFs as light but, as a consequence, may decrease the melatonin production. In this study, more than one hundred experimental data of human and animal studies of changes in melatonin levels due to power-frequency electric and magnetic fields exposure were analysed. Then, the results of this study were compared with the International Committee of Non-Ionizing Radiation Protection (ICNIRP) limit and also with the existing experimental results in the literature for the biological effect of magnetic fields, in order to quantify the effects. The results show that this comparison does not seem to be consistent despite the fact that it offers an advantage of drawing attention to the importance of the exposure limits to weak EMFs. In addition to those inconsistent results, the following were also observed from this work: (i) the ICNIRP recommendations are meant for the well-known acute effects, because effects of the exposure duration cannot be considered and (ii) the significance of not replicating the existing experimental studies is another limitation in the power-frequency EMFs. Regardless of these issues, the above observation agrees with our earlier study in which it was confirmed that it is not a reliable method to characterise biological effects by observing only the ratio of AC magnetic field strength to frequency. This is because exposure duration does not include the ICNIRP limit. Furthermore, the results show the significance of

Limited interface between physiotherapy primary care and people with severe mental illness: a qualitative study.

Science.gov (United States)

Lee, Samantha; Waters, Flavie; Briffa, Kathy; Fary, Robyn E

2017-07-01

How do mental health professionals perceive the role of physiotherapists in the care of people with severe and persistent mental illness, and what factors do they perceive as influencing access to physiotherapy services? How do people with severe and persistent mental illness understand the potential role of physiotherapy in their healthcare, and what factors do they perceive as influencing access to physiotherapy services? Qualitative study. Twenty-four mental health professionals and 35 people with severe and persistent mental illness. Interview schedules were developed to explore participants' understanding of physiotherapy, as well as barriers and enablers to service access. Focus groups and interviews were conducted for each group of participants. Transcripts were analysed using an inductive approach to derive key themes. Both the mental health professionals and the people with severe and persistent mental illness expressed a limited understanding of the role and relevance of physiotherapy for physical health in mental healthcare. Common barriers to service access were cost, transport and lack of motivation. Likewise, enablers of reduced cost, provision of transport and education about physiotherapy to improve their understanding were identified. The health system structure and perceived lack of mental health knowledge by physiotherapists influenced referrals from mental health professionals. Consequently, education in mental health for physiotherapists and integration of the service within mental health were identified as potential enablers to physiotherapy access. Limited understanding about physiotherapy and its relevance to physical health in mental healthcare among mental health professionals and people with severe and persistent mental illness was found to be a key factor influencing service access. Limited physiotherapy presence and advocacy within mental health were also highlighted. There is a need for greater understanding about physiotherapy among

Experimental observation and modelling of roughness variation due to supply-limited sediment transport in uni-directional flow

NARCIS (Netherlands)

Tuijnder, Arjan; Ribberink, Jan S.

2012-01-01

This paper presents a study on the relationship between supply-limited bedform formation and the hydraulic roughness of the riverbed. The results of several new sets of flume experiments with supply-limited or partial transport conditions with bimodal sediment are presented. The results show that

Heart failure due to severe myocardial calcification

International Nuclear Information System (INIS)

Takahashi, Shouichi; Maida, Kiyoshi; Yokoyama, Hitoshi; Tanaka, Shigeo

1993-01-01

A 28-year-old female who had had irradiation on the chest wall at the age of 5 as a remedy for keloid granulation after burn, recently developed congestive heart failure. Severe tricuspid regurgitation was demonstrated by echocardiography with a certain calcification in the cardiac shadow on chest radiogram. Calcified right ventricle and ventricular septum were noticed operatively, which disturbed ventricular motion and also caused tricuspid valve deformity. These calcified myocardium apparently corresponded with the irradiation field. After tricuspid valve replacement, she regained physical activity satisfactorily without congestive heart failure. Because she had no other known causes of cardiac calcification such as hypercalcemia, myocarditis, myocardial infarction or renal diseases, irradiation on the chest wall could be responsible for the severe myocardial calcification. (author)

A comparison between patients with epiphora and cataract of the activity limitations they experience in daily life due to their visual disability.

Science.gov (United States)

Bohman, Elin; Wyon, Maria; Lundström, Mats; Dafgård Kopp, Eva

2018-02-01

The objective of this study was to compare patients with epiphora and cataract in terms of the activity limitations they experience in daily life due to their visual disability and to validate the use of the Catquest-9SF questionnaire for epiphora patients. Seventy-two consecutively encountered adult patients with confirmed lacrimal obstruction and listed for dacryocystorhinostomy (DCR) or lacrimal intubation at the St. Erik Eye Hospital, Stockholm, Sweden, completed the Catquest-9SF questionnaire, which measures activity limitations in daily life due to visual disability. The psychometric qualities of the Catquest-9SF results obtained from this group of patients were evaluated by Rasch analysis. Rasch analysis was further employed to convert the ordinal raw data to a Rasch score for comparison with the preoperative scores of patients registered in the Swedish National Cataract Register (NCR) during March 2013. The Catquest-9SF exhibited good psychometric qualities when investigating epiphora patients, with the exception of a misfit for Item 4, the item regarding facial recognition. On the Rasch scale (-5.43 = no activity limitations to +5.01 = severe activity limitations), the mean score for epiphora patients was -0.82 while for patients listed for 1st eye and 2nd eye cataract surgery it was -0.17 and -0.76, respectively. An equivalence test confirmed that the reported visual disability of epiphora patients was not significantly different from visual disability reported by patients waiting for 2nd eye cataract surgery. The Catquest-9SF is a valid measure of visual disability in patients with epiphora. Epiphora patients experience visual disability to the same degree as patients awaiting 2nd eye cataract surgery. © 2017 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

Efficacy and safety of vedolizumab as a treatment option for moderate to severe refractory ulcerative colitis in two patients after liver transplant due to primary sclerosing cholangitis

Directory of Open Access Journals (Sweden)

Raúl Vicente Olmedo-Martín

Full Text Available Vedolizumab is a humanized IgG1 monoclonal antibody that selectively blocks the lymphocyte integrin α4β7 and prevents its interaction with endothelial adhesion molecules and subsequent transmigration to the gastrointestinal tract. The drug was approved in 2014 for the induction and maintenance treatment of ulcerative colitis and moderate to severe Crohn's disease that is refractory or intolerant to conventional treatment with corticoids and immunosuppressants and/or anti-TNFα drugs. However, inflammatory bowel disease has a variable behavior following liver transplant. One third of patients with ulcerative colitis associated with primary sclerosing cholangitis are expected to deteriorate despite receiving immunosuppression to prevent rejection. There is limited experience with anti-TNFα agents in patients with inflammatory bowel disease in the setting of liver transplantation and the studies to date involve a limited number of cases. The efficacy and safety data of vedolizumab in this situation are unreliable and very preliminary. We present two cases with the aim to present the efficacy and safety of vedolizumab after one year of treatment in two patients who underwent a transplant due to primary sclerosing cholangitis. One case had de novo post-transplant ulcerative colitis refractory to two anti-TNFα drugs (golimumab and infliximab. The other patient had a colostomy due to fulminant colitis and developed severe ulcerative proctitis refractory to infliximab after reconstruction with an ileorectal anastomosis.

Elucidating the Performance Limitations of Lithium-ion Batteries due to Species and Charge Transport through Five Characteristic Parameters

Science.gov (United States)

Jiang, Fangming; Peng, Peng

2016-01-01

Underutilization due to performance limitations imposed by species and charge transports is one of the key issues that persist with various lithium-ion batteries. To elucidate the relevant mechanisms, two groups of characteristic parameters were proposed. The first group contains three characteristic time parameters, namely: (1) te, which characterizes the Li-ion transport rate in the electrolyte phase, (2) ts, characterizing the lithium diffusion rate in the solid active materials, and (3) tc, describing the local Li-ion depletion rate in electrolyte phase at the electrolyte/electrode interface due to electrochemical reactions. The second group contains two electric resistance parameters: Re and Rs, which represent respectively, the equivalent ionic transport resistance and the effective electronic transport resistance in the electrode. Electrochemical modeling and simulations to the discharge process of LiCoO2 cells reveal that: (1) if te, ts and tc are on the same order of magnitude, the species transports may not cause any performance limitations to the battery; (2) the underlying mechanisms of performance limitations due to thick electrode, high-rate operation, and large-sized active material particles as well as effects of charge transports are revealed. The findings may be used as quantitative guidelines in the development and design of more advanced Li-ion batteries. PMID:27599870

Severe Hypertriglyceridemia due to a novel p.Q240H mutation in the Lipoprotein Lipase gene.

Science.gov (United States)

Soto, Angela Ganan; McIntyre, Adam; Agrawal, Sungeeta; Bialo, Shara R; Hegele, Robert A; Boney, Charlotte M

2015-09-04

Lipoprotein Lipase (LPL) deficiency is a rare autosomal recessive disorder with a heterogeneous clinical presentation. Several mutations in the LPL gene have been identified to cause decreased activity of the enzyme. An 11-week-old, exclusively breastfed male presented with coffee-ground emesis, melena, xanthomas, lipemia retinalis and chylomicronemia. Genomic DNA analysis identified lipoprotein lipase deficiency due to compound heterozygosity including a novel p.Q240H mutation in exon 5 of the lipoprotein lipase (LPL) gene. His severe hypertriglyceridemia, including xanthomas, resolved with dietary long-chain fat restriction. We describe a novel mutation of the LPL gene causing severe hypertriglyceridemia and report the response to treatment. A review of the current literature regarding LPL deficiency syndrome reveals a few potential new therapies under investigation.

Maternal and fetal recovery after severe respiratory failure due to influenza: a case report

Directory of Open Access Journals (Sweden)

Madsen Kristine

2013-02-01

Full Text Available Abstract Background During pregnancy women are at increased risk of severe complications to influenza infection, including death of mother or fetus, especially if chronic comorbid medical conditions such as diabetes mellitus are present. Case presentation A 36 years old Caucasian pregnant woman with type 1 diabetes underwent mechanical ventilation in gestation week 27 for severe respiratory failure due to influenza and pneumonia. For three weeks during and following her most severe illness, fetal growth could not be detected and the umbilical flows and amniotic fluid volumes were affected too. The possibility of preterm delivery and extracorporeal membrane oxygenation (ECMO treatment were considered, however the patient and her fetus recovered gradually on conservative treatment. Under close surveillance the pregnancy continued until term, with delivery of an infant with appropriate weight for gestational age. Conclusion Preterm delivery and decreased birth weight were reported for women with antepartum pneumonia. Mechanical ventilation and ECMO treatment for severe respiratory failure in pregnancy are life threatening conditions and have been associated with preterm delivery. It remains uncertain if delivery improves the respiratory status of a critically ill woman, and the fetal condition is likely to improve, if the maternal condition is stabilized. Severe respiratory insufficiency requiring mechanical ventilation in a diabetic pregnant woman with influenza was successfully treated conservatively. Despite clear signs of impaired fetal condition in the acute phase, watchful waiting resulted in delivery of a normal weight infant at term.

Benefits and limitations of computer gesture therapy for the rehabilitation of severe aphasia

Directory of Open Access Journals (Sweden)

Abi Roper

2016-11-01

Full Text Available Aphasia intervention has made increasing use of technology in recent years. The evidence base, which is largely limited to the investigation of spoken language outcomes, indicates positive treatment effects for people with mild to moderate levels of aphasia. Outcomes for those with severe aphasia however, are less well documented and - where reported - present less consistent gains for measures of spoken output. This study investigates the effects of a purpose-built gesture therapy technology for people with severe aphasia: GeST+. Study outcomes show significant improvement in gesture production abilities for adults with severe aphasia following computer intervention. They indicate no transfer of effects into naming gains or interactive gesture. Outcomes offer encouraging results for computer therapy methods within this hitherto under-researched population but indicate a need for further refinement of interventions in order to maximize persistence of effects and generalization into everyday communication.

Rhabdomyolysis in a Young Girl with Van Wyk-Grumbach Syndrome due to Severe Hashimoto Thyroiditis.

Science.gov (United States)

Leonardi, Alberto; Penta, Laura; Cofini, Marta; Lanciotti, Lucia; Principi, Nicola; Esposito, Susanna

2018-04-09

Background: Autoimmune hypothyroidism (Hashimoto thyroiditis; HT) is the most common postnatal thyroid disease. Clinical manifestations of HT vary according to disease severity. Due to the pleiotropic effects of thyroid hormone, less common signs and symptoms of HT can occur, leading to a delay in diagnosis. Case presentation: A 9-year-old girl of Indian origin was admitted for a one-week history of widespread myalgia, fatigue, muscle weakness, difficulty walking, and a significant increase in weight (approximately 2 kg) without any changes in daily habits. The only relevant medical history was several intermittent vaginal bleeding episodes since four years of age. Breast development was consistent with Tanner stage 2 without pubic or axillary hair; while height and weight were at the 10th percentile and the 38th percentile; respectively. Bone age from a left wrist X-ray was delayed 1 year. Pelvic ultrasonography revealed a uterine body/neck ratio of >1 (pubertal stage) and multifollicular ovaries. Her external genitalia had a childlike appearance. Laboratory examinations showed an increased thyroid-stimulating hormone, decreased free thyroxine, and positive anti-thyroglobulin antibody titres, as well as elevation of creatine phosphokinase, myoglobin, lactate dehydrogenase, serum aspartate aminotransferase, hypercholesterolemia, and a basal serum prolactin near the upper limit of normal. Follicle stimulating hormone and estradiol were slightly and significantly elevated, respectively. Thyroid ultrasound showed an increased gland size with irregular echostructures and high vascularization. Levothyroxine replacement therapy led to complete normalization of clinical and laboratory findings, including rhabdomyolysis indices. No further vaginal bleeding episodes were reported. Conclusion: This case report highlights how various can be the clinical picture of HT in children, and how rare clinical manifestations can be the only signs of disease at presentation leading to

Rhabdomyolysis in a Young Girl with Van Wyk-Grumbach Syndrome due to Severe Hashimoto Thyroiditis

Directory of Open Access Journals (Sweden)

Alberto Leonardi

2018-04-01

Full Text Available Background: Autoimmune hypothyroidism (Hashimoto thyroiditis; HT is the most common postnatal thyroid disease. Clinical manifestations of HT vary according to disease severity. Due to the pleiotropic effects of thyroid hormone, less common signs and symptoms of HT can occur, leading to a delay in diagnosis. Case presentation: A 9-year-old girl of Indian origin was admitted for a one-week history of widespread myalgia, fatigue, muscle weakness, difficulty walking, and a significant increase in weight (approximately 2 kg without any changes in daily habits. The only relevant medical history was several intermittent vaginal bleeding episodes since four years of age. Breast development was consistent with Tanner stage 2 without pubic or axillary hair; while height and weight were at the 10th percentile and the 38th percentile; respectively. Bone age from a left wrist X-ray was delayed 1 year. Pelvic ultrasonography revealed a uterine body/neck ratio of >1 (pubertal stage and multifollicular ovaries. Her external genitalia had a childlike appearance. Laboratory examinations showed an increased thyroid-stimulating hormone, decreased free thyroxine, and positive anti-thyroglobulin antibody titres, as well as elevation of creatine phosphokinase, myoglobin, lactate dehydrogenase, serum aspartate aminotransferase, hypercholesterolemia, and a basal serum prolactin near the upper limit of normal. Follicle stimulating hormone and estradiol were slightly and significantly elevated, respectively. Thyroid ultrasound showed an increased gland size with irregular echostructures and high vascularization. Levothyroxine replacement therapy led to complete normalization of clinical and laboratory findings, including rhabdomyolysis indices. No further vaginal bleeding episodes were reported. Conclusion: This case report highlights how various can be the clinical picture of HT in children, and how rare clinical manifestations can be the only signs of disease at

Fatal respiratory distress syndrome due to coronavirus infection in a child with severe combined immunodeficiency

OpenAIRE

Szczawinska‐Poplonyk, Aleksandra; Jonczyk‐Potoczna, Katarzyna; Breborowicz, Anna; Bartkowska‐Sniatkowska, Alicja; Figlerowicz, Magdalena

2012-01-01

Please cite this paper as: Szczawinska‐Poplonyk et al. (2012) Fatal respiratory distress syndrome due to coronavirus infection in a child with severe combined immunodeficiency. Influenza and Other Respiratory Viruses DOI: 10.1111/irv.12059. Coronaviruses have been demonstrated to contribute substantially to respiratory tract infections among the child population. Though infected children commonly present mild upper airway symptoms, in high‐risk patients with underlying conditions, particularl...

On the limits of effort testing: symptom validity tests and severity of neurocognitive symptoms in nonlitigant patients

NARCIS (Netherlands)

Merten, Thomas; Bossink, Linda; Schmand, Ben

2007-01-01

Modern symptom validity tests (SVTs) use empirical cutoffs for decision making. However, limits to the applicability of these cutoffs may arise when severe cognitive symptoms are present. The purpose of the studies presented here was to explore these limits of applicability. In Experiment 1, a group

The importance of human performance and procedures in limiting severe accident risks

International Nuclear Information System (INIS)

Higgins, J.C.

1990-01-01

Due to the defense in depth concept and redundancy in safety systems utilized, complex industrial plants, such as nuclear power plants (NPPs) can be operated safely. This capability has been demonstrated by many years of safe operation by numerous NPPs in the US and abroad. However, the occurrence of severe accidents has also demonstrated that constant vigilance in a number of areas is necessary to ensure continued safe operation. The areas noted as particularly important are Design, Organization and Management, Maintenance, and Operations (Human Performance). 18 refs

Severe acute caffeine poisoning due to intradermal injections: mesotherapy hazard.

Science.gov (United States)

Vukcević, Natasa Perković; Babić, Gordana; Segrt, Zoran; Ercegović, Gordana Vuković; Janković, Snezana; Aćimović, Ljubomir

2012-08-01

Caffeine is indicated in the treatment of migraine headaches, as well as neonatal apnea and bradycardia syndrome. In mild poisoning, the most prevalent symptoms are nausea, vomiting, diarrhea, tremor, anxiety and headache. In more severe cases, symptoms consist of heart rythym abnormalities, myocardial infarction and seizures. Due to its common lipolytic effect, caffeine is used in mesotherapy, usually in combination with drugs of similar effect. We presented a patient with acute iatrogenic caffeine poisoning. A 51-year-old woman, with preexisting hypertension and hypertensive cardiomyopathy was subjected to cosmetic treatment in order to remove fat by intradermal caffeine injections. During the treatment the patient felt sickness, an urge to vomit, and a pronounced deterioration of general condition. Upon examination, the patient exhibited somnolence, hypotension and nonsustained ventricular tachycardia, which was sufficient enough evidence for further hospitalization. On admission to the intensive care unit the patient was anxious with increased heart rate, normotensive, with cold, damp skin, and visible traces of injection sites with surrounding hematomas on the anterior abdominal wall. Paroxysmal supraventricular tachycardia (PSVT) on electrocardiographic monitoring was found. The laboratory analysis determined a lowered potassium level of 2.1 mmol/L (normal range 3,5 - 5.2 mmol/L), and a toxicological analysis (liquid chromatography with ultraviolet detection) proved a toxic concentration of caffeine in plasma - 85.03 mg/L (toxic concentration over 25 mg/L). On application of intensive therapy, antiarrhythmics, and substitution of potassium, as well as both symptomatic and supportive therapy, there was a significant recovery. The patient was discharged without any sequele within four days. A presented rare iatrogenic acute caffeine poisoning occured due to massive absorption of caffeine from the subcutaneous adipose tissue into the circulation when injected

Double filtration plasmapheresis in the treatment of pancreatitis due to severe hypertriglyceridemia.

Science.gov (United States)

Galán Carrillo, Isabel; Demelo-Rodriguez, Pablo; Rodríguez Ferrero, María Luisa; Anaya, Fernando

2015-01-01

Severe hypertriglyceridemia (HTG) leads to major complications such as acute pancreatitis. Lipoprotein apheresis has been proposed as a therapeutic tool for decreasing triglyceride levels, although experience is limited. To describe our experience with double filtration plasmapheresis (DFPP) in patients with severe HTG and pancreatitis in the plasmapheresis unit of a tertiary hospital in Spain. We recruited 4 patients with severe HTG (triglycerides [TGs] >1000 mg/dL) and acute pancreatitis. All the patients underwent DFPP as part of their treatment. Epidemiologic and laboratory data were collected before and after each plasmapheresis session. The average TG level before plasmapheresis was 3136 mg/dL (35.44 mmol/L; range, 1306-6693 mg/dL, 14.76-75.63 mmol/L), and the average Acute Physiology And Chronic Health Evaluation (APACHE) II level before the first session was 6 (range, 3-8). All patients made a full recovery, with a significant improvement in TG levels after plasmapheresis. The mean number of sessions was 2.1 (range, 1-3), and mean TG level after plasmapheresis was 428 mg/dL (4.84 mmol/L; range, 169-515 mg/dL; 1.91-5.82 mmol/L). After the first session, the mean decrease in TG levels was 69.16% (2169 mg/dL, range, 945-5925 mg/dL; 24.51 mmol/L, range, 10.78-66.95 mmol/L), and after the last session, TG levels fell by 89.09% (2794 mg/dL, range, 945-6198 mg/dL; 31.57 mmol/L, range, 10.68-70.04 mmol/L). None of the patients developed complications related to plasmapheresis. According to available evidence and our own experience, DFPP can be an effective and rapid treatment option in patients with severe HTG and complications. However, further research, including randomized controlled studies, is necessary. Copyright © 2015 National Lipid Association. Published by Elsevier Inc. All rights reserved.

Cognitive activity limitations one year post-trauma in patients admitted to sub-acute rehabilitation after severe traumatic brain injury

DEFF Research Database (Denmark)

Sommer, Jens Bak; Norup, Anne; Poulsen, Ingrid

2013-01-01

Objective: To examine cognitive activity limitations and predictors of outcome 1 year post-trauma in patients admitted to sub-acute rehabilitation after severe traumatic brain injury. Subjects: The study included 119 patients with severe traumatic brain injury admitted to centralized sub-acute re......Objective: To examine cognitive activity limitations and predictors of outcome 1 year post-trauma in patients admitted to sub-acute rehabilitation after severe traumatic brain injury. Subjects: The study included 119 patients with severe traumatic brain injury admitted to centralized sub......-acute rehabilitation in the Eastern part of Denmark during a 5-year period from 2005 to 2009. Methods: Level of consciousness was assessed consecutively during rehabilitation and at 1 year post-trauma. Severity of traumatic brain injury was classified according to duration of post-traumatic amnesia. The cognitive...... subscale of Functional Independence MeasureTM (Cog-FIM) was used to assess cognitive activity limitations. Multivariate logistic regression analyses were performed to identify predictors of an independent level of functioning. Results: The majority of patients progressed to a post-confusional level...

Approaching the Shockley-Queisser limit: General assessment of the main limiting mechanisms in photovoltaic cells

International Nuclear Information System (INIS)

Vossier, Alexis; Gualdi, Federico; Dollet, Alain; Ares, Richard; Aimez, Vincent

2015-01-01

In principle, the upper efficiency limit of any solar cell technology can be determined using the detailed-balance limit formalism. However, “real” solar cells show efficiencies which are always below this theoretical value due to several limiting mechanisms. We study the ability of a solar cell architecture to approach its own theoretical limit, using a novel index introduced in this work, and the amplitude with which the different limiting mechanisms affect the cell efficiency is scrutinized as a function of the electronic gap and the illumination level to which the cell is submitted. The implications for future generations of solar cells aiming at an improved conversion of the solar spectrum are also addressed

Prediction of limits of lubrication in strip reduction testing

DEFF Research Database (Denmark)

Olsson, David Dam; Bay, Niels; Andreasen, Jan Lasson

2004-01-01

Pick-up and galling due to lubricant film breakdown is a severe limitation in cold forming of tribologically difficult metals like stainless steel and aluminium. The present paper describes a method of combined experimental and numerical analysis to quantify the limits of lubrication in a dedicated...

Severe primary postpartum hemorrhage due to genital tract laceration after operative vaginal delivery: successful treatment with transcatheter arterial embolization

Energy Technology Data Exchange (ETDEWEB)

Fargeaudou, Yann; Soyer, Philippe; Sirol, Marc; Dref, Olivier le; Boudiaf, Mourad; Dahan, Henri; Rymer, Roland [Hopital Lariboisiere-APHP-GHU Nord et Universite Diderot-Paris 7, Department of Abdominal and Interventional Imaging, Paris (France); Morel, Olivier [Hopital Lariboisiere-APHP-GHU Nord et Universite Diderot-Paris 7, Department of Obstetrics, Paris (France)

2009-09-15

The purpose of this study was to report our experience in the management of severe primary postpartum hemorrhage due to genital tract laceration following operative vaginal delivery with forceps using pelvic transcatheter arterial embolization (TAE). Ten women (mean age, 31.9 years) with severe primary postpartum hemorrhage due to genital tract laceration after operative delivery with forceps were treated with TAE. TAE was indicated because of intractable bleeding that could not be controlled with uterotonic drugs, blood transfusion, attempted suturing and packing in all patients. Postdelivery perineal examination showed cervical or vaginal tears in all women and associated paravaginal hematoma in four. Angiography revealed extravasation of contrast material in six patients. TAE performed with gelatin sponge allowed to control the bleeding in all patients. Cervical and vaginal suturing was made possible and successfully achieved in the six women who had failed suturing attempts before TAE. Paravaginal hematoma was successfully evacuated in four patients in whom it was present after TAE. No complications related to TAE were noted. We conclude that in women with severe primary postpartum hemorrhage due to genital tract laceration after operative delivery with forceps, TAE is effective and safe for stopping the bleeding and helps genital tract suturing and evacuation of hematoma. (orig.)

Severe primary postpartum hemorrhage due to genital tract laceration after operative vaginal delivery: successful treatment with transcatheter arterial embolization

International Nuclear Information System (INIS)

Fargeaudou, Yann; Soyer, Philippe; Sirol, Marc; Dref, Olivier le; Boudiaf, Mourad; Dahan, Henri; Rymer, Roland; Morel, Olivier

2009-01-01

The purpose of this study was to report our experience in the management of severe primary postpartum hemorrhage due to genital tract laceration following operative vaginal delivery with forceps using pelvic transcatheter arterial embolization (TAE). Ten women (mean age, 31.9 years) with severe primary postpartum hemorrhage due to genital tract laceration after operative delivery with forceps were treated with TAE. TAE was indicated because of intractable bleeding that could not be controlled with uterotonic drugs, blood transfusion, attempted suturing and packing in all patients. Postdelivery perineal examination showed cervical or vaginal tears in all women and associated paravaginal hematoma in four. Angiography revealed extravasation of contrast material in six patients. TAE performed with gelatin sponge allowed to control the bleeding in all patients. Cervical and vaginal suturing was made possible and successfully achieved in the six women who had failed suturing attempts before TAE. Paravaginal hematoma was successfully evacuated in four patients in whom it was present after TAE. No complications related to TAE were noted. We conclude that in women with severe primary postpartum hemorrhage due to genital tract laceration after operative delivery with forceps, TAE is effective and safe for stopping the bleeding and helps genital tract suturing and evacuation of hematoma. (orig.)

Auditory agnosia due to long-term severe hydrocephalus caused by spina bifida - specific auditory pathway versus nonspecific auditory pathway.

Science.gov (United States)

Zhang, Qing; Kaga, Kimitaka; Hayashi, Akimasa

2011-07-01

A 27-year-old female showed auditory agnosia after long-term severe hydrocephalus due to congenital spina bifida. After years of hydrocephalus, she gradually suffered from hearing loss in her right ear at 19 years of age, followed by her left ear. During the time when she retained some ability to hear, she experienced severe difficulty in distinguishing verbal, environmental, and musical instrumental sounds. However, her auditory brainstem response and distortion product otoacoustic emissions were largely intact in the left ear. Her bilateral auditory cortices were preserved, as shown by neuroimaging, whereas her auditory radiations were severely damaged owing to progressive hydrocephalus. Although she had a complete bilateral hearing loss, she felt great pleasure when exposed to music. After years of self-training to read lips, she regained fluent ability to communicate. Clinical manifestations of this patient indicate that auditory agnosia can occur after long-term hydrocephalus due to spina bifida; the secondary auditory pathway may play a role in both auditory perception and hearing rehabilitation.

Severe acute caffeine poisoning due to intradermal injections: Mesotherapy hazard

Directory of Open Access Journals (Sweden)

Perković-Vukčević Nataša

2012-01-01

Full Text Available Introduction. Caffeine is indicated in the treatment of migraine headaches, as well as neonatal apnea and bradycardia syndrome. In mild poisoning, the most prevalent symptoms are nausea, vomiting, diarrhea, tremor, anxiety and headache. In more severe cases, symptoms consist of heart rythym abnormalities, myocardial infarction and seizures. Due to its common lipolytic effect, caffeine is used in mesotherapy, usually in combination with drugs of similar effect. We presented a patient with acute iatrogenic caffeine poisoning. Case report. A 51-year-old woman, with preexisting hypertension and hypertensive cardiomyopathy was subjected to cosmetic treatment in order to remove fat by intradermal caffeine injections. During the treatment the patient felt sickness, an urge to vomit, and a pronounced deterioration of general condition. Upon examination, the patient exhibited somnolence, hypotension and nonsustained ventricular tachycardia, which was sufficient enough evidence for further hospitalization. On admission to the intensive care unit the patient was anxious with increased heart rate, normotensive, with cold, damp skin, and visible traces of injection sites with surrounding hematomas on the anterior abdominal wall. Paroxysmal supraventricular tachycardia (PSVT on electrocardiographic monitoring was found. The laboratory analysis determined a lowered potassium level of 2.1 mmol/L (normal range 3,5 - 5.2 mmol/L, and a toxicological analysis (liquid chromatography with ultraviolet detection proved a toxic concentration of caffeine in plasma - 85.03 mg/L (toxic concentration over 25 mg/L. On application of intensive therapy, antiarrhythmics, and substitution of potassium, as well as both symptomatic and supportive therapy, there was a significant recovery. The patient was discharged without any sequele within four days. Conclusion. A presented rare iatrogenic acute caffeine poisoning occured due to massive absorption of caffeine from the

[Preclinical treatment of severe burn trauma due to an electric arc on an overhead railway cable].

Science.gov (United States)

Spelten, O; Wetsch, W A; Hinkelbein, J

2013-09-01

Severe burns due to electrical accidents occur rarely in Germany but represent a challenge for emergency physicians and their team. Apart from extensive burns cardiac arrhythmia, neurological damage caused by electric current and osseous injury corresponding to the trauma mechanism are also common. It is important to perform a survey of the pattern of injuries and treat acute life-threatening conditions immediately in the field. Furthermore, specific conditions related to burns must be considered, e.g. fluid resuscitation, thermal management and analgesia. In addition, a correct strategy for further medical care in an appropriate hospital is essential. Exemplified by this case guidelines for the treatment of severe burns and typical pitfalls are presented.

Case Report: Recurrent severe vomiting due to hyperthyroidism.

Science.gov (United States)

Chen, Li-ying; Zhou, Bo; Chen, Zhou-wen; Fang, Li-zheng

2010-03-01

Thyrotoxicosis may present in many ways; severe vomiting as a prominent symptom of thyrotoxicosis is uncommon. In this paper, we report a 24-year-old Chinese male with hyperthyroidism who presented with recurrent severe vomiting. The patient had had intermittent vomiting for seven years and had lost approximately 15 kg of weight. Gastroscopic examinations revealed chronic gastritis and one occasion peptic ulcer. He was treated with antacid and proton pump inhibitors, but his symptoms had no relief. His presenting symptoms suggested hyperthyroidism and were confirmed by laboratory data. After a month of propylthiouracil therapy, his symptoms were relieved. It should be noted that hyperthyroidism patients can have unexplained vomiting, and that hyperthyroidism may coexist with peptic ulcer in rare cases. Awareness of such atypical presentations of hyperthyroidism may help to make a correct diagnosis.

Future trends in the prevalence of severe activity limitations among older adults in Europe: a cross-national population study using EU-SILC

Science.gov (United States)

Scherbov, Sergei; Weber, Daniela

2017-01-01

Objective To project the proportion of population 65+ years with severe long-term activity limitations from 2017 to 2047. Design Large population study. Setting Population living in private households of the European Union (EU) and neighbouring countries. Participants Participants from the EU Statistics on Income and Living Conditions aged 55 years and older and living in one of 26 EU and neighbouring countries, who answered the health section of the questionnaire. Outcome measures Prevalence of severe long-term activity limitations of particular subpopulations (ie, 55+, 65+, 75+ and 85+ years) by sex and country. Results We find a huge variation in the prevalence of self-reported severe long-term limitations across Europe for both sexes. However, in 2017, about 20% of the female population aged 65 years and above and about 16% of their male counterparts are expected to report severe long-term activity limitations after accounting for differences in reporting. Accounting for cultural differences in reporting, we expect that European countries will have about 21% (decile 1: 19.5%; decile 9: 22.9%) of female and about 16.8% (decile 1: 15.4%; decile 9: 18.1%) of male 65+ years population with severe long-term activity limitations by 2047. Conclusions Overall, despite the expected increase of life expectancy in European countries, our results suggest almost constant shares of older adults with severe long-term activity limitations within the next 30 years. PMID:29061570

Central Sleep Apnea in Patients due to Severe Aortic Stenosis

Directory of Open Access Journals (Sweden)

Christian Prinz

2010-01-01

Full Text Available History. We report about the course of central sleep apnea (CSA in 3 patients (70.3±15.2 years with severe aortic stenosis (AS (AVA≤1.0 cm2, NYHA 2.7±1.4. Investigations. Every patient received echocardiography, left/right-heart catheterization, and cardiorespiratory polygraphy before and 6 months after surgical aortic valve replacement (without right-heart catheterization during follow up. Course. Preoperatively all patients demonstrated reduced systolic left ventricular function (EF <55%. They had elevated pulmoraryarterialy pressures and severe CSA. After valve replacement left ventricular function and exercise capacity improved, as well as the severity of CSA. Conclusion. Patients with severe AS can develop CSA, which seems to improve after surgery. Patients with severe AS should be screened for CSA, because CSA might be an additional risk factor and hint that myocardial adaptation is exhausting.

Beta limit due to resistive instabilities in T-10

International Nuclear Information System (INIS)

Kislov, D.A.; Esipchuk, Yu.V.; Kirneva, N.

2001-01-01

Soft beta limiting phenomena have been observed in T-10 in ECRH heated plasmas. Neoclassical tearing modes are supposed to be responsible for the beta limitation. The MHD onset was observed at high β p but low β N values. Critical β has been found to be almost independent of collisionality parameter ν e *. Sawtooth stabilization by ECCD does not result in an increase of critical β. Dependence of the critical β on the q(r) profile (modified by ECCD) has been observed. (author)

Severe maternal morbidity due to sepsis: The burden and preventability of disease in New Zealand.

Science.gov (United States)

Lepine, Sam; Lawton, Beverley; Geller, Stacie; Abels, Peter; MacDonald, Evelyn J

2018-02-20

Sepsis is a life-threatening systemic condition that appears to be increasing in the obstetric population. Clinical detection can be difficult and may result in increased morbidity via delays in the continuum of patient care. To describe the burden of severe maternal morbidity (SMM) caused by sepsis in New Zealand and investigate the potential preventability. A multidisciplinary expert review panel was established to review cases of obstetric sepsis admitted to intensive care or high-dependency units over an 18 month span in New Zealand. Cases were then analysed for the characteristics of infection and their preventability. Fifty cases met the inclusion criteria, most commonly due to uterine, respiratory or kidney infection. Fifty per cent (25) of these cases were deemed potentially preventable, predominantly due to delays in diagnosis and treatment. A high index of suspicion, development of early recognition systems and multi-disciplinary training are recommended to decrease preventable cases of maternal sepsis. © 2018 The Royal Australian and New Zealand College of Obstetricians and Gynaecologists.

Exchange transfusion of least incompatible blood for severe hemolytic disease of the newborn due to anti-Rh17.

Science.gov (United States)

Li, Bi-juan; Jiang, Yuan-jun; Yuan, Fen; Ye, Hong-xing

2010-02-01

HDN attributed to the rare Rh variants has become more and more significant caused by anti-D, but the compatible blood is usually very difficult to obtain when exchange transfusion is required. We treated a 10-hour neonate of O, D + C + c - E - e+ blood group with severe HDN due to anti-Rh17 with least incompatible blood typed O, D + C - c + E + e-. The neonatal hemolysis was relieved obviously and bilirubin was reduced gradually after exchange transfusion. The infant was discharged in good health 13 days after birth with 135.0 g/L, 28.0 micromol/L and 10.7 micromol/L of Hb, total bilirubin and direct bilirubin, respectively. No sequelae were observed in a three-year follow-up. The result suggesting that the least incompatible blood is an alternative choice for exchange transfusion in severe HDN due to anti-Rh17 in case that Rh17 antigen-negative blood is unavailable.

Severe gastric variceal haemorrhage due to splenic artery thrombosis and consecutive arterial bypass

Directory of Open Access Journals (Sweden)

Wasmuth Hermann E

2011-06-01

Full Text Available Abstract Background Upper gastrointestinal haemorrhage is mainly caused by ulcers. Gastric varicosis due to portal hypertension can also be held responsible for upper gastrointestinal bleeding. Portal hypertension causes the development of a collateral circulation from the portal to the caval venous system resulting in development of oesophageal and gastric fundus varices. Those may also be held responsible for upper gastrointestinal haemorrhage. Case presentation In this study, we describe the case of a 69-year-old male with recurrent severe upper gastrointestinal bleeding caused by arterial submucosal collaterals due to idiopathic splenic artery thrombosis. The diagnosis was secured using endoscopic duplex ultrasound and angiography. The patient was successfully treated with a laparoscopic splenectomy and complete dissection of the short gastric arteries, resulting in the collapse of the submucosal arteries in the gastric wall. Follow-up gastroscopy was performed on the 12th postoperative week and showed no signs of bleeding and a significant reduction in the arterial blood flow within the gastric wall. Subsequent follow-up after 6 months also showed no further gastrointestinal bleeding as well as subjective good quality of life for the patient. Conclusion Submucosal arterial collaterals must be excluded by endosonography via endoscopy in case of recurrent upper gastrointestinal bleeding. Laparoscopic splenectomy provides adequate treatment in preventing any recurrent bleeding, if gastric arterial collaterals are caused by splenic artery thrombosis.

Secondary Moments due to Prestressing with Different Bond at the Ultimate Limit State

Directory of Open Access Journals (Sweden)

Halvoník Jaroslav

2018-03-01

Full Text Available Secondary effects of prestressing develop in statically indeterminate structures (e.g., continuous beams due to the restraint of deformations imposed by hyperstatic restraints. These effects may significantly influence internal forces and stresses in prestressed structures. Secondary effects are influenced by the redundancy of a structural system, which raises the question of whether they will remain constant after a change in the structural system, e.g., due to the development of plastic hinge(s in a critical cross-section(s or after the development of a kinematic mechanism, or if they will disappear when the structure changes into a sequence of simply supported beams. The paper deals with an investigation of the behavior of continuous post-tensioned beams subjected to an ultimate load with significant secondary effects from prestressing. A total of 6 two-span beams prestressed by tendons with different bonds were tested in a laboratory with a load that changed their structural system into a kinematic mechanism. The internal forces and secondary effects of the prestressing were controlled through measurements of the reactions in all the supports. The results revealed that the secondary effects remained as a permanent part of the action on the experimental beams, even after the development of the kinematic mechanism. The results obtained confirmed that secondary effects should be included in all combinations of actions for verifications of ultimate limit states (ULS.

Secondary Moments due to Prestressing with Different Bond at the Ultimate Limit State

Science.gov (United States)

Halvoník, Jaroslav; Pažma, Peter; Vida, Radoslav

2018-03-01

Secondary effects of prestressing develop in statically indeterminate structures (e.g., continuous beams) due to the restraint of deformations imposed by hyperstatic restraints. These effects may significantly influence internal forces and stresses in prestressed structures. Secondary effects are influenced by the redundancy of a structural system, which raises the question of whether they will remain constant after a change in the structural system, e.g., due to the development of plastic hinge(s) in a critical cross-section(s) or after the development of a kinematic mechanism, or if they will disappear when the structure changes into a sequence of simply supported beams. The paper deals with an investigation of the behavior of continuous post-tensioned beams subjected to an ultimate load with significant secondary effects from prestressing. A total of 6 two-span beams prestressed by tendons with different bonds were tested in a laboratory with a load that changed their structural system into a kinematic mechanism. The internal forces and secondary effects of the prestressing were controlled through measurements of the reactions in all the supports. The results revealed that the secondary effects remained as a permanent part of the action on the experimental beams, even after the development of the kinematic mechanism. The results obtained confirmed that secondary effects should be included in all combinations of actions for verifications of ultimate limit states (ULS).

Limit lines for risk

International Nuclear Information System (INIS)

Cox, D.C.; Baybutt, P.

1982-01-01

Approaches to the regulation of risk from technological systems, such as nuclear power plants or chemical process plants, in which potential accidents may result in a broad range of adverse consequences must take into account several different aspects of risk. These include overall or average risk, accidents posing high relative risks, the rate at which accident probability decreases with increasing accident consequences, and the impact of high frequency, low consequence accidents. A hypothetical complementary cumulative distribution function (CCDF), with appropriately chosen parametric form, meets all these requirements. The Farmer limit line, by contrast, places limits on the risks due to individual accident sequences, and cannot adequately account for overall risk. This reduces its usefulness as a regulatory tool. In practice, the CCDF is used in the Canadian nuclear licensing process, while the Farmer limit line approach, supplemented by separate qualitative limits on overall risk, is employed in the United Kingdom

Corticosteroid-induced asthma: a manifestation of limited hyperinfection syndrome due to Strongyloides stercoralis.

Science.gov (United States)

Sen, P; Gil, C; Estrellas, B; Middleton, J R

1995-09-01

Inadequate therapeutic response to parenteral corticosteroids in patients with acute bronchial asthma is infrequent. We report four patients whose bronchial asthma symptoms worsened after treatment with parenteral corticosteroids. All had larvae of Strongyloides stercoralis in the stool. The new attack or the exacerbation of asthma appeared to be precipitated by systemic corticosteroid administration. The paradoxic therapeutic response of asthma to glucocorticoides was the major pulmonary manifestation of Strongyloides superinfection; there was no evidence of other organ involvement. Individuals with new onset of bronchial asthma or worsening of asthmatic episodes concurrent with the use of systemic corticosteroids should have thorough investigation for possible superinfection due to Strongyloides stercoralis. This is particularly important for patients who have resided in areas where intestinal helminthic infections are endemic. Discontinuance of steroid therapy or reduction in dosage of parenteral steroids appears necessary. Treatment with thiabendazole appears to be effective in patients with limited hyperinfection syndrome.

Factors associated with persistent airflow limitation in severe asthma

NARCIS (Netherlands)

ten Brinke, A.; Zwinderman, A. H.; Sterk, P. J.; Rabe, K. F.; Bel, E. H.

2001-01-01

Persistent airflow limitation can develop in nonsmoking patients with asthma. However, the prevalence and risk factors for airways obstruction with incomplete reversibility in asthma are unknown. We assessed the prevalence of persistent airflow limitation (defined as postbronchodilator FEV(1) or

Do elderly people at more severe activity of daily living limitation stages fall more?

Science.gov (United States)

Henry-Sánchez, John T; Kurichi, Jibby E; Xie, Dawei; Pan, Qiang; Stineman, Margaret G

2012-07-01

The aim of this study was to explore how activity of daily living (ADL) stages and the perception of unmet needs for home accessibility features associate with a history of falling. Participants were from a nationally representative sample from the Second Longitudinal Survey of Aging conducted in 1994. The sample included 9250 community-dwelling persons 70 yrs or older. The associations of ADL stage and perception of unmet needs for home accessibility features with a history of falling within the past year (none, once, or multiple times) were explored after accounting for sociodemographic characteristics and comorbidities using a multinomial logistic regression model. The adjusted relative risk of falling more than once peaked at 4.30 (95% confidence interval, 3.29-5.61) for persons with severe limitation (ADL-III) compared those with no limitation (ADL-0) then declined for those at complete limitation (ADL-IV). The adjusted relative risks of falling once and multiple times were 1.42 (95% confidence interval, 1.07-1.87) and 1.85 (95% confidence interval, 1.44-2.36), respectively, for those lacking home accessibility features. Risk of falling appeared greatest for those whose homes lacked accessibility features and peaked at intermediate ADL limitation stages, presumably at a point when people have significant disabilities but sufficient function to remain partially active.

Severe dyspnea due to a giant antrochoanal polyp

OpenAIRE

Coloma-Milano M; Gil-Carcedo-Sañudo E; Gil-Carcedo-García LM.; Martín-Batista S; Madrigal-Revuelta M; Vallejo-Valdezate LA

2012-01-01

SummaryIntroduction: The antrochoanal polyp is a prevalent pathology in teenagers and young adults. It usually presents with nasal obstruction.Patient and method: Case report: An 80-year-old male with alcoholic encephalopathy, chronic bronchial disease of unknown etiology and polypoid chronic rhinosinusitis came to the emergency service with severe dyspnea without laryngeal features.Anterior rhinoscopy showed a polypoid mass in left nostril that prevented the visualization with nasal endoscop...

Changes in the Severity and Injury Sources of Thoracic Aorta Injuries due to Vehicular Crashes.

Science.gov (United States)

Ryb, Gabriel; Dischinger, Patricia; Kerns, Timothy; Burch, Cynthia; Rabin, Joseph; Ho, Shiu

Research using the National Automotive Sampling System-Crashworthiness Data System (NASS-CDS) suggested a decreased adjusted risk of thoracic aorta injuries (TAI) for newer vehicles during near-side crashes and an increased adjusted TAI risk during frontal crashes. This study attempted to explore possible explanations of these findings. Adult front seat occupants in the Crash Injury Research and Engineering Network (CIREN) database through June 2012 were studied. TAI cases were compared with remaining cases in relation to crash and vehicular characteristics. TAI cases of later crash year (CY) (2004-2012) were compared to those in earlier CY (1996-2003) in relation to TAI severity (minor, moderate, severe and non-survivable). TAI cases in newer model year (MY) vehicles (1999-2012) were compared to those in older vehicles (1988-98) in relation to injury source (steering wheel, front, left, seat belt, air bag and other or unknown). Analysis was stratified by direction of impact (frontal and near-side) and the use of restraints. The similar TAI severity of earlier and later CY among frontal crashes suggests that the observed changes in the adjusted odds of injury seen in NASS-CDS are not due to an increase in injury detection. The decrease in TAI severity among newer vehicles in near-side crashes of later CY is consistent with a beneficial effect of crashworthiness improvements for this crash configuration. A shift of injury source in frontal crashes from the steering wheel in older vehicles to "front of vehicle structures", "seat belts" and "unknown and other" in newer vehicles should suggest potential sites for crashworthiness improvements.

Elevated Cytokines, Thrombin and PAI-1 in Severe HCPS Patients Due to Sin Nombre Virus

Directory of Open Access Journals (Sweden)

Virginie Bondu

2015-02-01

Full Text Available Sin Nombre Hantavirus (SNV, Bunyaviridae Hantavirus is a Category A pathogen that causes Hantavirus Cardiopulmonary Syndrome (HCPS with case fatality ratios generally ranging from 30% to 50%. HCPS is characterized by vascular leakage due to dysregulation of the endothelial barrier function. The loss of vascular integrity results in non-cardiogenic pulmonary edema, shock, multi-organ failure and death. Using Electric Cell-substrate Impedance Sensing (ECIS measurements, we found that plasma samples drawn from University of New Mexico Hospital patients with serologically-confirmed HCPS, induce loss of cell-cell adhesion in confluent epithelial and endothelial cell monolayers grown in ECIS cultureware. We show that the loss of cell-cell adhesion is sensitive to both thrombin and plasmin inhibitors in mild cases, and to thrombin only inhibition in severe cases, suggesting an increasing prothrombotic state with disease severity. A proteomic profile (2D gel electrophoresis and mass spectrometry of HCPS plasma samples in our cohort revealed robust antifibrinolytic activity among terminal case patients. The prothrombotic activity is highlighted by acute ≥30 to >100 fold increases in active plasminogen activator inhibitor (PAI-1 which, preceded death of the subjects within 48 h. Taken together, this suggests that PAI-1 might be a response to the severe pathology as it is expected to reduce plasmin activity and possibly thrombin activity in the terminal patients.

Assessment and limitation of radioactivity transfers in the event of a postulated severe PWR accident

International Nuclear Information System (INIS)

Gauvain, J.

1992-01-01

This report constitutes the supporting material for a lecture on severe accidents which could occur on PWR type nuclear reactors. It is assumed for present purposes that the reader has at least a rudimentary acquaintance with the basics of general physics if not with the operating processes of these reactors. After defining what is meant by a ''severe accident'' on a reactor, the possible phenomenology of such an accident is qualitatively described: loss of coolant and loss of containment integrity. A certain number of elements are then given for the quantitative assessment of these phenomena involving possible radioactivity transfers within and outside the plant. In conclusion, available means are indicated for the limitation and control of these environmental transfers. (author). 5 refs, figs

Knock-limited performance of several internal coolants

Science.gov (United States)

Bellman, Donald R; Evvard, John C

1945-01-01

The effect of internal cooling on the knock-limited performance of an-f-28 fuel was investigated in a CFR engine, and the following internal coolants were used: (1) water, (2), methyl alcohol-water mixture, (3) ammonia-methyl alcohol-water mixture, (4) monomethylamine-water mixture, (5) dimethylamine-water mixture, and (6) trimethylamine-water mixture. Tests were run at inlet-air temperatures of 150 degrees and 250 degrees F. to indicate the temperature sensitivity of the internal-coolant solutions.

Beam-limiting and radiation-limiting interlocks

International Nuclear Information System (INIS)

Macek, R.J.

1996-01-01

This paper reviews several aspects of beam-limiting and radiation- limiting interlocks used for personnel protection at high-intensity accelerators. It is based heavily on the experience at the Los Alamos Neutron Science Center (LANSCE) where instrumentation-based protection is used extensively. Topics include the need for ''active'' protection systems, system requirements, design criteria, and means of achieving and assessing acceptable reliability. The experience with several specific devices (ion chamber-based beam loss interlock, beam current limiter interlock, and neutron radiation interlock) designed and/or deployed to these requirements and criteria is evaluated

Energy resolution limitations in a gas scintillation proportional counter

International Nuclear Information System (INIS)

Simons, D.G.; de Korte, P.A.J.; Peacock, A.; Bleeker, J.A.M.

1985-01-01

An investigation is made of the factors limiting the energy resolution of a gas scintillation proportional counter (GSPC). Several of these limitations originate in the drift region of such a counter and data is presented, giving a quantitative description of those effects. Data is also presented of a GSPC without a drift region, that therefore largely circumvents most of those degrading factors. The results obtained so far indicate that in that detector the limitation to the resolution is most probably due to cleanliness of the gas. Further research is underway in order to assess quantitatively the limiting factors in such a driftless GSPC

Epidermolysis bullosa acquisita with moderately severe dysphagia due to esophageal strictures

Directory of Open Access Journals (Sweden)

Jenny Tu

2011-01-01

Full Text Available Epidermolysis bullosa acquisita (EBA is a chronic, autoimmune condition involving the skin and mucous membranes. Symptomatic mucosal involvement is rare, but can impact on quality of life, due to esophageal strictures and dysphagia. We report a case involving a 60-year-old male presenting with bullous skin lesions on areas of friction on his hands, feet and mouth. Milia were visible on some healed areas. Biopsy showed a subepidermal vesicle. Direct immunofluorescence showed intense linear junctional IgG and C3 at the dermo-epidermal junction. Serological tests also supported the diagnosis of EBA. Screening tests for underlying malignancies were negative. Despite treatment with systemic steroids, the patient developed increasing dysphagia, requiring further investigation with esophagoscopy and a barium swallow. Confirmation of extensive esophageal stricturing prompted adjustment of medications including an increase in systemic steroids and addition of azathioprine. Currently, the patient′s disease remains under control, with improvement in all his symptoms and return of anti-basement membrane antibody levels to normal, whilst he remains on azathioprine 150 mg daily and prednisolone 5 mg daily. This case highlights the fact that the treatment of a given patient with EBA depends on severity of disease and co-morbid symptoms. Newer immunoglobulin and biological therapies have shown promise in treatment resistant disease. Considering that long-term immunosuppressants or biologicals will be required, potential side effects of the drugs should be considered. If further deterioration occurs in this patient, cyclosporin A or intravenous immunoglobulin (IV Ig will be considered. Vigilance for associated co-morbidities, especially malignancies, should always be maintained.

Lifetime limitations of ohmic, contacting RF MEMS switches with Au, Pt and Ir contact materials due to accumulation of ‘friction polymer’ on the contacts

International Nuclear Information System (INIS)

Czaplewski, David A; Nordquist, Christopher D; Dyck, Christopher W; Patrizi, Gary A; Kraus, Garth M; Cowan, William D

2012-01-01

We present lifetime limitations and failure analysis of many packaged RF MEMS ohmic contacting switches with Au–Au, Au–Ir, and Au–Pt contact materials operating with 100 µN of contact force per contact in hermetically sealed glass wall packages. All metals were tested using the same switch design in a controlled environment to provide a comparison between the performance of the different materials and their corresponding failure mechanisms. The switch lifetimes of the different contact materials varied from several hundred cycles to 200 million cycles with different mechanisms causing failures for different contact materials. Switches with Au–Au contacts failed due to adhesion when thoroughly cleaned while switches with dissimilar metal contacts (Au–Ir and Au–Pt) operated without adhesion failures but failed due to carbon accumulation on the contacts even in a clean, packaged environment as a result of the catalytic behavior of the contact materials. Switch lifetimes correlated inversely with catalytic behavior of the contact metals. The data suggests the path to increase switch lifetime is to use favorable catalytic materials as contacts, design switches with higher contact forces to break through any residual contamination, and use cleaner, probably smaller, packages. (paper)

Possible limitations to SSPS use due to distribution of world population and world energy consumption centers

Energy Technology Data Exchange (ETDEWEB)

Claverie, M.J.; Dupas, A.P.

1980-09-01

Satellite solar power stations, as envisioned now, would be very large energy systems from the point of view of power output (about 5 GW) and of land requirements (more than 400 sq km for a rectenna and the associated exclusion area). These size constraints could lead to limitations in the use of SSPS in significant parts of the world, due to three main incompatibilities: too high population density, insufficient density of electrical demand, and obligation for a single power station to provide less than about 20% of the total electrical demand in a given geographical zone to assure reliability. The extent of these three possible limitations was assessed, using a future world energy model developed previously. The rationale behind this model is to divide the world into 10 deg latitude by 10 deg longitude zones, in which future electrical demands (in 2000 and 2020/2025) are computed according to energetical previsions of the Case Western Reserve University (CWRU) and of the World Energy Conference (WEC). The results are world wide maps of electrical demand densities in 2000 and 2020/2025.

Severe Hypothyroidism due to the Loss of Therapeutic Efficacy of l-Thyroxine in a Patient with Esophageal Complication Associated with Systemic Sclerosis.

Science.gov (United States)

Lobasso, Antonio; Nappi, Liliana; Barbieri, Letizia; Peirce, Carmela; Ippolito, Serena; Arpaia, Debora; Rossi, Francesca Wanda; de Paulis, Amato; Biondi, Bernadette

2017-01-01

Thyroid function abnormalities and thyroid autoantibodies have been frequently described in patients with systemic autoimmune diseases as systemic sclerosis (SSc). Serum TSH levels are higher in SSc patients with more severe skin diseases and a worse modified Rodnan skin score. Asymptomatic esophageal involvement due to SSc has never been described as a cause of severe hypothyroidism due to l-thyroxine (l-T4) malabsorption in patients with Hashimoto's thyroiditis (HT) and SSc. Here, we report a case of a 56-year-old female affected by both SSc and HT who developed severe hypothyroidism due to the loss of therapeutic efficacy of l-T4. Therapeutic failure resulted from the altered l-T4 absorption because of SSc esophageal complications. Clinical findings improved after the administration of oral liquid l-T4. Thyroid function completely normalized with a full clinical recovery, the disappearance of the pericardial effusion and the improvement of the pulmonary pressure. A recognition of a poor absorption is crucial in patients with hypothyroidism and SSc to reduce the risk of the subsequent adverse events. This case suggests the importance of clinical and laboratory surveillance in patients with SSc and HT because the systemic complications of these dysfunctions may worsen the prognosis of hypothyroid SSc/HT patients.

Severe deterioration of psoriasis due to an insulinoma.

LENUS (Irish Health Repository)

Field, S

2008-03-01

We report a case of a 56-year-old woman who presented with a severe exacerbation of psoriasis with concurrent hypoglycaemic episodes. Methotrexate 17.5 mg weekly was required to control her psoriasis. Investigation of her hypoglycaemia showed raised levels of insulin, C-peptide and proinsulin. Radiological investigation showed a tumour at the tail of the pancreas and the diagnosis was insulinoma. A spleen-preserving distal pancreatectomy was performed and the hypoglycaemic symptoms resolved. Immediately following the pancreatectomy, methotrexate was stopped and the patient\\'s psoriasis went into remission. During a 2-year follow-up, she has required only minimal topical treatment for her skin.

Severe Hypoglycemia due to Isolated ACTH Deficiency in Children: A New Case Report and Review of the Literature

OpenAIRE

Torchinsky, Michael Y.; Wineman, Robert; Moll, George W.

2011-01-01

Isolated ACTH deficiency causes life-threatening severe hypoglycemia. A 7-year-old girl with hypoglycemia due to this rare disorder is described. Our patient had undetectable plasma ACTH repeatedly and cortisol 0 mcg/dl before and after ACTH 1-24 stimulation. There was no evidence of other pituitary hormone deficiency. Glucocorticoid replacement therapy resulted in resolution of all symptoms and normalization of blood glucose. Previously published data on isolated ACTH deficiency in children ...

[A case of severe hemolytic disease of the newborn due to anti-Dia antibody].

Science.gov (United States)

Lee, Sun Min; Im, Sun Ju; Park, Su Eun; Lee, Eun Yup; Kim, Hyung Hoi

2007-10-01

Here we report a severe case of hemolytic anemia of the newborn with kernicterus caused by anti-Di(a) antibody. A full term male infant was transferred due to hyperbilirubinemia on the third day of life. Despite single phototherapy, the baby's total bilirubin had elevated to 30.1 mg/dL. After exchange transfusion, total bilirubin decreased to 11.45 mg/dL. The direct antiglobulin test on the infant's red cells was positive. The maternal and infant's sera showed a negative reaction in routine antibody detection tests, but were positive in Di(a) panel cells. The frequency of the Di(a) antigen among the Korean population is estimated to be 6.4-14.5%. Anti-Di(a) antibody could cause a hemolytic reaction against transfusion or hemolytic disease of the newborn. We suggest the need for reagent red blood cell panels to include Di(a) antigen positive cells in antibody identification test for Korean.

Severity of explicit memory impairment due to Alzheimer's disease improves effectiveness of implicit learning.

Science.gov (United States)

Klimkowicz-Mrowiec, Aleksandra; Slowik, Agnieszka; Krzywoszanski, Lukasz; Herzog-Krzywoszanska, Radosława; Szczudlik, Andrzej

2008-04-01

Consistent evidence from human and experimental animals studies indicates that memory is organized into two relatively independent systems with different functions and brain mechanisms. The explicit memory system, dependent on the hippocampus and adjacent medial temporal lobe structures, refers to conscious knowledge acquisition and intentional recollection of previous experiences. The implicit memory system, dependent on the striatum, refers to learning of complex information without awareness or intention. The functioning of implicit memory can be observed in progressive, gradual improvement across many trials in performance on implicit learning tasks. The influence of explicit memory on implicit memory has not been precisely identified yet. According to data from some studies, explicit memory seems to exhibit no influence on implicit memory,whereas the other studies indicate that explicit memory may inhibit or facilitate implicit memory. The analysis of performance on implicit learning tasks in patients with different severity of explicit memory impairment due to Alzheimer's disease allows one to identify the potential influence of the explicit memory system on the implicit memory system. 51 patients with explicit memory impairment due to Alzheimer's disease (AD) and 36 healthy controls were tested. Explicit memory was examined by means of a battery of neuropsychological tests. Implicit habit learning was examined on probabilistic classification task (weather prediction task). Patients with moderate explicit memory impairment performed the implicit task significantly better than those with mild AD and controls. Results of our study support the hypothesis of competition between the implicit and explicit memory systems in humans.

Severe Hypothyroidism due to the Loss of Therapeutic Efficacy of l-Thyroxine in a Patient with Esophageal Complication Associated with Systemic Sclerosis

Directory of Open Access Journals (Sweden)

Antonio Lobasso

2017-09-01

Full Text Available BackgroundThyroid function abnormalities and thyroid autoantibodies have been frequently described in patients with systemic autoimmune diseases as systemic sclerosis (SSc. Serum TSH levels are higher in SSc patients with more severe skin diseases and a worse modified Rodnan skin score. Asymptomatic esophageal involvement due to SSc has never been described as a cause of severe hypothyroidism due to l-thyroxine (l-T4 malabsorption in patients with Hashimoto’s thyroiditis (HT and SSc.Case reportHere, we report a case of a 56-year-old female affected by both SSc and HT who developed severe hypothyroidism due to the loss of therapeutic efficacy of l-T4. Therapeutic failure resulted from the altered l-T4 absorption because of SSc esophageal complications. Clinical findings improved after the administration of oral liquid l-T4. Thyroid function completely normalized with a full clinical recovery, the disappearance of the pericardial effusion and the improvement of the pulmonary pressure.ConclusionA recognition of a poor absorption is crucial in patients with hypothyroidism and SSc to reduce the risk of the subsequent adverse events. This case suggests the importance of clinical and laboratory surveillance in patients with SSc and HT because the systemic complications of these dysfunctions may worsen the prognosis of hypothyroid SSc/HT patients.

Percutaneous vertebroplasty performed with an 18 G needle for the treatment of severe compression fracture of cervical vertebral body due to malignancy

International Nuclear Information System (INIS)

Chen Long; Ni Caifang; Wang Zhentang; Liu Yizhi; Jin Yonghai; Zhu Xiaoli; Zou Jianwei; Xiao Xiangsheng

2010-01-01

Objective: To investigate the clinical feasibility and efficacy of percutaneous vertebroplasty performed with an 18G needle for the treatment of severe compression fracture of cervical vertebral body due to malignancy. Methods: During the period of 2006-2010 percutaneous vertebroplasty was performed in 10 patients with severe compression fracture of cervical vertebral body due to metastatic lesions. A total of 12 diseased vertebral bodies were detected, which distributed in the C 4 (n = 3), C 5 (n = 3), C 6 (n = 4) and C 7 (n = 2) vertebral bodies. Under DSA guidance an 18G needle was punctured into the target vertebral body and then polymethylmethacrylate bone cement was injected in. A follow-up lasting for one month was conducted. Results: The technical success of both needle puncturing and bone cement injection was achieved in all patients. The mean amount of bone cement injected in each diseased vertebra was 2.2 ml(1.5-3.2)ml. Marked pain relief was quickly obtained in al1 10 patients. No major complications occurred in this series, except for asymptomatic bone cement leaking around vertebra which appeared in 4 vertebral bodies. Conclusion: Percutaneous vertebroplasty, which is performed with an 18G needle, is a safe and effective technique for the treatment of severe compression fracture of cervical vertebral body due to malignancy. (authors)

Maternal and fetal recovery after severe respiratory failure due to influenza

DEFF Research Database (Denmark)

Madsen, Kristine; Strange, Ditte Gry; Hedegaard, Morten

2013-01-01

During pregnancy women are at increased risk of severe complications to influenza infection, including death of mother or fetus, especially if chronic comorbid medical conditions such as diabetes mellitus are present.......During pregnancy women are at increased risk of severe complications to influenza infection, including death of mother or fetus, especially if chronic comorbid medical conditions such as diabetes mellitus are present....

Severe Cushing’s syndrome due to small cell prostate carcinoma: a case and review of literature

Directory of Open Access Journals (Sweden)

M S Elston

2017-07-01

Full Text Available Cushing’s syndrome (CS due to ectopic adrenocorticotrophic hormone (ACTH is associated with a variety of tumours most of which arise in the thorax or abdomen. Prostate carcinoma is a rare but important cause of rapidly progressive CS. To report a case of severe CS due to ACTH production from prostate neuroendocrine carcinoma and summarise previous published cases. A 71-year-old male presented with profound hypokalaemia, oedema and new onset hypertension. The patient reported two weeks of weight gain, muscle weakness, labile mood and insomnia. CS due to ectopic ACTH production was confirmed with failure to suppress cortisol levels following low- and high-dose dexamethasone suppression tests in the presence of a markedly elevated ACTH and a normal pituitary MRI. Computed tomography demonstrated an enlarged prostate with features of malignancy, confirmed by MRI. Subsequent prostatic biopsy confirmed neuroendocrine carcinoma of small cell type and conventional adenocarcinoma of the prostate. Adrenal steroidogenesis blockade was commenced using ketoconazole and metyrapone. Complete biochemical control of CS and evidence of disease regression on imaging occurred after four cycles of chemotherapy with carboplatin and etoposide. By the sixth cycle, the patient demonstrated radiological progression followed by recurrence of CS and died nine months after initial presentation. Prostate neuroendocrine carcinoma is a rare cause of CS that can be rapidly fatal, and early aggressive treatment of the CS is important. In CS where the cause of EAS is unable to be identified, a pelvic source should be considered and imaging of the pelvis carefully reviewed.

Limits on Achievable Dimensional and Photon Efficiencies with Intensity-Modulation and Photon-Counting Due to Non-Ideal Photon-Counter Behavior

Science.gov (United States)

Moision, Bruce; Erkmen, Baris I.; Farr, William; Dolinar, Samuel J.; Birnbaum, Kevin M.

2012-01-01

An ideal intensity-modulated photon-counting channel can achieve unbounded photon information efficiencies (PIEs). However, a number of limitations of a physical system limit the practically achievable PIE. In this paper, we discuss several of these limitations and illustrate their impact on the channel. We show that, for the Poisson channel, noise does not strictly bound PIE, although there is an effective limit, as the dimensional information efficiency goes as e[overline] e PIE beyond a threshold PIE. Since the Holevo limit is bounded in the presence of noise, this illustrates that the Poisson approximation is invalid at large PIE for any number of noise modes. We show that a finite transmitter extinction ratio bounds the achievable PIE to a maximum that is logarithmic in the extinction ratio. We show how detector jitter limits the ability to mitigate noise in the PPM signaling framework. We illustrate a method to model detector blocking when the number of detectors is large, and illustrate mitigation of blocking with spatial spreading and altering. Finally, we illustrate the design of a high photon efficiency system using state-of-the-art photo-detectors and taking all these effects into account.

Perceived exercise limitation in asthma: The role of disease severity, overweight, and physical activity in children.

Science.gov (United States)

Westergren, Thomas; Berntsen, Sveinung; Lødrup Carlsen, Karin C; Mowinckel, Petter; Håland, Geir; Fegran, Liv; Carlsen, Kai-Håkon

2017-02-01

Children with asthma may be less physically active than their healthy peers. We aimed to investigate whether perceived exercise limitation (EL) was associated with lung function or bronchial hyper-responsiveness (BHR), socioeconomic factors, prenatal smoking, overweight, allergic disease, asthma severity, or physical activity (PA). The 302 children with asthma from the 10-year examination of the Environment and Childhood Asthma birth cohort study underwent a clinical examination including perceived EL (structured interview of child and parent(s)), measure of overweight (body mass index by sex and age passing through 25 kg/m 2 or above at 18 years), exercise-induced bronchoconstriction (forced expiratory volume in one-second (FEV 1 ) pre- and post-exercise), methacholine bronchial challenge (severe BHR; provocative dose causing ≥20% decrease in FEV 1 ≤ 1 μmol), and asthma severity score (dose of controller medication and exacerbations last 12 months). Multivariate logistic regression analyses were conducted to assess associations with perceived EL. In the final model explaining 30.1%, asthma severity score (OR: 1.49, (1.32, 1.67)) and overweight (OR: 2.35 (1.14, 4.82)) only were significantly associated with perceived EL. Excluding asthma severity and allergic disease, severe BHR (OR: 2.82 (1.38, 5.76)) or maximal reduction in FEV 1 post-exercise (OR: 1.48 (1.10, 1.98)) and overweight (OR: 2.15 (1.13, 4.08) and 2.53 (1.27, 5.03)) explained 9.7% and 8.4% of perceived EL, respectively. Perceived EL in children with asthma was independently associated with asthma severity and overweight, the latter doubling the probability of perceived EL irrespectively of asthma severity, allergy status, socioeconomic factors, prenatal smoking, or PA. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Severe oral infection due to Lactobacillus rhamnosus during induction chemotherapy for acute myeloid leukemia.

Science.gov (United States)

Ishihara, Yuko; Kanda, Junya; Tanaka, Kaori; Nakano, Hirofumi; Ugai, Tomotaka; Wada, Hidenori; Yamasaki, Ryoko; Kawamura, Koji; Sakamoto, Kana; Ashizawa, Masahiro; Sato, Miki; Terasako-Saito, Kiriko; Kimura, Shun-Ichi; Kikuchi, Misato; Nakasone, Hideki; Yamazaki, Rie; Kako, Shinichi; Nishida, Junji; Watanabe, Kunitomo; Kanda, Yoshinobu

2014-12-01

We report a case of severe oral infection with a high fever due to Lactobacillus rhamnosus during induction chemotherapy for acute myeloid leukemia. The patient did not improve on treatment with meropenem, clindamycin, or vancomycin until neutrophil recovery. Since L. rhamnosus GG is used in dairy products, and the patient ingested dairy products daily before starting chemotherapy, we suspected an association between the ingestion of dairy products and the development of infection. Pulsed-field gel electrophoresis using two different restriction enzymes showed that the strain isolated from the patient was identical to the L. rhamnosus GG strain isolated from dairy products and ATCC #53103. This was confirmed by a PCR assay with species-specific L. rhamnosus GG primers. Since Lactobacillus infection, particularly L. rhamnosus infection, can be fatal in immunocompromised hosts, we should consider Lactobacillus as a causative organism when Gram-positive rods are detected during treatment with broad-spectrum antibiotics and vancomycin. The causal association between the ingestion of dairy products containing Lactobacillus and Lactobacillus infection in immunocompromised hosts warrants further study.

New era of silicon technologies due to radical reaction based semiconductor manufacturing

International Nuclear Information System (INIS)

Ohmi, Tadahiro; Hirayama, Masaki; Teramoto, Akinobu

2006-01-01

Current semiconductor technology, the so-called the molecule reaction based semiconductor manufacturing, now faces a very severe standstill due to the drastic increase of gate leakage currents and drain leakage currents. Radical reaction based semiconductor manufacturing has been developed to completely overcome the current standstill by introducing microwave excited high density plasma with very low electron temperatures and without accompanying charge-up damage. The introduction of radical reaction based semiconductor manufacturing has made it possible to fabricate LSI devices on any crystal orientation Si substrate surface as well as (100) Si substrate surfaces, and to eliminate a very severe limitation to the antenna ratio in the circuit layout patterns, which is strictly limited to less than 100-200 in order to obtain a relatively high production yield. (topical review)

Intrinsic spatial resolution limitations due to differences between positron emission position and annihilation detection localization

International Nuclear Information System (INIS)

Perez, Pedro; Malano, Francisco; Valente, Mauro

2012-01-01

Since its successful implementation for clinical diagnostic, positron emission tomography (PET) represents the most promising medical imaging technique. The recent major growth of PET imaging is mainly due to its ability to trace the biologic pathways of different compounds in the patient's body, assuming the patient can be labeled with some PET isotope. Regardless of the type of isotope, the PET imaging method is based on the detection of two 511-keV gamma photons being emitted in opposite directions, with almost 180 deg between them, as a consequence of electron-positron annihilation. Therefore, this imaging method is intrinsically limited by random uncertainties in spatial resolutions, related with differences between the actual position of positron emission and the location of the detected annihilation. This study presents an approach with the Monte Carlo method to analyze the influence of this effect on different isotopes of potential implementation in PET. (author)

Severe hypokalaemic paralysis and rhabdomyolysis due to ingestion of liquorice

NARCIS (Netherlands)

A.E. van den Bosch (Annemien); J.M. van der Klooster; D.M. Zuidgeest; R.J.T. Ouwendijk (Rob); A. Dees

2005-01-01

textabstractChronic ingestion of liquorice induces a syndrome with findings similar to those in primary hyperaldosteronism. We describe a patient who, with a plasma K+ of 1.8 mmol/l, showed a paralysis and severe rhabdomyolysis after the habitual consumption of natural liquorice.

[Severe iatrogenic airway obstruction due to lingual lymphangioma].

Science.gov (United States)

Segado Arenas, A; Flores González, J-C; Rubio Quiñones, F; Quintero Otero, S; Hernández González, A; Pantoja Rosso, S

2011-09-01

Lymphangioma of the tongue is a rare and benign tumour involving congenital and cystic abnormalities derived from lymphatic vessels. Treatment modalities include surgery and a large number of different intralesional injections of sclerosing agents. Presently, OK-432 (Picibanil(®)) is the preferred sclerosant and when administered intralesionally will result in inflammation, sclerosis, and cicatricial contraction of the lesion. We report a case of microcystic lymphangioma of the tongue in a 5-year-old boy treated with an intralesional injection of OK-432. In the immediate postoperative period, the patient suffered severe diffuse swelling, progressive upper airway obstruction with inspiratory stridor, and respiratory distress requiring emergency fiberoptic nasotracheal intubation. Although OK-432 injections are found to be safe and effective as a first line of treatment for lymphangiomas, local swelling with potentially life-threatening airway compromise should be anticipated, especially when treating lesions near the upper airway. Copyright © 2011 Elsevier Masson SAS. All rights reserved.

Clinical correlates and outcomes in a group of Puerto Ricans with systemic lupus erythematosus hospitalized due to severe infections

Science.gov (United States)

Jordán-González, Patricia; Shum, Lee Ming; González-Sepúlveda, Lorena

2018-01-01

Objective: Infections are a major cause of morbidity and mortality in systemic lupus erythematosus. Clinical outcomes of systemic lupus erythematosus patients hospitalized due to infections vary among different ethnic populations. Thus, we determined the outcomes and associated factors in a group of Hispanics from Puerto Rico with systemic lupus erythematosus admitted due to severe infections. Methods: Records of systemic lupus erythematosus patients admitted to the Adult University Hospital, San Juan, Puerto Rico, from January 2006 to December 2014 were examined. Demographic parameters, lupus manifestations, comorbidities, pharmacologic treatments, inpatient complications, length of stay, readmissions, and mortality were determined. Patients with and without infections were compared using bivariate and multivariate analyses. Results: A total of 204 admissions corresponding to 129 systemic lupus erythematosus patients were studied. The mean (standard deviation) age was 34.7 (11.6) years; 90% were women. The main causes for admission were lupus flare (45.1%), infection (44.0%), and initial presentation of systemic lupus erythematosus (6.4%). The most common infections were complicated urinary tract infections (47.0%) and soft tissue infections (42.0%). In the multivariate analysis, patients admitted with infections were more likely to have diabetes mellitus (odds ratio: 4.20, 95% confidence interval: 1.23–14.41), exposure to aspirin prior to hospitalization (odds ratio: 4.04, 95% confidence interval: 1.03–15.80), and higher mortality (odds ratio: 6.00, 95% confidence interval: 1.01–35.68) than those without infection. Conclusion: In this population of systemic lupus erythematosus patients, 44% of hospitalizations were due to severe infections. Patients with infections were more likely to have diabetes mellitus and higher mortality. Preventive and control measures of infection could be crucial to improve survival in these patients.

Dose. Detriment. Limit assessment

International Nuclear Information System (INIS)

Breckow, J.

2015-01-01

One goal of radiation protection is the limitation of stochastic effects due to radiation exposure. The probability of occurrence of a radiation induced stochastic effect, however, is only one of several other parameters which determine the radiation detriment. Though the ICRP-concept of detriment is a quantitative definition, the kind of detriment weighting includes somewhat subjective elements. In this sense, the detriment-concept of ICRP represents already at the stage of effective dose a kind of assessment. Thus, by comparing radiation protection standards and concepts interconvertible or with those of environment or occupational protection one should be aware of the possibly different principles of detriment assessment.

Severe hyponatremia associated with escitalopram

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Gautam Rawal

2017-01-01

Full Text Available Hyponatremia is a rare but potentially fatal complication of selective serotonin reuptake inhibitor (SSRI therapy with only limited cases of escitalopram as the causative drug. We report the case of a 54-year-old hypertensive female who was admitted to the hospital with seizure episode and subsequently diagnosed to have severe hyponatremia due to SSRI-induced syndrome of inappropriate antidiuretic hormone (SIADH with the cause attributed to the short history of intake of escitalopram for depression. All SSRIs, including escitalopram, can cause SIADH and should be used with caution in the depressive patients with regular monitoring of electrolytes, especially in the elderly.

The limitation and modification of flux-limited diffusion theory

International Nuclear Information System (INIS)

Liu Chengan; Huang Wenkai

1986-01-01

The limitation of various typical flux-limited diffusion theory and advantages of asymptotic diffusion theory with time absorption constant are analyzed and compared. The conclusions are as following: Though the flux-limited problem in neutron diffusion theory are theoretically solved by derived flux-limited diffusion equation, it's going too far to limit flux due to the inappropriate assumption in deriving flux-limited diffusion equation. The asymptotic diffusion theory with time absorption constant has eliminated the above-mentioned limitation, and it is more accurate than flux-limited diffusion theory in describing neutron transport problem

Upper limits from counting experiments with multiple pipelines

International Nuclear Information System (INIS)

Sutton, Patrick J

2009-01-01

In counting experiments, one can set an upper limit on the rate of a Poisson process based on a count of the number of events observed due to the process. In some experiments, one makes several counts of the number of events, using different instruments, different event detection algorithms or observations over multiple time intervals. We demonstrate how to generalize the classical frequentist upper limit calculation to the case where multiple counts of events are made over one or more time intervals using several (not necessarily independent) procedures. We show how different choices of the rank ordering of possible outcomes in the space of counts correspond to applying different levels of significance to the various measurements. We propose an ordering that is matched to the sensitivity of the different measurement procedures and show that in typical cases it gives stronger upper limits than other choices. As an example, we show how this method can be applied to searches for gravitational-wave bursts, where multiple burst-detection algorithms analyse the same data set, and demonstrate how a single combined upper limit can be set on the gravitational-wave burst rate.

A review of severe accident assessment

International Nuclear Information System (INIS)

Kawashima, Kei

2000-01-01

One of the most difficult problems on evaluation of external costs on nuclear power generation is value on a severe accident risk. Once forming a severe accident, its effect is very important and extends to a wide range, to give a lot of damages. It is a main area of study on externality of energy to compare various risks by means of price conversion at unit kWh. Here was outlined on research examples on main severe accident risks before then. A common fact on estimation cost such research examples is to limit it to direct cost (mainly to health damage) at accident phenomenon. As an actual problem, it is very difficult to substantially quantify such parameters because of basically belonging to social psychology. It is due to no finding out decisive evaluation method on this problem to be adopted conventional EED (Expert Expected Damages) approach in the ExternE Phase III, either. (G.K.)

Value of pelvic embolization in the management of severe postpartum hemorrhage due to placenta accreta, increta or percreta

International Nuclear Information System (INIS)

Soyer, Philippe; Morel, Olivier; Fargeaudou, Yann; Sirol, Marc; Staub, Fabrice; Boudiaf, Mourad

2011-01-01

Objectives: To evaluate the role, efficacy and safety of pelvic embolization in the management of severe postpartum hemorrhage in women with placenta accreta, increta or percreta. Methods: The clinical files and angiographic examinations of 12 consecutive women with placenta accreta (n = 4), increta (n = 2) or percreta (n = 6) who were treated with pelvic embolization because of severe primary (n = 10) or secondary (n = 2) postpartum hemorrhage were reviewed. Before embolization, four women had complete placental conservation, four had partial placental conservation, three had an extirpative approach and one had hysterectomy after failed partial conservative approach. Results: In 10 women, pelvic embolization was successful and stopped the bleeding, after one (n = 7) or two sessions (n = 3). Emergency hysterectomy was needed in two women with persistent bleeding after embolization, both with placenta percreta and bladder involvement first treated by extirpation. One case of regressive hematoma at the puncture site was the single complication of embolization. Conclusions: In women with severe postpartum hemorrhage due to placenta accreta, increta or percreta, pelvic embolization is effective for stopping the bleeding in most cases, thus allowing uterine conservation and future fertility. Further studies, however, should be done to evaluate the potential of pelvic embolization in women with placenta percreta with bladder involvement.

Acute sensorineural hearing loss and severe otalgia due to scrub typhus

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Kim Dong-Min

2009-10-01

Full Text Available Abstract Background Scrub typhus is an acute febrile illness caused by Orientia tsutsugamushi. Case presentations We encountered a patient with sensorineural hearing loss complicating scrub typhus, and three patients with scrub typhus who complained of otalgia, which was sudden onset, severe, paroxysmal, intermittent yet persistent pain lasting for several seconds, appeared within 1 week after the onset of fever and rash. The acute sensorineural hearing loss and otalgia were resolved after antibiotic administration. Conclusion When patients in endemic areas present with fever and rash and have sensorineural hearing loss or otalgia without otoscopic abnormalities, clinicians should suspect scrub typhus and consider empirical antibiotic therapy.

A pre-operative group rehabilitation programme provided limited benefit for people with severe hip and knee osteoarthritis.

Science.gov (United States)

Wallis, Jason A; Webster, Kate E; Levinger, Pazit; Fong, Cynthia; Taylor, Nicholas F

2014-01-01

To determine if a pre-operative group rehabilitation programme can improve arthritis self-efficacy for people with severe hip and knee osteoarthritis. Single group, repeated measures design: 4-week baseline phase followed by a 6-week intervention phase of water exercise, and education with self-management strategies. The primary outcome was arthritis self-efficacy. The secondary outcomes were measures of pain (WOMAC), activity limitation (WOMAC), activity performance (30 s chair stand test, 10 m walk test) and health-related quality of life (EuroQol). Twenty participants (10 knee osteoarthritis and 10 hip osteoarthritis) with a mean age of 71 years (SD 7) attended 92% (SD 10%) of the scheduled sessions. All measures demonstrated baseline stability between two time points for measurements at week 1 and measurements at week 4. After the 6-week intervention programme there were no significant improvements for arthritis self-efficacy. There was a 12% increase for fast walking speed (mean increase of 0.14 m/s, 95% CI 0.07, 0.22). There were no significant improvements for other secondary outcomes. A pre-operative water-based exercise and educational programme did not improve arthritis self-efficacy, self-reported pain and activity limitation, and health-related quality of life for people with hip and knee osteoarthritis who were candidates for joint replacement. While there was a significant increase in one measure of activity performance (walking speed), these findings suggest the current programme may be of little value. Implications for Rehabilitation This pre-operative group rehabilitation programme for people with severe hip and knee osteoarthritis did not change arthritis self-efficacy, pain, activity limitation and health-related quality of life. This programme may have little value in preparing people for joint replacement surgery. The optimal pre-operative programme requires further design and investigation.

Standing balance in people with trans-tibial amputation due to vascular causes: A literature review.

Science.gov (United States)

Seth, Mayank; Lamberg, Eric

2017-08-01

Balance is an important variable to consider during the rehabilitation process of individuals with trans-tibial amputation. Limited evidence exists on the balance abilities of people with trans-tibial amputation due to vascular causes. The purpose of this article is to review literature and determine if standing balance is diminished in people with trans-tibial amputation due to vascular causes. Literature review. Data were obtained from PubMed, Google Scholar, OandP.org , CINHAL, and Science Direct. Studies were selected only if they included standing balance assessment of people with unilateral trans-tibial amputation due to vascular causes. The review yielded seven articles that met the inclusion criteria. The general test methodology required participants to stand still on force platforms, with feet together, while center of pressure or postural sway was recorded. According to the findings of this review, individuals with trans-tibial amputees due to vascular causes have diminished balance abilities. Limited evidence suggests their balance might be further diminished as compared to individuals with trans-tibial amputation due to trauma. Although the evidence is limited, because of the underlying pathology and presence of comorbidities in individuals with trans-tibial amputation due to vascular causes, one cannot ignore these findings, as even a minor injury from a fall may develop into a non-healing ulcer and affect their health and well-being more severely than individuals with trans-tibial amputation due to trauma. Clinical relevance Individuals with trans-tibial amputation due to vascular causes have diminished balance abilities compared to healthy individuals and individuals with trans-tibial amputation due to trauma. This difference should be considered when designing and fabricating prostheses. Prosthetists and rehabilitation clinicians should consider designing amputation cause-specific rehabilitation interventions, focussing on balance and other

Severe Hyponatremia due to Levofloxacin Treatment for Pseudomonas aeruginosa Community-Acquired Pneumonia in a Patient with Oropharyngeal Cancer

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Mihaela Mocan

2016-01-01

Full Text Available Hyponatremia (serum Na levels of <135 mEq/L is the most common electrolyte imbalance encountered in clinical practice, affecting up to 15–28% of hospitalized patients. This case report refers to a middle-aged man with severe hyponatremia due to Syndrome of Inappropriate Antidiuretic Hormone Secretion related to four possible etiological factors: glossopharyngeal squamous cell carcinoma, cisplatin treatment, right basal pneumonia with Pseudomonas aeruginosa, and the treatment with Levofloxacin. This case report discusses a rare complication of common conditions and of a common treatment. To our knowledge this is the first case of hyponatremia related to Levofloxacin and the second related to fluoroquinolones.

Twin pregnancy complicated by severe hemolytic disease of the fetus and newborn due to anti-g and anti-C.

Science.gov (United States)

Trevett, Thomas N; Moise, Kenneth J

2005-11-01

Hemolytic disease of the fetus and newborn caused by anti-G antibodies is rare, and in most previously reported cases, leads to a mild anemia. The RhG antigen is usually found in association with both RhD and RhC. We report a case of a twin pregnancy affected by both anti-G and anti-C alloantibodies leading to severe hemolytic disease of the fetus and newborn requiring multiple intrauterine transfusions and prolonged postnatal therapy. A patient with a prolonged history of previously affected pregnancies due to anti-D and anti-C was subsequently found to be affected with anti-G instead. She required aggressive therapy during her pregnancy, initially with intravenous immune globulin and plasmapheresis until umbilical blood sampling and intrauterine transfusions were feasible. Although hemolytic disease of the fetus and newborn due to anti-G antibodies is rare and usually mild, these pregnancies should be followed up closely and in utero therapy should be offered if necessary.

Prestressing of reinforcing bars in concrete slabs due to concrete expansion induced by Alkali-Silica Reaction

DEFF Research Database (Denmark)

Gustenhoff Hansen, Søren; Antonio Barbosa, Ricardo; Hoang, Linh Cao

2017-01-01

Alkali-silica reactions (ASR) in concrete bridges have been a major concern worldwide for many decades. In Denmark, several bridges are severely damaged due to ASR and over 600 bridges have the potential to develop ASR in the future. The majority of these bridges are slab-bridges. Despite the many...... cases, experimental research on structural safety and residual load carrying capacity of ASR-damaged bridges is limited. As ASR causes severe cracks in the concrete, which may affect the concrete compressive and tensile strength, concerns have been directed towards the residual shear capacity. Yet...

Relationship of airflow limitation severity with work productivity reduction and sick leave in a Japanese working population

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Onoue A

2016-03-01

Full Text Available Ayumi Onoue,1 Hisamitsu Omori,1 Takahiko Katoh,2 Kenichi Kubota,3 Yoshio Nonami,3 Yasuhiro Ogata,3 Hiromasa Inoue4 1Department of Biomedical Laboratory Sciences, 2Department of Public Health, Faculty of Life Sciences, Kumamoto University, 3Japanese Red Cross Kumamoto Health Care Center, Kumamoto, 4Department of Pulmonary Medicine, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan Background: The aim of this study was to reveal the association between airflow limitation (AL severity and reduction with work productivity as well as use of sick leave among Japanese workers.Methods: This cross-sectional study included 1,378 workers who underwent a lung function test during a health checkup at the Japanese Red Cross Kumamoto Health Care Center. AL was defined as forced expiratory volume in 1 second/forced vital capacity of <0.7. Workers completed a questionnaire on productivity loss at work and sick leave. The quality and quantity of productivity loss at work were measured on a ten-point scale indicating how much work was actually performed on the previous workday. Participants were asked how many days in the past 12 months they were unable to work because of health problems. Logistic regression analysis was used to assess the associations between AL severity and the quality and quantity of productivity loss at work as well as use of sick leave.Results: Compared with workers without AL, workers with moderate-to-severe AL showed a significant productivity loss (quality: odds ratio [OR] =2.04, 95% confidence interval [CI]: 1.12–3.71, P=0.02 and quantity: OR =2.19, 95% CI: 1.20–4.00, P=0.011 and use of sick leave (OR =2.69, 95% CI: 1.33–5.44, P=0.006 after adjusting for sex, age, body mass index, smoking status, hypertension, hyperglycemia, dyslipidemia, sleep duration, work hours per day, and workplace smoking environment.Conclusion: AL severity was significantly associated with work productivity loss and use

Glyphosate has limited short-term effects on commensal bacterial community composition in the gut environment due to sufficient aromatic amino acid levels.

Science.gov (United States)

Nielsen, Lene Nørby; Roager, Henrik M; Casas, Mònica Escolà; Frandsen, Henrik L; Gosewinkel, Ulrich; Bester, Kai; Licht, Tine Rask; Hendriksen, Niels Bohse; Bahl, Martin Iain

2018-02-01

Recently, concerns have been raised that residues of glyphosate-based herbicides may interfere with the homeostasis of the intestinal bacterial community and thereby affect the health of humans or animals. The biochemical pathway for aromatic amino acid synthesis (Shikimate pathway), which is specifically inhibited by glyphosate, is shared by plants and numerous bacterial species. Several in vitro studies have shown that various groups of intestinal bacteria may be differently affected by glyphosate. Here, we present results from an animal exposure trial combining deep 16S rRNA gene sequencing of the bacterial community with liquid chromatography mass spectrometry (LC-MS) based metabolic profiling of aromatic amino acids and their downstream metabolites. We found that glyphosate as well as the commercial formulation Glyfonova ® 450 PLUS administered at up to fifty times the established European Acceptable Daily Intake (ADI = 0.5 mg/kg body weight) had very limited effects on bacterial community composition in Sprague Dawley rats during a two-week exposure trial. The effect of glyphosate on prototrophic bacterial growth was highly dependent on the availability of aromatic amino acids, suggesting that the observed limited effect on bacterial composition was due to the presence of sufficient amounts of aromatic amino acids in the intestinal environment. A strong correlation was observed between intestinal concentrations of glyphosate and intestinal pH, which may partly be explained by an observed reduction in acetic acid produced by the gut bacteria. We conclude that sufficient intestinal levels of aromatic amino acids provided by the diet alleviates the need for bacterial synthesis of aromatic amino acids and thus prevents an antimicrobial effect of glyphosate in vivo. It is however possible that the situation is different in cases of human malnutrition or in production animals. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

Failure strains and proposed limit strains for an reactor pressure vessel under severe accident conditions

International Nuclear Information System (INIS)

Krieg, R.

2005-01-01

The local failure strains of essential design elements of a reactor vessel are investigated. The size influence of the structure is of special interest. Typical severe accident conditions including elevated temperatures and dynamic loads are considered. The main part of work consists of test families with specimens under uniaxial and biaxial load. Within one test family the specimen geometry and the load conditions are similar, but the size is varied up to reactor dimensions. Special attention is given to geometries with a hole or a notch causing non-uniform stress and strain distributions typical for the reactor vessel. A key problem is to determine the local failure strain. Here suitable methods had to be developed including the so-called 'vanishing gap method', and the 'forging die method'. They are based on post-test geometrical measurements of the fracture surfaces and reconstructions of the related strain fields using finite element models. The results indicate that stresses versus dimensionless deformations are approximately size independent up to failure for specimens of similar geometry under similar load conditions. Local failure strains could be determined. The values are rather high and size dependent. Statistical evaluation allow the proposal of limit strains which are also size dependent. If these limit strains are not exceeded, the structures will not fracture

Beam loss due to the aperture limitation resulting from intrabeam scattering

International Nuclear Information System (INIS)

Lee, S.Y.

1984-01-01

Diffusion equation is used to evaluate the beam loss in the presence of aperture limitation resulting from the intrabeam scattering. We discuss the effect of different boundary conditions. Satisfactory beam intensity can be maintained within the proposed RHIC operation time

A decision-making tool for exchange transfusions in infants with severe hyperbilirubinemia in resource-limited settings.

Science.gov (United States)

Olusanya, B O; Iskander, I F; Slusher, T M; Wennberg, R P

2016-05-01

Late presentation and ineffective phototherapy account for excessive rates of avoidable exchange transfusions (ETs) in many low- and middle-income countries. Several system-based constraints sometimes limit the ability to provide timely ETs for all infants at risk of kernicterus, thus necessitating a treatment triage to optimize available resources. This article proposes a practical priority-setting model for term and near-term infants requiring ET after the first 48 h of life. The proposed model combines plasma/serum bilirubin estimation, clinical signs of acute bilirubin encephalopathy and neurotoxicity risk factors for predicting the risk of kernicterus based on available evidence in the literature.

Severe infective endocarditis in a healthy adult due to Streptococcus agalactiae.

Science.gov (United States)

Fujita, Hiroaki; Nakamura, Itaru; Tsukimori, Ayaka; Sato, Akihiro; Ohkusu, Kiyofumi; Matsumoto, Tetsuya

2015-09-01

A case of severe endocarditis, with complications of multiple infarction, meningitis, and ruptured mitral chordae tendineae, caused by Streptococcus agalactiae in a healthy man, is reported. Emergency cardiovascular surgery was performed on the day of admission. Infective endocarditis caused by S. agalactiae is very rare, particularly in a healthy adult. In addition, microbiological analysis revealed that S. agalactiae of sequence type (ST) 19, which belongs to serotype III, was present in the patient's vegetation, mitral valve, and blood culture. It was therefore concluded that the endocarditis was caused by ST19, which has been reported as a non-invasive type of S. agalactiae. This was an extremely rare case in which S. agalactiae of ST19 caused very severe endocarditis in an adult patient with no underlying disease. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

NPP Krsko Severe Accident Management Guidelines Upgrade

International Nuclear Information System (INIS)

Mihalina, Mario; Spalj, Srdjan; Glaser, Bruno; Jalovec, Robi; Jankovic, Gordan

2014-01-01

Nuclear Power Plant Krsko (NEK) has decided to take steps for upgrade of safety measures to prevent severe accidents, and to improve the means to successfully mitigate their consequences. The content of the program for the NEK Safety Upgrade is consistent with the nuclear industry response to Fukushima accident, which revealed many new insights into severe accidents. Therefore, new strategies and usage of new systems and components should be integrated into current NEK Severe Accident Management Guidelines (SAMG's). SAMG's are developed to arrest the progression of a core damage accident and to limit the extent of resulting releases of fission products. NEK new SAMG's revision major changes are made due to: replacement of Electrical Recombiners by Passive Autocatalytic Recombiners (PARs) and the installation of Passive Containment Filtered Vent System (PCFV); to handle a fuel damage situation in Spent Fuel Pool (SFP) and to assess risk of core damage situation during shutdown operation. (authors)

Severe Hypoglycemia due to Isolated ACTH Deficiency in Children: A New Case Report and Review of the Literature

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Michael Y. Torchinsky

2011-01-01

Full Text Available Isolated ACTH deficiency causes life-threatening severe hypoglycemia. A 7-year-old girl with hypoglycemia due to this rare disorder is described. Our patient had undetectable plasma ACTH repeatedly and cortisol 0 mcg/dl before and after ACTH 1-24 stimulation. There was no evidence of other pituitary hormone deficiency. Glucocorticoid replacement therapy resulted in resolution of all symptoms and normalization of blood glucose. Previously published data on isolated ACTH deficiency in children is summarized. Review of the literature showed that the prevalence of this condition could be underestimated in the neonatal period and in Prader-Willi syndrome. Isolated ACTH deficiency occurs in older children as well as in neonates.

Impaired left ventricular systolic function reserve limits cardiac output and exercise capacity in HFpEF patients due to systemic hypertension.

Science.gov (United States)

Henein, Michael; Mörner, Stellan; Lindmark, Krister; Lindqvist, Per

2013-09-30

Heart failure (HF) patients with preserved left ventricular (LV) ejection fraction (EF) (HFpEF) due to systemic hypertension (SHT) are known to have limited exercise tolerance. Despite having normal EF at rest, we hypothesize that these patients have abnormal systolic function reserve limiting their exercise capacity. Seventeen patients with SHT (mean age 68 ± 9 years) but no valve disease and 14 healthy individuals (mean age of 65 ± 10 years) underwent resting and peak exercise echocardiography using conventional, tissue Doppler and speckle tracking techniques. The differences between resting and peak exercise values were also analyzed (Δ). Exercise capacity was determined as the workload divided by body surface area. Resting values for left atrial (LA) volume/BSA (r=-0.66, pexercise capacity. LVEF increased during exercise in normals (mean Δ EF=10 ± 8%) but failed to do so in patients (mean Δ EF=0.6 ± 9%, pexercise in patients, to the same extent as it did in normals (0.2 ± 0.2 vs. 0.6 ± 0.3 1/s, pexercise (Δ) in LV lateral wall systolic velocity from tissue Doppler (s') (0.71, pexercise capacity independent of changes in heart rate. HFpEF patients with hypertensive LV disease have significantly limited exercise capacity which is related to left atrial enlargement as well as compromised LV systolic function at the time of the symptoms. The limited myocardial systolic function reserve seems to be underlying important explanation for their limited exercise capacity. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

Pulmonary hypertension and right heart failure due to severe hypernatremic dehydration.

Science.gov (United States)

Chiwane, Saurabh; Ahmed, Tageldin M; Bauerfeld, Christian P; Chauhan, Monika

2017-07-01

Neonates are at risk of developing hypernatremic dehydration and its associated complications, such as stroke, dural sinus thrombosis and renal vein thrombosis. Pulmonary hypertension has not been described as a complication of hypernatremia. We report a case of a seven-day-old neonate with severe hypernatremic dehydration who went on to develop pulmonary hypertension and right heart failure needing extracorporeal membrane oxygenation (ECMO). Normal or high anion gap metabolic acidosis commonly accompanies hypernatremic dehydration. The presence of acidosis and/or hypoxia can delay the normal drop in pulmonary vascular resistance (PVR) after birth, causing pulmonary hypertension and right ventricular failure. A high index of suspicion is paramount to diagnose pulmonary hypertension and aggressive correction of the acidosis and hypoxia is needed. In the presence of severe right ventricular failure, ECMO can be used as a bridge to recovery while underlying metabolic derangements are being corrected.

Working memory limitations in children with severe language impairment

NARCIS (Netherlands)

Daal, J.G.H.L. van; Verhoeven, L.T.W.; Leeuwe, J.F.J. van; Balkom, L.J.M. van

2008-01-01

In the present study, the relations of various aspects of working memory to various aspects of language problems in a clinical sample of 97 Dutch speaking 5-year-old children with severe language problems were studied. The working memory and language abilities of the children were examined using an

Chronic obstructive pulmonary disease severity is associated with severe pneumonia

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Jung Seop Eom

2015-01-01

Full Text Available CONTEXT: Chronic obstructive pulmonary disease (COPD is a heterogeneous disorder, and various aspects of COPD may be associated with the severity of pneumonia in such patients. AIMS: We examined the risk factors associated with severe pneumonia in a COPD population. MATERIALS AND METHODS: We performed a retrospective observational study using a prospectively collected database of pneumonia patients who were admitted to our hospital through emergency department between 2008 and 2012. Patients with hospital-acquired pneumonia and those with an immunocompromised status were excluded. RESULTS: Of 148 pneumonia patients with COPD for whom chest computed tomography (CT scans were available, 106 (71.6% and 42 (28.4% were classified as non-severe and severe pneumonia, respectively. Multivariate logistic regression analysis revealed that the severity of airflow limitation [odds ratio (OR, 2.751; 95% confidence interval (CI, 1.074-7.050; P = 0.035] and the presence of emphysema on a chest CT scan (OR, 3.366; 95% CI, 1.104-10.265; P = 0.033 were independently associated with severe pneumonia in patients with COPD. CONCLUSIONS: The severity of COPD including the airflow limitation grade and the presence of pulmonary emphysema were independently associated with the development of severe pneumonia.

[Maternal death from severe malaria due to Plasmodium vivax].

Science.gov (United States)

Arróspide, Nancy; Espinoza, Máximo Manuel; Miranda-Choque, Edwin; Mayta-Tristán, Percy; Legua, Pedro; Cabezas, César

2016-06-01

Here we describe the case of a 19-year-old woman, in her 29th week of gestation, who was from Llumpe (Ancash, Peru) and had a history of traveling to Chanchamayo (Junín, Peru) and Rinconada (Ancash, Peru). The patient presented at Chacas Hospital (Chacas, Ancash, Peru) with general malaise, dehydration, respiratory distress, jaundice, the sensation of thermal rise, and abdominal pain. Analysis of blood smears revealed 60% hemoparasites. She was transferred to Ramos Guardia Hospital (Huaraz, Peru) where she presented increasing respiratory distress, choluria, hematuria, and decreased urine output, moreover she was positive for Plasmodium. From there she was transferred to Cayetano Heredia Hospital (Lima, Peru), where she was admitted to the intensive care unit (ICU) with multiple organ failure, stillbirth, and leading to death. She underwent mechanical ventilation, was administered clindamycin, and was prescribed quinine, which she did not received due a lack by availability. The evolution of the illness was torpid, and she ultimately developed multiple organ failure and died. Plasmodium vivax infection was confirmed. Accordingly, we emphasize the importance of improving our diagnostic capabilities and management techniques to enable clinicians to provide adequate and timely treatment.

Point-of-Care Ultrasound in Necrotizing Acute Pancreatitis Complicated by Perforated Ileum Due to Nonocclusive Mesenteric Ischemia

Directory of Open Access Journals (Sweden)

Sonia López-Cuenca

2016-09-01

Full Text Available Necrotizing acute pancreatitis is the most severe form of pancreatitis, and it is a potentially life-threatening condition. Its diagnosis and severity are based on radiological signs. Although computed tomography is the most used imaging tool, ultrasound can be a quick and useful technique in emergency and intensive care scenarios. The use of abdominal ultrasound is generally limited to ruling out cholecystitis. Bowel gas can limit the accuracy of pancreatic imaging. When the pancreas is visualized, ultrasound can reveal pancreatic enlargement, echotextural changes, and peripancreatic fluid. We present a patient with necrotizing pancreatitis who developed peritonitis due to ileal perforation, where the use of ultrasound as a bedside imaging technique was very useful.

Reduced growth due to belowground sink limitation is not fully explained by reduced photosynthesis.

Science.gov (United States)

Campany, Courtney E; Medlyn, Belinda E; Duursma, Remko A

2017-08-01

Sink limitation is known to reduce plant growth, but it is not known how plant carbon (C) balance is affected, limiting our ability to predict growth under sink-limited conditions. We manipulated soil volume to impose sink limitation of growth in Eucalyptus tereticornis Sm. seedlings. Seedlings were grown in the field in containers of different sizes and planted flush to the soil alongside freely rooted (Free) seedlings. Container volume negatively affected aboveground growth throughout the experiment, and light saturated rates of leaf photosynthesis were consistently lower in seedlings in containers (-26%) compared with Free seedlings. Significant reductions in photosynthetic capacity in containerized seedlings were related to both reduced leaf nitrogen content and starch accumulation, indicating direct effects of sink limitation on photosynthetic downregulation. After 120 days, harvested biomass of Free seedlings was on average 84% higher than seedlings in containers, but biomass distribution in leaves, stems and roots was not different. However, the reduction in net leaf photosynthesis over the growth period was insufficient to explain the reduction in growth, so that we also observed an apparent reduction in whole-plant C-use efficiency (CUE) between Free seedlings and seedlings in containers. Our results show that sink limitation affects plant growth through feedbacks to both photosynthesis and CUE. Mass balance approaches to predicting plant growth under sink-limited conditions need to incorporate both of these feedbacks. © The Author 2017. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Failure strength and elastic limit for concrete

International Nuclear Information System (INIS)

Robutti, G.; Ronzoni, E.; Ottosen, N.S.

1979-01-01

Due to increased demand for realistic analysis of structures such as prestressed concrete reactor vessels and reactor containments, the formulation of general constitutive equations for concrete is of considerable importance. In the field of constitutive equations the correct definition of the limit state represented by the concrete failure surface is a fundamental need. In this paper carried out by a Danish-Italian cooperation, several failure criteria obtained by different authors are compared with failure experimental data obtained with triaxial tests on concrete specimens. Such comparison allow to carry out conclusive considerations on the characteristics of the concrete failure surface and on the advantages and disadvantages of the different criteria. Considerations are also reported on the definition of a limit elastic surface, whose knowledge is of fundamental importance for designers of complex structures in concrete. (orig.)

Prosthetic fitting in a patient with a transtibial amputation due to a congenital vascular malformation of the right leg

NARCIS (Netherlands)

Simmelink, Elisabeth K.; Rommers, Gerardus M.; Gardeniers, Jean W. M.; Zijlstra, Henk

Background: The problems of prescribing a prosthesis for a young girl with severe congenital vascular malformation deformity leading to a transtibial amputation. Case description and methods: Due to the high risk of recurrent bleeding and limitations regarding full weight bearing of the stump, a

Zinc as an adjunct treatment for reducing case fatality due to clinical severe infection in young infants: study protocol for a randomized controlled trial.

Science.gov (United States)

Wadhwa, Nitya; Basnet, Sudha; Natchu, Uma Chandra Mouli; Shrestha, Laxman P; Bhatnagar, Shinjini; Sommerfelt, Halvor; Strand, Tor A; Ramji, Siddarth; Aggarwal, K C; Chellani, Harish; Govil, Anuradha; Jajoo, Mamta; Mathur, N B; Bhatt, Meenakshi; Mohta, Anup; Ansari, Imran; Basnet, Srijana; Chapagain, Ram H; Shah, Ganesh P; Shrestha, Binod M

2017-07-10

An estimated 2.7 of the 5.9 million deaths in children under 5 years of age occur in the neonatal period. Severe infections contribute to almost a quarter of these deaths. Mortality due to severe infections in developing country settings is substantial despite antibiotic therapy. Effective interventions that can be added to standard therapy for severe infections are required to reduce case fatality. This is a double-blind randomized placebo-controlled parallel group superiority trial to investigate the effect of zinc administered orally as an adjunct to standard therapy to infants aged 3 days up to 2 months (59 days) hospitalized with clinical severe infection, that will be undertaken in seven hospitals in Delhi, India and Kathmandu, Nepal. In a 1:1 ratio, we will randomly assign young infants to receive 10 mg of elemental zinc or placebo orally in addition to the standard therapy for a total of 14 days. The primary outcomes hospital case fatality, which is death due to any cause and at any time after enrolment while hospitalized for the illness episode, and extended case fatality, which encompasses the period until 12 weeks after enrolment. A previous study showed a beneficial effect of zinc in reducing the risk of treatment failure, as well as a non-significant effect on case fatality. This study was not powered to detect an effect on case fatality, which this current study is. If the results are consistent with this earlier trial, we would have provided strong evidence for recommending zinc as an adjunct to standard therapy for clinical severe infection in young infants. Universal Trial Number: U1111-1187-6479, Clinical Trials Registry - India: CTRI/2017/02/007966 : Registered on February 27, 2017.

Severe jaundice due to intrahepatic cholestasis after initiating anticoagulation with rivaroxaban.

Science.gov (United States)

Aslan, Abdullah N; Sari, Cenk; Baştuğ, Serdal; Sari, Sevil Ö; Akçay, Murat; Durmaz, Tahir; Bozkurt, Engin

2016-03-01

Rivaroxaban, a highly selective direct factor Xa inhibitor, is a new oral anticoagulant approved by the US Food and Drug Administration in November 2011 for stroke prophylaxis in patients with nonvalvular atrial fibrillation. Because of its efficacy and once-a-day dosing, it is commonly preferred in patients with nonvalvular atrial fibrillation and intolerance to warfarin in clinical practice. However, it can result in some adverse effects such as bleeding, rashes and liver injury. Here, we described a very rare adverse reaction of rivaroxaban, jaundice due to intrahepatic cholestasis, appeared in a 71-year-old male patient after taking rivaroxaban.

ICRF power limitation relation to density limit in ASDEX

International Nuclear Information System (INIS)

Ryter, F.

1992-01-01

Launching high ICRF power into ASDEX plasmas required good antenna-plasma coupling. This could be achieved by sufficient electron density in front of the antennas i.e. small antenna-plasma distance (1-2 cm) and moderate to high line-averaged electron density compared to the density window in ASDEX. These are conditions eventually close to the density limit. ICRF heated discharges terminated by plasma disruptions caused by the RF pulse limited the maximum RF power which can be injected into the plasma. The disruptions occurring in these cases have clear phenomenological similarities with those observed in density limit discharges. We show in this paper that the ICRF-power limitation by plasma disruptions in ASDEX was due to reaching the density limit. (orig.)

ICRF power limitation relation to density limit in ASDEX

International Nuclear Information System (INIS)

Ryter, F.

1992-01-01

Launching high ICRF power into ASDEX plasmas required good antenna-plasma coupling. This could be achieved by sufficient electron density in front of the antennas i.e. small antenna-plasma distance (1-2 cm) and moderate to high line-averaged electron density compared to the density window in ASDEX. These are conditions eventually close to the density limit. ICRF heated discharges terminated by plasma disruptions caused by the RF pulse limited the maximum RF power which can be injected into the plasma. The disruptions occurring in these cases have clear phenomenological similarities with those observed in density limit discharges. We show in this paper that the ICRF-power limitation by plasma disruptions in ASDEX was due to reaching the density limit. (author) 3 refs., 3 figs

Two Cases of Severe Degeneration of the Macula Following Vitrectomy with Indocyanine Green-Assisted Internal Limiting Membrane Peeling for Idiopathic Macular Hole

OpenAIRE

Inoue, Junji; Sakuma, Toshiro; Kiyokawa, Masatoshi; Kobayashi, Yasuhiko; Takebayashi, Hiroshi; Mizota, Atsushi; Tanaka, Minoru

2008-01-01

We describe three eyes of two cases of severe degeneration of the macula following vitrectomy with indocyanine green-assisted internal limiting membrane peeling for idiopathic macular hole. We need to remember the possibility of these complications and have to select the procedures that are safest to use for macular hole surgery.

Use of environmental TLD data at a nuclear power station to estimate detection limits for radiation exposure due to station operation

International Nuclear Information System (INIS)

Lang, E.; Hardeman, J.; Kahn, B.

1987-01-01

The environmental radiation monitoring network maintained by the Georgia Department of Natural Resources at the Hatch Nuclear Plant, Baxley, GA, was used to determine the variability in measured background exposures in order to estimate the detection limits for radiation due to station operation. Data were obtained from LiF thermoluminescent dosimeters (TLDs) exposed in sets of four at 46 locations for 16 consecutive quarters from 1982 to 1985. The average exposure for 695 values was 11.8 microC kg-1 y-1 (mR/quarter). At individual locations, the averages of quarterly exposures ranged from 9.3 to 14.3 microC kg-1 y-1 and had standard deviations from 0.8 to 2.2 microC kg-1 y-1 with a typical standard deviation of 1.5 microC kg-1 y-1. The standard deviation due to reading the TLDs and subtracting the transit plus storage exposure, estimated as 0.4 microC kg-1 y-1, contributed only a small fraction of the uncertainty of the mean background; the greater contribution is from temporal fluctuations. There is a spatial pattern of higher background along the Altamaha River but no distinct seasonal pattern. The observation that exposure values at most locations rose and fell in unison suggested a calculational model that adjusts the average exposure level at a location by an increment determined each quarter at control locations. This model reduced the standard deviation for a predicted quarterly background exposure to 0.9 microC kg-1 y-1, with a range of 0.5 to 1.3 microC kg-1 y-1. If the standard deviation of the net value is multiplied by an error probability constant of 3.3 (type I and II errors not greater than 5%), the detection limits range from 2 to 5 microC kg-1 y-1 at the individual locations, with an average of 3 microC kg-1 y-1. This approach or two similar ones described earlier are recommended for improving the detection limit where needed

RADIOACTIVE IODINE THERAPY WITHOUT RECENT ANTITHYROID DRUG PRETREATMENT FOR HYPERTHYROIDISM COMPLICATED BY SEVERE HYPERBILIRUBINEMIA DUE TO HEPATIC DYSFUNCTION: EXPERIENCE OF A CHINESE MEDICAL CENTER.

Science.gov (United States)

Ding, Yong; Xing, Jialiu; Qiu, Zewu; Wang, Yong; Zhang, Youren; Fang, Yi; Peng, Xiaobo; Long, Yahong; Deng, Pei

2016-02-01

The objective of this work is to report our experience with (131)I therapy without recent antithyroid drug (ATD) pretreatment for refractory severe hyperthyroidism complicated by hyperbilirubinemia due to hepatic dysfunction. Five patients with refractory severe hyperthyroidism were treated with (131)I at 90 to 120 μCi/g-thyroid (total activity, 6.2 to 10.1 mCi). The patients previously had received ATD treatment from 2 months to 12 years and discontinued ATDs from 2 months to 4 years before (131)I treatment due to treatment failure or severe jaundice. Prior to (131)I therapy, the patients were asked to take a low-iodine diet and were treated with bisoprolol fumarate, digoxin, furosemide, S-adenosylmethionine, polyene phosphatidylcholine, and plasma exchange as supportive treatment for related clinical conditions. Four of the patients also received lithium carbonate in conjunction with their (131)I treatment. The patients were followed for 4 to 9 years after (131)I therapy. After (131)I treatment, jaundice disappeared completely within 3 to 4 months in all patients, and liver function tests returned to normal. Concurrent atrial fibrillation and heart failure, leukopenia and thrombocytopenia, or thrombocytopenia and left cardiac enlargement improved remarkably in 3 patients during the follow-up period. Three to 45 months after (131)I treatment, hypothyroidism was noted in the patients and they were treated with L-thyroxine replacement therapy. (131)I therapy without recent ATD pretreatment for refractory severe hyperthyroidism complicated by serious jaundice appears to be safe and effective, with good long-term results. It may be the preferred therapy for such patients and should be used as early as possible.

Severe metabolic alkalosis due to pyloric obstruction: case presentation, evaluation, and management.

Science.gov (United States)

McCauley, Meredith; Gunawardane, Manjula; Cowan, Mark J

2006-12-01

A 46-year-old man presented to the emergency room with severe metabolic alkalosis, hypokalemia, and respiratory failure requiring intubation and mechanical ventilation. The cause of his acid-base disorder was initially unclear. Although alkalosis is common in the intensive care unit, metabolic alkalosis of this severity is unusual, carries a very high mortality rate, and requires careful attention to the pathophysiology and differential diagnosis to effectively evaluate and treat the patient. A central concept in the diagnosis of metabolic alkalosis is distinguishing chloride responsive and chloride nonresponsive states. Further studies are then guided by the history and physical examination in most cases. By using a systematic approach to the differential diagnosis, we were able to determine that a high-grade gastric outlet obstruction was the cause of the patients' alkalosis and to offer effective therapy for his condition. A literature review and algorithm for the diagnosis and management of metabolic alkalosis are also presented.

Severe pandemic 2009 H1N1 influenza disease due to pathogenic immune complexes

Science.gov (United States)

Monsalvo, Ana Clara; Batalle, Juan P.; Lopez, M. Florencia; Krause, Jens C.; Klemenc, Jennifer; Zea, Johanna; Maskin, Bernardo; Bugna, Jimena; Rubinstein, Carlos; Aguilar, Leandro; Dalurzo, Liliana; Libster, Romina; Savy, Vilma; Baumeister, Elsa; Aguilar, Liliana; Cabral, Graciela; Font, Julia; Solari, Liliana; Weller, Kevin P.; Johnson, Joyce; Echavarria, Marcela; Edwards, Kathryn M.; Chappell, James D.; Crowe, James E.; Williams, John V.; Melendi, Guillermina A.; Polack, Fernando P.

2010-01-01

Pandemic influenza viruses often cause severe disease in middle-aged adults without preexistent co-morbidities. The mechanism of illness associated with severe disease in this age group is not well understood1–10. Here, we demonstrate preexisting serum antibody that cross-reacts with, but does not protect against 2009 H1N1 influenza virus in middle-aged adults. Non-protective antibody is associated with immune complex(IC)-mediated disease after infection. High titers of serum antibody of low avidity for H1-2009 antigen, and low avidity pulmonary ICs against the same protein were detected in severely ill patients. Moreover, C4d deposition - a sensitive marker of complement activation mediated by ICs- was present in lung sections of fatal cases. Archived lung sections from adults with confirmed fatal influenza 1957 H2N2 infection revealed a similar mechanism of illness. These observations provide a novel biological mechanism for the unusual age distribution of severe cases during influenza pandemics. PMID:21131958

Limits of possible operation of the R-tokamak due to ideal MHD instabilities

International Nuclear Information System (INIS)

Naitou, H.; Yamazaki, K.; Takemoto, Y.; Abe, Y.; Gruber, R.; Saurenmann, H.; Troyon, F.

1984-09-01

A series of MHD stability calculations has been made with the ERATO code to know the maximum β which can be expected for the R-Tokamak using the parameters of the second phase design (an aspect ratio of 2.75, ellipticity of 1.8 and triangularity of 0.3). The highest β obtained under the condition that both the n=1 free boundary mode (with no wall stabilization) and the n=infinity ballooning modes are stable is about 6% at qsub(s)--2.0 and qsub(o) at the Mercier limit on axis. This result has been found by performing some optimization of the current and pressure profiles. If only the ballooning modes are concerned, the limiting β becomes 8.6%. The sensitivity of the result to elongation has been studied. It has been found that the maximum β increases and then decreases with elongation. The optimum β is obtained for an elongation of 1.8 if both the n=1 kink and n=infinity ballooning limits are considered and of 2.0 if only ballooning modes are considered. These results are compared with proposed scaling laws. (author)

Severe fluoropyrimidine toxicity due to novel and rare DPYD missense mutations, deletion and genomic amplification affecting DPD activity and mRNA splicing

DEFF Research Database (Denmark)

van Kuilenburg, André B P; Meijer, Judith; Maurer, Dirk

2017-01-01

Dihydropyrimidine dehydrogenase (DPD) is the initial and rate-limiting enzyme in the catabolism of 5-fluorouracil (5FU). Genetic variations in DPD have emerged as predictive risk factors for severe fluoropyrimidine toxicity. Here, we report novel and rare genetic variants underlying DPD deficiency...... in 9 cancer patients presenting with severe fluoropyrimidine-associated toxicity. All patients possessed a strongly reduced DPD activity, ranging from 9 to 53% of controls. Analysis of the DPD gene (DPYD) showed the presence of 21 variable sites including 4 novel and 4 very rare aberrations: 3 missense...... of exon 4 immediately upstream of the mutated splice-donor site in the process of DPD pre-mRNA splicing. A lethal toxicity in two DPD patients suggests that fluoropyrimidines combined with other therapies such as radiotherapy might be particularly toxic for DPD deficient patients. Our study advocates...

Optical limiting properties of fullerenes and related materials

Science.gov (United States)

Riggs, Jason Eric

Optical limiting properties of fullerene C60 and different C60 derivatives (methano-, pyrrolidino-, and amino-) towards nanosecond laser pulses at 532 nm were studied. The results show that optical limiting responses of the C60 derivatives are similar to those of the parent C60 despite their different linear absorption and emission properties. For C60 and the derivatives in room-temperature solutions of varying concentrations and optical path length, the optical limiting responses are strongly concentration dependent. The concentration dependence is not due to any optical artifacts since the results obtained under the same experimental conditions for reference systems show no such dependence. Similarly, optical limiting results of fullerenes are strongly dependent on the medium viscosity, with responses in viscous media weaker than that in room-temperature solutions. The solution concentration and medium viscosity dependencies are not limited to fullerenes. In fact, the results from a systematic investigation of several classes of nonlinear absorptive organic dyes show that the optical limiting responses are also concentration and medium viscosity dependent. Interestingly, however, such dependencies are uniquely absent in the optical limiting responses of metallophthalocyanines. In classical photophysics, the strong solution concentration and medium viscosity dependencies are indicative of significant contributions from photoexcited-state bimolecular processes. Thus, the experimental results are discussed in terms of a significantly modified five-level reverse saturable absorption mechanism. Optical limiting properties of single-walled and multiple-walled carbon nanotubes toward nanosecond laser pulses at 532 nm were also investigated. When suspended in water, the single-walled and multiple-walled carbon nanotubes exhibit essentially the same optical limiting responses, and the results are also comparable with those of carbon black aqueous suspension. For

Detector limitations, STAR

Energy Technology Data Exchange (ETDEWEB)

Underwood, D. G.

1998-07-13

Every detector has limitations in terms of solid angle, particular technologies chosen, cracks due to mechanical structure, etc. If all of the presently planned parts of STAR [Solenoidal Tracker At RHIC] were in place, these factors would not seriously limit our ability to exploit the spin physics possible in RHIC. What is of greater concern at the moment is the construction schedule for components such as the Electromagnetic Calorimeters, and the limited funding for various levels of triggers.

The limiting current in a one-dimensional situation: Transition from a space charge limited to magnetically limited flow

International Nuclear Information System (INIS)

Kumar, Raghwendra; Biswas, Debabrata

2008-01-01

For a nonrelativistic electron beam propagating in a cylindrical drift tube, it is shown that the limiting current density does not saturate to the electrostatic one-dimensional (1D) estimate with increasing beam radius. Fully electromagnetic particle-in-cell (PIC) simulation studies show that beyond a critical aspect ratio, the limiting current density is lower than the 1D electrostatic prediction. The lowering in the limiting current density is found to be due to the transition from the space charge limited to magnetically limited flow. An adaptation of Alfven's single particle trajectory method is used to estimate the magnetically limited current as well as the critical radius beyond which the flow is magnetically limited in a drift tube. The predictions are found to be in close agreement with PIC simulations

Acoustic Characteristics of the Question-Statement Contrast in Severe Dysarthria Due to Cerebral Palsy

Science.gov (United States)

Patel, Rupal

2003-01-01

Studies of prosodic control in severe dysarthria (DYS) have focused on differences between impaired and nonimpaired speech in terms of the range and variation of fundamental frequency (F0), intensity, and duration. Whether individuals with severe DYS can adequately signal prosodic contrasts and "which" acoustic cues they use to do so has received…

Dose. Detriment. Limit assessment; Dosis. Schadensmass. Grenzwertsetzung

Energy Technology Data Exchange (ETDEWEB)

Breckow, J. [Technische Hochschule Mittelhessen, Giessen (Germany). Inst. fuer Medizinische Physik und Strahlenschutz (IMPS)

2015-07-01

One goal of radiation protection is the limitation of stochastic effects due to radiation exposure. The probability of occurrence of a radiation induced stochastic effect, however, is only one of several other parameters which determine the radiation detriment. Though the ICRP-concept of detriment is a quantitative definition, the kind of detriment weighting includes somewhat subjective elements. In this sense, the detriment-concept of ICRP represents already at the stage of effective dose a kind of assessment. Thus, by comparing radiation protection standards and concepts interconvertible or with those of environment or occupational protection one should be aware of the possibly different principles of detriment assessment.

A History of Space Shuttle Main Engine (SSME) Redline Limits Management

Science.gov (United States)

Arnold, Thomas M.

2011-01-01

The Space Shuttle Main Engine (SSME) has several "redlines", which are operational limits designated to preclude a catastrophic shutdown of the SSME. The Space Shuttle Orbiter utilizes a combination of hardware and software to enable or disable the automated redline shutdown capability. The Space Shuttle is launched with the automated SSME redline limits enabled, but there are many scenarios which may result in the manual disabling of the software by the onboard crew. The operational philosophy for manually enabling and disabling the redline limits software has evolved continuously throughout the history of the Space Shuttle Program, due to events such as SSME hardware changes and updates to Space Shuttle contingency abort software. In this paper, the evolution of SSME redline limits management will be fully reviewed, including the operational scenarios which call for manual intervention, and the events that triggered changes to the philosophy. Following this review, improvements to the management of redline limits for future spacecraft will be proposed.

Rehabilitation in severe memory deficit: A case study.

Science.gov (United States)

Sousa, Nariana Mattos Figueiredo

2017-01-01

The term amnesia refers to a pathological state of mind in which memory and learning are affected to a greater extent than other cognitive functions in a patient without altered level of consciousness. The aim of the current study was to describe a case of severe amnesia in a patient during neurological rehabilitation and to report the importance of preserved cognitive functions to compensate for the mnemonic deficit. VJA presented a clinical condition suggestive of encephalopathy due to caloric-protein malnutrition following several abdominal surgical procedures for complicated choledocholithiasis. A descriptive analysis of the results was carried out to outline the goals attained and the factors limiting implementation of memory aids. After the intervention program, consisting of individual and group activities, VJA showed improvement in level of recall with repetition of tasks, but still required constant external monitoring. Longitudinal follow-up is necessary to obtain more consistent results.

Height-related growth declines in ponderosa pine are not due to carbon limitation.

Science.gov (United States)

Sala, Anna; Hoch, Günter

2009-01-01

Decreased gas exchange as trees grow tall has been proposed to explain age-related growth declines in trees. We examined changes of mobile carbon stores (starch, sugars and lipids) with tree height in ponderosa pine (Pinus ponderosa) at two sites differing in water availability, and tested the following hypotheses: (1) carbon supply does not become increasingly limited as trees grow tall; rather, the concentration of mobile carbon compounds increases with tree height reflecting greater reductions of carbon sink activities relative to carbon assimilation; and (2) increases of stored mobile carbon compounds with tree height are greater in drier sites. Height-related growth reductions were associated with significant increases of non-structural carbohydrates (NSC) and lipid concentrations in all tissues in the upper canopy and of NSC in the bole. Lipid concentrations in the bole decreased with tree height, but such decrease is not necessarily inconsistent with non-limiting carbon supply in tall trees. Furthermore, we found stronger increases of mobile carbon stores with tree height at the dry site relative to the moist site. Our results provide first direct evidence that carbon supply does not limit growth in tall trees and that decreases of water availability might negatively impact growth processes more than net-photosynthesis.

[Two cases of severe eye and cranial injuries due to firework explosions].

Science.gov (United States)

Saunte, J P; Trojaborg, N S; Nielsen, O A; Thygesen, J

1999-12-20

Two patients who sustained serious facial, cranial and eye trauma secondary to recreational fireworks injuries are reported. Initial assessment included axial and coronary computerized tomography, control of haemorrhage, debridement of wound and brain, and in one patient bilateral excenteration of the globe. Both patients suffered from intracranial haemorrhage, but both recovered without severe neurological sequelae.

Magnetic and material limiter discharges in Tokapole II

International Nuclear Information System (INIS)

Moyer, R.A.

1988-01-01

Disruptive instabilities have been studied in Tokapole II, a small poloidal divertor tokamak, in magnetic and material limiter configurations. In the magnetic limiter configuration, the divertor separatrix defines the tokamak current channel boundary. Limiters or neutralizer plates are not used to remove plasma in the scrape-off region. The relatively hot, dense plasma in the scrape-off region carries 5--20% of the current. In the material limiter configuration, limiter plates are inserted to the separatrix to remove plasma and current in the scrape-off region. The plates vary the tokamak current channel boundary condition in a controlled manner, and provide a benchmark for comparison with other tokamaks. Internal and external disruptions have been studied, and several unique features in the magnetic limiter configuration have been identified. The magnitic limiter configuration enables routine passing of the stability barriers at q(a) = 2 and q(a) = 1, where q(a) is the the edge safety factor, without a close fitting wall, external windings, or detailed profile control techniques. Passing the q(a) = 1 barrier permits operation in the q < 1 regime where total reconnection of the sawtooth does not occur. Discharges with q < 1 are also obtained in the material limiter configuration, suggesting that partial reconnection is characteristic of the sawteeth, and not the magnetic limiter configuration. The magnetic limiter configuration suppresses current termination in a major disruption. Current termination occurs in material limiter discharges due to enhanced interaction with the inboard limiter following the post-disruptive shift in major radius

Simulated reduction of hypoxia in the northern Gulf of Mexico due to phosphorus limitation

Directory of Open Access Journals (Sweden)

Arnaud Laurent

2014-02-01

Full Text Available Abstract Excess nutrient loading from the Mississippi-Atchafalaya River system promotes the seasonal development of hypoxic bottom waters on the Louisiana shelf with detrimental effects on the benthic fauna. In the Mississippi River plume, primary production becomes phosphorus-limited between May and July at the peak of nutrient loading, displacing a portion of primary production and depositional fluxes westward. Here we quantitatively assessed, for the first time, the effect of phosphorus limitation on hypoxia development in the Mississippi-Atchafalaya River plume using a realistic physical-biogeochemical model. Results indicate that, despite a redistribution of respiration processes toward the western shelf, phosphorus limitation does not promote a westward expansion or relocation of hypoxia, as previously speculated. Rather, the onset of hypoxia was delayed and the size of the hypoxic zone reduced. Sensitivity experiments showed that this feature is robust in our model. Results from simulations with altered river input indicate that, despite phosphorus limitation, the co-reduction of nitrogen and phosphorus loads remains the best strategy to reduce hypoxia. Yet, even though nutrient load reductions have an immediate effect on hypoxia in this analysis, a 50% reduction in both nutrients will not be sufficient to meet the Gulf Hypoxia action plan goal of a 5·103 km2 hypoxic area.

Performance limitations at ISABELLE

International Nuclear Information System (INIS)

Keil, E.

1975-01-01

The transverse stability of coasting beams in the planned ISABELLE storage rings was studied. The beam--beam tune shift limitation at 0.005 can be avoided, and a computer simulation seems to show 0.005 is a pessimistic limit. For beams of reasonable smoothness on the edge, the actual limit should be somewhat higher. Some coupling effects due to the beam--beam interaction are also examined

Moderate exercise does not increase the severity of mitral regurgitation due to mitral valve prolapse

DEFF Research Database (Denmark)

Pecini, Redi; Dalsgaard, Morten; Møller, Daniel Vega

2010-01-01

Mitral regurgitation (MR) secondary to ischemic heart disease (IHD) increases during exercise. We tested the hypothesis that the same is also true for MR due to mitral valve prolapse (MVP).......Mitral regurgitation (MR) secondary to ischemic heart disease (IHD) increases during exercise. We tested the hypothesis that the same is also true for MR due to mitral valve prolapse (MVP)....

SEVERE PULMONARY HYPERTENSION DUE TO SLEEP-DISORDERED BREATHING IN AN ACHONDROPLASIC CHILD

Directory of Open Access Journals (Sweden)

Vehbi Dogan

2014-03-01

Full Text Available Achondroplasia is the most common skeletal dysplasia in children. Achondroplasic patients often have respiratory problems associated with upper respiratory tract obstruction and craniaofacial dysmorphology. Chronic hypoxemia in these patients can result in pulmonary hypertension. In this report an achondroplasic child with severe day-time pulmonary hypertension is presented. [J Contemp Med 2014; 4(1.000: 41-43

Polymer quantum mechanics and its continuum limit

International Nuclear Information System (INIS)

Corichi, Alejandro; Vukasinac, Tatjana; Zapata, Jose A.

2007-01-01

A rather nonstandard quantum representation of the canonical commutation relations of quantum mechanics systems, known as the polymer representation, has gained some attention in recent years, due to its possible relation with Planck scale physics. In particular, this approach has been followed in a symmetric sector of loop quantum gravity known as loop quantum cosmology. Here we explore different aspects of the relation between the ordinary Schroedinger theory and the polymer description. The paper has two parts. In the first one, we derive the polymer quantum mechanics starting from the ordinary Schroedinger theory and show that the polymer description arises as an appropriate limit. In the second part we consider the continuum limit of this theory, namely, the reverse process in which one starts from the discrete theory and tries to recover back the ordinary Schroedinger quantum mechanics. We consider several examples of interest, including the harmonic oscillator, the free particle, and a simple cosmological model

Method to Solve the Problem of the Radioactivity Detection in Environmental Samples. Characteristic Limits; Metodos para la Resolucion del Problema de la Detecfcion de Radiactividad en Muestras Ambientales. Limites Caracteristicos

Energy Technology Data Exchange (ETDEWEB)

Gasco, C.; Martinez, M.; Heras, M.

2009-07-21

The problem of the detection or when the radioactivity can be considered as higher than the background using different measurement techniques has been the objective of several statistical studies and controversies. The detection limit and the critical limit were studied by Currie in year 1968 and used by radiochemistry laboratories considering different ways of calculation that introduced confusion and not correct implementations. In the last few years, and due to the increasing number of standardization processes on the field of radioactivity and accreditation, several international institutions have chosen to unify the criteria for using common determination of detection limits. The most used methods are those developed by MARLAP and International Standard Organization ISO (Standard-11929). In this report are summarised both standards doing a comparative study and giving some examples of how to apply these limits. In same cases, little differences in the uncertainty calculation have been observed but the final results have been concordant. A deeply study of these standards can be done consulting the web page of the American Labs that developed MARLAP or buying the original ISO standard ISO-11929 recently approved (2009). (Author) 17 refs.

A case of severe autoimmune hepatitis associated with Graves' disease

Directory of Open Access Journals (Sweden)

Samia Abdulla Bokhari

2016-01-01

Full Text Available Graves' disease is a common condition and is known to have a wide range of effects on a variety of organs. Hepatic dysfunction ranging from mild to severe due to direct effect of high circulating thyroid hormones as well as a deleterious effect of antithyroid medications (methimazole and propylthiouracil has been well - documented in literature. However, severe autoimmune hepatitis (AIH associated with Graves' disease is rare and limited to few case reports only. A 38-year-old woman presented with abdominal pain and yellowish discolouration of conjunctivae. On investigation, she was found to have Graves' disease and AIH. The liver histopathology showed typical features of AIH. She responded excellently to glucocorticoid therapy with normalisation of thyroid function and liver histology. The case is discussed with relevant literature review.

CORA-13 experiment on severe fuel damage

International Nuclear Information System (INIS)

Firnhaber, M.; Trambauer, K.; Hagen, S.; Hofmann, P.; Schanz, G.; Sepold, L.

1993-07-01

The major objectives of the experiment were to investigate the behavior of PWR fuel elements during early core degradation and fast cooldown due to refill. Measured quantities are boundary conditions, bundle temperatures, hydrogen generation and the final bundle configuration. Boundary conditions which could not be measured, but which are necessary for simplified test simulation (axial power profile, shroud insulation temperature, bundle refill flow) were estimated using ATHLET-CD. The capability of the codes in calculating the main degradation phenomena has been clearly illustrated and weaknesses concerning the modelling of some degradation processes have been identified. Among the degradation phenomena involved in the test, the more severe limitations concern the UO 2 -ZrO 2 dissolution by molten Zr, the solubility limits in the resulting U-Zr-O mixture and the cladding failure by the molten mixture. There is a lack concerning the Inconel spacer-grid interactions with the rods, the material interaction between control rod material and fuel rods, and in the modelling of hydrogen generation during cooldown. (orig./DG)

Rehabilitation in severe memory deficit: A case study

Directory of Open Access Journals (Sweden)

Nariana Mattos Figueiredo Sousa

Full Text Available ABSTRACT The term amnesia refers to a pathological state of mind in which memory and learning are affected to a greater extent than other cognitive functions in a patient without altered level of consciousness. The aim of the current study was to describe a case of severe amnesia in a patient during neurological rehabilitation and to report the importance of preserved cognitive functions to compensate for the mnemonic deficit. VJA presented a clinical condition suggestive of encephalopathy due to caloric-protein malnutrition following several abdominal surgical procedures for complicated choledocholithiasis. A descriptive analysis of the results was carried out to outline the goals attained and the factors limiting implementation of memory aids. After the intervention program, consisting of individual and group activities, VJA showed improvement in level of recall with repetition of tasks, but still required constant external monitoring. Longitudinal follow-up is necessary to obtain more consistent results.

Animal models of preeclampsia; uses and limitations.

LENUS (Irish Health Repository)

McCarthy, F P

2012-01-31

Preeclampsia remains a leading cause of maternal and fetal morbidity and mortality and has an unknown etiology. The limited progress made regarding new treatments to reduce the incidence and severity of preeclampsia has been attributed to the difficulties faced in the development of suitable animal models for the mechanistic research of this disease. In addition, animal models need hypotheses on which to be based and the slow development of testable hypotheses has also contributed to this poor progress. The past decade has seen significant advances in our understanding of preeclampsia and the development of viable reproducible animal models has contributed significantly to these advances. Although many of these models have features of preeclampsia, they are still poor overall models of the human disease and limited due to lack of reproducibility and because they do not include the complete spectrum of pathophysiological changes associated with preeclampsia. This review aims to provide a succinct and comprehensive assessment of current animal models of preeclampsia, their uses and limitations with particular attention paid to the best validated and most comprehensive models, in addition to those models which have been utilized to investigate potential therapeutic interventions for the treatment or prevention of preeclampsia.

Radiation Dose for Self-Disposal due to the Quantity of Radioactive Waste

Energy Technology Data Exchange (ETDEWEB)

Koo, Daeseo; Sung, Hyun-Hee; Kim, Seung-Soo; Kim, Gye-Nam; Choi, Jong-Won [Korea Atomic Energy Research Institute, Daejeon (Korea, Republic of)

2016-10-15

In this study, we evaluated resident radiation dose due to cover depth on contaminated zone such as uranium contaminated soil and concrete wastes under radiation dose limit using RESRAD Version 7.0. The uranium concentration of contaminated zone due to the cover depth are also analyzed. Possibility for self-disposal of uranium contaminated soil and concrete wastes is evaluated from these calculating data. There are several radioactive material disposal methods such as regulation exemption, decontamination and long term storage. To acquire radiation dose under self-disposal from them, the study on decontamination of some uranium contaminated soil and concrete wastes was performed using electrokinectic-electrodialytic. We evaluated radiation dose due to cover depth on contaminated zone such as uranium contaminated soil and concrete wastes under radiation dose limit using RESRAD Version 7.0. As cover depth increases, the tolerable uranium concentration increases up to cover depth (1.5 m) and then it showed saturated uranium concentration above cover depth (1.5 m). Therefore, to carry out self-disposal on the quantity (1000 drums≒300,000 kg) of radioactive waste is easier than to carry out on the quantity (2000 drums≒600,000 kg) of radioactive waste owing to the large tolerable uranium concentration for self-disposal of radioactive waste. As cover depth increases, the individual radiation dose rate decreased up to cover depth (1.5 m) and then it showed saturated individual radiation dose rate above cover depth (1.5 m)

Radiation Dose for Self-Disposal due to the Quantity of Radioactive Waste

International Nuclear Information System (INIS)

Koo, Daeseo; Sung, Hyun-Hee; Kim, Seung-Soo; Kim, Gye-Nam; Choi, Jong-Won

2016-01-01

In this study, we evaluated resident radiation dose due to cover depth on contaminated zone such as uranium contaminated soil and concrete wastes under radiation dose limit using RESRAD Version 7.0. The uranium concentration of contaminated zone due to the cover depth are also analyzed. Possibility for self-disposal of uranium contaminated soil and concrete wastes is evaluated from these calculating data. There are several radioactive material disposal methods such as regulation exemption, decontamination and long term storage. To acquire radiation dose under self-disposal from them, the study on decontamination of some uranium contaminated soil and concrete wastes was performed using electrokinectic-electrodialytic. We evaluated radiation dose due to cover depth on contaminated zone such as uranium contaminated soil and concrete wastes under radiation dose limit using RESRAD Version 7.0. As cover depth increases, the tolerable uranium concentration increases up to cover depth (1.5 m) and then it showed saturated uranium concentration above cover depth (1.5 m). Therefore, to carry out self-disposal on the quantity (1000 drums≒300,000 kg) of radioactive waste is easier than to carry out on the quantity (2000 drums≒600,000 kg) of radioactive waste owing to the large tolerable uranium concentration for self-disposal of radioactive waste. As cover depth increases, the individual radiation dose rate decreased up to cover depth (1.5 m) and then it showed saturated individual radiation dose rate above cover depth (1.5 m)

The LLNA: A Brief Review of Recent Advances and Limitations

Science.gov (United States)

Anderson, Stacey E.; Siegel, Paul D.; Meade, B. J.

2011-01-01

Allergic contact dermatitis is the second most commonly reported occupational illness, accounting for 10% to 15% of all occupational diseases. This highlights the importance of developing rapid and sensitive methods for hazard identification of chemical sensitizers. The murine local lymph node assay (LLNA) was developed and validated for the identification of low molecular weight sensitizing chemicals. It provides several benefits over other tests for sensitization because it provides a quantitative endpoint, dose-responsive data, and allows for prediction of potency. However, there are also several concerns with this assay including: levels of false positive responses, variability due to vehicle, and predictivity. This report serves as a concise review which briefly summarizes the progress, advances and limitations of the assay over the last decade. PMID:21747867

LANSCE Beam Current Limiter (XL)

International Nuclear Information System (INIS)

Gallegos, F.R.; Hall, M.J.

1997-01-01

The Radiation Security System (RSS) at the Los Alamos Neutron Science Center (LANSCE) is an engineered safety system that provides personnel protection from prompt radiation due to accelerated proton beams. The Beam Current Limiter (XL), as an active component of the RSS, limits the maximum average current in a beamline, thus the current available for a beam spill accident. Exceeding the pre-set limit initiates action by the RSS to mitigate the hazard (insertion of beam stoppers in the low energy beam transport). The beam limiter is an electrically isolated, toroidal transformer and associated electronics. The device was designed to continuously monitor beamline currents independent of any external timing. Fail-safe operation was a prime consideration in its development. Fail-safe operation is defined as functioning as intended (due to redundant circuitry), functioning with a more sensitive fault threshold, or generating a fault condition. This report describes the design philosophy, hardware, implementation, operation, and limitations of the device

Public radiation exposure due to radon transport from a uranium mine

International Nuclear Information System (INIS)

Akber, R.A.; Johnston, A.; Pfitzner, J.

1992-01-01

Radon and radon daughter concentrations at locations several kilometres away from a uranium mine are due both to the background sources and the mine-related sources. The contribution of these two types of sources should be distinguished because the authorised limits on public radiation dose apply only to the mine-related sources. Such a distinction can be achieved by measuring radon and radon daughter concentration in the wind sectors containing only the background sources and those in the wind sectors containing both the background and the mine-related sources. This approach has been used to make estimates of public radiation dose due to radon transport from the Ranger Uranium Mine in Australia. The residential town of Jabiru, the non-residential working town of Jabiru East, and the aboriginal camp sites in the vicinity of the mine were considered. The results indicate that, for the groups of population considered, the annual mine-related dose varies between 0.04 and 0.2 mSv. (author)

A Case Report of Severe Delirium after Amantadine Withdrawal

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Franz Marxreiter

2017-03-01

Full Text Available Amantadine is frequently used in addition to dopaminergic substances like dopamine agonists or L-Dopa in advanced Parkinson disease (PD. However, adverse effects like hallucinations limit its use. PD patients developing severe psychotic symptoms upon treatment with either dopaminergic substances and/or amantadine need to stop intake of any psychotropic substance. Here, we report the case of a 71-year-old PD patient without previously known cognitive impairment. He presented with drug-induced psychotic symptoms due to changes in his therapeutic regimen (increase in COMT inhibitors, newly introduced MAO B inhibitors. Also, amantadine had been part of his long-term medication for more than 2 years. The severity of his psychotic symptoms required a L-Dopa monotherapy. After changing his medication, the patient developed severe delirium that resolved rapidly after i.v. amantadine infusion, suggesting an amantadine withdrawal syndrome. Amantadine withdrawal syndrome is a rare adverse event that may present even in PD patients without cognitive impairment. This case report highlights the need for a gradual withdrawal of amantadine even if acute and severe psychotic symptoms are present. Moreover, this is the first report of a cognitively unimpaired patient developing an amantadine withdrawal syndrome.

Two unusual cases of severe recalcitrant hypocalcemia due to aminoglycoside-induced hypomagnesemia

Directory of Open Access Journals (Sweden)

Tarun Varma

2013-01-01

Full Text Available Aminoglycoside (AMG-induced renal toxicity is well-known and may manifest with non-oliguric renal failure or renal tubular dysfunction like Fanconi-like syndrome, Barter syndrome-like syndrome or distal renal tubular acidosis (RTA. These phenomena have been described with Gentamycin and Amikacin though rarely with Kanamycin. We present two cases of pulmonary tuberculosis that were treated with Kanamycin and during the course of treatment, developed severe recalcitrant hypocalcemia along with hypomagnesemia.

Successful treatment of inverted Takotsubo cardiomyopathy after severe traumatic brain injury with milrinone after dobutamine failure.

Science.gov (United States)

Mrozek, Ségolène; Srairi, Mohamed; Marhar, Fouad; Delmas, Clément; Gaussiat, François; Abaziou, Timothée; Larcher, Claire; Atthar, Vincent; Menut, Rémi; Fourcade, Olivier; Geeraerts, Thomas

2016-01-01

Takotsubo cardiomyopathy can occur at the early phase of severe acute brain injuries. In the case of cardiac output decrease or shock, the optimal treatment is still a matter of debate. Due to massive stress hormone release, the infusion of catecholamines may have limited effects and may even aggravate cardiac failure. Other inotropic agents may be an option. Levosimendan has been shown to have potential beneficial effects in this setting, although milrinone has not been studied. We report a case of a young female presenting with inverted Takotsubo cardiomyopathy syndrome after severe traumatic brain injury. Due to hemodynamic instability and increasing levels of infused norepinephrine, dobutamine infusion was begun but rapidly stopped due to tachyarrhythmia. Milrinone infusion stabilized the patient's hemodynamic status and improved cardiac output without deleterious effects. Milrinone could be a good alternative when inotropes are required in Takotsubo cardiomyopathy and when dobutamine infusion is associated with tachyarrhythmia. Copyright © 2016 Elsevier Inc. All rights reserved.

The limit of irrigation adaption due to the inter-crop conflict of water use under changing climate and landuse

Science.gov (United States)

Okada, M.; Iizumi, T.; Sakamoto, T.; Kotoku, M.; Sakurai, G.; Nishimori, M.

2017-12-01

Replacing rainfed cropping system by irrigated one is assumed to be an effective measure for climate change adaptation in agriculture. However, in many agricultural impact assessments, future irrigation scenarios are externally given and do not consider variations in the availability of irrigation water under changing climate and land use. Therefore, we assess the potential effects of adaption measure expanding irrigated area under climate change by using a large-scale crop-river coupled model, CROVER [Okada et al. 2015, JAMES]. The CROVER model simulates the large-scale terrestrial hydrological cycle and crop growth depending on climate, soil properties, landuse, crop cultivation management, socio-economic water demand, and reservoir operation management. The bias-corrected GCMs outputs under the RCP 8.5 scenario were used. The future expansion of irrigation area was estimated by using the extrapolation method based on the historical change in irrigated and rainfed areas. As the results, the irrigation adaptation has only a limited effect on the rice production in East Asia due to the conflict of water use for irrigation with the other crops, whose farmlands require unsustainable water extraction with the excessively expanding irrigated area. In contrast, the irrigation adaptation benefits maize production in Europe due to the little conflict of water use for irrigation. Our findings suggest the importance of simulating the river water availability and crop production in a single model for the more realistic assessment in the irrigation adaptation potential effects of crop production under changing climate and land use.

Monitoring biological diversity: strategies, tools, limitations, and challenges

Science.gov (United States)

Beever, E.A.

2006-01-01

Monitoring is an assessment of the spatial and temporal variability in one or more ecosystem properties, and is an essential component of adaptive management. Monitoring can help determine whether mandated environmental standards are being met and can provide an early-warning system of ecological change. Development of a strategy for monitoring biological diversity will likely be most successful when based upon clearly articulated goals and objectives and may be enhanced by including several key steps in the process. Ideally, monitoring of biological diversity will measure not only composition, but also structure and function at the spatial and temporal scales of interest. Although biodiversity monitoring has several key limitations as well as numerous theoretical and practical challenges, many tools and strategies are available to address or overcome such challenges; I summarize several of these. Due to the diversity of spatio-temporal scales and comprehensiveness encompassed by existing definitions of biological diversity, an effective monitoring design will reflect the desired sampling domain of interest and its key stressors, available funding, legal requirements, and organizational goals.

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

Directory of Open Access Journals (Sweden)

Nobuhiro Nakanishi

2017-01-01

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

[Dehydration due to "mouth broken"].

Science.gov (United States)

Meijler, D P M; van Mossevelde, P W J; van Beek, R H T

2012-09-01

Two children were admitted to a medical centre due to dehydration after an oral injury and the extraction of a tooth. One child complained of "mouth broken". Dehydration is the most common water-electrolyte imbalance in children. Babies and young children are prone to dehydration due to their relatively large body surface area, the high percentage extracellular fluid, and the limited ability of the kidneys to conserve water. After the removal ofa tooth, after an oral trauma or in case of oral discomfort, a child is at greater risk of dehydration by reduced fluid and food intake due to oral pain and/or discomfort and anxiety to drink. In those cases, extra attention needs to be devoted to the intake of fluids.

LANSCE beam current limiter

International Nuclear Information System (INIS)

Gallegos, F.R.

1996-01-01

The Radiation Security System (RSS) at the Los Alamos Neutron Science Center (LANSCE) provides personnel protection from prompt radiation due to accelerated beam. Active instrumentation, such as the Beam Current Limiter, is a component of the RSS. The current limiter is designed to limit the average current in a beam line below a specific level, thus minimizing the maximum current available for a beam spill accident. The beam current limiter is a self-contained, electrically isolated toroidal beam transformer which continuously monitors beam current. It is designed as fail-safe instrumentation. The design philosophy, hardware design, operation, and limitations of the device are described

Fathers' experience of starting family life with an infant born prematurely due to mothers' severe illness.

Science.gov (United States)

Værland, Inger Emilie; Vevatne, Kari; Brinchmann, Berit Støre

2017-10-01

To describe fathers' experiences of starting family life with an infant delivered prematurely out of necessity of saving the mother's and infant's lives due to the mother's severe preeclampsia. A descriptive, qualitative design was used. Six fathers were interviewed twice: from 6 to 24 days and from 4 to 22 weeks after delivery. Data were transcribed verbatim and analyzed using a reflective lifeworld research approach. The essence of the fathers' experiences of establishing a family with a seriously ill mother and a premature infant can be described as a process of becoming a family through reflection on life and death in a context of separation. The essence specifically comprised the following constituents: (1) starting fatherhood facing existential issues, (2) connecting the family, (3) becoming familiar with your infant, and (4) becoming a father in a public area. The fathers were able to develop their relationship to their infants; this emphasizes the importance of the fathers being able to spend their time in the NICU. The privacy of the fathers were more or less challenged, health professionals should be aware of individualize their approach to the fathers. The study reveals that family life started with separation. Health professionals should try to ensure that the family should be together. Mutual guidelines between the wards that treats mother and child should be implemented. When new mother and child-centers are planned a family friendly environment should be prioritized. Copyright © 2017 Elsevier B.V. All rights reserved.

Method to Solve the Problem of the Radioactivity Detection in Environmental Samples. Characteristic Limits

International Nuclear Information System (INIS)

Gasco, C.; Martinez, M.; Heras, M.

2009-01-01

The problem of the detection or when the radioactivity can be considered as higher than the background using different measurement techniques has been the objective of several statistical studies and controversies. The detection limit and the critical limit were studied by Currie in year 1968 and used by radiochemistry laboratories considering different ways of calculation that introduced confusion and not correct implementations. In the last few years, and due to the increasing number of standardization processes on the field of radioactivity and accreditation, several international institutions have chosen to unify the criteria for using common determination of detection limits. The most used methods are those developed by MARLAP and International Standard Organization ISO (Standard-11929). In this report are summarised both standards doing a comparative study and giving some examples of how to apply these limits. In same cases, little differences in the uncertainty calculation have been observed but the final results have been concordant. A deeply study of these standards can be done consulting the web page of the American Labs that developed MARLAP or buying the original ISO standard ISO-11929 recently approved (2009). (Author) 17 refs

Pars plana vitrectomy combined with internal limiting membrane peeling for recurrent macular edema due to branch retinal vein occlusion after antivascular endothelial growth factor treatments

Directory of Open Access Journals (Sweden)

Shirakata Y

2016-02-01

Full Text Available Yukari Shirakata,1 Kouki Fukuda,1 Tomoyoshi Fujita,1 Yuki Nakano,1 Hiroyuki Nomoto,2 Hidetaka Yamaji,3 Fumio Shiraga,4 Akitaka Tsujikawa1 1Department of Ophthalmology, Faculty of Medicine, Kagawa University, Miki-cho, 2Nomoto Eye Clinic, Himeji, 3Department of Ophthalmology, Shirai Eye Hospital, Mitoyo, 4Department of Ophthalmology, Okayama University, Okayama, Japan Purpose: To evaluate the anatomic and functional outcomes of pars plana vitrectomy combined with internal limiting membrane peeling for recurrent macular edema (ME due to branch retinal vein occlusion (BRVO after intravitreal injections of antivascular endothelial growth factor (anti-VEGF agents. Methods: Twenty-four eyes of 24 patients with treatment-naive ME from BRVO were treated with intravitreal injections of anti-VEGF agents. Recurred ME was treated with pars plana vitrectomy combined with internal limiting membrane peeling. Results: After the surgery, ME was significantly reduced at 1 month (P=0.031 and the reduction increased with time (P=0.007 at the final visit. With the reduction in ME, treated eyes showed a slow improvement in visual acuity (VA. At the final visit, improvement in VA was statistically significant compared with baseline (P=0.048. The initial presence of cystoid spaces, serous retinal detachment, or subretinal hemorrhage under the fovea, as well as retinal perfusion status, showed no association with VA improvement. However, the presence of epiretinal membrane showed a significant association with the visual recovery. Although eyes without epiretinal membrane showed visual improvement (-0.10±0.32 in logarithm of the minimum angle of resolution [logMAR], eyes with epiretinal membrane showed greater visual improvement (-0.38±0.12 in logMAR, P=0.012. Conclusion: For recurrent ME due to BRVO after anti-VEGF treatment, particularly when accompanied by epiretinal membrane, pars plana vitrectomy combined with internal limiting membrane peeling might be a

Improved split renal function after percutaneous nephrostomy in young adults with severe hydronephrosis due to ureteropelvic junction obstruction.

Science.gov (United States)

Zhang, Shiwei; Zhang, Qing; Ji, Changwei; Zhao, Xiaozhi; Liu, Guangxiang; Zhang, Shun; Li, Xiaogong; Lian, Huibo; Zhang, Gutian; Guo, Hongqian

2015-01-01

We evaluated percutaneous nephrostomy for adult kidneys with severe hydronephrosis due to ureteropelvic junction obstruction and less than 10% split renal function. In this retrospective analysis we included patients who underwent percutaneous nephrostomy for unilateral ureteropelvic junction obstruction of the kidneys with hydronephrosis and less than 10% split renal function at our hospital between May 2009 and January 2012. Adults (age 18 years or greater) were divided into those 35 years or younger (young adults) and older than 35 years (older adults). The percutaneous nephrostomy remained in situ a mean ± SD of 6.62 ± 2.55 weeks and patients underwent repeat renography before pyeloplasty. When there was no significant improvement in split renal function (10% or greater) and drainage (greater than 400 ml per day), nephrectomy was performed. Otherwise pyeloplasty was performed. Patients were followed by renography, ultrasound and contrast computerized tomography at 3 and 6 months, at 1 year and annually thereafter. Of 53 patients 30 (56.6%) showed improvement after percutaneous nephrostomy drainage and urine output greater than 400 ml per day with percutaneous nephrostomy. Pyeloplasty was then performed. Of 29 young adults 24 (82.8%) showed improved split renal function vs 6 of 24 older adults (25%). Nephrectomy of the other 23 kidneys was performed. At a mean followup of 19.27 ± 7.82 months (range 12 to 36), no patient showed hypertension or urinary tract infection. Split renal function detected by renography may not accurately predict recovered, poorly functioning kidneys, especially in young adults. First observing the recoverability of hydronephrotic kidneys by percutaneous nephrostomy drainage and then preserving select kidneys may be an effective method to manage poorly functioning kidneys due to ureteropelvic junction obstruction. Copyright © 2015 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights

Irreversible climate change due to carbon dioxide emissions

Science.gov (United States)

Solomon, Susan; Plattner, Gian-Kasper; Knutti, Reto; Friedlingstein, Pierre

2009-01-01

The severity of damaging human-induced climate change depends not only on the magnitude of the change but also on the potential for irreversibility. This paper shows that the climate change that takes place due to increases in carbon dioxide concentration is largely irreversible for 1,000 years after emissions stop. Following cessation of emissions, removal of atmospheric carbon dioxide decreases radiative forcing, but is largely compensated by slower loss of heat to the ocean, so that atmospheric temperatures do not drop significantly for at least 1,000 years. Among illustrative irreversible impacts that should be expected if atmospheric carbon dioxide concentrations increase from current levels near 385 parts per million by volume (ppmv) to a peak of 450–600 ppmv over the coming century are irreversible dry-season rainfall reductions in several regions comparable to those of the “dust bowl” era and inexorable sea level rise. Thermal expansion of the warming ocean provides a conservative lower limit to irreversible global average sea level rise of at least 0.4–1.0 m if 21st century CO2 concentrations exceed 600 ppmv and 0.6–1.9 m for peak CO2 concentrations exceeding ≈1,000 ppmv. Additional contributions from glaciers and ice sheet contributions to future sea level rise are uncertain but may equal or exceed several meters over the next millennium or longer. PMID:19179281

Operating limits for subassembly deformation in EBR-II

International Nuclear Information System (INIS)

Bottcher, J.H.

1977-01-01

The deformation of a subassembly in response to the core environment is frequently the life limiting factor for that component in an LMFBR. Deformation can occur as diametral and axial growth or bowing of the subassembly. Such deformation has caused several handling problems in both the core and the storage basket of EBR-II and may also have contributed to reactivity anomalies during reactor operation. These problems generally affect plant availability but the reactivity anomalies could lead to a potential safety hazard. Because of these effects the deformation mechanisms must be understood and modeled. Diametral and axial growth of subassembly ducts in EBR-II is due to swelling and creep and is a function of temperature, neutron fluence and stress. The source of stress in a duct is the hydraulic pressure difference across the wall. By coupling the calculated subassembly growth rate to the available clearance in the core or storage basket a limiting neutron fluence, or exposure, can be established

Therapeutic embolization of renal artery to control severe hypertension due to renal trauma

Energy Technology Data Exchange (ETDEWEB)

Cotroneo, A R; Patane, D; De Cinque, M; Falappa, P; Doglietto, G

1987-05-01

In a young patient with a post-traumatic renal hematoma, severe systemic hypertension, secondary to the activation of the renin-angiotensin axis, developed. Because of persistent hypertension, after 3 months of drug therapy, selective percutaneous embolization of the damaged vessels was performed. One year after procedure, the patient is normotensive without drugs.

Therapeutic embolization of renal artery to control severe hypertension due to renal trauma

International Nuclear Information System (INIS)

Cotroneo, A.R.; Patane, D.; De Cinque, M.; Falappa, P.; Doglietto, G.

1987-01-01

In a young patient with a post-traumatic renal hematoma, severe systemic hypertension, secondary to the activation of the renin-angiotensin axis, developed. Because of persistent hypertension, after 3 months of drug therapy, selective percutaneous embolization of the damaged vessels was performed. One year after procedure, the patient is normotensive without drugs. (orig.)

A severe capacity limit in the consolidation of orientation information into visual short-term memory.

Science.gov (United States)

Becker, Mark W; Miller, James R; Liu, Taosheng

2013-04-01

Previous research has suggested that two color patches can be consolidated into visual short-term memory (VSTM) via an unlimited parallel process. Here we examined whether the same unlimited-capacity parallel process occurs for two oriented grating patches. Participants viewed two gratings that were presented briefly and masked. In blocks of trials, the gratings were presented either simultaneously or sequentially. In Experiments 1 and 2, the presentation of the stimuli was followed by a location cue that indicated the grating on which to base one's response. In Experiment 1, participants responded whether the target grating was oriented clockwise or counterclockwise with respect to vertical. In Experiment 2, participants indicated whether the target grating was oriented along one of the cardinal directions (vertical or horizontal) or was obliquely oriented. Finally, in Experiment 3, the location cue was replaced with a third grating that appeared at fixation, and participants indicated whether either of the two test gratings matched this probe. Despite the fact that these responses required fairly coarse coding of the orientation information, across all methods of responding we found superior performance for sequential over simultaneous presentations. These findings suggest that the consolidation of oriented gratings into VSTM is severely limited in capacity and differs from the consolidation of color information.

Exploring exposure to Agent Orange and increased mortality due to bladder cancer.

Science.gov (United States)

Mossanen, Matthew; Kibel, Adam S; Goldman, Rose H

2017-11-01

During the Vietnam War, many veterans were exposed to Agent Orange (AO), a chemical defoliant containing varying levels of the carcinogen dioxin. The health effects of AO exposure have been widely studied in the VA population. Here we review and interpret data regarding the association between AO exposure and bladder cancer (BC) mortality. Data evaluating the association between AO and BC is limited. Methods characterizing exposure have become more sophisticated over time. Several studies support the link between AO exposure and increased mortality due to BC, including the Korean Veterans Health Study. Available data suggest an association with exposure to AO and increased mortality due to BC. In patients exposed to AO, increased frequency of cystoscopic surveillance and potentially more aggressive therapy for those with BC may be warranted but utility of these strategies remains to be proven. Additional research is required to better understand the relationship between AO and BC. Copyright © 2017 Elsevier Inc. All rights reserved.

Anomalous scaling due to correlations: limit theorems and self-similar processes

International Nuclear Information System (INIS)

Stella, Attilio L; Baldovin, Fulvio

2010-01-01

We derive theorems which outline explicit mechanisms by which anomalous scaling for the probability density function of the sum of many correlated random variables asymptotically prevails. The results characterize general anomalous scaling forms, explain their universal character, and specify universality domains in the spaces of joint probability density functions of the summand variables. These density functions are assumed to be invariant under arbitrary permutations of their arguments. Examples from the theory of critical phenomena are discussed. The novel notion of stability implied by the limit theorems also allows us to define sequences of random variables whose sum satisfies anomalous scaling for any finite number of summands. If regarded as developing in time, the stochastic processes described by these variables are non-Markovian generalizations of Gaussian processes with uncorrelated increments, and provide, e.g., explicit realizations of a recently proposed model of index evolution in finance

Relationship between perceived limit-setting abilities, autism spectrum disorder severity, behaviour problems and parenting stress in mothers of children with autism spectrum disorder.

Science.gov (United States)

Reed, Phil; Howse, Jessie; Ho, Ben; Osborne, Lisa A

2017-11-01

Parenting stress in mothers of children with autism spectrum disorder (ASD) is high and impacts perceptions about parenting. This study examined the relationship between parenting stress and observer-perceived limit-setting ability. Participants' perceptions of other parents' limit-setting ability were assessed by showing participants video clips of parenting behaviours. Mothers of 93 children with autism spectrum disorder completed an online survey regarding the severity of their own child's autism spectrum disorder (Social Communication Questionnaire), their child's behaviour problems (Strengths and Difficulties Questionnaire) and their own levels of parenting stress (Questionnaire on Resources and Stress). They were shown five videos of other parents interacting with children with autism spectrum disorder and were asked to rate the limit-setting abilities observed in each video using the Parent-Child Relationship Inventory. Higher parenting stress negatively related to judgements about others' limit-setting skills. This mirrors the literature regarding the relationship between self-reported parenting stress and rating child behaviour more negatively. It suggests that stress negatively impacts a wide range of judgements and implies that caution may be required when interpreting the results of studies in which parenting skills are assessed by self-report.

Mitigation of commutation failures in LCC–HVDC systems based on superconducting fault current limiters

Energy Technology Data Exchange (ETDEWEB)

Lee, Jong-Geon; Khan, Umer Amir; Lee, Ho-Yun; Lim, Sung-Woo; Lee, Bang-Wook, E-mail: bangwook@hanyang.ac.kr

2016-11-15

Commutation failure in line commutated converter based HVDC systems cause severe damages on the entire power grid system. For LCC–HVDC, thyristor valves are turned on by a firing signal but turn off control is governed by the external applied AC voltage from surrounding network. When the fault occurs in AC system, turn-off control of thyristor valves is unavailable due to the voltage collapse of point of common coupling (PCC), which causes the commutation failure in LCC–HVDC link. Due to the commutation failure, the power transfer interruption, dc voltage drop and severe voltage fluctuation in the AC system could be occurred. In a severe situation, it might cause the protection system to block the valves. In this paper, as a solution to prevent the voltage collapse on PCC and to limit the fault current, the application study of resistive superconducting fault current limiter (SFCL) on LCC–HVDC grid system was performed with mathematical and simulation analyses. The simulation model was designed by Matlab/Simulink considering Haenam-Jeju HVDC power grid in Korea which includes conventional AC system and onshore wind farm and resistive SFCL model. From the result, it was observed that the application of SFCL on LCC–HVDC system is an effective solution to mitigate the commutation failure. And then the process to determine optimum quench resistance of SFCL which enables the recovery of commutation failure was deeply investigated.

Mitigation of commutation failures in LCC–HVDC systems based on superconducting fault current limiters

International Nuclear Information System (INIS)

Lee, Jong-Geon; Khan, Umer Amir; Lee, Ho-Yun; Lim, Sung-Woo; Lee, Bang-Wook

2016-01-01

Commutation failure in line commutated converter based HVDC systems cause severe damages on the entire power grid system. For LCC–HVDC, thyristor valves are turned on by a firing signal but turn off control is governed by the external applied AC voltage from surrounding network. When the fault occurs in AC system, turn-off control of thyristor valves is unavailable due to the voltage collapse of point of common coupling (PCC), which causes the commutation failure in LCC–HVDC link. Due to the commutation failure, the power transfer interruption, dc voltage drop and severe voltage fluctuation in the AC system could be occurred. In a severe situation, it might cause the protection system to block the valves. In this paper, as a solution to prevent the voltage collapse on PCC and to limit the fault current, the application study of resistive superconducting fault current limiter (SFCL) on LCC–HVDC grid system was performed with mathematical and simulation analyses. The simulation model was designed by Matlab/Simulink considering Haenam-Jeju HVDC power grid in Korea which includes conventional AC system and onshore wind farm and resistive SFCL model. From the result, it was observed that the application of SFCL on LCC–HVDC system is an effective solution to mitigate the commutation failure. And then the process to determine optimum quench resistance of SFCL which enables the recovery of commutation failure was deeply investigated.

Mitigation of commutation failures in LCC-HVDC systems based on superconducting fault current limiters

Science.gov (United States)

Lee, Jong-Geon; Khan, Umer Amir; Lee, Ho-Yun; Lim, Sung-Woo; Lee, Bang-Wook

2016-11-01

Commutation failure in line commutated converter based HVDC systems cause severe damages on the entire power grid system. For LCC-HVDC, thyristor valves are turned on by a firing signal but turn off control is governed by the external applied AC voltage from surrounding network. When the fault occurs in AC system, turn-off control of thyristor valves is unavailable due to the voltage collapse of point of common coupling (PCC), which causes the commutation failure in LCC-HVDC link. Due to the commutation failure, the power transfer interruption, dc voltage drop and severe voltage fluctuation in the AC system could be occurred. In a severe situation, it might cause the protection system to block the valves. In this paper, as a solution to prevent the voltage collapse on PCC and to limit the fault current, the application study of resistive superconducting fault current limiter (SFCL) on LCC-HVDC grid system was performed with mathematical and simulation analyses. The simulation model was designed by Matlab/Simulink considering Haenam-Jeju HVDC power grid in Korea which includes conventional AC system and onshore wind farm and resistive SFCL model. From the result, it was observed that the application of SFCL on LCC-HVDC system is an effective solution to mitigate the commutation failure. And then the process to determine optimum quench resistance of SFCL which enables the recovery of commutation failure was deeply investigated.

Respiratory Failure due to Severe Obesity and Kyphoscoliosis in a 24-Year-Old Male with Molecularly Confirmed Prader-Willi Syndrome in Tertiary Hospital in Northern Tanzania

Directory of Open Access Journals (Sweden)

Elichilia R. Shao

2017-01-01

Full Text Available Obesity, mild intellectual disability, hypotonia, poor sucking, cryptorchidism in males, hypogonadism, and kyphoscoliosis are common features of Prader-Willi syndrome (PWS. We report a case who had severe respiratory complications due to extreme obesity and kyphoscoliosis, which are important causes of morbidity and mortality, and discuss management. Furthermore, this is the first molecularly confirmed PWS case in Sub-Saharan Africa outside South Africa.

Possibilities of hydrogen removal. Phase 2: Limitation of hydrogen effects in hypothetical severe accidents in PWR reactors

International Nuclear Information System (INIS)

Langer, G.; Koehling, A.; Nikodem, H.

1984-01-01

In the event of hypothetical severe accidents in light-water reactors, considerable amounts of hydrogen may be produced and released into the containment. Combustion of the hydrogen may jeopardize the integrity of the containment. The study reported here aimed to identify methods to mitigate the hydrogen problem. These methods should either prevent hydrogen combustion, or limit its effects. The following methods have been investigated: pre-inerting; chemical oxygen absorption; removal of oxygen by combustion; post-inerting with N 2 , CO 2 , or halon; aqueous foam; water fog; deliberate ignition; containment purging; and containment venting. The present state of the art in both nuclear and non-nuclear facilities, has been identified. The assessment of the methods was based on accident scenarios assuming significant release of hydrogen and the spectrum of requirements derived from these scenarios was used to determine the advantages and drawbacks of the various methods, assuming their application in a pressurized water reactor of German design. (orig./RW) [de

Marine Biotoxins: Occurrence, Toxicity, Regulatory Limits and Reference Methods

Directory of Open Access Journals (Sweden)

Pierina Visciano

2016-07-01

Full Text Available Harmful algal blooms are natural phenomena caused by the massive growth of phytoplankton that may contain highly toxic chemicals, the so-called marine biotoxins causing illness and even death to both aquatic organisms and humans. Their occurrence has been increased in frequency and severity, suggesting a worldwide public health risk. Marine biotoxins can accumulate in bivalve molluscs and regulatory limits have been set for some classes according to European Union legislation. These compounds can be distinguished in water- and fat-soluble molecules. The first group involves those of Paralytic Shellfish Poisoning and Amnesic Shellfish Poisoning, whereas the toxins soluble in fat can cause Diarrheic Shellfish Poisoning and Neurotoxic Shellfish Poisoning. Due to the lack of long-term toxicity studies, establishing tolerable daily intakes for any of these marine biotoxins was not possible, but an acute reference dose can be considered more appropriate, because these molecules show an acute toxicity. Dietary exposure assessment is linked both to the levels of marine biotoxins present in bivalve molluscs and the portion that could be eaten by consumers. Symptoms may vary from a severe gastrointestinal intoxication with diarrhea, nausea, vomiting, and abdominal cramps to neurological disorders such as ataxia, dizziness, partial paralysis, and respiratory distress. The official method for the detection of marine biotoxins is the mouse bioassay (MBA showing some limits due to ethical restrictions and insufficient specificity. For this reason, the liquid chromatography–mass spectrometry method has replaced MBA as the reference technique. However, the monitoring of algal blooms producing marine biotoxins should be regularly assessed in order to obtain more reliable, accurate estimates of bloom toxicity and their potential impacts.

Methodology for determination of the operational limits in a atmospheric oven as a function of the load characteristics; Metodologia para determinacao dos limites operacionais de um forno atmosferico em funcao das caracteristicas da carga

Energy Technology Data Exchange (ETDEWEB)

Mundstock, Rene [Refinaria Alberto Pasqualini (REFAP), Canoas, RS (Brazil); Correa, Eduardo Coelho [PETROBRAS, Rio de Janeiro, RJ (Brazil)

2000-07-01

The necessity of increasing the crude processing with operation periods even greater, are resulting in Atmospheric Distillation Units in severe conditions, requiring even more rigorous operational procedures. The crude fired heaters are the critical equipment in this context, because they are the most susceptible to failures, if some determined limits are exceeded. This work was originated from the tube failure analysis of the fired heater F-101 of Alberto Pasqualini Refinery (REFAP), occurred in july/98, due to internal cocking, with unit emergency shut-down. During this analysis, it was verified that the operational limit of a fired heater cannot be determined only by its design thermal duty, it must be also taken into account the influence of the crude composition. This will determine, due to its film coefficient, the region of the radiation zone of the fired heater where it will begin the crude vaporization and will occur the greater temperatures. The work conclusions resulted on the revision of the Unit operational procedures and definition of new crude processing limits. The fired heater operates with no problems since then. (author)

Towards Improved Optical Limiters

National Research Council Canada - National Science Library

Huffman, Peter

2002-01-01

.... The first approach was to synthesize and study soluble thallium phthalocyanines. Thallium, due to its proximity to lead and indium on the periodic table, should exhibit favorable optical limiting properties...

The Course of Headache in Patients With Moderate-to-Severe Headache Due to Aneurysmal Subarachnoid Hemorrhage: A Retrospective Cross-Sectional Study.

Science.gov (United States)

Hong, Chang-Ki; Joo, Jin-Yang; Kim, Yong Bae; Shim, Yu Shik; Lim, Yong Cheol; Shin, Yong Sam; Chung, Joonho

2015-01-01

The purpose of this study was to evaluate the course of headache in patients with moderate-to-severe headache due to aneurysmal subarachnoid hemorrhage (aSAH) and to identify its predisposing factors. Little is known about the long-term course of headache in patients with aSAH. Since September 2009, patients with aSAH have had their headaches prospectively rated using a numeric rating scale (NRS). From this database containing 838 patients, 217 were included and all included patients met the following criteria: (1) presence of ruptured intracranial aneurysms on computed tomography angiography or magnetic resonance angiography; (2) alert consciousness (Glasgow Coma Scale 15); (3) newly onset moderate-to-severe headache (NRS ≥ 4) due to ruptured intracranial aneurysms; and (4) good clinical outcome at discharge (modified Rankin Scale 0, 1, or 2). We observed the changes in NRS scores from initial to 12-month follow-up and identified the predisposing factors of NRS changes. Of the 217 patients, 182 (83.9%) experienced improvement in NRS score ≤ 3 upon discharge. The NRS scores at discharge were significantly lower than those on admission (P headache improvement included previous stroke (odds ratio [OR] = 0.141; 95% CI 0.051-0.381; P headache treated with medication (OR = 0.079; 95% CI 0.010-0.518; P = .008), and endovascular treatment (EVT; OR = 2.531; 95% CI 1.141-5.912; P = .026). The NRS scores tended to decrease continuously until the 12-month follow-up. EVT and symptomatic vasospasm were independently associated with a decrease of NRS in the follow-up periods. The course of headache in patients with aSAH continuously improved during the 12 months of follow-up. Headache improvement might be expected in patients who were treated with EVT and in those who did not have previous stroke or headache. © 2015 American Headache Society.

Therapy of moderate and severe psoriasis

Directory of Open Access Journals (Sweden)

Werfel, Thomas

2006-04-01

Full Text Available Objective and methods: This health technology assessment (HTA report synthesises systematically randomized controlled studies (RCT on the therapy of moderate and severe psoriasis vulgaris which were published between 1999 and 2004; it includes some important clinical studies which have been published after 2004 and thus updates the English HTA report by Griffiths et al. [1]. The major objective is the evaluation of the medical effectiveness of different therapeutical approaches and the cost effectiveness with relevance for Germany. Results: The major conclusions from the results of medical RCT on moderate and severe psoriasis vulgaris are: Oral fumarates are effective in the treatment of moderate to severe psoriasis vulgaris. However, fumarates quiet frequently cause moderate side effects. Cyclosporine and methotrexate are both effective in the treatment of severe psoriasis vulgaris. Both substances have a different spectrum of side effects which may limit the individual applicability. Acetritin is only moderately effective in the treatment of severe psoriasis of the plaque type. Calcipotriol or UV-radiation used at the same time can increase the clinical effectiveness of acetritin. Systemic PUVA, balneo-PUVA and UVB therapy are all effective for the treatment of severe psoriasis. The combination of UV therapy with vitamin D3 analogues or with topical steroids is more effective than the treatment with UV radiation alone. Saltwater baths increase the effectiveness of UVB therapy. No RCT on the therapeutical effects of topical tar or of dithranol in combination with UV therapy have been published so far. A continuous therapy with PUVA should not be applied due to its proven photocarcinogenicity. Three substances from the group of biologicals (Efalizumab, Etanercept, and Infliximab are now available in Europe and a further substance (Alefacept is available in the USA for the treatment of moderate to severe psoriasis. All biologicals have been

The influence of the key limiting factors on the limitations of heat transfer in heat pipes with various working fluids

Directory of Open Access Journals (Sweden)

Melnyk R. S.

2017-04-01

Full Text Available Aluminium and copper heat pipes with grooved and metal fibrous capillary structure are high effective heat transfer devices. They are used in different cooling systems of electronic equipment like a LED modules, microprocessors, receive-transmit modules and so on. However thus heat pipes have heat transfer limitations. There are few types of this limitations: hydraulic limitation, boiling limitation, liquid entrainment by vapor flow and sonic limitation. There is necessity to know which one of these limitations is determinant for heat pipe due to design process. At a present article calculations of maximum heat transfer ability represented. All these calculations were made for LED cooling by using heat pipes with grooved and metal fibrous capillary structures. Pentane, acetone, isobutane and water were used as a coolants. It was shown that the main operation limit for axial grooved heat pipe, which determinate maximum heat transfer ability due to inclination angle for location of cooling zone higher than evaporation zone case, is entrainment limit for pentane and acetone coolants. Nevertheless, for isobutane coolant the main limitation is a boiling limit. However, for heat pipes with metal fibrous capillary structure the main limitation is a capillary limit. This limitation was a determinant for all calculated coolants: water, pentane and acetone. For high porosity range of capillary structure, capillary limit transfer to sonic limit for heat pipes with water, that means that the vapor velocity increases to sonic velocity and can't grow any more. Due to this, coolant cant in a needed quantity infill condensation zone and the last one drained. For heat pipes with acetone and pentane, capillary limit transfer to boiling limit. All calculations were made for vapor temperature equal to 50°C, and for porosity range from 30% to 90%.

Severe HDN due to anti-Ce that required exchange tranfusion.

Science.gov (United States)

Wagner, T; Resch, B; Legler, T J; Mossier, C; Helmberg, W; Köhler, M; Lanzer, G

2000-05-01

Rh system antibodies are commonly encountered in blood bank practice as well as during pregnancy. Nevertheless, no examples of anti-Ce (RH7) have been reported as a cause of HDN that requires exchange transfusion. A 38-year-old woman in her fourth pregnancy was typed as blood group O D+, C-, c+, E+, e-. Anti-C and anti-e were detected in her serum during a routine prenatal work-up. Further evaluation, including flow cytometric analysis, revealed the presence of a strong anti-Ce and a weak anti-e. Her partner was typed as group A D+, C+, c-, E-, e+. A seemingly healthy male infant was delivered at 40 weeks of gestation. The infant's RBCs were typed as group O D-, C+, c+, E+, e+ with a positive DAT (titer 128). Twenty-five hours after birth, the baby had to be transferred to the neonatal intensive care unit because of rapidly rising total serum bilirubin. Despite intensive treatment, including double phototherapy, albumin infusion, and the administration of furosemide and IVIG, the total serum bilirubin level increased during the following day and exchange transfusion with 2 units of type O D-, C-, c+, E+, e- had to be performed; this resulted in a prompt decrease in total serum bilirubin without relapse. Anti-Ce caused severe HDN requiring exchange transfusion. This highlights the need for a close follow-up throughout pregnancy if unexpected RBC antibodies are present, to permit the provision of compatible blood in case of a rare antibody.

Dental implants for severely atrophied jaws due to ectodermal dysplasia

Directory of Open Access Journals (Sweden)

Preetha Balaji

2015-01-01

Full Text Available The aim was to present the successful esthetical and functional rehabilitation of partial anodontia in a case of severe ectodermal dysplasia with complete atrophy of the jaws. A 17-year-old male with Class III malocclusion with partial anodontia sought dental implant treatment. His expectation was that of Class I occlusion. The challenge in the case was to match the expectation, reality, and the clinical possibilities. Ridge augmentation was performed with a combination of rib graft and recombinant human bone morphogenetic protein-2. Simultaneously, 6 implants (Nobel Biocare™ - Tapered Groovy were placed in maxillary arch and 10 in the mandible. Simultaneous placement ensured faster and better osseointegration though a mild compromise of the primary stability was observed initially. After adequate healing, Customized Zirconia Procera™ system was used to build the framework. Zirconia crown was cemented to the framework. Radiological and clinical evidence of osseointegration was observed in all 16 dental implants. Successful conversion of Class III to Class I occlusion was achieved with the combination of preprosthetic alveolar ridge augmentation, Procera™ Implant Bridge system. Abnormal angulations and or placement of dental implants would result in failure of the implant. Hence conversion of Class III to Class I occlusion needs complete and complex treatment planning so that the entire masticatory apparatus is sufficiently remodeled. Planning should consider the resultant vectors that would otherwise result in failure of framework or compromise the secondary stability of the dental implant during function. A successful case of rehabilitation of complex partial anodontia is presented.

Persistent intestinal bleeding due to severe CMV-related thrombocytopenia in a preterm newborn.

Science.gov (United States)

Berardi, Alberto; Spaggiari, Eugenio; Cattelani, Chiara; Roversi, Maria Federica; Pecorari, Monica; Lazzarotto, Tiziana; Ferrari, Fabrizio

2018-05-01

The optimal threshold for neonatal platelet transfusions in sick newborns is still uncertain. We report a congenital cytomegalovirus (CMV) infection in a premature neonate with severe thrombocytopenia who subsequently presented with necrotizing enterocolitis and intestinal bleeding. The baby recovered after platelet transfusions were discontinued and the therapy was switched from intravenous ganciclovir to oral valganciclovir. We discuss both measures, speculating on the key role of platelet transfusions.

Management of Sick Leave due to Musculoskeletal Disorders

NARCIS (Netherlands)

E. Faber (Elske)

2007-01-01

textabstractMusculoskeletal disorders are a common problem that may lead to func-Ational limitations and (work) disability. It is not clear yet how improvement in Apain or functional limitations is related to return to work after an episode of sick Aleave. Furthermore, several physicians are

Impact of reduced dose limits on NRC licensed activities. Major issues in the implementation of ICRP/NCRP dose limit recommendations: Final report

International Nuclear Information System (INIS)

Meinhold, C.B.

1995-05-01

This report summarizes information required to estimate, at least qualitatively, the potential impacts of reducing occupational dose limits below those given in 10 CFR 20 (Revised). For this study, a questionnaire was developed and widely distributed to the radiation protection community. The resulting data together with data from existing surveys and sources were used to estimate the impact of three dose-limit options; 10 mSv yr -1 (1 rem yr -1 ), 20 mSv yr -1 (2 rem yr -1 ), and a combination of an annual limit of 50 mSv yr -1 (5 rem yr -1 ) coupled with a cumulative limit, in rem, equal to age in years. Due to the somewhat small number of responses and the lack of data in some specific areas, a working committee of radiation protection experts from a variety of licensees was employed to ensure the exposure data were representative. The following overall conclusions were reached: (1) although 10 mSv yr -1 is a reasonable limit for many licensees, such a limit could be extraordinarily difficult to achieve and potentially destructive to the continued operation of some licensees, such as nuclear power, fuel fabrication, and medicine; (2) twenty mSv yr -1 as a limit is possible for some of these groups, but for others it would prove difficult. (3) fifty mSv yr -1 and age in 10s of mSv appear reasonable for all licensees, both in terms of the lifetime risk of cancer and severe genetic effects to the most highly exposed workers, and the practicality of operation

Management of Severe Hypertriglyceridemia with Plasmapheresis During Pregnancy

Directory of Open Access Journals (Sweden)

Gokhan Boyraz

2016-01-01

Full Text Available Although severe hypertriglyceridemia is rarely seen in pregnancy, it may result in acute pancreatitis leading to increased morbidity in both mother and fetus. Restriction of dietary lipid and lipid-lowering medications are the cornerstones of the treatment. Experiences with plasmapheresis are limited. Herein, a pregnant woman with hypertriglyceridemia who was given preconceptional counseling and medical therapy and kept under close observation since the early weeks of gestation, succesfully managed with dietary lipid restriction and especially with serial plasmapheresis is discussed. Her previous pregnancy was remarkable with fetal demise due to acute pancreatitis at 24th weeks of gestation. It is important that the clinicians have a clear understanding of the normal lipid profile during pregnancy, the clinical picture, the potential complications, available treatment options of hypertriglyceridemia particularly during pregnancy.

Transcatheter valve-in-valve implantation due to severe aortic regurgitation in a degenerated aortic homograft

DEFF Research Database (Denmark)

Olsen, Lene Kjaer; Engstrøm, Thomas; Søndergaard, Lars

2009-01-01

Transcatheter aortic valve implantation (TAVI) in severe aortic stenosis has proven to be a feasible and effective treatment modality for inoperable patients. Until now, neither aortic regurgitation nor degenerated bioprostheses has been an indication for TAVI. However, this article reports...... a successful valve-in-valve implantation of a CoreValve aortic valve prosthesis through the right subclavian artery in a case of severe aortic regurgitation within a degenerated aortic homograft. The case exemplifies the possibilities of expanding the indications for TAVI, as well as other vascular access...

Severe Hemoperitoneum Following Rupture of Uterine Diverticulum due to Pregnancy: a Case Report

Directory of Open Access Journals (Sweden)

Yaghmaei Minoo

2009-06-01

Full Text Available Uterovaginal malformations, occur in 0.16% of women and contribute to the problems of infertility, recurrent pregnancy loss, dysmenorrhea, dyspareunia, amenorrhea and a poor outcome in pregnancy. True diverticulum is an exceedingly rare anomaly and is like a tubular formation connected to uterine cavity that ends in a cul-de sac and It is not classified as any of mullerian duct anomalies. In this article a case of uterine diverticulum rupture due to pregnancy in a 19 years old woman with nausea, vomiting and abdominal pain is reported. Although rare, in complicated pregnancy we should think to genital tract anomalies.

The results of therapeutic plasma exchange in patients with severe hyperthyroidism: a retrospective multicenter study.

Science.gov (United States)

Keklik, Muzaffer; Kaynar, Leylagul; Yilmaz, Mehmet; Sivgin, Serdar; Solmaz, Musa; Pala, Cigdem; Aribas, Sulbiye; Akyol, Gulsah; Unluhizarci, Kursat; Cetin, Mustafa; Eser, Bulent; Unal, Ali

2013-06-01

Hyperthyroidism characterized by elevated serum levels of circulating thyroid hormones. The aim of hyperthyroidism treatment is to achieve a euthyroid state as soon as possible and to maintain euthyroid status. However, drug withdrawal and utilization of alternative therapies are needed in cases in which leucopenia or impairment in liver functions is observed during medical therapy. In the present study, we aimed to present our cases which underwent therapeutic plasma exchange (TPE) due to severe hyperthyroidism. The results of 22 patients who underwent therapeutic plasma exchange due to hyperthyroidism in Apheresis Units of Erciyes University and Gaziantep University, between 2006 and 2012, were retrospectively reviewed. These cases had severe thyrotoxic values despite anti-thyroid drug use. After TPE, we observed a significant decrease in free thyroxin (FT4) (phyperthyroidism by TPE in 20 cases (91%). Both FT3 and FT4 levels remained above the normal limits in two of 22 patients. TPE should be considered as an effective and safe therapeutic option to achieve euthyroid state before surgery or radioactive iodine treatment. TPE is a useful option in cases with severe hyperthyroidism unresponsive to anti-thyroid agents and in those with clinical manifestations of cardiac failure and in patients with severe adverse events during anti-thyroid therapy. Copyright © 2013 Elsevier Ltd. All rights reserved.

Comparison of Thoracic Injury Risk in Frontal Car Crashes for Occupant Restrained without Belt Load Limiters and Those Restrained with 6 kN and 4 kN Belt Load Limiters.

Science.gov (United States)

Foret-Bruno, J Y; Trosseille, X; Page, Y; Huère, J F; Le Coz, J Y; Bendjellal, F; Diboine, A; Phalempin, T; Villeforceix, D; Baudrit, P; Guillemot, H; Coltat, J C

2001-11-01

In France, as in other countries, accident research studies show that a large proportion of restrained occupants who sustain severe or fatal injuries are involved in frontal impacts (65% and 50%, respectively). In severe frontal impacts with restrained occupants and where intrusion is not preponderant, the oldest occupants very often sustain severe thoracic injuries due to the conventional seat belt. As we have been observing over the last years, we will expect in the coming years developments which include more solidly-built cars, as offset crash test procedures are widely used to evaluate the passive safety of production vehicles. The reduction of intrusion for the most severe frontal impacts, through optimization of car deformation, usually translates into an increase in restraint forces and hence thoracic injury risk with a conventional retractor seat belt for a given impact severity. It is, therefore essential to limit the restraint forces exerted by the seat belt on the thorax in order to reduce the number of road casualties. In order to address thoracic injury risk in frontal impact, Renault cars have been equipped with the Programmed Restraint System (PRS) since 1995. The PRS is a restraint system that combines belt load limitation and pyrotechnic belt pretension. In an initial design of the Programmed Restraint System (PRS1), the belt load limiter was a steel component designed to shear at a given shoulder force, namely 6 kN. It was mounted between the retractor and the lower anchorage point of the belt. The design of the PRS was modified in 1998 (PRS2), but the principle of load limitation was maintained. The threshold was decreased to 4 kN and this lower belt belt-force limiter has been combined with a specially designed airbag. This paper reports on 347 real-world frontal accidents where the EES (Equivalent Energy Speed) ranged from 35 to 75 km/h. One hundred and ninety-eight (198) of these accidents involved cars equipped with the 6 kN load limiter

[Severe burns of lower limb due to association of hot water and citrullus colocynthis].

Science.gov (United States)

Fejjal, N; Gharib, N E; El Mazouz, S; Abbassi, A; Belmahi, A

2011-06-30

The case is reported of a patient suffering from severe burns through having used Citrullus colocynthis as a medicinal plant together with hot water. This led to carbonization of the foot and to its amputation. A description of the plant and its toxicity is given.

Evaluating the limits of solar photovoltaics (PV) in electric power systems utilizing energy storage and other enabling technologies

International Nuclear Information System (INIS)

Denholm, Paul; Margolis, Robert M.

2007-01-01

In this work, we evaluate technologies that will enable solar photovoltaics (PV) to overcome the limits of traditional electric power systems. We performed simulations of a large utility system using hourly solar insolation and load data and attempted to provide up to 50% of this system's energy from PV. We considered several methods to avoid the limits of unusable PV that result at high penetration due to the use of inflexible baseload generators. The enabling technologies considered in this work are increased system flexibility, load shifting via demand responsive appliances, and energy storage

Limits of the petroleum consumption in Brazil; Limites do consumo de petroleo no Brasil

Energy Technology Data Exchange (ETDEWEB)

Galbieri, Rodrigo [Universidade Estadual de Campinas (UNICAMP), SP (Brazil). Fac. de Engenharia Mecanica], email: galbieri@fem.unicamp.br; Simoes, Andre Felipe [Universidade de Sao Paulo (EACH/USP), SP (Brazil). Escola de Artes, Ciencias e Humanidades], email: afsimoes@usp.br

2010-07-01

The great demand of Diesel oil for cargoes transportation, added to the technical limitations in refining capacity in Brazil, do not allow the level of the feedstock balance itself with the demand of derivatives (especially because of high demand of Diesel oil), making Brazil an importer of Diesel, naphtha and LPG and exporter of fuel oil and gasoline A. This fact sets the country in a vulnerable situation due to oscillate in oil prices and the value of national currency, that might sometimes bring trade deficits of billions of dollars to the country. Due to economic growth, ever greater volumes of oil are needed. This present paper analyzes the main limiting factors for expansion of oil consumption in Brazil. (author)

Simulating the potential yield and yield gaps of sugar beet due to water and nitrogen limitations in Khorasan province using SUCROS model

Directory of Open Access Journals (Sweden)

R Deihimfard

2015-12-01

Full Text Available Introduction Crop productivity is highly constrained by water and nitrogen limitations in many areas of the world (Kalra et al., 2007. Therefore, there is a need to investigate more on nitrogen and water management to achieve higher production as well as quality. Irrigated sugar beet in the cropping systems of Khorasan province in northeastern of Iran accounts for about 34% of the land area under sugar beet production (~115,000 ha with an average yield of around 36 t.ha-1 (Anonymous, 2009. However, there is a huge yield gap (the difference between potential and water and nitrogen-limited yield mainly due to biotic and abiotic factors causing major reduction in farmers’ yield. Accordingly, yield gap analysis should be carried out to reduce the yield reduction and reach the farmer’s yield to the potential yield. The current study aimed to simulate potential yield as well as yield gap related to water and nitrogen shortage in the major sugar beet-growing areas of Khorasan province of Iran. Materials and methods This study was carried out in 6 locations across Khorasan province, which is located in the northeast of Iran. Long term weather data for 1986 to 2009 were obtained from Iran Meteorological Organization for 6 selected locations. The weather data included daily sunshine hours (h, daily maximum and minimum temperatures (◦C, and daily rainfall (mm. Daily solar radiation was estimated using the Goudriaan (1993 method. The validated SUCROSBEET model (Deihimfard, 2011; Deihimfard et al., 2011 was then used to estimate potential, water and nitrogen-limited yield and yield gap of sugar beet for 6 selected locations across the Khorasan province in the northeast of Iran. This model simulates the impacts of weather, genotype and management factors on crop growth and development, soil water and nitrogen balance on a daily basis and finally it predicts crop yield. The model requires input data, including local weather and soil conditions, cultivar

Development of gene therapy: potential in severe combined immunodeficiency due to adenosine deaminase deficiency

Directory of Open Access Journals (Sweden)

Claudia A Montiel-Equihua

2009-12-01

Full Text Available Claudia A Montiel-Equihua, Adrian J Thrasher, H Bobby GasparCentre for Immunodeficiency, Molecular Immunology Unit, UCL Institute of Child Health, London, UKAbstract: The history of stem cell gene therapy is strongly linked to the development of gene therapy for severe combined immunodeficiencies (SCID and especially adenosine deaminase (ADA-deficient SCID. Here we discuss the developments achieved in over two decades of clinical and laboratory research that led to the establishment of a protocol for the autologous transplant of retroviral vector-mediated gene-modified hematopoietic stem cells, which has proved to be both successful and, to date, safe. Patients in trials in three different countries have shown long-term immunological and metabolic correction. Nevertheless, improvements to the safety profile of viral vectors are underway and will undoubtedly reinforce the position of stem cell gene therapy as a treatment option for ADA-SCID.Keywords: adenosine deaminase, severe combined immunodeficiency, gene therapy, hematopoietic stem cell, retrovirus, clinical trial

Toward Modeling Limited Plasticity in Ceramic Materials

National Research Council Canada - National Science Library

Grinfeld, Michael; Schoenfeld, Scott E; Wright, Tim W

2008-01-01

The characteristic features of many armor-related ceramic materials are the anisotropy on the micro-scale level and the very limited, though non-vanishing, plasticity due to limited number of the planes for plastic slip...

Enhanced Shear-induced Platelet Aggregation Due to Low-temperature Storage

Science.gov (United States)

2013-07-01

Grewal PK, Wandall HH, Josefsson EC, Sorensen AL, Larson G, Marth JD, Hartwig JH, Hoffmeister KM. Dual roles for hepatic lectin receptors in the clearance ...PLT aggregation due to low temperature storage may be a beneficial strategy to prevent severe bleeding in trauma . P latelets (PLTs) are transfused to...prevent bleed- ing due to thrombocytopenia associated with hematologic malignancies or to manage severe blood loss during surgery or trauma . PLTs are

Effect of dewatering on seismic performance of multi-anchor wall due to high ground water level

Science.gov (United States)

Kobayashi, Makoto; Miura, Kinya; Konami, Takeharu; Hayashi, Taketo; Sato, Hiroki

2017-10-01

Previous research reported that the ground water in the backfill of reinforced soil wall made it deteriorate. According to the damage investigation of Great East Earthquake 2011, the reinforced soil structure due to high ground water level by seismic wave were deformed remarkably. Some of them classified ultimate limit state or restorability limit state. However, more than 90% of reinforced soil structure, which suffered from this earthquake, were classified into no damage condition. Therefore, it is necessary that the seismic behaviors of multi-anchor wall due to seepage flow should be clarified in order to adopt the performance-based design in such reinforced soil structure. In this study, a series of centrifugal shaking table tests were conducted to investigate the seismic behavior of multi-anchor wall due to high ground water level. The reinforced drainage pipes were installed into the backfill in order to verify the dewatering effect and additional reinforcement. Furthermore, to check only the dewatering effect, the model tests was carried out with several ground water table that was modeled the case reinforced drainage pipes installed. The test results show unique behavior of reinforced region that moved integrally. This implies that the reinforced region has been behaved as if it became one mass, and this behavior make this structure increase seismic performance. Thus, the effectiveness of dewatering was observed remarkably because of decreasing the inertial force during earthquake.

CT findings in severe thoracic sarcoidosis

International Nuclear Information System (INIS)

Hennebicque, Anne-Sophie; Brillet, Pierre-Yves; Moulahi, Hassen; Brauner, Michel W.; Nunes, Hilario; Valeyre, Dominique

2005-01-01

Severe thoracic sarcoidosis includes manifestations with significant clinical and functional impairment and a risk of mortality. Severe thoracic sarcoidosis can take on various clinical presentations and is associated with increased morbidity. The purpose of this article was to describe the CT findings in severe thoracic sarcoidosis and to explain some of their mechanisms. Subacute respiratory insufficiency is a rare and early complication due to a high profusion of pulmonary lesions. Chronic respiratory insufficiency due to pulmonary fibrosis is a frequent and late complication. Three main CT patterns are identified: bronchial distortion, honeycombing and linear opacities. CT can be helpful in diagnosing some mechanisms of central airway obstruction such as bronchial distortion due to pulmonary fibrosis or an extrinsic bronchial compression by enlarged lymph nodes. An intrinsic narrowing of the bronchial wall by endobronchial granulomatous lesions may be suggested by CT when it shows evidence of bronchial mural thickening. Pulmonary hypertension usually occurs in patients with end-stage pulmonary disease and is related to fibrotic destruction of the distal capillary bed and to the resultant chronic hypoxemia. Several other mechanisms may contribute to the development of pulmonary hypertension including extrinsic compression of major pulmonary arteries by enlarged lymph nodes and secondary pulmonary veno-occlusive disease. Aspergilloma colonization of a cavity is the main cause of hemoptysis in sarcoidosis. Other rare causes are bronchiesctasis, necrotizing bronchial aspergillosis, semi-invasive pulmonary aspergillosis, erosion of a pulmonary artery due to a necrotic sarcoidosis lesion, necrosis of parenchymal sarcoidosis lesions and specific endobronchial macroscopic lesions. (orig.)

Microstructural and superficial modification in a Cu-Al-Be shape memory alloy due to superficial severe plastic deformation under sliding wear conditions

Science.gov (United States)

Figueroa, C. G.; Garcia-Castillo, F. N.; Jacobo, V. H.; Cortés-Pérez, J.; Schouwenaars, R.

2017-05-01

Stress induced martensitic transformation in copper-based shape memory alloys has been studied mainly in monocrystals. This limits the use of such results for practical applications as most engineering applications use polycristals. In the present work, a coaxial tribometer developed by the authors was used to characterise the tribological behaviour of polycrystalline Cu-11.5%Al-0.5%Be shape memory alloy in contact with AISI 9840 steel under sliding wear conditions. The surface and microstructure characterization of the worn material was conducted by conventional scanning electron microscopy and atomic force microscopy, while the mechanical properties along the transversal section were measured by means of micro-hardness testing. The tribological behaviour of Cu-Al-Be showed to be optimal under sliding wear conditions since the surface only presented a slight damage consisting in some elongated flakes produced by strong plastic deformation. The combination of the plastically modified surface and the effects of mechanically induced martensitic transformation is well-suited for sliding wear conditions since the modified surface provides the necessary strength to avoid superficial damage while superelasticity associated to martensitic transformation is an additional mechanism which allows absorbing mechanical energy associated to wear phenomena as opposed to conventional ductile alloys where severe plastic deformation affects several tens of micrometres below the surface.

Novel limiter pump topologies

International Nuclear Information System (INIS)

Schultz, J.H.

1981-01-01

The use of limiter pumps as the principle plasma exhaust system of a magnetic confinement fusion device promises significant simplification, when compared to previously investigating divertor based systems. Further simplifications, such as the integration of the exhaust system with a radio frequency heating system and with the main reactor shield and structure are investigated below. The integrity of limiters in a reactor environment is threatened by many mechanisms, the most severe of which may be erosion by sputtering. Two novel topolgies are suggested which allow high erosion without limiter failure

Novel limiter pump topologies

International Nuclear Information System (INIS)

Schultz, J.H.

1981-01-01

The use of limiter pumps as the principle plasma exhaust system of a magnetic confinement fusion device promises significant simplification, when compared to previously investigating divertor based systems. Further simplifications, such as the integration of the exhaust system with a radio frequency heating system and with the main reactor shield and structure are investigated below. The integrity of limiters in a reactor environment is threatened by many mechanisms, the most severe of which may be erosion by sputtering. Two novel topologies are suggested which allow high erosion without limiter failure

Case report: Severe hemolytic disease of the fetus and newborn due to anti-C+G.

Science.gov (United States)

Jernman, Riina; Stefanovic, Vedran; Korhonen, Anu; Haimila, Katri; Sareneva, Inna; Sulin, Kati; Kuosmanen, Malla; Sainio, Susanna

2015-01-01

Anti-G is commonly present with anti-D and/or anti-C and can confuse serological investigations. in general, anti-G is not considered a likely cause of severe hemolytic disease of the fetus and newborn (HDFN), but it is important to differentiate it from anti-D in women who should be administered anti-D immunoglobulin prophylaxis. We report one woman with three pregnancies severely affected by anti-C+G requiring intrauterine treatment and a review of the literature. In our case, the identification of the correct antibody was delayed because the differentiation of anti-C+G and anti-D+C was not considered important during pregnancy since the father was D-. In addition, anti-C+G and anti-G titer levels were not found to be reliable as is generally considered in Rh immunization. Severe HDFN occurred at a maternal anti-C+G antibody titer of S and anti-G titer of 1 in comparison with the critical titer level of 16 or more in our laboratory. close collaboration between the immunohematology laboratory and the obstetric unit is essential. In previously affected families, early assessment for fetal anemia is required even when titers are low.

Haemosuccus pancreaticus due to true splenic artery aneurysm: a rare cause of massive upper gastrointestinal bleeding

Directory of Open Access Journals (Sweden)

MK Roy

2010-07-01

Full Text Available “Haemosuccus pancreaticus” is an unusual cause of severe upper gastrointestinal bleeding and results from rupture of splenic artery aneurysm into the pancreatic duct. More commonly, it is a pseudoaneurysm of the splenic artery which develops as sequelae of pancreatitis. However, true aneurysm of the splenic artery without pancreatitis has rarely been incriminated as the etiologic factor of this condition. Owing to the paucity of cases and limited knowledge about the disease, diagnosis as well as treatment become challenging. Here we describe a 60-year-old male presenting with severe recurrent upper gastrointestinal bleeding and abdominal pain, which, after considerable delay, was diagnosed to be due to splenic artery aneurysm. Following an unsuccessful endovascular embolisation, the patient was cured by distal pancreatectomy and ligation of aneurysm.

Severe Hypertriglyceridemia Induced Pancreatitis in Pregnancy

OpenAIRE

Gupta, Natasha; Ahmed, Seema; Shaffer, Lemuel; Cavens, Paula; Blankstein, Josef

2014-01-01

Acute pancreatitis caused by severe gestational hypertriglyceridemia is a rare complication of pregnancy. Acute pancreatitis has been well associated with gallstone disease, alcoholism, or drug abuse but rarely seen in association with severe hypertriglyceridemia. Hypertriglyceridemia may occur in pregnancy due to normal physiological changes leading to abnormalities in lipid metabolism. We report a case of severe gestational hypertriglyceridemia that caused acute pancreatitis at full term an...

Non-Operative Management of Isolated Pneumoperitoneum Due to Severe Blunt Abdominal Trauma

Directory of Open Access Journals (Sweden)

Murat Kilic

2016-02-01

Full Text Available Nonoperative management of blunt abdominal trauma is the treatment of choice for hemodynamically stable patients. The results of nonoperative management are more successful in isolated solid organ injuries such as the liver and spleen than hollow viscus injury. In this approach, both the clinical course of the patient and the computed tomography findings play an important role. Isolated pneumoperitoneum in blunt abdominal trauma may be a surgical challenge for clinicians because it is usually a significant radiological sign for hallow viscus perforations. Here, we report a case of isolated pneumoperitoneum detected on computed tomography and managed non-surgically, in a young man suffered from a severe blunt abdominal trauma. Our aim is to attract the attention of surgeons to the management problems of the presence of pneumoperitoneum in the absence of other radiological findings in blunt abdominal trauma.

Impact of reduced dose limits on NRC licensed activities. Major issues in the implementation of ICRP/NCRP dose limit recommendations: Final report

Energy Technology Data Exchange (ETDEWEB)

Meinhold, C.B. [Brookhaven National Lab., Upton, NY (United States)

1995-05-01

This report summarizes information required to estimate, at least qualitatively, the potential impacts of reducing occupational dose limits below those given in 10 CFR 20 (Revised). For this study, a questionnaire was developed and widely distributed to the radiation protection community. The resulting data together with data from existing surveys and sources were used to estimate the impact of three dose-limit options; 10 mSv yr{sup {minus}1} (1 rem yr{sup {minus}1}), 20 mSv yr{sup {minus}1} (2 rem yr{sup {minus}1}), and a combination of an annual limit of 50 mSv yr{sup {minus}1} (5 rem yr{sup {minus}1}) coupled with a cumulative limit, in rem, equal to age in years. Due to the somewhat small number of responses and the lack of data in some specific areas, a working committee of radiation protection experts from a variety of licensees was employed to ensure the exposure data were representative. The following overall conclusions were reached: (1) although 10 mSv yr{sup {minus}1} is a reasonable limit for many licensees, such a limit could be extraordinarily difficult to achieve and potentially destructive to the continued operation of some licensees, such as nuclear power, fuel fabrication, and medicine; (2) twenty mSv yr{sup {minus}1} as a limit is possible for some of these groups, but for others it would prove difficult. (3) fifty mSv yr{sup {minus}1} and age in 10s of mSv appear reasonable for all licensees, both in terms of the lifetime risk of cancer and severe genetic effects to the most highly exposed workers, and the practicality of operation.

Successful recovery from iatrogenic severe hypernatremia and severe metabolic acidosis resulting from accidental use of inappropriate bicarbonate concentrate for hemodialysis treatment

Directory of Open Access Journals (Sweden)

Guruprasad P Bhosale

2015-01-01

Full Text Available Bicarbonate dialysis is the treatment modality of choice for correction of metabolic acidosis in chronic renal failure. However, improper selection of dialysate concentrate can result in life-threatening human errors. We report a case of iatrogenic severe hypernatremia (sodium 207 mEq/L and severe metabolic acidosis (pH 6.65 that resulted due to accidental use of inappropriate bicarbonate concentrate for hemodialysis treatment. There was successful recovery in this patient with no neurological sequelae. To the best of our knowledge, this is the first case report in adults of severe hypernatremia along with severe metabolic acidosis due to error in the preparation of dialysis fluid.

Working memory limitations in children with severe language impairment.

Science.gov (United States)

van Daal, John; Verhoeven, Ludo; van Leeuwe, Jan; van Balkom, Hans

2008-01-01

In the present study, the relations of various aspects of working memory to various aspects of language problems in a clinical sample of 97 Dutch speaking 5-year-old children with severe language problems were studied. The working memory and language abilities of the children were examined using an extensive battery of tests. Working memory was operationalized according to the model of Baddeley. Confirmative factor analyses revealed three memory factors: phonological, visual and central executive. Language was construed as a multifactorial construct, and confirmative factor analyses revealed four factors: lexical-semantic abilities, phonological abilities, syntactic abilities and speech production abilities. Moderate to high correlations were found between the memory and language factors. Structural equation modelling was used to further explore the relations between the different factors. Phonological memory was found to predict phonological abilities; central-executive memory predicted lexical-semantic abilities; and visual memory predicted speech production abilities. Phonological abilities also predicted syntactic abilities. Both the theoretical and clinical implications of the findings are discussed. The reader will be introduced to the concepts of multifactorial components of working memory as well as language impairment. Secondly the reader will recognize that working memory and language impairment factors can be related. Particular emphasis will be placed on phonological memory, central-executive memory and visual memory and their possible prediction of specific components of language impairment.

Development of a severe accident training simulator using a MELCOR code

International Nuclear Information System (INIS)

Kim, Ko Ryu; Jeong, Kwang Sub; Ha, Jae Joo; Jung, Won Dae

2002-03-01

Nuclear power plants' severe accidents are, despite of their rareness, very important in safety aspects, because of their huge damages when occurred. For the appropriate execution of severe accident strategy, more information for decision-making are required because of the uncertainties included in severe accidents. Earlier NRC raised concerns over severe accident training in the report NUREC/CR-477, and accordingly, developing effective training tools for severe accident were emphasized. In fact the training tools were requested from industrial area, nevertheless, few training tools were developed due to the uncertainties in severe accidents, lacks of analysis computer codes and technical limitations. SATS, the severe accident training simulator, is developed as a multi-purpose tools for severe accident training. SATS uses the calculation results of MELCOR, an integral severe accident analysis code, and with the help of SL-GMS graphic tools, provides dynamic displays of severe accident phenomena on the terminal of IBM PC. It aimed to have two main features: one is to provide graphic displays to represent severe accident phenomena and the other is to process and simulate severe accident strategy given by plant operators and TSC staffs. Severe accident strategies are basically composed of series of operations of available pumps, valves and other equipments. Whenever executing strategies with SATS, the trainee should follow the HyperKAMG, the on line version of the recently developed severe accident guidance (KAMG). Severe accident strategies are closely related to accidents scenarios. TLOFW and LOCA , two representative severe accident scenarios of Uljin 3,4, are developed as a built-in scenarios of SATS. Although SATS has some minor problems at this time, we expect SATS will be a good severe accident training tool after the appropriate addition of accident scenarios. Moreover, we also expect SATS will be a good advisory tool for the severe accident research

The impact of regulations, safety considerations and physical limitations on research progress at maximum biocontainment.

Science.gov (United States)

Shurtleff, Amy C; Garza, Nicole; Lackemeyer, Matthew; Carrion, Ricardo; Griffiths, Anthony; Patterson, Jean; Edwin, Samuel S; Bavari, Sina

2012-12-01

We describe herein, limitations on research at biosafety level 4 (BSL-4) containment laboratories, with regard to biosecurity regulations, safety considerations, research space limitations, and physical constraints in executing experimental procedures. These limitations can severely impact the number of collaborations and size of research projects investigating microbial pathogens of biodefense concern. Acquisition, use, storage, and transfer of biological select agents and toxins (BSAT) are highly regulated due to their potential to pose a severe threat to public health and safety. All federal, state, city, and local regulations must be followed to obtain and maintain registration for the institution to conduct research involving BSAT. These include initial screening and continuous monitoring of personnel, controlled access to containment laboratories, accurate and current BSAT inventory records. Safety considerations are paramount in BSL-4 containment laboratories while considering the types of research tools, workflow and time required for conducting both in vivo and in vitro experiments in limited space. Required use of a positive-pressure encapsulating suit imposes tremendous physical limitations on the researcher. Successful mitigation of these constraints requires additional time, effort, good communication, and creative solutions. Test and evaluation of novel vaccines and therapeutics conducted under good laboratory practice (GLP) conditions for FDA approval are prioritized and frequently share the same physical space with important ongoing basic research studies. The possibilities and limitations of biomedical research involving microbial pathogens of biodefense concern in BSL-4 containment laboratories are explored in this review.

The Impact of Regulations, Safety Considerations and Physical Limitations on Research Progress at Maximum Biocontainment

Directory of Open Access Journals (Sweden)

Jean Patterson

2012-12-01

Full Text Available We describe herein, limitations on research at biosafety level 4 (BSL-4 containment laboratories, with regard to biosecurity regulations, safety considerations, research space limitations, and physical constraints in executing experimental procedures. These limitations can severely impact the number of collaborations and size of research projects investigating microbial pathogens of biodefense concern. Acquisition, use, storage, and transfer of biological select agents and toxins (BSAT are highly regulated due to their potential to pose a severe threat to public health and safety. All federal, state, city, and local regulations must be followed to obtain and maintain registration for the institution to conduct research involving BSAT. These include initial screening and continuous monitoring of personnel, controlled access to containment laboratories, accurate and current BSAT inventory records. Safety considerations are paramount in BSL-4 containment laboratories while considering the types of research tools, workflow and time required for conducting both in vivo and in vitro experiments in limited space. Required use of a positive-pressure encapsulating suit imposes tremendous physical limitations on the researcher. Successful mitigation of these constraints requires additional time, effort, good communication, and creative solutions. Test and evaluation of novel vaccines and therapeutics conducted under good laboratory practice (GLP conditions for FDA approval are prioritized and frequently share the same physical space with important ongoing basic research studies. The possibilities and limitations of biomedical research involving microbial pathogens of biodefense concern in BSL-4 containment laboratories are explored in this review.

The Impact of Regulations, Safety Considerations and Physical Limitations on Research Progress at Maximum Biocontainment

Science.gov (United States)

Shurtleff, Amy C.; Garza, Nicole; Lackemeyer, Matthew; Carrion, Ricardo; Griffiths, Anthony; Patterson, Jean; Edwin, Samuel S.; Bavari, Sina

2012-01-01

We describe herein, limitations on research at biosafety level 4 (BSL-4) containment laboratories, with regard to biosecurity regulations, safety considerations, research space limitations, and physical constraints in executing experimental procedures. These limitations can severely impact the number of collaborations and size of research projects investigating microbial pathogens of biodefense concern. Acquisition, use, storage, and transfer of biological select agents and toxins (BSAT) are highly regulated due to their potential to pose a severe threat to public health and safety. All federal, state, city, and local regulations must be followed to obtain and maintain registration for the institution to conduct research involving BSAT. These include initial screening and continuous monitoring of personnel, controlled access to containment laboratories, accurate and current BSAT inventory records. Safety considerations are paramount in BSL-4 containment laboratories while considering the types of research tools, workflow and time required for conducting both in vivo and in vitro experiments in limited space. Required use of a positive-pressure encapsulating suit imposes tremendous physical limitations on the researcher. Successful mitigation of these constraints requires additional time, effort, good communication, and creative solutions. Test and evaluation of novel vaccines and therapeutics conducted under good laboratory practice (GLP) conditions for FDA approval are prioritized and frequently share the same physical space with important ongoing basic research studies. The possibilities and limitations of biomedical research involving microbial pathogens of biodefense concern in BSL-4 containment laboratories are explored in this review. PMID:23342380

A fatal case of severe neck abscess due to a third branchial cleft fistula: morphologic and immunohistochemical analyses.

Science.gov (United States)

Tong, Fang; Liang, Yue; Khan, Muhammad Fasahat; Zhang, Lin; Li, Wenhe; Mahmoodurrahman, Mohammed; Zhou, Yiwu

2016-09-15

Branchial cleft anomalies constitute a frequently encountered and commonly non-lethal disease in otolaryngology, and result from aberrant embryonic development. The third branchial cleft fistula is one of the four known specific types of branchial cleft anomalies, and always presents as recurrent neck abscess and suppurative thyroiditis. Here, we report an unexpected death due to severe neck infection following a third branchial cleft fistula. A 19-year-old man was sent to the hospital with a 1-week history of recurrent left-sided neck abscess, and was scheduled for incision and drainage of the abscess. However, before the surgery was performed, the man's condition deteriorated and he died. A review of his medical history showed that he had undergone a previous incision and drainage for a neck abscess 2 years ago. Postmortem examination revealed that the fatal neck abscess was induced by a third branchial cleft fistula. We conclude that a histopathological examination of neck tissue combined with a detailed review of medical history and examination of ultrasonographic and CT images can provide a rapid and accurate diagnosis of third branchial cleft fistula. This common, non-lethal disease can potentially lead to death if the neck infection is not properly diagnosed and treated. In medico-legal practice, medical examiners should be aware of this condition, as this knowledge would be important in the diagnosis of the cause of death.

Limit cycle analysis of nuclear coupled density wave oscillations

International Nuclear Information System (INIS)

Ward, M.E.

1985-01-01

An investigation of limit cycle behavior for the nuclear-coupled density wave oscillation (NCDWO) in a boiling water reactor (BWR) was performed. A simplified nonlinear model of BWR core behavior was developed using a two-region flow channel representation, coupled with a form of the point-kinetics equation. This model has been used to investigate the behavior of large amplitude NCDWO's through conventional time-integration solutions and through application of a direct relaxation-oscillation limit cycle solution in phase space. The numerical solutions demonstrate the potential for severe global power and flow oscillations in a BWR core at off-normal conditions, such as might occur during Anticipated Transients without Scram. Because of the many simplifying assumptions used, it is felt that the results should not be interpreted as an absolute prediction of core behavior, but as an indication of the potential for large oscillations and a demonstration of the corresponding limit cycle mechanisms. The oscillations in channel density drive the core power variations, and are reinforced by heat flux variations due to the changing fuel temperature. A global temperature increase occurs as energy is accumulated in the fuel, and limits the magnitude of the oscillations because as the average channel density decreases, the amplitude and duration of positive void reactivity at a given oscillation amplitude is lessened

Desmin myopathy with severe cardiomyopathy in a Uruguayan family due to a codon deletion in a new location within the desmin 1A rod domain.

Science.gov (United States)

Vernengo, Luis; Chourbagi, Oussama; Panuncio, Ana; Lilienbaum, Alain; Batonnet-Pichon, Sabrina; Bruston, Francine; Rodrigues-Lima, Fernando; Mesa, Rosario; Pizzarossa, Carlos; Demay, Laurence; Richard, Pascale; Vicart, Patrick; Rodriguez, Maria-Mirta

2010-03-01

Desmin myopathy is a heterogeneous neuromuscular disorder characterized by skeletal myopathy and cardiomyopathy, inherited mostly in an autosomal dominant pattern. We report a five generation Uruguayan family with severe cardiomyopathy and skeletal myopathy. Its most striking features are: atrial dilation, arrhythmia, conduction block and sudden death due to conduction impairment. Affected skeletal muscle shows alteration of mitochondria with paracrystallin inclusions and granulofilamentous material scattered in the muscle fibres. This family carries an unusual deletion p.E114del within the 1A rod domain of desmin. Transfected cells expressing the mutated desmin show punctuated and speckled cytoplasmic aggregates. The mutation causes a local conformational change in heptads a/d residues and charge positions. These findings lead to the hypothesis that coiled-coil interactions may be impaired, resulting in severe alterations in the desmin network. This is the first time that a mutation affecting this domain in the desmin molecule is described in a desminopathy. Copyright 2010. Published by Elsevier B.V.

Ponderomotive enhancement of charged particle beam limiting current

International Nuclear Information System (INIS)

Grebogi, C.; Uhm, H.S.

1987-01-01

The space charge limiting current problem is investigated for a magnetized particle beam propagating in a cylindrical drift tube and in presence of a waveguide mode. It is shown that with a proper choice of a waveguide mode, the limiting current can be greatly enhanced due to ponderomotive effects. Physically, this is accomplished by using the ponderomotive energy to reduce the potential depression due to the beam's self space charge field. Formulas for the limiting current as a function of beam energy and waveguide r.f. field for solid and hollow beams are derived. It is found from these formulas that, in appropriate parameter regimes, the space charge limiting current, say, of a 250kV bem can be enhanced by 70%

Severe Bradycardia Possibly due to a Local Anesthetic Oral Mucosal Injection during General Anesthesia

OpenAIRE

Satoh, Kenichi; Ohashi, Ayako; Kumagai, Miho; Hoshi, Hideki; Otaka, Kousei; Joh, Shigeharu

2015-01-01

Local anesthesia may induce systemic complications leading to parasympathetic activity leading to bradycardia and hypotension. We report a case of a 50-year-old man undergoing dental surgery under general anesthesia who experienced severe bradycardia and hypotension after local anesthesia infiltration. Concerns regarding the utilization of a relatively large lumen injection needle for local anesthesia during general anesthesia are discussed.

The prevalence and predictors of severe depression among the elderly in Malaysia.

Science.gov (United States)

Rashid, Abdul; Tahir, Ibrahim

2015-03-01

The population of Malaysia is relatively young, due to this there is a dearth in research conducted among the elderly especially relating to depression. The aim of this study is to determine the prevalence and the predictors of severe depression among the elderly in Malaysia. A sample of 2005 older adults randomly selected from the Penang State government's list of elderly receiving aid participated in the study. The Geriatric Depression Scale was used to screen for depression. Socio-demographic, social support, disease, functional and other factors were looked at as possible predictor variables. The prevalence of severe depression was 19.2 %. Indians (aOR = 2.0), being married (aOR = 10.5), widowed & divorced (aOR = 5.2), having poor (aOR = 2.7) or moderate social support (aOR = 2.7), having no one (aOR = 2.9), relatives (aOR = 2.3) or religious figures & others (aOR = 1.9) as compared to a spouse as a source of emotional support, feeling extremely lonely (aOR = 3.4), not socially active (aOR = 2.3), cognitively impaired (aOR 2.5), activities limited due to illness or disability (aOR = 1.6) and poor sleep quality (aOR = 3.6) were significant predictor variables. The prevalence of severe depression was high. It is pertinent that older adults, especially those with risk factors identified in this study be screened for depression at every opportunity.

Recent decline in the global land evapotranspiration trend due to limited moisture supply.

Science.gov (United States)

Jung, Martin; Reichstein, Markus; Ciais, Philippe; Seneviratne, Sonia I; Sheffield, Justin; Goulden, Michael L; Bonan, Gordon; Cescatti, Alessandro; Chen, Jiquan; de Jeu, Richard; Dolman, A Johannes; Eugster, Werner; Gerten, Dieter; Gianelle, Damiano; Gobron, Nadine; Heinke, Jens; Kimball, John; Law, Beverly E; Montagnani, Leonardo; Mu, Qiaozhen; Mueller, Brigitte; Oleson, Keith; Papale, Dario; Richardson, Andrew D; Roupsard, Olivier; Running, Steve; Tomelleri, Enrico; Viovy, Nicolas; Weber, Ulrich; Williams, Christopher; Wood, Eric; Zaehle, Sönke; Zhang, Ke

2010-10-21

More than half of the solar energy absorbed by land surfaces is currently used to evaporate water. Climate change is expected to intensify the hydrological cycle and to alter evapotranspiration, with implications for ecosystem services and feedback to regional and global climate. Evapotranspiration changes may already be under way, but direct observational constraints are lacking at the global scale. Until such evidence is available, changes in the water cycle on land−a key diagnostic criterion of the effects of climate change and variability−remain uncertain. Here we provide a data-driven estimate of global land evapotranspiration from 1982 to 2008, compiled using a global monitoring network, meteorological and remote-sensing observations, and a machine-learning algorithm. In addition, we have assessed evapotranspiration variations over the same time period using an ensemble of process-based land-surface models. Our results suggest that global annual evapotranspiration increased on average by 7.1 ± 1.0 millimetres per year per decade from 1982 to 1997. After that, coincident with the last major El Niño event in 1998, the global evapotranspiration increase seems to have ceased until 2008. This change was driven primarily by moisture limitation in the Southern Hemisphere, particularly Africa and Australia. In these regions, microwave satellite observations indicate that soil moisture decreased from 1998 to 2008. Hence, increasing soil-moisture limitations on evapotranspiration largely explain the recent decline of the global land-evapotranspiration trend. Whether the changing behaviour of evapotranspiration is representative of natural climate variability or reflects a more permanent reorganization of the land water cycle is a key question for earth system science.

Wind power limit calculation basedon frequency deviation using Matlab

International Nuclear Information System (INIS)

Santos Fuentefria, Ariel; Salgado Duarte, Yorlandis; MejutoFarray, Davis

2017-01-01

The utilization of the wind energy for the production of electricity it’s a technology that has promoted itself in the last years, like an alternative before the environmental deterioration and the scarcity of the fossil fuels. When the power generation of wind energy is integrated into the electrical power systems, maybe take place problems in the frequency stability due to, mainly, the stochastic characteristic of the wind and the impossibility of the wind power control on behalf of the dispatchers. In this work, is make an analysis of frequency deviation when the wind power generation rise in an isolated electrical power system. This analysis develops in a computerized frame with the construction of an algorithm using Matlab, which allowed to make several simulations in order to obtain the frequency behavior for different loads and wind power conditions. Besides, it was determined the wind power limit for minimum, medium and maximum load. The results show that the greatest values on wind power are obtained in maximum load condition. However, the minimum load condition limit the introduction of wind power into the system. (author)

Survival in a case of diffuse alveolar hemorrhage due to Strongyloides stercoralis hyperinfection.

Science.gov (United States)

Steinhaus, Daniel A; Gainor, Justin F; Vernovsky, Inna; Winsett, Julie; Beer, Dennis J

2012-01-01

Strongyloides stercoralis is an intestinal nematode endemic to tropical and sub-tropical regions. Although infection is typically asymptomatic or self-limited, immunocompromised individuals can develop a severe form of disease marked by hyperinfection. Pulmonary involvement accompanies hyperinfection in a majority of cases, though manifestations range from asymptomatic infiltrates to diffuse alveolar hemorrhage (DAH) and respiratory failure. When complicated by DAH, the hyperinfection syndrome is usually fatal. We report a case of a 65-year-old Guatemalan woman with chronic inflammatory demyelinating polyneuropathy (CIDP) treated with chronic steroids who presented with Escherichia coli urosepsis. She was initially treated with antibiotics and corticosteroids. She subsequently developed DAH due to disseminated strongyloidiasis. She was treated with oral and subcutaneous ivermectin and had complete recovery.

Two-fluid limits on stellarator performance: Explanation of three stellarator puzzles and comparison to axisymmetric plasmas

International Nuclear Information System (INIS)

Sugiyama, L.E.; Strauss, H.R.; Park, W.; Fu, G.Y.; Breslau, J.A.; Chen, J.

2005-01-01

The basic two-fluid processes, those related to the nonlinearly self-consistent diamagnetic drifts of the electrons and ions, are shown to have fundamentally different effects on the steady state and beta limits of stellarator configurations, compared to MHD predictions. Nonlinear numerical simulation shows that the ideal MHD ballooning modes and the resistive MHD ballooning and interchange modes at relatively high mode numbers, that set the most severe theoretical limits on beta in stellarators with fixed boundary, are easily stabilized by two-fluid effects at realistic parameters, including finite Larmor radius effects related to the ion diamagnetic drift. Magnetic reconnection at low-order rational magnetic surfaces, on the other hand, is enhanced through the parallel component of the two-fluid electron pressure gradient in Ohm's law. The accelerated reconnection rates may impose the true intrinsic limit on beta in stellarators, as a 'soft' or confinement mediated limit in β e , due to steady confinement degradation in the presence of large magnetic islands. Study of the corresponding axisymmetric configurations shows that the helical component of the stellarator configuration provides an important amplifying factor for these effects. The two-fluid results may explain several previously puzzling experimental observations on stellarator behavior. (author)

The Fanconi anemia pathway limits the severity of mutagenesis.

Science.gov (United States)

Hinz, John M; Nham, Peter B; Salazar, Edmund P; Thompson, Larry H

2006-08-13

Fanconi anemia (FA) is a developmental and cancer predisposition disorder in which key, yet unknown, physiological events promoting chromosome stability are compromised. FA cells exhibit excess metaphase chromatid breaks and are universally hypersensitive to DNA interstrand crosslinking agents. Published mutagenesis data from single-gene mutation assays show both increased and decreased mutation frequencies in FA cells. In this review we discuss the data from the literature and from our isogenic fancg knockout hamster CHO cells, and interpret these data within the framework of a molecular model that accommodates these seemingly divergent observations. In FA cells, reduced rates of recovery of viable X-linked hypoxanthine phosphoribosyltransferase (hprt) mutants are characteristically observed for diverse mutagenic agents, but also in untreated cultures, indicating the relevance of the FA pathway for processing assorted DNA lesions. We ascribe these reductions to: (1) impaired mutagenic translesion synthesis within hprt during DNA replication and (2) lethality of mutant cells following replication fork breakage on the X chromosome, caused by unrepaired double-strand breaks or large deletions/translocations encompassing essential genes flanking hprt. These findings, along with studies showing increased spontaneous mutability of FA cells at two autosomal loci, support a model in which FA proteins promote both translesion synthesis at replication-blocking lesions and repair of broken replication forks by homologous recombination and DNA end joining. The essence of this model is that the FANC protein pathway serves to restrict the severity of mutational outcome by favoring base substitutions and small deletions over larger deletions and chromosomal rearrangements.

Severe malaria in Europe

DEFF Research Database (Denmark)

Kurth, Florian; Develoux, Michel; Mechain, Matthieu

2017-01-01

BACKGROUND: Malaria remains one of the most serious infections for travellers to tropical countries. Due to the lack of harmonized guidelines a large variety of treatment regimens is used in Europe to treat severe malaria. METHODS: The European Network for Tropical Medicine and Travel Health (Trop......Net) conducted an 8-year, multicentre, observational study to analyse epidemiology, treatment practices and outcomes of severe malaria in its member sites across Europe. Physicians at participating TropNet centres were asked to report pseudonymized retrospective data from all patients treated at their centre...... for microscopically confirmed severe Plasmodium falciparum malaria according to the 2006 WHO criteria. RESULTS: From 2006 to 2014 a total of 185 patients with severe malaria treated in 12 European countries were included. Three patients died, resulting in a 28-day survival rate of 98.4%. The majority of infections...

Influence of Disease Severity and Exercise Limitation on Exercise Training Intensity and Load and Health Benefits From Pulmonary Rehabilitation in Patients with COPD: AN EXPLORATORY STUDY.

Science.gov (United States)

Huynh, Virginia C; Fuhr, Desi P; Byers, Bradley W; Selzler, Anne-Marie; Moore, Linn E; Stickland, Michael K

2018-04-11

Some patients with chronic obstructive pulmonary disease (COPD) fail to achieve health benefits with pulmonary rehabilitation (PR). Exercise intensity and load represent stimulus for adaptation but it is unclear whether inappropriate exercise intensity and/or load are affected by severity of COPD, which may affect health benefits. The purpose was to determine whether COPD severity and/or the severity of pulmonary limitation to exercise (PLE) impacted exercising intensity or load and whether resultant intensity/load affected health outcomes derived from PR. Patients with COPD (n = 58, age = 67 ± 7 y, forced expiratory volume in the first second of expiration [FEV1] % predicted = 52 ± 21%) were recruited upon referral to PR. Primary health outcomes evaluated were 6-min walk distance and St George's Respiratory Questionnaire. Patients were stratified for disease severity using Global Initiative for Obstructive Lung Disease (GOLD) staging and PLE severity by change in inspiratory capacity during exercise. Exercise intensity and load were calculated from daily exercise records. Participants achieved comparable training duration and load regardless of GOLD severity. Patients with more severe PLE achieved greater training duration (more severe: 546 ± 143 min., less severe: 451 ± 109 min., P = .036), and relative training load (more severe: 2200.8 ± 595.3 kcal, less severe: 1648.3 ± 597.8 kcal, P = .007). Greater overall training load was associated with greater improvements in 6-min walk distance (r = 0.24, P = .035). No significant relationships were observed between PLE, GOLD severity, training parameters, and St George's Respiratory Questionnaire response. Improvements in exercise tolerance can be explained by achieving greater training loads, demonstrating the importance of appropriate training load to maximize health outcomes in PR.

Treatment Options for Severe Obesity in the Pediatric Population: Current Limitations and Future Opportunities.

Science.gov (United States)

Ryder, Justin R; Fox, Claudia K; Kelly, Aaron S

2018-06-01

Severe obesity is the only obesity classification increasing in prevalence among children and adolescents. Treatment options that produce meaningful and sustained weight loss and comorbidity resolution are urgently needed. The purpose of this review is to provide a brief overview of the current treatment options for pediatric severe obesity and offer suggestions regarding future opportunities for accelerating the development and evaluation of innovative treatment strategies. At present, there are three treatment options for youth with severe obesity: lifestyle modification therapy, pharmacotherapy, and bariatric surgery. Lifestyle modification therapy can be useful for improving many chronic disease risk factors and comorbid conditions but often fails to achieve clinically meaningful and sustainable weight loss. Pharmacotherapy holds promise as an effective adjunctive treatment but remains in the primordial stages of development in the pediatric population. Bariatric surgery provides robust weight loss and risk factor/comorbidity improvements but is accompanied by higher risks and lower uptake compared to lifestyle modification therapy and pharmacotherapy. New areas worth pursuing include combination pharmacotherapy, device therapy, identification of predictors of response aimed at precision treatment, and interventions in the postbariatric surgical setting to improve long-term outcomes. Treating pediatric severe obesity effectively and safely is extremely challenging. Some progress has been made, but substantially more effort and innovation are needed in the future to combat this serious and ongoing medical and public health issue. © 2018 The Obesity Society.

Severe ASR damaged concrete bridges

DEFF Research Database (Denmark)

Antonio Barbosa, Ricardo; Gustenhoff Hansen, Søren

2015-01-01

Technical University of Denmark (DTU) and University of Southern Denmark (SDU) have conducted several full-scale experiments with severe ASR deteriorated bridges. This paper presents few and preliminary results from both the shear tests and the measuring of the material properties. The shear test...... show that the shear capacity is almost unaffected of ASR despite significant reduction in compressive concrete strength. Furthermore, measurements show a significant tensile reinforcement strain developed due to ASR expansion....

Term limits and the tobacco industry.

Science.gov (United States)

Apollonio, Dorie E; Glantz, Stanton A; Bero, Lisa A

2014-03-01

In the 1990s several American states passed term limits on legislators with the stated intention of reducing the influence of wealthy industries on career legislators. Although term limits in the United States do not have a direct relationship to public health, the tobacco industry anticipated that term limits could have indirect effects by either limiting or expanding industry influence. We detail the strategy of the tobacco industry in the wake of term limits using internal tobacco company documents and a database of campaign contributions made to legislators in term limited states between 1988 and 2002. Despite some expectations that term limits would limit tobacco industry access to state legislators, term limits appear to have had the opposite effect. Copyright © 2013 Elsevier Ltd. All rights reserved.

Force Limit System

Science.gov (United States)

Pawlik, Ralph; Krause, David; Bremenour, Frank

2011-01-01

The Force Limit System (FLS) was developed to protect test specimens from inadvertent overload. The load limit value is fully adjustable by the operator and works independently of the test system control as a mechanical (non-electrical) device. When a test specimen is loaded via an electromechanical or hydraulic test system, a chance of an overload condition exists. An overload applied to a specimen could result in irreparable damage to the specimen and/or fixturing. The FLS restricts the maximum load that an actuator can apply to a test specimen. When testing limited-run test articles or using very expensive fixtures, the use of such a device is highly recommended. Test setups typically use electronic peak protection, which can be the source of overload due to malfunctioning components or the inability to react quickly enough to load spikes. The FLS works independently of the electronic overload protection.

Intestinal Necrosis due to Giant Ovarian Cyst: A Case Report

OpenAIRE

Duran, Ali; Duran, Fulay Yilmaz; Cengiz, Fevzi; Duran, Ozgur

2013-01-01

Intestinal pathologies due to ovarian cyst are observed rarely. Although a limited number of cases in neonatal and adolescent periods have been observed, no adult case has been reported in the literature. Two mechanisms are involved in intestinal complications due to ovarian cysts: torsion due to adhesion or compression of giant ovarian mass with a diameter of 9-10 cm. We report here a terminal ileum necrosis case due to compression by an ovarian cyst with 11 × 10 × 7 cm size in an 81-year-ol...

The Limits of Exercise Physiology

DEFF Research Database (Denmark)

Gabriel, Brendan M; Zierath, Juleen R

2017-01-01

Many of the established positive health benefits of exercise have been documented by historical discoveries in the field of exercise physiology. These investigations often assess limits: the limits of performance, or the limits of exercise-induced health benefits. Indeed, several key findings have...... been informed by studying highly trained athletes, in addition to healthy or unhealthy people. Recent progress has been made in regard to skeletal muscle metabolism and personalized exercise regimes. In this perspective, we review some of the historical milestones of exercise physiology, discuss how...

A Comparative Study Between Strain And Stress Based Forming Limit Analysis By Applying Several Phenomenological Yield Criteria

International Nuclear Information System (INIS)

Butuc, Marilena C.; Vincze, Gabriela T.; Gracio, Jose J.; Barata da Rocha, A.

2005-01-01

The present work aims at analyzing a comparative study between the strain-based forming limit criterion (FLD) and the stress-based forming limit criterion (FLSD), under linear and complex strain paths. The selected material is an AA5182-0 aluminium alloy. Some relevant remarks about stress-based forming limit criterion concept are presented

[Severe macrocytic anaemia and secondary hyperparathyroidism in a vegan].

Science.gov (United States)

Førland, Elizabeth Siren Bjerga; Lindberg, Mats Jacob Hermansson

2015-08-10

Nutritional deficiency anaemia in vegans is common and usually due to lack of vitamin B12, as this vitamin is found almost exclusively in animal-based food products. In this case report we present a 39-year-old male vegan with severe macrocytic anaemia due to vitamin B12 deficiency as well as secondary hyperparathyroidism due to severe vitamin D deficiency. We want to emphasize the importance of a detailed nutritional history for patients with anaemia, and the need for vitamin B12 and vitamin D supplements for people who comply with a vegan diet.

Conducting financial due diligence of medical practices.

Science.gov (United States)

Louiselle, P

1995-12-01

Many healthcare organizations are acquiring medical practices in an effort to build more integrated systems of healthcare products and services. This acquisition activity must be approached cautiously to ensure that medical practices being acquired do not have deficiencies that would jeopardize integration efforts. Conducting a thorough due diligence analysis of medical practices before finalizing the transaction can limit the acquiring organizations' legal and financial exposure and is a necessary component to the acquisition process. The author discusses the components of a successful financial due diligence analysis and addresses some of the risk factors in a practice acquisition.

Calculation of the effects of pumping, divertor configuration and fueling on density limit in a tokamak model problem

International Nuclear Information System (INIS)

Stacey, W. M.

2001-01-01

Several series of model problem calculations have been performed to investigate the predicted effect of pumping, divertor configuration and fueling on the maximum achievable density in diverted tokamaks. Density limitations due to thermal instabilities (confinement degradation and multifaceted axisymmetric radiation from the edge) and to divertor choking are considered. For gas fueling the maximum achievable density is relatively insensitive to pumping (on or off), to the divertor configuration (open or closed), or to the location of the gas injection, although the gas fueling rate required to achieve this maximum achievable density is quite sensitive to these choices. Thermal instabilities are predicted to limit the density at lower values than divertor choking. Higher-density limits are predicted for pellet injection than for gas fueling

Freight economic vulnerabilities due to flooding events.

Science.gov (United States)

2016-12-01

Extreme weather events, and flooding in particular, have been occurring more often and with increased severity over the past decade, and there is reason to expect this trend will continue in the future due to a changing climate. Flooding events can u...

Predicting incident size from limited information

International Nuclear Information System (INIS)

Englehardt, J.D.

1995-01-01

Predicting the size of low-probability, high-consequence natural disasters, industrial accidents, and pollutant releases is often difficult due to limitations in the availability of data on rare events and future circumstances. When incident data are available, they may be difficult to fit with a lognormal distribution. Two Bayesian probability distributions for inferring future incident-size probabilities from limited, indirect, and subjective information are proposed in this paper. The distributions are derived from Pareto distributions that are shown to fit data on different incident types and are justified theoretically. The derived distributions incorporate both inherent variability and uncertainty due to information limitations. Results were analyzed to determine the amount of data needed to predict incident-size probabilities in various situations. Information requirements for incident-size prediction using the methods were low, particularly when the population distribution had a thick tail. Use of the distributions to predict accumulated oil-spill consequences was demonstrated

Dermatoses due to Indian cultural practices.

Science.gov (United States)

Gupta, Divya; Thappa, Devinder Mohan

2015-01-01

A wide prevalence of socio-religious and cultural practices in the Asian subcontinent often leads to multitude of skin diseases which may be missed by the dermatologists because of a lack of awareness. 'Henna' use causes IgE-mediated hypersensitivity reactions and contact dermatitis. 'Kumkum' application can result in pigmented contact dermatitis and lichen planus pigmentosus. Sticker 'bindis' and 'alta' induce contact leukoderma. Irritant and allergic contact dermatitis occurs after playing with 'Holi' colors. Threading and drawstring dermatitis lead to koebnerization of pre-existing dermatoses, infections and even squamous cell carcinoma of skin. Mild irritant reactions and contact sensitization occur secondary to balm and hair oil use. 'Mudichood' represents the comedogenic effect of hair oils combined with occlusion and humidity. Aromatherapy oils can cause contact dermatitis and photosensitive reactions. Heavy metal and steroid toxicity along with severe cutaneous adverse effects like erythroderma can occur as a consequent to the use of alternative medicines. Squamous cell carcinoma due to chronic heat exposure from the heating device "kangri" is seen in Kashmiris. Prayer nodules in Muslims and traction alopecia in Sikhs illustrate how religious practices can negatively affect the skin. With increasing globalization and migration, the practice of indigenous customs and traditions is no longer limited to regional territories, making it imperative for the dermatologists to be acquainted with the cutaneous side effects they can cause.

Hospital Management of Severe Hypertriglyceridemia in Children.

Science.gov (United States)

Valaiyapathi, Badhma; Ashraf, Ambika P

2017-01-01

Severe Hypertriglyceridemia (HTG), i.e., plasma triglyceride levels exceeding 1000 mg/dL, is one of the established causes of acute pancreatitis and severe abdominal pain. There are no established pediatric guidelines regarding treatment of children and adolescents with severe HTG. To review the pathophysiology and etiology of severe HTG in the pediatric age group, and to discuss management options. Severe HTG is usually due to deficient or absent Lipoprotein Lipase (LPL) activity, which can be due to primary genetic etiology or secondary causes triggering HTG in those with underlying genetic susceptibility. Hospitalization is indicated for patients with severe HTG who are symptomatic with abdominal pain or pancreatitis, in those with uncontrolled diabetes requiring insulin, or, in those with substantial elevations of plasma TG. Fasting followed by fat free diet until plasma TG declines to severe pancreatitis, shock or multi-organ failure. Medications such as fibrates and omega-3 fatty acids are not effective if LPL activity is absent or when plasma TG is >1800 mg/dL. Medications only have an adjunct role in the management. Low fat diet, lifestyle changes, weight loss, control of secondary causes, and patient education form the mainstay of management once the patient is discharged. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

Doubling of coastal flooding frequency within decades due to sea-level rise

Science.gov (United States)

Vitousek, Sean; Barnard, Patrick L.; Fletcher, Charles H.; Frazer, Neil; Erikson, Li; Storlazzi, Curt D.

2017-01-01

Global climate change drives sea-level rise, increasing the frequency of coastal flooding. In most coastal regions, the amount of sea-level rise occurring over years to decades is significantly smaller than normal ocean-level fluctuations caused by tides, waves, and storm surge. However, even gradual sea-level rise can rapidly increase the frequency and severity of coastal flooding. So far, global-scale estimates of increased coastal flooding due to sea-level rise have not considered elevated water levels due to waves, and thus underestimate the potential impact. Here we use extreme value theory to combine sea-level projections with wave, tide, and storm surge models to estimate increases in coastal flooding on a continuous global scale. We find that regions with limited water-level variability, i.e., short-tailed flood-level distributions, located mainly in the Tropics, will experience the largest increases in flooding frequency. The 10 to 20 cm of sea-level rise expected no later than 2050 will more than double the frequency of extreme water-level events in the Tropics, impairing the developing economies of equatorial coastal cities and the habitability of low-lying Pacific island nations.

Doubling of coastal flooding frequency within decades due to sea-level rise.

Science.gov (United States)

Vitousek, Sean; Barnard, Patrick L; Fletcher, Charles H; Frazer, Neil; Erikson, Li; Storlazzi, Curt D

2017-05-18

Global climate change drives sea-level rise, increasing the frequency of coastal flooding. In most coastal regions, the amount of sea-level rise occurring over years to decades is significantly smaller than normal ocean-level fluctuations caused by tides, waves, and storm surge. However, even gradual sea-level rise can rapidly increase the frequency and severity of coastal flooding. So far, global-scale estimates of increased coastal flooding due to sea-level rise have not considered elevated water levels due to waves, and thus underestimate the potential impact. Here we use extreme value theory to combine sea-level projections with wave, tide, and storm surge models to estimate increases in coastal flooding on a continuous global scale. We find that regions with limited water-level variability, i.e., short-tailed flood-level distributions, located mainly in the Tropics, will experience the largest increases in flooding frequency. The 10 to 20 cm of sea-level rise expected no later than 2050 will more than double the frequency of extreme water-level events in the Tropics, impairing the developing economies of equatorial coastal cities and the habitability of low-lying Pacific island nations.

Human due diligence.

Science.gov (United States)

Harding, David; Rouse, Ted

2007-04-01

Most companies do a thorough job of financial due diligence when they acquire other companies. But all too often, deal makers simply ignore or underestimate the significance of people issues in mergers and acquisitions. The consequences are severe. Most obviously, there's a high degree of talent loss after a deal's announcement. To make matters worse, differences in decision-making styles lead to infighting; integration stalls; and productivity declines. The good news is that human due diligence can help companies avoid these problems. Done early enough, it helps acquirers decide whether to embrace or kill a deal and determine the price they are willing to pay. It also lays the groundwork for smooth integration. When acquirers have done their homework, they can uncover capability gaps, points of friction, and differences in decision making. Even more important, they can make the critical "people" decisions-who stays, who goes, who runs the combined business, what to do with the rank and file-at the time the deal is announced or shortly thereafter. Making such decisions within the first 30 days is critical to the success of a deal. Hostile situations clearly make things more difficult, but companies can and must still do a certain amount of human due diligence to reduce the inevitable fallout from the acquisition process and smooth the integration. This article details the steps involved in conducting human due diligence. The approach is structured around answering five basic questions: Who is the cultural acquirer? What kind of organization do you want? Will the two cultures mesh? Who are the people you most want to retain? And how will rank-and-file employees react to the deal? Unless an acquiring company has answered these questions to its satisfaction, the acquisition it is making will be very likely to end badly.

Comparison of Automated and Manual Recording of Brief Episodes of Intracranial Hypertension and Cerebral Hypoperfusion and Their Association with Outcome After Severe Traumatic Brain Injury

Science.gov (United States)

2017-03-01

which could limit our ability to evaluate the difference between EVD ICP and IPM ICP. Second, due to the complexity of the human brain and our...quartile 24.8 years and third quartile 49.3 years. There were 68 males and 13 females in this study group. In terms of the severity, those patients...Hypoperfusion and Their Association with Outcome After Severe Traumatic Brain Injury Peter Hu, PhD; Yao Li, MS; Shiming Yang, PhD; Catriona

Two siblings with isolated GH deficiency due to loss-of-function mutation in the GHRHR gene: successful treatment with growth hormone despite late admission and severe growth retardation.

Science.gov (United States)

Sıklar, Zeynep; Berberoğlu, Merih; Legendre, Maria; Amselem, Serge; Evliyaoğlu, Olcay; Hacıhamdioğlu, Bülent; Savaş Erdeve, Senay; Oçal, Gönül

2010-01-01

Patients with growth hormone releasing hormone receptor (GHRHR) mutations exhibit pronounced dwarfism and are phenotypically and biochemically indistinguishable from other forms of isolated growth hormone deficiency (IGHD). We presented here two siblings with clinical findings of IGHD due to a nonsense mutation in the GHRHR gene who reached their target height in spite of late GH treatment. Two female siblings were admitted to our clinic with severe short stature at the age of 13.8 (patient 1) and 14.8 years (patient 2). On admission, height in patient 1 was 107 cm (-8.6 SD) and 117 cm (-6.7 SD) in patient 2. Bone age was delayed in both patients (6 years and 9 years). Clinical and biochemical analyses revealed a diagnosis of complete IGHD (peak GH levels on stimulation test was 0.06 ng/mL in patient 1 and 0.16 ng/mL in patient 2). Patients were given recombinant human GH treatment. Genetic analysis of the GH and GHRHR genes revealed that both patientscarried the GHRHR gene mutation p.Glu72X (c.214 G>T) in exon 3 in homozygous (or hemizygous) state. After seven years of GH treatment, the patients reached a final height appropriate for their target height. Final height was 151 cm (-1.5 SD) in patient 1 and 153 cm (-1.2 SD) in patient 2. In conclusion, genetic analysis is indicated in IGHD patients with severe growth failure and a positive family history. In spite of the very late diagnosis in these two patients who presented with severe growth deficit due to homozygous loss-of-function mutations in GHRHR, their final heights reached the target height.

Limits on the space density of gamma-ray burst sources

International Nuclear Information System (INIS)

Epstein, R.I.

1985-01-01

Gamma-ray burst spectra which extend to several MeV without significant steepening indicate that there is negligible degradation due to two-photon pair production. The inferred low rate of photon-photon reactions is used to give upper limits to the distances to the sources and to the intensity of the radiation from the sources. These limits are calculated under the assumptions that the bursters are neutron stars which emit uncollimated gamma rays. The principal results are that the space density of the gamma-ray burst sources exceeds approx.10 -6 pc -3 if the entire surface of the neutron star radiates and exceeds approx.10 -3 pc -3 if only a small cap or thin strip in the stellar surface radiates. In the former case the density of gamma-ray bursters is approx.1% of the inferred density of extinct pulsars, and in the latter case the mean mass density of burster sources is a few percent of the density of unidentified dark matter in the solar neighborhood. In both cases the X-ray intensity of the sources is far below the Rayleigh-Jeans limit, and the total flux is at most comparable to the Eddington limit. This implies that low-energy self-absorption near 10 keV is entirely negligible and that radiation-driven explosions are just barely possible

Operational limit of a planar DC magnetron cluster source due to target erosion

International Nuclear Information System (INIS)

Rai, A.; Mutzke, A.; Bandelow, G.; Schneider, R.; Ganeva, M.; Pipa, A.V.; Hippler, R.

2013-01-01

The binary collision-based two dimensional SDTrimSP-2D model has been used to simulate the erosion process of a Cu target and its influence on the operational limit of a planar DC magnetron nanocluster source. The density of free metal atoms in the aggregation region influences the cluster formation and cluster intensity during the target lifetime. The density of the free metal atoms in the aggregation region can only be predicted by taking into account (i) the angular distribution of the sputtered flux from the primary target source and (ii) relative downwards shift of the primary source of sputtered atoms during the erosion process. It is shown that the flux of the sputtered atoms smoothly decreases with the target erosion

Band magnetism due to f-electrons

International Nuclear Information System (INIS)

Brodsky, M.B.; Trainor, R.J.

1976-01-01

Specific heat data illustrate several types of itinerant or band magnetism in actinide intermetallic compounds. The results show ferromagnetic spin fluctuations in UAl 2 with T/sub sf/ equals 25K, itinerant antiferromagnetism in NpSn 3 with T/sub N/ equals 9.5K and itinerant ferromagnetism in NpOs 2 with T/sub C/ equals 7.9K. Specific heat studies of dilute U/sub 1-x/Th/sub x/Al 2 show the theoretically predicted modifications due to impurity scattering in a spin fluctuation system. For NpSn 3 it is possible to show the BCS nature of the transition due to the gap formation

Prediction of cerebral ischemia due to cerebral vasospasm in SAH using SPECT and 123I-IMP with acetazolamide test

International Nuclear Information System (INIS)

Nakagawara, Jyoji; Wada, Keiji; Takeda, Rihei; Usami, Takashi; Hashimoto, Ikuo; Shimazaki, Mitsuteru; Tanaka, Chiharu; Nakamura, Jun-ichi; Suematsu, Katsumi.

1989-01-01

To investigate the possibility of predicting cerebral ischemia due to cerebral vasospasm in subarachnoid hemorrhage (SAH), serial evaluation of the cerebral vasodilatory capacity by the acetazolamide test was conducted, using single photon emission computed tomography (SPECT) and N-isopropyl 123 I-p-iodoamphetamine (IMP), in 17 patients with cerebral vasospasm following early surgery for ruptured aneurysms. The degree of vasospasm measured on the angiograms was classified into the following three types; mild degree (25%>stenosis), moderate degree (25∼50% stenosis), and severe degree(50%limitation of cerebral vasodiratory capacity was observed between the 6th and 16th day after a rupture of the cerebral aneurysm. In five patients with symptomatic vasospasm resulting in reversible ischemia, a marked limitation of cerebral vasodilatory capacity was noted between the 7th and 15th day, and a delayed recovery of cerebral vasodilatory capacity was observed. This reversibility of cerebral vasodilatory capacity in patients with cerebral vasospasm suggests that a local decrease of purfusion pressure due to cerebral vasospasm causes compensatory vasodilation of intraparenchymal arteries and the vasodilatory reaction to acetazolamide was limited until the release of the cerebral vasospasm. Therefore, assessment of cerebral vasodilatory capacity in SAH by the acetazolamide test might predict the appearance and continuation of potential ischemia of the brain caused by the reduction of perfusion pressure due to cerebral vasospasm. (J.P.N.)

Conditions for oxygen-deficient combustion during accidents with severe core concrete thermal attack

International Nuclear Information System (INIS)

Luangdilok, W.; Elicson, G.T.; Berger, W.E. Jr.

1993-01-01

This paper addresses the interactions between MCCI (molten core-concrete interactions)-induced offgas releases, mostly the combustible gases, natural circulation between the cavity and the lower containment based on recent research developments in the area of mixed convection flow (Epstein, et al., 1989; Epstein, 1988; Epstein, 1992) between compartments, and their effects on combustion in PWR containments during prolonged severe accidents. Specifically, large dry PWR containments undergoing severe core-concrete attack during station blackouts where the containment atmosphere is expected to be inerted are objects of this analysis. The purpose of this paper, given the conditions that oxygen can be brought to the cavity, is to demonstrate that consumption of most oxygen present in the containment can be achieved in a reasonable time scale assuming that combustion is not subject to flammability limits due to the high cavity temperatures. The conditions for cavity combustion depend on several factors including good gas flowpaths between the cavity and other containment regions, and combustion processes within the cavity with the hot debris acting as the ignition source

Optical shielding of nickel nanoparticle by a bubble: Optical limiting gets limited

Energy Technology Data Exchange (ETDEWEB)

Shukla, Vijay; Jayabalan, J., E-mail: jjaya@rrcat.gov.in; Chari, Rama [Ultrafast Spectroscopy Laboratory, Laser Physics Applications Section, Raja Ramanna Centre for Advanced Technology, Indore 452013 (India)

2016-06-13

We have demonstrated that in a nickel nanoparticle colloid, the optical limiting action reduces if a vapor bubble forms around the nanoparticle. The energy-dependent transmission and z-scan measurements on nickel nanoparticles in toluene show the onset of an additional process. At high fluence excitation, the particle becomes less visible to the later part of the incoming pulse due to the heat generated bubble formed around it. We have proposed a simple “particle-in-bubble” model which fits the optical limiting and z-scan curves quite well. Using this model, we have also estimated that the bubble radius increases at a rate of 4.5 m/s.

Optical shielding of nickel nanoparticle by a bubble: Optical limiting gets limited

International Nuclear Information System (INIS)

Shukla, Vijay; Jayabalan, J.; Chari, Rama

2016-01-01

We have demonstrated that in a nickel nanoparticle colloid, the optical limiting action reduces if a vapor bubble forms around the nanoparticle. The energy-dependent transmission and z-scan measurements on nickel nanoparticles in toluene show the onset of an additional process. At high fluence excitation, the particle becomes less visible to the later part of the incoming pulse due to the heat generated bubble formed around it. We have proposed a simple “particle-in-bubble” model which fits the optical limiting and z-scan curves quite well. Using this model, we have also estimated that the bubble radius increases at a rate of 4.5 m/s.

Genetic and Biological Changes of Newcastle Disease Virus Due to The Development of Chicken Production System

Directory of Open Access Journals (Sweden)

Sudarisman

2009-09-01

Full Text Available In many countries, Newcastle Disease (ND is one of the most important diseases of poultry. It causes serious economic losses in poultry industry. Newcastle Disease or pseudo-fowl pest is a highly infectious viral disease that causes very high mortality (up to 100% in severe epidemics in poultry and wild birds around the world. Newcastle Disease remains endemic in many regions and continues to severely limit poultry production in some developing countries. The disease is currently being controlled by routine vaccinations in many countries. However, it was reported that outbreaks of ND in vaccinated flocks often occur on the field may not only be due to differences in the antigenicity of the NDV wild field strains and vaccine strains, but could also be as a result of differences in pathogenicity and virulence between different strains used as vaccine seed in NDV vaccine production.

Item response theory analysis to evaluate reliability and minimal clinically important change of the Roland-Morris Disability Questionnaire in patients with severe disability due to back pain from vertebral compression fractures.

Science.gov (United States)

Lee, Minji K; Yost, Kathleen J; McDonald, Jennifer S; Dougherty, Ryne W; Vine, Roanna L; Kallmes, David F

2017-06-01

The majority of validation done on the Roland-Morris Disability Questionnaire (RMDQ) has been in patients with mild or moderate disability. There is paucity of research focusing on the psychometric quality of the RMDQ in patients with severe disability. To evaluate the psychometric quality of the RMDQ in patients with severe disability. Observational clinical study. The sample consisted of 214 patients with painful vertebral compression fractures who underwent vertebroplasty or kyphoplasty. The 23-item version of the RMDQ was completed at two time points: baseline and 30-day postintervention follow-up. With the two-parameter logistic unidimensional item response theory (IRT) analyses, we derived the range of scores that produced reliable measurement and investigated the minimal clinically important difference (MCID). Scores for 214 (100%) patients at baseline and 108 (50%) patients at follow-up did not meet the reliability criterion of 0.90 or higher, with the majority of patients having disability due to back pain that was too severe to be reliably measured by the RMDQ. Depending on methodology, MCID estimates ranged from 2 to 8 points and the proportion of patients classified as having experienced meaningful improvement ranged from 26% to 68%. A greater change in score was needed at the extreme ends of the score scale to be classified as having achieved MCID using IRT methods. Replacing items measuring moderate disability with items measuring severe disability could yield a version of the RMDQ that better targets patients with severe disability due to back pain. Improved precision in measuring disability would be valuable to clinicians who treat patients with greater functional impairments. Caution is needed when choosing criteria for interpreting meaningful change using the RMDQ. Copyright © 2017 Elsevier Inc. All rights reserved.

The Impact of Heat Waves on Occurrence and Severity of Construction Accidents.

Science.gov (United States)

Rameezdeen, Rameez; Elmualim, Abbas

2017-01-11

The impact of heat stress on human health has been extensively studied. Similarly, researchers have investigated the impact of heat stress on workers' health and safety. However, very little work has been done on the impact of heat stress on occupational accidents and their severity, particularly in South Australian construction. Construction workers are at high risk of injury due to heat stress as they often work outdoors, undertake hard manual work, and are often project based and sub-contracted. Little is known on how heat waves could impact on construction accidents and their severity. In order to provide more evidence for the currently limited number of empirical investigations on the impact of heat stress on accidents, this study analysed 29,438 compensation claims reported during 2002-2013 within the construction industry of South Australia. Claims reported during 29 heat waves in Adelaide were compared with control periods to elicit differences in the number of accidents reported and their severity. The results revealed that worker characteristics, type of work, work environment, and agency of accident mainly govern the severity. It is recommended that the implementation of adequate preventative measures in small-sized companies and civil engineering sites, targeting mainly old age workers could be a priority for Work, Health and Safety (WHS) policies.

The Impact of Heat Waves on Occurrence and Severity of Construction Accidents

Science.gov (United States)

Rameezdeen, Rameez; Elmualim, Abbas

2017-01-01

The impact of heat stress on human health has been extensively studied. Similarly, researchers have investigated the impact of heat stress on workers’ health and safety. However, very little work has been done on the impact of heat stress on occupational accidents and their severity, particularly in South Australian construction. Construction workers are at high risk of injury due to heat stress as they often work outdoors, undertake hard manual work, and are often project based and sub-contracted. Little is known on how heat waves could impact on construction accidents and their severity. In order to provide more evidence for the currently limited number of empirical investigations on the impact of heat stress on accidents, this study analysed 29,438 compensation claims reported during 2002–2013 within the construction industry of South Australia. Claims reported during 29 heat waves in Adelaide were compared with control periods to elicit differences in the number of accidents reported and their severity. The results revealed that worker characteristics, type of work, work environment, and agency of accident mainly govern the severity. It is recommended that the implementation of adequate preventative measures in small-sized companies and civil engineering sites, targeting mainly old age workers could be a priority for Work, Health and Safety (WHS) policies. PMID:28085067

Enhancement of transport properties of a Brownian particle due to quantum effects: Smoluchowski limit

International Nuclear Information System (INIS)

Shit, Anindita; Chattopadhyay, Sudip; Chaudhuri, Jyotipratim Ray

2012-01-01

Graphical abstract: By invoking physically motivated coordinate transformation into quantum Smoluchowski equation, we have presented a transparent treatment for the determination of the effective diffusion coefficient and current of a quantum Brownian particle. Substantial enhancement in the efficiency of the diffusive transport is envisaged due to the quantum correction effects. Highlights:: ► Transport of a quantum Brownian particle in a periodic potential has been addressed. ► Governing quantum Smoluchowski equation (QSE) includes state dependent diffusion. ► A coordinate transformation is used to recast QSE with constant diffusion. ► Transport properties increases in comparison to the corresponding classical result. ► This enhancement is purely a quantum effect. - Abstract: The transport property of a quantum Brownian particle that interacts strongly with a bath (in which a typical damping constant by far exceeds a characteristic frequency of the isolated system) under the influence of a tilted periodic potential has been studied by solving quantum Smoluchowski equation (QSE). By invoking physically motivated coordinate transformation into QSE, we have presented a transparent treatment for the determination of the effective diffusion coefficient of a quantum Brownian particle and the current (the average stationary velocity). Substantial enhancement in the efficiency of the diffusive transport is envisaged due to the quantum correction effects only if the bath temperature hovers around an appropriate range of intermediate values. Our findings also confirm the results obtained in the classical cases.

Constraints on cosmic strings due to black holes formed from collapsed cosmic string loops

International Nuclear Information System (INIS)

Caldwell, R.R.; Gates, E.

1993-05-01

The cosmological features of primordial black holes formed from collapsed cosmic string loops are studied. Observational restrictions on a population of primordial black holes are used to restrict f, the fraction of cosmic string loops which collapse to form black holes, and μ, the cosmic string mass-per-unit-length. Using a realistic model of cosmic strings, we find the strongest restriction on the parameters f and μ is due to the energy density in 100MeV photons radiated by the black holes. We also find that inert black hole remnants cannot serve as the dark matter. If earlier, crude estimates of f are reliable, our results severely restrict μ, and therefore limit the viability of the cosmic string large-scale structure scenario

Current concepts of severe asthma

Science.gov (United States)

Raundhal, Mahesh; Oriss, Timothy B.; Ray, Prabir; Wenzel, Sally E.

2016-01-01

The term asthma encompasses a disease spectrum with mild to very severe disease phenotypes whose traditional common characteristic is reversible airflow limitation. Unlike milder disease, severe asthma is poorly controlled by the current standard of care. Ongoing studies using advanced molecular and immunological tools along with improved clinical classification show that severe asthma does not identify a specific patient phenotype, but rather includes patients with constant medical needs, whose pathobiologic and clinical characteristics vary widely. Accordingly, in recent clinical trials, therapies guided by specific patient characteristics have had better outcomes than previous therapies directed to any subject with a diagnosis of severe asthma. However, there are still significant gaps in our understanding of the full scope of this disease that hinder the development of effective treatments for all severe asthmatics. In this Review, we discuss our current state of knowledge regarding severe asthma, highlighting different molecular and immunological pathways that can be targeted for future therapeutic development. PMID:27367183

Attitude toward contraception and abortion among Curaçao women. Ineffective contraception due to limited sexual education?

Directory of Open Access Journals (Sweden)

Meyboom-de Jong Betty

2011-06-01

Full Text Available Abstract Background In Curaçao is a high incidence of unintended pregnancies and induced abortions. Most of the induced abortions in Curaçao are on request of the woman and performed by general practitioners. In Curaçao, induced abortion is strictly prohibited, but since 1999 there has been a policy of connivance. We present data on the relevance of economic and socio-cultural factors for the high abortion-rates and the ineffective use of contraception. Methods Structured interviews to investigate knowledge and attitudes toward sexuality, contraception and abortion and reasons for ineffective use of contraceptives among women, visiting general practitioners. Results Of 158 women, 146 (92% participated and 82% reported that their education on sexuality and about contraception was of good quality. However 'knowledge of reliable contraceptive methods' appeared to be - in almost 50% of the cases - false information, misjudgements or erroneous views on the chance of getting pregnant using coitus interruptus and about the reliability and health effects of oral contraceptive pills. Almost half of the interviewed women had incorrect or no knowledge about reliability of condom use and IUD. 42% of the respondents risked by their behavior an unplanned pregnancy. Most respondents considered abortion as an emergency procedure, not as contraception. Almost two third experienced emotional, physical or social problems after the abortion. Conclusions Respondents had a negative attitude toward reliable contraceptives due to socio-cultural determined ideas about health consequences and limited sexual education. Main economic factors were costs of contraceptive methods, because most health insurances in Curaçao do not cover contraceptives. To improve the effective use of reliable contraceptives, more adequate information should be given, targeting the wrong beliefs and false information. The government should encourage health insurance companies to reimburse

Ombuds' Corner: A section leader on a limited-duration contract

CERN Multimedia

Vincent Vuillemin

2011-01-01

In this series, the Bulletin aims to explain the role of the Ombuds at CERN by presenting practical examples of misunderstandings that could have been resolved by the Ombuds if he had been contacted earlier. Please note that, in all the situations we present, the names are fictitious and used only to improve clarity.   Bob* has been working at CERN for almost four years on a limited-duration contract. Due to the early retirement of one of his colleagues, he was appointed Section Leader very early in his career, as he was the only one who was able to replace this person. As Section Leader, Bob had to provide annual assessments for several staff members, which he did in a very honest and balanced way. When staff members were given their results from the MARS exercise, George – one of Bob’s supervisees – accused Bob of not giving him the promotion he deserved. George had been expecting his MARS appraisal to include work that he claims Bob, being under a limited-durati...

Severe prosthetic joint infection in an immunocompetent male patient due to a therapy refractory Pseudallescheria apiosperma.

NARCIS (Netherlands)

Lackner, M.; Man, F.H. de; Eygendaal, D.; Wintermans, R.G.; Kluytmans, J.A.; Klaassen, C.H.; Meis, J.F.G.M.

2011-01-01

Prosthetic joint infections (PJI) are rarely due to fungal agents and if so they are mainly caused by Candida strains. This case represents a PJI caused by a multi-drug resistant Pseudallescheria apiosperma, with poor in vivo response to itraconazole and voriconazole. This case differs also by the

Severe Vaginal Burns in a 5-Year-Old Girl Due to an Alkaline Battery in the Vagina.

Science.gov (United States)

Semaan, Alexander; Klein, Tobias; Vahdad, Mohammad Reza; Boemers, Thomas M; Pohle, Rebecca

2015-10-01

The ingestion or insertion of alkaline batteries in the body can cause severe damage to hollow organs. We report here a case of severe vaginal burns in a young patient caused by an alkaline battery. A 5-year-old girl presented to our outpatient department with pelvic pain and vaginal discharge. Further workup suggested the presence of a vaginal foreign body. Under general anesthesia, an alkaline battery was removed from her vagina, which showed severe burns with partial-thickness necrosis. Complete healing was confirmed at 3 months after initial presentation. In this rare case of an alkaline battery present in the vagina of a prepubescent girl, we discuss the available treatment and management options in comparison to similar previously reported cases. Copyright © 2015 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.

Optimization and limitations of known DEMO divertor concepts

Energy Technology Data Exchange (ETDEWEB)

Reiser, Jens, E-mail: Jens.Reiser@kit.edu [Karlsruhe Institute of Technology, Institute for Applied Materials, P.O. Box 3640, 76021 Karlsruhe (Germany); Rieth, Michael [Karlsruhe Institute of Technology, Institute for Applied Materials, P.O. Box 3640, 76021 Karlsruhe (Germany)

2012-08-15

Highlights: Black-Right-Pointing-Pointer Limitations of the materials. Black-Right-Pointing-Pointer Improved H{sub 2}O cooled divertor. Black-Right-Pointing-Pointer Improved He cooled divertor. - Abstract: In this work we will introduce and discuss improvements for two types of DEMO divertors based on known designs: (i) gas cooled designs and (ii) liquid coolant concepts. In a first step, the advantages and disadvantages of gas cooling as well as the necessity of a jet impingement to increase the heat transfer coefficients will be discussed. Further discussion deals with the pros and cons of liquid coolant concepts, like for example, liquid metal or water cooling. Thereafter, we will present two rather contrary DEMO divertor concepts which are based on today's knowledge on refractory materials science, fabrication and joining technology. The first improved concept uses water flowing through steel pipes, typically made of Eurofer steel. It is well known that using Eurofer at low temperatures is critical due to its severe embrittlement under neutron irradiation. Here we make a proposal how it could be possible to use the Eurofer steel anyway: the solution could consist in a limited operation period followed by an annealing cycle at 550 Degree-Sign C for a few hours during any maintenance shut down phases. The second design is based on the known helium cooling concept using jet impingement. Drawbacks of the actual He-cooled divertor design are small scale parts as well as the necessary high helium inlet temperature of about 600-800 Degree-Sign C which leads to the question: How can we deal with such high helium temperatures? This paper shows a solution for large scale components as well as a new thermal management for the helium outlet gas that we call 'cooling of the coolant'. Both concepts are discussed in terms of materials selection due to material limits and joining technology with a special focus on the material issue using already existing and

Optimization and limitations of known DEMO divertor concepts

International Nuclear Information System (INIS)

Reiser, Jens; Rieth, Michael

2012-01-01

Highlights: ► Limitations of the materials. ► Improved H 2 O cooled divertor. ► Improved He cooled divertor. - Abstract: In this work we will introduce and discuss improvements for two types of DEMO divertors based on known designs: (i) gas cooled designs and (ii) liquid coolant concepts. In a first step, the advantages and disadvantages of gas cooling as well as the necessity of a jet impingement to increase the heat transfer coefficients will be discussed. Further discussion deals with the pros and cons of liquid coolant concepts, like for example, liquid metal or water cooling. Thereafter, we will present two rather contrary DEMO divertor concepts which are based on today's knowledge on refractory materials science, fabrication and joining technology. The first improved concept uses water flowing through steel pipes, typically made of Eurofer steel. It is well known that using Eurofer at low temperatures is critical due to its severe embrittlement under neutron irradiation. Here we make a proposal how it could be possible to use the Eurofer steel anyway: the solution could consist in a limited operation period followed by an annealing cycle at 550 °C for a few hours during any maintenance shut down phases. The second design is based on the known helium cooling concept using jet impingement. Drawbacks of the actual He-cooled divertor design are small scale parts as well as the necessary high helium inlet temperature of about 600–800 °C which leads to the question: How can we deal with such high helium temperatures? This paper shows a solution for large scale components as well as a new thermal management for the helium outlet gas that we call ‘cooling of the coolant’. Both concepts are discussed in terms of materials selection due to material limits and joining technology with a special focus on the material issue using already existing and available materials.

Numerical Limit Analysis of Precast Concrete Structures

DEFF Research Database (Denmark)

Herfelt, Morten Andersen

Precast concrete elements are widely used in the construction industry as they provide a number of advantages over the conventional in-situ cast concrete structures. Joints cast on the construction site are needed to connect the precast elements, which poses several challenges. Moreover, the curr...... problems are solved efficiently using state-of-the-art solvers. It is concluded that the framework and developed joint models have the potential to enable efficient design of precast concrete structures in the near future......., the current practice is to design the joints as the weakest part of the structure, which makes analysis of the ultimate limit state behaviour by general purpose software difficult and inaccurate. Manual methods of analysis based on limit analysis have been used for several decades. The methods provide...... of the ultimate limit state behaviour. This thesis introduces a framework based on finite element limit analysis, a numerical method based on the same extremum principles as the manual limit analysis. The framework allows for efficient analysis and design in a rigorous manner by use of mathematical optimisation...

Prolonged limitation of tree growth due to warmer spring in semi-arid mountain forests of Tianshan, northwest China

International Nuclear Information System (INIS)

Wu Xiuchen; Liu Hongyan; Wang Yufu; Deng Minghua

2013-01-01

Based on radial tree growth measurements in nine plots of area 625 m 2 (369 trees in total) and climate data, we explored the possibly changing effects of climate on regional tree growth in the temperate continental semi-arid mountain forests in the Tianshan Mountains in northwest China during 1933–2005. Tree growth in our study region is generally limited by the soil water content of pre- and early growing season (February–July). Remarkably, moving correlation functions identified a clear temporal change in the relationship between tree growth and mean April temperature. Tree growth showed a significant (p < 0.05) and negative relationship to mean April temperature since approximately the beginning of the 1970s, which indicated that the semi-arid mountain forests are suffering a prolonged growth limitation in recent years accompanying spring warming. This prolonged limitation of tree growth was attributed to the effects of soil water limitation in early spring (March–April) caused by the rapid spring warming. Warming-induced prolonged drought stress contributes, to a large part, to the marked reduction of regional basal area increment (BAI) in recent years and a much slower growth rate in young trees. Our results highlight that the increasing water limitation induced by spring warming on tree growth most likely aggravated the marked reduction in tree growth. This work provides a better understanding of the effects of spring warming on tree growth in temperate continental semi-arid forests. (letter)

On the Limitations of Biological Knowledge

Science.gov (United States)

Dougherty, Edward R; Shmulevich, Ilya

2012-01-01

Scientific knowledge is grounded in a particular epistemology and, owing to the requirements of that epistemology, possesses limitations. Some limitations are intrinsic, in the sense that they depend inherently on the nature of scientific knowledge; others are contingent, depending on the present state of knowledge, including technology. Understanding limitations facilitates scientific research because one can then recognize when one is confronted by a limitation, as opposed to simply being unable to solve a problem within the existing bounds of possibility. In the hope that the role of limiting factors can be brought more clearly into focus and discussed, we consider several sources of limitation as they apply to biological knowledge: mathematical complexity, experimental constraints, validation, knowledge discovery, and human intellectual capacity. PMID:23633917

Hadron collider luminosity limitations

CERN Document Server

Evans, Lyndon R

1992-01-01

The three colliders operated to date have taught us a great deal about the behaviour of both bunched and debunched beams in storage rings. The main luminosity limitations are now well enough understood that most of them can be stronglu attenuated or eliminated by approriate design precautions. Experience with the beam-beam interaction in both the SPS and the Tevatron allow us to predict the performance of the new generation of colliders with some degree of confidence. One of the main challenges that the accelerator physicist faces is the problem of the dynamic aperture limitations due to the lower field quality expected, imposed by economic and other constraints.

Prediction of cerebral ischemia due to cerebral vasospasm in SAH using SPECT and sup 123 I-IMP with acetazolamide test

Energy Technology Data Exchange (ETDEWEB)

Nakagawara, Jyoji; Wada, Keiji; Takeda, Rihei; Usami, Takashi; Hashimoto, Ikuo; Shimazaki, Mitsuteru; Tanaka, Chiharu; Nakamura, Jun-ichi (Nakamura Memorial Hospital, Sapporo (Japan)); Suematsu, Katsumi

1989-11-01

To investigate the possibility of predicting cerebral ischemia due to cerebral vasospasm in subarachnoid hemorrhage (SAH), serial evaluation of the cerebral vasodilatory capacity by the acetazolamide test was conducted, using single photon emission computed tomography (SPECT) and N-isopropyl {sup 123}I-p-iodoamphetamine (IMP), in 17 patients with cerebral vasospasm following early surgery for ruptured aneurysms. The degree of vasospasm measured on the angiograms was classified into the following three types; mild degree (25%>stenosis), moderate degree (25{approx}50% stenosis), and severe degree(50%limitation of cerebral vasodiratory capacity was observed between the 6th and 16th day after a rupture of the cerebral aneurysm. In five patients with symptomatic vasospasm resulting in reversible ischemia, a marked limitation of cerebral vasodilatory capacity was noted between the 7th and 15th day, and a delayed recovery of cerebral vasodilatory capacity was observed. This reversibility of cerebral vasodilatory capacity in patients with cerebral vasospasm suggests that a local decrease of purfusion pressure due to cerebral vasospasm causes compensatory vasodilation of intraparenchymal arteries and the vasodilatory reaction to acetazolamide was limited until the release of the cerebral vasospasm. Therefore, assessment of cerebral vasodilatory capacity in SAH by the acetazolamide test might predict the appearance and continuation of potential ischemia of the brain caused by the reduction of perfusion pressure due to cerebral vasospasm. (J.P.N.).

Resolution and systematic limitations in beam based alignment

Energy Technology Data Exchange (ETDEWEB)

Tenenbaum, P.G.

2000-03-15

Beam based alignment of quadrupoles by variation of quadrupole strength is a widely-used technique in accelerators today. The authors describe the dominant systematic limitation of this technique, which arises from the change in the center position of the quadrupole as the strength is varied, and derive expressions for the resulting error. In addition, the authors derive an expression for the statistical resolution of such techniques in a periodic transport line, given knowledge of the line's transport matrices, the resolution of the beam position monitor system, and the details of the strength variation procedure. These results are applied to the Next Linear Collider main linear accelerator, an 11 kilometer accelerator containing 750 quadrupoles and 5,000 accelerator structures. The authors find that in principle a statistical resolution of 1 micron is easily achievable but the systematic error due to variation of the magnetic centers could be several times larger.

Physicians in transition: practice due diligence.

Science.gov (United States)

Paterick, Timothy E

2013-01-01

The landscape of healthcare is changing rapidly. That landscape is now a business model of medicine. That rapid change resulting in a business model is affecting physicians professionally and personally. The new business model of medicine has led to large healthcare organizations hiring physicians as employees. The role of a physician as an employee has many limitations in terms of practice and personal autonomy. Employed physicians sign legally binding employment agreements that are written by the legal team working for the healthcare organization. Thus physicians should practice due diligence before signing the employment agreement. "Due diligence" refers to the care a reasonable person should take before entering into an agreement with another party. That reasonable person should seek expertise to represent his or her interests when searching a balanced agreement between the physician and organization.

Molecular mechanisms of severe acute respiratory syndrome (SARS

Directory of Open Access Journals (Sweden)

Zabel Peter

2005-01-01

Full Text Available Abstract Severe acute respiratory syndrome (SARS is a new infectious disease caused by a novel coronavirus that leads to deleterious pulmonary pathological features. Due to its high morbidity and mortality and widespread occurrence, SARS has evolved as an important respiratory disease which may be encountered everywhere in the world. The virus was identified as the causative agent of SARS due to the efforts of a WHO-led laboratory network. The potential mutability of the SARS-CoV genome may lead to new SARS outbreaks and several regions of the viral genomes open reading frames have been identified which may contribute to the severe virulence of the virus. With regard to the pathogenesis of SARS, several mechanisms involving both direct effects on target cells and indirect effects via the immune system may exist. Vaccination would offer the most attractive approach to prevent new epidemics of SARS, but the development of vaccines is difficult due to missing data on the role of immune system-virus interactions and the potential mutability of the virus. Even in a situation of no new infections, SARS remains a major health hazard, as new epidemics may arise. Therefore, further experimental and clinical research is required to control the disease.

An Efficient Measure for Nonlinear Distortion Severity due to HPA in Downlink DS-CDMA Signals

Directory of Open Access Journals (Sweden)

Helaly TarekK

2010-01-01

Full Text Available This paper deals with the nonlinear distortion (NLD effects of high power amplifiers (HPAs on direct sequence-code division multiple access systems. Such a distortion drastically degrades the system performance in terms of bit error rate (BER degradation and spectral regrowth. Much effort has been conducted to minimize NLD. A key requirement to do so is to define a certain measure for the HPA nonlinearity, which when reduced often allows NLD to also be reduced. Several measures were proposed such as peak-to-average power ratio, instantaneous power variance, and cubic metric. In this paper, we show that such measures are not closely related to NLD and their reduction does not always lead to optimum performance. Hence, we introduce an efficient measure, namely, nonlinearity severity (NLS, to characterize NLD effects, as an alternative to the existing measures. The NLS is characterized by having direct link to the system performance as it is formulated based on the signal characteristics contributing to BER performance and spectral regrowth. Additionally, a major advantage of the NLS measure is that it is linked to the IBO level allowing the possibility of improving performance at all IBO levels of interest.

Elastic limit and microplastic response of hardened steels

Energy Technology Data Exchange (ETDEWEB)

Zaccone, M.A. (McDonnell Douglas Aerospace Co., St. Louis, MO (United States)); Krauss, G. (Colorado School of Mines, Golden, CO (United States). Dept. of Metallurgical and Materials Engineering)

1993-10-01

Tempered martensite-retained austenite microstructures were produced by direct quenching a series of 41XX medium carbon steels, direct quenching and reheating a series of five 0.8C-Cr-Ni-Mo steels and intercritically austenitizing at various temperatures, and quenching a SAE 52100 steel. All specimens were tempered either at 150 C or at 200 C. Specimens were subjected to compression and tension testing in the microstrain regime to determine the elastic limits and microplastic response of the microstructures. The retained austenite and matrix carbon content of the intercritically austenized specimens were measured by X-ray diffraction and Mossbauer spectroscopy. The elastic limit of the microstructures decreases with increasing amounts of retained austenite. Refining of the austenite distribution increases the elastic limit. Low elastic limits are mainly due to low flow stresses in the austenite and not internal stresses. The elastic limit correlates with the largest austenite free-mean path by a Hall-Petch type equation. The elastic limit increases with decreasing intercritical austenitizing temperature in the SAE 52100 due to a lower carbon content in the matrix reducing the retained austenite levels and retained carbides that refine grain size and, therefore, the austenite distribution in quenched specimens. In the microplastic region, the strain is accommodated by successively smaller austenite regions until the flow strength matches that of the martensite. Reheating and quenching refines the microstructure and renders the austenite unstable in the microplastic regime, causing transformation of the austenite to martensite by a strain-induced mechanism. The transformation of austenite to martensite occurs by a stress-assisted mechanism in medium carbon steels. The low elastic limits in medium carbon steels were due to the inability of the strain from the stress-assisted transformation to balance the plastic strain accumulated in the austenite.

Modeling U-Shaped Exposure-Response Relationships for Agents that Demonstrate Toxicity Due to Both Excess and Deficiency.

Science.gov (United States)

Milton, Brittany; Farrell, Patrick J; Birkett, Nicholas; Krewski, Daniel

2017-02-01

Essential elements such as copper and manganese may demonstrate U-shaped exposure-response relationships due to toxic responses occurring as a result of both excess and deficiency. Previous work on a copper toxicity database employed CatReg, a software program for categorical regression developed by the U.S. Environmental Protection Agency, to model copper excess and deficiency exposure-response relationships separately. This analysis involved the use of a severity scoring system to place diverse toxic responses on a common severity scale, thereby allowing their inclusion in the same CatReg model. In this article, we present methods for simultaneously fitting excess and deficiency data in the form of a single U-shaped exposure-response curve, the minimum of which occurs at the exposure level that minimizes the probability of an adverse outcome due to either excess or deficiency (or both). We also present a closed-form expression for the point at which the exposure-response curves for excess and deficiency cross, corresponding to the exposure level at which the risk of an adverse outcome due to excess is equal to that for deficiency. The application of these methods is illustrated using the same copper toxicity database noted above. The use of these methods permits the analysis of all available exposure-response data from multiple studies expressing multiple endpoints due to both excess and deficiency. The exposure level corresponding to the minimum of this U-shaped curve, and the confidence limits around this exposure level, may be useful in establishing an acceptable range of exposures that minimize the overall risk associated with the agent of interest. © 2016 Society for Risk Analysis.

Dermatoses due to indian cultural practices

Directory of Open Access Journals (Sweden)

Divya Gupta

2015-01-01

Full Text Available A wide prevalence of socio-religious and cultural practices in the Asian subcontinent often leads to multitude of skin diseases which may be missed by the dermatologists because of a lack of awareness. ′Henna′ use causes IgE-mediated hypersensitivity reactions and contact dermatitis. ′Kumkum′ application can result in pigmented contact dermatitis and lichen planus pigmentosus. Sticker ′bindis′ and ′alta′ induce contact leukoderma. Irritant and allergic contact dermatitis occurs after playing with ′Holi′ colors. Threading and drawstring dermatitis lead to koebnerization of pre-existing dermatoses, infections and even squamous cell carcinoma of skin. Mild irritant reactions and contact sensitization occur secondary to balm and hair oil use. ′Mudichood′ represents the comedogenic effect of hair oils combined with occlusion and humidity. Aromatherapy oils can cause contact dermatitis and photosensitive reactions. Heavy metal and steroid toxicity along with severe cutaneous adverse effects like erythroderma can occur as a consequent to the use of alternative medicines. Squamous cell carcinoma due to chronic heat exposure from the heating device "kangri" is seen in Kashmiris. Prayer nodules in Muslims and traction alopecia in Sikhs illustrate how religious practices can negatively affect the skin. With increasing globalization and migration, the practice of indigenous customs and traditions is no longer limited to regional territories, making it imperative for the dermatologists to be acquainted with the cutaneous side effects they can cause.

Increasing the beta limit due to neoclassical tearing modes by raising the axial safety factor q(0) > 1

International Nuclear Information System (INIS)

La Haye, R.J.; Strait, E.J.; Rice, B.W.

2000-01-01

Resistive neoclassical tearing modes (NTMs) can cause the stable beta value in long pulse, high confinement plasmas to fall significantly below that predicted by ideal theory. The NTM islands which degrade confinement and limit beta are induced and sustained by helically perturbed bootstrap currents. A combination of shaping and q-profile modification is used in the DIII-D tokamak to increase this beta limit. (author)

Life Threatening Severe QTc Prolongation in Patient with Systemic Lupus Erythematosus due to Hydroxychloroquine

Directory of Open Access Journals (Sweden)

John P. O’Laughlin

2016-01-01

Full Text Available We present a case of a syncopal episode resulting from significant QT interval prolongation in a patient on hydroxychloroquine for the treatment of systemic lupus erythematosus and end stage renal disease. The patient had been treated with hydroxychloroquine for two years prior to presentation. After thorough workup for secondary causes of QT interval prolongation hydroxychloroquine was discontinued and the patient’s QT interval shortened. The patient was treated with mexiletine to prevent sudden ventricular arrhythmias, which was unique compared to other documented cases in which lidocaine was used. The patient was noted to have mild prolongation of the QT interval on electrocardiogram prior to initiation of hydroxychloroquine therapy which was exacerbated by its use and may have been caused due to toxicity from underlying renal failure.

Effects of large bending deflections on blade flutter limits

Energy Technology Data Exchange (ETDEWEB)

Kallesoee, Bjarne Skovmose; Hartvig Hansen, Morten

2008-04-15

The coupling of bending and torsion due to large blade bending are assumed to have some effects of the flutter limits of wind turbines. In the present report, the aeroelastic blade model suggested by Kallesoee, which is similar to a second order model, is used to investigate the aeroelastic stability limits of the RWT blade with and without the effects of the large blade deflection. The investigation shows no significant change of the flutter limit on the rotor speed due to the blade deflection,whereas the first edgewise bending mode becomes negatively damped due to the coupling with blade torsion which causes a change of the effective direction of blade vibration. These observations are confirmed by nonlinear aeroelastic simulations using HAWC2. This work is part of the UpWind project funded by the European Commission under the contract number SES6-CT-2005-019945 which is gratefully acknowledged. This report is the deliverable D2.3 of the UpWind project. (au)

75 FR 64314 - Product Development Program for Interventions in Patients With Severe Bleeding Due to Trauma or...

Science.gov (United States)

2010-10-19

... this public workshop is to discuss possible paradigms for the evaluation of products indicated for use...-available basis beginning at 7:30 a.m. If you need special accommodations due to a disability, please...

77 FR 27381 - Financial Crimes Enforcement Network: Customer Due Diligence Requirements for Financial...

Science.gov (United States)

2012-05-10

...-AB15 Financial Crimes Enforcement Network: Customer Due Diligence Requirements for Financial... concerning customer due diligence requirements for financial institutions. DATES: Written comments on the... customer due diligence requirements for financial institutions.\\1\\ FinCEN received several comments on the...

Sesgos de confusión por indicación y gravedad en estudios observacionales Confounding bias due to indication and severity in observational studies

Directory of Open Access Journals (Sweden)

Javier Nuevo

2011-04-01

Full Text Available Los estudios observacionales están sujetos a sesgos que pueden conducir a una interpretación errónea de los resultados. El presente estudio tuvo como objetivo determinar la influencia del tratamiento con omeprazol sobre la duración de la baja laboral en pacientes con esguince de tobillo que tomaban antiinflamatorios no esteroideos. Se utilizaron los registros de la base de datos de la mutua Ibermutuamur. En contra de lo esperado, se observó que los pacientes que recibieron omeprazol presentaron una baja más prolongada que los que no recibieron omeprazol. Es probable que estos hallazgos se deban a la influencia de un sesgo de confusión por gravedad, pues los pacientes que recibieron omeprazol presentaban un esguince más grave, aunque no se puede descartar un sesgo de confusión por indicación. Para evitar la influencia de estos errores sistemáticos se deben controlar los sesgos a lo largo de todo el estudio, desde el diseño hasta el análisis de los datos.Observational studies are subject to biases that may lead to misinterpretation of the results. This study aimed to determine the influence of omeprazole treatment on the duration of sick leave in patients with ankle sprains treated with non-steroidal anti-inflammatory drugs. We used the Ibermutuamur database. Contrary to our expectations, sick leave was longer in patients who received omeprazole than in those who did not. These findings were probably due to the influence of a bias due to confounding by severity, given that patients who received omeprazole had a worse kind of ankle sprain; however, a bias due to confounding by indication cannot be excluded. To avoid the influence of these systematic errors, biases should be monitored from the design stage to the data analysis stage.

Limitations to private properties in the vicinity of nuclear power plants

International Nuclear Information System (INIS)

Martini, L.E.

1978-01-01

This study, based on Argentine legislation, analyses the limitations to private property in the surroundings of nuclear power plants, due to public interest. A nuclear power plant could demand different kinds of property limitation, that could vary from restrictions to the absolute nature of property, to expropriation. Limitation of property is a different concept from restriction of property, the concept of limitation is wider. The author analyses for both concepts: validy requirements, competent bodies, and jurisdiction in case of conflict. He also explains the conditions and process of expropriation. Article 14 of the Constitution constitutes the positive legal basis for limitations of property. In the hypotheses of limitations to property due to vicinity of nuclear power plants, national legislation takes precedence over provincial law, since it is a matter of public national interest. (author)

Escape patterns due to ergodic magnetic limiters in tokamaks with reversed magnetic shear

International Nuclear Information System (INIS)

Roberto, M.; Da Silva, E.C.; Caldas, I.L.; Viana, R.L.

2004-01-01

In this work we study the ergodic magnetic limiters (EML) action on field lines from the point of view of a chaotic scattering process, considering the so-called exit basins, or sets of points in the chaotic region which originate field lines hitting the wall in some specified region. We divide the tokamak wall into three areas of equal poloidal angular length, corresponding to different exits for a chaotic field line. In order to obtain the exit basins we used a grid chosen inside a small rectangle which comprises a representative part of the chaotic region near the wall. Thus, exit basins were obtained for a tokamak wall with reversed magnetic shear. The no-twist mapping describes the perturbed magnetic field lines with two chains of magnetic islands and chaotic field lines in their vicinity. For a perturbing resonant magnetic field with a fixed helicity, the observed escape pattern changes with the perturbation intensity. (authors)

[Organic and functional limitations due to milking phenomenon: a clinical case report].

Science.gov (United States)

Gómez-Henry, Juan Carlos; Rodríguez-Pérez, Francisco Antonio

2014-01-01

The incidence of milking phenomenon is between 0.6 and 4 % in angiographic series; however, autopsy studies raise the incidence of myocardial bridges up to 85 %. This malformation goes unnoticed in most cases but can have a big impact on personal and professional level. The objective was to present an example of milking phenomenon with disability and professional consequences. Male, 44 years old, bricklayer and farmhand laborer. He referred tonsillectomy and osteoarthritis and being a smoker of 10 cigarettes per day, drinking 2-3 cups of coffee daily and 2-3 glasses of wine at the weekends. The primary care physician referred him to cardiologist with suspicion of arrhythmia. The cardiology service report mentioned electrocardiogram at sinusal rhythm, 90 beats per minute and incomplete right bundle-branch block. At ergonomics test, in the first stage of Bruce protocol, the patient's development of hypertensive crisis suggested a milking phenomenon. Finally, the diagnosis was established by angiographic studies with left common branch, circumflex coronary artery, right coronary artery and anterior descendent artery, without evidence of pathology but it was seen systolic compression on the medial segment. The case was concluded by the disability assessment team, recognizing a total permanent disability with limitations for activities requiring moderate physical efforts. The milking phenomenon diagnosis that could be related with ischemic heart disease is by angiography. Finally, the patient ended with total permanent disability.

Alignment of the TFTR bumper limiter

International Nuclear Information System (INIS)

Barnes, G.W.; Owens, D.K.; Loesser, G.D.; Ulrickson, M.

1989-01-01

The TFTR Bumper Limiter (BL) is an axisymmetric toroidal limiter mounted on the inner wall of the vacuum vessel. It subtends 120 degree poloidally and has a surface area of 22 m 2 . The plasma facing surface consists of 1,000 kg of graphite tiles mounted on watercooled Inconel backing plates. During the initial installation in the Spring of 1985, the limiter surface was aligned to the toroidal magnetic field by mechanical and magnetic measurements to an estimated accuracy of ±2 mm. During subsequent operation, especially in the 1988 run period in which 30 MW of Neutral Beam Injection routinely occurred, several tiles at points on the limiter which protruded slightly into the plasma were severely damaged. The damage, cracked and spalled tiles, is believed to be initiated by high energy disruptions and aggravated by normal high power operation. The damage pattern and temperature rise during normal operation are consistent with this interpretation. A vacuum vessel opening to replace the damaged tiles and realign the limiter was required. The bumper limiter was reshaped to be circular to ±0.5 mm at the midplane by means of mechanical measurements in order to better distribute the heat loads and eliminate hot spots. The ±0.5 mm accuracy is determined by the variation in individual tile thickness which is ±0.5 mm. This paper describes the methods used to mechanically align the limiter and presents evidence based on machine operation with plasma that the limiter is reasonably well aligned with the toroidal field. Future work dealing with the alignment of the total limiter to the toroidal field using mechanical and magnetic measurements and the replacement of a subset of the carbon tiles with carbon-carbon composite material is also discussed. 7 refs., 4 figs

Gene transfer from wild Helianthus to sunflower: topicalities and limits

Directory of Open Access Journals (Sweden)

Breton Catherine

2010-03-01

Full Text Available Sunflower (2n=17 belongs to the Helianthus genus (Asteraceae. Wild Helianthus species display morphological variation for branching and stem number, for architecture and seed size, and for resistance to abiotic and biotic stresses due to which they thrive in different environments in North America. The genus is divided into botanical sections, two for annual as sunflower, and two for perennial species as Jerusalem artichoke that produces rhizomes (tubers. We explain the difficulties and successes obtained by crossing sunflower with these species to improve the agronomic traits of the sunflower crop. It is easier to cross the annual species than the perennials’ with sunflower. Several traits such as Cytoplasmic male sterility and restorer Rf-PET1 genes, Downy mildew resistance, Phomopsis resistance, Sclerotinia resistance, Rust resistance, and Orobanche resistance have already been introduced from annual species into sunflower crop, but the complex genomic organization of these species compared to sunflower limits their important potential. Perennial species are much more diverse, and their genomes display 2n, 4n, or 6n chromosomes for n 17. The realities of inter-specific hybridization are relatively disappointing due to the introgression lines that have low oil and low seed yield. We report here several attempts to introgress agronomic traits from these species to sunflower, and we present as a case study, an introgressed progenies from H. mollis, a diploid species with sessile small leaves. We constructed a preliminary genetic map with AFLP markers in 21 BC1 plants, and we then showed that some progenies display 6 to 44% of introgression from H. mollis. Although this study is promising due to the novel compact architecture of the progenies, we cannot estimate the transferability from H. mollis to other perennial Helianthus to improve sunflower.

CE/Bechtel design containment response to severe accident phenomenology: A comparison among several combustion engineering plants

International Nuclear Information System (INIS)

Khalil, Y.F.; Schneider, R.E.

1995-01-01

The objectives of this paper are to: (1) discuss the types of severe accident phenomena that drive containment failure modes in CE plants and (2) contribute to the current state of knowledge of CE/Bechtel-design containment response to severe accident phenomenology. The second objective is addressed by providing a comparative study of containment response to severe accidents among several CE plants including Millstone Unit 2 (MP2), Palisades (Consumers Power), Calvert Cliffs (Baltimore Gas and Electric Company), Palo Verde (Arizona Public Service), and SONGS Units 2 and 3 (Southern California Edison). The motivation for addressing the second objective is based on the current lack of comprehensive literature on CE/Bechtel design containment failure modes and mechanisms for accidents that progress beyond the design basis limits. The first part of this paper addresses severe accident phenomena-related failure mechanisms in CE/Bechtel-designed containments. The second part of this work provides a comparative study of containment response among several CE plants

Variable Speed Limit (VSL) - Best Management Practice [Summary

Science.gov (United States)

2012-01-01

In variable speed limit (VSL) zones, the speed : limit changes in response to traffic congestion, : adverse weather, or road conditions. VSL zones are : often highly automated and have been employed : successfully in several U.S. and European : locat...

Identification of Fitness Determinants during Energy-Limited Growth Arrest in Pseudomonas aeruginosa.

Science.gov (United States)

Basta, David W; Bergkessel, Megan; Newman, Dianne K

2017-11-28

Microbial growth arrest can be triggered by diverse factors, one of which is energy limitation due to scarcity of electron donors or acceptors. Genes that govern fitness during energy-limited growth arrest and the extent to which they overlap between different types of energy limitation are poorly defined. In this study, we exploited the fact that Pseudomonas aeruginosa can remain viable over several weeks when limited for organic carbon (pyruvate) as an electron donor or oxygen as an electron acceptor. ATP values were reduced under both types of limitation, yet more severely in the absence of oxygen. Using transposon-insertion sequencing (Tn-seq), we identified fitness determinants in these two energy-limited states. Multiple genes encoding general functions like transcriptional regulation and energy generation were required for fitness during carbon or oxygen limitation, yet many specific genes, and thus specific activities, differed in their relevance between these states. For instance, the global regulator RpoS was required during both types of energy limitation, while other global regulators such as DksA and LasR were required only during carbon or oxygen limitation, respectively. Similarly, certain ribosomal and tRNA modifications were specifically required during oxygen limitation. We validated fitness defects during energy limitation using independently generated mutants of genes detected in our screen. Mutants in distinct functional categories exhibited different fitness dynamics: regulatory genes generally manifested a phenotype early, whereas genes involved in cell wall metabolism were required later. Together, these results provide a new window into how P. aeruginosa survives growth arrest. IMPORTANCE Growth-arrested bacteria are ubiquitous in nature and disease yet understudied at the molecular level. For example, growth-arrested cells constitute a major subpopulation of mature biofilms, serving as an antibiotic-tolerant reservoir in chronic

Fault current limiter using bulk oxides superconductors

International Nuclear Information System (INIS)

Belmont, O.; Ferracci, P.; Porcar, L.; Barbut, J.M.; Tixador, P.; Noudem, J.G.; Bourgault, D.; Tournier, R.

1998-01-01

We study the limitation possibilities of bulk Bi high T c materials. For this we test these materials with AC or DC currents above their critical currents. We study particularly the evolution of the voltage with time or with current. The material, the value of the current and the time duration play important parts. For sintered Bi samples the voltage depends only on the current even for values much larger than the critical current. With textured samples the V(I) curves shows an hysteretic behaviour due to a warming up. The textured materials are more interesting than sintered ones in terms of required volume for the current limitation. In both cases the superconductors are in a dissipative state but not in the normal state. This state is nevertheless reached if the dissipated energy inside the sample is sufficient. We have tried to apply a magnetic field on the samples in order to trigger a more effective limitation. The voltage increases but with a limited effect for currents much higher (3-4 times) than the critical zero field current. We think that the dissipative state is due mainly to the grain boundaries which become resistive above the critical current. (orig.)

Protein Redox Dynamics During Light-to-Dark Transitions in Cyanobacteria and Impacts Due to Nutrient Limitation

Directory of Open Access Journals (Sweden)

Aaron T Wright

2014-07-01

Full Text Available Protein redox chemistry constitutes a major void in knowledge pertaining to photoautotrophic system regulation and signaling processes. We have employed a chemical biology approach to analyze redox sensitive proteins in live Synechococcus sp. PCC 7002 cells in both light and dark periods, and to understand how cellular redox balance is disrupted during nutrient perturbation. The present work identified 300 putative redox-sensitive proteins that are involved in the generation of reductant, macromolecule synthesis, and carbon flux through central metabolic pathways, and may be involved in cell signaling and response mechanisms. Furthermore, our research suggests that dynamic redox changes in response to specific nutrient limitations, including carbon and nitrogen limitations, contribute to the regulatory changes driven by a shift from light to dark. Taken together, these results contribute to a high-level understanding of post-translational mechanisms regulating flux distributions and suggest potential metabolic engineering targets for redirecting carbon towards biofuel precursors.

Assessment of new limit values for wind turbines. Influence of different limit values on exposure, annoyance and potential development locations

International Nuclear Information System (INIS)

Verheijen, E.; Jabben, J.; Schreurs, E.; Koeman, T.; Van Poll, R.; Du Pon, B.

2009-01-01

Approximately 1500 people living in the close vicinity of wind turbines in the Netherlands run the risk of suffering severe annoyance effects due to noise exposure. New guidelines that limit new wind turbines to a maximum noise level of 45 dB can minimize any further increase in noise health effects. Noise levels above 45 dB will likely result in a further increase in annoyance effects and sleep disturbances. Compared to other noise sources, noise emitted from a wind turbine causes annoyance at relatively low noise levels. The amount of available land for the placement of new wind turbines depends on the limit value that is chosen. A limit value of 40 dB would enable an additional 7000 megawatt of renewable energy to be obtained from new turbines. A limit value of 45 dB, however, would enable wind turbines to be constructed on additional land, resulting in the production of approximately 25,000 megawatt. A new noise regulation for wind turbines is currently being prepared that sets limits on the noise levels experienced by residents of nearby dwellings. The regulation aims at limiting the effects of noise annoyance caused by new wind turbines within the framework of policy targets for renewable energy. This new regulation will be in line with existing ones for road- and railway traffic in setting both a preferable and maximum allowable value for the noise level (Lden) in nearby residences. Below the preferred value, there will be no noise restriction; above the maximum value, local authorities will not be allowed to issue building permits. For noise levels that fall in between, the decision for/against construction will be based on the results of a public inquiry process involving the major stakeholders. The National Institute for Public Health and Environment (RIVM) has investigated the consequences of different choices for the preferred and maximum noise limits. Aspects of annoyance and health effects, amount of land available for new turbines within the

The Arabidopsis halophytic relative Thellungiella halophila tolerates nitrogen-limiting conditions by maintaining growth, nitrogen uptake, and assimilation.

Science.gov (United States)

Kant, Surya; Bi, Yong-Mei; Weretilnyk, Elizabeth; Barak, Simon; Rothstein, Steven J

2008-07-01

A comprehensive knowledge of mechanisms regulating nitrogen (N) use efficiency is required to reduce excessive input of N fertilizers while maintaining acceptable crop yields under limited N supply. Studying plant species that are naturally adapted to low N conditions could facilitate the identification of novel regulatory genes conferring better N use efficiency. Here, we show that Thellungiella halophila, a halophytic relative of Arabidopsis (Arabidopsis thaliana), grows better than Arabidopsis under moderate (1 mm nitrate) and severe (0.4 mm nitrate) N-limiting conditions. Thellungiella exhibited a lower carbon to N ratio than Arabidopsis under N limitation, which was due to Thellungiella plants possessing higher N content, total amino acids, total soluble protein, and lower starch content compared with Arabidopsis. Furthermore, Thellungiella had higher amounts of several metabolites, such as soluble sugars and organic acids, under N-sufficient conditions (4 mm nitrate). Nitrate reductase activity and NR2 gene expression in Thellungiella displayed less of a reduction in response to N limitation than in Arabidopsis. Thellungiella shoot GS1 expression was more induced by low N than in Arabidopsis, while in roots, Thellungiella GS2 expression was maintained under N limitation but was decreased in Arabidopsis. Up-regulation of NRT2.1 and NRT3.1 expression was higher and repression of NRT1.1 was lower in Thellungiella roots under N-limiting conditions compared with Arabidopsis. Differential transporter gene expression was correlated with higher nitrate influx in Thellungiella at low (15)NO(3)(-) supply. Taken together, our results suggest that Thellungiella is tolerant to N-limited conditions and could act as a model system to unravel the mechanisms for low N tolerance.

Accelerated carbonation testing of mortar with supplementary cement materials. Limitation of the acceleration due to drying

NARCIS (Netherlands)

Visser, J.H.M.

2012-01-01

In the design stage of a concrete structure, decisions have to be made on how to fulfil the required service life and consequently, what concrete composition to use. Concrete compositions can be chosen on account of known performances but this will limit the choice of compositions and materials to

The Impact of Heat Waves on Occurrence and Severity of Construction Accidents

Directory of Open Access Journals (Sweden)

Rameez Rameezdeen

2017-01-01

Full Text Available The impact of heat stress on human health has been extensively studied. Similarly, researchers have investigated the impact of heat stress on workers’ health and safety. However, very little work has been done on the impact of heat stress on occupational accidents and their severity, particularly in South Australian construction. Construction workers are at high risk of injury due to heat stress as they often work outdoors, undertake hard manual work, and are often project based and sub-contracted. Little is known on how heat waves could impact on construction accidents and their severity. In order to provide more evidence for the currently limited number of empirical investigations on the impact of heat stress on accidents, this study analysed 29,438 compensation claims reported during 2002–2013 within the construction industry of South Australia. Claims reported during 29 heat waves in Adelaide were compared with control periods to elicit differences in the number of accidents reported and their severity. The results revealed that worker characteristics, type of work, work environment, and agency of accident mainly govern the severity. It is recommended that the implementation of adequate preventative measures in small-sized companies and civil engineering sites, targeting mainly old age workers could be a priority for Work, Health and Safety (WHS policies.

FUEL CASK IMPACT LIMITER VULNERABILITIES

International Nuclear Information System (INIS)

Leduc, D.; England, J.; Rothermel, R.

2009-01-01

Cylindrical fuel casks often have impact limiters surrounding just the ends of the cask shaft in a typical 'dumbbell' arrangement. The primary purpose of these impact limiters is to absorb energy to reduce loads on the cask structure during impacts associated with a severe accident. Impact limiters are also credited in many packages with protecting closure seals and maintaining lower peak temperatures during fire events. For this credit to be taken in safety analyses, the impact limiter attachment system must be shown to retain the impact limiter following Normal Conditions of Transport (NCT) and Hypothetical Accident Conditions (HAC) impacts. Large casks are often certified by analysis only because of the costs associated with testing. Therefore, some cask impact limiter attachment systems have not been tested in real impacts. A recent structural analysis of the T-3 Spent Fuel Containment Cask found problems with the design of the impact limiter attachment system. Assumptions in the original Safety Analysis for Packaging (SARP) concerning the loading in the attachment bolts were found to be inaccurate in certain drop orientations. This paper documents the lessons learned and their applicability to impact limiter attachment system designs

Autoregulation of brain circulation in severe arterial hypertension

DEFF Research Database (Denmark)

Strandgaard, S; Olesen, Jes; Skinhoj, E

1973-01-01

Cerebral blood flow was studied by the arteriovenous oxygen difference method in patients with severe hypertension and in normotensive controls. The blood pressure was lowered to study the lower limit of autoregulation (the pressure below which cerebral blood flow decreases) and the pressure limit...... of brain hypoxia. Both limits were shifted upwards in the hypertensive patients, probably as a consequence of hypertrophy of the arteriolar walls. These findings have practical implications for antihypertensive therapy.When the blood pressure was raised some patients showed an upper limit of autoregulation...

Hygienic estimation of population doses due to stratospheric fallout

International Nuclear Information System (INIS)

Marej, A.N.; Knizhnikov, V.A.

1980-01-01

The hygienic estimation of external and internal irradiation of the USSR population due to stratospheric global fallouts of fission products after nuclear explosions and weapon tests, is carried out. Numerical values which characterize the dose-effect dependence in the case of radiation of marrow, bone tissue and whole body are presented. Values of mean individual and population doses of irradiation due to global fallouts within 1963-1975, types of injury and the number of mortal cases due to malignant neoplasms are presented. A conclusion is made that the contribution of radiation due to stratospheric fallouts in the mortality due to malignant neoplasms is insignificant. Annual radiation doses, conditioned by global fallouts within the period of 1963-1975 constitute but several percent from the dose of radiation of the natural radiation background. Results of estimation of genetic consequences of irradiation due to atmospheric fallouts are presented

Statistical properties and pre-hit dynamics of price limit hits in the Chinese stock markets.

Science.gov (United States)

Wan, Yu-Lei; Xie, Wen-Jie; Gu, Gao-Feng; Jiang, Zhi-Qiang; Chen, Wei; Xiong, Xiong; Zhang, Wei; Zhou, Wei-Xing

2015-01-01

Price limit trading rules are adopted in some stock markets (especially emerging markets) trying to cool off traders' short-term trading mania on individual stocks and increase market efficiency. Under such a microstructure, stocks may hit their up-limits and down-limits from time to time. However, the behaviors of price limit hits are not well studied partially due to the fact that main stock markets such as the US markets and most European markets do not set price limits. Here, we perform detailed analyses of the high-frequency data of all A-share common stocks traded on the Shanghai Stock Exchange and the Shenzhen Stock Exchange from 2000 to 2011 to investigate the statistical properties of price limit hits and the dynamical evolution of several important financial variables before stock price hits its limits. We compare the properties of up-limit hits and down-limit hits. We also divide the whole period into three bullish periods and three bearish periods to unveil possible differences during bullish and bearish market states. To uncover the impacts of stock capitalization on price limit hits, we partition all stocks into six portfolios according to their capitalizations on different trading days. We find that the price limit trading rule has a cooling-off effect (object to the magnet effect), indicating that the rule takes effect in the Chinese stock markets. We find that price continuation is much more likely to occur than price reversal on the next trading day after a limit-hitting day, especially for down-limit hits, which has potential practical values for market practitioners.

Diffusion-limited mixing by incompressible flows

Science.gov (United States)

Miles, Christopher J.; Doering, Charles R.

2018-05-01

Incompressible flows can be effective mixers by appropriately advecting a passive tracer to produce small filamentation length scales. In addition, diffusion is generally perceived as beneficial to mixing due to its ability to homogenize a passive tracer. However we provide numerical evidence that, in cases where advection and diffusion are both actively present, diffusion may produce negative effects by limiting the mixing effectiveness of incompressible optimal flows. This limitation appears to be due to the presence of a limiting length scale given by a generalised Batchelor length (Batchelor 1959 J. Fluid Mech. 5 113–33). This length scale limitation may in turn affect long-term mixing rates. More specifically, we consider local-in-time flow optimisation under energy and enstrophy flow constraints with the objective of maximising the mixing rate. We observe that, for enstrophy-bounded optimal flows, the strength of diffusion may not impact the long-term mixing rate. For energy-constrained optimal flows, however, an increase in the strength of diffusion can decrease the mixing rate. We provide analytical lower bounds on mixing rates and length scales achievable under related constraints (point-wise bounded speed and rate-of-strain) by extending the work of Lin et al (2011 J. Fluid Mech. 675 465–76) and Poon (1996 Commun. PDE 21 521–39).

Analysis of factors influencing survival in patients with severe acute pancreatitis.

Science.gov (United States)

Kim, Yeon Ji; Kim, Dae Bum; Chung, Woo Chul; Lee, Ji Min; Youn, Gun Jung; Jung, Yun Duk; Choi, Sooa; Oh, Jung Hwan

2017-08-01

Acute pancreatitis (AP) ranges from a mild and self-limiting disease to a fulminant illness with significant morbidity and mortality. Severe acute pancreatitis (SAP) is defined as persistent organ failure lasting for 48 h. We aimed to determine the factors that predict survival and mortality in patients with SAP. We reviewed a consecutive series of patients who were admitted with acute pancreatitis between January 2003 and January 2013. A total of 1213 cases involving 660 patients were evaluated, and 68 cases with SAP were selected for the study. Patients were graded based on the Computer Tomography Severity Index (CTSI), the bedside index for severity (BISAP), and Ranson's criteria. The frequency of SAP was 5.6% (68/1213 cases). Among these patients, 17 died due to pancreatitis-induced causes. We compared several factors between the survivor (n = 51) and non-survivor (n = 17) groups. On multivariate analysis, there were significant differences in the incidence of diabetes mellitus (p = .04), Ranson score (p = .03), bacteremia (p = .05) and body mass index (BMI) (p = .02) between the survivor and non-survivor groups. Bacteremia, high Ranson score, DM, and lower BMI were closely associated with mortality in patients with SAP. When patients with SAP show evidence of bacteremia or diabetes, aggressive treatment is necessary. For the prediction of disease mortality, the Ranson score might be a useful tool in SAP.

An estimate by two methods of thyroid absorbed doses due to BRAVO fallout in several Northern Marshall Islands.

Science.gov (United States)

Musolino, S V; Greenhouse, N A; Hull, A P

1997-10-01

Estimates of the thyroid absorbed doses due to fallout originating from the 1 March 1954 BRAVO thermonuclear test on Bikini Atoll have been made for several inhabited locations in the Northern Marshall Islands. Rongelap, Utirik, Rongerik and Ailinginae Atolls were also inhabited on 1 March 1954, where retrospective thyroid absorbed doses have previously been reconstructed. The current estimates are based primarily on external exposure data, which were recorded shortly after each nuclear test in the Castle Series, and secondarily on soil concentrations of 137Cs in samples collected in 1978 and 1988, along with aerial monitoring done in 1978. The external exposures and 137Cs soil concentrations were representative of the atmospheric transport and deposition patterns of the entire Castle Series tests and show that the BRAVO test was the major contributor to fallout exposure during the Castle series and other test series which were carried out in the Marshall Islands. These data have been used as surrogates for fission product radioiodines and telluriums in order to estimate the range of thyroid absorbed doses that may have occurred throughout the Marshall Islands. Dosimetry based on these two sets of estimates agreed within a factor of 4 at the locations where BRAVO was the dominant contributor to the total exposure and deposition. Both methods indicate that thyroid absorbed doses in the range of 1 Gy (100 rad) may have been incurred in some of the northern locations, whereas the doses at southern locations did not significantly exceed levels comparable to those from worldwide fallout. The results of these estimates indicate that a systematic medical survey for thyroid disease should be conducted, and that a more definitive dose reconstruction should be made for all the populated atolls and islands in the Northern Marshall Islands beyond Rongelap, Utirik, Rongerik and Ailinginae, which were significantly contaminated by BRAVO fallout.

An estimate by two methods of thyroid absorbed doses due to BRAVO fallout in several northern Marshall Islands

International Nuclear Information System (INIS)

Musolino, S.V.; Hull, A.P.; Greenhouse, N.A.

1997-01-01

Estimates of the thyroid absorbed doses due to fallout originating from the 1 March 1954 BRAVO thermonuclear test on Bikini Atoll have been made for several inhabited locations in the Northern Marshall Islands. Rongelap, Utirik, Rongerik and Ailinginae Atolls were also inhabited on 1 March 1954, where retrospective thyroid absorbed doses have previously been reconstructed. Current estimates are based primarily on external exposure data, which were recorded shortly after each nuclear test in the Castle Series, and secondarily on soil concentrations of 137 Cs in samples collected in 1978 and 1988, along with aerial monitoring done in 1978. External exposures and 137 Cs Soil concentrations were representative of the atmospheric transport and deposition patterns of the entire Castle Series tests and show that the BRAVO test was the major contributor to fallout exposure during the Castle series and other test series which were carried out in the Marshall Islands. These data have been used as surrogates for fission product radioiodines and telluriums in order to estimate the range of thyroid absorbed doses that may have occurred throughout the Marshall Islands. Dosimetry based on these two sets of estimates agreed within a factor of 4 at the locations where BRAVO was the dominant contributor to the total exposure and deposition. Both methods indicate that thyroid absorbed doses in the range of 1 Gy (100 rad) may have been incurred in some of the northern locations, whereas the doses at southern locations did not significantly exceed levels comparable to those from worldwide fallout. The results of these estimates indicate that a systematic medical survey for thyroid disease should be conducted, and that a more definitive dose reconstruction should be made for all the populated atolls and islands in the Northern Marshall Islands beyond Rongelap, Utirik, Rongerik and Ailinginae, which were significantly contaminated by BRAVO fallout. 30 refs., 2 figs., 10 tabs

Computed-tomography attenuation values of the peritoneum reflect the severity of peritonitis due to upper gastrointestinal perforations

International Nuclear Information System (INIS)

Tsujimoto, Hironori; Yaguchi, Yoshihisa; Hiraki, Shuichi; Kinoshita, Manabu; Yamamoto, Junji; Hase, Kazuo; Ono, Satoshi

2011-01-01

The aim of this study was to evaluate computed tomography (CT) attenuation values of the peritoneum and to relate these values to the severity of peritonitis in patients with upper gastrointestinal tract (UGI) perforations. A total of 27 consecutive patients with UGI perforations who underwent CT and emergency laparotomy in our hospital were enrolled in this study. The CT attenuation values of the peritoneum were measured at a workstation by 2 independent investigators, and these values were analyzed in relation to the severity of illness. There were significant negative correlations between the peritoneal CT attenuation values and the sequential organ failure assessment score, acute physiology and chronic health evaluation II score, and the Mannheim peritonitis index. There was a significant negative correlation between the peritoneal CT attenuation values and the length of stay in the intensive care unit. Furthermore, patients with dysfunctions in ≥3 organs had significantly lower peritoneal CT attenuation values than those with dysfunction in ≤2 organs. In conclusion, evaluation of peritoneal CT attenuation values in peritonitis patients is simple and can be employed for objective assessment of the severity of peritonitis. (author)

Mugwort-Mustard Allergy Syndrome due to Broccoli Consumption

Directory of Open Access Journals (Sweden)

Yuri Sugita

2016-01-01

Full Text Available Pollen-food allergy syndrome (PFAS is a relatively rare form of food allergy which develops in individuals who are sensitized to pollen. Tree pollens, especially birch pollen, frequently induce PFAS; however, the incidence of PFAS due to grass or weed pollens such as ragweed or mugwort is relatively rare. Mugwort-mustard allergy syndrome (MMAS is an example of a PFAS in which individuals sensitized to mugwort may develop an allergy to mustard and experience severe reactions. We herein describe a case of MMAS due to broccoli consumption.

How phosphorus limitation can control climatic gas sources and sinks

Science.gov (United States)

Gypens, Nathalie; Borges, Alberto V.; Ghyoot, Caroline

2017-04-01

Since the 1950's, anthropogenic activities severely increased river nutrient loads in European coastal areas. Subsequent implementation of nutrient reduction policies have considerably reduced phosphorus (P) loads from mid-1980's, while nitrogen (N) loads were maintained, inducing a P limitation of phytoplankton growth in many eutrophied coastal areas such as the Southern Bight of the North Sea (SBNS). When dissolved inorganic phosphorous (DIP) is limiting, most phytoplankton organisms are able to indirectly acquire P from dissolved organic P (DOP). We investigate the impact of DOP use on the importance of phytoplankton production and atmospheric fluxes of CO2 and dimethylsulfide (DMS) in the SBNS from 1951 to 2007 using an extended version of the R-MIRO-BIOGAS model. This model includes a description of the ability of phytoplankton organisms to use DOP as a source of P. Results show that primary production can increase up to 70% due to DOP uptake in limiting DIP conditions. Consequently, simulated DMS emissions double while CO2 emissions to the atmosphere decrease, relative to the reference simulation without DOP uptake. At the end of the simulated period (late 2000's), the net direction of air-sea CO2 annual flux, changed from a source to a sink for atmospheric CO2 in response to use of DOP and increase of primary production.

Evaluation of a strict protocol approach in managing women with severe disease due to hypertension in pregnancy: A before and after study

Directory of Open Access Journals (Sweden)

Backer Fèbè

2005-09-01

Full Text Available Abstract Background To evaluate whether the introduction of a strict protocol based on the systemic evaluation of critically ill pregnant women with complications of hypertension affected the outcome of those women. Method Study group: Indigent South African women managed in the tertiary hospitals of the Pretoria Academic Complex. Since 1997 a standard definition of women with severe acute maternal morbidity (SAMM, also referred to as a Nearmiss, has been used in the Pretoria Academic Complex. All cases of SAMM and maternal deaths (MD were entered on the Maternal Morbidity and Mortality Audit System programme (MaMMAS. A comparison of outcome of severely ill women who had complications of hypertension in pregnancy was performed between 1997–1998 (original protocol and 2002–2003 (strict protocol. Data include women referred from outside the Pretoria Academic Complex area to the tertiary hospitals. Results Between 1997–1998 there were 79 women with SAMM and 18 maternal deaths due to complications of hypertension, compared with 91 women with SAMM and 13 maternal deaths in 2002–2003. The mortality index (MI declined from 18.6% to 12.5% (OR 0.62, 95% CI 0.27–1.45. Statistically significant fewer women had renal failure (RR 0.37, 95% CI 0.21 – 0.66 and cerebral complications (RR 0.52, 95%CI 0.34 – 0.81 during the second period, and liver dysfunction (RR 0.27 95%CI 0.06 – 1.25 tended to be lower. However, there tended to be an increase in the number of women, who had immune system failure (RR 4.2 95%CI 0.93 – 18.94 and respiratory failure (RR 1.42 95%CI 0.88 – 2.29 although it did not reach significance. Cardiac failure remained constant (RR 0.84 95%CI 0.54 – 1.30. Conclusion The strict protocol approach based on the systemic evaluation of severely ill pregnant women with complications of hypertension and an intensive, regular feedback mechanism has been associated with a reduction in the number of patients with renal failure and

Evidence of hot spot formation on carbon limiters due to thermal electron emission

International Nuclear Information System (INIS)

Philipps, V.; Samm, U.; Tokar, M.Z.; Unterberg, B.; Pospieszczyk, A.; Schweer, B.

1993-01-01

Carbon test limiters have been exposed in TEXTOR to high heat loads up to about 30 MW/m 2 . The evolutions of the surface temperature distribution and of the carbon release have been observed by means of local diagnostics. A sudden acceleration of the rise of the surface temperature has been found at a critical temperature of approx. 2400 deg. C. The increase of the rate of the temperature rise is consistent with an enhancement of the power loading by a factor of 2.5-3. Following the temperature jump (hot spot), a quasi-equilibrium temperature establishes at approx. 2700 deg. C. The development of the hot spot is explained by an increase of the local power loading to the breakdown of the sheath potential by thermal emission of electrons from the carbon surface. Simultaneously with the appearance of the hot spot, the carbon release from the surface increases sharply. This increase can be explained by normal thermal sublimation. Sublimation cooling contributes to the establishment of the quasi-equilibrium temperature at about 2700 deg. C. (author). 16 refs, 10 figs

Provisional thoughts on limitations to the right to procreate ...

African Journals Online (AJOL)

... also had a severe non-intended impact on the social and economic situation in China. It is suggested, therefore, that positive measures (eg proper education and social provision) be considered to limit population growth. KEYWORDS: Limitation of rights; right to procreate; overpopulation; limitation of the right to procreate; ...

Severe pediatric ocular injury due to explosion of a firecracker inside a soda bottle

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Tarek A Shazly

2010-10-01

Full Text Available Tarek A ShazlyDepartment of Ophthalmology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, MA, USAAbstract: This case report describes a penetrating ocular injury, followed by endophthalmitis, in a four-year-old girl, resulting from explosion of a small K0201 match-cracker inside a soda bottle. The patient presented with two corneal lacerations, ruptured crystalline lens, multiple intraocular foreign bodies, and hyphema of the right eye, for which immediate surgical exploration and repair was performed. The patient developed aggressive endophthalmitis that led to atrophy of the eye within a few weeks. Severe ocular injuries can result from small, relatively “safe” firecrackers. Therefore, this type of firework should not be used, especially by minors.Keywords: pediatric trauma, endophthalmitis, firecracker

Limiting effects in double EEX beamline

Science.gov (United States)

Ha, G.; Power, J. G.; Conde, M.; Doran, D. S.; Gai, W.

2017-07-01

The double emittance exchange (EEX) beamline is suggested to overcome the large horizontal emittance and transverse jitter issues associated with the single EEX beamline while preserving its powerful phase-space manipulation capability. However, the double EEX beamline also has potential limitations due to coherent synchrotron radiation (CSR) and transverse jitter. The former limitation arises because double EEX uses twice as many bending magnets as single EEX which means stronger CSR effects degrading the beam quality. The latter limitation arises because a longitudinal jitter in front of the first EEX beamline is converted into a transverse jitter in the middle section (between the EEX beamlines) which can cause beam loss or beam degradation. In this paper, we numerically explore the effects of these two limitations on the emittance and beam transport.

Limiting effects in double EEX beamline

International Nuclear Information System (INIS)

Ha, G; Power, J G; Conde, M; Doran, D S; Gai, W

2017-01-01

The double emittance exchange (EEX) beamline is suggested to overcome the large horizontal emittance and transverse jitter issues associated with the single EEX beamline while preserving its powerful phase-space manipulation capability. However, the double EEX beamline also has potential limitations due to coherent synchrotron radiation (CSR) and transverse jitter. The former limitation arises because double EEX uses twice as many bending magnets as single EEX which means stronger CSR effects degrading the beam quality. The latter limitation arises because a longitudinal jitter in front of the first EEX beamline is converted into a transverse jitter in the middle section (between the EEX beamlines) which can cause beam loss or beam degradation. In this paper, we numerically explore the effects of these two limitations on the emittance and beam transport. (paper)

The Limits to Giving Back

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Jade S. Sasser

2014-07-01

Full Text Available In this thematic section, authors consider the limitations on giving back that they faced in field research, or saw others face. For some authors, their attempts at giving back were severely limited by the scope of their projects, or their understandings of local cultures or histories. For others, very specific circumstances and historical interventions of foreigners in certain places can limit how and to what extent a researcher is able to have a reciprocal relationship with the participating community. Some authors, by virtue of their lesser positions of power relative to those that they were studying, simply decided not to give back to those communities. In each article it becomes apparent that how and in what ways people give back is unique (and limited both to their personal values and the contexts in which they do research.

Limiting values for radioactive materials in food

International Nuclear Information System (INIS)

Steiner, Martin

2014-01-01

The contribution describes the fundamentals of radiation protection: LNT (linear, no threshold) hypotheses, ALARA (a slow as reasonably achievable), limiting values. Using the example the nuclear accident in Chernobyl the differences in contamination development in different foodstuffs in Germany is demonstrated including recommended limiting values and the radiation exposures after 30 years due to consumption of contaminated food. The natural radioactivity is about 0.3 mSv/year.

Density limits in Tokamaks

International Nuclear Information System (INIS)

Tendler, M.

1984-06-01

The energy loss from a tokamak plasma due to neutral hydrogen radiation and recycling is of great importance for the energy balance at the periphery. It is shown that the requirement for thermal equilibrium implies a constraint on the maximum attainable edge density. The relation to other density limits is discussed. The average plasma density is shown to be a strong function of the refuelling deposition profile. (author)

Physics considerations for the FED limiter

International Nuclear Information System (INIS)

Howe, H.C.

1981-07-01

The physics of the scrapeoff plasma and its interaction with a pumping limiter is reviewed. The governing equations for heat and particle transport in the scrapeoff are solved analytically with several simplifying assumptions. The assumed scrapeoff model is widely used and is presented here for completeness. From the solution, a shape for the limiter is derived which has a uniform heat loading on the front surface. The assumed crossfield transport coefficient is varied to examine the sensitivity of the heat loading to variations in plasma scrapeoff thickness. The heat flux to the limiter leading edge is an extremely sensitive function of variations in scrapeoff thickness, and we argue that uncertainties in the plasma crossfield transport preclude derivation of a believable limiter shape. We also discuss the problems involved with an edgeless, perforated limiter and with a global limiter. Finally, a solution is proposed using a flat-plate limiter with the heat flux to the leading edge controlled by major radius motion of the plasma

Diffusion limited reactions in crystalline solids

International Nuclear Information System (INIS)

Fastenau, R.

1982-01-01

Diffusion limited reactions in crystal lattices are studied with diffusion and random walk theory. First the random walk on a crystal lattice is studied. These results are used in a formal study of diffusion limited reactions in which the following simplified traps are discussed: planes, cylinders, spheres, disks and rings. The traps are either present at the start of the process (annealing) or fed into the crystal at a constant rate (continuous production). For the study of trapping processes occurring in real crystals it was necessary to investigate the interaction of the reacting species on the atomic level. Using lattice relaxation calculations, several reactions were studied. These calculations result in a model for the potential energy of the crystal versus the separation of the reaction partners. This model is used in Monte Carlo simulations of the trapping process, which are made at a high trap density, since the extrapolation to the low density regime can be made using the formal part of this work. The following reactions were studied: the trapping of interstitial helium atoms by vacancies, self interstitial vacancy recombination, the trapping of vacancies by immobile, helium filled, vacancies and the capture of self interstitials and vacancies by dislocations. A part of these results is used in two models for the low temperature nucleation and growth of bubbles due to helium bombardment. The models described give the right bubble density versus helium dose, but differ widely in the fraction of helium present in the bubbles found. A mechanism of blistering based on a percolation effect is also discussed. (Auth.)

Associations of emotional arousal, dissociation and symptom severity with operant conditioning in borderline personality disorder.

Science.gov (United States)

Paret, Christian; Hoesterey, Steffen; Kleindienst, Nikolaus; Schmahl, Christian

2016-10-30

Those with borderline personality disorder (BPD) display altered evaluations regarding reward and punishment compared to others. The processing of rewards is basal for operant conditioning. However, studies addressing operant conditioning in BPD patients are rare. In the current study, an operant conditioning task combining learning acquisition and reversal was used. BPD patients and matched healthy controls (HCs) were exposed to aversive and neutral stimuli to assess the influence of emotion on learning. Picture content, dissociation, aversive tension and symptom severity were rated. Error rates were measured. Results showed no group interactions between aversive versus neutral scenes. The higher emotional arousal, dissociation and tension, the worse the acquisition, but not reversal, scores were for BPD patients. Scores from the Borderline Symptom List were associated with more errors in the reversal, but not the acquisition phase. The results are preliminary evidence for impaired acquisition learning due to increased emotional arousal, dissociation and tension in BPD patients. A failure to process punishment in the reversal phase was associated with symptom severity and may be related to neuropsychological dysfunctioning involving the ventromedial prefrontal cortex. Conclusions are limited due to the correlational study design and the small sample size. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Sensitivity of reactivity feedback due to core bowing in a metallic-fueled core

International Nuclear Information System (INIS)

Nakagawa, Masatoshi; Kawashima, Masatoshi; Endo, Hiroshi; Nishimura, Tomohiro

1991-01-01

A sensitivity study has been carried out on negative reactivity feedback caused by core bowing to assess the potential effectiveness of FBR passive safety features in regard to withstanding an anticipated transient without scram (ATWS). In the present study, an analysis has been carried to obtain the best material and geometrical conditions concerning the core restraint system out for several power to flow rates (P/F), up to 2.0 for a 300 MWe metallic-fueled core. From this study, it was clarified that the pad stiffness at an above core loading pads (ACLP) needs to be large enough to ensure negative reactivity feedback against ATWS. It was also clarified that there is an upper limit for the clearances between ducts at ACLP. A new concept, in regard to increasing the absolute value for negative reactivity feedback due to core bowing at ATWS, is proposed and discussed. (author)

Severe asthma in childhood

International Nuclear Information System (INIS)

Ciznar, P.

2013-01-01

Patients with severe asthma are clinically, physiologically and biologically a heterogeneous group. About half of children referred for medical examination for severe asthma have true severe, therapy resistant asthma. The rest of referred patients have difficult to treat asthma. Symptoms persist mostly due to drug non-compliance, inappropriate inhalation technique, persistent environmental exposures or co-morbid conditions. Compared with adults have children more frequently atopic form of severe asthma. This is associated with eosinophilia in peripheral blood and sensitization to inhaled allergens. The IgE levels are high. Therapy of co-morbidities and improvement of treatment compliance lead in most cases to full asthma control. Proportion of children will benefit from biologics like anti-IgE monoclonal antibody, administered by subcutaneous injections in 2 to 4 week intervals. By this therapy it is not only possible to suppress symptoms, but also decrease the total steroid dose and the risk of adverse effects associated with its long-term administration. By achieving a full asthma control we lower future risk of exacerbations and probably improve long-term prognosis of disease, frequently persisting for the rest of life. (author)

Proton decay due to operators of dimension 5

International Nuclear Information System (INIS)

Aliev, T.M.; Vysotskii, M.I.

1983-01-01

Proton decay in supersymmetric unified theories due to operators with d = 5 is studied. The matrix elements of these operators are calculated. The experimental limit on the proton lifetime leads to the following bound on the Majorana mass of the W bosino: M/sub lambdaW/ + ν/sub μ/. For M/sub lambdag/ = 12 GeV, tau/sub p/ = 10 31 yr

Severe Hypertriglyceridemia Induced Pancreatitis in Pregnancy

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Natasha Gupta

2014-01-01

Full Text Available Acute pancreatitis caused by severe gestational hypertriglyceridemia is a rare complication of pregnancy. Acute pancreatitis has been well associated with gallstone disease, alcoholism, or drug abuse but rarely seen in association with severe hypertriglyceridemia. Hypertriglyceridemia may occur in pregnancy due to normal physiological changes leading to abnormalities in lipid metabolism. We report a case of severe gestational hypertriglyceridemia that caused acute pancreatitis at full term and was successfully treated with postpartum therapeutic plasma exchange. Patient also developed several other complications related to her substantial hypertriglyceridemia including preeclampsia, chylous ascites, retinal detachment, pleural effusion, and chronic pericarditis. This patient had no previous family or personal history of lipid abnormality and had four successful prior pregnancies without developing gestational hypertriglyceridemia. Such a severe hypertriglyceridemia is usually seen in patients with familial chylomicronemia syndromes where hypertriglyceridemia is exacerbated by the pregnancy, leading to fatal complications such as acute pancreatitis.

The limits of adaptation of functional protein synthesis to sever undernutrition

International Nuclear Information System (INIS)

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

1994-01-01

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

The limits of adaptation of functional protein synthesis to sever undernutrition

Energy Technology Data Exchange (ETDEWEB)

Jahoor, F; Bhattiprolu, S; Reeds, P [Baylor Coll. of Medicine, Houston, TX (United States). Children` s Nutrition Research Centre; Forrester, T; Boyne, M [West Indies Univ., Mona (Jamaica). Tropical Metabolism Research Unit

1994-12-31

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

Intrinsic space charge resonances and the space charge limit

International Nuclear Information System (INIS)

Parzen, G.

1990-01-01

A study has been done of the dependence of the space charge limit on the choice of ν-values using a simulation program. This study finds a strong dependence of the space charge limit on the location of the ν-values relative to the intrinsic space charge resonances, which are driven by the space charge forces due to the beam itself. Four accelerators were studied. For some of these accelerators the study suggest that the space charge limit can be increased by about a factor of 2 proper choice of the ν-values. The lower order 1/2 and 1/4 intrinsic resonances appear to be the important resonances. There is some evidence for effects due to the 1/6 and 1/8 intrinsic resonances, particularly for larger synchrotrons. 5 figs

Congenital scoliosis - presentation of three severe cases treated conservatively.

Science.gov (United States)

Weiss, H-R

2008-01-01

In view of the very limited data about conservative treatment of patients with congenital scoliosis (CS) available, early surgery is suggested already in mild cases with formation failures in the first three years of life. It is common sense that patients with failures of segmentation will not benefit from conservative treatment at all and the same applies to failures of formation with curves of >50 degrees in infancy. Two patients with rib synostosis denied surgery before entering the pubertal growth spurt. These patients have been treated conservatively with braces and Scoliosis In-Patient Rehabilitation (SIR) and now are beyond the pubertal growth spurt. One patient with a formation failure and a curve of >50 degrees lumbar has been treated with the help of braces and physiotherapy from 1.6 years on and is still under treatment now at the age of 15 years. Severe decompensation was prevented in the two patients with failure of segmentation, however a severe thoracic deformity is evident with underdeveloped lung function and severe restrictive ventilation disorder. The patient with failure of formation is well developed, now without cosmetic or physical complaints although his curve progressed at the end of the growth spurt due to final mal-compliance. Failures of segmentation should be advised to have surgery before entering the pubertal growth spurt. In case they deny, conservative treatment can at least in part be beneficial. For patients with failures of formation conservative treatment should be suggested in the first place because long-term outcomes of early surgery beyond pubertal growth spurt are not yet revealed.

Compliance of feed limits, does not mean compliance of food limits

Directory of Open Access Journals (Sweden)

van Raamsdonk LWD.

2009-01-01

Full Text Available The carry-over of contaminants from feed to animal food products is an important aspect of the animal production chain. For a proper containment, limits for feed as well food products are fixed for a series of chemicals, e.g. dioxins and dioxin-like PCBs, lead, cadmium, some chlorinated pesticides, and aflatoxin B1 (and its metabolite M1 in milk. The relationship between feed and food limits is an important issue. An ideal goal is to assure that compliance to a feed limits automatically results in compliance to food limits. In order to collect information about this relationship, several simulation models and a large database on transfer factors have been developed. An optimal choice between either a model or an application of data from the Transfer Database is based on both the knowledge level, and on the circumstances of the specific situation. To reach and validate such an optimal choice an Expert System Carry-Over is currently in development, containing four different modules: 1 the different calculation models and the Transfer Database, 2 a decision tree for choosing the optimal strategy, 3 data tables indicating knowledge levels of compound/animal/product parameters, and 4 supporting databases containing information on consumption and composition of daily diets, animal parameters, and amounts of (daily production. Calculations indicate that for dioxins compliance to feed levels does not necessarily mean that food limits are complied as well. Besides an estimation of the compliance to limits, the expert system is a tool for feed related risk assessments, and for planning of future research.

Confinement of acoustical modes due to the electron-phonon interaction within 2D-electron gas

International Nuclear Information System (INIS)

Kochelap, V.A.; Gulseren, O.

1992-09-01

We study the confinement of acoustical modes within 2DEG due only to the electron-phonon interaction. The confined modes split out from the bulk phonons even at uniform lattice parameters, when the 2DEG is created by means of modulation doping. The effect is more pronounced when the wave vector q of the modes increases and is maximum at q = 2 k F (k F is the Fermi wave vector). In the case of several electron sheets the additional features of the confinement effect appear. In the limit of the strong electron-phonon coupling and high surface concentration of the electrons the considered system can suffer Peierls-type phase transition. In this case periodical deformation of the lattice and charge density wave are confined within the electron sheet. (author). 18 refs, 2 figs

Considering built environment and spatial correlation in modelling pedestrian injury severity

DEFF Research Database (Denmark)

Prato, Carlo G.; Kaplan, Sigal; Patrier, Alexandre

traffic calming measures, illumination solutions, road maintenance programs and speed limit reductions. Moreover, this study emphasises the role of the built environment, as shopping areas, residential areas, and walking traffic density are positively related to a reduction in pedestrian injury severity......This study looks at mitigating and aggravating factors that are associated with the injury severity of pedestrians when they have crashes with another road user and overcomes existing limitations in the literature by posing attention on the built environment and considering spatial correlation...... of pedestrians to sustain a severe or fatal injury conditional on the occurrence of a crash with another road user. This study confirms previous findings about older pedestrians and intoxicated pedestrians being the most vulnerable road users, and crashes with heavy vehicles and in roads with higher speed limits...

Considering built environment and spatial correlation in modelling pedestrian injury severity

DEFF Research Database (Denmark)

Prato, Carlo G.; Kaplan, Sigal; Patrier, Alexandre

2018-01-01

traffic calming measures, illumination solutions, road maintenance programs and speed limit reductions. Moreover, this study emphasises the role of the built environment, as shopping areas, residential areas, and walking traffic density are positively related to a reduction in pedestrian injury severity......This study looks at mitigating and aggravating factors that are associated with the injury severity of pedestrians when they have crashes with another road user and overcomes existing limitations in the literature by posing attention on the built environment and considering spatial correlation...... of pedestrians to sustain a severe or fatal injury conditional on the occurrence of a crash with another road user. This study confirms previous findings about older pedestrians and intoxicated pedestrians being the most vulnerable road users, and crashes with heavy vehicles and in roads with higher speed limits...

Severe Hypoglycemia Accompanied with Thyroid Crisis

Directory of Open Access Journals (Sweden)

Yuki Nakatani

2012-01-01

Full Text Available We report a 32-year-old Japanese women with severe hypoglycemia accompanied with thyroid crisis. She complained of dyspnea, general fatigue, and leg edema. She was diagnosed with hyperthyroidism with congestive heart failure and liver dysfunction. Soon after admission, sudden cardiopulmonary arrest occurred. She was then transferred to the intensive care unit. Her serum glucose level was 7 mg/dl. Intravenous glucose, hydrocortisone, diuretics, and continuous hemodiafiltration (CHDF saved her. We considered that hypoglycemia occurred due to heart failure and liver dysfunction due to thyroid crisis.

Investigation of fatalities due to acute gasoline poisoning.

Science.gov (United States)

Martínez, María A; Ballesteros, Salomé

2005-10-01

This paper presents a simple, rapid, reliable, and validated method suited for forensic examination of gasoline in biological samples. The proposed methodology has been applied to the investigation of four fatal cases due to gasoline poisoning that occurred in Spain in 2003 and 2004. Case histories and pathological and toxicological findings are described in order to illustrate the danger of gasoline exposure under several circumstances. Gasoline's tissular distribution, its quantitative toxicological significance, and the possible mechanisms leading to death are also discussed. The toxicological screening and quantitation of gasoline was performed by means of gas chromatography (GC) with flame-ionization detection, and confirmation was performed using GC-mass spectrometry in total ion chromatogram mode. m,p-Xylene peak was selected to estimate gasoline in all biological samples. Gasoline analytical methodology was validated at five concentration levels from 1 to 100 mg/L. The method provided extraction recoveries between 77.6% and 98.3%. The limit of detection was 0.3 mg/L, and the limit of quantitation was 1.0 mg/L. The linearity of the blood calibration curves was excellent with r2 values of > 0.997. Intraday and interday precisions had a coefficient of variation inhalation of gasoline vapor inside a small enclosed space. Case 3 is a death by recreational gasoline inhalation in a male adolescent. Heart blood concentrations were 28.4, 18.0, and 38.3 mg/L, respectively; liver concentrations were 41.4, 52.9, and 124.2 mg/kg, respectively; and lung concentrations were 5.6, 8.4, and 39.3 mg/kg, respectively. Case 4 was an accidental death due to gasoline ingestion of a woman with senile dementia. Peripheral blood concentration was 122.4 mg/L, the highest in our experience. Because pathological findings were consistent with other reports of gasoline intoxication and constituents of gasoline were found in the body, cause of death was attributed to acute gasoline

Bioremediation techniques-classification based on site of application: principles, advantages, limitations and prospects.

Science.gov (United States)

Azubuike, Christopher Chibueze; Chikere, Chioma Blaise; Okpokwasili, Gideon Chijioke

2016-11-01

Environmental pollution has been on the rise in the past few decades owing to increased human activities on energy reservoirs, unsafe agricultural practices and rapid industrialization. Amongst the pollutants that are of environmental and public health concerns due to their toxicities are: heavy metals, nuclear wastes, pesticides, green house gases, and hydrocarbons. Remediation of polluted sites using microbial process (bioremediation) has proven effective and reliable due to its eco-friendly features. Bioremediation can either be carried out ex situ or in situ, depending on several factors, which include but not limited to cost, site characteristics, type and concentration of pollutants. Generally, ex situ techniques apparently are more expensive compared to in situ techniques as a result of additional cost attributable to excavation. However, cost of on-site installation of equipment, and inability to effectively visualize and control the subsurface of polluted sites are of major concerns when carrying out in situ bioremediation. Therefore, choosing appropriate bioremediation technique, which will effectively reduce pollutant concentrations to an innocuous state, is crucial for a successful bioremediation project. Furthermore, the two major approaches to enhance bioremediation are biostimulation and bioaugmentation provided that environmental factors, which determine the success of bioremediation, are maintained at optimal range. This review provides more insight into the two major bioremediation techniques, their principles, advantages, limitations and prospects.

Optimal Taxation in a Limited Commitment Economy

OpenAIRE

Yena Park

2012-01-01

This article studies optimal Ramsey taxation when risk sharing in private insurance markets is imperfect due to limited enforcement. In a limited commitment economy, there are externalities associated with capital and labour because individuals do not take into account that their labour and saving decisions affect aggregate labour and capital supply and wages, and thus the value of autarky. Therefore, a Ramsey government has an additional goal, which is to internalize these externalities of l...

Limitations and pitfalls of climate change impact analysis on urban rainfall extremes

DEFF Research Database (Denmark)

Willems, P.; Olsson, J.; Arnbjerg-Nielsen, Karsten

Under the umbrella of the IWA/IAHR Joint Committee on Urban Drainage, the International Working Group on Urban Rainfall (IGUR) has reviewed existing methodologies for the analysis of long-term historical and future trends in urban rainfall extremes and their effects on urban drainage systems, due...... to anthropogenic climate change. Current practices have several limitations and pitfalls, which are important to be considered by trend or climate change impact modellers and users of trend/impact results. Climate change may well be the driver that ensures that changes in urban drainage paradigms are identified...... and suitable solutions implemented. Design and optimization of urban drainage infrastructure considering climate change impacts and co-optimizing with other objectives will become ever more important to keep our cities liveable into the future....

Statistical Properties and Pre-Hit Dynamics of Price Limit Hits in the Chinese Stock Markets

Science.gov (United States)

Wan, Yu-Lei; Xie, Wen-Jie; Gu, Gao-Feng; Jiang, Zhi-Qiang; Chen, Wei; Xiong, Xiong; Zhang, Wei; Zhou, Wei-Xing

2015-01-01

Price limit trading rules are adopted in some stock markets (especially emerging markets) trying to cool off traders’ short-term trading mania on individual stocks and increase market efficiency. Under such a microstructure, stocks may hit their up-limits and down-limits from time to time. However, the behaviors of price limit hits are not well studied partially due to the fact that main stock markets such as the US markets and most European markets do not set price limits. Here, we perform detailed analyses of the high-frequency data of all A-share common stocks traded on the Shanghai Stock Exchange and the Shenzhen Stock Exchange from 2000 to 2011 to investigate the statistical properties of price limit hits and the dynamical evolution of several important financial variables before stock price hits its limits. We compare the properties of up-limit hits and down-limit hits. We also divide the whole period into three bullish periods and three bearish periods to unveil possible differences during bullish and bearish market states. To uncover the impacts of stock capitalization on price limit hits, we partition all stocks into six portfolios according to their capitalizations on different trading days. We find that the price limit trading rule has a cooling-off effect (object to the magnet effect), indicating that the rule takes effect in the Chinese stock markets. We find that price continuation is much more likely to occur than price reversal on the next trading day after a limit-hitting day, especially for down-limit hits, which has potential practical values for market practitioners. PMID:25874716

The effect of an outdoor activities' intervention delivered by older volunteers on the quality of life of older people with severe mobility limitations: a randomized controlled trial.

Science.gov (United States)

Rantanen, Taina; Äyräväinen, Irma; Eronen, Johanna; Lyyra, Tiinamari; Törmäkangas, Timo; Vaarama, Marja; Rantakokko, Merja

2015-04-01

Older community-living disabled people often have unmet activity needs and participation restrictions potentially reducing their quality of life (QoL). We examined the effects of an individualized out-of-home activity intervention delivered by volunteers on QoL among community-living older people, who have difficulty accessing the outdoors independently. Volunteering, Access to Outdoor Activities and Wellbeing in Older People (VOW; ISRCTN56847832) was a two-arm randomized single-blinded, controlled effectiveness trial (RCT) in Jyväskylä, Finland. The inclusion criteria were: age 65 or over, severe mobility limitation, able to communicate, and agree to participate in a RCT. Each intervention group member was assigned a trained volunteer with whom out-of-home activities were done once a week for 3 months (e.g., running errands or recreational activities). The primary outcome was the environmental subscore of QoL assessed with WHOQOL-BREF. Secondary outcomes were the overall QoL, physical capacity, psychological well-being, and social relationships assessed with WHOQOL_BREF and lower-extremity performance assessed with Short Physical Performance Battery (SPPB). 121 people aged 67-92 years (mean age 81.9 years, SD 5.9, 90 % women) were randomized. No treatment effect on the environmental QoL subscore was observed, but for physical capacity subscore a significant treatment effect was observed (General Linear Model, Group by Time p = 0.001). No effects were observed for the other QoL subscores or for SPPB score. This study suggests that individualized out-of-home activity intervention delivered by volunteers may influence the QoL of old severely mobility-limited community-living people in a positive way. Further studies are needed to better understand how to improve QoL of older disabled community-living people and potentially buffer them against more severe care needs and institutionalization.

A predictive model for the tokamak density limit

International Nuclear Information System (INIS)

Teng, Q.; Brennan, D. P.; Delgado-Aparicio, L.; Gates, D. A.; Swerdlow, J.; White, R. B.

2016-01-01

We reproduce the Greenwald density limit, in all tokamak experiments by using a phenomenologically correct model with parameters in the range of experiments. A simple model of equilibrium evolution and local power balance inside the island has been implemented to calculate the radiation-driven thermo-resistive tearing mode growth and explain the density limit. Strong destabilization of the tearing mode due to an imbalance of local Ohmic heating and radiative cooling in the island predicts the density limit within a few percent. Furthermore, we found the density limit and it is a local edge limit and weakly dependent on impurity densities. Our results are robust to a substantial variation in model parameters within the range of experiments.

Transport due to ion pressure gradient turbulence

International Nuclear Information System (INIS)

Connor, J.W.

1986-01-01

Turbulent transport due to the ion pressure gradient (or temperature drift) instability is thought to be significant when etasub(i)=d(ln Tsub(i))/d(ln n)>1. The invariance properties of the governing equations under scale transformations are used to discuss the characteristics of this turbulence. This approach not only clarifies the relationships between earlier treatments but also, in certain limits, completely determines the scaling properties of the fluctuations and the consequent thermal transport. (author)

"Ingraham v. Wright" and the Decline of Due Process.

Science.gov (United States)

Clark, Gerard J.

1978-01-01

Suggests that the constitutional questions in "Ingraham vs Wright" lend credence to a concern that the Court is seeking to eliminate all due process intervention outside of the incorporation and privacy cases and to limit even these cases to defenses of a criminal prosecution. Available from Suffolk University Law Review Office, 41…

Elastic limit at macroscopic deformation of icosahedral Al-Pd-Mn single quasicrystals

International Nuclear Information System (INIS)

Ledig, L.; Bartsch, M.; Messerschmidt, U.

2006-01-01

Al 70.5 Pd 21 Mn 8.5 single quasicrystals were plastically deformed between 482 and 821 deg. C. The strain rate sensitivity of the flow stress was measured by stress relaxation tests. At several temperatures, the dislocation structures were imaged by diffraction contrast in a high-voltage electron microscope for determining the dislocation densities. At all temperatures, the plastic deformation starts with a range of very high work-hardening. The transition point between almost elastic and elastic-plastic deformation is called the elastic limit. At low temperatures, the deformation was stopped at about 1.5 GPa to prevent fracture. Above about 580 deg. C, the stress-strain curves bend down and show a yield point effect followed by a range of almost steady state deformation. At low temperatures, the elastic limit is much lower than the steady state flow stress or the maximum stresses reached without fracture. The activation parameters are different for the elastic limit, the range of high work-hardening and steady state deformation. The flow stresses are interpreted by the stress necessary to move individual dislocations and the athermal component due to the elastic interaction between dislocations. At low temperatures, a further component is necessary to explain the very high flow stresses reached by work-hardening

A relativistic self-consistent model for studying enhancement of space charge limited field emission due to counter-streaming ions

International Nuclear Information System (INIS)

Lin, M. C.; Lu, P. S.; Chang, P. C.; Ragan-Kelley, B.; Verboncoeur, J. P.

2014-01-01

Recently, field emission has attracted increasing attention despite the practical limitation that field emitters operate below the Child-Langmuir space charge limit. By introducing counter-streaming ion flow to neutralize the electron charge density, the space charge limited field emission (SCLFE) current can be dramatically enhanced. In this work, we have developed a relativistic self-consistent model for studying the enhancement of SCLFE by a counter-streaming ion current. The maximum enhancement is found when the ion effect is saturated, as shown analytically. The solutions in non-relativistic, intermediate, and ultra-relativistic regimes are obtained and verified with 1-D particle-in-cell simulations. This self-consistent model is general and can also serve as a benchmark or comparison for verification of simulation codes, as well as extension to higher dimensions

Severe gynecomastia due to anti androgens intake: A case report and literature review

Directory of Open Access Journals (Sweden)

Chentli Farida

2013-01-01

Full Text Available Gynecomastia is the most bothersome side effect in men taking antiandrogens. It is exceptionally severe and distressing physically and mentally as in the reported case. A man, aged 63, with a history of a well-treated macroprolactinoma, was referred in 2004 for gynecomastia that appeared after treatment by microsurgery, radiotherapy and flutamide for a lesion suspected to be prostate cancer. Clinical examination was normal except for huge enlargement of the breasts. Mammography and breasts MRI did not show any tumor. There was not any metastasis of the supposed prostate cancer and prostatic acid phosphates were within normal ranges. Hormonal exploration showed subclinical hypogonadism [testosterone: 7.4 ng/ml (n: 3-9, FSH: 14.9 mu/ml (n: 0.7-11 and LH: 9.7 mu/ml (n: 0.8-7.6]. Testes ultrasounds were normal. Radiological and hormonal adrenal explorations were normal [Cortisol: 76 ng/ml (n: 50-250, DHEA-S: 59 μg/ml (n: 50-560, E2:40.2 pg/ml (n < 50]. Body scan was normal too. The discussed etiologies were post radiation subclinical hypogonadism, and treatment with anti androgens. After flutamide withdraw, there was not any sign of prostate cancer recurrence, and gynecomastia decreased significantly, but did not disappear probably because of fibrosis.

Inhaled indacaterol for the treatment of COPD patients with destroyed lung by tuberculosis and moderate-to-severe airflow limitation: results from the randomized INFINITY study.

Science.gov (United States)

Kim, Cheong-Ju; Yoon, Hyoung-Kyu; Park, Myung-Jae; Yoo, Kwang-Ha; Jung, Ki-Suck; Park, Jeong-Woong; Lim, Seong Yong; Shim, Jae Jeong; Lee, Yong Chul; Kim, Young-Sam; Oh, Yeon-Mok; Kim, Song; Yoo, Chul-Gyu

2017-01-01

Pulmonary tuberculosis (TB) is a risk factor for chronic obstructive pulmonary disease (COPD); however, few clinical studies have investigated treatment effectiveness in COPD patients with destroyed lung by TB. The Indacaterol effectiveness in COPD patients with Tuberculosis history (INFINITY) study assessed the efficacy and safety of once-daily inhaled indacaterol 150 µg for the treatment of Korean COPD patients with destroyed lung by TB and moderate-to-severe airflow limitation. This was a multicenter, double-blind, parallel-group study, in which eligible patients were randomized (1:1) to receive either once-daily indacaterol 150 µg or placebo for 8 weeks. The primary efficacy endpoint was change from baseline in trough forced expiratory volume in 1 s at Week 8; the secondary endpoints included changes in transition dyspnea index score and St George's Respiratory Questionnaire for COPD score at Week 8. Safety was evaluated over 8 weeks. Of the 136 patients randomized, 119 (87.5%) completed the study treatment. At Week 8, indacaterol significantly improved trough forced expiratory volume in 1 s versus placebo (treatment difference [TD] 140 mL, P <0.001). Statistically significant improvement in transition dyspnea index score (TD =0.78, P <0.05) and numerical improvement in St George's Respiratory Questionnaire for COPD score (TD =-2.36, P =0.3563) were observed with indacaterol versus placebo at Week 8. Incidence of adverse events was comparable between the treatment groups. Indacaterol provided significantly superior bronchodilation, significant improvement in breathlessness and improved health status with comparable safety versus placebo in Korean COPD patients with destroyed lung by TB and moderate-to-severe airflow limitation.

Severe jaundice due to coexistence of Dubin-Johnson syndrome and hereditary spherocytosis: a case report.

Science.gov (United States)

Korkmaz, Uğur; Duman, Ali Erkan; Oğütmen Koç, Deniz; Gürbüz, Yeşim; Dındar, Gökhan; Ensaroğlu, Fatih; Sener, Selçuk Yusuf; Sentürk, Omer; Hülagü, Sadettin

2011-08-01

Dubin-Johnson syndrome is a chronic, benign, intermittent jaundice, mostly of conjugated hyperbilirubinemia. The level of bilirubin is not expected to be more than 20 mg/dl in this syndrome. In this article, we report a patient who was evaluated for hyperbilirubinemia and liver function test abnormalities and diagnosed with Dubin-Johnson syndrome coexisting with hereditary spherocytosis. We suggest that other diseases should be investigated if patients with Dubin-Johnson syndrome present with severe hyperbilirubinemia. Dubin-Johnson syndrome accompanied by hemolytic diseases might also have high coproporphyrin levels (as in Rotor's syndrome) than expected in pure Dubin-Johnson syndrome.

29 CFR 2520.104-26 - Limited exemption for certain unfunded dues financed welfare plans maintained by employee...

Science.gov (United States)

2010-07-01

... welfare plans maintained by employee organizations. 2520.104-26 Section 2520.104-26 Labor Regulations Relating to Labor (Continued) EMPLOYEE BENEFITS SECURITY ADMINISTRATION, DEPARTMENT OF LABOR REPORTING AND... exemption for certain unfunded dues financed welfare plans maintained by employee organizations. (a) Scope...

Evaluation of a bi-directional aluminum honeycomb impact limiter design

International Nuclear Information System (INIS)

Doman, M.J.

1995-01-01

A 120 Ton shipping cask is being developed for the on-site shipment of dry spent fuel at the Idaho National Engineering Laboratory. Impact limiters were incorporated in the cask design to limit the inertial load of the package and its contents during the hypothetical 9-meter (30-foot) drop accident required by 10CFR71. The design process included: (1) a series of static and dynamic tests to determine the crush characteristics of the bi-directional aluminum honeycomb impact limiter material, (2) the development of an analytical model to predict the cask deceleration force as a function of impact limiter crush, and (3) a series of quarter scale model drop tests to qualify the analytical model. The scale model testing, performed at Sandia National Laboratory in Albuquerque, New Mexico, revealed several design aspects which should be considered in developing bi-directional aluminum honeycomb impact limiters and several other design aspects which should be considered for impact limiter designs in general

Severe hemolytic disease of the newborn due to anti-Di b treated with phototherapy and intravenous immunoglobulin.

Science.gov (United States)

Oh, Eun-Jee; Jekarl, Dong Wook; Jang, Hyun-Sik; Park, Hae-Il; Park, Yeon-Joon; Choi, Hyun Ah; Chun, Chung-Sik; Kim, Yonggoo; Kim, Hyung Hoi

2008-01-01

The Di(b) antigen usually occurs with high incidence, except in certain Asian and South American Indian populations. In general, hemolysis caused by anti-Di(b) is not severe and its clinical course is benign. We report a Korean neonate with severe hemolytic disease of the newborn caused by anti-Di(b). The phenotype and genotype of the Diego blood group system of the patient and his mother were Di(a+b+) and Di(a+b-), respectively. The mother's serum and eluate from the neonate's erythrocytes contained anti-Di(b). This case was successfully managed with phototherapy and high dose iv immunoglobulin. Since most commercial antibody detection panels do not contain Di(b-) red cells, it is important to consider anti-Di(b) in cases of hemolytic disease of the newborn caused by an antibody against a high frequency antigen.

Limit of quantitation in atomic spectrometry: An unambiguous concept?

International Nuclear Information System (INIS)

Mermet, Jean-Michel

2008-01-01

This document presents a tutorial description of several concepts and definitions of limits of quantitation, such as the so-called 10 s, the RSD net , the method limit, the lower limit of the calibration graph and the uncertainty approaches. Use, advantages, limitations and complexity of the various approaches are illustrated with some examples taken from atomic spectrometry, using ICP-AES, ICP-MS and LIBS. Information that can be deduced from the calibration graph is emphasized

Surface severe plastic deformation of AISI 304 via conventional shot peening, severe shot peening and repeening

Energy Technology Data Exchange (ETDEWEB)

Unal, Okan, E-mail: unalokan78@gmail.com [Mechanical Engineering Department, Bartın University, Bartın 74100 (Turkey); Varol, Remzi [Mechanical Engineering Department, Suleyman Demirel University, Isparta 32200 (Turkey)

2015-10-01

Highlights: • CSP and SSP treatments transform austenite to metastable martensite structure. • Nanograin layer thickness after CSP and SSP is 8 μm and 22 μm, respectively. • Shot peening leads to carbon segregation from coarse to nano grain layer. • Repeening is an effective way to reduce surface roughness. - Abstract: Air blast conventional shot peening (CSP), severe shot peening (SSP) and repeening (RP) as a severe plastic deformation applications on AISI 304 austenitic stainless steel is addressed. Shot peened specimens are investigated based on optical, FESEM and digital microscope. The investigations present the austenite transformation to metastable martensite via mechanical twinning due to plastic deformation with high strain rates. It is found that SSP induces thicker nanograin layer with compared to CSP. In XRD studies, the austenite peaks broaden by means of severe shot peening and FWHM increase reveals the grain size reduction below 25 nm regimes on the surface. In EDAX line analysis of CSP specimen, carbon content increase has been detected from deformed layer through the nanocrystalline layer then the content reduces. The carbon segregation takes place due to the energy level distinction between dislocations and Fe−C bonds. 3d contour digital microscope studies and roughness investigations reveal that SSP has deleterious side effect on the surface roughness and surface flatness. However, RP is an effective way to reduce the surface roughness to reasonable values.

Topical 0.25% desoximetasone spray efficacy for moderate to severe plaque psoriasis: a randomized clinical trial.

Science.gov (United States)

Saleem, Mohammed D; Negus, Deborah; Feldman, Steven R

2018-02-01

Traditionally, ointments were the vehicle of choice for psoriasis. Poor adherence of traditional vehicles limits the use of topical corticosteroids. Alternative formulations have gained popularity due to their ease of application, improved adherence and efficacy. To evaluate the efficacy of topical desoximetasone 0.25% spray formulation in extensive psoriasis. This multicenter, double-blinded, randomized trial compared twice daily topical 0.25% desoximetasone spray to placebo in subjects ≥18 with moderate to severe plaque psoriasis. Primary outcome of the study was the proportion of subjects in each group that achieved clinical success (Physician Global Assessment [PGA] of 0 or 1) and/or treatment success at (target lesion score of 0 or 1) day 28. One-hundred-and-twenty subjects were enrolled. At baseline, 75.0% and 73.3% of the treatment and placebo group had at least moderate PGA, respectively. Clinical success in the intended-to treat and placebo group was 30% and 5% (p = .0003), respectively; treatment success was 39% and 7% (p psoriasis treatments limits the ability to compare the results to other treatments. Topical desoximetasone spray provides rapid control of moderate to severe psoriasis lesions and may be considered for patients awaiting approval of biologicals. Clinical Trial was registered at clinicaltrial.gov: NCT01206387.

Reactor Core Coolability Analysis during Hypothesized Severe Accidents of OPR1000

International Nuclear Information System (INIS)

Lee, Yongjae; Seo, Seungwon; Kim, Sung Joong; Ha, Kwang Soon; Kim, Hwan-Yeol

2014-01-01

Assessment of the safety features over the hypothesized severe accidents may be performed experimentally or numerically. Due to the considerable time and expenditures, experimental assessment is implemented only to the limited cases. Therefore numerical assessment has played a major role in revisiting severe accident analysis of the existing or newly designed power plants. Computer codes for the numerical analysis of severe accidents are categorized as the fast running integral code and detailed code. Fast running integral codes are characterized by a well-balanced combination of detailed and simplified models for the simulation of the relevant phenomena within an NPP in the case of a severe accident. MAAP, MELCOR and ASTEC belong to the examples of fast running integral codes. Detailed code is to model as far as possible all relevant phenomena in detail by mechanistic models. The examples of detailed code is SCDAP/RELAP5. Using the MELCOR, Carbajo. investigated sensitivity studies of Station Black Out (SBO) using the MELCOR for Peach Bottom BWR. Park et al. conduct regulatory research of the PWR severe accident. Ahn et al. research sensitivity analysis of the severe accident for APR1400 with MELCOR 1.8.4. Lee et al. investigated RCS depressurization strategy and developed a core coolability map for independent scenarios of Small Break Loss-of-Coolant Accident (SBLOCA), SBO, and Total Loss of Feed Water (TLOFW). In this study, three initiating cases were selected, which are SBLOCA without SI, SBO, and TLOFW. The initiating cases exhibit the highest probability of transitioning into core damage according to PSA 1 of OPR 1000. The objective of this study is to investigate the reactor core coolability during hypothesized severe accidents of OPR1000. As a representative indicator, we have employed Jakob number and developed JaCET and JaMCT using the MELCOR simulation. Although the RCS pressures for the respective accident scenarios were different, the JaMCT and Ja

Limit strains for severe accident conditions. Final report of the EU-project LISSAC

International Nuclear Information System (INIS)

Krieg, R.; Seidenfuss, M.

2003-10-01

The local failure strains of essential reactor vessel components are investigated. The size influence of the components is of special interest. Typical severe accident conditions including elevated temperatures and dynamic loads are considered. The main part of work consists of test families with specimens under uniaxial and biaxial static and dynamic loads. Within one test family the specimen geometries and the load conditions are similar, the temperature is the same; but the size is varied up to reactor dimensions. Special attention is given to geometries with a hole or a notch causing non-uniform stress and strain distributions typical for reactor components. There are indications that for such non-uniform distributions size effects may be stronger than for uniform distributions. Thus size effects on the failure strains and failure processes are determined under realistic conditions. Several tests with nominal identical parameters are performed for small size specimens. In this way some information is obtained about the scatter. A reduced number of tests is carried out for medium size specimens and only a few tests are carried out for large size specimens to reduce the costs to an acceptable level. To manufacture all specimens sufficient material was available from the unused reactor pressure vessel Biblis C consisting of the material 22NiMoCr37. Thus variations of the mechanical material properties, which could impair the interpretation of the test results, are quite small. This has been confirmed by an adequate number of additional quality assurance tests. A key problem was the definition of failure and the determination of the local strains at failure for very different specimens under varying load conditions. Here appropriate methods had to be developed including the so-called 'vanishing gap method' and the 'forging die method'. They are based on post test geometrical measurements of the fracture surfaces and reconstructions of the related strain fields

Weak diffusion limits of dynamic conditional correlation models

DEFF Research Database (Denmark)

Hafner, Christian M.; Laurent, Sebastien; Violante, Francesco

The properties of dynamic conditional correlation (DCC) models are still not entirely understood. This paper fills one of the gaps by deriving weak diffusion limits of a modified version of the classical DCC model. The limiting system of stochastic differential equations is characterized...... by a diffusion matrix of reduced rank. The degeneracy is due to perfect collinearity between the innovations of the volatility and correlation dynamics. For the special case of constant conditional correlations, a non-degenerate diffusion limit can be obtained. Alternative sets of conditions are considered...

Beam-beam limit in e+e- circular colliders

International Nuclear Information System (INIS)

Ohmi, K.; Tawada, M.; Kamada, S.; Oide, K.; Cai, Y.; Qiang, J.

2004-01-01

Beam-beam effects limit the luminosity of circular colliders. Once the bunch population exceeds a threshold, the luminosity increases at a slower rate. This phenomenon is called the beam-beam limit. Onset of the beam-beam limit has been analyzed with various simulation methods based on the weak-strong and strong-strong models. We have observed that an incoherent phenomenon is mainly concerned in the beam-beam limit. The simulation have shown that equilibrium distributions of the two colliding beams are distorted from Gaussians when the luminosity is limited. The beam-beam limit is estimated to be ξ∼0.1 for a B factory with damping time of several thousand turns

Limited data tomographic image reconstruction via dual formulation of total variation minimization

Science.gov (United States)

Jang, Kwang Eun; Sung, Younghun; Lee, Kangeui; Lee, Jongha; Cho, Seungryong

2011-03-01

The X-ray mammography is the primary imaging modality for breast cancer screening. For the dense breast, however, the mammogram is usually difficult to read due to tissue overlap problem caused by the superposition of normal tissues. The digital breast tomosynthesis (DBT) that measures several low dose projections over a limited angle range may be an alternative modality for breast imaging, since it allows the visualization of the cross-sectional information of breast. The DBT, however, may suffer from the aliasing artifact and the severe noise corruption. To overcome these problems, a total variation (TV) regularized statistical reconstruction algorithm is presented. Inspired by the dual formulation of TV minimization in denoising and deblurring problems, we derived a gradient-type algorithm based on statistical model of X-ray tomography. The objective function is comprised of a data fidelity term derived from the statistical model and a TV regularization term. The gradient of the objective function can be easily calculated using simple operations in terms of auxiliary variables. After a descending step, the data fidelity term is renewed in each iteration. Since the proposed algorithm can be implemented without sophisticated operations such as matrix inverse, it provides an efficient way to include the TV regularization in the statistical reconstruction method, which results in a fast and robust estimation for low dose projections over the limited angle range. Initial tests with an experimental DBT system confirmed our finding.

Due diligence duties for an environmental liability

International Nuclear Information System (INIS)

Huebsch, M.

2000-04-01

Jurisdiction turned out well to create a basic ruling for due diligence duties. These due diligence duties are high standards for the law of torts (outside of contracts) within the Austrian civil law and represent a liability-extension for the holder of the source of danger. They establish an action for injunction in particular for preventing (further) damages. Therewith due diligence duties get a general sense in the range of a civil law for environmental liability. The responsible holder of a danger zone will therefore influence his way of acting to protect potential victims and the environment. The burden of proof is on the plaintiff (victims) under the Civil Code. Victims have specific sources of danger including high endangering special facilities in their argumentation with the so-called prima-facie-proof or first-appearance-proof. A turning back of the presentation of evidence to the polluter is wrong. The polluter himself has a continuing liability for dangerous activities and his clerks in the case of an extremely high danger of damage. All due diligence duties can be arranged in three areas: in information-, danger-avoidance- and danger-prevention-duties. The determination of range and essence of the duties has to be adjusted to each individual case. The range of the specific danger area is the essential link. The intensity of due diligence duties is increasing with the size of danger in the way of a movable system depending on the protected interest. Due diligence duties have to be kept within reasonable limits with two criterions: necessarity and demand. Proportionality of actions is a third criterion to avoid exaggeration of due diligence duties to obtain an effective protection for victims including the environment. (author)

Comparative Assessment of Severe Accidents in the Chinese Energy Sector

Energy Technology Data Exchange (ETDEWEB)

Hirschberg, S; Burgherr, P; Spiekerman, G; Cazzoli, E; Vitazek, J; Cheng, L

2003-03-01

This report deals with the comparative assessment of accidents risks characteristic for the various electricity supply options. A reasonably complete picture of the wide spectrum of health, environmental and economic effects associated with various energy systems can only be obtained by considering damages due to normal operation as well as due to accidents. The focus of the present work is on severe accidents, as these are considered controversial. By severe accidents we understand potential or actual accidents that represent a significant risk to people, property and the environment and may lead to large consequences. (author)

Impact of residual by-products from tungsten film deposition on process integration due to nonuniformity of the tungsten film

CERN Document Server

Sidhwa, A; Gandy, T; Melosky, S; Brown, W; Ang, S; Naseem, H; Ulrich, R

2002-01-01

The effects of residual by products from a tungsten film deposition process and their impact on process integration due to the nonuniformity of the tungsten film were investigated in this work. The tungsten film deposition process involves three steps: nucleation, stabilization, and tungsten bulk fill. Six experiments were conducted in search for a solution to the problem. The resulting data suggest that excess nitrogen left in the chamber following the tungsten nucleation step, along with residual by products, causes a shift in the tungsten film uniformity during the tungsten bulk fill process. Data reveal that, due to the residual by products, an abnormal grain growth occurs causing a variation in the tungsten thickness across the wafer during the bulk fill step. Although several possible solutions were revealed by the experiments, potential integration problems limited the acceptable solutions to one. The solution chosen was the introduction of a 10 s pumpdown immediately following the nucleation step. Thi...

Development and validation of a questionnaire to measure the severity of functional limitations and reduction of sports ability in German-speaking patients with exercise-induced leg pain.

Science.gov (United States)

Nauck, Tanja; Lohrer, Heinz; Padhiar, Nat; King, John B

2015-01-01

Currently, there is no generally agreed measure available to quantify a subject's perceived severity of exercise-induced leg pain symptoms. The aim of this study was to develop and validate a questionnaire that measures the severity of symptoms that impact on function and sports ability in patients with exercise-induced leg pain. The exercise-induced leg pain questionnaire for German-speaking patients (EILP-G) was developed in five steps: (1) initial item generation, (2) item reduction, (3) pretesting, (4) expert meeting and (5) validation. The resulting EILP-G was tested for reliability, validity and internal consistency in 20 patients with exercise-induced leg pain, 20 asymptomatic track and field athletes serving as a population at risk and 33 asymptomatic sport students. The patient group scored the EILP-G questionnaire significantly lower than both control groups (each psports ability in patients with exercise-induced leg pain. It can be recommended as a robust tool for measuring the subjectively perceived severity in German-speaking patients with exercise-induced leg pain. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

What is the appropriate upper limit for added sugars consumption?

Science.gov (United States)

Rippe, James M; Sievenpiper, John L; Lê, Kim-Anne; White, John S; Clemens, Roger; Angelopoulos, Theodore J

2017-01-01

Dramatic increases in obesity and diabetes have occurred worldwide over the past 30 years. Some investigators have suggested that these increases may be due, in part, to increased added sugars consumption. Several scientific organizations, including the World Health Organization, the Scientific Advisory Council on Nutrition, the Dietary Guidelines Advisory Committee 2015, and the American Heart Association, have recommended significant restrictions on upper limits of sugars consumption. In this review, the scientific evidence related to sugars consumption and its putative link to various chronic conditions such as obesity, diabetes, heart disease, nonalcoholic fatty liver disease, and the metabolic syndrome is examined. While it appears prudent to avoid excessive calories from sugars, the scientific basis for restrictive guidelines is far from settled. © The Author(s) 2016. Published by Oxford University Press on behalf of the International Life Sciences Institute. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

The density limit in JET diverted plasmas

Energy Technology Data Exchange (ETDEWEB)

Campbell, D J; Clement, S; Gottardi, N; Gowers, C; Harbour, P; Loarte, A; Horton, L; Lingertat, J; Lowry, C G; Saibene, G; Stamp, M; Stork, D [Commission of the European Communities, Abingdon (United Kingdom). JET Joint Undertaking; Monk, R [Royal Holloway Coll., London (United Kingdom). Dept. of Physics

1994-07-01

In JET limiter plasmas the density limit is associated with radiated power fractions of 100% and, in plasmas with carbon limiters, it is invariably disruptive. However, in discharges with solid beryllium limiters the limit is identified with the formation of a MARFE and disruptions are less frequent. In addition, the improved conditioning of the vessel arising from the use of beryllium has significantly improved the density limit scaling, so that the maximum density rises with the square root of the input power. In diverted plasmas several confinement regimes exist, making the characterization of the density limit more complex. While the density limit in L-mode plasmas is generally disruptive, the limit in ELMy and ELM-free H-modes generally prompts a return to the L-mode and a disruption is not inevitable. The density limit does rise with the increasing power, but the L-to-H transition complicates the analysis. Nevertheless, at low plasma currents (<2 MA), densities significantly above the Greenwald limit can be achieved, while at higher currents power handling limitations have constrained the range of density which can be achieved. (authors). 7 refs., 4 figs.

Classifying and assembling two-dimensional X-ray laser diffraction patterns of a single particle to reconstruct the three-dimensional diffraction intensity function: resolution limit due to the quantum noise.

Science.gov (United States)

Tokuhisa, Atsushi; Taka, Junichiro; Kono, Hidetoshi; Go, Nobuhiro

2012-05-01

A new two-step algorithm is developed for reconstructing the three-dimensional diffraction intensity of a globular biological macromolecule from many experimentally measured quantum-noise-limited two-dimensional X-ray laser diffraction patterns, each for an unknown orientation. The first step is classification of the two-dimensional patterns into groups according to the similarity of direction of the incident X-rays with respect to the molecule and an averaging within each group to reduce the noise. The second step is detection of common intersecting circles between the signal-enhanced two-dimensional patterns to identify their mutual location in the three-dimensional wavenumber space. The newly developed algorithm enables one to detect a signal for classification in noisy experimental photon-count data with as low as ~0.1 photons per effective pixel. The wavenumber of such a limiting pixel determines the attainable structural resolution. From this fact, the resolution limit due to the quantum noise attainable by this new method of analysis as well as two important experimental parameters, the number of two-dimensional patterns to be measured (the load for the detector) and the number of pairs of two-dimensional patterns to be analysed (the load for the computer), are derived as a function of the incident X-ray intensity and quantities characterizing the target molecule. © 2012 International Union of Crystallography

Piezoelectric scattering limited mobility of hybrid organic-inorganic perovskites CH3NH3PbI3

Science.gov (United States)

Lu, Ying-Bo; Kong, Xianghua; Chen, Xiaobin; Cooke, David G.; Guo, Hong

2017-01-01

Carrier mobility is one of the most important parameters for semiconducting materials and their use in optoelectronic devices. Here we report a systematic first principles analysis of the acoustic phonon scattering mechanism that limits the mobility of CH3NH3PbI3 (MAPbI3) perovskites. Due to the unique hybrid organic-inorganic structure, the mechanical, electronic and transport properties are dominated by the same factor, i.e. the weak interatomic bond and the easy rotation of methylammonium (MA) molecules under strain. Both factors make MAPbI3 soft. Rotation of MA molecule induces a transverse shift between Pb and I atoms, resulting in a very low deformation potential and a strong piezoelectricity in MAPbI3. Hence the carrier mobility of pristine MAPbI3 is limited by the piezoelectric scattering, which is consistent to the form of its temperature dependence. Our calculations suggest that in the pristine limit, a high mobility of about several thousand cm2 V−1 S−1 is expected for MAPbI3. PMID:28150743

Mechanisms Mediating Pediatric Severe Asthma and Potential Novel Therapies

Directory of Open Access Journals (Sweden)

Aldara Martin Alonso

2017-07-01

Full Text Available Although a rare disease, severe therapy-resistant asthma in children is a cause of significant morbidity and results in utilization of approximately 50% of health-care resources for asthma. Improving control for children with severe asthma is, therefore, an urgent unmet clinical need. As a group, children with severe asthma have severe and multiple allergies, steroid resistant airway eosinophilia, and significant structural changes of the airway wall (airway remodeling. Omalizumab is currently the only add-on therapy that is licensed for use in children with severe asthma. However, limitations of its use include ineligibility for approximately one-third of patients because of serum IgE levels outside the recommended range and lack of clinical efficacy in a further one-third. Pediatric severe asthma is thus markedly heterogeneous, but our current understanding of the different mechanisms underpinning various phenotypes is very limited. We know that there are distinctions between the factors that drive pediatric and adult disease since pediatric disease develops in the context of a maturing immune system and during lung growth and development. This review summarizes the current data that give insight into the pathophysiology of pediatric severe asthma and will highlight potential targets for novel therapies. It is apparent that in order to identify novel treatments for pediatric severe asthma, the challenge of undertaking mechanistic studies using age appropriate experimental models and airway samples from children needs to be accepted to allow a targeted approach of personalized medicine to be achieved.

Reduction in thermal conductivity of ceramics due to radiation damage

International Nuclear Information System (INIS)

Klemens, P.G.; Hurley, G.F.; Clinard, F.W. Jr.

1976-01-01

Ceramics are required for a number of applications in fusion reactors. In several of these applications, the thermal conductivity is an important design parameter as it affects the level of temperature and thermal stress in service. Ceramic insulators are known to suffer substantial reduction in thermal conductivity due to neutron irradiation damage. The present study estimates the reduction in thermal conductivity at high temperature due to radiation induced defects. Point, extended, and extended partly transparent defects are considered

A canned food scheduling problem with batch due date

Science.gov (United States)

Chung, Tsui-Ping; Liao, Ching-Jong; Smith, Milton

2014-09-01

This article considers a canned food scheduling problem where jobs are grouped into several batches. Jobs can be sent to the next operation only when all the jobs in the same batch have finished their processing, i.e. jobs in a batch, have a common due date. This batch due date problem is quite common in canned food factories, but there is no efficient heuristic to solve the problem. The problem can be formulated as an identical parallel machine problem with batch due date to minimize the total tardiness. Since the problem is NP hard, two heuristics are proposed to find the near-optimal solution. Computational results comparing the effectiveness and efficiency of the two proposed heuristics with an existing heuristic are reported and discussed.

Voltage variation due to solar photovoltaic in distribution network

International Nuclear Information System (INIS)

Azad, H I; Ramachandaramurthy, V K; Maleki, Hesamaldin

2013-01-01

Grid integration of solar photovoltaic (PV) plant offers reduction in greenhouse emissions and independence from fossil fuels for power generation. The integration of such forms of power generation also brings with it a variety of policy and technical issues. One of the technical issues is the variation in grid voltages in the presence of solar photovoltaic (PV) plant, resulting in degradation of power quality. In this paper, the application of a dq current controller to limit the voltage variation at the point of common coupling (PCC) due to a 2 MW solar photovoltaic (PV) plant will be discussed. The controller's goal is to ensure that the voltage variation meets the momentary voltage change limits specified in TNB's Technical Guidebook for the connection of distributed generation. The proposed dq current controller is shown to be able to limit the voltage variation.

Tokamak plasma interaction with limiters

International Nuclear Information System (INIS)

Pitcher, C.S.

1987-11-01

The importance of plasma purity is first discussed in terms of the general requirements of controlled thermonuclear fusion. The tokamak approach to fusion and its inherent problem of plasma contamination are introduced. A main source of impurities is due to the bombardment of the limiter by energetic particles and thus the three main aspects of the plasma-limiter interaction are reviewed, boundary plasma conditions, fuelling/recycling and impurity production. The experiments, carried out on the DITE tokamak at Culham Laboratory, UK, investigated these three topics and the results are compared with predicted behaviour; new physical phenomena are presented in all three areas. Simple one-dimensional fluid equations are found to adequately describe the SOL plasma, except in regard to the pre-sheath electric field and ambipolarity; that is, the electric field adjacent to the limiter surface appears to be weak and the associated plasma flow can be non-ambipolar. Recycling of fuel particles from the limiter is observed to be near unity at all times. The break-up behaviour of recycled and gas puffed D 2 molecules is dependent on the electron temperature, as expected. Impurity production at the limiter is chemical erosion of graphite being negligible. Deposition of limiter and wall-produced impurities is found on the limiter. The spatial distributions of impurities released from the limiter are observed and are in good agreement with a sputtered atom transport code. Finally, preliminary experiments on the transport of impurity ions along field lines away from the limiter have been performed and compared with simple analytic theory. The results suggest that the pre-sheath electric field in the SOL is much weaker than the simple fluid model would predict

Dynamical limitations to heavy ion fusion

International Nuclear Information System (INIS)

Back, B.B.

1983-01-01

Dynamical limitations to heavy ion fusion reaction are considered. The experimental signatures and the importance of a quasi-fission process are examined. The anaular distributions of fission fragments for the 32 S+ 208 Pb and 16 O+ 238 U systems are presented. It is shown that the observations of quasi-fission for even rather ''light'' heavy ions poeess severe limitations on the fusion process. This result may consequently be responsible for the lack of success of the search for super heavy elements in heavy ion fusion reactions

Intravenous Immunoglobulins: Mechanism of Action and Limitations of Clinical Application in Pediatrics

Directory of Open Access Journals (Sweden)

S.O. Mokiia-Serbina

2016-02-01

IVIG consumption is increasing due to the fact that in many cases the drugs are being used off-label. IVIG were more likely to be used in autoimmune and systemic inflammatory diseases. However, in randomized clinical trials, a good effect was achieved only in Kawasaki disease and immune thrombocytopenic purpura. Current clinical guidelines narrowed the indications for IVIG, limiting their use in sepsis. Immunoglobulin replacement therapy is recommended for children with physiological delay of immunoglobulin production only in repeated infections, which can not be controlled or prevented with antibiotics. In secondary ID, replacement therapy must be carried out if the cause of hypogammaglobulinemia can not be eliminated or elimination is contraindicated, as well as in association with β-cell cancers, in which severe infections caused by encapsulated bacteria persist despite preventive antibiotic therapy.

Environmental radiation standards and risk limitation

International Nuclear Information System (INIS)

Kocher, D.C.

1987-01-01

The Environmental Protection Agency and Nuclear Regulatory Commission have established environmental radiation standards for specific practices which correspond to limits on risk to the public that vary by several orders of magnitude and often are much less than radiation risks that are essentially unregulated, e.g., risks from radon in homes. This paper discusses a proposed framework for environmental radiation standards that would improve the correspondence with limitation of risk. This framework includes the use of limits on annual effective dose equivalent averaged over a lifetime, rather than limits on dose equivalent to whole body or any organ for each year of exposure, and consideration of exposures of younger age groups as well as adults; limits on annual effective dose equivalent averaged over a lifetime no lower than 0.25 mSv (25 mrem) per practice; maintenance of all exposures as low as reasonably achievable (ALARA); and establishment of a generally applicable de minimis dose for public exposures. Implications of the proposed regulatory framework for the current system of standards for limiting public exposures are discussed. 20 refs

Detecting signals of seasonal influenza severity through age dynamics

DEFF Research Database (Denmark)

Lee, Elizabeth C.; Viboud, Cécile; Simonsen, Lone

2015-01-01

stages of an outbreak. To address the limitations of traditional indicators, we propose a novel severity index based on influenza age dynamics estimated from routine physician diagnosis data that can be used retrospectively and for early warning. METHODS: We developed a quantitative 'ground truth......' severity benchmark that synthesizes multiple traditional severity indicators from publicly available influenza surveillance data in the United States. Observing that the age distribution of cases may signal severity early in an epidemic, we constructed novel retrospective and early warning severity indexes....... The retrospective index was well correlated with the severity benchmark and correctly identified the two most severe seasons. The early warning index performance varied, but it projected 2007-08 as relatively severe 10 weeks prior to the epidemic peak. Influenza severity varied significantly among states within...

Invasive Acer negundo outperforms native species in non-limiting resource environments due to its higher phenotypic plasticity.

Science.gov (United States)

Porté, Annabel J; Lamarque, Laurent J; Lortie, Christopher J; Michalet, Richard; Delzon, Sylvain

2011-11-24

To identify the determinants of invasiveness, comparisons of traits of invasive and native species are commonly performed. Invasiveness is generally linked to higher values of reproductive, physiological and growth-related traits of the invasives relative to the natives in the introduced range. Phenotypic plasticity of these traits has also been cited to increase the success of invasive species but has been little studied in invasive tree species. In a greenhouse experiment, we compared ecophysiological traits between an invasive species to Europe, Acer negundo, and early- and late-successional co-occurring native species, under different light, nutrient availability and disturbance regimes. We also compared species of the same species groups in situ, in riparian forests. Under non-limiting resources, A. negundo seedlings showed higher growth rates than the native species. However, A. negundo displayed equivalent or lower photosynthetic capacities and nitrogen content per unit leaf area compared to the native species; these findings were observed both on the seedlings in the greenhouse experiment and on adult trees in situ. These physiological traits were mostly conservative along the different light, nutrient and disturbance environments. Overall, under non-limiting light and nutrient conditions, specific leaf area and total leaf area of A. negundo were substantially larger. The invasive species presented a higher plasticity in allocation to foliage and therefore in growth with increasing nutrient and light availability relative to the native species. The higher level of plasticity of the invasive species in foliage allocation in response to light and nutrient availability induced a better growth in non-limiting resource environments. These results give us more elements on the invasiveness of A. negundo and suggest that such behaviour could explain the ability of A. negundo to outperform native tree species, contributes to its spread in European resource

[Development of a software standardizing optical density with operation settings related to several limitations].

Science.gov (United States)

Tu, Xiao-Ming; Zhang, Zuo-Heng; Wan, Cheng; Zheng, Yu; Xu, Jin-Mei; Zhang, Yuan-Yuan; Luo, Jian-Ping; Wu, Hai-Wei

2012-12-01

To develop a software that can be used to standardize optical density to normalize the procedures and results of standardization in order to effectively solve several problems generated during standardization of in-direct ELISA results. The software was designed based on the I-STOD method with operation settings to solve the problems that one might encounter during the standardization. Matlab GUI was used as a tool for the development. The software was tested with the results of the detection of sera of persons from schistosomiasis japonica endemic areas. I-STOD V1.0 (WINDOWS XP/WIN 7, 0.5 GB) was successfully developed to standardize optical density. A serial of serum samples from schistosomiasis japonica endemic areas were used to examine the operational effects of I-STOD V1.0 software. The results indicated that the software successfully overcame several problems including reliability of standard curve, applicable scope of samples and determination of dilution for samples outside the scope, so that I-STOD was performed more conveniently and the results of standardization were more consistent. I-STOD V1.0 is a professional software based on I-STOD. It can be easily operated and can effectively standardize the testing results of in-direct ELISA.

A geomorphic process law for detachment-limited hillslopes

Science.gov (United States)

Turowski, Jens

2015-04-01

Geomorphic process laws are used to assess the shape evolution of structures at the Earth's surface over geological time scales, and are routinely used in landscape evolution models. There are two currently available concepts on which process laws for hillslope evolution rely. In the transport-limited concept, the evolution of a hillslope is described by a linear or a non-linear diffusion equation. In contrast, in the threshold slope concept, the hillslope is assumed to collapse to a slope equal to the internal friction angle of the material when the load due to the relief exists the material strength. Many mountains feature bedrock slopes, especially in the high mountains, and material transport along the slope is limited by the erosion of the material from the bedrock. Here, I suggest a process law for detachment-limited or threshold-dominated hillslopes, in which the erosion rate is a function of the applied stress minus the surface stress due to structural loading. The process law leads to the prediction of an equilibrium form that compares well to the shape of many mountain domes.

The Arabidopsis Halophytic Relative Thellungiella halophila Tolerates Nitrogen-Limiting Conditions by Maintaining Growth, Nitrogen Uptake, and Assimilation1[W][OA

Science.gov (United States)

Kant, Surya; Bi, Yong-Mei; Weretilnyk, Elizabeth; Barak, Simon; Rothstein, Steven J.

2008-01-01

A comprehensive knowledge of mechanisms regulating nitrogen (N) use efficiency is required to reduce excessive input of N fertilizers while maintaining acceptable crop yields under limited N supply. Studying plant species that are naturally adapted to low N conditions could facilitate the identification of novel regulatory genes conferring better N use efficiency. Here, we show that Thellungiella halophila, a halophytic relative of Arabidopsis (Arabidopsis thaliana), grows better than Arabidopsis under moderate (1 mm nitrate) and severe (0.4 mm nitrate) N-limiting conditions. Thellungiella exhibited a lower carbon to N ratio than Arabidopsis under N limitation, which was due to Thellungiella plants possessing higher N content, total amino acids, total soluble protein, and lower starch content compared with Arabidopsis. Furthermore, Thellungiella had higher amounts of several metabolites, such as soluble sugars and organic acids, under N-sufficient conditions (4 mm nitrate). Nitrate reductase activity and NR2 gene expression in Thellungiella displayed less of a reduction in response to N limitation than in Arabidopsis. Thellungiella shoot GS1 expression was more induced by low N than in Arabidopsis, while in roots, Thellungiella GS2 expression was maintained under N limitation but was decreased in Arabidopsis. Up-regulation of NRT2.1 and NRT3.1 expression was higher and repression of NRT1.1 was lower in Thellungiella roots under N-limiting conditions compared with Arabidopsis. Differential transporter gene expression was correlated with higher nitrate influx in Thellungiella at low 15NO3− supply. Taken together, our results suggest that Thellungiella is tolerant to N-limited conditions and could act as a model system to unravel the mechanisms for low N tolerance. PMID:18467466

Decision Threshold and Detection Limit in Spectrometric Measurements. Part 1: Application to Gamma Spectrometry; Umbral de Decision y Limite de Deteccion en Medidas Espectrometricas. Parte 1: Aplicacion a la Espectrometria Gamma

Energy Technology Data Exchange (ETDEWEB)

Perez, C.; Gasco, C.; Lopez, M.A.

2010-03-03

This report summarised the author's lecture of the advanced gamma spectrometry course organised by CIEMAT. The characteristic limits determination in gamma spectrometry generally is obtained through the programming that the trade marks offers to the client with the objective of the automatic calculation of the activity concentrations existing in a sample. In this report, the examples shown in the ISO 11929 standard are compared to the programming realised by Genie 2k for determining characteristic limits. The main difference of both is located in the uncertainty calculations due to the efficiency calibration that is considered by ISO and not by Genie 2K. Through implementation in the software developed by trade marks will be possible to introduce this uncertainty and to assimilate to the calculation done by ISO 11929. In the second part of this report will be analyzed the more complicated samples of this application as counting in a whole body counter (following ISO-28218 about Performance Criteria for radio bioassay), multiplet, overlapping, addition of several peaks for obtaining the activity concentration, etc. (Author) 19 refs.

Rotational Energy as Mass in H3 + and Lower Limits on the Atomic Masses of D and 3He

Science.gov (United States)

Smith, J. A.; Hamzeloui, S.; Fink, D. J.; Myers, E. G.

2018-04-01

We have made precise measurements of the cyclotron frequency ratios H3 +/HD+ and H3 +/ 3He+ and observe that different H3+ ions result in different cyclotron frequency ratios. We interpret these differences as due to the molecular rotational energy of H3 + changing its inertial mass. We also confirm that certain high J , K rotational levels of H3+ have mean lifetimes exceeding several weeks. From measurements with the lightest H3+ ion we obtain lower limits on the atomic masses of deuterium and helium-3 with respect to the proton.

Rotational Energy as Mass in H_{3}^{+} and Lower Limits on the Atomic Masses of D and ^{3}He.

Science.gov (United States)

Smith, J A; Hamzeloui, S; Fink, D J; Myers, E G

2018-04-06

We have made precise measurements of the cyclotron frequency ratios H_{3}^{+}/HD^{+} and H_{3}^{+}/^{3}He^{+} and observe that different H_{3}^{+} ions result in different cyclotron frequency ratios. We interpret these differences as due to the molecular rotational energy of H_{3}^{+} changing its inertial mass. We also confirm that certain high J, K rotational levels of H_{3}^{+} have mean lifetimes exceeding several weeks. From measurements with the lightest H_{3}^{+} ion we obtain lower limits on the atomic masses of deuterium and helium-3 with respect to the proton.

Hepatitis E-induced severe myositis.

Science.gov (United States)

Mengel, Annerose M; Stenzel, Werner; Meisel, Andreas; Büning, Carsten

2016-02-01

Hepatitis E virus (HEV) is endemic in Asian and African countries but is rarely reported in Western countries. Although there are some prominent neurological manifestations, HEV is rarely recognized by neurologists. This is a case report of myositis induced by HEV. We report the life-threatening case of a 57-year-old man with flaccid tetraparesis due to myositis, acute hepatitis, and renal failure caused by HEV infection. Muscle biopsy revealed scattered myofiber necrosis with a diffuse, mild lymphomonocytic infiltrate in the endomysium and perimysium. Because the patient suffered from an acute HEV infection with a rapidly progressive course of severe myopathy, we started ribavirin treatment. He recovered partially within 3 weeks and recovered fully within 6 months. This case highlights a neurological manifestation of endemic HEV infection with severe myositis in a patient with alcoholic chronic liver disease. Ribavirin treatment is effective in severe HEV infection and may also lead to rapid neurological recovery. © 2015 Wiley Periodicals, Inc.

Classifying and assembling two-dimensional X-ray laser diffraction patterns of a single particle to reconstruct the three-dimensional diffraction intensity function: resolution limit due to the quantum noise

International Nuclear Information System (INIS)

Tokuhisa, Atsushi; Taka, Junichiro; Kono, Hidetoshi; Go, Nobuhiro

2012-01-01

A new algorithm is developed for reconstructing the high-resolution three-dimensional diffraction intensity function of a globular biological macromolecule from many quantum-noise-limited two-dimensional X-ray laser diffraction patterns, each for an unknown orientation. The structural resolution is expressed as a function of the incident X-ray intensity and quantities characterizing the target molecule. A new two-step algorithm is developed for reconstructing the three-dimensional diffraction intensity of a globular biological macromolecule from many experimentally measured quantum-noise-limited two-dimensional X-ray laser diffraction patterns, each for an unknown orientation. The first step is classification of the two-dimensional patterns into groups according to the similarity of direction of the incident X-rays with respect to the molecule and an averaging within each group to reduce the noise. The second step is detection of common intersecting circles between the signal-enhanced two-dimensional patterns to identify their mutual location in the three-dimensional wavenumber space. The newly developed algorithm enables one to detect a signal for classification in noisy experimental photon-count data with as low as ∼0.1 photons per effective pixel. The wavenumber of such a limiting pixel determines the attainable structural resolution. From this fact, the resolution limit due to the quantum noise attainable by this new method of analysis as well as two important experimental parameters, the number of two-dimensional patterns to be measured (the load for the detector) and the number of pairs of two-dimensional patterns to be analysed (the load for the computer), are derived as a function of the incident X-ray intensity and quantities characterizing the target molecule

Association of functional limitation with health care needs and experiences of children with special health care needs.

Science.gov (United States)

Nageswaran, Savithri; Silver, Ellen Johnson; Stein, Ruth E K

2008-05-01

The goal was to evaluate whether having a functional limitation was associated with health care needs and experiences of children with special health care needs. We used caregivers' responses in the National Survey of Children with Special Health Care Needs (2001). Functional limitation was categorized as severe, some, or no limitation. We performed analyses of the relationships of functional limitation to measures of health care needs and experiences. Children with special health care needs with severe functional limitation were more likely to have received specialized educational services, to have had physician visits, and to have needed health services, compared with those with no limitation. They had significantly greater odds of delayed care, unmet health care and care-coordination needs, referral problems, dissatisfaction, and difficulty using health services, compared with those without limitation. Caregivers of children with special health care needs with severe limitation were twice as likely as those with no limitation to report that providers did not spend enough time, listen carefully, provide needed information, and make family members partners in the child's care. Compared with children with special health care needs without limitation, those with severe limitation had worse health insurance experiences, in terms of insurance coverage, copayments, being able to see needed providers, and problems with health insurance. The impact on families (financial problems, need to provide home care, or need to stop or to cut work) of children with special health care needs with severe functional limitation was much greater than the impact on families of children with special health care needs without limitation. For most measures examined, results for some limitation were between those for severe limitation and no limitation. Functional limitation is significantly associated with the health care needs and experiences of children with special health care needs.

Limits of detection and decision. Part 4

International Nuclear Information System (INIS)

Voigtman, E.

2008-01-01

Probability density functions (PDFs) have been derived for a number of commonly used limit of detection definitions, including several variants of the Relative Standard Deviation of the Background-Background Equivalent Concentration (RSDB-BEC) method, for a simple linear chemical measurement system (CMS) having homoscedastic, Gaussian measurement noise and using ordinary least squares (OLS) processing. All of these detection limit definitions serve as both decision and detection limits, thereby implicitly resulting in 50% rates of Type 2 errors. It has been demonstrated that these are closely related to Currie decision limits, if the coverage factor, k, is properly defined, and that all of the PDFs are scaled reciprocals of noncentral t variates. All of the detection limits have well-defined upper and lower limits, thereby resulting in finite moments and confidence limits, and the problem of estimating the noncentrality parameter has been addressed. As in Parts 1-3, extensive Monte Carlo simulations were performed and all the simulation results were found to be in excellent agreement with the derived theoretical expressions. Specific recommendations for harmonization of detection limit methodology have also been made

Limiting characteristics of the superconducting fault current limiter applied to the neutral line of conventional transformer

International Nuclear Information System (INIS)

Im, I.G.; Choi, H.S.; Jung, B.I.

2013-01-01

Highlights: •Fault current limiter was used a high-speed interrupter. •High-speed interrupter was operated to bypass to the current limiter line. •The size of the fault current was limited to about 80% after the fault occurred. •The fault current was limited quickly within a half-cycle after the fault occurred. -- Abstract: The increased electricity demands influenced by the recent industrial development make the electric power distribution system more comprehensive, and the risks are high to cause failures to steady state electric line due to the extended range of fault at the time of fault occurrence. Also, the high performance and the high precision electric appliances that sensitive to switching surge and fault current expose vulnerability of reduced life span and increased fault occurrence ratio. Therefore, this thesis analyzed the fault limiting characteristics by the fault types by applying the superconducting fault current limiter to the neutral line of the transformer in order to reduce the fault currents that flow such high performance appliances. A current transformer (CT) that detects the fault current in the simulated power distribution system, a switching control system that is self-developed and a transformer are used in constructing a circuit. When a fault occurs, the initial fault current is restricted by the superconducting fault current limiter and simultaneously detours the fault current by operating the SCR contact of the switching control system through the detection by CT. This thesis analyzed the limiting characteristics of the superconducting fault current limiter that are applied to the neutral line of the transformer by the fault types

Limiting characteristics of the superconducting fault current limiter applied to the neutral line of conventional transformer

Energy Technology Data Exchange (ETDEWEB)

Im, I.G., E-mail: asiligo@gmail.com; Choi, H.S., E-mail: hyosang@chosun.ac.kr; Jung, B.I.

2013-11-15

Highlights: •Fault current limiter was used a high-speed interrupter. •High-speed interrupter was operated to bypass to the current limiter line. •The size of the fault current was limited to about 80% after the fault occurred. •The fault current was limited quickly within a half-cycle after the fault occurred. -- Abstract: The increased electricity demands influenced by the recent industrial development make the electric power distribution system more comprehensive, and the risks are high to cause failures to steady state electric line due to the extended range of fault at the time of fault occurrence. Also, the high performance and the high precision electric appliances that sensitive to switching surge and fault current expose vulnerability of reduced life span and increased fault occurrence ratio. Therefore, this thesis analyzed the fault limiting characteristics by the fault types by applying the superconducting fault current limiter to the neutral line of the transformer in order to reduce the fault currents that flow such high performance appliances. A current transformer (CT) that detects the fault current in the simulated power distribution system, a switching control system that is self-developed and a transformer are used in constructing a circuit. When a fault occurs, the initial fault current is restricted by the superconducting fault current limiter and simultaneously detours the fault current by operating the SCR contact of the switching control system through the detection by CT. This thesis analyzed the limiting characteristics of the superconducting fault current limiter that are applied to the neutral line of the transformer by the fault types.

Liver dysfunction in patients with severe anorexia nervosa.

Science.gov (United States)

Rosen, Elissa; Sabel, Allison L; Brinton, John T; Catanach, Brittany; Gaudiani, Jennifer L; Mehler, Philip S

2016-02-01

Evaluation of liver dysfunction in patients with severe anorexia nervosa (AN) has typically been limited to small case series. We report an investigation into the admission characteristics and clinical outcomes associated with liver dysfunction in a large cohort of adults hospitalized for medical stabilization of severe AN. We retrospectively evaluated electronic medical records to quantify the cumulative incidence of elevated aspartate aminotransferase (AST) and alanine aminotransferase (ALT). We compared mean (±SD), frequencies (%), and median (IQR) values of clinical covariates of interest by incidence of liver enzyme elevation. The study included 181 adults, admitted for medical stabilization of AN, from October 1, 2008 to December 31, 2013. AST and ALT were mildly elevated in 27.6% of patients and severely elevated (more than three times the upper limit of normal) in 35.4% of patients. On admission, patients with severely elevated liver enzymes had a lower body mass index (BMI) (11.9 ± 1.8 kg/m(2) vs.13.3 ± 1.7 kg/m(2)), lower percentage ideal body weight (56.5% ± 7.7% vs. 63.5% ± 8.3%), and lower prealbumin (64% vs. 37%) compared with the rest of the cohort (p < 0.001). While hospitalized, patients with severely elevated liver enzymes more often developed hypoglycemia, hypophosphatemia, and experienced longer lengths of stay (p < 0.001). Elevated liver enzymes are common in our patient population with severe AN. Liver enzymes reached near normal values by the time of discharge. Severely elevated liver enzymes were associated with a lower BMI and the development of hypoglycemia. © 2015 Wiley Periodicals, Inc.

Epidemiology of severe trauma.

Science.gov (United States)

Alberdi, F; García, I; Atutxa, L; Zabarte, M

2014-12-01

Major injury is the sixth leading cause of death worldwide. Among those under 35 years of age, it is the leading cause of death and disability. Traffic accidents alone are the main cause, fundamentally in low- and middle-income countries. Patients over 65 years of age are an increasingly affected group. For similar levels of injury, these patients have twice the mortality rate of young individuals, due to the existence of important comorbidities and associated treatments, and are more likely to die of medical complications late during hospital admission. No worldwide, standardized definitions exist for documenting, reporting and comparing data on severely injured trauma patients. The most common trauma scores are the Abbreviated Injury Scale (AIS), the Injury Severity Score (ISS) and the Trauma and Injury severity Score (TRISS). Documenting the burden of injury also requires evaluation of the impact of post-trauma impairments, disabilities and handicaps. Trauma epidemiology helps define health service and research priorities, contributes to identify disadvantaged groups, and also facilitates the elaboration of comparable measures for outcome predictions. Copyright © 2014 Elsevier España, S.L.U. y SEMICYUC. All rights reserved.

A review on data-driven fault severity assessment in rolling bearings

Science.gov (United States)

Cerrada, Mariela; Sánchez, René-Vinicio; Li, Chuan; Pacheco, Fannia; Cabrera, Diego; Valente de Oliveira, José; Vásquez, Rafael E.

2018-01-01

Health condition monitoring of rotating machinery is a crucial task to guarantee reliability in industrial processes. In particular, bearings are mechanical components used in most rotating devices and they represent the main source of faults in such equipments; reason for which research activities on detecting and diagnosing their faults have increased. Fault detection aims at identifying whether the device is or not in a fault condition, and diagnosis is commonly oriented towards identifying the fault mode of the device, after detection. An important step after fault detection and diagnosis is the analysis of the magnitude or the degradation level of the fault, because this represents a support to the decision-making process in condition based-maintenance. However, no extensive works are devoted to analyse this problem, or some works tackle it from the fault diagnosis point of view. In a rough manner, fault severity is associated with the magnitude of the fault. In bearings, fault severity can be related to the physical size of fault or a general degradation of the component. Due to literature regarding the severity assessment of bearing damages is limited, this paper aims at discussing the recent methods and techniques used to achieve the fault severity evaluation in the main components of the rolling bearings, such as inner race, outer race, and ball. The review is mainly focused on data-driven approaches such as signal processing for extracting the proper fault signatures associated with the damage degradation, and learning approaches that are used to identify degradation patterns with regards to health conditions. Finally, new challenges are highlighted in order to develop new contributions in this field.

Noble gas control room accident filtration system for severe accident conditions (N-CRAFT)

International Nuclear Information System (INIS)

Hill, Axel; Stiepani, Cristoph; Drechsler, Michael

2015-01-01

Severe accidents might cause the release of airborne radioactive substances to the environment of the NPP either due to containment leakages or due to intentional filtered containment venting. In the latter case aerosols and iodine are retained, however noble gases are not retainable by the FCVS or by conventional air filtration systems like HEPA filters and iodine absorbers. Radioactive noble gases nevertheless dominate the activity release depending on the venting procedure and the weather conditions. To prevent unacceptable contamination of the control room atmosphere by noble gases, AREVA GmbH has developed a noble gas control room accident filtration system (CRAFT) which can supply purified fresh air to the control room without time limitation. The retention process is based on dynamic adsorption of noble gases on activated carbon. The system consists of delay lines (carbon columns) which are operated by a continuous and simultaneous adsorption and desorption process. CRAFT allows minimization of the dose rate inside the control room and ensures low radiation exposure to the staff by maintaining the control room environment suitable for prolonged occupancy throughout the duration of the accident. CRAFT consists of a proven modular design either transportable or permanently installed. (author)

Appendix : airborne incidents : an econometric analysis of severity

Science.gov (United States)

2014-12-19

This is the Appendix for Airborne Incidents: An Econometric Analysis of Severity Report. : Airborne loss of separation incidents occur when an aircraft breaches the defined separation limit (vertical and/or horizontal) with another aircraft or terrai...

Design features of ACR in severe accident mitigation

International Nuclear Information System (INIS)

Shapiro, H.; Krishnan, V.S.; Santamaura, P.; Lekakh, B.; Blahnik, C.

2007-01-01

New reactor designs require the evaluation of design alternatives to reduce the radiological risk by preventing severe accidents or by limiting releases from the plant in the event of such accidents. The Advanced CANDU Reactor TM (ACR TM ) design has provisions to prevent and mitigate severe accidents. This paper describes key ACR design features for severe accident mitigation. It provides a high-level overview of the findings to date. Several design provisions have not yet been finalized or decided, but the designers are keenly aware of the SAM concepts and their requirements. The active heat sinks for 'vessels' (i.e., the fuel channels, the calandria vessel, the calandria end-shields and the calandria vault) are all amply capable of dissipating the severe accident heat loads. These heat sinks are designed to be operable under severe accident environmental conditions; however, their operability is yet to be confirmed by assessments. The active heat sinks for the various process vessels are 'backed up' by passive heat sinks (i.e., steaming plus water make-up from the RWS). The supply side of passive heat sinks is simple, rugged, and not vulnerable to failures of plant systems. The importance of the steam relief side is recognized, and the adequate relief capacity will be provided. The passive heat sinks will give the SAM more than 1 day (likely several days) to diagnose the accident and to establish the ultimate heat sinks. The spray system for containment pressure suppression is designed for high reliability and has ample capacity to ensure low containment leakage without external intervention, after which time alternative supply to the sprays can be brought on line manually. The sprays are backed up by the LACs which are assessed for operability following a severe accident. The strong ACR containment will provide a long time of completely passive protection for any severe accident at decay power. Its characteristics are not prone to catastrophic failures. The

Successful use of long acting octreotide in two cases with Beckwith-Wiedemann syndrome and severe hypoglycemia.

Science.gov (United States)

Al-Zubeidi, Hiba; Gottschalk, Michael E; Newfield, Ron S

2014-01-01

Hyperinsulinism associated with Beckwith-Wiedemann syndrome (BWS) can occur in about 50% of cases, causing hypoglycemia of variable severity. Parenteral use of octreotide may be indicated if unresponsive to diazoxide. There is limited data on use of octreotide in BWS. Chart review describing 2 cases with BWS and hypoglycemia treated with long acting Octreotide as a monthly injection. We describe two unrelated females born large for gestational age found to have clinical features consistent with BWS, who developed severe hypoglycemia. Genetic diagnosis of BWS was confirmed. The first patient was born at 37 weeks and developed hypoglycemia shortly after birth. She was initially started on diazoxide but developed pulmonary congestion and was therefore switched to depot octreotide (LAR). She maintained euglycemia with LAR. In the second patient (born at 26-4/7 weeks), onset of hypoglycemia was delayed till 11 weeks of age due to hydrocortisone (indicated hemodynamically) and continuous feeding, and was partially responsive to diazoxide. She was switched to octreotide 4 times daily, treated till at age 18 months. Despite frequent feeds, she required treatment again between ages 4-6.5 years, initially with diazoxide but due to severe hypertrichosis she was switched to LAR with an excellent response. Both patients treated with LAR for over two years achieved euglycemia above 70 mg/dl and had normal height gain, without side effects. Successful treatment of hypoglycemia can be achieved and maintained with LAR in infants and children with BWS who are either resistant or cannot tolerate diazoxide.

Severe accident training simulator APROS SA

International Nuclear Information System (INIS)

Raiko, Eerikki; Salminen, Kai; Lundstroem, Petra; Harti, Mika; Routamo, Tomi

2003-01-01

APROS SA is a severe accident training simulator based on the APROS simulation environment. APROS SA has been developed in Fortum Nuclear Services Ltd to serve as a training tool for the personnel of the Loviisa NPP. Training with APROS SA gives the personnel a deeper understanding of the severe accident phenomena and thus it is an important part of the implementation of the severe accident management strategy. APROS SA consists of two parts, a comprehensive Loviisa plant model and an external severe accident model. The external model is an extension to the Loviisa plant model, which allows the simulation to proceed into the severe accident phase. The severe accident model has three submodels: the core melting and relocation model, corium pool model and fission product model. In addition to these, a new thermal-hydraulic solver is introduced to the core region of the Loviisa plant model to replace the more limited APROS thermal-hydraulic solver. The full APROS SA training simulator has a graphical user interface with visualizations of both severe accident management panels at the operator room and the important physical phenomena during the accident. This paper describes the background of the APROS SA training simulator, the severe accident submodels and the graphical user interface. A short description how APROS SA will be used as a training tool at the Loviisa NPP is also given

High beta tokamak operation in DIII-D limited at low density/collisionality by resistive tearing modes

International Nuclear Information System (INIS)

La Haye, R.J.; Lao, L.L.; Strait, E.J.; Taylor, T.S.

1997-01-01

The maximum operational high beta in single-null divertor (SND) long pulse tokamak discharges in the DIII-D tokamak with a cross-sectional shape similar to the proposed International Thermonuclear Experimental Reactor (ITER) device is found to be limited by the onset of resistive instabilities that have the characteristics of neoclassically destabilized tearing modes. There is a soft limit due to the onset of an m/n=3/2 rotating tearing mode that saturates at low amplitude and a hard limit at slightly higher beta due to the onset of an m/n=2/1 rotating tearing mode that grows, slows down and locks. By operating at higher density and thus collisionality, the practical beta limit due to resistive tearing modes approaches the ideal magnetohydrodynamic (MHD) limit. (author). 15 refs, 4 figs

Concrete cover cracking due to uniform reinforcement corrosion

DEFF Research Database (Denmark)

Solgaard, Anders Ole Stubbe; Michel, Alexander; Geiker, Mette Rica

2013-01-01

and reinforcement de-passivation is a frequently used limit state. The present paper investigates an alternative limit state: corrosion-induced cover cracking. Results from numerical simulations of concrete cover cracking due to reinforcement corrosion are presented. The potential additional service life...... is calculated using literature data on corrosion rate and Faraday’s law. The parameters varied comprise reinforcement diameter, concrete cover thickness and concrete material properties, viz. concrete tensile strength and ductility (plain concrete and fibre reinforced concrete). Results obtained from......Service life design (SLD) is an important tool for civil engineers to ensure that the structural integrity and functionality of the structure is not compromised within a given time frame, i.e. the service life. In SLD of reinforced concrete structures, reinforcement corrosion is of major concern...

Acute Kidney Injury Risk Assessment: Differences and Similarities Between Resource-Limited and Resource-Rich Countries

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Kianoush Kashani

2017-07-01

Full Text Available The incidence of acute kidney injury (AKI among acutely ill patients is reportedly very high and has vexing consequences on patient outcomes and health care systems. The risks and impact of AKI differ between developed and developing countries. Among developing countries, AKI occurs in young individuals with no or limited comorbidities, and is usually due to environmental causes, including infectious diseases. Although several risk factors have been identified for AKI in different settings, there is limited information on how risk assessment can be used at population and patient levels to improve care in patients with AKI, particularly in developing countries where significant health disparities may exist. The Acute Disease Quality Initiative consensus conference work group addressed the issue of identifying risk factors for AKI and provided recommendations for developing individualized risk stratification strategies to improve care. We proposed a 5-dimension, evidence-based categorization of AKI risk that allows clinicians and investigators to study, define, and implement individualized risk assessment tools for the region or country where they practice. These dimensions include environmental, socioeconomic and cultural factors, processes of care, exposures, and the inherent risks of AKI. We provide examples of these risks and describe approaches for risk assessments in the developing world. We anticipate that these recommendations will be useful for health care providers to plan and execute interventions to limit the impact of AKI on society and each individual patient. Using a modified Delphi process, this group reached consensus regarding several aspects of AKI risk stratification.

Illustrating the Central Limit Theorem through Microsoft Excel Simulations

Science.gov (United States)

Moen, David H.; Powell, John E.

2005-01-01

Using Microsoft Excel, several interactive, computerized learning modules are developed to demonstrate the Central Limit Theorem. These modules are used in the classroom to enhance the comprehension of this theorem. The Central Limit Theorem is a very important theorem in statistics, and yet because it is not intuitively obvious, statistics…

Density limit in FTU tokamak during Ohmic operation

International Nuclear Information System (INIS)

Frigione, D.; Pieroni, L.

1993-01-01

The understanding of the physical mechanisms that regulate the density limit in a Tokamak is very important in view of a future fusion reactor. On one hand density enters as a factor in the figure of merit needed to achieve a burning plasma, and on the other hand a high edge density is a prerequisite for avoiding excessive erosion of the first walls and to limit the impurity influx into the hot plasma core. Furthermore a reactor should work in a safe zone of the operation parameters in order to avoid disruptive instabilities. The density limit problem has been tackled since the 70's, but so far a unique physics picture has not still emerged. In the last few years, due to the availability of better diagnostics, especially for the plasma edge, the use of pellet injectors to fuel the plasma and the experience gained on many different Tokamak, a consensus has been reached on the edge density as the real parameter responsible for the density limit. There are still two main mechanisms invoked to explain this limit: one refers to the power balance between the heat conducted and/or convected across the plasma radius and the power lost by impurity line radiation at the edge. When the latter overcomes the former, shrinking of the current channel occurs, which leads to instabilities due to tearing modes (usually the m/n=2/1) and then to disruption. The other explanation, for now valid for divertor machines, is based on the particle and energy balance in the scrape off layer (SOL). The limit in the edge density is then associated with the thermal collapse of the divertor plasma. In this work we describe the experiments on the density limit in FTU with Ohmic heating, the reason why we also believe that the limit is on the edge density, and discuss its relation to a simple model based on the SOL power balance valid for a limiter Tokamak. (author) 7 refs., 4 figs

A relativistic self-consistent model for studying enhancement of space charge limited emission due to counter-streaming ions

Science.gov (United States)

Lin, M. C.; Verboncoeur, J.

2016-10-01

A maximum electron current transmitted through a planar diode gap is limited by space charge of electrons dwelling across the gap region, the so called space charge limited (SCL) emission. By introducing a counter-streaming ion flow to neutralize the electron charge density, the SCL emission can be dramatically raised, so electron current transmission gets enhanced. In this work, we have developed a relativistic self-consistent model for studying the enhancement of maximum transmission by a counter-streaming ion current. The maximum enhancement is found when the ion effect is saturated, as shown analytically. The solutions in non-relativistic, intermediate, and ultra-relativistic regimes are obtained and verified with 1-D particle-in-cell simulations. This self-consistent model is general and can also serve as a comparison for verification of simulation codes, as well as extension to higher dimensions.

[Tracheobronchoplasty for Severe Diffuse Tracheomalacia].

Science.gov (United States)

Hoffmann, H; Gompelmann, D; Heußel, C P; Dienemann, H; Eberhardt, R

2016-09-01

Patients with diffuse airway instability due to tracheobronchomalacia or excessive dynamic airway collapse are typically highly symptomatic, with marked dyspnoea, recurrent bronchopulmonary infections and excruciating intractable cough. Silicone stents achieve immediate symptom control, but are - due to the typical complications associated with stent treatment - usually not an option for long-term treatment. The aim of surgical intervention is definitive stabilisation of the trachea and of both main bronchi by posterior splinting of the Paries membranaceus with a polypropylene mesh. This operation is an appropriate treatment option for patients with documented severe tracheobronchomalacia or excessive dynamic airway collapse and is ultimately the only therapy that can achieve permanent symptom control. The success of the operation, however, depends on many factors and requires close interdisciplinary collaboration. Georg Thieme Verlag KG Stuttgart · New York.

Severe upper extremity polyneuropathy due to inferior brachial plexus compression as a result of left subclavian artery pseudoaneurism

Directory of Open Access Journals (Sweden)

George Kosmadakis

2012-01-01

Full Text Available In the present report, we describe the case of a 76-year-old hemodialysis patient who was admitted with clinical features of neurological thoracic exit syndrome due to subclavian artery pseudoaneurism following the insertion of a dual lumen vascular internal jugular catheter (vascath with excellent outcome after endo-arterial stent placement.

Severe hepatocytolisis syndrome - a challenge in medical therapy of Cushing’s disease

Directory of Open Access Journals (Sweden)

Valea Ana

2015-08-01

Full Text Available Introduction Cushing’s disease is a rare endocrine disorder characterized by persistent hypercortisolism due to excessive, autonomous ACTH secretion by a pituitary adenoma. Transsphenoidal adenomectomy is the main therapeutic option in Cushing’s disease. When imaging studies are unable to demonstrate an obvious pituitary mass complete tumor resection is difficult and often encumbered by risk of relapse. Medical therapy is a second-line option or the first-line treatment for patients with high surgical risk, incomplete surgical resection or relapse. Rarely classic clinical manifestations limit the selection of medical therapy for Cushing’s disease. Case presentation We present the case of a male patient with Cushing’s disease complicated with diabetes mellitus and severe hepatocytolisis syndrome with no visible pituitary adenoma on MRI studies. In the absence of technical equipment petrosal sinus sampling could not be performed in order to improve surgery outcome

Pregnancy-associated severe sepsis.

Science.gov (United States)

Oud, Lavi

2016-04-01

This article examines the contemporary knowledge and uncertainties about the burden of pregnancy-associated severe sepsis (PASS), and its manifestations, management, and outcomes. There are relatively sparse data on PASS, related in part to infrequent reports and varying use of terminology and case definitions. PASS remains rare, although its incidence appears to be rapidly rising in some high-resource countries, affecting especially women with limited resources, minorities, and those with chronic illness. High level of clinician vigilance and rapid initiation of appropriate antimicrobial therapy, coupled with effective systemic support for organ dysfunction and correction of occult and overt hypoperfusion are the keys to limit adverse outcomes. However, timely diagnosis and provision of effective care remain a challenge, with reported prevalent delay in recognition and delivery of time-sensitive care interventions among maternal decedents. The mortality rate of PASS has been rising and its case fatality, although relatively low, has remained unchanged, in contrast to the outcome gains in the general population. The long-term sequelae of PASS remain unknown. The relatively limited contemporary data on PASS suggest a rising public health hazard in the obstetric population in high-resource countries, with ongoing challenges in assuring consistent provision of time-sensitive care.

Asthma Is More Severe in Older Adults

Science.gov (United States)

Dweik, Raed A.; Comhair, Suzy A.; Bleecker, Eugene R.; Moore, Wendy C.; Peters, Stephen P.; Busse, William W.; Jarjour, Nizar N.; Calhoun, William J.; Castro, Mario; Chung, K. Fan; Fitzpatrick, Anne; Israel, Elliot; Teague, W. Gerald; Wenzel, Sally E.; Love, Thomas E.; Gaston, Benjamin M.

2015-01-01

Background Severe asthma occurs more often in older adult patients. We hypothesized that the greater risk for severe asthma in older individuals is due to aging, and is independent of asthma duration. Methods This is a cross-sectional study of prospectively collected data from adult participants (N=1130; 454 with severe asthma) enrolled from 2002 – 2011 in the Severe Asthma Research Program. Results The association between age and the probability of severe asthma, which was performed by applying a Locally Weighted Scatterplot Smoother, revealed an inflection point at age 45 for risk of severe asthma. The probability of severe asthma increased with each year of life until 45 years and thereafter increased at a much slower rate. Asthma duration also increased the probability of severe asthma but had less effect than aging. After adjustment for most comorbidities of aging and for asthma duration using logistic regression, asthmatics older than 45 maintained the greater probability of severe asthma [OR: 2.73 (95 CI: 1.96; 3.81)]. After 45, the age-related risk of severe asthma continued to increase in men, but not in women. Conclusions Overall, the impact of age and asthma duration on risk for asthma severity in men and women is greatest over times of 18-45 years of age; age has a greater effect than asthma duration on risk of severe asthma. PMID:26200463

Lectures on counterexamples in several complex variables

CERN Document Server

Fornæss, John Erik

2007-01-01

Counterexamples are remarkably effective for understanding the meaning, and the limitations, of mathematical results. Fornæss and Stensønes look at some of the major ideas of several complex variables by considering counterexamples to what might seem like reasonable variations or generalizations. The first part of the book reviews some of the basics of the theory, in a self-contained introduction to several complex variables. The counterexamples cover a variety of important topics: the Levi problem, plurisubharmonic functions, Monge-Ampère equations, CR geometry, function theory, and the \\bar\\

[Cervical lymphoadenopathy due to Pseudomonas aeruginosa following mesotherapy].

Science.gov (United States)

Shaladi, Ali Muftah; Crestani, Francesco; Bocchi, Anna; Saltari, Maria Rita; Piva, Bruno; Tartari, Stefano

2009-09-01

Mesotherapy is a treatment method devised for controlling several diseases by means of subcutaneous microinjections given at or around the affected areas at short time intervals. It is used to treat a variety of medical conditions, amongst which all orthopaedic diseases and rheumatic pain. Mesotherapy is especially indicated for neck pain. The mechanism of action is twofold: a pharmacological effect due to the drug administered, and a reflexogenic effect, the skin containing many nerve endings that are sensitive to the mechanical action of the needle. Although this therapy is safe, like any other medical intervention it cannot be considered free of complications that may occur, such as allergies, haematomas, bruising, wheals, granulomas and telangiectasias. Infective complications are also possible, due to pathogenic bacteria that are inoculated through contamination of products, of the materials used for the procedure or even from germs on the skin. We present the case of a patient who had cervical lymphadenopathy due to Pseudomonas aeruginosa after mesotherapy treatment for neck pain.

Development of Severe Accident Containment Analysis Package

Energy Technology Data Exchange (ETDEWEB)

Park, Chang-Hwan; Kim, Dong-Min; Seo, Jea-Uk; Lee, Dea-Young; Park, Soon-Ho; Lee, Jae-Gwon; Lee, Jin-Yong; Lee, Byung-Chul [FNC Technology Co., Yongin (Korea, Republic of)

2016-10-15

In safety viewpoint, the pressure and temperature of the containment is the important parameters, of course, the local hydrogen concentration is also the parameter of the major concern because of its flammability and the risk of the detonation. In addition, there are possibilities of occurrence of other relevant phenomena following the reactor core melting such as DCH(direct containment heating) due to HPME(high pressure melt ejection), steam explosion due to fuel-coolant interaction in the reactor cavity and molten core concrete interaction at the late stage. It is important to predict the containment responses during a severe accident by a reasonable accuracy for establishing of effective mitigation strategies and preparation of the safety features required. In this paper, the overview of the SACAP development status is presented. SACAP is developed so as to be able to analyze, so called, Ex-Vessel severe accident phenomena including thermal-hydraulics, combustible gas burn, direct containment heating, steam explosion and molten core-concrete interaction. At the parallel time, SACAP and In-Vessel analysis module named CSPACE are processed for integration through MPI communication coupling. Development of the integrated severe accident analysis code system will be completed in following one year to make the code revision zero to be released.

Flame acceleration due to wall friction: Accuracy and intrinsic limitations of the formulations

Science.gov (United States)

Demirgok, Berk; Sezer, Hayri; Akkerman, V.'Yacheslav

2015-11-01

The analytical formulations on the premixed flame acceleration induced by wall friction in two-dimensional (2D) channels [Bychkov et al., Phys. Rev. E 72 (2005) 046307] and cylindrical tubes [Akkerman et al., Combust. Flame 145 (2006) 206] are revisited. Specifically, pipes with one end closed are considered, with a flame front propagating from the closed pipe end to the open one. The original studies provide the analytical formulas for the basic flame and fluid characteristics such as the flame acceleration rate, the flame shape and its propagation speed, as well as the flame-generated flow velocity profile. In the present work, the accuracy of these approaches is verified, computationally, and the intrinsic limitations and validity domains of the formulations are identified. Specifically, the error diagrams are presented to demonstrate how the accuracy of the formulations depends on the thermal expansion in the combustion process and the Reynolds number associated with the flame propagation. It is shown that the 2D theory is accurate enough for a wide range of parameters. In contrast, the zeroth-order approximation for the cylindrical configuration appeared to be quite inaccurate and had to be revisited. It is subsequently demonstrated that the first-order approximation for the cylindrical geometry is very accurate for realistically large thermal expansions and Reynolds numbers. Consequently, unlike the zeroth-order approach, the first-order formulation can constitute a backbone for the comprehensive theory of the flame acceleration and detonation initiation in cylindrical tubes. Cumulatively, the accuracy of the formulations deteriorates with the reduction of the Reynolds number and thermal expansion.

Ergonomic practices within patient care units are associated with musculoskeletal pain and limitations

Science.gov (United States)

Dennerlein, Jack T.; Hopcia, Karen; Sembajwe, Grace; Kenwood, Christopher; Stoddard, Anne M.; Tveito, T. Helene; Hashimoto, Dean M.; Sorensen, Glorian

2013-01-01

Background With the high prevalence of musculoskeletal disorders (MSDs) for patient care unit workers, prevention efforts through ergonomic practices within units may be related to symptoms associated with typical work-related MSDs. Methods We completed a cross-sectional survey of patient care workers (n=1572) in two large academic hospitals in order to evaluate relationships between self-reported musculoskeletal pain, work interference due to this pain, and limitations during activities of daily living (functional limitations) and with ergonomic practices and other organizational policy and practices metrics within the unit. Bivariate and multiple logistic regression analyses tested the significance of these associations. Results Prevalence of self-reported musculoskeletal symptoms in the past 3-months was 74% with 53% reporting pain in the low back. 32.8% reported that this pain interfered with their work duties and 17.7% reported functional limitations in the prior week. Decreased ergonomic practices were significantly associated with reporting pain in four body areas (low back, neck/shoulder, arms, and lower extremity) in the previous 3-months, interference with work caused by this pain, symptom severity and limitations in completing activities of daily living in the past week. Except for low back pain and work interference, these associations remained significant when psychosocial covariates such as psychological demands were included in multiple logistic regressions, Conclusions Ergonomic practices appear to be associated with many of the musculoskeletal symptoms denoting their importance for prevention efforts in acute health care settings. PMID:22113975

Electrical characteristics of an ideal tokamak limiter

International Nuclear Information System (INIS)

Motley, R.W.

1981-01-01

The intrusion of an equipotential poloidal limiter into the edge plasma of a circular tokamak discharge distorts the axisymmetry in several ways: (1) it (partially) shorts out the top-to-bottom Pfirsch-Schlueter potentials, (2) it creates zones of reversed equilibrium current flow into the limiter, and (3) it generates an electrostatic field opposing the loop current. The resulting boundary mismatch between the outer layers and the inner axisymmetric Pfirsch-Schlueter layer increases the free energy available to drive the edge plasma unstable. A number of special limiters are proposed to symmetrize the edge plasma and thereby reduce the electrical and MHD activity in the boundary layer. (author)

Hyperammonemic encephalopathy due to suture line breakdown after bladder operation.

Science.gov (United States)

Boogerd, W; Zoetmulder, F A; Moffie, D

1990-01-01

A patient is described with a severe encephalopathy and hyperammonemia in absence of liver dysfunction, attributed to urine absorption into the systemic circulation due to suture line breakdown after bladder dome resection. At autopsy characteristic Alzheimer type II astrocytes were found in the basal ganglia.

Discuss the technology for decrease the detection limit of NaI(Tl) gamma spectrometer

International Nuclear Information System (INIS)

Guo Xiaobin; Qu Guopu; Liu Zhiying; Wang Hongyan; Wang Lieming

2011-01-01

The radioelement species is complex and quantity is few after nuclear explosion, thus it is hard to tell the difference when using the Nal (TI) Gamma spectrometer detection due to several kinds of the peak of nuclide overlapped in the scattering region. So there is a high demand for spectrometer stability, energy resolution, solution spectrum and minimum detective activity. The paper analysed the influenced factors to Nal (TI) Gamma spectrometer and the measures of detection limit decrease by experiments and MCNP simulation, which proposed the methods to reduce background through shielding in order to improve minimum detective activity. The experiment shows that choosing reasonable shielding can reduce the background effectively and improve the spectrometer low level radioactive detect ability. (authors)

Immediate and long-term relationship between severe maternal morbidity and health-related quality of life: a prospective double cohort comparison study

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Mohd Noor Norhayati

2016-08-01

Full Text Available Abstract Background Given the growing interest in severe maternal morbidity (SMM, the need to assess its effects on quality of life is pressing. The objective of this study was to compare the quality of life scores between women with and without SMM at 1-month and 6-month postpartum in Kelantan, Malaysia. Methods A prospective double cohort study design was applied at two tertiary referral hospitals over a 6-month period. The study population included all postpartum women who delivered in 2014. Postpartum women with and without SMM were selected as the exposed and non-exposed groups, respectively. For each exposed case identified, a non-exposed case with a similar mode of delivery was selected. The main outcome measures used were scores from the Short Form-12 Health Survey (SF-12. Results The study measured 145 exposed and 187 non-exposed women. The group-time interaction of the repeated measure analysis of variance (RM ANOVA showed no significant difference in the mean overall SF-12 physical component summary score changes (P = 0.534 between women with and without SMM. Similarly, the group-time interaction of the RM ANOVA showed no significant difference in the mean overall SF-12 mental component summary score changes (P = 0.674 between women with and without SMM. However, women with SMM scored significantly lower on a general health perceptions subscale at 1-month (P = 0.031, role limitations due to physical health subscale at 6-month (P = 0.019, vitality subscale at 1-month (P = 0.007 and 6-month (P = 0.008, and role limitations due to emotional problems subscales at 6-month (P = 0.008. Conclusions Women with severe maternal morbidity demonstrated comparable quality of life during the 6-month postpartum period compared to women without severe maternal morbidity.

Casimir effect: The classical limit

International Nuclear Information System (INIS)

Feinberg, J.; Mann, A.; Revzen, M.

2001-01-01

We analyze the high temperature (or classical) limit of the Casimir effect. A useful quantity which arises naturally in our discussion is the 'relative Casimir energy', which we define for a configuration of disjoint conducting boundaries of arbitrary shapes, as the difference of Casimir energies between the given configuration and a configuration with the same boundaries infinitely far apart. Using path integration techniques, we show that the relative Casimir energy vanishes exponentially fast in temperature. This is consistent with a simple physical argument based on Kirchhoff's law. As a result the 'relative Casimir entropy', which we define in an obviously analogous manner, tends, in the classical limit, to a finite asymptotic value which depends only on the geometry of the boundaries. Thus the Casimir force between disjoint pieces of the boundary, in the classical limit, is entropy driven and is governed by a dimensionless number characterizing the geometry of the cavity. Contributions to the Casimir thermodynamical quantities due to each individual connected component of the boundary exhibit logarithmic deviations in temperature from the behavior just described. These logarithmic deviations seem to arise due to our difficulty to separate the Casimir energy (and the other thermodynamical quantities) from the 'electromagnetic' self-energy of each of the connected components of the boundary in a well defined manner. Our approach to the Casimir effect is not to impose sharp boundary conditions on the fluctuating field, but rather take into consideration its interaction with the plasma of 'charge carriers' in the boundary, with the plasma frequency playing the role of a physical UV cutoff. This also allows us to analyze deviations from a perfect conductor behavior

Kinetic theory of plasma in the limiter-scrape-off layer

International Nuclear Information System (INIS)

Daybelge, U.; Bein, B.

1977-01-01

An asymptotic solution is given for the ion-drift-kinetic equation with a full Fokker--Planck term for the limiter-scrape-off layer in a tokamak. In this layer, the plasma is assumed to consist of hot, collisionless ions, and cold, collisional electrons. From the solution of the boundary-layer problem, ion and electron particle and energy losses to the limiter are calculated. Limiter load profiles due to ions are explicitly given as functions of the poloidal angle

Chest computed tomography of a patient revealing severe hypoxia due to amniotic fluid embolism: a case report

Directory of Open Access Journals (Sweden)

Inui Daisuke

2010-02-01

Full Text Available Abstract Introduction Amniotic fluid embolism is one of the most severe complications in the peripartum period. Because its onset is abrupt and fulminant, it is unlikely that there will be time to examine the condition using thoracic computed tomography (CT. We report a case of life-threatening amniotic fluid embolism, where chest CT in the acute phase was obtained. Case presentation A 22-year-old Asian Japanese primiparous woman was suspected of having an amniotic fluid embolism. After a Cesarean section for cephalopelvic disproportion, her respiratory condition deteriorated. Her chest CT images were examined. CT findings revealed diffuse homogeneous ground-glass shadow in her bilateral peripheral lung fields. She was therefore transferred to our hospital. On admission to our hospital's intensive care unit, she was found to have severe hypoxemia, with SpO2 of 50% with a reservoir mask of 15 L/min oxygen. She was intubated with the support of noninvasive positive pressure ventilation. She was successfully extubated on the sixth day, and discharged from the hospital on the twentieth day. Conclusion This is the first case report describing amniotic fluid embolism in which CT revealed an acute respiratory distress syndrome-like shadow.

Shipping container response to three severe railway accident scenarios

International Nuclear Information System (INIS)

Mok, G.C.; Fischer, L.E.; Murty, S.S.; Witte, M.C.

1998-01-01

The probability of damage and the potential resulting hazards are analyzed for a representative rail shipping container for three severe rail accident scenarios. The scenarios are: (1) the rupture of closure bolts and resulting opening of closure lid due to a severe impact, (2) the puncture of container by an impacting rail-car coupler, and (3) the yielding of container due to side impact on a rigid uneven surface. The analysis results indicate that scenario 2 is a physically unreasonable event while the probabilities of a significant loss of containment in scenarios 1 and 3 are extremely small. Before assessing the potential risk for the last two scenarios, the uncertainties in predicting complex phenomena for rare, high- consequence hazards needs to be addressed using a rigorous methodology

Decision Threshold and Detection Limit in Spectrometric Measurements. Part 1: Application to Gamma Spectrometry

International Nuclear Information System (INIS)

Perez, C.; Gasco, C.; Lopez, M. A.

2010-01-01

This report summarised the author's lecture of the advanced gamma spectrometry course organised by CIEMAT. The characteristic limits determination in gamma spectrometry generally is obtained through the programming that the trade marks offers to the client with the objective of the automatic calculation of the activity concentrations existing in a sample. In this report, the examples shown in the ISO 11929 standard are compared to the programming realised by Genie 2k for determining characteristic limits. The main difference of both is located in the uncertainty calculations due to the efficiency calibration that is considered by ISO and not by Genie 2K. Through implementation in the software developed by trade marks will be possible to introduce this uncertainty and to assimilate to the calculation done by ISO 11929. In the second part of this report will be analyzed the more complicated samples of this application as counting in a whole body counter (following ISO-28218 about Performance Criteria for radio bioassay), multiplet, overlapping, addition of several peaks for obtaining the activity concentration, etc. (Author) 19 refs.

Clinical-anthropometric characteristics of COPD outpatients belonging to the different groups and having different severity of airway obstruction

Directory of Open Access Journals (Sweden)

Gashynova K.Y.

2015-06-01

Full Text Available The aim of the study was to compare the clinical and anthropometric characteristics of patients with COPD, which differ in the degree of airways obstruction and belong to groups A, B, C, D in accordance with GOLD, 2011 classification. A total of 112 ambulatory COPD patients in remission made the study sample. Anthropometric data, body mass index, medical history, dyspnea by mMRC scale, and spirometry was performed for all patients. There was confirmed that outpatients with COPD is a heterogeneous group, in which the majority are those with moderate (48.22 % and severe (30.36 %, airway obstruction. Despite the vast majority of men among outpatients, the percentage of women among patients with mild to moderate obstruction (22.58±5.31 % was significantly higher (p=0.002 as compared with those with severe or very severe limitation of airflow (6.00±3.36 %. Patients with severe and very severe obstruction were of significantly older age (p = 0.024. At the same time, the distribution of patients according to the GOLD, 2011 classification, demonstrate that all groups did not differ on any of the anthropometric indicators, including gender and age (p > 0.050. Distribution of patients by groups with different risk for future exacerbations is not a mirror image of gradation in accordance with the degree of airway obstruction. Every second (50.00±4.43 % of cases patient is included in group C and every tenth (10.20±4.32 % belongs to the group D not due to degree of bronchial obstruction, but due to the number of exa­cerbations in the past year. Therefore, in future studies it is advisable to use both principles of patients’ classification.

Analysis of performance limitations for superconducting cavities

International Nuclear Information System (INIS)

J. R. Delayen; L. R. Doolittle; C. E. Reece

1998-01-01

The performance of superconducting cavities in accelerators can be limited by several factors, such as: field emission, quenches, arcing, rf power; and the maximum gradient at which a cavity can operate will be determined by the lowest of these limitations for that particular cavity. The CEBAF accelerator operates with over 300 cavities and, for each of them, the authors have determined the maximum operating gradient and its limiting factor. They have developed a model that allows them to determine the distribution of gradients that could be achieved for each of these limitations independently of the others. The result of this analysis can guide an R and D program to achieve the best overall performance improvement. The same model can be used to relate the performance of single-cell and multi-cell cavities

Monitoring severe accidents using AI techniques

Energy Technology Data Exchange (ETDEWEB)

No, Young Gyu; Ahn, Kwang Il [Korea Atomic Energy Research Institute, Daejeon (Korea, Republic of); Kim, Ju Hyun; Na, Man Gyun [Dept. of Nuclear Engineering, Chosun University, Gwangju (Korea, Republic of); Lim, Dong Hyuk [Korea Institute of Nuclear Nonproliferation and Control, Daejon (Korea, Republic of)

2012-05-15

After the Fukushima nuclear accident in 2011, there has been increasing concern regarding severe accidents in nuclear facilities. Severe accident scenarios are difficult for operators to monitor and identify. Therefore, accurate prediction of a severe accident is important in order to manage it appropriately in the unfavorable conditions. In this study, artificial intelligence (AI) techniques, such as support vector classification (SVC), probabilistic neural network (PNN), group method of data handling (GMDH), and fuzzy neural network (FNN), were used to monitor the major transient scenarios of a severe accident caused by three different initiating events, the hot-leg loss of coolant accident (LOCA), the cold-leg LOCA, and the steam generator tube rupture in pressurized water reactors (PWRs). The SVC and PNN models were used for the event classification. The GMDH and FNN models were employed to accurately predict the important timing representing severe accident scenarios. In addition, in order to verify the proposed algorithm, data from a number of numerical simulations were required in order to train the AI techniques due to the shortage of real LOCA data. The data was acquired by performing simulations using the MAAP4 code. The prediction accuracy of the three types of initiating events was sufficiently high to predict severe accident scenarios. Therefore, the AI techniques can be applied successfully in the identification and monitoring of severe accident scenarios in real PWRs.

Monitoring severe accidents using AI techniques

International Nuclear Information System (INIS)

No, Young Gyu; Ahn, Kwang Il; Kim, Ju Hyun; Na, Man Gyun; Lim, Dong Hyuk

2012-01-01

After the Fukushima nuclear accident in 2011, there has been increasing concern regarding severe accidents in nuclear facilities. Severe accident scenarios are difficult for operators to monitor and identify. Therefore, accurate prediction of a severe accident is important in order to manage it appropriately in the unfavorable conditions. In this study, artificial intelligence (AI) techniques, such as support vector classification (SVC), probabilistic neural network (PNN), group method of data handling (GMDH), and fuzzy neural network (FNN), were used to monitor the major transient scenarios of a severe accident caused by three different initiating events, the hot-leg loss of coolant accident (LOCA), the cold-leg LOCA, and the steam generator tube rupture in pressurized water reactors (PWRs). The SVC and PNN models were used for the event classification. The GMDH and FNN models were employed to accurately predict the important timing representing severe accident scenarios. In addition, in order to verify the proposed algorithm, data from a number of numerical simulations were required in order to train the AI techniques due to the shortage of real LOCA data. The data was acquired by performing simulations using the MAAP4 code. The prediction accuracy of the three types of initiating events was sufficiently high to predict severe accident scenarios. Therefore, the AI techniques can be applied successfully in the identification and monitoring of severe accident scenarios in real PWRs.

Pathophysiological mechanisms of severe anaemia in Malawian children.

Directory of Open Access Journals (Sweden)

Michaël Boele van Hensbroek

2010-09-01

Full Text Available Severe anaemia is a major cause of morbidity and mortality in African children. The aetiology is multi-factorial, but interventions have often targeted only one or a few causal factors, with limited success.We assessed the contribution of different pathophysiological mechanisms (red cell production failure [RCPF], haemolysis and blood loss to severe anaemia in Malawian children in whom etiological factors have been described previously. More complex associations between etiological factors and the mechanisms were explored using structural equation modelling. In 235 children with severe anaemia (haemoglobin<3.2 mMol/L [5.0 g/dl] studied, RCPF, haemolysis and blood loss were found in 48.1%, 21.7% and 6.9%, respectively. The RCPF figure increased to 86% when a less stringent definition of RCPF was applied. RCPF was the most common mechanism in each of the major etiological subgroups (39.7-59.7%. Multiple aetiologies were common in children with severe anaemia. In the final model, nutritional and infectious factors, including malaria, were directly or indirectly associated with RCPF, but not with haemolysis.RCPF was the most common pathway leading to severe anaemia, from a variety of etiological factors, often found in combination. Unlike haemolysis or blood loss, RCPF is a defect that is likely to persist to a significant degree unless all of its contributing aetiologies are corrected. This provides a further explanation for the limited success of the single factor interventions that have commonly been applied to the prevention or treatment of severe anaemia. Our findings underline the need for a package of measures directed against all of the local aetiologies of this often fatal paediatric syndrome.

Acute skin lesions due to localized ''hot particle'' radiation exposures

International Nuclear Information System (INIS)

Baum, J.W.; Carsten, A.L.; Kaurin, D.G.L.; Schaefer, C.W.

1996-01-01

Purpose of the studies was to determine incidence and severity of lesions resulting from localized deposition of dose to the skin from small ( 2 at 70μm depth) from isotopes having max beta particle energies from about 0.3-3 MeV. Incidence of erythema and scabs (indicating ulceration) were scored routinely for up to 71 days post-irradiation. Responses followed normal probability distributions, and thus, no true threshold could be defined. Ten and 50% incidence rates were deduced using probit analyses. Lowest dose producing 10% incidence was about 1 Gy for exposures to Yb-175 (0.5 MeV max energy) beta particles. Severity of lesions was estimated using diameters and persistence. From preliminary considerations of probability of induction, size, and persistence of acute lesions, a special limit for hot particle exposures in the range of 5-50 Gy may be reasonable, with an action level between about 1 Gy and the limit

Numerical design of electron guns and space charge limited transport systems

International Nuclear Information System (INIS)

Herrmannsfeldt, W.B.

1980-10-01

This paper describes the capabilities and limitations of computer programs used to design electron guns and similarly space-charge limited transport systems. Examples of computer generated plots from several different types of gun problems are included

Severe dermatophytosis due to Trichophyton mentagrophytes var. interdigitale in flocks of green iguanas (Iguana iguana).

Science.gov (United States)

Khosravi, A R; Shokri, H; Rostami, A; Tamai, I A; Erfanmanesh, A; Memarian, I

2012-05-01

To describe the clinical, mycological, histopathological and molecular findings in green iguanas (Iguana iguana) affected with severe dermatophytosis in selected flocks near Tehran, Iran. Samples were collected from the scales of skin lesions and tested with standard mycological methods and dermatophyte-specific PCR amplification analysis using the primer pair for the chitin synthase 1(CHS1) gene. All iguanas were definitively diagnosed with dermatophytosis using both traditional and molecular diagnostic methods. PCR fingerprinting profiles using simple repetitive (GACA)4 primers showed that all diagnosed iguanas had the same pattern profile. Intraspecific variability was not observed for these isolates. Oligonucleotide sequencing of CHS1 gene PCR products confirmed Trichophyton mentagrophytes var. interdigitale as the infectious agent. These results suggest that (GACA)4-based PCR has utility both as a simple and rapid method for identification of dermatophyte species and for differentiation of T. mentagrophytes variants. © 2012 British Small Animal Veterinary Association.

The burden of severe asthma in childhood and adolescence

DEFF Research Database (Denmark)

Fleming, Louise; Murray, Clare; Bansal, Aruna T

2015-01-01

U-BIOPRED aims to characterise paediatric and adult severe asthma using conventional and innovative systems biology approaches. A total of 99 school-age children with severe asthma and 81 preschoolers with severe wheeze were compared with 49 school-age children with mild/moderate asthma and 53...... in the severe wheeze cohort. Almost all participants in each cohort were atopic and had a normal body mass index. Asthma-related quality of life, as assessed by the Paediatric Asthma Quality of Life Questionnaire (PAQLQ) and the Paediatric Asthma Caregiver's Quality of Life Questionnaire (PACQLQ), was worse...... and mild/moderate cohorts were clinically very similar. Children with severe preschool wheeze or severe asthma are usually atopic and have impaired quality of life that is associated with poor control and airflow limitation: a very different phenotype from adult severe asthma. In-depth phenotyping...

Ubiquitous-severance hospital project: implementation and results.

Science.gov (United States)

Chang, Bung-Chul; Kim, Nam-Hyun; Kim, Young-A; Kim, Jee Hea; Jung, Hae Kyung; Kang, Eun Hae; Kang, Hee Suk; Lee, Hyung Il; Kim, Yong Ook; Yoo, Sun Kook; Sunwoo, Ilnam; An, Seo Yong; Jeong, Hye Jeong

2010-03-01

The purpose of this study was to review an implementation of u-Severance information system with focus on electronic hospital records (EHR) and to suggest future improvements. Clinical Data Repository (CDR) of u-Severance involved implementing electronic medical records (EMR) as the basis of EHR and the management of individual health records. EHR were implemented with service enhancements extending to the clinical decision support system (CDSS) and expanding the knowledge base for research with a repository for clinical data and medical care information. The EMR system of Yonsei University Health Systems (YUHS) consists of HP integrity superdome servers using MS SQL as a database management system and MS Windows as its operating system. YUHS is a high-performing medical institution with regards to efficient management and customer satisfaction; however, after 5 years of implementation of u-Severance system, several limitations with regards to expandability and security have been identified.

Limitations Of The Current State Space Modelling Approach In Multistage Machining Processes Due To Operation Variations

Science.gov (United States)

Abellán-Nebot, J. V.; Liu, J.; Romero, F.

2009-11-01

The State Space modelling approach has been recently proposed as an engineering-driven technique for part quality prediction in Multistage Machining Processes (MMP). Current State Space models incorporate fixture and datum variations in the multi-stage variation propagation, without explicitly considering common operation variations such as machine-tool thermal distortions, cutting-tool wear, cutting-tool deflections, etc. This paper shows the limitations of the current State Space model through an experimental case study where the effect of the spindle thermal expansion, cutting-tool flank wear and locator errors are introduced. The paper also discusses the extension of the current State Space model to include operation variations and its potential benefits.

Seizure Severity Is Correlated With Severity of Hypoxic-Ischemic Injury in Abusive Head Trauma.

Science.gov (United States)

Dingman, Andra L; Stence, Nicholas V; O'Neill, Brent R; Sillau, Stefan H; Chapman, Kevin E

2017-12-12

The objective of this study was to characterize hypoxic-ischemic injury and seizures in abusive head trauma. We performed a retrospective study of 58 children with moderate or severe traumatic brain injury due to abusive head trauma. Continuous electroencephalograms and magnetic resonance images were scored. Electrographic seizures (51.2%) and hypoxic-ischemic injury (77.4%) were common in our cohort. Younger age was associated with electrographic seizures (no seizures: median age 13.5 months, interquartile range five to 25 months, versus seizures: 4.5 months, interquartile range 3 to 9.5 months; P = 0.001). Severity of hypoxic-ischemic injury was also associated with seizures (no seizures: median injury score 1.0, interquartile range 0 to 3, versus seizures: 4.5, interquartile range 3 to 8; P = 0.01), but traumatic injury severity was not associated with seizures (no seizures: mean injury score 3.78 ± 1.68 versus seizures: mean injury score 3.83 ± 0.95, P = 0.89). There was a correlation between hypoxic-ischemic injury severity and seizure burden when controlling for patient age (r s =0.61, P interquartile range 0 to 0.23 on magnetic resonance imaging done within two days versus median restricted diffusion ratio 0.13, interquartile range 0.01 to 0.43 on magnetic resonance imaging done after two days, P = 0.03). Electrographic seizures are common in children with moderate to severe traumatic brain injury from abusive head trauma, and therefore children with suspected abusive head trauma should be monitored with continuous electroencephalogram. Severity of hypoxic-ischemic brain injury is correlated with severity of seizures, and evidence of hypoxic-ischemic injury on magnetic resonance imaging may evolve over time. Therefore children with a high seizure burden should be reimaged to evaluate for evolving hypoxic-ischemic injury. Published by Elsevier Inc.

Reliability Evaluation of Bridges Based on Nonprobabilistic Response Surface Limit Method

OpenAIRE

Chen, Xuyong; Chen, Qian; Bian, Xiaoya; Fan, Jianping

2017-01-01

Due to many uncertainties in nonprobabilistic reliability assessment of bridges, the limit state function is generally unknown. The traditional nonprobabilistic response surface method is a lengthy and oscillating iteration process and leads to difficultly solving the nonprobabilistic reliability index. This article proposes a nonprobabilistic response surface limit method based on the interval model. The intention of this method is to solve the upper and lower limits of the nonprobabilistic ...

An outbreak of gastroenteritis due to Escherichia coli 0142 H6 in a neonatal department

NARCIS (Netherlands)

Gerards, L. J.; Hennekam, R. C.; von Dijk, W. C.; Roord, J. J.; Fleer, A.

1984-01-01

An outbreak of gastroenteritis due to Escherichia coli 0142 H6 in a neonatal ward is described. The epidemic affected 16 of 24 infants (infection-rate 66 per cent), of whom one died due to necrotizing enterocolitis. Administration of antibiotics was of limited value in treatment or in eradicating E.

Length limits fail to restructure a Largemouth Bass population: A 28‐year case history

Science.gov (United States)

Miranda, Leandro E.; Colvin, M.E.; Shamaskin, A. C.; Bull, L. A.; Holman, T.; Jones, R.

2017-01-01

Length limits have been implemented by fisheries management agencies to achieve population density, size structure, and angler satisfaction objectives. By redirecting harvest towards or away from particular length‐ or age‐groups, length limits rely on harvest by anglers to maintain a population at or near a desired state. The fish population changes that follow the implementation of harvest regulations may take several years to manifest, so long‐term monitoring may be needed to adequately evaluate length limits. We used an innovative application of cluster analysis to facilitate evaluation of the effects of three consecutive length limits on a population of Largemouth Bass Micropterus salmoides over a 28‐year period in Ross Barnett Reservoir, Mississippi. A 13–16‐in protected slot length limit (10 years), followed by a 15‐in minimum length limit (MLL; 11 years), followed by a 12‐in MLL (7 years) failed to restructure the Largemouth Bass population due to what we suggest was the expansion of a voluntary catch‐and‐release attitude that started in the first decade of the study period. Various population metrics shifted towards values expected in an unharvested population, and the observed shifts can be attributed to a harvest deficit created by the prevailing catch‐and‐release attitude. Largemouth Bass harvest regulations may no longer be relevant in many waters. The utility of regulations for restructuring Largemouth Bass populations is largely dependent on harvesting attitudes that vary geographically, depending on cultural characteristics and demographics.

Prenatal Stress due to a Natural Disaster Predicts Adiposity in Childhood: The Iowa Flood Study

Directory of Open Access Journals (Sweden)

Kelsey N. Dancause

2015-01-01

Full Text Available Prenatal stress can affect lifelong physical growth, including increased obesity risk. However, human studies remain limited. Natural disasters provide models of independent stressors unrelated to confounding maternal characteristics. We assessed degree of objective hardship and subjective distress in women pregnant during severe flooding. At ages 2.5 and 4 years we assessed body mass index (BMI, subscapular plus triceps skinfolds (SS + TR, an index of total adiposity, and SS : TR ratio (an index of central adiposity in their children (n=106. Hierarchical regressions controlled first for several potential confounds. Controlling for these, flood exposure during early gestation predicted greater BMI increase from age 2.5 to 4, as well as total adiposity at 2.5. Greater maternal hardship and distress due to the floods, as well as other nonflood life events during pregnancy, independently predicted greater increase in total adiposity between 2.5 and 4 years. These results support the hypothesis that prenatal stress increases adiposity beginning in childhood and suggest that early gestation is a sensitive period. Results further highlight the additive effects of maternal objective and subjective stress, life events, and depression, emphasizing the importance of continued studies on multiple, detailed measures of maternal mental health and experience in pregnancy and child growth.

Stretch due to Penile Prosthesis Reservoir Migration

Directory of Open Access Journals (Sweden)

E. Baten

2016-03-01

Full Text Available A 43-year old patient presented to the emergency department with stretch, due to impossible deflation of the penile prosthesis, 4 years after successful implant. A CT-scan showed migration of the reservoir to the left rectus abdominis muscle. Refilling of the reservoir was inhibited by muscular compression, causing stretch. Removal and replacement of the reservoir was performed, after which the prosthesis was well-functioning again. Migration of the penile prosthesis reservoir is extremely rare but can cause several complications, such as stretch.

Nonconvulsive status epilepticus due to ifosfamide.

Science.gov (United States)

Kilickap, Saadettin; Cakar, Mustafa; Onal, Ibrahim K; Tufan, Abdurrahman; Akoglu, Hadim; Aksoy, Sercan; Erman, Mustafa; Tekuzman, Gulten

2006-02-01

To report 2 cases of nonconvulsive status epilepticus (NCSE) following infusion of ifosfamide. Two patients who received ifosfamide-containing chemotherapy developed NCSE. One woman received ifosfamide 1000 mg/m2 (1 h infusion on days 1-5); confusion, lethargy, and speech deterioration developed on day 3. The second patient developed similar symptoms on day 3 of treatment with 2500 mg/m2. Both patients responded to intravenous administration of diazepam 10 mg and were given levetiracetam as maintenance therapy. The severity and presentation of central nervous system toxicity due to ifosfamide varies greatly and involves a spectrum ranging from subclinical electroencephalogram changes to coma. NCSE, an epileptic disorder in which typical convulsive activity is absent, has previously been reported in only 4 patients receiving ifosfamide. Levetiracetam may be used for maintenance antiepileptic therapy after diazepam administration. Among the many presentations of ifosfamide neurotoxicity, clinicians should consider NCSE as a possible explanation for changes in consciousness in a patient receiving this agent. An objective causality assessment by use of the Naranjo probability scale revealed that NCSE due to ifosfamide was probable.

Variable Eddington factors and flux-limiting diffusion coefficients

International Nuclear Information System (INIS)

Whalen, P.P.

1982-01-01

Variable Eddington factors and flux limiting diffusion coefficients arise in two common techniques of closing the moment equations of transport. The first two moment equations of the full transport equation are still frequently used to solve many problems of radiative or particle transport. An approximate analysis, developed by Levermore, exhibits the relation between the coefficients of the two different techniques. This analysis is described and then used to test the validity of several commonly used flux limiters and Eddington factors. All of the ad-hoc flux limiters have limited validity. All of the variable Eddington factors derived from some underlying description of the angular distribution function are generally valid. The use of coefficients from Minerbo's elegant maximum entropy Eddington factor analysis is suggested for use in either flux limited diffusion or variable Eddington factor equations

Assesment of safe discharge limits in the nuclear industry

International Nuclear Information System (INIS)

Van As, D.

1984-01-01

Routine releases from the nuclear industry to the environment are controlled by three principles, viz. that the practice creating the effluents should be kept as low as reasonably achievable, and radiation dose limits should not be exceeded. In the nuclear industry, the discharge of radioactive effluent is controlled by a system of dose limitation. The application of this system to conventional effluents require: i) a quantitative relationship between intake and effect so as to establish intake limits; ii) environmental models that will allow calculation of the relationship between discharge and intake; iii) a measure of the total detriment due to the discharge. For such a system discharge limits can be established for the desired level of risk (safety)

Admissions through the emergency department due to drug-related problems

International Nuclear Information System (INIS)

Yosef H Al-Olah; Khalifa M Al Thiab

2010-01-01

Hospital admissions due to drug-related problems (DRPs) have been studied internationally, but local data are limited. Therefore, we undertook a prospective, observational study of all admissions through the emergency department (ED) at a tertiary referral hospital in Saudi Arabia to determine the incidence of admissions through the ED due to DRPs, types of DRPs, length of stay (LOS) in the hospital after ED admissions due to DRPs, and assessment of preventability of admissions due to DRPs.All admissions through the ED over a period of 28 consecutive days were evaluated to determine if they were due to definite or possible DRPs. Data was collected on a daily basis for each admission over the previous 24 hours. Each incident was assessed by three investigators Of 557 patients admitted through the ED, 82 (14.7%) admissions were due to DRP (53 definite, 29 possible). The most common types of DRP were failure to receive medication in 25 cases (47.2%), an adverse drug reaction in 13 cases (24.5%), and drug overdose in 6 cases (11.3%). In the definite DRP group, 83.0% were definitely preventable, 3.8% were possibly preventable and 13.2% were definitely non-preventable.DRPs are a serious and costly issue facing health care professionals and health care systems. Most admissions due to DRPs are avoidable (Author).

Fear of movement, passive coping, manual handling, and severe or radiating pain increase the likelihood of sick leave due to low back pain.

Science.gov (United States)

Dawson, Anna P; Schluter, Philip J; Hodges, Paul W; Stewart, Simon; Turner, Catherine

2011-07-01

Sick leave due to low back pain (LBP-SL) is costly and compromises workforce productivity. The fear-avoidance model asserts that maladaptive pain-related cognitions lead to avoidance and disuse, which can perpetuate ongoing pain. Staying home from work is an avoidant behavior, and hence pain-related psychological features may help explain LBP-SL. We examined the relative contribution of pain catastrophizing, fear of movement, and pain coping (active and passive) in LBP-SL in addition to pain characteristics and other psychosocial, occupational, general health, and demographic factors. Two-way interactions between age and gender and candidate exposures were also considered. Our sample comprised 2164 working nurses and midwives with low back pain in the preceding year. Binary logistic regression was performed on cross-sectional data by manual backward stepwise elimination of nonsignificant terms to generate a parsimonious multivariable model. From an extensive array of exposures assessed, fear of movement (women, odds ratio [OR]=1.05, 95% confidence interval [CI] 1.02-1.08; men, OR=1.17, 95% CI 1.05-1.29), passive coping (OR=1.07, 95% CI 1.04-1.11), pain severity (OR=1.61, 95% CI 1.50-1.72), pain radiation (women, OR=1.45, 95% CI 1.10-1.92; men, OR=4.13, 95% CI 2.15-7.95), and manual handling frequency (OR=1.03, 95% CI 1.01-1.05) increased the likelihood of LBP-SL in the preceding 12 months. Administrators and managers were less likely to report LBP-SL (OR=0.44, 95% CI 0.27-0.71), and age had a protective effect in individuals in a married or de facto relationship (OR=0.97, 95% CI 0.95-0.98). In summary, fear of movement, passive coping, frequent manual handling, and severe or radiating pain increase the likelihood of LBP-SL. Gender-specific responses to pain radiation and fear of movement are evident. Crown Copyright © 2011. Published by Elsevier B.V. All rights reserved.

Peak-counts blood flow model-errors and limitations

International Nuclear Information System (INIS)

Mullani, N.A.; Marani, S.K.; Ekas, R.D.; Gould, K.L.

1984-01-01

The peak-counts model has several advantages, but its use may be limited due to the condition that the venous egress may not be negligible at the time of peak-counts. Consequently, blood flow measurements by the peak-counts model will depend on the bolus size, bolus duration, and the minimum transit time of the bolus through the region of interest. The effect of bolus size on the measurement of extraction fraction and blood flow was evaluated by injecting 1 to 30ml of rubidium chloride in the femoral vein of a dog and measuring the myocardial activity with a beta probe over the heart. Regional blood flow measurements were not found to vary with bolus sizes up to 30ml. The effect of bolus duration was studied by injecting a 10cc bolus of tracer at different speeds in the femoral vein of a dog. All intravenous injections undergo a broadening of the bolus duration due to the transit time of the tracer through the lungs and the heart. This transit time was found to range from 4-6 second FWHM and dominates the duration of the bolus to the myocardium for up to 3 second injections. A computer simulation has been carried out in which the different parameters of delay time, extraction fraction, and bolus duration can be changed to assess the errors in the peak-counts model. The results of the simulations show that the error will be greatest for short transit time delays and for low extraction fractions

Low cost continuous femoral nerve block for relief of acute severe cancer related pain due to pathological fracture femur

Directory of Open Access Journals (Sweden)

Rachel Cherian Koshy