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Sample records for speeds hemostasis trial

  1. Endoscopic hemostasis for peptic ulcer bleeding: systematic review and meta-analyses of randomized controlled trials.

    Science.gov (United States)

    Baracat, Felipe; Moura, Eduardo; Bernardo, Wanderley; Pu, Leonardo Zorron; Mendonça, Ernesto; Moura, Diogo; Baracat, Renato; Ide, Edson

    2016-06-01

    Peptic ulcer represents the most common cause of upper gastrointestinal bleeding. Endoscopic therapy can reduce the risks of rebleeding, continued bleeding, need for surgery, and mortality. The objective of this review is to compare the different modalities of endoscopic therapy. Studies were identified by searching electronic databases MEDLINE, Embase, Cochrane, LILACS, DARE, and CINAHL. We selected randomized clinical trials that assessed contemporary endoscopic hemostatic techniques. The outcomes evaluated were: initial hemostasis, rebleeding rate, need for surgery, and mortality. The possibility of publication bias was evaluated by funnel plots. An additional analysis was made, including only the higher-quality trials. Twenty-eight trials involving 2988 patients were evaluated. Injection therapy alone was inferior to injection therapy with hemoclip and with thermal coagulation when evaluating rebleeding and the need for emergency surgery. Hemoclip was superior to injection therapy in terms of rebleeding; there were no statistically significant differences between hemoclip alone and hemoclip with injection therapy. There was considerable heterogeneity in the comparisons between hemoclip and thermal coagulation. There were no statistically significant differences between thermal coagulation and injection therapy, though their combination was superior, in terms of rebleeding, to thermal coagulation alone. Injection therapy should not be used alone. Hemoclip is superior to injection therapy, and combining hemoclip with an injectate does not improve hemostatic efficacy above hemoclip alone. Thermal coagulation has similar efficacy as injection therapy; combining these appears to be superior to thermal coagulation alone. Therefore, we recommend the application of hemoclips or the combined use of injection therapy with thermal coagulation for the treatment of peptic ulcer bleeding.

  2. Kelainan Hemostasis pada Leukemia

    Directory of Open Access Journals (Sweden)

    Zelly Dia Rofinda

    2012-09-01

    Full Text Available AbstrakLatar belakang: Leukemia adalah penyakit keganasan pada jaringan hematopoietik yang ditandai denganpenggantian elemen sumsum tulang normal oleh sel darah abnormal atau sel leukemik. Salah satu manifestasi klinisdari leukemia adalah perdarahan yang disebabkan oleh berbagai kelainan hemostasis.Kelainan hemostasis yang dapat terjadi pada leukemia berupa trombositopenia, disfungsi trombosit,koagulasi intravaskuler diseminata, defek protein koagulasi, fibrinolisis primer dan trombosis. Patogenesis danpatofosiologi kelainan hemostasis pada leukemia tersebut terjadi dengan berbagai mekanisme.Kata kunci: leukemia, kelainan hemostasisAbstractBackground: AbstractLeukemia is a malignancy of hematopoietic tissue which is characterized bysubstituted of bone marrow element with abnormal blood cell or leukemic cell. One of clinical manifestation ofleukemia is bleeding that is caused by several hemostasis disorders.Hemostasis disorders in leukemia such asthrombocytopenia, platelet dysfunction, disseminated intravascular coagulation, coagulation protein defect, primaryfibrinolysis and thrombosis. Pathogenesis and pathophysiology of thus hemostasis disorders in leukemia occur withdifferent mechanism.Keywords: leukemia, hemostasis disorder

  3. Hemostasis and ageing

    OpenAIRE

    Mari, D.; Ogliari, G.; Castaldi, D.; Vitale, G.; Bollini, E.M.; Lio, D.

    2008-01-01

    Abstract On March 19, 2008 a Symposium on Pathophysiology of Ageing and Age-Related Diseases was held in Palermo, Italy. The lecture of D. Mari on Hemostasis and ageing is summarized herein. Physiological ageing is associated with increased plasma levels of many proteins of blood coagulation together with fibrinolysis impairment. This may be of great concern in view of the known association between vascular and thromboembolic diseases and ageing. On the other hand, centenarians are characteri...

  4. New models of hemostasis.

    Science.gov (United States)

    McMichael, Maureen

    2012-05-01

    Hemostasis is an essential protective mechanism that depends on a delicate balance of procoagulant and anticoagulant processes. The waterfall/cascade models of coagulation are useful for understanding several essential steps of coagulation in vitro. These have resulted in the creation of the plasma-based tests used commonly and the ability to identify deficiencies in the extrinsic, intrinsic, and common pathways of coagulation. The model was also essential in elucidating the role of several of the inhibitors of coagulation and is currently used to demonstrate coagulation as it occurs in plasma in a static environment that is devoid of endothelial interactions. The intrinsic pathway originally described by these models does not appear to be essential for in vivo hemostasis but may play a role in pathologic thrombosis. The waterfall/cascade models' lack of cellular elements sets the stage for the cell-based model of coagulation. The cell-based model of blood coagulation, which includes the varied, complicated network of factors necessary for appropriate in vivo coagulation to occur, was the next step in the evolution of our understanding of coagulation. Recently, researchers have focused on real-time, in vivo models of hemostasis and this research reveals unexpected phenomena. Copyright © 2012 Elsevier Inc. All rights reserved.

  5. The FINISH-3 Trial : A Phase 3, International, Randomized, Single-Blind, Controlled Trial of Topical Fibrocaps in Intraoperative Surgical Hemostasis

    NARCIS (Netherlands)

    Bochicchio, Grant V.; Gupta, Navyash; Porte, Robert J.; Renkens, Kenneth L.; Pattyn, Piet; Topal, Baki; Troisi, Roberto Ivan; Muir, William; Chetter, Ian; Gillen, Daniel L.; Zuckerman, Linda A.; Frohna, Paul A.

    BACKGROUND: This Phase 3, international, randomized, single-blind, controlled trial (FINISH-3) compared the efficacy and safety of Fibrocaps, a ready-to-use, dry-powder fibrin sealant containing human plasma-derived thrombin and fibrinogen, vs gelatin sponge alone for use as a hemostat for surgical

  6. A refined model of the genomic basis for phenotypic variation in vertebrate hemostasis.

    Science.gov (United States)

    Ribeiro, Ângela M; Zepeda-Mendoza, M Lisandra; Bertelsen, Mads F; Kristensen, Annemarie T; Jarvis, Erich D; Gilbert, M Thomas P; da Fonseca, Rute R

    2015-06-30

    Hemostasis is a defense mechanism that enhances an organism's survival by minimizing blood loss upon vascular injury. In vertebrates, hemostasis has been evolving with the cardio-vascular and hemodynamic systems over the last 450 million years. Birds and mammals have very similar vascular and hemodynamic systems, thus the mechanism that blocks ruptures in the vasculature is expected to be the same. However, the speed of the process varies across vertebrates, and is particularly slow for birds. Understanding the differences in the hemostasis pathway between birds and mammals, and placing them in perspective to other vertebrates may provide clues to the genetic contribution to variation in blood clotting phenotype in vertebrates. We compiled genomic data corresponding to key elements involved in hemostasis across vertebrates to investigate its genetic basis and understand how it affects fitness. We found that: i) fewer genes are involved in hemostasis in birds compared to mammals; and ii) the largest differences concern platelet membrane receptors and components from the kallikrein-kinin system. We propose that lack of the cytoplasmic domain of the GPIb receptor subunit alpha could be a strong contributor to the prolonged bleeding phenotype in birds. Combined analysis of laboratory assessments of avian hemostasis with the first avian phylogeny based on genomic-scale data revealed that differences in hemostasis within birds are not explained by phylogenetic relationships, but more so by genetic variation underlying components of the hemostatic process, suggestive of natural selection. This work adds to our understanding of the evolution of hemostasis in vertebrates. The overlap with the inflammation, complement and renin-angiotensin (blood pressure regulation) pathways is a potential driver of rapid molecular evolution in the hemostasis network. Comparisons between avian species and mammals allowed us to hypothesize that the observed mammalian innovations might have

  7. Speed

    Indian Academy of Sciences (India)

    First page Back Continue Last page Overview Graphics. Speed. The rate of information transferred per second is the speed of the information. Measured in bits per second. Need for speed on the net: You-Tube phenomenon; IPTV; 3D Video telephony. Online gaming; HDTV.

  8. Hemostasis and endothelial damage during sepsis.

    Science.gov (United States)

    Johansen, Maria Egede

    2015-08-01

    as infection severity. In the second study of the thesis, the role of endothelial damage during sepsis was explored. Levels of biomarkers of superficial and profound endothelial damage (syndecan-1 and soluble thrombomodulin (sTM), respectively) were determined in a cohort of 1103 critically ill patients. The results showed that only high levels of sTM were associated with a markedly increased risk of 90-day mortality, as well as multi-organ failure. The finding suggests that profound damage to the endothelium is centrally involved in the pathogenesis of death in sepsis. Thus, the endothelium may be a target for new interventions against sepsis. In the third study, we investigated, using a randomized controlled trial, how mild induced hypothermia (cooling to 32-34°C for 24 hours, MIH) influenced sepsis-related coagulopathy using TEG; functional coagulopathy improved in patients exposed to the intervention compared with the control group. This improvement of coagulopathy parameters during MIH persisted after rewarming. These results not only add to the understanding of the effect of hypothermia on the hemostatic system, but indicate that MIH reduces sepsis-related coagulopathy assessed by TEG. Overall, this thesis emphasizes that the role of the hemostatic system during sepsis is not only complex, but centrally involved in disease severity and prognosis. The endothelium seems to play a central role in the morbidity and mortality of sepsis, which cannot be explained simply by the presences of organ failure. Thus, restoring the broken endothelium and reducing coagulopathy appears to be essential in order to significantly improve sepsis out-comes. MIH could be a promising intervention in sepsis, in part due to the improvement of the coagulopathy. Despite the increased focus on the hemostatic system during sepsis, it seems that continued research on restoring disrupted hemostasis - including endothelial damage - is needed.

  9. Pacing Strategy, Muscle Fatigue and Technique in 1500m Speed Skating and Cycling Time-Trials

    NARCIS (Netherlands)

    Stoter, Inge K; MacIntosh, Brian R; Fletcher, Jared R; Pootz, Spencer; Zijdewind, Inge; Hettinga, Florentina J

    2016-01-01

    PURPOSE: To evaluate pacing behavior and peripheral and central contributions to muscle fatigue in 1500m speed skating and cycling time-trials, when a faster or slower start is instructed. METHODS: Nine speed skaters and nine cyclists, all competing at regional or national level, performed two 1500m

  10. Pacing Strategy, Muscle Fatigue, and Technique in 1500-m Speed-Skating and Cycling Time Trials.

    Science.gov (United States)

    Stoter, Inge K; MacIntosh, Brian R; Fletcher, Jared R; Pootz, Spencer; Zijdewind, Inge; Hettinga, Florentina J

    2016-04-01

    To evaluate pacing behavior and peripheral and central contributions to muscle fatigue in 1500-m speed-skating and cycling time trials when a faster or slower start is instructed. Nine speed skaters and 9 cyclists, all competing at regional or national level, performed two 1500-m time trials in their sport. Athletes were instructed to start faster than usual in 1 trial and slower in the other. Mean velocity was measured per 100 m. Blood lactate concentrations were measured. Maximal voluntary contraction (MVC), voluntary activation (VA), and potentiated twitch (PT) of the quadriceps muscles were measured to estimate central and peripheral contributions to muscle fatigue. In speed skating, knee, hip, and trunk angles were measured to evaluate technique. Cyclists showed a more explosive start than speed skaters in the fast-start time trial (cyclists performed first 300 m in 24.70 ± 1.73 s, speed skaters in 26.18 ± 0.79 s). Both trials resulted in reduced MVC (12.0% ± 14.5%), VA (2.4% ± 5.0%), and PT (25.4% ± 15.2%). Blood lactate concentrations after the time trial and the decrease in PT were greater in the fast-start than in the slow-start trial. Speed skaters showed higher trunk angles in the fast-start than in the slow-start trial, while knee angles remained similar. Despite similar instructions, behavioral adaptations in pacing differed between the 2 sports, resulting in equal central and peripheral contributions to muscle fatigue in both sports. This provides evidence for the importance of neurophysiological aspects in the regulation of pacing. It also stresses the notion that optimal pacing needs to be studied sport specifically, and coaches should be aware of this.

  11. Study of hemostasis procedures for posterior epistaxis.

    Science.gov (United States)

    Iimura, Jiro; Hatano, Atsushi; Ando, Yuji; Arai, Chiaki; Arai, Satoshi; Shigeta, Yasushi; Kojima, Hiromi; Otori, Nobuyoshi; Wada, Kota

    2016-06-01

    Hemostasis is difficult in patients with bleeding emanating from the deep regions in the nasal cavity; however, there is no standard treatment method. We studied hemostasis procedures in patients who visited our outpatient department and presented with idiopathic epistaxis extending from the posterior nasal cavity to Kiesselbach's area. The subjects were patients with epistaxis who visited our hospital between June 2008 and May 2010. We asked specific questions at the time of the hospital visit and examined patients using a nasal speculum, a flexible endoscope, and a rigid endoscope (0 or 70 degree) to identify bleeding sites. Hemostasis using electrocoagulation was selected as the first-line therapy for patients in whom a bleeding point had been identified, whereas hemostasis using a gauze tampon was performed in patients in whom the bleeding point was unknown. The subjects were analyzed by multivariate logistic regression analysis. The bleeding point was unknown in most cases of recurrent posterior epistaxis. Electrocoagulation was the best hemostasis procedure. Identifying the bleeding points as much as possible and performing electrocoagulation at these sites was the preferred procedures. We propose the treatment procedure for refractory epistaxis. When it is difficult to identify a bleeding point in a patient with refractory epistaxis due to a deviated nasal septum, a bleeding point should be identified after septoplasty; for bleeding from the sphenopalatine artery region, electrocoagulation or endoscopic cauterization of the sphenopalatine artery should be performed. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  12. Gender related issues in thrombosis and hemostasis

    DEFF Research Database (Denmark)

    Hvas, Anne-Mette; Favaloro, Emmanuel J

    2017-01-01

    Introduction: Many aspects of hemostasis, both primary and secondary, as well as fibrinolysis display sex differences. From a clinical viewpoint, certain differential phenotypic presentations clearly arise within various disorders of thrombosis and hemostasis. Areas covered: The present mini......-review summarizes selected clinical entities where sex differences are reflected in both frequency and clinical presentation of hemostasis disorders. Sex differences are discussed within the settings of cardiovascular disease, including coronary artery disease and ischemic stroke, venous thromboembolism...... and inherited bleeding disorders. Moreover, pregnancy and labor present particular challenges in terms of increased thromboembolic and bleeding risk, and this is also summarized. Expert commentary: Available knowledge on sex differences in risk factors and clinical presentation of disorders within thrombosis...

  13. Critical laboratory values in hemostasis: toward consensus.

    Science.gov (United States)

    Lippi, Giuseppe; Adcock, Dorothy; Simundic, Ana-Maria; Tripodi, Armando; Favaloro, Emmanuel J

    2017-09-01

    The term "critical values" can be defined to entail laboratory test results that significantly lie outside the normal (reference) range and necessitate immediate reporting to safeguard patient health, as well as those displaying a highly and clinically significant variation compared to previous data. The identification and effective communication of "highly pathological" values has engaged the minds of many clinicians, health care and laboratory professionals for decades, since these activities are vital to good laboratory practice. This is especially true in hemostasis, where a timely and efficient communication of critical values strongly impacts patient management. Due to the heterogeneity of available data, this paper is hence aimed to analyze the state of the art and provide an expert opinion about the parameters, measurement units and alert limits pertaining to critical values in hemostasis, thus providing a basic document for future consultation that assists laboratory professionals and clinicians alike. KEY MESSAGES Critical values are laboratory test results significantly lying outside the normal (reference) range and necessitating immediate reporting to safeguard patient health. A broad heterogeneity exists about critical values in hemostasis worldwide. We provide here an expert opinion about the parameters, measurement units and alert limits pertaining to critical values in hemostasis.

  14. Technological advances in the hemostasis laboratory.

    Science.gov (United States)

    Lippi, Giuseppe; Plebani, Mario; Favaloro, Emmanuel J

    2014-03-01

    Automation is conventionally defined as the use of machines, control systems, and information technologies to optimize productivity. Although automation is now commonplace in several areas of diagnostic testing, especially in clinical chemistry and immunochemistry, the concept of extending this process to hemostasis testing has only recently been advanced. The leading drawbacks are still represented by the almost unique biological matrix because citrated plasma can only be used for clotting assays and few other notable exceptions, and by the highly specific pretreatment of samples, which is particularly distinct to other test systems. Despite these important limitations, a certain degree of automation is also now embracing hemostasis testing. The more relevant developments include the growing integration of routine hemostasis analyzers with track line systems and workcells, the development of specific instrumentation tools to enhance reliability of testing (i.e., signal detection with different technologies to increase test panels, plasma indices for preanalytical check of interfering substances, failure patterns sensors for identifying insufficient volume, clots or bubbles, cap-piercing for enhancing operator safety, automatic reflex testing, automatic redilution of samples, and laser barcode readers), preanalytical features (e.g., positive identification, automatic systems for tube(s) labeling, transillumination devices), and postphlebotomy tools (pneumatic tube systems for reducing turnaround time, sample transport boxes for ensuring stability of specimens, monitoring systems for identifying unsuitable conditions of transport). Regardless of these important innovations, coagulation/hemostasis testing still requires specific technical and clinical expertise, not only in terms of measurement procedures but also for interpreting and then appropriately utilizing the derived information. Thus, additional and special caution has to be used when designing projects of

  15. Hemostasis in Hypothyroidism and Autoimmune Thyroid Disorders

    OpenAIRE

    Ordookhani, Arash; Burman, Kenneth D.

    2017-01-01

    Context There are contradictory results on the effect of hypothyroidism on the changes in hemostasis. Inadequate population-based studies limited their clinical implications, mainly on the risk of venous thromboembolism (VTE). This paper reviews the studies on laboratory and population-based findings regarding hemostatic changes and risk of VTE in hypothyroidism and autoimmune thyroid disorders. Evidence Acquisition A comprehensive literature search was conducted employing MEDLINE database. T...

  16. Hemostasis in Overt and Subclinical Hyperthyroidism

    OpenAIRE

    Ordookhani, Arash; Burman, Kenneth D.

    2017-01-01

    Context There are contradictory results on the effect of hyperthyroidism on hemostasis. Inadequate population-based studies limited their clinical implications, mainly on the risk of venous thromboembolism (VTE). The present review focuses on hemostatic changes in overt and subclinical hyperthyroidism. Methods A systematic literature search was conducted employing MEDLINE database. The following words were used for the search: Hyperthyroidism; thyrotoxicosis; Graves disease; goiter, nodular; ...

  17. Hemostasis in Hypothyroidism and Autoimmune Thyroid Disorders.

    Science.gov (United States)

    Ordookhani, Arash; Burman, Kenneth D

    2017-04-01

    There are contradictory results on the effect of hypothyroidism on the changes in hemostasis. Inadequate population-based studies limited their clinical implications, mainly on the risk of venous thromboembolism (VTE). This paper reviews the studies on laboratory and population-based findings regarding hemostatic changes and risk of VTE in hypothyroidism and autoimmune thyroid disorders. A comprehensive literature search was conducted employing MEDLINE database. The following words were used for the search: Hypothyroidism; thyroiditis, autoimmune; blood coagulation factors; blood coagulation tests; hemostasis, blood coagulation disorders; thyroid hormones; myxedema; venous thromboembolism; fibrinolysis, receptors thyroid hormone. The papers that were related to hypothyroidism and autoimmune thyroid disorder and hemostasis are used in this review. Overt hypothyroidism is more associated with a hypocoagulable state. Decreased platelet count, aggregation and agglutination, von Willebrand factor antigen and activity, several coagulation factors such as factor VIII, IX, XI, VII, and plasminogen activator-1 are detected in overt hypothyrodism. Increased fibrinogen has been detected in subclinical hypothyroidism and autoimmune thyroid disease rendering a tendency towards a hypercoagulability state. Increased factor VII and its activity, and plasminogen activator inhibitor-1 are among several findings contributing to a prothrombotic state in subclinical hypothyroidism. Overt hypothyroidism is associated with a hypocoagulable state and subclinical hypothyroidism and autoimmune thyroid disorders may induce a prothrombotic state. However, there are contradictory findings for the abovementioned thyroid disorders. Prospective studies on the risk of VTE in various levels of hypofunctioning of the thyroid and autoimmune thyroid disorders are warranted.

  18. Hemostasis in Overt and Subclinical Hyperthyroidism

    Science.gov (United States)

    Ordookhani, Arash; Burman, Kenneth D.

    2017-01-01

    Context There are contradictory results on the effect of hyperthyroidism on hemostasis. Inadequate population-based studies limited their clinical implications, mainly on the risk of venous thromboembolism (VTE). The present review focuses on hemostatic changes in overt and subclinical hyperthyroidism. Methods A systematic literature search was conducted employing MEDLINE database. The following words were used for the search: Hyperthyroidism; thyrotoxicosis; Graves disease; goiter, nodular; hemostasis; blood coagulation factors; blood coagulation disorders; venous thromboembolism; bleeding; fibrinolysis. The articles that were related to hyperthyroidism and hemostasis are used in this manuscript. Results Hyperthyroidism, either overt or subclinical, renders a hypercoagulable state, although there are several studies with contradictory findings in the literature. Hypercoagulability may be caused by an increase in the level of various coagulation factors such as factor (F) VIII, FX, FIX, von Willebrand F (vWF), and fibrinogen, while hypofibrinolysis by changes in coagulation parameters such as a decrease in plasmin and plasmin activator or an increase in α2-antiplasmin, plasminogen activator inhibitor-1 and thrombin activatable fibrinolysis inhibitor Conclusions Although many reports are in favor of a hypercoagulable state in overt hyperthyroidism but this finding at the biochemical level and its clinical implication, on the occurrence of VTE, has yet to be confirmed. PMID:29201071

  19. How does speed affect the rebound effect in car travel? Conceptual issues explored in case study of 900 Formula 1 Grand Prix speed trials

    International Nuclear Information System (INIS)

    Galvin, Ray

    2017-01-01

    The “rebound effect” occurs when reductions in energy consumption following energy efficiency increases are lower than engineering estimates. In cars this happens when drivers increase their distance travelled or average speed, as a behavioural response to cheaper travel. Rebound effects due to increased distance travelled have been extensively studied, but only one existing study attempts to quantify rebound effects due to increased average speed. This paper builds on that study, using a much larger empirical base and offering more generalised and more widely applicable mathematical modelling. It uses data from 30 Formula 1 Grand Prix time trial sessions of 10 vehicles doing 3 trials each, in 2014 and 2015. The heavily regulated Formula 1 regime, with its precisely measured data, provides a highly controlled framework for developing mathematics of average speed rebounds. The study thereby shows how speed and distance rebounds can be coherently combined in road vehicle travel to produce total rebound figures. It then shows how even small increases in average speed can nullify all the energy savings that are expected from energy efficiency increases. It also raises critical questions on the adequacy of proposed new road vehicle fuel efficiency testing procedures. - Highlights: • Rebound effects in car travel have been well studied for distance but not speed. • But speed rebound effects reduce fuel savings from energy efficiency upgrades. • A mathematical model is developed for dealing with average speed rebounds. • This model is tested with precise data from 900 Formula 1 Grand Prix time trials. • It is shown how speed and distance rebounds can be combined in everyday car travel.

  20. Clinical use of femoral artery hemostasis sticking after interventional procedure via femoral artery access

    International Nuclear Information System (INIS)

    Zhu Zhongsheng; Chen Shaoliang; Ye Fei; Zhang Junjie; Zhou Jie; Tian Nailiang; Lin Song; Liu Zhizhong; Xiao Pingxi; Qu Hong

    2010-01-01

    Objective: To observe the clinical effect of the use of femoral artery hemostasis sticking V+PAD after the interventional procedure via femoral artery access. Methods: By using random permutation list 80 patients, who decided to receive coronary angiography and percutaneous transluminal coronary angioplasty, were randomly selected. Of the 80 patients, hemostasis sticking V + PAD was employed in 40 patients with even numbers (trial group), only manual compression was adopted to stop bleeding in another 40 patients with odd numbers (control group). All the patients were informed about this trial and had to sign a consent letter. The pressure time, the treatment method of access site after hemostasis, the posture in bed, the immobilization time, the comfort degree of patients, the complications of access site prior to discharge, etc. were observed and the results were compared between two groups. Results: There was no significant difference between two groups as respect to age, gender ratios,activated clotting time (ACT) value and blood pressure. However, significantly difference in the compression time and bed rest time existed between the two groups. The compression time in trial group and control group was (7.9 ± 0.5) min and (19.8 ± 5.1) min respectively (P<0.01), while the bed rest time in trial group and control group was (6.1 ± 5.0) hours and (23.9 ± 0.2) hours respectively (P<0.01). All patients in trial group was supine in bed with the head side of the bed raised at 30 degree immediately after the procedure, and the head side of the bed was further raised to 90 degree one hour later. The puncture site was bandaged with conventional compression and immobilization was not employed. Patients could lie in bed with free posture and the patient's comfort degree was greatly improved. During hospitalization no complications related to puncture site occurred in all patients except one obese woman in trial group who developed pseudoaneurysm. Conclusion: Femoral

  1. Toward a computational model of hemostasis

    Science.gov (United States)

    Leiderman, Karin; Danes, Nicholas; Schoeman, Rogier; Neeves, Keith

    2017-11-01

    Hemostasis is the process by which a blood clot forms to prevent bleeding at a site of injury. The formation time, size and structure of a clot depends on the local hemodynamics and the nature of the injury. Our group has previously developed computational models to study intravascular clot formation, a process confined to the interior of a single vessel. Here we present the first stage of an experimentally-validated, computational model of extravascular clot formation (hemostasis) in which blood through a single vessel initially escapes through a hole in the vessel wall and out a separate injury channel. This stage of the model consists of a system of partial differential equations that describe platelet aggregation and hemodynamics, solved via the finite element method. We also present results from the analogous, in vitro, microfluidic model. In both models, formation of a blood clot occludes the injury channel and stops flow from escaping while blood in the main vessel retains its fluidity. We discuss the different biochemical and hemodynamic effects on clot formation using distinct geometries representing intra- and extravascular injuries.

  2. Comparison of Hemostasis Times With a Kaolin-Based Hemostatic Pad (QuikClot Radial) vs Mechanical Compression (TR Band) Following Transradial Access: A Pilot Prospective Study.

    Science.gov (United States)

    Roberts, Jonathan S; Niu, Jianli; Pastor-Cervantes, Juan A

    2017-10-01

    Hemostasis following transradial access (TRA) is usually achieved by mechanical compression. We investigated use of the QuikClot Radial hemostasis pad (Z-Medica) compared with the TR Band (Terumo Medical) to shorten hemostasis after TRA. Thirty patients undergoing TRA coronary angiography and/or percutaneous coronary intervention were randomized into three cohorts post TRA: 10 patients received mechanical compression with the TR Band, 10 patients received 30 min of compression with the QuikClot Radial pad, and 10 patients received 60 min of compression with the QuikClot Radial pad. Times to hemostasis and access-site complications were recorded. Radial artery patency was evaluated 1 hour after hemostasis by the reverse Barbeau's test. There were no differences in patient characteristics, mean dose of heparin (7117 ± 1054 IU), or mean activated clotting time value (210 ± 50 sec) at the end of procedure among the three groups. Successful hemostasis was achieved in 100% of patients with both the 30-min and 60-min compression groups using the QuikClot pad. Hemostasis failure occurred in 50% of patients when the TR Band was initially weaned at the protocol-driven time (40 min after sheath removal). Mean compression time for hemostasis with the TR Band was 149.4 min compared with 30.7 min and 60.9 min for the 30-min and 60-min QuikClot groups, respectively. No radial artery occlusion occurred in any subject at the end of the study. Use of the QuikClot Radial pad following TRA in this pilot trial significantly shortened hemostasis times when compared with the TR Band, with no increased complications noted.

  3. Laboratory hemostasis: milestones in Clinical Chemistry and Laboratory Medicine.

    Science.gov (United States)

    Lippi, Giuseppe; Favaloro, Emmanuel J

    2013-01-01

    Hemostasis is a delicate, dynamic and intricate system, in which pro- and anti-coagulant forces cooperate for either maintaining blood fluidity under normal conditions, or else will prompt blood clot generation to limit the bleeding when the integrity of blood vessels is jeopardized. Excessive prevalence of anticoagulant forces leads to hemorrhage, whereas excessive activation of procoagulant forces triggers excessive coagulation and thrombosis. The hemostasis laboratory performs a variety of first, second and third line tests, and plays a pivotal role in diagnostic and monitoring of most hemostasis disturbances. Since the leading targets of Clinical Chemistry and Laboratory Medicine include promotion of progress in fundamental and applied research, along with publication of guidelines and recommendations in laboratory diagnostics, this journal is an ideal source of information on current developments in the laboratory technology of hemostasis, and this article is aimed to celebrate some of the most important and popular articles ever published by the journal in the filed of laboratory hemostasis.

  4. Brain training game improves executive functions and processing speed in the elderly: a randomized controlled trial.

    Science.gov (United States)

    Nouchi, Rui; Taki, Yasuyuki; Takeuchi, Hikaru; Hashizume, Hiroshi; Akitsuki, Yuko; Shigemune, Yayoi; Sekiguchi, Atsushi; Kotozaki, Yuka; Tsukiura, Takashi; Yomogida, Yukihito; Kawashima, Ryuta

    2012-01-01

    The beneficial effects of brain training games are expected to transfer to other cognitive functions, but these beneficial effects are poorly understood. Here we investigate the impact of the brain training game (Brain Age) on cognitive functions in the elderly. Thirty-two elderly volunteers were recruited through an advertisement in the local newspaper and randomly assigned to either of two game groups (Brain Age, Tetris). This study was completed by 14 of the 16 members in the Brain Age group and 14 of the 16 members in the Tetris group. To maximize the benefit of the interventions, all participants were non-gamers who reported playing less than one hour of video games per week over the past 2 years. Participants in both the Brain Age and the Tetris groups played their game for about 15 minutes per day, at least 5 days per week, for 4 weeks. Each group played for a total of about 20 days. Measures of the cognitive functions were conducted before and after training. Measures of the cognitive functions fell into four categories (global cognitive status, executive functions, attention, and processing speed). Results showed that the effects of the brain training game were transferred to executive functions and to processing speed. However, the brain training game showed no transfer effect on any global cognitive status nor attention. Our results showed that playing Brain Age for 4 weeks could lead to improve cognitive functions (executive functions and processing speed) in the elderly. This result indicated that there is a possibility which the elderly could improve executive functions and processing speed in short term training. The results need replication in large samples. Long-term effects and relevance for every-day functioning remain uncertain as yet. UMIN Clinical Trial Registry 000002825.

  5. Brain training game improves executive functions and processing speed in the elderly: a randomized controlled trial.

    Directory of Open Access Journals (Sweden)

    Rui Nouchi

    Full Text Available The beneficial effects of brain training games are expected to transfer to other cognitive functions, but these beneficial effects are poorly understood. Here we investigate the impact of the brain training game (Brain Age on cognitive functions in the elderly.Thirty-two elderly volunteers were recruited through an advertisement in the local newspaper and randomly assigned to either of two game groups (Brain Age, Tetris. This study was completed by 14 of the 16 members in the Brain Age group and 14 of the 16 members in the Tetris group. To maximize the benefit of the interventions, all participants were non-gamers who reported playing less than one hour of video games per week over the past 2 years. Participants in both the Brain Age and the Tetris groups played their game for about 15 minutes per day, at least 5 days per week, for 4 weeks. Each group played for a total of about 20 days. Measures of the cognitive functions were conducted before and after training. Measures of the cognitive functions fell into four categories (global cognitive status, executive functions, attention, and processing speed. Results showed that the effects of the brain training game were transferred to executive functions and to processing speed. However, the brain training game showed no transfer effect on any global cognitive status nor attention.Our results showed that playing Brain Age for 4 weeks could lead to improve cognitive functions (executive functions and processing speed in the elderly. This result indicated that there is a possibility which the elderly could improve executive functions and processing speed in short term training. The results need replication in large samples. Long-term effects and relevance for every-day functioning remain uncertain as yet.UMIN Clinical Trial Registry 000002825.

  6. Hemostasis in tubeless PNL: point of technique.

    Science.gov (United States)

    Aron, Monish; Goel, Rajiv; Kesarwani, Pawan K; Gupta, Narmada P

    2004-01-01

    Tubeless PNL (percutaneous nephrolithotomy), in a highly selected group of patients, is a modification aimed at reducing the morbidity of PNL. We present a simple technique of achieving tract hemostasis as an adjunct to the safe performance of a tubeless PNL. Charts of 40 consecutive patients who underwent tubeless PNL at our center were reviewed. In the latter 20 consecutive patients, diathermy coagulation of the intrarenal bleeders and tract was done and these patients were compared with the earlier 20 patients in whom fulguration was not done. Drop in hemoglobin, postoperative analgesic requirement, operating time, length of hospitalization and postoperative complications were compared. No statistical difference was found between the operative times and drop in hemoglobin for both the groups. The length of hospitalization and postoperative analgesic requirement were significantly less in the fulguration group. No significant complications were noted in either of the two groups. Fulguration of visible intrarenal and tract bleeders is a simple, safe and effective hemostatic adjunct in patients undergoing tubeless PNL. copyright 2004 S. Karger AG, Basel

  7. Lonomia obliqua Walker (Lepidoptera: Saturniidae: hemostasis implications

    Directory of Open Access Journals (Sweden)

    Silviane Maggi

    2015-06-01

    Full Text Available Summary In southern Brazil, since 1989, several cases of accidents produced by unwilling contact with the body of poisonous caterpillars of the moth species Lonomia obliqua Walker, 1855 (Lepidoptera: Saturniidae, were described. L. obliqua caterpillars have gregarious behavior and feed on leaves of host trees during the night, staying grouped in the trunk during the day, which favors the occurrence of accidents with the species. This caterpillar has the body covered with bristles that on contact with the skin of individuals, breaks and release their contents, inoculating the venom into the victim. The basic constitution of the venom is protein and its components produce physiological changes in the victim, which include disturbances in hemostasis. Hemorrhagic syndrome associated with consumption coagulopathy, intravascular hemolysis and acute renal failure are some of the possible clinical manifestations related to poisoning by L. obliqua. Specific laboratory tests for diagnosis of poisoning have not been described previously. The diagnosis of poisoning is made based on the patient's medical history, clinical manifestations, erythrocyte levels, and, primarily, parameters that evaluate blood coagulation. Treatment is performed with the use of supportive care and the administration of specific hyperimmune antivenom. Poisoning can be serious and even fatal.

  8. Offline identification of imagined speed of wrist movements in paralyzed ALS patients from single-trial EEG

    Directory of Open Access Journals (Sweden)

    Ying Gu

    2009-08-01

    Full Text Available The study investigated the possibility of identifying the speed of an imagined movement from EEG recordings in amyotrophic lateral sclerosis (ALS patients. EEG signals were acquired from four ALS patients during imagination of wrist extensions at two speeds (fast and slow, each repeated up to 100 times in random order. The movement-related cortical potentials (MRCPs and averaged sensorimotor rhythm associated with the two tasks were obtained from the EEG recordings. Moreover, offline single-trial EEG classification was performed with discrete wavelet transform for feature extraction and support vector machine for classification. The speed of the task was encoded in the time delay of peak negativity in the MRCPs, which was shorter for faster than for slower movements. The average single-trial misclassification rate between speeds was 30.4 ± 3.5 % when the best scalp location and time interval were selected for each individual. The scalp location and time interval leading to the lowest misclassification rate varied among patients. The results indicate that the imagination of movements at different speeds is a viable strategy for controlling a brain-computer interface system by ALS patients.

  9. Acute Management of Hemostasis in Patients With Neurological Injury.

    Science.gov (United States)

    Baharoglu, M Irem; Brand, Anneke; Koopman, Maria M; Vermeulen, Marinus; Roos, Yvo B W E M

    2017-10-01

    Neurological injuries can be divided into those with traumatic and nontraumatic causes. The largest groups are traumatic brain injury (TBI) and nontraumatic stroke. TBI patients may present with intracranial hemorrhages (contusions, or subdural or epidural hematomas). Strokes are ischemic or hemorrhagic. In all these disorders, thrombosis and hemostasis play a major role. Treatment aims to either cease bleeding and/or restore perfusion. We reviewed hemostatic and thrombolytic therapies in patients with neurological injuries by MEDLINE and EMBASE search using various key words for neurological disorders and hemostatic therapies restricted to English language and human adults. Review of articles fulfilling inclusion criteria and relevant references revealed that, in patients with ischemic stroke, intravenous thrombolytic therapy with recombinant tissue plasminogen activator within 4.5-5 hours after onset of symptoms improves clinical outcome. In contrast, there are no hemostatic therapies that are proven to improve clinical outcome of patients with hemorrhagic stroke or TBI. In patients with hemorrhagic stroke who use vitamin K antagonist or direct oral anticoagulants, there is evidence that specific reversal therapies improve hemostatic laboratory parameters but without an effect on clinical recovery. In patients with hemorrhagic stroke or TBI who use concomitant antiplatelet therapy, there is evidence for harm of platelet transfusion. In patients with aneurysmal subarachnoid hemorrhage, tranexamic acid was shown to reduce rebleeding rate without improving clinical outcome. The effects of tranexamic acid in patients with TBI are still under investigation. We conclude that, in patients with ischemic stroke, thrombolytic therapy improves outcome when given within 4.5-5 hours. In hemorrhagic stroke and TBI, most hemostatic therapies improved or corrected laboratory parameters but not clinical outcome. Currently, in several trials, the effects of tranexamic acid are

  10. The state of hemostasis in pregnant women with hydramnion

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    I. A. Lyoshenko

    2016-05-01

    Abstract Purpose. To determine the state of various stages of hemostasis in pregnant women with hydramnion as a risk factor for premature detachment of the placenta. Results. There was investigated the state of hemostasis in pregnant women with hydramnion by low piezoelectric thromboelastography (LPTEG and standard coagulogram. According to the LPTEG results this group of women was found to have increased plasma coagulation potential manifested in elevated constant thrombin activity (TAC by 76.8%, the intensity of coagulation drive (ICD by 74.9%, maximum clot density (MA by 16.8%, shortening of coagulation time (T3 by 7.8% and inhibition of fibrinolysis manifested by decrease in retraction intensity and clot lysis (RICL by 67.7% (p<0.05. Conclusions. The state of hemostasis in pregnant women with hydramnion is characterized by increased plasma coagulation and inhibition of fibrinolysis potential that are factors of preparing the woman’s body for the upcoming birth to control and minimize blood loss.   Keywords: pregnancy, hydramnion, hemostasis, thromboelastography.

  11. Effects of inhaled nitric oxide on hemostasis in healthy adults treated with heparin: a randomized, controlled, blinded crossover study

    Directory of Open Access Journals (Sweden)

    Goldstein Brahm

    2012-01-01

    Full Text Available Abstract Background Effects of nitric oxide (NO on hemostasis have been studied in various investigational settings, but data regarding inhaled NO on bleeding and platelet function are conflicting. It is not known if inhaled NO has an effect when administered with drugs that influence hemostasis. This trial evaluated effects of inhaled NO on hemostasis in the presence of heparin using aspirin as a positive control. Patients/Methods Twelve healthy adult males were enrolled in a single-center, randomized, single-blind, four-way crossover trial. Subjects received 80 ppm NO or medical air (placebo inhalation for 30 min with simultaneous injection of placebo or heparin. Aspirin capsules were used as a positive control. Parameters of hemostasis were measured before treatment and at post-treatment intervals. Results Activated clotting time (ACT, prothrombin time (PT and activated partial thromboplastin time (aPTT increased only in groups that received heparin. Areas under the curve for ACT in heparin groups receiving inhaled NO were judged to be equivalent to those receiving medical air for both 0- to 4-h (ratio: 1.00; 90% CI, 0.90-1.11 and 0- to 24-h time intervals (ratio: 1.01; 90% CI, 0.92-1.12. Changes in bleeding time and platelet aggregation were observed only in aspirin groups. No clinically significant changes in hemoglobin, red blood cell counts or haematocrit were observed in any group. Conclusions Inhaled NO, when administered with heparin, exhibited no significant additive effects on ACT, PT, aPTT, bleeding time or platelet aggregation.

  12. Hemostatic efficacy of TachoSil in liver resection compared with argon beam coagulator treatment: An open, randomized, prospective, multicenter, parallel-group trial

    DEFF Research Database (Denmark)

    Fischer, Lars; Seiler, Christoph M.; Broelsch, Christoph E.

    2011-01-01

    surgical trial with 2 parallel groups. Patients were eligible for intra-operative randomization after elective resection of ≥1 liver segment and primary hemostasis. The primary end point was the time to hemostasis after starting the randomized intervention to obtain secondaty hemostasis. Secondary end...

  13. The acute effects of heavy back and front squats on speed during forty-meter sprint trials.

    Science.gov (United States)

    Yetter, Mike; Moir, Gavin L

    2008-01-01

    The purpose of the present study was to investigate the effects of performing heavy back squats (HBS) and heavy front squats (HFS) on the average speed during each 10-m interval of 40-m sprint trials. In a randomized, cross-over design, 10 strength-trained men performed a HBS, HFS, or control treatment before performing three 40-m sprint trials separated by 3 minutes. The HBS and HFS treatments consisted of performing parallel back or front squats with 30%, 50%, and 70% of the subject's 1 repetition maximum after 5 minutes of cycling. The control treatment consisted of cycling for 5 minutes. The sprint trials were performed 4 minutes after completing the HBS, HFS, or control treatments. Significant increases in speed were found during the 10- to 20-m interval for the HBS compared with the control treatment (mean difference, 0.12 m x s(-1); 95% likely range, 0.05-0.18 m x s(-1); P = 0.001). During the 30- to 40-m interval, HBS produced significantly greater speeds compared with the HFS treatment (mean difference, 0.24 m x s(-1); 95% likely range, 0.02-0.45 m x s(-1); P = 0.034) and the control treatment (mean difference, 0.18 m x s(-1); 95% likely range, 0.03-0.32 m x s(-1); P = 0.021). The differing effects of the treatments may reflect different levels of muscular activation or different mechanical aspects of the squat exercises. Similarly, the multidimensional nature of sprint running means that other specific exercises may confer improvements in sprinting performance during other intervals. It is suggested that coaches could incorporate HBS into the warm-up procedure of athletes to improve sprinting performance.

  14. Brain training game boosts executive functions, working memory and processing speed in the young adults: a randomized controlled trial.

    Directory of Open Access Journals (Sweden)

    Rui Nouchi

    Full Text Available BACKGROUND: Do brain training games work? The beneficial effects of brain training games are expected to transfer to other cognitive functions. Yet in all honesty, beneficial transfer effects of the commercial brain training games in young adults have little scientific basis. Here we investigated the impact of the brain training game (Brain Age on a wide range of cognitive functions in young adults. METHODS: We conducted a double-blind (de facto masking randomized controlled trial using a popular brain training game (Brain Age and a popular puzzle game (Tetris. Thirty-two volunteers were recruited through an advertisement in the local newspaper and randomly assigned to either of two game groups (Brain Age, Tetris. Participants in both the Brain Age and the Tetris groups played their game for about 15 minutes per day, at least 5 days per week, for 4 weeks. Measures of the cognitive functions were conducted before and after training. Measures of the cognitive functions fell into eight categories (fluid intelligence, executive function, working memory, short-term memory, attention, processing speed, visual ability, and reading ability. RESULTS AND DISCUSSION: Our results showed that commercial brain training game improves executive functions, working memory, and processing speed in young adults. Moreover, the popular puzzle game can engender improvement attention and visuo-spatial ability compared to playing the brain training game. The present study showed the scientific evidence which the brain training game had the beneficial effects on cognitive functions (executive functions, working memory and processing speed in the healthy young adults. CONCLUSIONS: Our results do not indicate that everyone should play brain training games. However, the commercial brain training game might be a simple and convenient means to improve some cognitive functions. We believe that our findings are highly relevant to applications in educational and clinical fields

  15. Small Acute Benefits of 4 Weeks Processing Speed Training Games on Processing Speed and Inhibition Performance and Depressive Mood in the Healthy Elderly People: Evidence from a Randomized Control Trial.

    Science.gov (United States)

    Nouchi, Rui; Saito, Toshiki; Nouchi, Haruka; Kawashima, Ryuta

    2016-01-01

    Background: Processing speed training using a 1-year intervention period improves cognitive functions and emotional states of elderly people. Nevertheless, it remains unclear whether short-term processing speed training such as 4 weeks can benefit elderly people. This study was designed to investigate effects of 4 weeks of processing speed training on cognitive functions and emotional states of elderly people. Methods: We used a single-blinded randomized control trial (RCT). Seventy-two older adults were assigned randomly to two groups: a processing speed training game (PSTG) group and knowledge quiz training game (KQTG) group, an active control group. In PSTG, participants were asked to play PSTG (12 processing speed games) for 15 min, during five sessions per week, for 4 weeks. In the KQTG group, participants were asked to play KQTG (four knowledge quizzes) for 15 min, during five sessions per week, for 4 weeks. We measured several cognitive functions and emotional states before and after the 4 week intervention period. Results: Our results revealed that PSTG improved performances in processing speed and inhibition compared to KQTG, but did not improve performance in reasoning, shifting, short term/working memory, and episodic memory. Moreover, PSTG reduced the depressive mood score as measured by the Profile of Mood State compared to KQTG during the 4 week intervention period, but did not change other emotional measures. Discussion: This RCT first provided scientific evidence related to small acute benefits of 4 week PSTG on processing speed, inhibition, and depressive mood in healthy elderly people. We discuss possible mechanisms for improvements in processing speed and inhibition and reduction of the depressive mood. Trial registration: This trial was registered in The University Hospital Medical Information Network Clinical Trials Registry (UMIN000022250).

  16. ENDOVASCULAR HEMOSTASIS IN UTERINE BLEEDING IN PATIENTS WITH UTERINE LEIOMYOMA

    Directory of Open Access Journals (Sweden)

    M. M. Damirov

    2017-01-01

    Full Text Available We report results of treatment for 72 patients with uterine leiomyoma (LM of various sizes and location, who had arrived with excessive uterine bleeding. All patients underwent urgent or urgently-delayed endovascular hemostasis by performing uterine arteries embolization (UAE. We analyzed clinical features of the disease after UAE in various sizes of tumors and studied immediate and long-term results of UAE in patients with LM.

  17. Brain training game boosts executive functions, working memory and processing speed in the young adults: a randomized controlled trial.

    Science.gov (United States)

    Nouchi, Rui; Taki, Yasuyuki; Takeuchi, Hikaru; Hashizume, Hiroshi; Nozawa, Takayuki; Kambara, Toshimune; Sekiguchi, Atsushi; Miyauchi, Carlos Makoto; Kotozaki, Yuka; Nouchi, Haruka; Kawashima, Ryuta

    2013-01-01

    Do brain training games work? The beneficial effects of brain training games are expected to transfer to other cognitive functions. Yet in all honesty, beneficial transfer effects of the commercial brain training games in young adults have little scientific basis. Here we investigated the impact of the brain training game (Brain Age) on a wide range of cognitive functions in young adults. We conducted a double-blind (de facto masking) randomized controlled trial using a popular brain training game (Brain Age) and a popular puzzle game (Tetris). Thirty-two volunteers were recruited through an advertisement in the local newspaper and randomly assigned to either of two game groups (Brain Age, Tetris). Participants in both the Brain Age and the Tetris groups played their game for about 15 minutes per day, at least 5 days per week, for 4 weeks. Measures of the cognitive functions were conducted before and after training. Measures of the cognitive functions fell into eight categories (fluid intelligence, executive function, working memory, short-term memory, attention, processing speed, visual ability, and reading ability). Our results showed that commercial brain training game improves executive functions, working memory, and processing speed in young adults. Moreover, the popular puzzle game can engender improvement attention and visuo-spatial ability compared to playing the brain training game. The present study showed the scientific evidence which the brain training game had the beneficial effects on cognitive functions (executive functions, working memory and processing speed) in the healthy young adults. Our results do not indicate that everyone should play brain training games. However, the commercial brain training game might be a simple and convenient means to improve some cognitive functions. We believe that our findings are highly relevant to applications in educational and clinical fields. UMIN Clinical Trial Registry 000005618.

  18. Analysis of Documentation Speed Using Web-Based Medical Speech Recognition Technology: Randomized Controlled Trial.

    Science.gov (United States)

    Vogel, Markus; Kaisers, Wolfgang; Wassmuth, Ralf; Mayatepek, Ertan

    2015-11-03

    Clinical documentation has undergone a change due to the usage of electronic health records. The core element is to capture clinical findings and document therapy electronically. Health care personnel spend a significant portion of their time on the computer. Alternatives to self-typing, such as speech recognition, are currently believed to increase documentation efficiency and quality, as well as satisfaction of health professionals while accomplishing clinical documentation, but few studies in this area have been published to date. This study describes the effects of using a Web-based medical speech recognition system for clinical documentation in a university hospital on (1) documentation speed, (2) document length, and (3) physician satisfaction. Reports of 28 physicians were randomized to be created with (intervention) or without (control) the assistance of a Web-based system of medical automatic speech recognition (ASR) in the German language. The documentation was entered into a browser's text area and the time to complete the documentation including all necessary corrections, correction effort, number of characters, and mood of participant were stored in a database. The underlying time comprised text entering, text correction, and finalization of the documentation event. Participants self-assessed their moods on a scale of 1-3 (1=good, 2=moderate, 3=bad). Statistical analysis was done using permutation tests. The number of clinical reports eligible for further analysis stood at 1455. Out of 1455 reports, 718 (49.35%) were assisted by ASR and 737 (50.65%) were not assisted by ASR. Average documentation speed without ASR was 173 (SD 101) characters per minute, while it was 217 (SD 120) characters per minute using ASR. The overall increase in documentation speed through Web-based ASR assistance was 26% (P=.04). Participants documented an average of 356 (SD 388) characters per report when not assisted by ASR and 649 (SD 561) characters per report when assisted

  19. Molecular aspects in clinical hemostasis research at Karolinska Institutet.

    Science.gov (United States)

    Blombäck, Margareta

    2010-05-21

    The development of hemostasis research at Karolinska Institutet is described, focusing first on the initial findings of the fibrinogen structure and the hereditary bleeding disorders, hemophilia A and von Willebrand's disease. Basic research has focused on new biomarkers for cardiovascular/thromboembolic disorders, such as myocardial infarction and stroke, including preeclampsia and diabetes, with studies on the importance of decreased fibrinolysis in these disorders. Since long, the structure of the fibrin network has been evaluated, and recently the influence of aspirin and new thrombin and factor Xa inhibitors has been investigated. Research on the contact pathway of coagulation has also started at the Unit. 2010 Elsevier Inc. All rights reserved.

  20. Microparticle Analysis in Disorders of Hemostasis and Thrombosis

    Science.gov (United States)

    Mooberry, Micah J.; Key, Nigel S.

    2015-01-01

    Microparticles (MPs) are submicron vesicles released from the plasma membrane of eukaryotic cells in response to activation or apoptosis. MPs are known to be involved in numerous biologic processes, including inflammation, the immune response, cancer metastasis, and angiogenesis. Their earliest recognized and most widely accepted role, however, is the ability to promote and support the process of blood coagulation. Consequently, there is ongoing interest in studying MPs in disorders of hemostasis and thrombosis. Both phosphatidylserine (PS) exposure and the presence of tissue factor (TF) in the MP membrane may account for their procoagulant properties, and elevated numbers of MPs in plasma have been reported in numerous prothrombotic conditions. To date, however, there are few data on true causality linking MPs to the genesis of thrombosis. A variety of methodologies have been employed to characterize and quantify MPs, although detection is challenging due to their submicron size. Flow cytometry (FCM) remains the most frequently utilized strategy for MP detection; however, it is associated with significant technological limitations. Additionally, pre-analytical and analytical variables can influence the detection of MPs by FCM, rendering data interpretation difficult. Lack of methodologic standardization in MP analysis by FCM confounds the issue further, although efforts are currently underway to address this limitation. Moving forward, it will be important to address these technical challenges as a scientific community if we are to better understand the role that MPs play in disorders of hemostasis and thrombosis. PMID:25704723

  1. A randomized controlled trial of cognitive training using a visual speed of processing intervention in middle aged and older adults.

    Directory of Open Access Journals (Sweden)

    Fredric D Wolinsky

    Full Text Available Age-related cognitive decline is common and may lead to substantial difficulties and disabilities in everyday life. We hypothesized that 10 hours of visual speed of processing training would prevent age-related declines and potentially improve cognitive processing speed.Within two age bands (50-64 and ≥ 65 681 patients were randomized to (a three computerized visual speed of processing training arms (10 hours on-site, 14 hours on-site, or 10 hours at-home or (b an on-site attention control group using computerized crossword puzzles for 10 hours. The primary outcome was the Useful Field of View (UFOV test, and the secondary outcomes were the Trail Making (Trails A and B Tests, Symbol Digit Modalities Test (SDMT, Stroop Color and Word Tests, Controlled Oral Word Association Test (COWAT, and the Digit Vigilance Test (DVT, which were assessed at baseline and at one year. 620 participants (91% completed the study and were included in the analyses. Linear mixed models were used with Blom rank transformations within age bands.All intervention groups had (p<0.05 small to medium standardized effect size improvements on UFOV (Cohen's d = -0.322 to -0.579, depending on intervention arm, Trails A (d = -0.204 to -0.265, Trails B (d = -0.225 to -0.320, SDMT (d = 0.263 to 0.351, and Stroop Word (d = 0.240 to 0.271. Converted to years of protection against age-related cognitive declines, these effects reflect 3.0 to 4.1 years on UFOV, 2.2 to 3.5 years on Trails A, 1.5 to 2.0 years on Trails B, 5.4 to 6.6 years on SDMT, and 2.3 to 2.7 years on Stroop Word.Visual speed of processing training delivered on-site or at-home to middle-aged or older adults using standard home computers resulted in stabilization or improvement in several cognitive function tests. Widespread implementation of this intervention is feasible.ClinicalTrials.gov NCT-01165463.

  2. A refined model of the genomic basis for phenotypic variation in vertebrate hemostasis

    DEFF Research Database (Denmark)

    Ribeiro, Ângela M.; Zepeda Mendoza, Marie Lisandra; Bertelsen, Mads Frost

    2015-01-01

    BACKGROUND: Hemostasis is a defense mechanism that enhances an organism's survival by minimizing blood loss upon vascular injury. In vertebrates, hemostasis has been evolving with the cardio-vascular and hemodynamic systems over the last 450 million years. Birds and mammals have very similar vasc...

  3. Changes in hemostasis in foals naturally infected with Strongylus vulgaris

    DEFF Research Database (Denmark)

    Pihl, Tina Holberg; Krarup Nielsen, Martin; Jacobsen, Stine

    2017-01-01

    Strongylus vulgaris has been found endemic in equine populations subject to parasite control by targeted selective anthelmintic therapy. This study investigated hemostasis in foals naturally infected with S. vulgaris and monitored this response over the course of progressing infection stages...... 4. Strongylus vulgaris antibody levels were statistically associated with D-dimer (P = .0076) and fibrinogen (P = .0004) concentrations. Naturally acquired infection with S. vulgaris was associated with changes suggestive of mild activation of coagulation, fibrinolysis, and inflammation. The results....... The hemostatic indices D-dimer, antithrombin III (ATIII), fibrinogen, prothrombin time (PT), and activated partial thromboplastin time were evaluated in weekly blood samples for up to 50 weeks in 12 foals born into a herd with high prevalence of S. vulgaris. Results were compared with weekly S. vulgaris antibody...

  4. Platelets in thrombosis and hemostasis: old topic with new mechanisms.

    Science.gov (United States)

    Wang, Yiming; Andrews, Marc; Yang, Yan; Lang, Sean; Jin, Joseph W; Cameron-Vendrig, Alison; Zhu, Guangheng; Reheman, Adili; Ni, Heyu

    2012-12-01

    Platelets are small anucleate cells generated from megakaryocytes in the bone marrow. After being released into the circulation, platelets play key roles in the surveillance of vascular injury, and can quickly adhere and aggregate at the site of injury, which are critical events for vascular repair and hemostasis. However, the same biological processes of platelet adhesion and aggregation may also cause thrombotic disorders. The formation of a platelet plug at sites of atherosclerotic lesion rupture is the most common mechanism leading to myocardial or cerebral infarction. Platelet-related deep vein thrombosis is also one of the leading causes of mortality worldwide. The contribution of several platelet receptors and their ligands has been highlighted in these processes. In platelet adhesion, particularly at high shear stress, GPIbα-von Willebrand factor (VWF) interaction may initiate this event, which is followed by GPVI signalling and firm platelet adhesion mediated by members of the integrin family, such as β3 (αIIbβ3) and β1 (α2β1, α5β1) integrins. In platelet aggregation, although GPIbα-VWF, P selectin-sulfatides, and other molecules, may be involved, the process is mainly mediated by β3 (αIIbβ3) integrin and its ligands, such as fibrinogen and VWF. It is intriguing that platelet adhesion and aggregation still occur in mice lacking both fibrinogen and VWF, suggesting that other unforeseen molecule(s) may also be important in these processes. Identification and characterization of these molecules will enrich our knowledge in the basic science of hemostasis and thrombosis, and may lead to the development of new therapies against bleeding disorders and thrombotic diseases.

  5. Magnesium, hemostasis, and outcomes in patients with intracerebral hemorrhage.

    Science.gov (United States)

    Liotta, Eric M; Prabhakaran, Shyam; Sangha, Rajbeer S; Bush, Robin A; Long, Alan E; Trevick, Stephen A; Potts, Matthew B; Jahromi, Babak S; Kim, Minjee; Manno, Edward M; Sorond, Farzaneh A; Naidech, Andrew M; Maas, Matthew B

    2017-08-22

    We tested the hypothesis that admission serum magnesium levels are associated with hematoma volume, hematoma growth, and functional outcomes in patients with intracerebral hemorrhage (ICH). Patients presenting with spontaneous ICH were enrolled in an observational cohort study that prospectively collected demographic, clinical, laboratory, radiographic, and outcome data. We performed univariate and adjusted multivariate analyses to assess for associations between serum magnesium levels and initial hematoma volume, final hematoma volume, and in-hospital hematoma growth as radiographic measures of hemostasis, and functional outcome measured by the modified Rankin Scale (mRS) at 3 months. We included 290 patients for analysis. Admission serum magnesium was 2.0 ± 0.3 mg/dL. Lower admission magnesium levels were associated with larger initial hematoma volumes on univariate ( p = 0.02), parsimoniously adjusted ( p = 0.002), and fully adjusted models ( p = 0.006), as well as greater hematoma growth ( p = 0.004, p = 0.005, and p = 0.008, respectively) and larger final hematoma volumes ( p = 0.02, p = 0.001, and p = 0.002, respectively). Lower admission magnesium level was associated with worse functional outcomes at 3 months (i.e., higher mRS; odds ratio 0.14, 95% confidence interval 0.03-0.64, p = 0.011) after adjustment for age, admission Glasgow Coma Scale score, initial hematoma volume, time from symptom onset to initial CT, and hematoma growth, with evidence that the effect of magnesium is mediated through hematoma growth. These data support the hypothesis that magnesium exerts a clinically meaningful influence on hemostasis in patients with ICH. © 2017 American Academy of Neurology.

  6. Alterations in hemostasis associated with pregnancy in patients with glycemic disorders

    Directory of Open Access Journals (Sweden)

    Irina Arkad'evna Bondar'

    2013-06-01

    Full Text Available In this review we present a comparative analysis of alterations in hemostasis and blood coagulation during normal pregnancy with those in pregnant women with glycemic disorders (diabetes mellitus type 1 and 2, gestational diabetes.

  7. Networks of enzymatically oxidized membrane lipids support calcium-dependent coagulation factor binding to maintain hemostasis

    NARCIS (Netherlands)

    Lauder, S.N.; Allen-Redpath, K.; Slatter, D.A.; Aldrovandi, M.; O'Connor, A.; Farewell, D.; Percy, C.L.; Molhoek, J.E.; Rannikko, S.; Tyrrell, V.J.; Ferla, S.; Milne, G.L.; Poole, A.W.; Thomas, C.P.; Obaji, S.; Taylor, P.R.; Jones, S.A.; Groot, P.G. de; Urbanus, R.T.; Horkko, S.; Uderhardt, S.; Ackermann, J.; Jenkins, P.V.; Brancale, A.; Kronke, G.; Collins, P.W.; O'Donnell, V.B.

    2017-01-01

    Blood coagulation functions as part of the innate immune system by preventing bacterial invasion, and it is critical to stopping blood loss (hemostasis). Coagulation involves the external membrane surface of activated platelets and leukocytes. Using lipidomic, genetic, biochemical, and mathematical

  8. El mecanismo de la hemostasis en neurocirugía

    Directory of Open Access Journals (Sweden)

    Alejandro Jiménez Arango

    1949-05-01

    Full Text Available Desde los primeros tiempos de la cirugía, la hemorragia ha sido uno de los principales problemas que ha tenido que afrontar el cirujano, y uno de los mayores riesgos para la vida del paciente. Al paso que la anestesia y la antisepsia son adquisiciones relativamente recientes, la hemostasis ha tenido una evolución de muchos siglos y los principios generales que hoy en día se aplican no difieren de los que usaban los cirujanos de la antigüedad. Así, vemos que los egipcios, los chinos y los hindúes usaban la compresión y los estípticos, los griegos introdujeron la ligadura y el cauterio, que posteriormente se usó como hemostático. Finalmente, Ambrosio Paré ideó la primera pinza hemostática a la que llamó "bec de corbin", y de allí en adelante se siguieron perfeccionando los métodos instrumentales.

  9. Effect of intraosseous anesthesia on control of hemostasis in pigs.

    Science.gov (United States)

    Baker, Tyler F; Torabinejad, Mahmoud; Schwartz, Stephen F; Wolf, David

    2009-11-01

    Intraosseous anesthesia is used to deliver anesthetic into cancellous bone adjacent to the root apices. No study has assessed the effect of this anesthetic technique on hemostasis. The purpose of this study was to compare the amount of bleeding from soft tissue and bone in pig jaws after preoperative intraosseous or infiltration anesthesia with 2% lidocaine containing 1:50,000 epinephrine. Twelve pigs were divided into 3 groups. The first group received infiltration anesthesia on one half of the jaw and no anesthesia on the other half. The second group received intraosseous anesthesia on one half of the jaw and no anesthesia on the other half. The third group received infiltration anesthesia on one half of the jaw and intraosseous anesthesia on the second half. Blood was collected during flap reflection to measure the volume of soft tissue bleeding. Osteotomies were then prepared with blood collected from the surgical site to measure the volume of osseous bleeding. The median soft tissue blood loss observed in animals receiving infiltration anesthesia (1.14 mL) was significantly less as compared with animals that received no anesthesia (4.49 mL) or intraosseous anesthesia (2.45 mL). Compared with median hard tissue blood loss observed in animals without anesthesia (1.51 mL), significantly less blood loss was observed in animals receiving either infiltration anesthesia (0.67 mL) or intraosseous anesthesia (0.76 mL). Infiltration anesthesia resulted in significantly less soft tissue bleeding (p = .004) as compared with no anesthesia. Infiltration and intraosseous anesthesia resulted in significantly less osseous bleeding than the use of no anesthetic (p < .001). The volume of blood loss for each animal was shown to be below the maximum safe volume of blood loss for a single procedure.

  10. Hemostasis biomarkers and incident cognitive impairment: the REGARDS study.

    Science.gov (United States)

    Gillett, S R; McClure, L A; Callas, P W; Thacker, E L; Unverzagt, F W; Wadley, V G; Letter, A J; Cushman, M

    2018-05-07

    Vascular risk factors are associated with cognitive impairment, a condition with substantial public health burden. We hypothesized that hemostasis biomarkers related to vascular disease would be associated with risk of incident cognitive impairment. We performed a nested case control study including 1,082 participants with 3.5 years of follow-up in the Reasons for Geographic and Racial Differences in Stroke (REGARDS) study, a longitudinal cohort study of 30,239 black and white Americans ≥45 years old. Participants were free of stroke or cognitive impairment at baseline. Baseline D-dimer, fibrinogen, factor VIII, and protein C were measured in 495 cases who developed cognitive impairment during follow-up (based on abnormal scores on ≥2 of 3 cognitive tests) and 587 controls. Unadjusted ORs for incident cognitive impairment were 1.32 (95% CI 1.02, 1.70) for D-dimer >0.50 μg/mL, 1.83 (CI 1.24, 2.71) for fibrinogen >90 th percentile, 1.63 (CI 1.11, 2.38) for factor VIII >90 th percentile and 1.10 (CI 0.73, 1.65) for protein C impairment, with an adjusted OR 1.73 (CI 1.10, 2.69). Elevated D-dimer, fibrinogen, and factor VIII were not associated with occurrence of cognitive impairment after multivariable adjustment; however, having at least 2 abnormal biomarkers was associated, suggesting the burden of these biomarkers is relevant. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

  11. A randomised controlled trial evaluating the effect of an individual auditory cueing device on freezing and gait speed in people with Parkinson's disease

    Directory of Open Access Journals (Sweden)

    Lynch Deirdre

    2008-12-01

    Full Text Available Abstract Background Parkinson's disease is a progressive neurological disorder resulting from a degeneration of dopamine producing cells in the substantia nigra. Clinical symptoms typically affect gait pattern and motor performance. Evidence suggests that the use of individual auditory cueing devices may be used effectively for the management of gait and freezing in people with Parkinson's disease. The primary aim of the randomised controlled trial is to evaluate the effect of an individual auditory cueing device on freezing and gait speed in people with Parkinson's disease. Methods A prospective multi-centre randomised cross over design trial will be conducted. Forty-seven subjects will be randomised into either Group A or Group B, each with a control and intervention phase. Baseline measurements will be recorded using the Freezing of Gait Questionnaire as the primary outcome measure and 3 secondary outcome measures, the 10 m Walk Test, Timed "Up & Go" Test and the Modified Falls Efficacy Scale. Assessments are taken 3-times over a 3-week period. A follow-up assessment will be completed after three months. A secondary aim of the study is to evaluate the impact of such a device on the quality of life of people with Parkinson's disease using a qualitative methodology. Conclusion The Apple iPod-Shuffle™ and similar devices provide a cost effective and an innovative platform for integration of individual auditory cueing devices into clinical, social and home environments and are shown to have immediate effect on gait, with improvements in walking speed, stride length and freezing. It is evident that individual auditory cueing devices are of benefit to people with Parkinson's disease and the aim of this randomised controlled trial is to maximise the benefits by allowing the individual to use devices in both a clinical and social setting, with minimal disruption to their daily routine. Trial registration The protocol for this study is registered

  12. A pilot clinical trial on a Variable Automated Speed and Sensing Treadmill (VASST) for hemiparetic gait rehabilitation in stroke patients.

    Science.gov (United States)

    Chua, Karen S G; Chee, Johnny; Wong, Chin J; Lim, Pang H; Lim, Wei S; Hoo, Chuan M; Ong, Wai S; Shen, Mira L; Yu, Wei S

    2015-01-01

    Impairments in walking speed and capacity are common problems after stroke which may benefit from treadmill training. However, standard treadmills, are unable to adapt to the slower walking speeds of stroke survivors and are unable to automate training progression. This study tests a Variable Automated Speed and Sensing Treadmill (VASST) using a standard clinical protocol. VASST is a semi-automated treadmill with multiple sensors and micro controllers, including wireless control to reposition a fall-prevention harness, variable pre-programmed exercise parameters and laser beam foot sensors positioned on the belt to detect subject's foot positions. An open-label study with assessor blinding was conducted in 10 community-dwelling chronic hemiplegic patients who could ambulate at least 0.1 m/s. Interventions included physiotherapist-supervised training on VASST for 60 min three times per week for 4 weeks (total 12 h). Outcome measures of gait speed, quantity, balance, and adverse events were assessed at baseline, 2, 4, and 8 weeks. Ten subjects (8 males, mean age 55.5 years, 2.1 years post stroke) completed VASST training. Mean 10-m walk test speed was 0.69 m/s (SD = 0.29) and mean 6-min walk test distance was 178.3 m (84.0). After 4 weeks of training, 70% had significant positive gains in gait speed (0.06 m/s, SD = 0.08 m/s, P = 0.037); and 90% improved in walking distance. (54.3 m, SD = 30.9 m, P = 0.005). There were no adverse events. This preliminary study demonstrates the initial feasibility and short-term efficacy of VASST for walking speed and distance for people with chronic post-stroke hemiplegia.

  13. Thermal ablation for partial splenectomy hemostasis, spleen trauma, splenic metastasis and hypersplenism.

    Science.gov (United States)

    Duan, Ya-Qi; Liang, Ping

    2013-05-01

    Many studies have been conducted on splenic thermal ablation for partial splenectomy hemostasis, spleen trauma, splenic metastasis and hypersplenism. In this article, we review the evolution and current status of radiofrequency and microwave ablation in the treatment of spleen diseases. All publications from 1990 to 2011 on radiofrequency and microwave ablation for partial splenectomy hemostasis, spleen trauma, splenic metastasis and hypersplenism were retrieved by searching PubMed. Thermal ablation in the spleen for partial splenectomy hemostasis, spleen trauma, splenic metastasis and hypersplenism can preserve part of the spleen and maintain splenic immunologic function. Thermal ablation for assisting hemostasis in partial splenectomy minimizes blood loss during operation. Thermal ablation for spleen trauma reduces the number of splenectomy and the amount of blood transfusion. Thermal ablation for splenic metastasis is minimally invasive and can be done under the guidance of an ultrasound, which helps shorten the recovery time. Thermal ablation for hypersplenism increases platelet (PLT) and white blood cell (WBC) counts and improves liver function. It also helps to maintain splenic immunologic function and even improves splenic immunologic function in the short-term. In conclusion, thermal ablative approaches are promising for partial splenectomy hemostasis, spleen trauma, splenic metastasis and hypersplenism. In order to improve therapeutic effects, directions for future studies may include standardized therapeutic indications, prolonged observation periods and enlarged sample sizes.

  14. Comparative efficiency of endoscopic hemostasis methods in bleeding undercomplicated peptic ulcer in children

    Directory of Open Access Journals (Sweden)

    Сергій Олександрович Сокольник

    2015-05-01

    Full Text Available Aim. To compare the effectiveness of endoscopic hemostasis in complex treatment of gastrointestinal bleeding in children of Chernovtsy region with peptic ulcer disease.Methods. 43 cases of bleeding in peptic ulcer disease in children are analyzed. Argon plasma coagulation is undergone in order to stop the bleeding for 11 patients, for others – aminocaproic acid irrigation.Results. Using argon plasma coagulation, in contrast to the aminocaproic acid irrigation reduces the risk of rebleeding 0.59 times when the number of patients who must be treated – 2.99.Conclusions. The most effective method of endoscopic hemostasis of bleeding in peptic ulcer disease in children is argon plasma coagulation, which allows you to achieve a stable hemostasis and reduce the risk of rebleeding

  15. Enzymatic lipid oxidation by eosinophils propagates coagulation, hemostasis, and thrombotic disease

    Science.gov (United States)

    Uderhardt, Stefan; Ackermann, Jochen A.; Fillep, Tobias; Hammond, Victoria J.; Willeit, Johann; Stark, Konstantin; Rossaint, Jan; Schubert, Irene; Mielenz, Dirk; Dietel, Barbara; Raaz-Schrauder, Dorette; Ay, Cihan; Thaler, Johannes; Heim, Christian; Collins, Peter W.; Schabbauer, Gernot; Mackman, Nigel; Voehringer, David; Nadler, Jerry L.; Lee, James J.; Massberg, Steffen; Rauh, Manfred; O’Donnell, Valerie B.

    2017-01-01

    Blood coagulation is essential for physiological hemostasis but simultaneously contributes to thrombotic disease. However, molecular and cellular events controlling initiation and propagation of coagulation are still incompletely understood. In this study, we demonstrate an unexpected role of eosinophils during plasmatic coagulation, hemostasis, and thrombosis. Using a large-scale epidemiological approach, we identified eosinophil cationic protein as an independent and predictive risk factor for thrombotic events in humans. Concurrent experiments showed that eosinophils contributed to intravascular thrombosis by exhibiting a strong endogenous thrombin-generation capacity that relied on the enzymatic generation and active provision of a procoagulant phospholipid surface enriched in 12/15-lipoxygenase–derived hydroxyeicosatetraenoic acid–phosphatidylethanolamines. Our findings reveal a previously unrecognized role of eosinophils and enzymatic lipid oxidation as regulatory elements that facilitate both hemostasis and thrombosis in response to vascular injury, thus identifying promising new targets for the treatment of thrombotic disease. PMID:28566277

  16. Publication Speed, Reporting Metrics, and Citation Impact of Cardiovascular Trials Supported by the National Heart, Lung, and Blood Institute.

    Science.gov (United States)

    Gordon, David; Cooper-Arnold, Katharine; Lauer, Michael

    2015-07-31

    We previously demonstrated that cardiovascular (CV) trials funded by the National Heart, Lung, and Blood Institute (NHLBI) were more likely to be published in a timely manner and receive high raw citation counts if they focused on clinical endpoints. We did not examine the metrics of trial reports, and our citation measures were limited by failure to account for topic-related citation behaviors. Of 244 CV trials completed between 2000 and 2011, we identified 184 whose main results were published by August 20, 2014. One investigator who was blinded to rapidity of publication and citation data read each publication and characterized it according to modified Delphi criteria. There were 46 trials (25%) that had Delphi scores of 8 or 9 (of a possible 9); these trials published faster (median time from trial completion to publication, 12.6 [interquartile range {IQR}, 6.7 to 23.3] vs. 21.8 [IQR, 12.1 to 34.9] months; Pcitation impact (median citation percentile for topic and date of publication, with 0 best and 100 worst, 1.92 [IQR, 0.64 to 7.83] vs. 8.41 [IQR, 1.80 to 24.75]; P=0.002). By random forest regression, we found that the 3 most important predictors of normalized citation percentile values were total costs, intention-to-treat analyses (as a modified Delphi quality measure), and focus on clinical (not surrogate) endpoints. NHLBI CV trials were more likely to publish results quickly and yield higher topic-normalized citation impact if they reported results according to well-defined metrics, along with focus on clinical endpoints. © 2015 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley Blackwell.

  17. Rediscovering the wound hematoma as a site of hemostasis during major arterial hemorrhage.

    Science.gov (United States)

    White, N J; Mehic, E; Wang, X; Chien, D; Lim, E; St John, A E; Stern, S A; Mourad, P D; Rieger, M; Fries, D; Martinowitz, U

    2015-12-01

    Treatments for major internal bleeding after injury include permissive hypotension to decrease the rate of blood loss, intravenous infusion of plasma or clotting factors to improve clot formation, and rapid surgical hemostasis or arterial embolization to control bleeding vessels. Yet, little is known regarding major internal arterial hemostasis, or how these commonly used treatments might influence hemostasis. (i) To use a swine model of femoral artery bleeding to understand the perivascular hemostatic response to contained arterial hemorrhage. (ii) To directly confirm the association between hemodynamics and bleeding velocity. (iii) To observe the feasibility of delivering an activated clotting factor directly to internal sites of bleeding using a simplified angiographic approach. Ultrasound was used to measure bleeding velocity and in vivo clot formation by elastography in a swine model of contained femoral artery bleeding with fluid resuscitation. A swine model of internal pelvic and axillary artery hemorrhage was also used to demonstrate the feasibility of local delivery of an activated clotting factor. In this model, clots formed slowly within the peri-wound hematoma, but eventually contained the bleeding. Central hemodynamics correlated positively with bleeding velocity. Infusion of recombinant human activated factor VII into the injured artery near the site of major internal hemorrhage in the pelvis and axillae was feasible. We rediscovered that clot formation within the peri-wound hematoma is an integral component of hemostasis and a feasible target for the treatment of major internal bleeding using activated clotting factors delivered using a simplified angiographic approach. © 2015 International Society on Thrombosis and Haemostasis.

  18. Effect on hemostasis of an absorbable hemostatic gelatin sponge after transrectal prostate needle biopsy

    Directory of Open Access Journals (Sweden)

    Kohei Kobatake

    2015-04-01

    Full Text Available Objectives To examine the usefulness of an absorbable hemostatic gelatin sponge for hemostasis after transrectal prostate needle biopsy. Subjects and Methods The subjects comprised 278 participants who underwent transrectal prostate needle biopsy. They were randomly allocated to the gelatin sponge insertion group (group A: 148 participants and to the non-insertion group (group B: 130 participants. In group A, the gelatin sponge was inserted into the rectum immediately after biopsy. A biopsy-induced hemorrhage was defined as a case in which a subject complained of bleeding from the rectum, and excretion of blood clots was confirmed. A blood test was performed before and after biopsy, and a questionnaire survey was given after the biopsy. Results Significantly fewer participants in group A required hemostasis after biopsy compared to group B (3 (2.0% vs. 11 (8.5%, P=0.029. The results of the blood tests and the responses from the questionnaire did not differ significantly between the two groups. In multivariate analysis, only “insertion of a gelatin sponge into the rectum” emerged as a significant predictor of hemostasis. Conclusion Insertion of a gelatin sponge into the rectum after transrectal prostate needle biopsy significantly increases hemostasis without increasing patient symptoms, such as pain and a sense of discomfort.

  19. Giving blood: Donor stress and hemostasis : Don't let your blood run cold

    NARCIS (Netherlands)

    Hoogerwerf, M.D.

    2017-01-01

    Does a donation induce stress in blood donors, and does this affect the donor’s hemostasis? Donation-induced psychological, hormonal and physiological stress response patterns during a blood donation procedure were examined, and the effects of donation-induced stress response on immediate changes in

  20. TAM receptors, Gas6, and protein S: roles in inflammation and hemostasis.

    Science.gov (United States)

    van der Meer, Jonathan H M; van der Poll, Tom; van 't Veer, Cornelis

    2014-04-17

    TAM receptors (Tyro3, Axl, and Mer) belong to a family of receptor tyrosine kinases that have important effects on hemostasis and inflammation. Also, they affect cell proliferation, survival, adhesion, and migration. TAM receptors can be activated by the vitamin K-dependent proteins Gas6 and protein S. Protein S is more commonly known as an important cofactor for protein C as well as a direct inhibitor of multiple coagulation factors. To our knowledge, the functions of Gas6 are limited to TAM receptor activation. When activated, the TAM receptors have effects on primary hemostasis and coagulation and display an anti-inflammatory or a proinflammatory effect, depending on cell type. To comprehend the effects that the TAM receptors and their ligands have on hemostasis and inflammation, we compare studies that report the different phenotypes displayed by mice with deficiencies in the genes of this receptor family and its ligands (protein S(+/-), Gas6(-/-), TAM(-/-), and variations of these). In this manner, we aim to display which features are attributable to the different ligands. Because of the effects TAM receptors have on hemostasis, inflammation, and cancer growth, their modulation could make interesting therapeutic targets in thromboembolic disease, atherosclerosis, sepsis, autoimmune disease, and cancer.

  1. TAM receptors, Gas6, and protein S: roles in inflammation and hemostasis

    NARCIS (Netherlands)

    van der Meer, Jonathan H. M.; van der Poll, Tom; van 't Veer, Cornelis

    2014-01-01

    TAM receptors (Tyro3, Axl, andMer) belong to a family of receptor tyrosine kinases that have important effects on hemostasis and inflammation. Also, they affect cell proliferation, survival, adhesion, and migration. TAM receptors can be activated by the vitamin K-dependent proteins Gas6 and protein

  2. International Society on Thrombosis and Haemostasis core curriculum project: core competencies in clinical thrombosis and hemostasis

    NARCIS (Netherlands)

    McLintock, C.; Pabinger, I.; Bauer, K. A.; Laffan, M.; Angchaisuksiri, P.; Rezende, S. M.; Middeldorp, S.; Ross, M.

    2016-01-01

    Essentials The priority of ISTH was to establish a global core curriculum in thrombosis and hemostasis. International survey to determine competencies required for clinical specialists was carried out in the field. Competency framework provides a reference point for mapping and developing regional

  3. Infusion of DDAVP does not improve primary hemostasis in patients with cirrhosis

    NARCIS (Netherlands)

    F. Arshad (Freeha); S.C.M. Stoof (Carina); F.W.G. Leebeek (Frank); K. Ruitenbeek (Karin); J. Adelmeijer (Jelle); Blokzijl, H. (Hans); A.P. van den Berg (Arie P.); R.J. Porte (Robert); M.J.H.A. Kruip (Marieke); Lisman, T. (Ton)

    2015-01-01

    textabstractBackground & Aims: Cirrhosis frequently affects multiple components of hemostasis. Reversal of the coagulopathy of these patients is frequently required in case of bleeding episodes, or as prophylaxis before invasive procedures. Although 1-deamino-8-D-arginine vasopressin (DDAVP) is

  4. High-speed resistance training and balance training for people with knee osteoarthritis to reduce falls risk: study protocol for a pilot randomized controlled trial.

    Science.gov (United States)

    Levinger, Pazit; Dunn, Jeremy; Bifera, Nancy; Butson, Michael; Elias, George; Hill, Keith D

    2017-08-18

    The number of falls experienced by people with knee osteoarthritis (OA) is almost double the number experienced by people with no OA. The neuromuscular elements required to arrest a fall are more impaired in people with knee OA compared to their asymptomatic counterparts. Therefore, these elements may need to be incorporated into an exercise intervention to reduce the risk of falling. The aim of this study will be to examine the feasibility, safety and patient satisfaction of a high-speed resistance-training program, with and without balance exercises, in people with knee OA compared to a control group. The effect of these exercise programs on lower-limb muscle strength and physiological and functional risk factors for falls will also be examined. This study will be a pilot randomized controlled trial with a pre- and post-intervention design (outcome assessments at baseline and 8 weeks after participation commencement) comparing three groups: a control group (no intervention), a high-speed resistance-training group and a high-speed resistance-training plus balance exercises group. Thirty people with knee osteoarthritis aged 60-90 years will be recruited and randomized to one of the three groups. Feasibility and safety will be assessed by examining adherence to the exercise program, dropout rate, pain level during and following exercise, number of exercises stopped due to pain, and any adverse event or any incident that prevents the participant from completing the prescribed exercise. Secondary measures of lower-limb strength, physical function, self-reported pain and function, fear of falls, and executive function and quality of life will also be assessed. To determine statistical trends of effectiveness and hence to inform sample size for a fully powered study, analyses of the secondary outcomes will be performed to assess the changes within and between groups over time (pre-post) using repeated measure ANOVA. The results of this study will improve understanding

  5. Immediate arterial hemostasis after cardiac catheterization: initial experience with a new puncture closure device.

    Science.gov (United States)

    Aker, U T; Kensey, K R; Heuser, R R; Sandza, J G; Kussmaul, W G

    1994-03-01

    A novel device for obtaining arterial hemostasis after invasive procedures was tested in 30 patients undergoing diagnostic catheterization (26 patients) or coronary angioplasty (4 patients). The device is deployed through an arterial sheath and forms a positive mechanical seal both inside and outside the defect in the arterial wall. The components are all bioabsorbable. Thirteen patients received a heparin bolus during the catheterization procedure. The activated clotting time recorded in 15 patients just prior to device deployment averaged 264 sec. 29 of 32 attempted device deployments were successful (91%); and the remaining 3 devices pulled completely out as called for by design in the event of incomplete deployment. Twenty-nine patients ultimately achieved successful hemostasis using the device, with the other patient receiving manual hemostasis. Of these 29, hemostasis was immediate and complete in 19 patients. Light digital pressure was required in another 8 patients for less than 5 min. There was minor delayed bleeding requiring supplemental light pressure in several cases. A total of 11 patients required supplemental pressure in addition to the hemostasis device. The use of bolus heparin was significantly (P = 0.05, Fisher's exact test) related to the requirement for supplemental pressure. Three patients developed hematomas, one of which was present prior to device deployment. The other two patients had received bolus heparin. No patient required transfusion or surgical repair. There was no change in the ankle/brachial systolic blood pressure index after device deployment or at late (30-60 day) follow-up. Ultrasound studies revealed no significant pathology relative to the device.(ABSTRACT TRUNCATED AT 250 WORDS)

  6. Secure hemostasis in transhiatal esophagectomy for esophageal cancer with gauze packing

    Directory of Open Access Journals (Sweden)

    Hirahara Noriyuki

    2012-12-01

    Full Text Available Abstract Background Transhiatal esophagectomy for esophageal cancer implies blind manipulation of the intrathoracic esophagus. We report a secure hemostatic method with gauze packing in transhiatal esophagectomy. Methods The gauze-packing technique is utilized for hemostasis just after removal of the thoracic esophagus during transhiatal esophagectomy. After confirming cancer-free margins, the abdominal esophagus and cervical esophagus are transected. A vein stripper is inserted into the oral-side stump of the esophagus and led to exit from the abdominal-side stump of the esophagus. The vein stripper and the oral stump of the esophagus are affixed by silk thread. A polyester tape is then affixed to the vein stripper, as the polyester tape is left in the posterior mediastinum after removal of the esophagus toward the abdominal side. The polyester tape on the cervical side is ligated with gauze and the polyester tape is removed toward the abdominal side. The oral stump of gauze and new additional gauze are affixed. As the first gauze is pulled out from the abdominal side, the second gauze gets drawn from the cervical wound into the mediastinum. The posterior mediastinum is finally packed with gauze and possible bleeding at this site undergoes a complete astriction. The status of hemostasis with the gauze packing is checked by an observation of color and bloodstain on the gauze. Results Between January 2005 and February 2012, 13 consecutive patients with esophageal cancer underwent a transhiatal esophagectomy with the gauze-packing hemostatic technique. Hemostasis at the posterior mediastinum was performed successfully and quickly in all cases with this method, requiring up to four pieces of gauze for a complete hemostasis. Median required time for hemostasis was 1219 (range 1896 to 1293 seconds and estimated blood loss was 20.4 (range 15 to 25 ml during gauze packing. Conclusions Our technique could minimize bleeding after the removal of the

  7. An essential primer for understanding the role of topical hemostats, surgical sealants, and adhesives for maintaining hemostasis.

    Science.gov (United States)

    Gabay, Michael; Boucher, Bradley A

    2013-09-01

    A wide variety of topical hemostats are approved as adjunctive therapies in the maintenance of hemostasis during surgical procedures in which conventional methods are insufficient or not practical. A multidisciplinary approach to the selection and application of these agents requires input from all members of the surgical team including surgeons, perioperative nurses, blood bank specialists, and pharmacists. However, pharmacist knowledge regarding topical hemostats may be limited based on lack of formal education within college of pharmacy curricula as well as their use being predominantly in the operating room setting. Furthermore, some of these agents might be procured through central supply rather than the hospital pharmacy. Topical hemostats include agents that act as a mechanical barrier to bleeding and provide a physical matrix for clotting, biologically active agents that catalyze coagulation, combination therapies, and synthetic sealants and adhesives. Although many of the topical hemostats were approved for use before the requirement for clinical trials, this review provides an overview of the available clinical evidence regarding the appropriate uses and safety considerations associated with these agents. Proper use of these agents is vital to achieving the best clinical outcomes. Specifically, knowledge of the contraindications and potential adverse events associated with topical hemostats can help prevent unwanted outcomes. Therefore, an understanding of the benefits and potential risks associated with these agents will allow hospital pharmacists to assist in the development and implementation of institutional policies regarding the safe and effective use of hemostatic agents commonly used in the surgical suite. © 2013 Pharmacotherapy Publications, Inc.

  8. [Medical hemostasis. II. Systemic hemostatics, a critical evaluation].

    Science.gov (United States)

    van den Bogaard, A E

    1989-02-01

    The control of spontaneous and traumatic haemorrhage is a matter of constant concern to veterinary practitioners. In some instances, the control of bleeding may be relatively simple using some topical therapeutic procedure, but when haemostatic defects are present, treatment with topical agents alone might not be sufficient, and more radical and life-saving procedures are indicated: replacement therapy with blood or blood products. As this is not easy to perform in most veterinary clinical situations, any therapeutic agent, which facilitates control of haemorrhage is a welcome addition to the therapeutic armament. Besides vitamin K, blood products and agents for topical use, there are only a few agents having a well-defined action on the mechanism of haemostasis. On the other hand several drugs are propagated in the Netherlands as systemic haemostatics in the treatment of bleeding disorders and prevention of haemorrhage during operation. None of these is of proven clinical value in veterinary practice. The only agent, which possibly showed some clinical effect: ethamsylate, has recently been withdrawn from the Dutch market by the manufacturers. Double-blind prospective trials with quantitation of loss of blood showed that antifibrinolytic agents such as tranexamic acid are clinically effective in certain conditions in humans. Because of their mode of action, it might reasonably be expected that these drugs might have positive results in veterinary medicine. Therefore, clinical trials with antifibrinolytic agents are urgently indicated to evaluate the effectiveness and side-effects of these drugs in animals showing severe bleeding or in the prevention of peroperative haemorrhage.

  9. A case of advanced gastric cancer resected for rebleeding after palliative radiotherapy for hemostasis

    International Nuclear Information System (INIS)

    Muneoka, Yusuke; Ichikawa, Hiroshi; Ishikawa, Takashi

    2016-01-01

    We report a case of advanced gastric cancer (AGC) that was resected for rebleeding after palliative radiotherapy for hemostasis. A 74-year-old man with Stage IV gastric cancer received chemotherapy and achieved stable disease. After 23 months, he experienced continuous bleeding from the tumor due to regrowth. Palliative radiotherapy was conducted to control the bleeding, and the tumor successfully achieved hemostasis. However, 6 weeks later, the patient experienced rebleeding and developed hemostatic shock. We then performed a successful emergency gastrectomy. Bleeding negatively affects quality of life in patients with AGC and is potentially lethal. Although palliative radiotherapy for bleeding of gastric cancer is a safe and useful treatment within a short time frame in cases of rebleeding, emergency gastrectomy may be necessary. Therefore, when we select this treatment, the possibility of subsequent surgical treatment must be considered. (author)

  10. [Pharmacological study on hemostasis, analgesic and anti inflammation effects of the alcohol extract of Hibiscus tiliaceus].

    Science.gov (United States)

    Qiu, Fen; Tian, Hui; Zhang, Zhi; Yuan, Xian-Ling; Tan, Yuan-Feng; Ning, Xiao-Qing

    2013-10-01

    To study the effects of hemostasis, analgesic and anti inflammation of the alcohol extract of Hibiscus tiliaceus and offer pharmacological and experimental basis for its safe and effective use in clinic. The effects of hemostasist were observed with tail breaking method, capillary tube method and slide method; Hot board and body distortion induced by acetic acid methods were applied in mice analgesia experiment, the mice model of acute auricle swelling induced by dmi ethylbenzene and capillary permeability induced by acetic acid were applied to observe the anti inflammatory effects. The alcohol extract of Hibiscus tiliaceus could significantly reduce the bleeding time and the clotting time, delay the plant reaction time and reduce the writhing times of the mice, and it also had effect on inhibiting swelling of mice ear and the permeability of the capillary. These results suggest that the alcohol extract of Hibiscus tiliaceus has the effects of hemostasis, analgesic and anti inflammation.

  11. Hemostasis system in patients with pulmonary cancer during multimodality treatment with the use of artificial hyperglycemia

    International Nuclear Information System (INIS)

    Demidchik, Yu.E.; Zharkov, V.V.; Antipova, L.I.; Kurchin, V.P.; Moiseev, P.I.

    1990-01-01

    The main hemostasis indices at all stages of combined treatment of 105 patients with pulmonary cancer, involving radiotherapy artificial hyperglycemia and surgical intervention, are estimated. The functional status of the hemostasis system was estimated on the basis of a complex of hemocoagulation tests. All patients were subjected to preoperative remote large-fractioned irradiation with 20 Gy total absorbed dose in 5 fractions of 4 Gy in a week. It is established that at the irradiation stage of combined treatment hyperglycemia leads to hyper coagulation and increases the risk of thromboembolic complications. For prophylaxis of the complications it is reasonable to combine low doses of heparin and preparations, improving blood rheology either before or after surgical intervention. 7 refs.; 2 tabs

  12. The Use of a Hemostasis Introducer for Percutaneous Extraction of Bile Duct Stones.

    Science.gov (United States)

    Feisthammel, Juergen; Moche, Micheal; Mossner, Joachim; Hoffmeister, Albrecht

    2012-02-01

    Choledocholithiasis is defined as presence of at least one gallstone in the bile duct. Those bile duct stones (BDS) usually are extracted by ERCP. In case the bile duct is not accessible endoscopically (e.g. after major abdominal surgery), PTCD has to be performed. Extraction of the stones via PTCD has several risks as are hemorrhage, pancreatitis and injuries of the liver tissue. We here report about our experience with a significant modification of this technique by use of a 13-french hemostasis introducer as a sheath to track the transhepatic access to the bile ducts in order to reduce time and risk. Three patients were treated by use of the reported modification. In all cases, the stones were successfully removable without complications. We demonstrate that the use of a hemostasis introducer for percutaneous extraction of common bile duct stones seems to be promising in terms of shortening hospital stay and increasing patient safety.

  13. Impaired platelet aggregation and rebalanced hemostasis in patients with chronic hepatitis C virus infection

    DEFF Research Database (Denmark)

    Nielsen, Nick S.; Jespersen, Sofie; Gaardbo, Julie C.

    2017-01-01

    Increased risk of both cardiovascular disease (CVD) and bleeding has been found in patients with chronic hepatitis C (CHC) infection, and a re-balanced hemostasis has been proposed. The aim of this study was to investigate functional whole blood coagulation and platelet function in CHC infection....... The prospective study included 82 patients with CHC infection (39 with advanced liver fibrosis and 43 with no or mild liver fibrosis) and 39 healthy controls. A total of 33 patients were treated for CHC infection and achieved sustained virological response (SVR). Baseline and post-treatment blood samples were...... collected. Hemostasis was assessed by both standard coagulation tests and functional whole blood hemostatic assays (thromboelastograhy (TEG), and platelet aggregation (Multiplate). Patients with CHC and advanced fibrosis had impaired platelet aggregation both compared to patients with no or mild fibrosis...

  14. Impaired Platelet Aggregation and Rebalanced Hemostasis in Patients with Chronic Hepatitis C Virus Infection

    Directory of Open Access Journals (Sweden)

    Nick S. Nielsen

    2017-05-01

    Full Text Available Increased risk of both cardiovascular disease (CVD and bleeding has been found in patients with chronic hepatitis C (CHC infection, and a re-balanced hemostasis has been proposed. The aim of this study was to investigate functional whole blood coagulation and platelet function in CHC infection. The prospective study included 82 patients with CHC infection (39 with advanced liver fibrosis and 43 with no or mild liver fibrosis and 39 healthy controls. A total of 33 patients were treated for CHC infection and achieved sustained virological response (SVR. Baseline and post-treatment blood samples were collected. Hemostasis was assessed by both standard coagulation tests and functional whole blood hemostatic assays (thromboelastograhy (TEG, and platelet aggregation (Multiplate. Patients with CHC and advanced fibrosis had impaired platelet aggregation both compared to patients with no or mild fibrosis and to healthy controls. Patients with CHC and advanced fibrosis also had lower antithrombin, platelet count, and coagulation factors II-VII-X compared to healthy controls. In contrast, TEG did not differ between groups. In treated patients achieving SVR, post-treatment platelet count was higher than pre-treatment counts (p = 0.033 and ADPtest, ASPItest, and RISTOhightest all increased post treatment (all p < 0.05. All Multiplate tests values, however, remained below those in the healthy controls. CHC-infected patients displayed evidence of rebalanced hemostasis with only partly hemostatic normalization in patients achieving SVR. The implications of rebalanced hemostasis and especially the impact on risk of CVD and bleeding warrants further studies.

  15. Compare Complication of Classic versus Patent Hemostasis in Transradial Coronary Angiography

    OpenAIRE

    Roghani, Farshad; Tajik, Mohammad Nasim; Khosravi, Alireza

    2017-01-01

    Background: Coronary artery disease (CAD) is multifactorial disease, in which thrombotic occlusion and calcification occur usually. New strategies have been made for diagnosis and treatment of CAD, such as transradial catheterization. Hemostasis could be done in two approaches: traditional and patent. Our aim is to find the best approach with lowest complication. Materials and Methods: In a comparative study, 120 patients were recruited and divided randomly into two subgroups, including tradi...

  16. ebb® Complete Tamponade System: effective hemostasis for postpartum hemorrhage

    OpenAIRE

    McQuivey,Ross W; Block,Jon E; Massaro,Robert A

    2018-01-01

    Ross W McQuivey,1 Jon E Block,2 Robert A Massaro3 1Clinical Innovations, Salt Lake City, UT, USA; 2Independent Clinical Consultant, San Francisco, CA, USA; 3Monmouth Medical Center, Long Branch, NJ, USA Abstract: As a leading cause of maternal death, postpartum hemorrhage (PPH) remains a worldwide obstetrical problem. However, in most cases, mortality and morbidity can be averted if efforts are immediately undertaken to achieve hemostasis. Uterine balloon tamponade has been shown to provide e...

  17. Hemostasis in acquired hemophilia--role of intracavitary instillation of EACA.

    Directory of Open Access Journals (Sweden)

    Sahu S

    1996-07-01

    Full Text Available An 82 year old man developed antibodies against coagulation factor VIII:C without any apparent cause. Bleeding from the soft tissue cavity could not be controlled by factor VIII:C concentrates, immunosuppression with steroids and intravenous immunoglobulin therapy in the standard dosages. However, a single injection of Epsilon Aminocaproic Acid (EACA instilled into the cavity under aseptic precautions achieved lasting hemostasis with resultant wound healing.

  18. The academic challenge of teaching psychomotor skills for hemostasis of solid organ injury.

    Science.gov (United States)

    Lucas, Charles E; Ledgerwood, Anna M

    2009-03-01

    This study highlights the inherent challenges of achieving psychomotor skills in an era of nonoperative therapy for solid organ injuries. Technical procedures on the liver, the most frequent intra-abdominal solid organ injured, were assessed in five decades. Guided by prospective assessment and registry data, all patients with liver injury seen during 24 months in five consecutive decades were reviewed. Initially (1960s), all injuries were explored; currently (2000s), most injuries are observed. The number of patients was 235 (1960s), 228 (1970s), 79 (1980s), 116 (1990s), and 64 (2000s). The greater number in the 1990s reflects the diagnosis of minor, clinically insignificant, blunt injuries after abdominal CAT scan became available. Each injury was categorized by cause, severity (Abbreviated Injury Scale), associated shock, and primary therapy (observe [OBS], operation alone [OR], hepatorrhaphy [SUT], tractotomy [TRACT] with intraparenchymal hemostasis, hepatic dearterialization [HAL], and resection [RESECT]). Packing, used in each decade, was placed in one of the above primary treatment groups. The primary techniques for hemostasis are shown in the text table.Shock and Abbreviated Injury Scale correlated with mortality averaged 16%; 40 of 116 deaths (34%) exsanguinated from hepatic injury. During training, a resident performed an average of 12.0, 12.0, 2.4, 4.0, and 1.3 procedures for hemostasis. Reduced incidence and decreased therapeutic laparotomies for liver injury have created a training vacuum for future trauma surgeons. Surgical residents will need to supplement their clinical experience with solid organ hemostasis by practice on appropriate animal models of injury and cadaver dissections.

  19. ebb® Complete Tamponade System: effective hemostasis for postpartum hemorrhage

    Directory of Open Access Journals (Sweden)

    McQuivey RW

    2018-03-01

    Full Text Available Ross W McQuivey,1 Jon E Block,2 Robert A Massaro3 1Clinical Innovations, Salt Lake City, UT, USA; 2Independent Clinical Consultant, San Francisco, CA, USA; 3Monmouth Medical Center, Long Branch, NJ, USA Abstract: As a leading cause of maternal death, postpartum hemorrhage (PPH remains a worldwide obstetrical problem. However, in most cases, mortality and morbidity can be averted if efforts are immediately undertaken to achieve hemostasis. Uterine balloon tamponade has been shown to provide effective control of PPH and avoid more invasive surgical procedures and even the emergency peripartum hysterectomy. Recent clinical recommendation suggests that balloon tamponade should be considered earlier in the treatment cascade in conjunction with uterotonic agents to ensure hemostasis in the most timely fashion and maximize clinical outcomes. This paper profiles the ebb® Complete Tamponade System, a unique dual-balloon single-use device that was developed specifically for hemostatic management of PPH. The ebb system combines a uterine conforming balloon that can be rapidly deployed with a vaginal balloon that eliminates the need for vaginal packing. The description, indications for use, procedural steps, and clinical characterization of this device are presented. Keywords: postpartum hemorrhage, balloon tamponade, hemostasis, maternal bleeding

  20. Low-cost 420nm blue laser diode for tissue cutting and hemostasis

    Science.gov (United States)

    Linden, Kurt J.

    2016-03-01

    This paper describes the use of a 420 nm blue laser diode for possible surgery and hemostasis. The optical absorption of blood-containing tissue is strongly determined by the absorption characteristics of blood. Blood is primarily comprised of plasma (yellowish extracellular fluid that is approximately 95% water by volume) and formed elements: red blood cells (RBCs), white blood cells (WBCs) and platelets. The RBCs (hemoglobin) are the most numerous, and due to the spectral absorption characteristics of hemoglobin, the optical absorption of blood has a strong relative maximum value in the 420 nm blue region of the optical spectrum. Small, low-cost laser diodes emitting at 420 nm with tens of watts of continuous wave (CW) optical power are becoming commercially available. Experiments on the use of such laser diodes for tissue cutting with simultaneous hemostasis were carried out and are here described. It was found that 1 mm deep x 1 mm wide cuts can be achieved in red meat at a focused laser power level of 3 W moving at a velocity of ~ 1 mm/s. The peripheral necrosis and thermal damage zone extended over a width of approximately 0.5 mm adjacent to the cuts. Preliminary hemostasis experiments were carried out with fresh equine blood in Tygon tubing, where it was demonstrated that cauterization can occur in regions of intentional partial tubing puncture.

  1. Evaluation of hemostasis parameters and the role of the oxidative damage to plasma proteins in the modulation of hemostasis in patients with nephrolithiasis before and after extracorporeal shock wave lithotripsy.

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    Paweł Woźniak

    Full Text Available Extracorporeal shock wave lithotripsy (ESWL is a commonly-used method in urology, which may modulate hemostasis and may induce lipid peroxidation in patients with nephrolithiasis. However, previous studies only examine changes occurring in patients 30-240 min after ESWL. The main aim of the present study was to determine whether oxidative stress may modulate the hemostatic activity of plasma in patients with nephrolithiasis before ESWL and the day after treatment ESWL. This will be performed by measuring selected parameters of hemostasis in these patients, both before ESWL and the following day, and assessing the level of oxidative damage to plasma proteins in these patients by measuring two biomarkers.Twelve patients with nephrolithiasis and 10 healthy participants were included. The following parameters of hemostasis were measured: the activated partial thromboplastin time (APTT, prothrombin time (PT, and thrombin time (TT of plasma, the level of fibrinogen, the level of D-dimer and blood platelet count. In addition, two selected biomarkers of oxidative stress were measured: protein carbonylation level and the number of protein thiol groups.No difference was observed between patients with nephrolithiasis before and after ESWL and healthy controls with regard to PT, TT or APTT. Fibrinogen concentration and blood platelet count were lower in the nephrolithiasis patients in the period after ESWL than before ESWL. The nephrolithiasis patients demonstrated elevated D-dimer concentration after ESWL. However, although oxidative damage was observed in the plasma proteins in the nephrolithiasis patients, this was not influenced by ESWL.Oxidative stress may induce changes of hemostasis in patients with nephrolithiasis, both before and after ESWL. In addition, changes of hemostasis parameters such as fibrinogen, blood platelet count and D-dimer level can be observed in these patients, especially after ESWL, and this may suggest that ESWL modulates

  2. Evaluation of hemostasis parameters and the role of the oxidative damage to plasma proteins in the modulation of hemostasis in patients with nephrolithiasis before and after extracorporeal shock wave lithotripsy.

    Science.gov (United States)

    Woźniak, Paweł; Kontek, Bogdan; Różański, Waldemar; Olas, Beata

    2017-01-01

    Extracorporeal shock wave lithotripsy (ESWL) is a commonly-used method in urology, which may modulate hemostasis and may induce lipid peroxidation in patients with nephrolithiasis. However, previous studies only examine changes occurring in patients 30-240 min after ESWL. The main aim of the present study was to determine whether oxidative stress may modulate the hemostatic activity of plasma in patients with nephrolithiasis before ESWL and the day after treatment ESWL. This will be performed by measuring selected parameters of hemostasis in these patients, both before ESWL and the following day, and assessing the level of oxidative damage to plasma proteins in these patients by measuring two biomarkers. Twelve patients with nephrolithiasis and 10 healthy participants were included. The following parameters of hemostasis were measured: the activated partial thromboplastin time (APTT), prothrombin time (PT), and thrombin time (TT) of plasma, the level of fibrinogen, the level of D-dimer and blood platelet count. In addition, two selected biomarkers of oxidative stress were measured: protein carbonylation level and the number of protein thiol groups. No difference was observed between patients with nephrolithiasis before and after ESWL and healthy controls with regard to PT, TT or APTT. Fibrinogen concentration and blood platelet count were lower in the nephrolithiasis patients in the period after ESWL than before ESWL. The nephrolithiasis patients demonstrated elevated D-dimer concentration after ESWL. However, although oxidative damage was observed in the plasma proteins in the nephrolithiasis patients, this was not influenced by ESWL. Oxidative stress may induce changes of hemostasis in patients with nephrolithiasis, both before and after ESWL. In addition, changes of hemostasis parameters such as fibrinogen, blood platelet count and D-dimer level can be observed in these patients, especially after ESWL, and this may suggest that ESWL modulates hemostasis. By

  3. Prognostic Performance Evaluation of the International Society on Thrombosis and Hemostasis and the Korean Society on Thrombosis and Hemostasis Scores in the Early Phase of Trauma.

    Science.gov (United States)

    Kim, Hong Sug; Lee, Dong Hun; Lee, Byung Kook; Cho, Yong Soo

    2018-01-15

    Disseminated intravascular coagulation (DIC) contributes to poor outcome in the early phase of trauma. We aimed to analyze and compare the prognostic performances of the International Society on Thrombosis and Hemostasis (ISTH) and the Korean Society on Thrombosis and Hemostasis (KSTH) scores in the early phase of trauma. Receiver operating characteristics analysis was used to examine the prognostic performance of both scores, and multivariate analysis was used to estimate the prognostic impact of the ISTH and KSTH scores in the early phase of trauma. The primary outcome was 24-hour mortality and the secondary outcome was massive transfusion. Of 1,229 patients included in the study, the 24-hour mortality rate was 7.6% (n = 93), and 8.1% (n = 99) of patients who received massive transfusions. The area under the curves (AUCs) of the KSTH and ISTH scores for 24-hour mortality were 0.784 (95% confidence interval [CI], 0.760-0.807) and 0.744 (95% CI, 0.718-0.768), respectively. The AUC of KSTH and ISTH scores for massive transfusion were 0.758 (95% CI, 0.734-0.782) and 0.646 (95% CI, 0.619-0.673), respectively. The AUCs of the KSTH score was significantly different from those of the ISTH score. Overt DIC according to KSTH criteria only, was independently associated with 24-hour mortality (odds ratio [OR], 2.630; 95% CI, 1.456-4.752). Only the KSTH score was independently associated with massive transfusion (OR, 1.563; 95% CI, 1.182-2.068). The KSTH score demonstrates a better prognostic performance for outcomes than the ISTH score in the early phase of trauma. © 2018 The Korean Academy of Medical Sciences.

  4. The role of platelets in hemostasis and the effects of snake venom toxins on platelet function.

    Science.gov (United States)

    de Queiroz, Mayara Ribeiro; de Sousa, Bruna Barbosa; da Cunha Pereira, Déborah Fernanda; Mamede, Carla Cristine Neves; Matias, Mariana Santos; de Morais, Nadia Cristina Gomes; de Oliveira Costa, Júnia; de Oliveira, Fábio

    2017-07-01

    The human body has a set of physiological processes, known as hemostasis, which keeps the blood fluid and free of clots in normal vessels; in the case of vascular injury, this process induces the local formation of a hemostatic plug, preventing hemorrhage. The hemostatic system in humans presents complex physiological interactions that involve platelets, plasma proteins, endothelial and subendothelial structures. Disequilibrium in the regulatory mechanisms that control the growth and the size of the thrombus is one of the factors that favors the development of diseases related to vascular disorders such as myocardial infarction and stroke, which are among the leading causes of death in the western world. Interfering with platelet function is a strategy for the treatment of thrombotic diseases. Antiplatelet drugs are used mainly in cases related to arterial thrombosis and interfere in the formation of the platelet plug by different mechanisms. Aspirin (acetylsalicylic acid) is the oldest and most widely used antithrombotic drug. Although highly effective in most cases, aspirin has limitations compared to other drugs used in the treatment of homeostatic disorders. For this reason, research related to molecules that interfere with platelet aggregation are of great relevance. In this regard, snake venoms are known to contain a number of molecules that interfere with hemostasis, including platelet function. The mechanisms by which snake venom components inhibit or activate platelet aggregation are varied and can be used as tools for the diagnosis and the treatment of several hemostatic disorders. The aim of this review is to present the role of platelets in hemostasis and the mechanisms by which snake venom toxins interfere with platelet function. Copyright © 2017 Elsevier Ltd. All rights reserved.

  5. Hemorrhages and hemostasis in guinea-pigs exposed to irradiation at high altitude

    International Nuclear Information System (INIS)

    Tartakovskij, V.N.; Daniyarov, S.B.

    1988-01-01

    Hemorrhagic intensity, hemostasis and blood vessel wall resistance to mechanical effects were studied in guinea-pigs exposed to whole-body irradiation (3.0 Gy). The animals were irradiated at low altitude (760 m above sea level) and at high altitude (3200 m above sea level) after 1 and 31 days of adaptation. It was demonstrated that hemorrhagic intensity in both groups of guinea-pigs irradiated at high altitude was significantly reduced in comparison with that at low altitude. The decrease of radiation-induced hemorrhages at high altitude is associated with less severe changes in thrombopoiesis, blood vessel wall and blood coagulation

  6. AN EXPERIMENTAL STUDY OF THE EFFICACY AND SAFETY OF VARIOUS ENDOSCOPIC HEMOSTASIS TECHNIQUES

    Directory of Open Access Journals (Sweden)

    A. I. Cherepanin

    2014-01-01

    Full Text Available ABSTRACT. The treatment of bleeding peptic ulcers remains one of the pressing challenges in urgent surgery. Currently available endoscopic hemostasis modalities only partially meet the requirements of safety, efficiency and reliability, and therefore total and postoperative mortality rates are still high, both in our country, and around the world. The aim of the study was to identify the benefits and shortcomings of endoscopic radiofrequency energy exposure compared to standard hemostatic techniques used in the world practice to treat bleeding peptic ulcers. 

  7. The changing face of hemostasis testing in modern laboratories: consolidation, automation, and beyond.

    Science.gov (United States)

    Lippi, Giuseppe; Plebani, Mario; Favaloro, Emmanuel J

    2015-04-01

    The reality of laboratory diagnostics as a whole, and hemostasis testing in particular, is evolving under new paradigms of efficiency. The driving forces of health care and laboratory diagnostics in the third millennium are mainly represented by macro- and microeconomics. In a world with limited resources, shattered by an unprecedented economic crisis, laboratory diagnostics is undergoing a substantial reorganization, with emergence of new models under the imperative of terms, such as bedside testing, consolidation, and networking. The paradigms under which these changes are being developed include a variety of environment, preanalytical, technological, professional, and health-care aspects. The maintenance of continued quality is indeed the major challenge to be faced in the foreseeable future. In fact, some challenges prepotently emerge during a consolidation process, which basically involve delayed testing, centrifugation, transportation, and stability of the specimens, as well as the potential mismatch of sample matrix. This article is aimed to provide an overview of the current economic scenario of laboratory diagnostics and discuss the changing face of hemostasis testing in modern laboratories, providing a synthetic overview about potential drawbacks of actualized solutions. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  8. The Design and Testing of a Dual Fiber Textile Matrix for Accelerating Surface Hemostasis

    Science.gov (United States)

    Fischer, Thomas H.; Vournakis, John N.; Manning, James E.; McCurdy, Shane L.; Rich, Preston B.; Nichols, Timothy C.; Scull, Christopher M.; McCord, Marian G.; Decorta, Joseph A.; Johnson, Peter C.; Smith, Carr J.

    2011-01-01

    The standard treatment for severe traumatic injury is frequently compression and application of gauze dressing to the site of hemorrhage. However, while able to rapidly absorb pools of shed blood, gauze fails to provide strong surface (topical) hemostasis. The result can be excess hemorrhage-related morbidity and mortality. We hypothesized that cost-effective materials (based on widespread availability of bulk fibers for other commercial uses) could be designed based on fundamental hemostatic principles to partially emulate the wicking properties of gauze while concurrently stimulating superior hemostasis. A panel of readily available textile fibers was screened for the ability to activate platelets and the intrinsic coagulation cascade in vitro. Type E continuous filament glass and a specialty rayon fiber were identified from the material panel as accelerators of hemostatic reactions and were custom woven to produce a dual fiber textile bandage. The glass component strongly activated platelets while the specialty rayon agglutinated red blood cells. In comparison with gauze in vitro, the dual fiber textile significantly enhanced the rate of thrombin generation, clot generation as measured by thromboelastography, adhesive protein adsorption and cellular attachment and activation. These results indicate that hemostatic textiles can be designed that mimic gauze in form but surpass gauze in ability to accelerate hemostatic reactions. PMID:19489008

  9. The effects of nanomaterials on blood coagulation in hemostasis and thrombosis.

    Science.gov (United States)

    Simak, Jan; De Paoli, Silvia

    2017-09-01

    The blood coagulation balance in the organism is achieved by the interaction of the blood platelets (PLTs) with the plasma coagulation system (PCS) and the vascular endothelial cells. In healthy organism, these systems prevent thrombosis and, in events of vascular damage, enable blood clotting to stop bleeding. The dysregulation of hemostasis may cause serious thrombotic and/or hemorrhagic pathologies. Numerous engineered nanomaterials are being investigated for biomedical purposes and are unavoidably exposed to the blood. Also, nanomaterials may access vascular system after occupational, environmental, or other types of exposure. Thus, it is essential to evaluate the effects of engineered nanomaterials on hemostasis. This review focuses on investigations of nanomaterial interactions with the blood components involved in blood coagulation: the PCS and PLTs. Particular emphases include the pathophysiology of effects of nanomaterials on the PCS, including the kallikrein-kinin system, and on PLTs. Methods for investigating these interactions are briefly described, and a review of the most important studies on the interactions of nanomaterials with plasma coagulation and platelets is provided. WIREs Nanomed Nanobiotechnol 2017, 9:e1448. doi: 10.1002/wnan.1448 For further resources related to this article, please visit the WIREs website. © Published 2017. This article is a U.S. Government work and is in the public domain in the USA.

  10. COGNITIVE FUNCTIONS IN PATIENTS WITH ARTERIAL HYPERTENSION DEPENDING ON THE STATE OF HEMOSTASIS AND RENAL FUNCTION

    Directory of Open Access Journals (Sweden)

    Oleh Shmanko

    2015-09-01

      Summary. In 58 patients with arterial hypertension cognitive functions were examined depending on the state of hemostasis and renal function. The evaluation was conducted using short scale assessment of mental status (MMSE, Montreal scale (MOCA for studying attention and concentration, executive functions, memory, language performance, constructive visual performance, abstract thinking, mental calculation, spatial and temporal orientation. The sustainability of attentional focus and speed of sensorimotor reactions were investigated using the tables of Schulte. The quality of life of patients was assessed for physical and mental components employing a questionnaire SF-12. It was found that such indicators of hemostasis system as international normalized ratio, prothrombin index, level of fibrinogen are diagnostic predictors of the risk of cognitive impairment development in patients with arterial hypertension, considering the results of neuropsychological assessment and evaluation of quality of life. No significant dependence was found between the glomerular filtration rate and the development of cognitive impairment in patients with arterial hypertension.   Keywords: arterial hypertension, cognitive impairment, international normalized ratio, prothrombin index, fibrinogen, glomerular filtration rate.       Резюме У 58 пацієнтів з артеріальною гіпертензією досліджено когнітивні функції в залежності від стану згортальної системи крові та функції нирок.  Оцінку когнітивного статусу проводили за допомогою короткої шкали оцінки психічного статусу (MMSE, Монреальської шкали (MOCA для вивчення уваги та концентрації, виконавчих функцій, пам’яті, мови, конструкти

  11. The Hemostasis Apparatus in Pancreatic Cancer and Its Importance beyond Thrombosis

    International Nuclear Information System (INIS)

    Echrish, Hussein; Madden, Leigh A.; Greenman, John; Maraveyas, Anthony

    2011-01-01

    Laboratory evidence of aberrant coagulation is found in the majority of patients with advanced pancreatic cancer and a clinical consequence of this is the high incidence and prevalence of vascular thromboembolic events. Other sequelae are hypothesized to be the facilitation and acceleration of mechanisms that define the malignant phenotype, such as invasion, trafficking and anchoring, establishing the metastatic niche and inducing angiogenesis. We review the in vitro and preclinical evidence that supports the role of the coagulation apparatus in the metastatic process of pancreatic cancer, with a particular emphasis on interaction of this pathway with clinically-targeted growth factor receptor pathways. Links between hemostasis, angiogenesis and epidermal growth factor pathways and their significance as therapeutic targets are considered

  12. Features state of hemostasis and immunopathological reactions in epstein-barr virus infection in children

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    S. A. Hmilevskaya

    2015-01-01

    Full Text Available The results of clinical laboratory analysis conducted in 64 children with Epstein-Barr virus mononucleosis during the acute period and in different time follow-up observations are presents. It is shown that EBV-mononucleosis in children is accompanied by distinct changes of hemostasis, the Genesis of which play some role virusinduced autoimmune mechanisms, developing on the background of hyperactively immune system. The revealed correlation of data breaches with the severity of the infectious process. It was found that the criterion prolongation hemostatic changes are persistent viral activity. Interferon therapy in complex treatment of children, the sick EBV-mononucleosis, contributed to a more rapid regression of a number of clinical symptoms of disease and normalization gemostaziologicheskikh of indicators. Recommended expansion of the research program of follow-up of persons with EBV infection. 

  13. Compare Complication of Classic versus Patent Hemostasis in Transradial Coronary Angiography.

    Science.gov (United States)

    Roghani, Farshad; Tajik, Mohammad Nasim; Khosravi, Alireza

    2017-01-01

    Coronary artery disease (CAD) is multifactorial disease, in which thrombotic occlusion and calcification occur usually. New strategies have been made for diagnosis and treatment of CAD, such as transradial catheterization. Hemostasis could be done in two approaches: traditional and patent. Our aim is to find the best approach with lowest complication. In a comparative study, 120 patients were recruited and divided randomly into two subgroups, including traditional group (60 patients; 24 females, 36 males; mean age: 64.35 ± 10.56 years) and patent group (60 patients; 28 females, 32 males; mean age: 60.15 ± 8.92 years). All demographic data including age, gender, body mass index, and CAD-related risk factors (smoking, diabetes, hypertension) and technical data including the number of catheters, procedure duration, and hemostatic compression time and clinical outcomes (radial artery occlusion [RAO], hematoma, bleeding) were collected. Data were analyzed by SPSS version 16. Our findings revealed that the incidence of RAO was significantly lower in patent groups compared with traditional group ( P = 0.041). Furthermore, the difference incidence of RAO was higher in early occlusion compare with late one ( P = 0.041). Moreover, there were significant relationship between some factors in patients of traditional group with occlusion (gender [ P = 0.038], age [ P = 0.031], diabetes mellitus [ P = 0.043], hemostatic compression time [ P = 0.036]) as well as in patent group (age [ P = 0.009], hypertension [ P = 0.035]). Our findings showed that RAO, especially type early is significantly lower in patent method compared classic method; and patent hemostasis is the safest method and good alternative for classical method.

  14. Compare Complication of Classic versus Patent Hemostasis in Transradial Coronary Angiography

    Directory of Open Access Journals (Sweden)

    Farshad Roghani

    2017-01-01

    Full Text Available Background: Coronary artery disease (CAD is multifactorial disease, in which thrombotic occlusion and calcification occur usually. New strategies have been made for diagnosis and treatment of CAD, such as transradial catheterization. Hemostasis could be done in two approaches: traditional and patent. Our aim is to find the best approach with lowest complication. Materials and Methods: In a comparative study, 120 patients were recruited and divided randomly into two subgroups, including traditional group (60 patients; 24 females, 36 males; mean age: 64.35 ± 10.56 years and patent group (60 patients; 28 females, 32 males; mean age: 60.15 ± 8.92 years. All demographic data including age, gender, body mass index, and CAD-related risk factors (smoking, diabetes, hypertension and technical data including the number of catheters, procedure duration, and hemostatic compression time and clinical outcomes (radial artery occlusion [RAO], hematoma, bleeding were collected. Data were analyzed by SPSS version 16. Results: Our findings revealed that the incidence of RAO was significantly lower in patent groups compared with traditional group (P = 0.041. Furthermore, the difference incidence of RAO was higher in early occlusion compare with late one (P = 0.041. Moreover, there were significant relationship between some factors in patients of traditional group with occlusion (gender [P = 0.038], age [P = 0.031], diabetes mellitus [P = 0.043], hemostatic compression time [P = 0.036] as well as in patent group (age [P = 0.009], hypertension [P = 0.035]. Conclusion: Our findings showed that RAO, especially type early is significantly lower in patent method compared classic method; and patent hemostasis is the safest method and good alternative for classical method.

  15. The Effect of Severe Birth Asphyxia on the Hemostasis System in Newborns During the First Hour of Life

    Directory of Open Access Journals (Sweden)

    I. E. Golub

    2017-01-01

    Full Text Available In newborns with severe intranatal asphyxia, the hemostasis system adaptation is impaired, thus increasing the risk of bleeding during the first day of life.The purpose of the work was to evaluate the effect of severe birth asphyxia and metabolic acidosis on the newborns' hemostasis system, based on the thromboelastography (TEG findings.Materials and methods. A retrospective analysis of medical records of 40 severely asphyxiated newborns (group 1 and 20 healthy newborns (group 2 was performed. The study was carried out during the first hour of life of the newborns.Results. Infants in group 1 demonstrated a reduced activity of platelets and enzymatic components of the coagulation. The enzymatic phase of the coagulation hemostasis (P<0.001 and the kinetics of clot strength growth significantly decreased in group 1 newborns, as compared to the second group (P<0.001 and P<0.01, respectively. The fibrin network growth rate and its structurization in group 1 newborns was lower than that in group 2 newborns (P<0.05. The platelet activity in group 1 infants was reduced as compared to group 2 (P< 0.05.Fibrinolysis in newborns did not differ at the 30th minute of the study. The correlation analysis demonstrated that decreased pH and Be values and hyperlactacidemia correlated; platelet and coagulation hemostasis parameters were altered with a shift to hypocoagulation. Conclusion. Thromboelastographic study of whole blood samples demonstrated a shift of the hemostatic system to hypocoagulation for both platelet and enzymatic components of hemostasis, without any changes in the clot lysis in severely asphyxiated newborns.

  16. Speed mathematics

    CERN Document Server

    Handley, Bill

    2012-01-01

    This new, revised edition of the bestselling Speed Mathematics features new chapters on memorising numbers and general information, calculating statistics and compound interest, square roots, logarithms and easy trig calculations. Written so anyone can understand, this book teaches simple strategies that will enable readers to make lightning-quick calculations. People who excel at mathematics use better strategies than the rest of us; they are not necessarily more intelligent. With Speed Mathematics you'll discover methods to make maths easy and fun. This book is perfect for stud

  17. Reading aloud and solving simple arithmetic calculation intervention (Learning therapy improves inhibition, verbal episodic memory, focus attention, and processing speed in healthy elderly people: Evidence from a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Rui eNouchi

    2016-05-01

    Full Text Available BackgroundPrevious reports have described that simple cognitive training using reading aloud and solving simple arithmetic calculations, so-called learning therapy, can improve executive functions and processing speed in the older adults. Nevertheless, it is not well-known whether learning therapy improve a wide range of cognitive functions or not. We investigated the beneficial effects of learning therapy on various cognitive functions in healthy older adults.MethodsWe used a single-blinded intervention with two groups (learning therapy group: LT and waiting list control group: WL. Sixty-four elderly were randomly assigned to LT or WL. In LT, participants performed reading Japanese aloud and solving simple calculations training tasks for 6 months. WL did not participate in the intervention. We measured several cognitive functions before and after 6 months intervention periods.ResultsCompared to WL, results revealed that LT improved inhibition performance in executive functions (Stroop: LT (Mean = 3.88 vs. WL (Mean = 1.22, adjusted p =.013 and reverse Stroop LT (Mean = 3.22 vs. WL (Mean = 1.59, adjusted p =.015, verbal episodic memory (logical memory: LT (Mean = 4.59 vs. WL (Mean = 2.47, adjusted p =.015, focus attention(D-CAT: LT (Mean = 2.09 vs. WL (Mean = -0.59, adjusted p =.010 and processing speed compared to the waiting list control group (digit symbol coding: LT (Mean = 5.00 vs. WL (Mean = 1.13, adjusted p =.015 and symbol search: LT (Mean = 3.47 vs. WL (Mean = 1.81, adjusted p =.014.DiscussionThis RCT can showed the benefit of learning therapy on inhibition of executive functions, verbal episodic memory, focus attention, and processing speed in healthy elderly people. Our results were discussed under overlapping hypothesis.Trial registrationThis trial was registered in The University Hospital Medical Information Network Clinical Trials Registry (UMIN000006998.

  18. Pay as You Speed, ISA with incentive for not speeding

    DEFF Research Database (Denmark)

    Lahrmann, Harry Spaabæk; Agerholm, Niels; Tradisauskas, Nerius

    2012-01-01

    To simulate a market introduction of Intelligent Speed Adaptation (ISA) and to study the effect of a Pay as You Speed (PAYS) concept, a field trial with 153 drivers was conducted during 2007–2009. The participants drove under PAYS conditions for a shorter or a longer period. The PAYS concept......, with and without incentive crossed with informative ISA present or absent. The results showed that ISA is an efficient tool for reducing speeding particularly on rural roads. The analysis of speed data demonstrated that the proportion of distance driven above the speed where the ISA equipment responded (PDA...... level. Both informative ISA and incentive ISA reduced the PDA, but there was no statistically significant interaction. Informative reduced it more than the incentive....

  19. Trials

    Directory of Open Access Journals (Sweden)

    Michele Fornaro

    2010-01-01

    Full Text Available Mental Retardation (MR is a developmental disability characterized by impairments in adaptive daily life skills and difficulties in social and interpersonal functioning. Since multiple causes may contribute to MR, associated clinical pictures may vary accordingly. Nevertheless, when psychiatric disorders as Treatment Resistant Depression (TRD and/or alcohol abuse co-exist, their proper detection and management is often troublesome, essentially due to a limited vocabulary MR people could use to describe their symptoms, feelings and concerns, and the lack of reliable screening tools. Furthermore, MR people are among the most medicated subjects, with (over prescription of antidepressants and/or typical antipsychotics being the rule rather than exception. Thus, treatment resistance or even worsening of depression, constitute frequent occurrences. This report describes the case of a person with MR who failed to respond to repetitive trials of antidepressant monotherapies, finally recovering using aripiprazole to fluvoxamine augmentation upon consideration of a putative bipolar diathesis for “agitated” TRD. Although further controlled investigations are needed to assess a putative bipolar diathesis in some cases of MR associated to TRD, prudence is advised in the long-term prescription of antidepressant monotherapies in such conditions.

  20. Peculiarities of coagulation hemostasis disorders in patients with chronic obstructive pulmonary disease

    Directory of Open Access Journals (Sweden)

    Yakovlieva V.H.

    2015-09-01

    Full Text Available The violation of blood coagulation properties is observed in many diseases of the respiratory system, including chronic obstructive pulmonary disease (COPD. It is known that in a stable COPD phase release of proinflammatory cytokines in blood is observed, it leads to disturbance of hemostasis parameters toward hypercoagulation. The aim of our study was to determine possibility of coagulation disorders formation in patients with COPD in a stable phase of pathological process at different stages of disease course and identify relationship between coagulation parameters levels and degree of violation of ventilation lung function. Materials and methods. We examined 30 patients with COPD in a stable disease phase, included in the main group (FEV1 =49,5±15,5% of the due, there were 27 men (90.0%, 3 (30.0% women, mean age was 61,8±7,9 years, level of pack /years index - 34,2±15,3. The control group consisted of 10 healthy subjects matched with the patients of the main group by age and sex. All patients were divided into 2 subgroups. Subgroup 1 included 16 patients with moderate COPD, that is the level of FEV1>50% (61,8±7,4% of predicted, and subgroup 2 - 14 COPD patients with severe COPD, that is the level of FEV1 <50% (35,3±8,2% of predicted. Patients received standard treatment according to the disease stage. Main indicators of coagulation levels: prothrombin index (PI, prothrombin ratio (PR, international normalized ratio (INR, activated partial thromboplastin time (APTT, thrombin time (TT and antithrombin III (AT III were identified in all patients. Results. The levels of PI, PR and INR in the subgroup 1 differed significantly from those of in the subgroup 2, control group (p<0,05 and pointed at hypercoagulation, whereas in the subgroup 2 all indicators were absolutely identical with control group. Correlation link between the level of INR levels and FEV1 (r=-0,73; p<0.01 in patients of the main group was determined. Levels of APTT, TT and AT

  1. Left Atrial 4D Blood Flow Dynamics and Hemostasis following Electrical Cardioversion of Atrial Fibrillation

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    Merih Cibis

    2017-12-01

    Full Text Available Background: Electrical cardioversion in patients with atrial fibrillation is followed by a transiently impaired atrial mechanical function, termed atrial stunning. During atrial stunning, a retained risk of left atrial thrombus formation exists, which may be attributed to abnormal left atrial blood flow patterns. 4D Flow cardiovascular magnetic resonance (CMR enables blood flow assessment from the entire three-dimensional atrial volume throughout the cardiac cycle. We sought to investigate left atrial 4D blood flow patterns and hemostasis during left atrial stunning and after left atrial mechanical function was restored.Methods: 4D Flow and morphological CMR data as well as blood samples were collected in fourteen patients at two time-points: 2–3 h (Time-1 and 4 weeks (Time-2 following cardioversion. The volume of blood stasis and duration of blood stasis were calculated. In addition, hemostasis markers were analyzed.Results: From Time-1 to Time-2: Heart rate decreased (61 ± 7 vs. 56 ± 8 bpm, p = 0.01; Maximum change in left atrial volume increased (8 ± 4 vs. 22 ± 15%, p = 0.009; The duration of stasis (68 ± 11 vs. 57 ± 8%, p = 0.002 and the volume of stasis (14 ± 9 vs. 9 ± 7%, p = 0.04 decreased; Thrombin-antithrombin complex (TAT decreased (5.2 ± 3.3 vs. 3.3 ± 2.2 μg/L, p = 0.008. A significant correlation was found between TAT and the volume of stasis (r2 = 0.69, p < 0.001 at Time-1 and between TAT and the duration of stasis (r2 = 0.34, p = 0.04 at Time-2.Conclusion: In this longitudinal study, left atrial multidimensional blood flow was altered and blood stasis was elevated during left atrial stunning compared to the restored left atrial mechanical function. The coagulability of blood was also elevated during atrial stunning. The association between blood stasis and hypercoagulability proposes that assessment of left atrial 4D flow can add to the pathophysiological understanding of thrombus formation during atrial fibrillation

  2. Left Atrial 4D Blood Flow Dynamics and Hemostasis following Electrical Cardioversion of Atrial Fibrillation

    Science.gov (United States)

    Cibis, Merih; Lindahl, Tomas L.; Ebbers, Tino; Karlsson, Lars O.; Carlhäll, Carl-Johan

    2017-01-01

    Background: Electrical cardioversion in patients with atrial fibrillation is followed by a transiently impaired atrial mechanical function, termed atrial stunning. During atrial stunning, a retained risk of left atrial thrombus formation exists, which may be attributed to abnormal left atrial blood flow patterns. 4D Flow cardiovascular magnetic resonance (CMR) enables blood flow assessment from the entire three-dimensional atrial volume throughout the cardiac cycle. We sought to investigate left atrial 4D blood flow patterns and hemostasis during left atrial stunning and after left atrial mechanical function was restored. Methods: 4D Flow and morphological CMR data as well as blood samples were collected in fourteen patients at two time-points: 2–3 h (Time-1) and 4 weeks (Time-2) following cardioversion. The volume of blood stasis and duration of blood stasis were calculated. In addition, hemostasis markers were analyzed. Results: From Time-1 to Time-2: Heart rate decreased (61 ± 7 vs. 56 ± 8 bpm, p = 0.01); Maximum change in left atrial volume increased (8 ± 4 vs. 22 ± 15%, p = 0.009); The duration of stasis (68 ± 11 vs. 57 ± 8%, p = 0.002) and the volume of stasis (14 ± 9 vs. 9 ± 7%, p = 0.04) decreased; Thrombin-antithrombin complex (TAT) decreased (5.2 ± 3.3 vs. 3.3 ± 2.2 μg/L, p = 0.008). A significant correlation was found between TAT and the volume of stasis (r2 = 0.69, p < 0.001) at Time-1 and between TAT and the duration of stasis (r2 = 0.34, p = 0.04) at Time-2. Conclusion: In this longitudinal study, left atrial multidimensional blood flow was altered and blood stasis was elevated during left atrial stunning compared to the restored left atrial mechanical function. The coagulability of blood was also elevated during atrial stunning. The association between blood stasis and hypercoagulability proposes that assessment of left atrial 4D flow can add to the pathophysiological understanding of thrombus formation during atrial fibrillation related

  3. Hormonal, electrolyte disturbances and features of hemostasis in term newborn infants of mothers with gestational diabetes mellitus.

    Directory of Open Access Journals (Sweden)

    Evgeny Viktorovich Mikhalev

    2015-03-01

    Full Text Available The article reviews the available data on investigations in the field of electrolyte (calcium, magnesium, hormonal (insulin, leptin and hemostasis disturbances in term newborns from women with gestational diabetes; possible mechanisms of their development are also highlighted. The review describes changes in blood glucose concentration in term newborns from women with gestational diabetes, and their impact on the child's condition. In addition to already known factors causing macrosomia and other metabolic disorders in term neonates, the role of leptin (peptide hormone that regulates energy metabolism is quite discussable. Low leptin levels lead to the development of obesity. It is also confirmed, that leptin influences brain development of the newborn, leading to later cognitive deficits in children from women with GDM. The aim of the review is to summarize the available data on investigations in the field of electrolyte (calcium, magnesium, hormonal (insulin, leptin and hemostasis disturbances in term newborns from women with gestational diabetes.

  4. Successful Endoscopic Hemostasis Is a Protective Factor for Rebleeding and Mortality in Patients with Nonvariceal Upper Gastrointestinal Bleeding.

    Science.gov (United States)

    Han, Yong Jae; Cha, Jae Myung; Park, Jae Hyun; Jeon, Jung Won; Shin, Hyun Phil; Joo, Kwang Ro; Lee, Joung Il

    2016-07-01

    Rebleeding and mortality rates remain high in patients with nonvariceal upper gastrointestinal bleeding. To identify clinical and endoscopic risk factors for rebleeding and mortality in patients with nonvariceal upper gastrointestinal bleeding. This study was performed in patients with nonvariceal upper gastrointestinal bleeding who underwent upper endoscopic procedures between July 2006 and February 2013. Clinical and endoscopic characteristics were compared among patients with and without rebleeding and mortality. Logistic regression analysis was performed to determine independent risk factors for rebleeding and mortality. After excluding 64 patients, data for 689 patients with nonvariceal upper gastrointestinal bleeding were analyzed. Peptic ulcer (62.6 %) was by far the most common source of bleeding. Endoscopic intervention was performed within 24 h in 99.0 % of patients, and successful endoscopic hemostasis was possible in 80.7 % of patients. The 30-day rebleeding rate was 13.1 % (n = 93). Unsuccessful endoscopic hemostasis was found to be the only independent risk factor for rebleeding (odds ratio 79.6; 95 % confidence interval 37.8-167.6; p = 0.000). The overall 30-day mortality rate was 3.2 % (n = 23). Unsuccessful endoscopic hemostasis (odds ratio 4.9; 95 % confidence interval 1.7-13.9; p = 0.003) was also associated with increased 30-day mortality in patients with nonvariceal upper gastrointestinal bleeding. Successful endoscopic hemostasis is an independent protective factor for both rebleeding and mortality in patients with nonvariceal upper gastrointestinal bleeding.

  5. REGENERATIVE PECULIARITIES OF LIVER TISSUE AFTER HEMOSTASIS BY NONEQUILIBRIUM PLASMA ON 90TH AND 180TH DAY (EXPERIMENTAL STUDY

    Directory of Open Access Journals (Sweden)

    Ye. V. Semichev

    2014-01-01

    Full Text Available Liver damages occur to 17.8% of blunt abdominal trauma cases. Postoperative mortality in liver damage is a high. It amounts to 4–10% in case of stab wounds, to 30.4–35,2% in case of closed injury, to 39.3% in case of concomitant injury. Complete hemostasis without damage to organ parenchyma is needed for liver surgical operation.The aim of research is to evaluate the regenerative characteristics of liver tissue after hemostasis by nonequilibrium plasma in a long-term period.Material and methods. Research was performed on 20 laboratory rats, 3 experimental groups. 10 intact animals and 5 animals in groups on 90th and 180th day. Surgery is resection of liver left lobe and coagulation with cold plasma coagulator. The biochemical control (glucose, ALT, AST, total bilirubin, direct, alkaline phosphatase, total protein, urea, α-amylase, CRP, fibrinogen, aPTT, PTT, INR, morphological study of rat liver were performed.Results. After surgery with cold plasma hemostasis animals are active, early begin to eat. Fatal cases are not. Analysis of biochemical markers doesn't reveal statistically significant differences from the norm for the majority of indicators. Decrease of glucose concentration in the blood serum is observed in a long-term period. Histological analysis reveals an increase of the central and interlobular veins and moderate signs of edema on the 90th day. Hepatocytes with pronounced signs of protein and fatty degeneration are identified. Liver histology corresponds to the usual structure and is represented by liver lobules, separated by a small layer of connective tissue on the 180th day.Conclusion. Cold plasma coagulation in liver surgery showed effective hemostasis, minimal trauma of organ parenchyma, the lack of systemic effect and the subsequent complete regeneration of liver tissue in the treatment area.

  6. Comparison of a priori versus provisional heparin therapy on radial artery occlusion after transradial coronary angiography and patent hemostasis (from the PHARAOH Study).

    Science.gov (United States)

    Pancholy, Samir B; Bertrand, Olivier F; Patel, Tejas

    2012-07-15

    Systemic anticoagulation decreases the risk of radial artery occlusion (RAO) after transradial catheterization and standard occlusive hemostasis. We compared the efficacy and safety of provisional heparin use only when the technique of patent hemostasis was not achievable to standard a priori heparin administration after radial sheath introduction. Patients referred for coronary angiography were randomized in 2 groups. In the a priori group, 200 patients received intravenous heparin (50 IU/kg) immediately after sheath insertion. In the provisional group, 200 patients did not receive heparin during the procedure. After sheath removal, hemostasis was obtained using a TR band (Terumo corporation, Tokyo, Japan) with a plethysmography-guided patent hemostasis technique. In the provisional group, no heparin was given if radial artery patency could be obtained and maintained. If radial patency was not achieved, a bolus of heparin (50 IU/kg) was given. Radial artery patency was evaluated at 24 hours (early RAO) and 30 days after the procedure (late RAO) by plethysmography. Patent hemostasis was obtained in 67% in the a priori group and 74% in the provisional group (p = 0.10). Incidence of RAO remained similar in the 2 groups at the early (7.5% vs 7.0%, p = 0.84) and late (4.5% vs 5.0%, p = 0.83) evaluations. Women, patients with diabetes, patients having not received heparin, and patients without radial artery patency during hemostasis had more RAO. By multivariate analysis, patent radial artery during hemostasis (odds ratio [OR] 0.03, 95% confidence interval [CI] 0.004 to 0.28, p = 0.002) and diabetes (OR 11, 95% CI 3 to 38,p patent hemostasis is maintained. Copyright © 2012 Elsevier Inc. All rights reserved.

  7. Task-Specific and Functional Effects of Speed-Focused Elliptical or Motor-Assisted Cycle Training in Children With Bilateral Cerebral Palsy: Randomized Clinical Trial.

    Science.gov (United States)

    Damiano, Diane L; Stanley, Christopher J; Ohlrich, Laurie; Alter, Katharine E

    2017-08-01

    Locomotor training using treadmills or robotic devices is commonly utilized to improve gait in cerebral palsy (CP); however, effects are inconsistent and fail to exceed those of equally intense alternatives. Possible limitations of existing devices include fixed nonvariable rhythm and too much limb or body weight assistance. To quantify and compare effectiveness of a motor-assisted cycle and a novel alternative, an elliptical, in CP to improve interlimb reciprocal coordination through intensive speed-focused leg training. A total of 27 children with bilateral CP, 5 to 17 years old, were randomized to 12 weeks of 20 minutes, 5 days per week home-based training (elliptical = 14; cycle = 13) at a minimum of 40 revolutions per minute, with resistance added when speed target was achieved. Primary outcomes were self-selected and fastest voluntary cadence on the devices and gait speed. Secondary outcomes included knee muscle strength, and selective control and functional mobility measures. Cadence on trained but not nontrained devices increased, demonstrating task specificity of training and increased exercise capability. Mean gait speed did not increase in either group, nor did parent-reported functional mobility. Knee extensor strength increased in both. An interaction between group and time was seen in selective control with scores slightly increasing for the elliptical and decreasing for the cycle, possibly related to tighter limb coupling with cycling. Task-specific effects were similarly positive across groups, but no transfer was seen to gait or function. Training dose was low (≤20 hours) compared with intensive upper-limb training recommendations and may be insufficient to produce appreciable clinical change.

  8. The Use of ExoSeal Vascular Closure Device for Direct Antegrade Superficial Femoral Artery Puncture Site Hemostasis

    Energy Technology Data Exchange (ETDEWEB)

    Rimon, Uri, E-mail: rimonu@sheba.health.gov.il; Khaitovich, Boris, E-mail: borislena@012.net.il [Tel-Aviv University, Diagnostic and Interventional Imaging Department, Chaim Sheba Medical Center, Tel-Hashomer, Affiliated to the Sackler School of Medicine (Israel); Yakubovich, Dmitry, E-mail: Dmitry.Yakubovitch@sheba.health.gov.il [Tel-Aviv University, Vascular Surgery Department, Chaim Sheba Medical Center, Tel-Hashomer, Affiliated to the Sackler School of Medicine (Israel); Bensaid, Paul, E-mail: paulbensaid@hotmail.com; Golan, Gil, E-mail: gilgolan201@gmail.com [Tel-Aviv University, Diagnostic and Interventional Imaging Department, Chaim Sheba Medical Center, Tel-Hashomer, Affiliated to the Sackler School of Medicine (Israel); Silverberg, Daniel, E-mail: Daniel.Silverberg@sheba.health.gov.il [Tel-Aviv University, Vascular Surgery Department, Chaim Sheba Medical Center, Tel-Hashomer, Affiliated to the Sackler School of Medicine (Israel)

    2015-06-15

    PurposeThis study was designed to assess the efficacy and safety of the ExoSeal vascular closure device (VCD) to achieve hemostasis in antegrade access of the superficial femoral artery (SFA).MethodsWe retrospectively reviewed the outcome of ExoSeal VCD used for hemostasis in 110 accesses to the SFA in 93 patients between July 2011 and July 2013. All patients had patent proximal SFA based on computer tomography angiography or ultrasound duplex. Arterial calcifications at puncture site were graded using fluoroscopy. The SFA was accessed in an antegrade fashion with ultrasound or fluoroscopic guidance. In all patients, 5–7F vascular sheaths were used. The ExoSeal VCD was applied to achieve hemostasis at the end of the procedure. All patients were clinically examined and had ultrasound duplex exam for any puncture site complications during the 24 h postprocedure.ResultsIn all procedures, the ExoSeal was applied successfully. We did not encounter any device-related technical failure. There were four major complications in four patients (3.6 %): three pseudoaneurysms, which were treated with direct thrombin injection, and one hematoma, which necessitated transfusion of two blood units. All patients with complications were treated with anticoagulation preprocedure or received thrombolytic therapy.ConclusionsThe ExoSeal VCD can be safely used for antegrade puncture of the SFA, with a high procedural success rate (100 %) and a low rate of access site complications (3.6 %)

  9. Thromboelastography as a Surrogate Marker of Perisurgical Hemostasis in Gaucher Disease.

    Science.gov (United States)

    Ioscovich, Alexander; Fadeev, Dmitri; Kenet, Gili; Naamad, Mira; Schtrechman, Gal; Zimran, Ari; Elstein, Deborah

    2016-10-01

    Thromboelastography (TEG) has long been available for routine monitoring of perisurgical and postpartum hemostasis, especially at point of care. The purpose of this study is to retrospectively compare TEG parameters to concomitant standard clotting test results in an unselected cohort of patients with Gaucher disease to ascertain whether TEG values are specific and sensitive enough to substitute for classic coagulation tests for decision making. This remains a cogent concern because of high incidence of thrombocytopenia in patients with Gaucher disease. Thromboelastography values were compared to concomitant platelet counts, partial thromboplastin time, international normalization ratio, and plasma fibrinogen. Demographic characteristics were collected from patients' files. There were 22 patients with Gaucher disease (2 children; 12.5%) for whom there were 24 TEG results at the same time as classic coagulation test results and 30% performed platelet function tests. The current study shows linear and/or monotonic relationships between platelet counts and several TEG values that were significant over a range of platelet counts including severe thrombocytopenia. The fibrinogen component, correlating only with the rate of clot lysis, played a lesser role. Based on these preliminary results albeit in a small cohort with only 1 case of hemorrhage, there is putative support for the intention to treat patients with Gaucher disease based on TEG results using the same TEG protocol as for other patients undergoing comparable procedures in our institution. © The Author(s) 2015.

  10. Direct Fibrinolytic Snake Venom Metalloproteinases Affecting Hemostasis: Structural, Biochemical Features and Therapeutic Potential.

    Science.gov (United States)

    Sanchez, Eladio F; Flores-Ortiz, Renzo J; Alvarenga, Valeria G; Eble, Johannes A

    2017-12-05

    Snake venom metalloproteinases (SVMPs) are predominant in viperid venoms, which provoke hemorrhage and affect hemostasis and thrombosis. P-I class enzymes consist only of a single metalloproteinase domain. Despite sharing high sequence homology, only some of them induce hemorrhage. They have direct fibrin(ogen)olytic activity. Their main biological substrate is fibrin(ogen), whose Aα-chain is degraded rapidly and independently of activation of plasminogen. It is important to understand their biochemical and physiological mechanisms, as well as their applications, to study the etiology of some human diseases and to identify sites of potential intervention. As compared to all current antiplatelet therapies to treat cardiovascular events, the SVMPs have outstanding biochemical attributes: (a) they are insensitive to plasma serine proteinase inhibitors; (b) they have the potential to avoid bleeding risk; (c) mechanistically, they are inactivated/cleared by α2-macroglobulin that limits their range of action in circulation; and (d) few of them also impair platelet aggregation that represent an important target for therapeutic intervention. This review will briefly highlight the structure-function relationships of these few direct-acting fibrinolytic agents, including, barnettlysin-I, isolated from Bothrops barnetti venom, that could be considered as potential agent to treat major thrombotic disorders. Some of their pharmacological advantages are compared with plasmin.

  11. Outcomes in Patients Treated with a Novel, Simple Method for Hemostasis of Dermal Avulsion Injuries.

    Science.gov (United States)

    Dowling, Sean Taylor; Lin, Brian Wai

    2017-10-01

    A recently described technique proposes a simple method to achieve permanent hemostasis of distal fingertip dermal avulsion injuries. It is simple to learn and easy to perform with readily available materials found in most emergency departments. However, long-term outcomes for patients treated with this technique have not yet been evaluated. A primary objective of the current article is to provide safety data for the technique using an off-label product indication. Emergency department of Kaiser Permanente Medical Center, San Francisco, California. Six patients were treated in the emergency department for fingertip dermal avulsion injuries using a tourniquet and tissue adhesive glue (Dermabond by Ethicon, Somerville, New Jersey). Patients were subsequently contacted to assess healing and satisfaction with cosmetic outcome through interview and photographs of their wounds at 9 months following the date of injury. All 6 patients were satisfied with the cosmetic outcome of treatment, and none received a diagnosis of serious complications. This series demonstrates cosmetic outcomes for injuries treated with the technique, highlights potential problems that may be perceived by patients during their clinical course, and creates the groundwork for a larger clinical study examining the use of the technique.

  12. Decidualized Human Endometrial Stromal Cells Mediate Hemostasis, Angiogenesis, and Abnormal Uterine Bleeding

    Science.gov (United States)

    Lockwood, Charles J.; Krikun, Graciela; Hickey, Martha; Huang, S. Joseph; Schatz, Frederick

    2011-01-01

    Factor VII binds trans-membrane tissue factor to initiate hemostasis by forming thrombin. Tissue factor expression is enhanced in decidualized human endometrial stromal cells during the luteal phase. Long-term progestin only contraceptives elicit: 1) abnormal uterine bleeding from fragile vessels at focal bleeding sites, 2) paradoxically high tissue factor expression at bleeding sites; 3) reduced endometrial blood flow promoting local hypoxia and enhancing reactive oxygen species levels; and 4) aberrant angiogenesis reflecting increased stromal cell-expressed vascular endothelial growth factor, decreased Angiopoietin-1 and increased endothelial cell-expressed Angiopoietin-2. Aberrantly high local vascular permeability enhances circulating factor VII to decidualized stromal cell-expressed tissue factor to generate excess thrombin. Hypoxia-thrombin interactions augment expression of vascular endothelial growth factor and interleukin-8 by stromal cells. Thrombin, vascular endothelial growth factor and interlerukin-8 synergis-tically augment angiogenesis in a milieu of reactive oxygen species-induced endothelial cell activation. The resulting enhanced vessel fragility promotes abnormal uterine bleeding. PMID:19208784

  13. Direct Injection of Blood Products Versus Gelatin Sponge as a Technique for Local Hemostasis

    Energy Technology Data Exchange (ETDEWEB)

    Haaga, John [University Hospitals Case Medical Center, Department of Radiology (United States); Rahim, Shiraz, E-mail: Shiraz.rahim@uhhospitals.org

    2017-02-15

    PurposeTo provide a method of reducing risk of minimally invasive procedures on patients with abnormal hemostasis and evaluate efficacy of direct fresh frozen plasma injection through a procedure needle tract compared to Gelfoam (gelatin sponge) administration.Materials and MethodsEighty patients with elevated international standardized ratio (INR) undergoing minimally invasive procedures using imaging guidance were selected retrospectively. Forty patients had received Gelfoam as a means of tract embolization during the procedure. The other 40 received local fresh frozen plasma (FFP) through the needle tract. The number of complications and clinically significant bleeding events were recorded. A threshold of 30 cc of blood loss after a procedure was used to identify excess bleeding.ResultsNo patients experienced clinically significant bleeding after administration of FFP. Five patients experienced postoperative drops in hemoglobin or hematomas after administration of Gelfoam.ConclusionLocal injection of blood products can reduce postprocedure bleeding in patients undergoing minimally invasive procedures and provides a safe alternative to the use of synthetic fibrin plugs.

  14. Direct Fibrinolytic Snake Venom Metalloproteinases Affecting Hemostasis: Structural, Biochemical Features and Therapeutic Potential

    Directory of Open Access Journals (Sweden)

    Eladio F. Sanchez

    2017-12-01

    Full Text Available Snake venom metalloproteinases (SVMPs are predominant in viperid venoms, which provoke hemorrhage and affect hemostasis and thrombosis. P-I class enzymes consist only of a single metalloproteinase domain. Despite sharing high sequence homology, only some of them induce hemorrhage. They have direct fibrin(ogenolytic activity. Their main biological substrate is fibrin(ogen, whose Aα-chain is degraded rapidly and independently of activation of plasminogen. It is important to understand their biochemical and physiological mechanisms, as well as their applications, to study the etiology of some human diseases and to identify sites of potential intervention. As compared to all current antiplatelet therapies to treat cardiovascular events, the SVMPs have outstanding biochemical attributes: (a they are insensitive to plasma serine proteinase inhibitors; (b they have the potential to avoid bleeding risk; (c mechanistically, they are inactivated/cleared by α2-macroglobulin that limits their range of action in circulation; and (d few of them also impair platelet aggregation that represent an important target for therapeutic intervention. This review will briefly highlight the structure–function relationships of these few direct-acting fibrinolytic agents, including, barnettlysin-I, isolated from Bothrops barnetti venom, that could be considered as potential agent to treat major thrombotic disorders. Some of their pharmacological advantages are compared with plasmin.

  15. Comparative evaluation of two techniques of hemostasis in neonatal circumcision using the Plastibell device.

    Science.gov (United States)

    Kazem, Moslemi Mohammad; Mehdi, Abedin Zadeh; Golrasteh, Kholaseh Zadeh; Behzad, Feis Zadeh

    2010-06-01

    To evaluate the safety of the Plastibell neonatal circumcision technique and the incidence of complications in Iranian neonates. In this study, 7510 term neonates born between 2001 and 2006 in Rafsanjan medical centers, with age range of 3-36h, were randomized into two groups. In group A (3760 cases), an incision was made in the dorsal surface of the prepuce and then 3min frenular manual compression was performed with a sponge. In group B (3750 cases), frenular hemostasis was achieved using ophthalmologic thermal cautery. The two groups were compared in terms of complications of hemorrhage, wound infection, urine retention and delayed wound healing. In group A, bleeding occurred in 15 cases (0.4%), and in group B in two cases (0.05%). The bleeding rate in group A was significantly higher (P=0.002). In group A, urinary retention was seen in 12 cases (0.03%), in comparison to 35 cases (0.9%) in group B. This complication rate was significantly higher in group B (P=0.001). Local or systemic infection was not seen in either group. Although using thermal cautery we have less bleeding, the total complication rate is increased significantly. Copyright (c) 2010 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.

  16. Safety of high speed ground transportation systems: X2000 US demonstration vehicle dynamics trials, preliminary test report. Report for October 1992-January 1993

    Energy Technology Data Exchange (ETDEWEB)

    Whitten, B.T.; Kesler, J.K.

    1993-01-01

    The report documents the procedures, events, and results of vehicle dynamic tests carried out on the ASEA-Brown Boveri (ABB) X2000 tilt body trainset in the US between October 1992 and January 1993. These tests, sponsored by Amtrak and supported by the FRA, were conducted to assess the suitability of the X2000 trainset for safe operation at elevated cant deficiencies and speeds in Amtrak's Northeast Corridor under existing track conditions in a revenue service demonstration. The report describes the safety criteria against which the performance of the X2000 test train was examined, the instrumentation used, the test locations, and the track conditions. Preliminary results are presented from tests conducted on Amtrak lines between Philadelphia and Harrisburg, PA, and between Washington DC and New York NY, in which cant deficiencies of 12.5 inches and speeds of 154 mph were reached in a safe and controlled manner. The significance of the results is discussed, and preliminary conclusions and recommendations are presented.

  17. Effects of a progressive resistance exercise program with high-speed component on the physical function of older women with sarcopenic obesity: a randomized controlled trial.

    Science.gov (United States)

    Vasconcelos, Karina S S; Dias, João M D; Araújo, Marília C; Pinheiro, Ana C; Moreira, Bruno S; Dias, Rosângela C

    2016-07-11

    Sarcopenic obesity is associated with disability in older people, especially in women. Resistance exercises are recommended for this population, but their efficacy is not clear. To evaluate the effects of a progressive resistance exercise program with high-speed component on the physical function of older women with sarcopenic obesity. Twenty-eight women 65 to 80 years old, with a body mass index ≥30kg/m2 and handgrip strength ≤21kg were randomly allocated to two groups. The experimental group underwent a 10-week resistance exercise program designed to improve strength, power, and endurance of lower-limb muscles, with open chain and closed chain exercises. The control group had their health status monitored through telephone calls. The primary outcomes were lower limb muscle performance measured by knee extensor strength, power and fatigue by isokinetic dynamometry, and mobility measured by the Short Physical Performance Battery and by gait velocity. The secondary outcome was health-related quality of life assessed by the SF-36 Questionnaire. The average rate of adherence was 85%, with few mild adverse effects. There were no significant between-group differences for any of the outcomes. In this study, a progressive resistance exercise program with high-speed component was not effective for improving the physical function of older women with sarcopenic obesity.

  18. Alteraciones de la hemostasia en la diabetes mellitus Alterations of hemostasis in the diabetes mellitus

    Directory of Open Access Journals (Sweden)

    Patricia Caunedo Almagro

    2005-04-01

    Full Text Available La diabetes mellitus (DM se clasifica en 2 tipos de acuerdo con su patogénesis: la tipo 1 representa menos del 10 % del total de pacientes, la DM tipo 2 es más común dentro de la población de pacientes diabéticos. Se han encontrado múltiples alteraciones de la hemostasia en los pacientes con este padecimiento. Estudios realizados en plaquetas, coagulación sanguínea y fibrinólisis han permitido asegurar que estos trastornos son posiblemente un factor importante en el estado pretrombótico que presentan estos enfermos. Las investigaciones en las plaquetas han demostrado una hiperreactividad plaquetaria, un aumento de la actividad procoagulante de las plaquetas. Por otra parte, la mayoría de los autores coinciden en la actualidad en que la DM es un estado de hipercoagulabilidad,lo cual se basa en numerosas investigaciones sobre la enfermedad y el mecanismo de la coagulación que demuestran el aumento del fibrinógeno, factor VII y factor von Willebrand, así como de los marcadores de activación de este sistema. Además, se han demostrado alteraciones en el sistema fibrinolítico, como el aumento del inhibidor del activador del plasminógeno y del inhibidor de la fibrinólisis activado por trombina. En este trabajo se presentan algunos mecanismos que pudieran explicar las alteraciones en la hemostasia que posiblemente contribuyan al desarrollo de complicaciones trombóticas que se presentan en estos pacientes.Diabetes mellitus is classified into 2 types according to its pathogenesis: type 1 accounts for less than 10 % of the total of patients, whereas type 2 is the most common in the population of diabetic patients. Multiple alterations of hemostasis have been found among the patients suffering from this disease. The studies conducted in platelets, blood coagulation and fibrinolysis have allowed to assert that these disorders are probably an important factor in the prethrombotic state of these patients. The investigations carried out with

  19. A review of three stand-alone topical thrombins for surgical hemostasis.

    Science.gov (United States)

    Cheng, Christine M; Meyer-Massetti, Carla; Kayser, Steven R

    2009-01-01

    bovine thrombin, the percentages of patients who achieved hemostasis within 10 minutes of topical thrombin application were 95.4% and 95.1%, respectively (95% CI, -3.7 to 5.0). The incidence of hemostasis within 10 minutes was also similar in a Phase III comparison of human plasma-derived thrombin and bovine thrombin (both, 97.4% [95% CI, 0.96 to 1.05]). In the study that compared human recombinant and bovine thrombin, the incidence of antiproduct antibody formation was 21.5% (43/200) in the bovine thrombin group and 1.5% (3/198) in the human recombinant thrombin group (P vial basis. The average wholesale prices (US $, 2008) for 5000-IU vials of bovine thrombin and human recombinant thrombin were $87.85 and $103.20, respectively; the average wholesale price for a 4000- to 6000-IU vial of human plasma-derived thrombin was $96.00. Topical thrombins vary in the ways in which they are manufactured and their safety profiles, storage requirements, and costs. Human recombinant thrombin and human plasma-derived thrombin have each been shown to have hemostatic efficacy comparable to that of bovine thrombin. Bovine thrombin carries the risk of formation of cross-reactive antibodies to bovine thrombin, factor V, and other impurities that may be present in these formulations. Immunogenicity data for the currently marketed, highly purified bovine thrombin relative to older formulations of bovine thrombin could not be found. Whether the potential safety advantage justifies the added cost of the human products remains to be established.

  20. The role of platelet and endothelial GARP in thrombosis and hemostasis.

    Science.gov (United States)

    Vermeersch, Elien; Denorme, Frederik; Maes, Wim; De Meyer, Simon F; Vanhoorelbeke, Karen; Edwards, Justin; Shevach, Ethan M; Unutmaz, Derya; Fujii, Hodaka; Deckmyn, Hans; Tersteeg, Claudia

    2017-01-01

    Glycoprotein-A Repetitions Predominant protein (GARP or LRRC32) is present on among others human platelets and endothelial cells. Evidence for its involvement in thrombus formation was suggested by full knockout of GARP in zebrafish. To evaluate the role of GARP in platelet physiology and in thrombus formation using platelet and endothelial conditional GARP knock out mice. Platelet and endothelial specific GARP knockout mice were generated using the Cre-loxP recombination system. The function of platelets without GARP was measured by flow cytometry, spreading analysis and aggregometry using PAR4-activating peptide and collagen related peptide. Additionally, clot retraction and collagen-induced platelet adhesion and aggregation under flow were analyzed. Finally, in vivo tail bleeding time, occlusion time of the mesenteric and carotid artery after FeCl3-induced thrombosis were determined in platelet and endothelial specific GARP knock out mice. Platelet specific GARP knockout mice had normal surface GPIb, GPVI and integrin αIIb glycoprotein expression. Although GARP expression was increased upon platelet activation, platelets without GARP displayed normal agonist induced activation, spreading on fibrinogen and aggregation responses. Furthermore, absence of GARP on platelets did not influence clot retraction and had no impact on thrombus formation on collagen-coated surfaces under flow. In line with this, neither the tail bleeding time nor the occlusion time in the carotid- and mesenteric artery after FeCl3-induced thrombus formation in platelet or endothelial specific GARP knock out mice were affected. Evidence is provided that platelet and endothelial GARP are not important in hemostasis and thrombosis in mice.

  1. Comparison of polyurethane with cyanoacrylate in hemostasis of vascular injury in guinea pigs.

    Science.gov (United States)

    Kubrusly, Luiz Fernando; Formighieri, Marina Simões; Lago, José Vitor Martins; Graça, Yorgos Luiz Santos de Salles; Sobral, Ana Cristina Lira; Lago, Marianna Martins

    2015-01-01

    To evaluate the behavior of castor oil-derived polyurethane as a hemostatic agent and tissue response after abdominal aortic injury and to compare it with 2-octyl-cyanoacrylate. Twenty-four Guinea Pigs were randomly divided into three groups of eight animals (I, II, and III). The infrarenal abdominal aorta was dissected, clamped proximally and distally to the vascular puncture site. In group I (control), hemostasis was achieved with digital pressure; in group II (polyurethane) castor oil-derived polyurethane was applied, and in group III (cyanoacrylate), 2-octyl-cyanoacrylate was used. Group II was subdivided into IIA and IIB according to the time of preparation of the hemostatic agent. Mean blood loss in groups IIA, IIB and III was 0.002 grams (g), 0.008 g, and 0.170 g, with standard deviation of 0.005 g, 0.005 g, and 0.424 g, respectively (P=0.069). The drying time for cyanoacrylate averaged 81.5 seconds (s) (standard deviation: 51.5 seconds) and 126.1 s (standard deviation: 23.0 s) for polyurethane B (P=0.046). However, there was a trend (P=0.069) for cyanoacrylate to dry more slowly than polyurethane A (mean: 40.5 s; SD: 8.6 s). Furthermore, polyurethane A had a shorter drying time than polyurethane B (P=0.003), mean IIA of 40.5 s (standard deviation: 8.6 s). In group III, 100% of the animals had mild/severe fibrosis, while in group II only 12.5% showed this degree of fibrosis (P=0.001). Polyurethane derived from castor oil showed similar hemostatic behavior to octyl-2-cyanoacrylate. There was less perivascular tissue response with polyurethane when compared with cyanoacrylate.

  2. Identification of extant vertebrate Myxine glutinosa VWF: evolutionary conservation of primary hemostasis.

    Science.gov (United States)

    Grant, Marianne A; Beeler, David L; Spokes, Katherine C; Chen, Junmei; Dharaneeswaran, Harita; Sciuto, Tracey E; Dvorak, Ann M; Interlandi, Gianluca; Lopez, José A; Aird, William C

    2017-12-07

    Hemostasis in vertebrates involves both a cellular and a protein component. Previous studies in jawless vertebrates (cyclostomes) suggest that the protein response, which involves thrombin-catalyzed conversion of a soluble plasma protein, fibrinogen, into a polymeric fibrin clot, is conserved in all vertebrates. However, similar data are lacking for the cellular response, which in gnathostomes is regulated by von Willebrand factor (VWF), a glycoprotein that mediates the adhesion of platelets to the subendothelial matrix of injured blood vessels. To gain evolutionary insights into the cellular phase of coagulation, we asked whether a functional vwf gene is present in the Atlantic hagfish, Myxine glutinosa We found a single vwf transcript that encodes a simpler protein compared with higher vertebrates, the most striking difference being the absence of an A3 domain, which otherwise binds collagen under high-flow conditions. Immunohistochemical analyses of hagfish tissues and blood revealed Vwf expression in endothelial cells and thrombocytes. Electron microscopic studies of hagfish tissues demonstrated the presence of Weibel-Palade bodies in the endothelium. Hagfish Vwf formed high-molecular-weight multimers in hagfish plasma and in stably transfected CHO cells. In functional assays, botrocetin promoted VWF-dependent thrombocyte aggregation. A search for vwf sequences in the genome of sea squirts, the closest invertebrate relatives of hagfish, failed to reveal evidence of an intact vwf gene. Together, our findings suggest that VWF evolved in the ancestral vertebrate following the divergence of the urochordates some 500 million years ago and that it acquired increasing complexity though sequential insertion of functional modules. © 2017 by The American Society of Hematology.

  3. Lack of grading agreement among international hemostasis external quality assessment programs.

    Science.gov (United States)

    Olson, John D; Jennings, Ian; Meijer, Piet; Bon, Chantal; Bonar, Roslyn; Favaloro, Emmanuel J; Higgins, Russell A; Keeney, Michael; Mammen, Joy; Marlar, Richard A; Meley, Roland; Nair, Sukesh C; Nichols, William L; Raby, Anne; Reverter, Joan C; Srivastava, Alok; Walker, Isobel

    2018-01-01

    : Laboratory quality programs rely on internal quality control and external quality assessment (EQA). EQA programs provide unknown specimens for the laboratory to test. The laboratory's result is compared with other (peer) laboratories performing the same test. EQA programs assign target values using a variety of methods statistical tools and performance assessment of 'pass' or 'fail' is made. EQA provider members of the international organization, external quality assurance in thrombosis and hemostasis, took part in a study to compare outcome of performance analysis using the same data set of laboratory results. Eleven EQA organizations using eight different analytical approaches participated. Data for a normal and prolonged activated partial thromboplastin time (aPTT) and a normal and reduced factor VIII (FVIII) from 218 laboratories were sent to the EQA providers who analyzed the data set using their method of evaluation for aPTT and FVIII, determining the performance for each laboratory record in the data set. Providers also summarized their statistical approach to assignment of target values and laboratory performance. Each laboratory record in the data set was graded pass/fail by all EQA providers for each of the four analytes. There was a lack of agreement of pass/fail grading among EQA programs. Discordance in the grading was 17.9 and 11% of normal and prolonged aPTT results, respectively, and 20.2 and 17.4% of normal and reduced FVIII results, respectively. All EQA programs in this study employed statistical methods compliant with the International Standardization Organization (ISO), ISO 13528, yet the evaluation of laboratory results for all four analytes showed remarkable grading discordance.

  4. Lack of grading agreement among international hemostasis external quality assessment programs

    Science.gov (United States)

    Olson, John D.; Jennings, Ian; Meijer, Piet; Bon, Chantal; Bonar, Roslyn; Favaloro, Emmanuel J.; Higgins, Russell A.; Keeney, Michael; Mammen, Joy; Marlar, Richard A.; Meley, Roland; Nair, Sukesh C.; Nichols, William L.; Raby, Anne; Reverter, Joan C.; Srivastava, Alok; Walker, Isobel

    2018-01-01

    Laboratory quality programs rely on internal quality control and external quality assessment (EQA). EQA programs provide unknown specimens for the laboratory to test. The laboratory's result is compared with other (peer) laboratories performing the same test. EQA programs assign target values using a variety of methods statistical tools and performance assessment of ‘pass’ or ‘fail’ is made. EQA provider members of the international organization, external quality assurance in thrombosis and hemostasis, took part in a study to compare outcome of performance analysis using the same data set of laboratory results. Eleven EQA organizations using eight different analytical approaches participated. Data for a normal and prolonged activated partial thromboplastin time (aPTT) and a normal and reduced factor VIII (FVIII) from 218 laboratories were sent to the EQA providers who analyzed the data set using their method of evaluation for aPTT and FVIII, determining the performance for each laboratory record in the data set. Providers also summarized their statistical approach to assignment of target values and laboratory performance. Each laboratory record in the data set was graded pass/fail by all EQA providers for each of the four analytes. There was a lack of agreement of pass/fail grading among EQA programs. Discordance in the grading was 17.9 and 11% of normal and prolonged aPTT results, respectively, and 20.2 and 17.4% of normal and reduced FVIII results, respectively. All EQA programs in this study employed statistical methods compliant with the International Standardization Organization (ISO), ISO 13528, yet the evaluation of laboratory results for all four analytes showed remarkable grading discordance. PMID:29232255

  5. Comparison of polyurethane with cyanoacrylate in hemostasis of vascular injury in guinea pigs

    Directory of Open Access Journals (Sweden)

    Luiz Fernando Kubrusly

    2015-02-01

    Full Text Available Objective: To evaluate the behavior of castor oil-derived polyurethane as a hemostatic agent and tissue response after abdominal aortic injury and to compare it with 2-octyl-cyanoacrylate. Methods: Twenty-four Guinea Pigs were randomly divided into three groups of eight animals (I, II, and III. The infrarenal abdominal aorta was dissected, clamped proximally and distally to the vascular puncture site. In group I (control, hemostasis was achieved with digital pressure; in group II (polyurethane castor oil-derived polyurethane was applied, and in group III (cyanoacrylate, 2-octyl-cyanoacrylate was used. Group II was subdivided into IIA and IIB according to the time of preparation of the hemostatic agent. Results: Mean blood loss in groups IIA, IIB and III was 0.002 grams (g, 0.008 g, and 0.170 g, with standard deviation of 0.005 g, 0.005 g, and 0.424 g, respectively (P=0.069. The drying time for cyanoacrylate averaged 81.5 seconds (s (standard deviation: 51.5 seconds and 126.1 s (standard deviation: 23.0 s for polyurethane B (P=0.046. However, there was a trend (P=0.069 for cyanoacrylate to dry more slowly than polyurethane A (mean: 40.5 s; SD: 8.6 s. Furthermore, polyurethane A had a shorter drying time than polyurethane B (P=0.003, mean IIA of 40.5 s (standard deviation: 8.6 s. In group III, 100% of the animals had mild/severe fibrosis, while in group II only 12.5% showed this degree of fibrosis (P=0.001. Conclusion: Polyurethane derived from castor oil showed similar hemostatic behavior to octyl-2-cyanoacrylate. There was less perivascular tissue response with polyurethane when compared with cyanoacrylate.

  6. Normal levels of anticoagulant heparan sulfate are not essential for normal hemostasis

    Science.gov (United States)

    HajMohammadi, Sassan; Enjyoji, Keiichi; Princivalle, Marc; Christi, Patricia; Lech, Miroslav; Beeler, David; Rayburn, Helen; Schwartz, John J.; Barzegar, Samad; de Agostini, Ariane I.; Post, Mark J.; Rosenberg, Robert D.; Shworak, Nicholas W.

    2003-01-01

    Endothelial cell production of anticoagulant heparan sulfate (HSact) is controlled by the Hs3st1 gene, which encodes the rate-limiting enzyme heparan sulfate 3-O-sulfotransferase-1 (3-OST-1). In vitro, HSact dramatically enhances the neutralization of coagulation proteases by antithrombin. The in vivo role of HSact was evaluated by generating Hs3st1–/– knockout mice. Hs3st1–/– animals were devoid of 3-OST-1 enzyme activity in plasma and tissue extracts. Nulls showed dramatic reductions in tissue levels of HSact but maintained wild-type levels of tissue fibrin accumulation under both normoxic and hypoxic conditions. Given that vascular HSact predominantly occurs in the subendothelial matrix, mice were subjected to a carotid artery injury assay in which ferric chloride administration induces de-endothelialization and occlusive thrombosis. Hs3st1–/– and Hs3st1+/+ mice yielded indistinguishable occlusion times and comparable levels of thrombin•antithrombin complexes. Thus, Hs3st1–/– mice did not show an obvious procoagulant phenotype. Instead, Hs3st1–/– mice exhibited genetic background–specific lethality and intrauterine growth retardation, without evidence of a gross coagulopathy. Our results demonstrate that the 3-OST-1 enzyme produces the majority of tissue HSact. Surprisingly, this bulk of HSact is not essential for normal hemostasis in mice. Instead, 3-OST-1–deficient mice exhibited unanticipated phenotypes suggesting that HSact or additional 3-OST-1–derived structures may serve alternate biologic roles. PMID:12671048

  7. The role of platelet and endothelial GARP in thrombosis and hemostasis.

    Directory of Open Access Journals (Sweden)

    Elien Vermeersch

    Full Text Available Glycoprotein-A Repetitions Predominant protein (GARP or LRRC32 is present on among others human platelets and endothelial cells. Evidence for its involvement in thrombus formation was suggested by full knockout of GARP in zebrafish.To evaluate the role of GARP in platelet physiology and in thrombus formation using platelet and endothelial conditional GARP knock out mice.Platelet and endothelial specific GARP knockout mice were generated using the Cre-loxP recombination system. The function of platelets without GARP was measured by flow cytometry, spreading analysis and aggregometry using PAR4-activating peptide and collagen related peptide. Additionally, clot retraction and collagen-induced platelet adhesion and aggregation under flow were analyzed. Finally, in vivo tail bleeding time, occlusion time of the mesenteric and carotid artery after FeCl3-induced thrombosis were determined in platelet and endothelial specific GARP knock out mice.Platelet specific GARP knockout mice had normal surface GPIb, GPVI and integrin αIIb glycoprotein expression. Although GARP expression was increased upon platelet activation, platelets without GARP displayed normal agonist induced activation, spreading on fibrinogen and aggregation responses. Furthermore, absence of GARP on platelets did not influence clot retraction and had no impact on thrombus formation on collagen-coated surfaces under flow. In line with this, neither the tail bleeding time nor the occlusion time in the carotid- and mesenteric artery after FeCl3-induced thrombus formation in platelet or endothelial specific GARP knock out mice were affected.Evidence is provided that platelet and endothelial GARP are not important in hemostasis and thrombosis in mice.

  8. Starclose SE® hemostasis after 6F direct antegrade superficial femoral artery access distal to the femoral head for peripheral endovascular procedures in obese patients.

    Science.gov (United States)

    Spiliopoulos, Stavros; Kitrou, Panagiotis; Christeas, Nikolaos; Karnabatidis, Dimitris

    2016-01-01

    Direct superficial femoral artery (SFA) antegrade puncture is a valid alternative to common femoral artery (CFA) access for peripheral vascular interventions. Data investigating vascular closure device (VCD) hemostasis of distant SFA 6F access are limited. We aimed to investigate the safety and effectiveness of the Starclose SE® VCD for hemostasis, following direct 6F antegrade SFA access distal to the femoral head. This prospective, single-center study included patients who were not suitable for CFA puncture and were scheduled to undergo peripheral endovascular interventions using direct antegrade SFA 6F access, at least 2 cm below the inferior edge of femoral head. Hemostasis was obtained with the Starclose SE® VCD (Abbott Laboratories). Primary endpoints were successful hemostasis rate and periprocedural (30-day) major complication rate. Secondary endpoint was the rate of minor complications. Clinical and Doppler ultrasound follow-up was performed at discharge and at one month. Between September 2014 and August 2015, a total of 30 patients (21 male; 70.0%) with a mean body mass index of 41.2 kg/m2 were enrolled. Mean age was 72±9 years (range, 67-88 years). Most patients suffered from critical limb ischemia (87.1%) and diabetes (61.3%). Calcifications were present in eight cases (26.6%). Reason for direct SFA puncture was obesity (100%). Successful hemostasis was achieved in 100% of the cases. No major complications were noted after one-month follow-up. Minor complications included two <5 cm hematomas (6.6%) not necessitating treatment. In this prospective study, Starclose SE® VCD was safe and effective for hemostasis of antegrade direct SFA puncture. Uncomplicated hemostasis was achieved even in cases of puncturing 2 to 7 cm below the inferior edge of the femoral head.

  9. Effect of Metformin on Handgrip Strength, Gait Speed, Myostatin Serum Level, and Health-related Quality of Life: A Double Blind Randomized Controlled Trial among Non-diabetic Pre-frail Elderly Patients.

    Science.gov (United States)

    Laksmi, Purwita Wijaya; Setiati, Siti; Tamin, Tirza Z; Soewondo, Pradana; Rochmah, Wasilah; Nafrialdi, Nafrialdi; Prihartono, Joedo

    2017-04-01

    sarcopenia contributes to the development of frailty syndrome. Frailty syndrome is potentially improved by modifying insulin resistance, inflammation, and myostatin level. This study is aimed to investigate the effect of metformin on handgrip strength, gait speed, myostatin serum level, and health-related quality of life (HR-QoL) among non-diabetic pre-frail elderly patients. a double blind randomized controlled trial study was conducted on non-diabetic elderly outpatients aged ≥ 60 years with pre-frail status based on phenotype and/ or index criteria (Cardiovascular Health Study and/ or Frailty Index 40 items) consecutively recruited from March 2015 to June 2016 at Cipto Mangunkusumo Hospital. One-hundred-twenty subjects who met the research criteria were randomized and equally assigned into 3 x 500 mg metformin or placebo group. The study outcomes were measured at baseline and after 16 weeks of intervention. out of 120 subjects, 43 subjects in metformin group and 48 subjects in placebo group who completed the intervention. There was a significant improvement on the mean gait speed of metformin group by 0.39 (0.77) second or 0.13 (0.24) meter/second that remained significant after adjusting for important prognostic factors (p = 0.024). There was no significant difference on handgrip strength, myostatin serum level, and HR-QoL between both groups. 3 x 500 mg metformin for 16 weeks was statistically significant and clinically important in improving usual gait speed as one of the HR-QoL dimensions, but did not significantly improve the EQ-5D index score, handgrip strength, nor myostatin serum level.

  10. Obesity: An Independent Risk Factor for Insufficient Hemostasis Using the AngioSeal Vascular Closure Device After Antegrade Puncture

    Energy Technology Data Exchange (ETDEWEB)

    Minko, Peter, E-mail: peterminko@yahoo.com; Katoh, Marcus [University Hospital Saarland, Department of Diagnostic and Interventional Radiology (Germany); Graeber, Stefan [University Hospital Saarland, Institute of Medical Biometry, Epidemiology and Medical Informatics (Germany); Buecker, Arno [University Hospital Saarland, Department of Diagnostic and Interventional Radiology (Germany)

    2012-08-15

    Purpose: This study was designed to investigate the efficacy of the AngioSeal vascular closure device after antegrade puncture of the femoral artery. Methods: In a prospective study, 120 consecutive patients underwent lower limb vascular intervention by an antegrade access to the common femoral artery (CFA). After intervention, a 6F (n = 88) or an 8F (n = 32) AngioSeal vascular closure device was used to achieve hemostasis. The technical success or the cause of failure was documented. In addition, the coagulation status (platelets, INR, prothrombin time, atrial thromboplastin time (PTT)), hypertonus, locoregional habitus of the groin, body mass index (BMI), presence of calcifications, and history of previous surgical interventions of the CFA were evaluated. Results: Hemostasis was achieved in 97 patients (81%). In 12 patients (10%), persistent bleeding of the puncture site required manual compression. In another nine patients (8%) a kink of the sheath obviated the passage of the collagen plug toward the vessel, and in two patients the anchor dislodged out of the vessel, requiring manual compression. There were no significant differences between the groups of successful and unsuccessful sealing regarding the mean platelets (241 vs. 254 * 10{sup 9}/l; P = 0.86), INR (1.06 vs. 1.02; P = 0.52), prothrombin time (90% vs. 90%; P = 0.86), and PTT (30 vs. 31 s; P = 0.82). However, unsuccessful sealing was more likely in obese patients with an increased BMI (26.6 vs. 28.8 kg/m{sup 2}; P = 0.04). Conclusions: Obesity seems to be an independent risk factor for insufficient sealing using the AngioSeal vascular closure device after antegrade puncture of the CFA. In 8% of our patients, hemostasis could not be achieved due to kink of the flexible sheath.

  11. Use of over-the-scope clips (OTSC) for hemostasis in gastrointestinal bleeding in patients under antithrombotic therapy.

    Science.gov (United States)

    Lamberts, Regina; Koch, Anna; Binner, Christian; Zachäus, Marcus; Knigge, Ingrid; Bernhardt, Mark; Halm, Ulrich

    2017-05-01

    Background and study aims  In patients taking different regimens of antithrombotic and/or anticoagulant therapy, endoscopic management of gastrointestinal bleeding represents a major challenge due to failing endogenous hemostasis. In this retrospective study we report on success rates with the over-the-scope clip (OTSC) system in upper and lower gastrointestinal bleeding in this high-risk patient population. Patients and methods  Between February 2011 and June 2014, 75 patients were treated with an OTSC for active gastrointestinal bleeding. Success rates with the first endoscopic therapy, rebleeding episodes, their management and the influence of antithrombotic or anticoagulant therapy were analyzed retrospectively. Results  Application of the OTSC resulted in immediate hemostasis (primary success rate) in all 75 patients. However, in 34.7 % a rebleeding episode was noted that could be treated by further endoscopic interventions. Only 3 patients had to be sent to the operating room because of failure of endoscopic therapy. In the rebleeding group the use of antiplatelet therapies was higher (73.1 % vs. 48.9 %). Conclusions  Application of the OTSC in GI bleeding results in a high rate of primary hemostasis. Rebleeding occurs in up to 35 % of patients receiving antithrombotic/anticoagulant therapy but can be managed successfully with further endoscopic treatments. Patients in the rebleeding group were more frequently treated with antiplatelet agents. Radiological or surgical therapy was reserved for a small subgroup not successfully managed by repeated endoscopic therapies. OTSC application is the treatment of choice in high-risk patients when conventional clips used as first-line treatment fail.

  12. Benefits of applying low-temperature plasma treatment to wound care and hemostasis from the viewpoints of physics and pathology

    Science.gov (United States)

    Shimizu, Tetsuji; Ikehara, Yuzuru

    2017-12-01

    Over the last decade, low-temperature plasma (LTP) technology has reached the life sciences and introduced the benefits of using such technology at atmospheric pressure for medical applications. The active elements from LTP, such as reactive molecular species, charged particles and photons, appear to react with biomolecules on wounds and at bleeding points. This action by LTP might be analogous with semiconductor fabrication techniques such as etching and surface modification. From this perspective, we discuss the general aspects and principles of LTP devices used at atmospheric pressure in wound care and hemostasis as an interdisciplinary fusion of applied physics and pathology.

  13. Effects of different doses of high-speed resistance training on physical performance and quality of life in older women: a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Ramirez-Campillo R

    2016-12-01

    Objective: This study aimed to compare the effects of two frequencies of high-speed resistance training (HSRT on physical performance and quality of life of older women.Methods: A total of 24 older women participated in a 12-week HSRT program composed of either two or three sessions/week (equated for volume and intensity. Women were randomized into three arms: a control group (CG, n=8, a resistance training group performing two sessions/week (RT2, n=8, and a resistance training group performing three sessions/week (RT3, n=8. The training program for both experimental groups included exercises that required high-speed concentric muscle actions.Results: No baseline differences were observed among groups. Compared with the CG, both training groups showed similar small to moderate improvements (P<0.05 in muscle strength, power, functional performance, balance, and quality of life.Conclusion: These results suggest that equated for volume and intensity, two and three training sessions/week of HSRT are equally effective for improving physical performance and quality of life of older women. Keywords: aging, muscle strength, adaptation, frailty

  14. Impact of hemostasis methods, electrocoagulation versus suture, in laparoscopic endometriotic cystectomy on the ovarian reserve: a randomized controlled trial.

    Science.gov (United States)

    Tanprasertkul, Chamnan; Ekarattanawong, Sophapun; Sreshthaputra, Opas; Vutyavanich, Teraporn

    2014-08-01

    To evaluate the impact on ovarian reserve between two different methods ofhemostasis after laparoscopic ovarian endometrioma excision. A randomized controlled study was conducted from January to December 2013 in Thammasat University Hospital, Thailand. Reproductive women, age 18-45years who underwent laparoscopic ovarian cystectomy were randomized in electrocoagulation and suture groups. Clinical baseline data and ovarian reserve outcome (anti-Mullerian hormone (AMH)) were evaluated. Fifty participants were recruited and randomized in two groups. Electrocoagulation and suture groups consisted of 25 participants. Baseline characteristics between 2 groups (age, weight, BMI, height, cyst diameter, duration and estimated blood loss) were not statistically different. There were no significant difference of AMIH between electrocoagulation and suture group atpre-operative (2.90±2.26 vs. 2.52±2.37 ng/ml), 1 week (1.78±1.51 vs. 1.99±1.71 ng/ml), 1 month (1.76±1.50 vs. 2.09±1.62 ng/ml), 3 months (2.09±1.66 vs. 1.96±1.68 ng/ml) and 6 months (2.11±1.84 vs 1.72±1.68 ng/ml), respectively. However mean AMH ofboth groups significantly decreased since the first week of operation. Effect oflaparoscopic ovarian surgery had significantly declined and sustained AMH level until 6 months. Laparoscopic cystectomy of ovarian endometrioma has negative impact to ovarian reserve. Either electroco- agulation or suture method had no different effects.

  15. Thrombin generation by activated factor VII on platelet activated by different agonists. Extending the cell-based model of hemostasis

    Directory of Open Access Journals (Sweden)

    Herrera Maria

    2006-04-01

    Full Text Available Abstract Background Platelet activation is crucial in normal hemostasis. Using a clotting system free of external tissue factor, we investigated whether activated Factor VII in combination with platelet agonists increased thrombin generation (TG in vitro. Methods and results TG was quantified by time parameters: lag time (LT and time to peak (TTP, and by amount of TG: peak of TG (PTG and area under thrombin formation curve after 35 minutes (AUC→35min in plasma from 29 healthy volunteers using the calibrated automated thrombography (CAT technique. TG parameters were measured at basal conditions and after platelet stimulation by sodium arachidonate (AA, ADP, and collagen (Col. In addition, the effects of recombinant activated FVII (rFVIIa alone or combined with the other platelet agonists on TG parameters were investigated. We found that LT and TTP were significantly decreased (p 35min were significantly increased (p 35min (but not PTG when compared to platelet rich plasma activated with agonists in the absence of rFVIIa. Conclusion Platelets activated by AA, ADP, Col or rFVIIa triggered TG. This effect was increased by combining rFVIIa with other agonists. Our intrinsic coagulation system produced a burst in TG independent of external tissue factor activity an apparent hemostatic effect with little thrombotic capacity. Thus we suggest a modification in the cell-based model of hemostasis.

  16. Technical evaluation of the novel preanalytical module on instrumentation laboratory ACL TOP: advancing automation in hemostasis testing.

    Science.gov (United States)

    Lippi, Giuseppe; Ippolito, Luigi; Favaloro, Emmanuel J

    2013-10-01

    Automation in hemostasis testing is entering an exciting and unprecedented phase. This study was planned to assess the performance of the new preanalytical module on the hemostasis testing system Instrumentation Laboratory ACL TOP. The evaluation included interference studies to define reliable thresholds for rejecting samples with significant concentrations of interfering substances; within-run imprecision studies of plasma indices on four different interference degrees for each index; comparison studies with reference measures of hemolysis index, bilirubin, and triglycerides on clinical chemistry analyzers; and calculation of turnaround time with and without automatic performance of preanalytical check. The upper limits for sample rejection according to our interference studies were 3.6 g/L for hemoglobin, 13.6 mg/dL for bilirubin, and 1454 mg/dL for triglycerides. We found optimal precision for all indices (0.6% to 3.1% at clinically relevant thresholds) and highly significant correlations with reference measures on clinical chemistry analyzers (from 0.985 to 0.998). The limited increase of turnaround time (i.e., +3% and +5% with or without cap-piercing), coupled with no adjunctive costs over performance of normal coagulation assays, contribute to make the automatic check of plasma indices on ACL TOP a reliable and practical approach for improving testing quality and safeguarding patient safety.

  17. CLINICAL SIGNIFICANCE OF ANTIPHOSPHOLIPID ANTIBODIES AND GENE MUTATIONS IN HEMOSTASIS OF CHILDREN WITH SYSTEMIC LUPUS ERYTHEMATOSUS AND JUVENILE DERMATOMYOSITIS

    Directory of Open Access Journals (Sweden)

    O.A. Solntseva

    2006-01-01

    Full Text Available Thrombophilia in children with diffuse connective tissue disorders as systemic lupus erythematosus (SLE and juvenile dermatomyositis (JDM could arise from various causes including peripherial blood circulation of antiphospholipid antibodies (APH and genetic mutations in the system of hemostasis. Thrombosis is a serious and prognostically unfavorable complication that has negative impact on the underlying disease course. The study included 96 children, 65 of them had diagnosed SLE and the other 31 had JDM. The Elisa method was used to detect antiphospholipid antibodies, coagulation method was used to detect lupus anticoagulant (LAC and antibodies to cardiolipins (anticl, ?2:glycoprotein 1 (anti ? 2 gp 1 and prothrombin (APT. The PCR method (DNA diagnostics was used to detect DNA mutations as factor resistance to of activated protein c (Leiden 5,10 methylen tetrahydrofolate reductase (MTHFR gene polymorphism. The incidence of APL antibodies was registered in 61.5% patients with SLE and in 32.2% of patients with JDM. Ac ligg, anti ?2 gp 1 Igg were clinically significant in thrombotic events in patients with SLE and JDM, and so was LAC in patients with SLE. The prevalence of the hemostasis system mutations is concordant with reported data. Conclusion thrombophilia is frequently associated with APH antibodies or combination of APH antibodies with genetic abnormalities. Sole genetic mutations are salient in patients with JDM.Key words: thrombophilia, systemic lupus erythematosus, juvenile dermatomyositis, antiphospholipid antibodies, lupus anticoagulant, leiden, prothrombin, methylentet rahydrofolate reductase.

  18. Trauma hemostasis and oxygenation research position paper on remote damage control resuscitation: definitions, current practice, and knowledge gaps.

    Science.gov (United States)

    Jenkins, Donald H; Rappold, Joseph F; Badloe, John F; Berséus, Olle; Blackbourne, Lorne; Brohi, Karim H; Butler, Frank K; Cap, Andrew P; Cohen, Mitchell Jay; Davenport, Ross; DePasquale, Marc; Doughty, Heidi; Glassberg, Elon; Hervig, Tor; Hooper, Timothy J; Kozar, Rosemary; Maegele, Marc; Moore, Ernest E; Murdock, Alan; Ness, Paul M; Pati, Shibani; Rasmussen, Todd; Sailliol, Anne; Schreiber, Martin A; Sunde, Geir Arne; van de Watering, Leo M G; Ward, Kevin R; Weiskopf, Richard B; White, Nathan J; Strandenes, Geir; Spinella, Philip C

    2014-05-01

    The Trauma Hemostasis and Oxygenation Research Network held its third annual Remote Damage Control Resuscitation Symposium in June 2013 in Bergen, Norway. The Trauma Hemostasis and Oxygenation Research Network is a multidisciplinary group of investigators with a common interest in improving outcomes and safety in patients with severe traumatic injury. The network's mission is to reduce the risk of morbidity and mortality from traumatic hemorrhagic shock, in the prehospital phase of resuscitation through research, education, and training. The concept of remote damage control resuscitation is in its infancy, and there is a significant amount of work that needs to be done to improve outcomes for patients with life-threatening bleeding secondary to injury. The prehospital phase of resuscitation is critical in these patients. If shock and coagulopathy can be rapidly identified and minimized before hospital admission, this will very likely reduce morbidity and mortality. This position statement begins to standardize the terms used, provides an acceptable range of therapeutic options, and identifies the major knowledge gaps in the field.

  19. The role of decidual cells in uterine hemostasis, menstruation, inflammation, adverse pregnancy outcomes and abnormal uterine bleeding.

    Science.gov (United States)

    Schatz, Frederick; Guzeloglu-Kayisli, Ozlem; Arlier, Sefa; Kayisli, Umit A; Lockwood, Charles J

    2016-06-01

    Human pregnancy requires robust hemostasis to prevent hemorrhage during extravillous trophoblast (EVT) invasion of the decidualized endometrium, modification of spiral arteries and post-partum processes. However, decidual hemorrhage (abruption) can occur throughout pregnancy from poorly transformed spiral arteries, causing fetal death or spontaneous preterm birth (PTB), or it can promote the aberrant placentation observed in intrauterine growth restriction (IUGR) and pre-eclampsia; all leading causes of perinatal or maternal morbidity and mortality. In non-fertile cycles, the decidua undergoes controlled menstrual bleeding. Abnormal uterine bleeding (AUB) accompanying progestin-only, long-acting, reversible contraception (pLARC) accounts for most discontinuations of these safe and highly effective agents, thereby contributing to unwanted pregnancies and abortion. The aim of this study was to investigate the role of decidual cells in uterine hemostasis, menstruation, inflammation, adverse pregnancy outcomes and abnormal uterine bleeding. We conducted a critical review of the literature arising from PubMed searches up to December 2015, regarding in situ and in vitro expression and regulation of several specific proteins involved in uterine hemostasis in decidua and cycling endometrium. In addition, we discussed clinical and molecular mechanisms associated with pLARC-induced AUB and pregnancy complications with abruptions, chorioamnionitis or pre-eclampsia. Progestin-induced decidualization of estradiol-primed human endometrial stromal cells (HESCs) increases in vivo and in vitro expression of tissue factor (TF) and type-1 plasminogen activator inhibitor (PAI-1) while inhibiting plasminogen activators (PAs), matrix metalloproteinases (MMPs), and the vasoconstrictor, endothelin-1 (ET-1). These changes in decidual cell-derived regulators of hemostasis, fibrinolysis, extracellular matrix (ECM) turnover, and vascular tone prevent hemorrhage during EVT invasion and

  20. Speeds in school zones.

    Science.gov (United States)

    2009-02-01

    School speed zones are frequently requested traffic controls for school areas, based on the common belief : that if the transportation agency would only install a reduced speed limit, then drivers would no longer : speed through the area. This resear...

  1. Anti-Mullerian hormone trend evaluation after laparoscopic surgery of monolateral endometrioma using a new dual wavelengths laser system (DWLS) for hemostasis.

    Science.gov (United States)

    Nappi, Luigi; Angioni, Stefano; Sorrentino, Felice; Cinnella, Gilda; Lombardi, Michela; Greco, Pantaleo

    2016-01-01

    Operative laparoscopy is the gold standard in the treatment of endometriotic ovarian cysts. Excisional surgery is the best technique to prevent recurrences and improve symptoms but it may result in ovarian reserve damage due to the removal of healthy ovarian cortex. The aim of this study was to assess the impact on ovarian reserve of the use of dual wavelengths laser system (DWLS) hemostasis after stripping technique of monolateral endometrioma, by dosing the anti-Mullerian hormone (AMH). This prospective study was conducted at the Institute of Obstetrics and Gynecology, University of Foggia, from December 2013 to January 2015. Forty-five women underwent excision of monolateral endometriotic ovarian cyst by stripping without using a bipolar coagulation and performing hemostasis with a DWLS. The AMH serum levels were estimated before the surgery (T0), 4-6 weeks (T1) and 6-9 months (T2) after surgery. Our results suggest that an appropriate surgical technique with the use of laser hemostasis does not determine a significant reduction of ovarian reserve. Laser hemostasis could prevent follicular reserve loss after ovarian endometrioma surgery.

  2. The impact of selective and non-selective non-steroid anti-inflammatory drugs on secondary hemostasis in healthy volunteers

    DEFF Research Database (Denmark)

    Schjerning, Ole; Larsen, Torben B; Damkier, Per

    2009-01-01

    BACKGROUND: Clinical and epidemiological studies have associated selective COX-2 inhibitors with an increased risk of cardiovascular events. There are no clinical studies on the possible effects of these drugs on secondary hemostasis. The hypothesis for this study is that the use of selective COX-2...

  3. Parameters of metabolism and hemostasis in patients with type 1 diabetes mellitus and microgiopathy of different severity

    Directory of Open Access Journals (Sweden)

    Galina Georgievna Petrik

    2010-06-01

    Full Text Available Aim. To identify risk factors of macro-microvascular lesions at different stages of pathological process in patients with type 1 diabetes mellitus andmicrogiopathy of different severity. Materials and methods. Comprehensive analysis of parameters of metabolism, hemogram, platelet and plasma hemostasis in 121 patients (67 menand 54 women of mean age 28.2?10.7 years with type 1 diabetes mellitus and angiopathy of different severity. Results. All patients had hyperglycemia along with dysproteinemia and altered lipid spectrum. Mean platelet volume and aggregation activity increasedwhile activated partial thromboplastic time decreased compared with control subjects regardless of the presence and severity of microangiopathy. Conclusion. Morphological and functional characteristics of platelets and activated partial throm-boplastic time are differently related to metabolicchanges.

  4. Pitfalls in hemostasis exploration, a case report of a girl with Henoch-Schönlein type vasculitis

    Directory of Open Access Journals (Sweden)

    Arghirescu Smaranda

    2017-07-01

    Full Text Available The adequate performance and correct interpretation of assays for coagulation factor inhibitors play a critical role for the hemostasis laboratory. Both, false positive and false negative inhibitor assays may be reported, leading to erroneous patient’s management. Therefore, we decided to present a case with a spurious image of an exceptionally rare acquired combined haemophilia A, B and C, with severe factor ( F VIII, IX and XI deficiency, associated with high titre anti - F VIII, IX and XI inhibitors in a 4 years old girl with Henoch-Schönlein type vasculitis. Finally, performing, beside coagulometric methods also antigenic ELISA assays, we had to invalidate the diagnosis. The performance of antiphospholipd antibodies clarified the diagnosis , finally concluding as definite diagnosis Transient Lupus Anticoagulant Syndrome, with decisive impact on therapy and follow-up.

  5. A comparison between tourniquet application and epinephrine injection for hemostasis during hypospadias surgery: The effect on bleeding and postoperative outcome.

    Science.gov (United States)

    Alizadeh, F; Fakoor, A; Haghdani, S

    2016-06-01

    To compare tourniquet application and epinephrine injection for hemostasis during hypospadias surgery in terms of bleeding and complications. Between April 2013 and September 2014, patients who were admitted for hypospadias repair were divided by random allocation into either a diluted epinephrine injection (DE) group or tourniquet application (T) group for hemostasis during the procedure. In the T group, a rubber band was applied at the base of the penis after skin dissection, and in the DE group, epinephrine 1/100,000 was injected along the incision lines. The patients' ages, urethral defect lengths, pre-operative, intraoperative and postoperative variables were compared between the two groups. A total of 70 patients (35 in each group) were enrolled into the study. The mean ages and preoperative variables were not significantly different. Average blood loss was 23.51 ± 15.36 cc in the tourniquet group and 15.99 ± 10.00 cc in the epinephrine group, and was significantly higher in tourniquet group (P = 0.022); however, the mean operative time was not significantly different. Postoperative complications, described as Clavian classification, were reported in eight patients (23%) in the T group and 10 patients (30%) in the DE group, which was not significantly different. Epinephrine injections minimize operative bleeding without significant harmful effects on postoperative outcomes; therefore, it could be considered to be a safe and effective method for preparation of a bloodless field during hypospadias surgery. Copyright © 2016 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.

  6. Measures for speed management.

    NARCIS (Netherlands)

    2009-01-01

    Measures for speed management are essential for limiting the negative effects of driving too fast and at inappropriate speeds. To begin with, safe and credible speed limits need to be determined. Dynamic and variable speed limits that take into account the current circumstances, such as weather

  7. Speed management program plan.

    Science.gov (United States)

    2014-05-01

    Changing public attitudes regarding speeding and speed management will require a comprehensive and concerted effort, involving a wide variety of strategies. This plan identifies six primary focus areas: : A. Data and Data-Driven Approaches, : B. Rese...

  8. Small portable speed calculator

    Science.gov (United States)

    Burch, J. L.; Billions, J. C.

    1973-01-01

    Calculator is adapted stopwatch calibrated for fast accurate measurement of speeds. Single assembled unit is rugged, self-contained, and relatively inexpensive to manufacture. Potential market includes automobile-speed enforcement, railroads, and field-test facilities.

  9. Electric vehicle speed control

    Energy Technology Data Exchange (ETDEWEB)

    Krueger, W.R.; Mc Auliffe, G.N.; Schlageter, G.A.

    1987-06-23

    This patent describes an electric vehicle driven by a DC motor. The vehicle has a field winding, an electric resistance element in circuit with the field winding, a switch in the circuit operative when closed to place. The element in parallel with the field winding weakens the field and increases potential motor speed. Also are relay means for operating the switch, means to determine motor speed, computer means for determining whether the motor speed is increasing or decreasing, and means for operating the relay means to close the switch at a first speed. If the motor speed is increased, it actuates the switch at a second speed lower than the first speed but only if switch has been closed previously and motor speed is decreasing.

  10. EVALUATION OF DISORDERS OF HEMOSTASIS, FUNCTIONAL STATE OF THE KIDNEYS AND RENAL HEMODYNAMICS IN CHILDREN WITH NEPHROTIC SYNDROME OF ACUTE GLOMERULONEPHRITIS

    Directory of Open Access Journals (Sweden)

    Elena Genadievna Makhova

    2016-04-01

    Full Text Available Was made analysis of status single links in haemostatic system at children with sharp glomerulonephritis, changes in haemostatic links and changes of intrarenal subcapsular bloodstream during anticoagulant therapy. Among 44 children was made a standard medical checkup and survey of hemostasis system and duplex scaning of kidneys vessels. Was evaluated the dynamics changes of hemostasis and at intrarenal subcapsular bloodstream during anticoagulant therapy. It found that the debut is accompanied by signs of hypercoagulability at the mark of homeostasis and irregularities in duplex scanning of kidneys vessels with deterioration signs of subcapsular bloodstream. At sharp glomerulonephritis the risk of blood clots will grow up, and that can worsen disease and be the reason of process chronicis.

  11. Speed in Acquisitions

    DEFF Research Database (Denmark)

    Meglio, Olimpia; King, David R.; Risberg, Annette

    2017-01-01

    The advantage of speed is often invoked by academics and practitioners as an essential condition during post-acquisition integration, frequently without consideration of the impact earlier decisions have on acquisition speed. In this article, we examine the role speed plays in acquisitions across...... the acquisition process using research organized around characteristics that display complexity with respect to acquisition speed. We incorporate existing research with a process perspective of acquisitions in order to present trade-offs, and consider the influence of both stakeholders and the pre......-deal-completion context on acquisition speed, as well as the organization’s capabilities to facilitating that speed. Observed trade-offs suggest both that acquisition speed often requires longer planning time before an acquisition and that associated decisions require managerial judgement. A framework for improving...

  12. ASVCP quality assurance guidelines: control of preanalytical and analytical factors for hematology for mammalian and nonmammalian species, hemostasis, and crossmatching in veterinary laboratories.

    Science.gov (United States)

    Vap, Linda M; Harr, Kendal E; Arnold, Jill E; Freeman, Kathleen P; Getzy, Karen; Lester, Sally; Friedrichs, Kristen R

    2012-03-01

    In December 2009, the American Society for Veterinary Clinical Pathology (ASVCP) Quality Assurance and Laboratory Standards committee published the updated and peer-reviewed ASVCP Quality Assurance Guidelines on the Society's website. These guidelines are intended for use by veterinary diagnostic laboratories and veterinary research laboratories that are not covered by the US Food and Drug Administration Good Laboratory Practice standards (Code of Federal Regulations Title 21, Chapter 58). The guidelines have been divided into 3 reports: (1) general analytical factors for veterinary laboratory performance and comparisons; (2) hematology, hemostasis, and crossmatching; and (3) clinical chemistry, cytology, and urinalysis. This particular report is one of 3 reports and provides recommendations for control of preanalytical and analytical factors related to hematology for mammalian and nonmammalian species, hemostasis testing, and crossmatching and is adapted from sections 1.1 and 2.3 (mammalian hematology), 1.2 and 2.4 (nonmammalian hematology), 1.5 and 2.7 (hemostasis testing), and 1.6 and 2.8 (crossmatching) of the complete guidelines. These guidelines are not intended to be all-inclusive; rather, they provide minimal guidelines for quality assurance and quality control for veterinary laboratory testing and a basis for laboratories to assess their current practices, determine areas for improvement, and guide continuing professional development and education efforts. © 2012 American Society for Veterinary Clinical Pathology.

  13. The safety and efficacy of hemostasis with Clo-Sur P.A.D. after transcatheter arterial chemoembolization

    International Nuclear Information System (INIS)

    Jung, Seung Chai; Jae, Hwan Jun; Kim, Sang Youn; Lee, Whal; Chung, Jin Wook; Park, Jae Hyung

    2007-01-01

    We wanted to evaluate the safety and efficacy of a new hemostatic device, Clo-Sur P.A.D., at an arterial access site after performing femoral arterial catheterization to achieve transcatheter arterial chemoembolization (TACE). From August 2002 to March 2005, 113 patients who underwent TACE and agreed on using the Clo-Sur P.A.D. were enrolled in this study. We evaluated the mean time interval from compression to the first movement and also to the first walk. We also evaluated such complications as rebleeding, pseudoaneurysm, vascular occlusion, hematoma, infection and pain. For 92 patients who had previous experiences with manual compression, we evaluated their preference of hemostatic method by asking them. Successful hemostasis was achieved with the Clo-Sur P.A.D. in 105 subjects (92%). The mean time interval from compression to the first movement was 201 minutes, and that to the first walk was 267 minutes. There was no statistical difference between the complicated and the uncomplicated groups for the mean time, prothrombin time, Child-Pugh class and platelet count (ρ > 0.05). Rebleeding occurred in 3 patients (2.7%) and mild hematoma around puncture site was noted in 5 patients (5.4%). Eighty-seven patients (95%) preferred Clo-Sur P.A.D. to the manual compression method. The Clo-Sur P.A.D. is a safe and effective hemostatic device and it provides early ambulation after TACE

  14. Characteristics of hemostasis system and hemorrhagic syndrome in infants with congenital heart disease in operations with cardiopulmonary bypass

    Directory of Open Access Journals (Sweden)

    Н. П. Леонов

    2016-01-01

    Full Text Available 97 neonates were included in this prospective observational study. While using the exclusion criteria, two groups without demographic differences were formed: the first group included 35 patients with blood loss greater than 10 ml/kg in the first 4 hours postoperatively, the second one consisted of 46 patients who did not have such blood loss. Hemostatic standard tests and thromboelastography were performed before surgery, immediately after surgery and 24 hours after it. As a result, a detailed description of the changes of hemostasis in the perioperative period in newborns with CHD was developed. It was found out that significant postoperative bleeding increases the incidence of coagulopathy, resuscitation after surgery, duration of mechanical ventilation, length of stay at ICU and 30-day mortality. It is confirmed that the main pathogenetic mechanisms of increased bleeding in the first hours after the operation are due to cardiopulmonary bypass coagulopathy, the dynamics and implications of which are documented in our study. Also established are prognostic clinical and laboratory predictors of coagulopathy associated with severe multiple organ failure.

  15. The fatal risk in hepatic artery embolization for hemostasis after pancreatic and hepatic surgery: importance of collateral arterial pathways.

    Science.gov (United States)

    Sato, Akihiro; Yamada, Takayuki; Takase, Kei; Matsuhashi, Toshio; Higano, Shuichi; Kaneda, Tomohiro; Egawa, Shinichi; Takeda, Kazunori; Ishibashi, Tadashi; Takahashi, Shoki

    2011-03-01

    To assess retrospectively the cause of hepatic failure related to hepatic arterial embolization (HAE) for hemostasis after pancreaticoduodenectomy or hepatic lobectomy. Between June 1993 and March 2006, Twenty HAEs in 17 patients (15 men, two women; mean age, 64 years) were performed. Angiographic findings, including portal vein stenosis, collateral arterial pathways after HAE, and the difference of embolic materials, were recorded. The morbidity (hepatic failure and abscess) and mortality were detailed according to collateral arterial pathways, portal vein stenosis, and embolic material used. Bleeding was controlled in all patients, although two patients required repeat embolization. Hepatic failure (n = 8) and abscess (n = 2) arose in nine of 20 HAEs. Death occurred after six of eight HAEs complicated by hepatic failure. The morbidity and mortality rates of HAE were 45% and 30%, respectively. Hepatic complication was eight times more likely to occur (P = .005) in cases with no hepatic collaterals involving hepatic, replaced, or accessory hepatic arteries. Death was observed only in the cases without hepatic collaterals (P = .011). The correlation between the embolization outcome and the presence of portal vein stenosis or the difference of embolic materials was not significant (P > .61). HAE can be used to successfully control bleeding secondary to hepatic arterial rupture. In the absence of hepatic collaterals, collateral circulation distal to the occlusion from nonhepatic sources may be inadequate and lead to hepatic failure after HAE. Copyright © 2011 SIR. Published by Elsevier Inc. All rights reserved.

  16. Potential for in-car speed assistance systems : results of a large-scale survey in Belgium and the Netherlands

    NARCIS (Netherlands)

    Vlassenroot, S.; Marchau, V.; De Mol, J.; Brookhuis, K.; Witlox, F.

    Speeding is generally considered to be a major cause of road traffic accidents. In-car speed assistance systems aim at reducing speeding. Several trials with different types of in-car speed assistance systems, in particular intelligent speed assistance (ISA), have shown that ISA can be an effective

  17. Capacity-speed relationships in prefrontal cortex.

    Directory of Open Access Journals (Sweden)

    Vivek Prabhakaran

    Full Text Available Working memory (WM capacity and WM processing speed are simple cognitive measures that underlie human performance in complex processes such as reasoning and language comprehension. These cognitive measures have shown to be interrelated in behavioral studies, yet the neural mechanism behind this interdependence has not been elucidated. We have carried out two functional MRI studies to separately identify brain regions involved in capacity and speed. Experiment 1, using a block-design WM verbal task, identified increased WM capacity with increased activity in right prefrontal regions, and Experiment 2, using a single-trial WM verbal task, identified increased WM processing speed with increased activity in similar regions. Our results suggest that right prefrontal areas may be a common region interlinking these two cognitive measures. Moreover, an overlap analysis with regions associated with binding or chunking suggest that this strategic memory consolidation process may be the mechanism interlinking WM capacity and WM speed.

  18. Speed and income

    DEFF Research Database (Denmark)

    Fosgerau, Mogens

    2005-01-01

    The relationship between speed and income is established in a microeconomic model focusing on the trade-off between travel time and the risk of receiving a penalty for exceeding the speed limit. This is used to determine when a rational driver will choose to exceed the speed limit. The relationship...... between speed and income is found again in the empirical analysis of a cross-sectional dataset comprising 60,000 observations of car trips. This is used to perform regressions of speed on income, distance travelled, and a number of controls. The results are clearly statistically significant and indicate...... an average income elasticity of speed of 0.02; it is smaller at short distances and about twice as large at the longest distance investigated of 200 km....

  19. High speed atom source

    International Nuclear Information System (INIS)

    Hoshino, Hitoshi.

    1990-01-01

    In a high speed atom source, since the speed is not identical between ions and electrons, no sufficient neutralizing effect for ionic rays due to the mixing of the ionic rays and the electron rays can be obtained failing to obtain high speed atomic rays at high density. In view of the above, a speed control means is disposed for equalizing the speed of ions forming ionic rays and the speed of electrons forming electron rays. Further, incident angle of the electron rays and/or ionic rays to a magnet or an electrode is made variable. As a result, the relative speed between the ions and the electrons to the processing direction is reduced to zero, in which the probability of association between the ions and the electrons due to the coulomb force is increased to improve the neutralizing efficiency to easily obtain fine and high density high speed electron rays. Further, by varying the incident angle, a track capable of obtaining an ideal mixing depending on the energy of the neutralized ionic rays is formed. Since the high speed electron rays has such high density, they can be irradiated easily to the minute region of the specimen. (N.H.)

  20. Computer ray tracing speeds.

    Science.gov (United States)

    Robb, P; Pawlowski, B

    1990-05-01

    The results of measuring the ray trace speed and compilation speed of thirty-nine computers in fifty-seven configurations, ranging from personal computers to super computers, are described. A correlation of ray trace speed has been made with the LINPACK benchmark which allows the ray trace speed to be estimated using LINPACK performance data. The results indicate that the latest generation of workstations, using CPUs based on RISC (Reduced Instruction Set Computer) technology, are as fast or faster than mainframe computers in compute-bound situations.

  1. Elevated hemostasis markers after pneumonia increases one-year risk of all-cause and cardiovascular deaths.

    Science.gov (United States)

    Yende, Sachin; D'Angelo, Gina; Mayr, Florian; Kellum, John A; Weissfeld, Lisa; Kaynar, A Murat; Young, Tammy; Irani, Kaikobad; Angus, Derek C

    2011-01-01

    Acceleration of chronic diseases, particularly cardiovascular disease, may increase long-term mortality after community-acquired pneumonia (CAP), but underlying mechanisms are unknown. Persistence of the prothrombotic state that occurs during an acute infection may increase risk of subsequent atherothrombosis in patients with pre-existing cardiovascular disease and increase subsequent risk of death. We hypothesized that circulating hemostasis markers activated during CAP persist at hospital discharge, when patients appear to have recovered clinically, and are associated with higher mortality, particularly due to cardiovascular causes. In a cohort of survivors of CAP hospitalization from 28 US sites, we measured D-Dimer, thrombin-antithrombin complexes [TAT], Factor IX, antithrombin, and plasminogen activator inhibitor-1 at hospital discharge, and determined 1-year all-cause and cardiovascular mortality. Of 893 subjects, most did not have severe pneumonia (70.6% never developed severe sepsis) and only 13.4% required intensive care unit admission. At discharge, 88.4% of subjects had normal vital signs and appeared to have clinically recovered. D-dimer and TAT levels were elevated at discharge in 78.8% and 30.1% of all subjects, and in 51.3% and 25.3% of those without severe sepsis. Higher D-dimer and TAT levels were associated with higher risk of all-cause mortality (range of hazard ratios were 1.66-1.17, p = 0.0001 and 1.46-1.04, p = 0.001 after adjusting for demographics and comorbid illnesses) and cardiovascular mortality (p = 0.009 and 0.003 in competing risk analyses). Elevations of TAT and D-dimer levels are common at hospital discharge in patients who appeared to have recovered clinically from pneumonia and are associated with higher risk of subsequent deaths, particularly due to cardiovascular disease.

  2. Elevated hemostasis markers after pneumonia increases one-year risk of all-cause and cardiovascular deaths.

    Directory of Open Access Journals (Sweden)

    Sachin Yende

    Full Text Available Acceleration of chronic diseases, particularly cardiovascular disease, may increase long-term mortality after community-acquired pneumonia (CAP, but underlying mechanisms are unknown. Persistence of the prothrombotic state that occurs during an acute infection may increase risk of subsequent atherothrombosis in patients with pre-existing cardiovascular disease and increase subsequent risk of death. We hypothesized that circulating hemostasis markers activated during CAP persist at hospital discharge, when patients appear to have recovered clinically, and are associated with higher mortality, particularly due to cardiovascular causes.In a cohort of survivors of CAP hospitalization from 28 US sites, we measured D-Dimer, thrombin-antithrombin complexes [TAT], Factor IX, antithrombin, and plasminogen activator inhibitor-1 at hospital discharge, and determined 1-year all-cause and cardiovascular mortality.Of 893 subjects, most did not have severe pneumonia (70.6% never developed severe sepsis and only 13.4% required intensive care unit admission. At discharge, 88.4% of subjects had normal vital signs and appeared to have clinically recovered. D-dimer and TAT levels were elevated at discharge in 78.8% and 30.1% of all subjects, and in 51.3% and 25.3% of those without severe sepsis. Higher D-dimer and TAT levels were associated with higher risk of all-cause mortality (range of hazard ratios were 1.66-1.17, p = 0.0001 and 1.46-1.04, p = 0.001 after adjusting for demographics and comorbid illnesses and cardiovascular mortality (p = 0.009 and 0.003 in competing risk analyses.Elevations of TAT and D-dimer levels are common at hospital discharge in patients who appeared to have recovered clinically from pneumonia and are associated with higher risk of subsequent deaths, particularly due to cardiovascular disease.

  3. Endurance in speed skating

    NARCIS (Netherlands)

    Kuper, G.H.; Sterken, E.

    2002-01-01

    We analyse the development of world records speed skating from 1893 to 2000 for bothmen and women. The historical data show that it is likely that the relation betweenskating speed and distance of the various events is non-linear and converges to a limitvalue. We pay special attention to technical

  4. Endurance in speed skating

    NARCIS (Netherlands)

    Kuper, Gerard H.; Sterken, Elmer

    2001-01-01

    We analyse the development of world records speed skating from 1893 to 2000 for both men and women. The historical data show that it is likely that the relation between skating speed and distance of the various events is non-linear and converges to a limit value. We pay special attention to

  5. Effectiveness of Motorcycle speed controlled by speed hump

    Directory of Open Access Journals (Sweden)

    Pornsiri Urapa

    2014-09-01

    Full Text Available Speed humps are one of the traffic calming measures widely accepted to control vehicle speed in the local road. Humps standards from the western countries are designed mainly for the passenger car. This study, therefore, aims to reveal the effectiveness of speed hump to control the motorcycle speed. This study observes the free-flow speed of the riders at the total of 20 speed bumps and humps. They are 0.3-14.8 meter in width and 5-18 centimeter in height. The results reveal that the 85th percentile speeds reduce 15-65 percent when crossing the speed bumps and speed humps. Besides, this study develops the speed model to predict the motorcycle mean speed and 85th percentile speed. It is found that speed humps follow the ITE standard can control motorcycle crossing speeds to be 25-30 Kph which are suitable to travel on the local road.

  6. Second-generation speed limit map updating applications

    DEFF Research Database (Denmark)

    Tradisauskas, Nerius; Agerholm, Niels; Juhl, Jens

    2011-01-01

    Intelligent Speed Adaptation is an Intelligent Transport System developed to significantly improve road safety in helping car drivers maintain appropriate driving behaviour. The system works in connection with the speed limits on the road network. It is thus essential to keep the speed limit map...... used in the Intelligent Speed Adaptation scheme updated. The traditional method of updating speed limit maps on the basis of long time interval observations needed to be replaced by a more efficient speed limit updating tool. In a Danish Intelligent Speed Adaptation trial a web-based tool was therefore...... for map updating should preferably be made on the basis of a commercial map provider, 2 such as Google Maps and that the real challenge is to oblige road authorities to carry out updates....

  7. Traffic speed management

    Directory of Open Access Journals (Sweden)

    Subotić Jovana Lj.

    2014-01-01

    Full Text Available Speed, and vehicles themselves, affect the level of service and road safety, quality of life, noise from traffic, the environment, health, air pollution, emission of carbon dioxide, global warming, the economy and consumption of non-renewable energy such as oil. Therefore, the speed management of the traffic of multiple significance and that should be primarily to provide effective and economical conditions of the modern and preventive protection of human life as the greatest treasure and then the material resources. The way to accomplish this is by using various (different measures such as: appropriate planning and projecting roads and streets, speed control, the legislation, enforcement, campaigns, education, advanced technologies (ITS.

  8. High-Speed Photography

    International Nuclear Information System (INIS)

    Paisley, D.L.; Schelev, M.Y.

    1998-01-01

    The applications of high-speed photography to a diverse set of subjects including inertial confinement fusion, laser surgical procedures, communications, automotive airbags, lightning etc. are briefly discussed. (AIP) copyright 1998 Society of Photo-Optical Instrumentation Engineers

  9. Wind_Speeds_Master

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — This data set included wind speeds for each subregion in the study (Georges Bank, Gulf of Maine, Southern New England, Middle Atlantic Bight) . The data came from...

  10. High speed data acquisition

    International Nuclear Information System (INIS)

    Cooper, P.S.

    1997-07-01

    A general introduction to high speed data acquisition system techniques in modern particle physics experiments is given. Examples are drawn from the SELEX(E78 1) high statistics charmed baryon production and decay experiment now taking data at Fermilab

  11. High speed heterostructure devices

    CERN Document Server

    Beer, Albert C; Willardson, R K; Kiehl, Richard A; Sollner, T C L Gerhard

    1994-01-01

    Volume 41 includes an in-depth review of the most important, high-speed switches made with heterojunction technology. This volume is aimed at the graduate student or working researcher who needs a broad overview andan introduction to current literature. Key Features * The first complete review of InP-based HFETs and complementary HFETs, which promise very low power and high speed * Offers a complete, three-chapter review of resonant tunneling * Provides an emphasis on circuits as well as devices.

  12. Assessment of effects of phenolic fractions from leaves and petals of dandelion in selected components of hemostasis.

    Science.gov (United States)

    Lis, Bernadetta; Jędrejek, Dariusz; Stochmal, Anna; Olas, Beata

    2018-05-01

    Aerial parts and roots of Taraxacum officinale (dandelion) have been found to be rich sources of polyphenols, including cinnamic acid derivatives, flavonoids and triterpenoids, which exert different biological activities, such as anti-inflammatory, anticancer and antimicrobial. Additionally, the whole plant is recognized as safe and well tolerated by humans, with no reported adverse effects. Nowadays, dandelion is a commonly available dietary supplement and a component of pharmaceutical preparations used for the treatment of bladder, liver, and spleen. Nevertheless, the effect of dandelion on blood platelets and plasma - components of hemostasis involved in the functioning of a cardiovascular system and linked with various cardiovascular diseases, has not been studied yet. Thus, the main objective of our in vitro experiments was to examine the anti-platelet and antioxidant properties of four standardized dandelion phenolic fractions, i.e. leaves 50% and 85% methanol fractions, and petals 50% and 85% methanol fractions, in blood platelets. Additionally, aforementioned plant preparations were investigated for hemostatic activity in plasma, using three selected hemostatic parameters: the activated partial thromboplastin time (APTT), prothrombin time (PT) and thrombin time (TT). None of the studied dandelion fractions, caused the damage of human blood platelets, at the whole tested range. The inhibition of lipid peroxidation in platelets treated with H 2 O 2 /Fe (the donor of OH) was observed for two fractions: leaves and petals 50% fractions, both at the dose 50 μg/mL. Analysis of the effect on the coagulation activity of human plasma demonstrated that three fractions: petals 50% fraction, and leaves and petals 85% fractions, significantly prolonged the thrombin time, at the whole tested range. On the contrary, none of the fractions changed the APTT and the PT. The obtained results demonstrate that dandelion preparations, based on aerial parts, especially rich in

  13. Cardiopulmonary bypass and hemostasis

    NARCIS (Netherlands)

    Eijsman, Leon

    1992-01-01

    In chapter 1, we recalled that intracardiac defects can only be corrected when cardiopulmonary circulation is maintained by extracorporeal criculation and ventilation. To prevent clot formation in this artificial circuit, the socalled cardiopulmonary bypass (CPB), we completely depend on the

  14. Everyone Deserves a Speeding Ticket.

    Science.gov (United States)

    Burris, Harold

    1993-01-01

    Presents a first day physics activity having students determine the fine for a speeding ticket if the speeds considered include the earth's rotation and revolution speed, and the movement through the galaxy. (MDH)

  15. PERSONALITY AND SPEEDING

    Directory of Open Access Journals (Sweden)

    Richard TAY

    2003-01-01

    Full Text Available While there has been extensive research on the effect of sensation seeking on risky driving, relatively little research has been conducted on Type-A personality. The motivations for speeding are likely to be different for each group and these differences have important implications for the design, implementation and expected efficacy of road safety countermeasures. This paper examines the influence of sensation seeking and Type-A behavior pattern on speeding behaviour. A sample of 139 staff and students in an Australian university were surveyed in July 2001 to gather information on their gender, age, personality and self-reported speeding behaviour. The data were analysed using correlations and analysis of variance procedures. Finally, some implications for road safety are discussed.

  16. Speed-calming measures and their Effect on driving speed

    DEFF Research Database (Denmark)

    Agerholm, Niels; Knudsen, Daniel; Variyeswaran, Kajan

    2017-01-01

    Highlights •Speed humps and chicanes are widespread speed-calming measures. •Humps and chicanes have virtually the same reducing effect on mean speed. •Chicanes reduce speed variation less than humps and might therefore be a less safe measure....

  17. Using road markings as a continuous cue for speed choice.

    Science.gov (United States)

    Charlton, Samuel G; Starkey, Nicola J; Malhotra, Neha

    2018-08-01

    The potential for using road markings to indicate speed limits was investigated in a driving simulator over the course of two sessions. Two types of experimental road markings, an "Attentional" set designed to provide visually distinct cues to indicate speed limits of 60, 80 and 100 km/h, and a "Perceptual" set designed to also affect drivers' perception of speed, were compared to a standard undifferentiated set of markings. Participants (n = 20 per group) were assigned to one of four experimental groups (Attentional-Explicit, Attentional-Implicit, Perceptual-Explicit, Perceptual-Implicit) or a Control group (n = 22; standard road markings). The Explicit groups were instructed about the meaning of the road markings while those in the Implicit and Control groups did not receive any explanation. Participants drove five 10 km simulated roads containing three speed zones (60, 80 and 100 km/h) during the first session. The participants returned to the laboratory approximately 3 days later to drive five more trials including roads they had not seen before, a trial that included a secondary task, and a trial where speed signs were removed and only markings were present. The findings indicated that both types of road markings improved drivers' compliance with speed limits compared to the control group, but that explicit instruction as to the meaning of the markings was needed to realise their full benefit. Although previous research has indicated the benefit of road markings used as warnings to indicate speed reductions in advance of horizontal or vertical curves, the findings of the present experiment also suggest that systematically associating road markings with specific speed limits may be a useful way to improve speed limit compliance and increase speed homogeneity. Copyright © 2018 The Authors. Published by Elsevier Ltd.. All rights reserved.

  18. Intelligent Speed Assistance (ISA).

    NARCIS (Netherlands)

    2015-01-01

    Intelligent Speed Assistance (ISA) has been a promising type of advanced driver support system for some decades. From a technical point of view, large scale ISA implementation is possible in the short term. The different types of ISA are expected to have different effects on behaviour and traffic

  19. Speed mathematics simplified

    CERN Document Server

    Stoddard, Edward

    1994-01-01

    Entertaining, easy-to-follow suggestions for developing greater speed and accuracy in doing mathematical calculations. Surefire methods for multiplying without carrying, dividing with half the pencil work of long division, plus advice on how to add and subtract rapidly, master fractions, work quickly with decimals, handle percentages, and much more.

  20. High speed metal removal

    Science.gov (United States)

    Pugh, R. F.; Pohl, R. F.

    1982-10-01

    Four types of steel (AISI 1340, 4140, 4340, and HF-1) which are commonly used in large caliber projectile manufacture were machined at different hardness ranges representing the as-forged and the heat treated condition with various ceramic tools using ceramic coated tungsten carbide as a reference. Results show that machining speeds can be increased significantly using present available tooling.

  1. Variable speed generators

    CERN Document Server

    Boldea, Ion

    2005-01-01

    With the deregulation of electrical energy production and distribution, says Boldea (Polytechnical Institute, Timisoara, Romania) producers are looking for ways to tailor their electricity for different markets. Variable-speed electric generators are serving that purpose, up to the 400 megavolt ampere unit size, in Japan since 1996 and Germany sinc

  2. Modulation of walking speed by changing optic flow in persons with stroke

    Directory of Open Access Journals (Sweden)

    Lamontagne Anouk

    2007-06-01

    Full Text Available Abstract Background Walking speed, which is often reduced after stroke, can be influenced by the perception of optic flow (OF speed. The present study aims to: 1 compare the modulation of walking speed in response to OF speed changes between persons with stroke and healthy controls and 2 investigate whether virtual environments (VE manipulating OF speed can be used to promote volitional changes in walking speed post stroke. Methods Twelve persons with stroke and 12 healthy individuals walked on a self-paced treadmill while viewing a virtual corridor in a helmet-mounted display. Two experiments were carried out on the same day. In experiment 1, the speed of an expanding OF was varied sinusoidally at 0.017 Hz (sine duration = 60 s, from 0 to 2 times the subject's comfortable walking speed, for a total duration of 5 minutes. In experiment 2, subjects were exposed to expanding OFs at discrete speeds that ranged from 0.25 to 2 times their comfortable speed. Each test trial was paired with a control trial performed at comfortable speed with matching OF. For each of the test trials, subjects were instructed to walk the distance within the same time as during the immediately preceding control trial. VEs were controlled by the CAREN-2 system (Motek. Instantaneous changes in gait speed (experiment 1 and the ratio of speed changes in the test trial over the control trial (experiment 2 were contrasted between the two groups of subjects. Results When OF speed was changing continuously (experiment 1, an out-of-phase modulation was observed in the gait speed of healthy subjects, such that slower OFs induced faster walking speeds, and vice versa. Persons with stroke displayed weaker (p 0.05, T-test. Conclusion Stroke affects the modulation of gait speed in response to changes in the perception of movement through different OF speeds. Nevertheless, the preservation of even a modest modulation enabled the persons with stroke to increase walking speed when

  3. Changes in hemostasis caused by different replacement fluids and outcome in therapeutic plasma exchange in pediatric patients in a retrospective single center study.

    Science.gov (United States)

    Witt, Volker; Pichler, Herbert; Beiglboeck, Elisabeth; Kursten, Friedrich; Weidner, Lisa

    2017-02-01

    Therapeutic plasma exchange (TPE) is a generally accepted and frequently performed procedure for numerous therapeutic indications in adults. Slowly, TPE is also becoming more and more popular in the treatment of pediatric patients. Although, we know that TPE is safe in pediatric patients, the outcome of children treated with TPE is rarely reported. Furthermore, there are only general recommendations regarding the plasma replacement fluid for children and these are adopted from adults. Data concerning outcome and the influence of different types of replacement fluids on hemostasis in children are scarce. We retrospectively evaluated 324 TPE treatments performed in 35 patients between 2008 and 2013 in our level 4 institution for pediatric hematology and oncology. The plasmapheresis procedures were categorized into three groups based on the replacement fluid used. The first group received solvent/detergent-treated (S/D) plasma (70.0% of patients), the second group was administered 5% human albumin (7.7% of patients) and the third group was treated with a combination of human albumin 5% and S/D plasma (22.3% of patients). To assess hemostasis, data on INR, aPTT, fibrinogen and ATIII were collected before and after plasmapheresis from the patients' charts. A modified Multi Organ Dysfunction Syndrome (MODS) Index was used to classify organ failure. Patient outcome, survival rate and adverse events were evaluated. We found a significant increase in the INR by 35.83% and of the aPTT by 18.53% within the human albumin group. The INR and aPTT of patients allocated to the S/D plasma group decreased by 1.58% and 15.77% on average, respectively. The combination group revealed a mild increase of the INR (9.47%), accompanied by a reduction of aPTT (5.97%). Furthermore we found that the survival rate was significantly associated with a MODS Index of <2 (p<0.001). Overall, the number of adverse events was low (1.2%) and none of these were considered life-threatening. Hemostasis

  4. Improving speed behaviour : the potential of in-car speed assistance and speed limit credibility.

    NARCIS (Netherlands)

    Nes, C.N. van Houtenbos, M. & Schagen, I.N.L.G. van

    2009-01-01

    Speeding is still a common practice on many roads and it contributes to a significant number of crashes. Two new approaches to solve speeding issues are focused on: intelligent speed assistance systems (ISA) and speed limit credibility. Research has indicated that ISA is promising with respect to

  5. Balancing Biomechanical Constraints: Optimal Escape Speeds When There Is a Trade-off between Speed and Maneuverability.

    Science.gov (United States)

    Clemente, C J; Wilson, R S

    2015-12-01

    The ability for prey to escape a pursuing predator is dependent both on the prey's speed away from the threat and on their ability to rapidly change directions, or maneuverability. Given that the biomechanical trade-off between speed and maneuverability limits the simultaneous maximization of both performance traits, animals should not select their fastest possible speeds when running away from a pursuing predator but rather a speed that maximizes the probability of successful escape. We explored how variation in the relationship between speed and maneuverability-or the shape of the trade-off-affects the optimal choice of speed for escaping predators. We used tablet-based games that simulated interactions between predators and prey (human subjects acting as predators attempting to capture "prey" moving across a screen). By defining a specific relationship between speed and maneuverability, we could test the survival of each of the possible behavioral choices available to this phenotype, i.e., the best combination of speed and maneuverability for prey fitness, based on their ability to escape. We found that the shape of the trade-off function affected the prey's optimal speed for success in escaping, the prey's maximum performance in escaping, and the breadth of speeds over which the prey's performance was high. The optimal speed for escape varied only when the trade-off between speed and maneuverability was non-linear. Phenotypes possessing trade-off functions for which maneuverability was only compromised at high speeds exhibited lower optimal speeds. Phenotypes that exhibited greater increases in maneuverability for any decrease in speed were more likely to have broader ranges of performance, meaning that individuals could attain their maximum performance across a broader range of speeds. We also found that there was a differential response of the subject's learning to these different components of locomotion. With increased experience through repeated trials

  6. Clinical Trials

    Medline Plus

    Full Text Available ... Clinical Trials About Clinical Trials Clinical trials are research studies that explore whether a medical strategy, treatment, or ... humans. What Are Clinical Trials? Clinical trials are research studies that explore whether a medical strategy, treatment, or ...

  7. High speed network sampling

    OpenAIRE

    Rindalsholt, Ole Arild

    2005-01-01

    Master i nettverks- og systemadministrasjon Classical Sampling methods play an important role in the current practice of Internet measurement. With today’s high speed networks, routers cannot manage to generate complete Netflow data for every packet. They have to perform restricted sampling. This thesis summarizes some of the most important sampling schemes and their applications before diving into an analysis on the effect of sampling Netflow records.

  8. The role of factors of the hemostasis system and fibrinolysis in the development of gastroesophageal reflux in patients with chronic obstructive pulmonary disease

    Directory of Open Access Journals (Sweden)

    Інна Володимирівна Дудка

    2015-11-01

    Full Text Available Gastroesophageal reflux disease (GERD and chronic obstructive pulmonary disease (COPD belong to common pathological conditions comorbid in 25–60 % of cases.Objective: to find probable mechanisms of GERD progressing against the ground of COPD by means of learning various links of the blood clotting system, anticoagulative blood activity and fibrinolysis for further improvement of the ways to correct the disorders found.Methods. 124 patients with COPD were examined including 90 with comorbid GERD. The control group included 24 practically healthy individuals of an appropriate age and sex. Clinical, biochemical, instrumental and statistical methods of examination were applied.Results. The patients were divided into the following groups: the 1st group – 34 patients with COPD, the 2nd group – 30 patients with COPD with endoscopically negative GERD, the 3rd group – 30 patients with COPD and endoscopically positive non-erosive GERD, the 4th group – 30 patients with COPD and endoscopically positive erosive GERD. The following results were found: while examining coagulation hemostasis – decrease of prothrombin time, fibrinogen content; while examining anticoagulation blood potential – decrease of thrombin time, activity of antithrombin III; while examining fibrinolytic blood activity – inhibition of the total fibrinolytic activity (at the expense of enzymatic activity decrease and compensatory increase of non-enzymatic fibrinolytic activity, decrease of Hageman-dependent fibrinolysis activity.Conclusions. Disorders of coagulation hemostasis, anti-coagulation potential and fibrinolytic blood activity are intensified with the increase of severity of bronchial obstructive syndrome and promote the development of endoscopically positive erosive GERD

  9. Balancing High-Speed Rotors at Low Speed

    Science.gov (United States)

    Giordano, J.; Zorzi, E.

    1986-01-01

    Flexible balancing reduces vibrations at operating speeds. Highspeed rotors in turbomachines dynamically balanced at fraction of operating rotor speed. New method takes into account rotor flexible rather than rigid.

  10. Speed, speed variation and crash relationships for urban arterials.

    Science.gov (United States)

    Wang, Xuesong; Zhou, Qingya; Quddus, Mohammed; Fan, Tianxiang; Fang, Shou'en

    2018-04-01

    Speed and speed variation are closely associated with traffic safety. There is, however, a dearth of research on this subject for the case of urban arterials in general, and in the context of developing nations. In downtown Shanghai, the traffic conditions in each direction are very different by time of day, and speed characteristics during peak hours are also greatly different from those during off-peak hours. Considering that traffic demand changes with time and in different directions, arterials in this study were divided into one-way segments by the direction of flow, and time of day was differentiated and controlled for. In terms of data collection, traditional fixed-based methods have been widely used in previous studies, but they fail to capture the spatio-temporal distributions of speed along a road. A new approach is introduced to estimate speed variation by integrating spatio-temporal speed fluctuation of a single vehicle with speed differences between vehicles using taxi-based high frequency GPS data. With this approach, this paper aims to comprehensively establish a relationship between mean speed, speed variation and traffic crashes for the purpose of formulating effective speed management measures, specifically using an urban dataset. From a total of 234 one-way road segments from eight arterials in Shanghai, mean speed, speed variation, geometric design features, traffic volume, and crash data were collected. Because the safety effects of mean speed and speed variation may vary at different segment lengths, arterials with similar signal spacing density were grouped together. To account for potential correlations among these segments, a hierarchical Poisson log-normal model with random effects was developed. Results show that a 1% increase in mean speed on urban arterials was associated with a 0.7% increase in total crashes, and larger speed variation was also associated with increased crash frequency. Copyright © 2018 Elsevier Ltd. All rights

  11. The role of visual processing speed in reading speed development.

    Science.gov (United States)

    Lobier, Muriel; Dubois, Matthieu; Valdois, Sylviane

    2013-01-01

    A steady increase in reading speed is the hallmark of normal reading acquisition. However, little is known of the influence of visual attention capacity on children's reading speed. The number of distinct visual elements that can be simultaneously processed at a glance (dubbed the visual attention span), predicts single-word reading speed in both normal reading and dyslexic children. However, the exact processes that account for the relationship between the visual attention span and reading speed remain to be specified. We used the Theory of Visual Attention to estimate visual processing speed and visual short-term memory capacity from a multiple letter report task in eight and nine year old children. The visual attention span and text reading speed were also assessed. Results showed that visual processing speed and visual short term memory capacity predicted the visual attention span. Furthermore, visual processing speed predicted reading speed, but visual short term memory capacity did not. Finally, the visual attention span mediated the effect of visual processing speed on reading speed. These results suggest that visual attention capacity could constrain reading speed in elementary school children.

  12. Monitoring speed before and during a speed publicity campaign.

    NARCIS (Netherlands)

    Schagen, I.N.L.G. van Commandeur, J.J.F. Goldenbeld, C. & Stipdonk, H.

    2016-01-01

    Driving speeds were monitored during a period of 16 weeks encompassing different stages of an anti-speeding campaign in the Netherlands. This campaign targeted speed limit violations in built-up areas. The observation periods differed in terms of intensity and media used for the campaign. Small

  13. The role of visual processing speed in reading speed development.

    Directory of Open Access Journals (Sweden)

    Muriel Lobier

    Full Text Available A steady increase in reading speed is the hallmark of normal reading acquisition. However, little is known of the influence of visual attention capacity on children's reading speed. The number of distinct visual elements that can be simultaneously processed at a glance (dubbed the visual attention span, predicts single-word reading speed in both normal reading and dyslexic children. However, the exact processes that account for the relationship between the visual attention span and reading speed remain to be specified. We used the Theory of Visual Attention to estimate visual processing speed and visual short-term memory capacity from a multiple letter report task in eight and nine year old children. The visual attention span and text reading speed were also assessed. Results showed that visual processing speed and visual short term memory capacity predicted the visual attention span. Furthermore, visual processing speed predicted reading speed, but visual short term memory capacity did not. Finally, the visual attention span mediated the effect of visual processing speed on reading speed. These results suggest that visual attention capacity could constrain reading speed in elementary school children.

  14. A randomized, placebo-controlled, double-blind trial of supplemental docosahexaenoic acid on cognitive processing speed and executive function in females of reproductive age with phenylketonuria: A pilot study☆, ☆☆

    Science.gov (United States)

    Yi, S.H.L.; Kable, J.A.; Evatt, M.L.; Singh, R.H.

    2014-01-01

    Low blood docosahexaenoic acid (DHA) is reported in patients with phenylketonuria (PKU); however, the functional implications in adolescents and adults are unknown. This pilot study investigated the effect of supplemental DHA on cognitive performance in 33 females with PKU ages 12–47 years. Participants were randomly assigned to receive DHA (10 mg/kg/day) or placebo for 4.5 months. Performance on cognitive processing speed and executive functioning tasks was evaluated at baseline and follow up. Intention-to-treat and per protocol analyses were performed. At follow up, biomarkers of DHA status were significantly higher in the DHA-supplemented group. Performance on the cognitive tasks and reported treatment-related adverse events did not differ. While no evidence of cognitive effect was seen, a larger sample size is needed to be conclusive, which may not be feasible in this population. Supplementation was a safe and effective way to increase biomarkers of DHA status (www.clinicaltrials.gov; Identifier: NCT00892554). PMID:22000478

  15. Speeding Fermat's factoring method

    Science.gov (United States)

    McKee, James

    A factoring method is presented which, heuristically, splits composite n in O(n^{1/4+epsilon}) steps. There are two ideas: an integer approximation to sqrt(q/p) provides an O(n^{1/2+epsilon}) algorithm in which n is represented as the difference of two rational squares; observing that if a prime m divides a square, then m^2 divides that square, a heuristic speed-up to O(n^{1/4+epsilon}) steps is achieved. The method is well-suited for use with small computers: the storage required is negligible, and one never needs to work with numbers larger than n itself.

  16. High Speed Photomicrography

    Science.gov (United States)

    Hyzer, William G.

    1983-03-01

    One of the most challenging areas in applying high-speed photography and videography in the plant and laboratory is in the recording of rapid events at macro and microscopic scales. Depth of field, exposure efficiency, working distance, and required exposure time are all reduced as optical magnification is increased, which severely taxes the skill and ingenuity of workers interested in recording any fast moving phenomena through the microscope or with magnifying lenses. This paper defines the problems inherent in photographing within macro and microscopic ranges and offers a systematic approach to optimizing the selection of equipment and choice of applicable techniques.

  17. Speeding Up Innovation

    DEFF Research Database (Denmark)

    Sørensen, Flemming; Mattsson, Jan

    2016-01-01

    Minimisation of time-to-market strategies can provide companies with a competitive advantage in dynamic and competitive environments. Using parallel innovation processes has been emphasised as one strategy to speed up innovation processes and consequently minimise the time-to-market of innovations....... Much innovation today takes place in open structures in which networks play an important role. However, little is known about how innovation networks can facilitate parallel innovation processes. This paper discusses how innovation network structures develop and support exploration and exploitation...... of the network facilitate the parallel innovation process but also how such processes place new requirements on such networks and their management....

  18. High speed rotary drum

    Energy Technology Data Exchange (ETDEWEB)

    Sagara, H

    1970-03-25

    A high speed rotary drum is disclosed in which the rotor vessel is a double-wall structure comprising an inner wave-shaped pipe inserted coaxially within an outer straight pipe, the object being to provide a strengthened composite light-weight structure. Since force induced axial deformation of the straight pipe and radial deformation of the corrugated pipe are small, the composite effectively resists external forces and, if the waves of the inner pipe are given a sufficient amplitude, the thickness of both pipes may be reduced to lower the overall weight. Thus high angular velocities can be obtained to separate U/sup 235/ from gaseous UF/sub 6/.

  19. Speed control variable rate irrigation

    Science.gov (United States)

    Speed control variable rate irrigation (VRI) is used to address within field variability by controlling a moving sprinkler’s travel speed to vary the application depth. Changes in speed are commonly practiced over areas that slope, pond or where soil texture is predominantly different. Dynamic presc...

  20. Safe Speeds and Credible Speed Limits (SaCredSpeed): New Vision for Decision Making on Speed Management.

    NARCIS (Netherlands)

    Aarts, L. Nes, N. van Wegman, F.C.M. Schagen, I.N.L.G. van & Louwerse, R.

    2009-01-01

    Speed is an inherent characteristic of mobility and a hazard to safety. Several approaches exist of how to manage speed. In the Netherlands, the emphasis has mainly been on harm minimisation during the last decades, due to the implementation of the Sustainable Safety vision. Speed management remains

  1. Pay as You Speed, ISA with incentives for not speeding

    DEFF Research Database (Denmark)

    Lahrmann, Harry Spaabæk; Agerholm, Niels; Tradisauskas, Nerius

    2012-01-01

    The Intelligent Speed Adaptation (ISA) project we describe in this article is based on Pay as You Drive principles. These principles assume that the ISA equipment informs a driver of the speed limit, warns the driver when speeding and calculates penalty points. Each penalty point entails the redu......The Intelligent Speed Adaptation (ISA) project we describe in this article is based on Pay as You Drive principles. These principles assume that the ISA equipment informs a driver of the speed limit, warns the driver when speeding and calculates penalty points. Each penalty point entails...... the reduction of a 30% discount on the driver's car insurance premium, which therefore produced the name, Pay as You Speed. The ISA equipment consists of a GPS-based On Board Unit with a mobile phone connection to a web server. The project was planned for a three-year test period with 300 young car drivers...

  2. Matching optical flow to motor speed in virtual reality while running on a treadmill

    Science.gov (United States)

    Lafortuna, Claudio L.; Mugellini, Elena; Abou Khaled, Omar

    2018-01-01

    We investigated how visual and kinaesthetic/efferent information is integrated for speed perception in running. Twelve moderately trained to trained subjects ran on a treadmill at three different speeds (8, 10, 12 km/h) in front of a moving virtual scene. They were asked to match the visual speed of the scene to their running speed–i.e., treadmill’s speed. For each trial, participants indicated whether the scene was moving slower or faster than they were running. Visual speed was adjusted according to their response using a staircase until the Point of Subjective Equality (PSE) was reached, i.e., until visual and running speed were perceived as equivalent. For all three running speeds, participants systematically underestimated the visual speed relative to their actual running speed. Indeed, the speed of the visual scene had to exceed the actual running speed in order to be perceived as equivalent to the treadmill speed. The underestimation of visual speed was speed-dependent, and percentage of underestimation relative to running speed ranged from 15% at 8km/h to 31% at 12km/h. We suggest that this fact should be taken into consideration to improve the design of attractive treadmill-mediated virtual environments enhancing engagement into physical activity for healthier lifestyles and disease prevention and care. PMID:29641564

  3. Self-selected speeds and metabolic cost of longboard skateboarding.

    Science.gov (United States)

    Board, Wayne J; Browning, Raymond C

    2014-11-01

    The purpose of this study was to determine self-selected speeds, metabolic rate, and gross metabolic cost during longboard skateboarding. We measured overground speed and metabolic rate while 15 experienced longboarders traveled at their self-selected slow, typical and fast speeds. Mean longboarding speeds were 3.7, 4.5 and 5.1 m s(-1), during slow, typical and fast trials, respectively. Mean rates of oxygen consumption were 24.1, 29.1 and 37.2 ml kg(-1) min(-1) and mean rates of energy expenditure were 33.5, 41.8 and 52.7 kJ min(-1) at the slow, typical and fast speeds, respectively. At typical speeds, average intensity was ~8.5 METs. There was a significant positive relationship between oxygen consumption and energy expenditure versus speed (R(2) = 0.69 (P < 0.001), and R(2) = 0.78 (P < 0.001), respectively). The gross metabolic cost was ~2.2 J kg(-1) m(-1) at the typical speed, greater than that reported for cycling and ~50% smaller than that of walking. These results suggest that longboarding is a novel form of physical activity that elicits vigorous intensity, yet is economical compared to walking.

  4. Clinical Trials

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    Full Text Available ... questions and clinical trials. Optimizing our Clinical Trials Enterprise NHLBI has a strong tradition of supporting clinical ... multi-pronged approach to Optimize our Clinical Trials Enterprise that will make our clinical trials enterprise even ...

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    Full Text Available ... to-kol). This plan explains how the trial will work. The trial is led by a principal ... for the clinical trial. The protocol outlines what will be done during the clinical trial and why. ...

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    Full Text Available ... take part in a clinical trial. When researchers think that a trial's potential risks are greater than ... care costs for clinical trials. If you're thinking about taking part in a clinical trial, find ...

  7. Clinical Trials

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    Full Text Available ... of clinical trials contribute to medical knowledge and practice. Why Clinical Trials Are Important Clinical trials are ... earlier than they would be in general medical practice. This is because late-phase trials have large ...

  8. Clinical Trials

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    Full Text Available ... clinical trials contribute to medical knowledge and practice. Why Clinical Trials Are Important Clinical trials are a ... will be done during the clinical trial and why. Each medical center that does the study uses ...

  9. Clinical Trials

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    Full Text Available ... medical strategy, treatment, or device is safe and effective for humans. What Are Clinical Trials? Clinical trials ... and Centers sponsor clinical trials. Many other groups, companies, and organizations also sponsor clinical trials. Examples include ...

  10. Clinical Trials

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    Full Text Available ... and treatments that work best. How Clinical Trials Work If you take part in a clinical trial, ... kol). This plan explains how the trial will work. The trial is led by a principal investigator ( ...

  11. Super high-speed magnetically levitated system approaches: practical use

    Energy Technology Data Exchange (ETDEWEB)

    Matsuda, S; Nakao, H; Takemasa, H

    1988-01-01

    The JR-MAGLEV, utilizing superconducting magnets, has been under development since 1970 with the manufacturing of a succession of trial vehicles such as the LSM 200, ML 100, ML 500 and MLU 001. In 1979, the ML 500 trial vehicle achieved a world-record speed of 517 km/h. This was followed by the MLU 001, which recorded a speed of 350 km/h as a 3-car formation in 1986 and 400 km/h as a 2-car formation with passengers in 1987. As a result of the satisfactory results obtained by the MLU 001, a prototype vehicle for commercial service, the MLU 002, was manufactured in March 1988 and is now under testing at the Miyazaki test track, with the aim of achieving a target operational speed of 420 km/h.

  12. Clinical Trials

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    Full Text Available ... Trial Protocol Each clinical trial has a master plan called a protocol (PRO-to-kol). This plan explains how the trial will work. The trial ... clinical trial; and detailed information about the treatment plan. Eligibility Criteria A clinical trial's protocol describes what ...

  13. Japan nuclear ship sea trial

    International Nuclear Information System (INIS)

    Yamazaki, Hiroshi; Kitamura, Toshikatus; Mizushima, Toshihiko

    1992-01-01

    The sea trial of the first Japan nuclear Ship 'MUTSU' was conducted from the end of October to December in 1990. The purpose of the sea trial was to verify the nuclear propulsive performances and maneuverabilities. The present report describes the results of the sea trial. These results are classified into four items: 1. Speed test and engineering performance tests 2. Maneuvering performance tests 3. Vibration tests 4. Other tests. Acceptable performances were demonstrated, as expected in the original design. The experience of the use of the Global Positioning System (GPS), which were newly adopted for the sea trial, is also reported. (author)

  14. Speed control at low wind speeds for a variable speed fixed pitch wind turbine

    Energy Technology Data Exchange (ETDEWEB)

    Rosmin, N.; Watson, S.J.; Tompson, M. [Loughborough Univ., Loughborough, Leicestershire (United Kingdom)

    2010-03-09

    The maximum power regulation below rated wind speed is regulated by changing the rotor/generator speed at large frequency range in a fixed pitch, variable speed, stall-regulated wind turbine. In order to capture the power at a maximum value the power coefficient is kept at maximum peak point by maintaining the tip speed ratio at its optimum value. The wind industry is moving from stall regulated fixed speed wind turbines to newer improved innovative versions with better reliability. While a stall regulated fixed pitch wind turbine is among the most cost-effective wind turbine on the market, its problems include noise, severe vibrations, high thrust loads and low power efficiency. Therefore, in order to improve such drawbacks, the rotation of the generator speed is made flexible where the rotation can be controlled in variable speed. This paper discussed the development of a simulation model which represented the behaviour of a stall regulated variable speed wind turbine at low wind speed control region by using the closed loop scalar control with adjustable speed drive. The paper provided a description of each sub-model in the wind turbine system and described the scalar control of the induction machine. It was concluded that by using a constant voltage/frequency ratio of the generator's stator side control, the generator speed could be regulated and the generator torque could be controlled to ensure the power coefficient could be maintained close to its maximum value. 38 refs., 1 tab., 10 figs.

  15. Estimation of effective wind speed

    Science.gov (United States)

    Østergaard, K. Z.; Brath, P.; Stoustrup, J.

    2007-07-01

    The wind speed has a huge impact on the dynamic response of wind turbine. Because of this, many control algorithms use a measure of the wind speed to increase performance, e.g. by gain scheduling and feed forward. Unfortunately, no accurate measurement of the effective wind speed is online available from direct measurements, which means that it must be estimated in order to make such control methods applicable in practice. In this paper a new method is presented for the estimation of the effective wind speed. First, the rotor speed and aerodynamic torque are estimated by a combined state and input observer. These two variables combined with the measured pitch angle is then used to calculate the effective wind speed by an inversion of a static aerodynamic model.

  16. High-speed AC motors

    Energy Technology Data Exchange (ETDEWEB)

    Jokinen, T.; Arkkio, A. [Helsinki University of Technology Laboratory of Electromechanics, Otaniemi (Finland)

    1997-12-31

    The paper deals with various types of highspeed electric motors, and their limiting powers. Standard machines with laminated rotors can be utilised if the speed is moderate. The solid rotor construction makes it possible to reach higher power and speed levels than those of laminated rotors. The development work on high-speed motors done at Helsinki University of Technology is presented, too. (orig.) 12 refs.

  17. Wind speed perception and risk.

    Directory of Open Access Journals (Sweden)

    Duzgun Agdas

    Full Text Available BACKGROUND: How accurately do people perceive extreme wind speeds and how does that perception affect the perceived risk? Prior research on human-wind interaction has focused on comfort levels in urban settings or knock-down thresholds. No systematic experimental research has attempted to assess people's ability to estimate extreme wind speeds and perceptions of their associated risks. METHOD: We exposed 76 people to 10, 20, 30, 40, 50, and 60 mph (4.5, 8.9, 13.4, 17.9, 22.3, and 26.8 m/s winds in randomized orders and asked them to estimate wind speed and the corresponding risk they felt. RESULTS: Multilevel modeling showed that people were accurate at lower wind speeds but overestimated wind speeds at higher levels. Wind speed perceptions mediated the direct relationship between actual wind speeds and perceptions of risk (i.e., the greater the perceived wind speed, the greater the perceived risk. The number of tropical cyclones people had experienced moderated the strength of the actual-perceived wind speed relationship; consequently, mediation was stronger for people who had experienced fewer storms. CONCLUSION: These findings provide a clearer understanding of wind and risk perception, which can aid development of public policy solutions toward communicating the severity and risks associated with natural disasters.

  18. Wind speed perception and risk.

    Science.gov (United States)

    Agdas, Duzgun; Webster, Gregory D; Masters, Forrest J

    2012-01-01

    How accurately do people perceive extreme wind speeds and how does that perception affect the perceived risk? Prior research on human-wind interaction has focused on comfort levels in urban settings or knock-down thresholds. No systematic experimental research has attempted to assess people's ability to estimate extreme wind speeds and perceptions of their associated risks. We exposed 76 people to 10, 20, 30, 40, 50, and 60 mph (4.5, 8.9, 13.4, 17.9, 22.3, and 26.8 m/s) winds in randomized orders and asked them to estimate wind speed and the corresponding risk they felt. Multilevel modeling showed that people were accurate at lower wind speeds but overestimated wind speeds at higher levels. Wind speed perceptions mediated the direct relationship between actual wind speeds and perceptions of risk (i.e., the greater the perceived wind speed, the greater the perceived risk). The number of tropical cyclones people had experienced moderated the strength of the actual-perceived wind speed relationship; consequently, mediation was stronger for people who had experienced fewer storms. These findings provide a clearer understanding of wind and risk perception, which can aid development of public policy solutions toward communicating the severity and risks associated with natural disasters.

  19. Wind Speed Perception and Risk

    Science.gov (United States)

    Agdas, Duzgun; Webster, Gregory D.; Masters, Forrest J.

    2012-01-01

    Background How accurately do people perceive extreme wind speeds and how does that perception affect the perceived risk? Prior research on human–wind interaction has focused on comfort levels in urban settings or knock-down thresholds. No systematic experimental research has attempted to assess people's ability to estimate extreme wind speeds and perceptions of their associated risks. Method We exposed 76 people to 10, 20, 30, 40, 50, and 60 mph (4.5, 8.9, 13.4, 17.9, 22.3, and 26.8 m/s) winds in randomized orders and asked them to estimate wind speed and the corresponding risk they felt. Results Multilevel modeling showed that people were accurate at lower wind speeds but overestimated wind speeds at higher levels. Wind speed perceptions mediated the direct relationship between actual wind speeds and perceptions of risk (i.e., the greater the perceived wind speed, the greater the perceived risk). The number of tropical cyclones people had experienced moderated the strength of the actual–perceived wind speed relationship; consequently, mediation was stronger for people who had experienced fewer storms. Conclusion These findings provide a clearer understanding of wind and risk perception, which can aid development of public policy solutions toward communicating the severity and risks associated with natural disasters. PMID:23226230

  20. Comparative analysis of changes in protein and lipid metabolism, lipid peroxidation, and hemostasis under the effects of polychlorinated dibenzo-p-dioxins and radiation

    International Nuclear Information System (INIS)

    Kuntsevich, A.D.; Baulin, S.I.; Golovkov, V.F.; Rembovskii, V.R.; Smirnova, L.A.; Troshkin, N.M.

    1994-01-01

    Polychlorinated dibenzo-p-dioxins (PCDD) and ionizing radiation are among the most hazardous environmental factors causing ecological catastrophes and mass afflications in various accidents involving nuclear power plants and chemical industrial enterprises. The authors previously established that the simultaneous action of a toxic dose of PCDD and ionizing radiation increases the combined toxic effect. The effects of these chemical and physical factors were superadditive (the biological potentiation effect). Here, the authors compare the effects of PCDD and irradiation on protein and lipid metabolism, lipid peroxidation, and hemostasis in order to learn more about biochemical mechanisms mediating the potentiation effect. The experimental evidence suggests that PCDD can modify the biological effects of ionizing radiation through the generation of free radicals and activation of the chain reactions of free-radical lipid peroxidation, such as the formation of peroxides or malonic dialdehyde. The toxic effects of PCDD and ionizing radiation are based on free-radical reactions and chemical pathology. In other words, the chemical and physical factors directly and selectively hit the same biological target, thereby increasing their combined toxic effects. The results can partially explain the observed potentiating effect of the combined action of ionizing radiation and PCDD on the body. This phenomenon is based on biochemical processes generating an abundance of products of lipid peroxidation and the decrease in the body's defenses caused by disorders in protein and lipid metabolism and blood coagulation

  1. High-Dose Barium Impaction Therapy Is Useful for the Initial Hemostasis and for Preventing the Recurrence of Colonic Diverticular Bleeding Unresponsive to Endoscopic Clipping

    Directory of Open Access Journals (Sweden)

    Ryota Niikura

    2013-01-01

    Full Text Available Most cases of colonic diverticular bleeding stop spontaneously, but some patients experience massive bleeding that requires emergency treatment. Endoscopy can be useful when the bleeding source is identified. However, bleeding sometimes recurs within a short period despite the successful endoscopic treatment. Under such conditions, more invasive therapy such as interventional angiography or surgery is required and can prolong hospitalization and involve frequent blood transfusions. We report the case of a 68-year-old woman who presented with massive hematochezia. The patient was in hemorrhagic shock and required 16 units of blood transfusion to recover to general condition. We performed multidetector row computed tomography, but it showed no sites of bleeding. We conducted colonoscopy and identified the source of bleeding as colonic diverticula. We treated the bleeding with endoscopic hemoclips and achieved hemostasis, but bleeding recurred the next day. Four units of blood transfusion were required. We tried high-dose barium impaction therapy to avoid further blood transfusion and surgery. No complications or recurrent bleeding was observed for an 18-month period. Therapeutic barium enema is an option for colonic diverticular bleeding unresponsive to endoscopic clipping and may be effective for preventing recurrent bleeding.

  2. Safety and effectiveness of a circumferential clip-based vascular closure device for hemostasis in off-label applications: Comparison with standard applications

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Seung Chan; Kim, Chang Won [Dept. of Radiology, Pusan National University School of Medicine, Pusan National University Hospital, Busan (Korea, Republic of); Jeon, Ung Bae [Dept. of Radiology, Pusan National University School of Medicine, Yangsan Pusan National University Hospital, Yangsan (Korea, Republic of)

    2016-09-15

    We investigated the efficacy and safety of a circumferential nitinol clip based arterial closure device following arteriotomy, especially in off-label applications. Consecutive patients who underwent the procedure with arteriotomy from January 2011 to February 2014 were included in this study. We defined standard use as the use of StarClose for retrograde puncture of the common femoral artery (CFA) and off-label use as the use of StarClose for retrograde puncture of the superficial femoral artery (SFA), antegrade puncture of the CFA or SFA, puncture of the brachial artery or puncture of the vascular graft. The procedures performed included percutaneous transluminal angioplasty and thrombolysis. Technical success was defined as complete hemostasis achieved within 3 minute after the closure. Complications, and laboratory findings associated with coagulation function, were also investigated. There were 146 cases of standard applications and 111 cases of off-label applications. Technical success was achieved in all cases. The off-label group comprised the use of StarClose for retrograde puncture of the SFA (n = 19), antegrade puncture of the CFA or SFA (n = 74), brachial artery puncture (n = 5), larger sheath than 6 Fr (n = 7) and vascular graft puncture (n = 6). Minor complications were noted in both groups (standard group: 7.5%, off-label group: 2.7%). Off-label use of StarClose is safe and feasible.

  3. Safety and effectiveness of a circumferential clip-based vascular closure device for hemostasis in off-label applications: Comparison with standard applications

    International Nuclear Information System (INIS)

    Lee, Seung Chan; Kim, Chang Won; Jeon, Ung Bae

    2016-01-01

    We investigated the efficacy and safety of a circumferential nitinol clip based arterial closure device following arteriotomy, especially in off-label applications. Consecutive patients who underwent the procedure with arteriotomy from January 2011 to February 2014 were included in this study. We defined standard use as the use of StarClose for retrograde puncture of the common femoral artery (CFA) and off-label use as the use of StarClose for retrograde puncture of the superficial femoral artery (SFA), antegrade puncture of the CFA or SFA, puncture of the brachial artery or puncture of the vascular graft. The procedures performed included percutaneous transluminal angioplasty and thrombolysis. Technical success was defined as complete hemostasis achieved within 3 minute after the closure. Complications, and laboratory findings associated with coagulation function, were also investigated. There were 146 cases of standard applications and 111 cases of off-label applications. Technical success was achieved in all cases. The off-label group comprised the use of StarClose for retrograde puncture of the SFA (n = 19), antegrade puncture of the CFA or SFA (n = 74), brachial artery puncture (n = 5), larger sheath than 6 Fr (n = 7) and vascular graft puncture (n = 6). Minor complications were noted in both groups (standard group: 7.5%, off-label group: 2.7%). Off-label use of StarClose is safe and feasible

  4. Speed limiter integrated fatigue analyzer (SLIFA) for speed and fatigue control on diesel engine truck and bus

    Science.gov (United States)

    Wahyudi, Haris; Pranoto, Hadi; Leman, A. M.; Sebayang, Darwin; Baba, I.

    2017-09-01

    Every second, the number of road traffic deaths is increased globally with millions more sustaining severe injuries and living with long-term adverse health consequences. Jakarta alone in year 2015 had recorded 556 people died due to road accidents, approximately reached 6.231 road accident cases. The identified major contributory factors of such unfortunate events are both driver fatigue and over speeding habit especially related to the driving of truck and bus. This paper presents the idea on how to control the electronic system from input fuel system of injection pump and the combustion chamber engine will control the valve solenoid in injection pump which can lock and fuel will stop for moment, and speed limit can be success, by using sensor heart rate we can input reduce speed limit when fatigue detection driver. Integration process this tool can be relevant when Speed Limiter Integrated Fatigue Analyser (SLIFA) trial in the diesel engine for truck and bus, the result of this research Speed Limiter Integrated Fatigue Analyser (SLIFA) able to control speed of diesel engine for truck and bus almost 30km/h, 60km/h, and until 70 km/h. The installation of the sensor heart rate as the input speed limit SLIFA would work when the driver is detected to be in the fatigue condition. We make Speed Limiter Integrated Fatigue Analyser (SLIFA) for control and monitoring system for diesel engine in truck and bus. Speed Limiter Integrated Fatigue Analyser (SLIFA) system can save the historical of the speed record, fatigue, rpm, and body temperature of the driver.

  5. Optimal Speed Control for Cruising

    DEFF Research Database (Denmark)

    Blanke, M.

    1994-01-01

    With small profit margins in merchant shipping and more than eighty percent of sailing time being cross ocean voyages, speed control is crucial for vessel profitability......With small profit margins in merchant shipping and more than eighty percent of sailing time being cross ocean voyages, speed control is crucial for vessel profitability...

  6. NTF – wind speed comparison

    DEFF Research Database (Denmark)

    Vesth, Allan; Gómez Arranz, Paula

    The report describes measurements carried out on a given turbine. A comparison between wind speed on the met mast and Nacelle Wind speed are made and the results are presented on graphs and in a table. The data used for the comparison are the data that are same as used for the power curve report...

  7. Clinical Trials

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    Full Text Available ... protocol affect the trial's results. Comparison Groups In most clinical trials, researchers use comparison groups. This means ... study before you agree to take part. Randomization Most clinical trials that have comparison groups use randomization. ...

  8. Clinical Trials

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    Full Text Available ... clinical trials are vital to the process of improving medical care. Many people volunteer because they want ... care costs for clinical trials. If you're thinking about taking part in a clinical trial, find ...

  9. Clinical Trials

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    Full Text Available ... or vulnerable patients (such as children). A DSMB's role is to review data from a clinical trial ... a Clinical Trial If you're interested in learning more about, or taking part in, clinical trials, ...

  10. Clinical Trials

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    Full Text Available ... Clinical Trials About Clinical Trials Clinical trials are research studies that explore whether a medical strategy, treatment, ... required to have an IRB. Office for Human Research Protections The U.S. Department of Health and Human ...

  11. Clinical Trials

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    Full Text Available ... Trials About Clinical Trials Clinical trials are research studies that explore whether a medical strategy, treatment, or ... and Clinical Studies Web page. Children and Clinical Studies Learn more about Children and Clinical Studies Importance ...

  12. Clinical Trials

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    Full Text Available ... criteria differ from trial to trial. They include factors such as a patient's age and gender, the ... bias. "Bias" means that human choices or other factors not related to the protocol affect the trial's ...

  13. Clinical Trials

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    Full Text Available ... more information about eligibility criteria, go to "How Do Clinical Trials Work?" Some trials enroll people who ... for adults. For more information, go to "How Do Clinical Trials Protect Participants?" For more information about ...

  14. Clinical Trials

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    Full Text Available ... you agree to take part in the trial. Talk with your doctor about specific trials you're ... part in a clinical trial is your decision. Talk with your doctor about all of your treatment ...

  15. Clinical Trials

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    Full Text Available ... any clinical trial before you agree to take part in the trial. Talk with your doctor about specific trials you're interested in. For a list of questions to ask your doctor and the ...

  16. Clinical Trials

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    Full Text Available ... and treatments that work best. How Clinical Trials Work If you take part in a clinical trial, ... study? How might this trial affect my daily life? Will I have to be in the hospital? ...

  17. Clinical Trials

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    Full Text Available ... and treatments that work best. How Clinical Trials Work If you take part in a clinical trial, ... from a study at any time, for any reason. Also, during the trial, you have the right ...

  18. Clinical Trials

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    Full Text Available ... or device is safe and effective for humans. What Are Clinical Trials? Clinical trials are research studies ... parents, clinicians, researchers, children, and the general public. What to Expect During a clinical trial, doctors, nurses, ...

  19. Clinical Trials

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    Full Text Available ... under way. For example, some trials are stopped early if benefits from a strategy or treatment are ... stop a trial, or part of a trial, early if the strategy or treatment is having harmful ...

  20. Level of recall, retrieval speed, and variability on the Cued-Recall Retrieval Speed Task (CRRST) in individuals with amnestic mild cognitive impairment.

    Science.gov (United States)

    Ramratan, Wendy S; Rabin, Laura A; Wang, Cuiling; Zimmerman, Molly E; Katz, Mindy J; Lipton, Richard B; Buschke, Herman

    2012-03-01

    Individuals with amnestic mild cognitive impairment (aMCI) show deficits on traditional episodic memory tasks and reductions in speed of performance on reaction time tasks. We present results on a novel task, the Cued-Recall Retrieval Speed Task (CRRST), designed to simultaneously measure level and speed of retrieval. A total of 390 older adults (mean age, 80.2 years), learned 16 words based on corresponding categorical cues. In the retrieval phase, we measured accuracy (% correct) and retrieval speed/reaction time (RT; time from cue presentation to voice onset of a correct response) across 6 trials. Compared to healthy elderly adults (HEA, n = 303), those with aMCI (n = 87) exhibited poorer performance in retrieval speed (difference = -0.13; p cued-learning and processing speed variability may facilitate early detection of dementia in at-risk older adults.

  1. Speed and accuracy of visual image discrimination by rats

    Directory of Open Access Journals (Sweden)

    Pamela eReinagel

    2013-12-01

    Full Text Available The trade-off between speed and accuracy of sensory discrimination has most often been studying using sensory stimuli that evolve over time, such as random dot motion discrimination tasks. We previously reported that when rats perform motion discrimination, correct trials have longer reaction times than errors, accuracy increases with reaction time, and reaction time increases with stimulus ambiguity. In such experiments, new sensory information is continually presented, which could partly explain interactions between reaction time and accuracy. The present study shows that a changing physical stimulus is not essential to those findings. Freely behaving rats were trained to discriminate between two static visual images in a self-paced, 2-alternative forced-choice (2AFC reaction time task. Each trial was initiated by the rat, and the two images were presented simultaneously and persisted until the rat responded, with no time limit. Reaction times were longer in correct trials than in error trials, and accuracy increased with reaction time, comparable to results previously reported for rats performing motion discrimination. In the motion task, coherence has been used to vary discrimination difficulty. Here morphs between the previously learned images were used to parametrically vary the image similarity. In randomly interleaved trials, rats took more time on average to respond in trials in which they had to discriminate more similar stimuli. For both the motion and image tasks, the dependence of reaction time on ambiguity is weak, as if rats prioritized speed over accuracy. Therefore we asked whether rats can change the priority of speed and accuracy adaptively in response to a change in reward contingencies. For two rats, the penalty delay was increased from two to six seconds. When the penalty was longer, reaction times increased, and accuracy improved. This demonstrates that rats can flexibly adjust their behavioral strategy in response to the

  2. SEAL FOR HIGH SPEED CENTRIFUGE

    Science.gov (United States)

    Skarstrom, C.W.

    1957-12-17

    A seal is described for a high speed centrifuge wherein the centrifugal force of rotation acts on the gasket to form a tight seal. The cylindrical rotating bowl of the centrifuge contains a closure member resting on a shoulder in the bowl wall having a lower surface containing bands of gasket material, parallel and adjacent to the cylinder wall. As the centrifuge speed increases, centrifugal force acts on the bands of gasket material forcing them in to a sealing contact against the cylinder wall. This arrangememt forms a simple and effective seal for high speed centrifuges, replacing more costly methods such as welding a closure in place.

  3. Alterações hemostáticas em pacientes com doença falciforme Changes in hemostasis in sickle cell disease patients

    Directory of Open Access Journals (Sweden)

    Jaíne B. Stypulkowski

    2010-02-01

    Full Text Available A doença falciforme (DF é uma doença hereditária que tem uma fisiopatologia complexa e diversificada. Além da falcização dos eritrócitos, responsável pelos fenômenos de vaso-oclusão e hemólise, alterações no sistema de coagulação parecem ter papel importante nas várias manifestações clínicas desta doença. Aproximadamente todos os componentes da hemostasia, incluindo função plaquetária, mecanismos procoagulantes, anticoagulantes e sistema fibrinolítico, estão alterados nesta patologia, mesmo em pacientes clinicamente estáveis. A presença da fosfatidilserina (FS na superfície externa da membrana do eritrócito e o aumento dos anticorpos antifosfolipídeos e do fator tecidual (FT marcam o início da ativação da coagulação nestes pacientes. Também a destruição dos eritrócitos diminui a biodisponibilidade do óxido nítrico (NO e, como consequência, modifica a hemostasia vascular, aumentando a ativação plaquetária e a adesão de moléculas ao endotélio. Assim, o objetivo deste trabalho foi abordar as diferentes alterações hemostáticas que ocorrem nos pacientes com doença falciforme, a fim de melhor compreender o estado "hipercoagulável" como é descrito nesta doença.Sickle cell disease is an inherited disease characterized by a complex and varied physiopathology. Apart from the sickle red blood cells, responsible for vascular occlusion and hemolytic anemia, changes in the coagulation system seem to play an important role in the clinical manifestations of this disorder. Nearly every component of hemostasis, including platelet function and the procoagulant, anticoagulant, and fibrinolytic systems, are altered in sickle Cell Disease even in non-crisis steady-state patients. The presence of phosphatidylserine on the external membrane of the red blood cell and the increase in antiphosphatidylserine antibodies and tissue factor mark the beginning of coagulation activation in these patients. Moreover, red

  4. Gene Delivery of Activated Factor VII Using Alternative Adeno-Associated Virus Serotype Improves Hemostasis in Hemophiliac Mice with FVIII Inhibitors and Adeno-Associated Virus Neutralizing Antibodies.

    Science.gov (United States)

    Sun, Junjiang; Hua, Baolai; Chen, Xiaojing; Samulski, Richard J; Li, Chengwen

    2017-08-01

    While therapeutic expression of coagulation factors from adeno-associated virus (AAV) vectors has been successfully achieved in patients with hemophilia, neutralizing antibodies to the vector and inhibitory antibodies to the transgene severely limit efficacy. Indeed, approximately 40% of mice transduced with human factor VIII using the AAV8 serotype developed inhibitory antibodies to factor VIII (FVIII inhibitor), as well as extremely high titers (≥1:500) of neutralizing antibodies to AAV8. To correct hemophilia in these mice, AAV9, a serotype with low in vitro cross-reactivity (≤1:5) to anti-AAV8, was used to deliver mouse-activated factor VII (mFVIIa). It was found that within 6 weeks of systemic administration of 2 × 10 13 particles/kg of AAV9/mFVIIa, hemophiliac mice with FVIII inhibitors and neutralizing antibodies (NAb) to AAV8 achieved hemostasis comparable to that in wild-type mice, as measured by rotational thromboelastometry. A level of 737 ng/mL mFVIIa was achieved after AAV9/mFVIIa adminstration compared to around 150 ng/mL without vector treatment, and concomitantly prothrombin time was shortened. Tissues collected after intra-articular hemorrhage from FVIII-deficient mice and mice with FVIII inhibitors were scored 4.7 and 5.5, respectively, on a scale of 0-10, indicating significant pathological damage. However, transduction with AAV9/mFVIIa decreased pathology scores to 3.6 and eliminated hemosiderin iron deposition in the synovium in most mice. Collectively, these results suggest that application of alternative serotypes of AAV vector to deliver bypassing reagents has the potential to correct hemophilia and prevent hemoarthrosis, even in the presence of FVIII inhibitor and neutralizing antibodies to AAV.

  5. RNA-Seq Analysis of Abdominal Fat in Genetically Fat and Lean Chickens Highlights a Divergence in Expression of Genes Controlling Adiposity, Hemostasis, and Lipid Metabolism

    Science.gov (United States)

    Resnyk, Christopher W.; Chen, Chuming; Huang, Hongzhan; Wu, Cathy H.; Simon, Jean; Le Bihan-Duval, Elisabeth; Duclos, Michel J.; Cogburn, Larry A.

    2015-01-01

    Genetic selection for enhanced growth rate in meat-type chickens (Gallus domesticus) is usually accompanied by excessive adiposity, which has negative impacts on both feed efficiency and carcass quality. Enhanced visceral fatness and several unique features of avian metabolism (i.e., fasting hyperglycemia and insulin insensitivity) mimic overt symptoms of obesity and related metabolic disorders in humans. Elucidation of the genetic and endocrine factors that contribute to excessive visceral fatness in chickens could also advance our understanding of human metabolic diseases. Here, RNA sequencing was used to examine differential gene expression in abdominal fat of genetically fat and lean chickens, which exhibit a 2.8-fold divergence in visceral fatness at 7 wk. Ingenuity Pathway Analysis revealed that many of 1687 differentially expressed genes are associated with hemostasis, endocrine function and metabolic syndrome in mammals. Among the highest expressed genes in abdominal fat, across both genotypes, were 25 differentially expressed genes associated with de novo synthesis and metabolism of lipids. Over-expression of numerous adipogenic and lipogenic genes in the FL chickens suggests that in situ lipogenesis in chickens could make a more substantial contribution to expansion of visceral fat mass than previously recognized. Distinguishing features of the abdominal fat transcriptome in lean chickens were high abundance of multiple hemostatic and vasoactive factors, transporters, and ectopic expression of several hormones/receptors, which could control local vasomotor tone and proteolytic processing of adipokines, hemostatic factors and novel endocrine factors. Over-expression of several thrombogenic genes in abdominal fat of lean chickens is quite opposite to the pro-thrombotic state found in obese humans. Clearly, divergent genetic selection for an extreme (2.5–2.8-fold) difference in visceral fatness provokes a number of novel regulatory responses that govern

  6. Assembly and activation of alternative complement components on endothelial cell-anchored ultra-large von Willebrand factor links complement and hemostasis-thrombosis.

    Directory of Open Access Journals (Sweden)

    Nancy A Turner

    Full Text Available Vascular endothelial cells (ECs express and release protein components of the complement pathways, as well as secreting and anchoring ultra-large von Willebrand factor (ULVWF multimers in long string-like structures that initiate platelet adhesion during hemostasis and thrombosis. The alternative complement pathway (AP is an important non-antibody-requiring host defense system. Thrombotic microangiopathies can be associated with defective regulation of the AP (atypical hemolytic-uremic syndrome or with inadequate cleavage by ADAMTS-13 of ULVWF multimeric strings secreted by/anchored to ECs (thrombotic thrombocytopenic purpura. Our goal was to determine if EC-anchored ULVWF strings caused the assembly and activation of AP components, thereby linking two essential defense mechanisms.We quantified gene expression of these complement components in cultured human umbilical vein endothelial cells (HUVECs by real-time PCR: C3 and C5; complement factor (CF B, CFD, CFP, CFH and CFI of the AP; and C4 of the classical and lectin (but not alternative complement pathways. We used fluorescent microscopy, monospecific antibodies against complement components, fluorescent secondary antibodies, and the analysis of >150 images to quantify the attachment of HUVEC-released complement proteins to ULVWF strings secreted by, and anchored to, the HUVECs (under conditions of ADAMTS-13 inhibition. We found that HUVEC-released C4 did not attach to ULVWF strings, ruling out activation of the classical and lectin pathways by the strings. In contrast, C3, FB, FD, FP and C5, FH and FI attached to ULVWF strings in quantitative patterns consistent with assembly of the AP components into active complexes. This was verified when non-functional FB blocked the formation of AP C3 convertase complexes (C3bBb on ULVWF strings.AP components are assembled and activated on EC-secreted/anchored ULVWF multimeric strings. Our findings provide one possible molecular mechanism for clinical

  7. A novel virtual reality simulation for hemostasis in a brain surgical cavity: perceived utility for visuomotor skills in current and aspiring neurosurgery residents.

    Science.gov (United States)

    Gasco, Jaime; Patel, Achal; Luciano, Cristian; Holbrook, Thomas; Ortega-Barnett, Juan; Kuo, Yong-Fang; Rizzi, Silvio; Kania, Patrick; Banerjee, Pat; Roitberg, Ben Z

    2013-12-01

    To understand the perceived utility of a novel simulator to improve operative skill, eye-hand coordination, and depth perception. We used the ImmersiveTouch simulation platform (ImmersiveTouch, Inc., Chicago, Illinois, USA) in two U.S. Accreditation Council for Graduate Medical Education-accredited neurosurgical training programs: the University of Chicago and the University of Texas Medical Branch. A total of 54 trainees participated in the study, which consisted of 14 residents (group A), 20 senior medical students who were neurosurgery candidates (group B), and 20 junior medical students (group C). The participants performed a simulation task that established bipolar hemostasis in a virtual brain cavity and provided qualitative feedback regarding perceived benefits in eye-hand coordination, depth perception, and potential to assist in improving operating skills. The perceived ability of the simulator to positively influence skills judged by the three groups: group A, residents; group B, senior medical students; and group C, junior medical students was, respectively, 86%, 100%, and 100% for eye-hand coordination; 86%, 100%, and 95% for depth perception; and 79%, 100%, and 100% for surgical skills in the operating room. From all groups, 96.2% found the simulation somewhat or very useful to improve eye-hand coordination, and 94% considered it beneficial to improve depth perception and operating room skills. This simulation module may be suitable for resident training, as well as for the development of career interest and skill acquisition; however, validation for this type of simulation needs to be further developed. Copyright © 2013 Elsevier Inc. All rights reserved.

  8. Guidelines for setting speed limits

    CSIR Research Space (South Africa)

    Wium, DJW

    1986-02-01

    Full Text Available , parking and loading manoeuvres, access to bounding properties, intersections, width of road without central median and clear roadside area. The method should result in greater uniformity in speed limits for similar circumstances as set by different...

  9. Comparison between two types of anaerobic speed endurance training in competitive soccer players

    DEFF Research Database (Denmark)

    Mohr, Magni; Krustrup, Peter

    2016-01-01

    The purpose of the present study was to examine the effects of additional in-season speed endurance production versus speed endurance maintenance training regimes on performance in competitive male soccer players. In a randomised controlled trial 18 male sub-elite players were exposed to additional...... during training were higher (psoccer players with superior...... speed endurance production (SEP) or speed endurance maintenance (SEM) training (two additional sessions/wk for 4 weeks) during the competitive season. Players performed the Yo-Yo intermittent recovery level 2 test (YYIR2) and a repeated sprint test (RST) pre- and postintervention. Yo-Yo IR2 performance...

  10. Speed management : enforcement and new technologies.

    NARCIS (Netherlands)

    Wegman, F.C.M. & Goldenbeld, C.

    2006-01-01

    Due to the massive character of speeding and inappropriate travel speeds, speed management continues to be an important and challenging policy area. Estimates are that in about a quarter to one third of fatal crashes excessive speeds are involved, making speed one of the crucial factors in road

  11. Speed Variance and Its Influence on Accidents.

    Science.gov (United States)

    Garber, Nicholas J.; Gadirau, Ravi

    A study was conducted to investigate the traffic engineering factors that influence speed variance and to determine to what extent speed variance affects accident rates. Detailed analyses were carried out to relate speed variance with posted speed limit, design speeds, and other traffic variables. The major factor identified was the difference…

  12. Clinical Trials

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    Full Text Available ... need to travel or stay in hospitals to take part in clinical trials. For example, the National Institutes of Health Clinical Center in ... Maryland, runs clinical trials. Many other clinical trials take place in medical centers and ... trial can have many benefits. For example, you may gain access to new treatments before ...

  13. Clinical Trials

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    Full Text Available ... of clinical trials contribute to medical knowledge and practice. Why Clinical Trials Are Important Clinical trials are a key ... Enterprise NHLBI has a strong tradition of supporting clinical trials that have not only shaped medical practice around the world, but have improved the health ...

  14. Clinical Trials

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    Full Text Available ... clinical trials. If you're thinking about taking part in a clinical trial, find out ahead of time about costs and coverage. You should learn about the risks and benefits of any clinical trial before you agree to take part in the trial. Talk with your doctor about ...

  15. Pumping speed of parallel-louvre-blind-type cryopumps

    International Nuclear Information System (INIS)

    Saho, Norihide; Ogata, Hisanao; Kunugi, Yosifumi; Uede, Taisei; Yamasita, Yasuo; Kawakami, Hiroyuki.

    1993-01-01

    As a new type of actual-sized cryopump with high pumping speed, a parallel-louvre-blind type cryopump of a rectangular cross section with opening distance B, width C and depth D, is proposed and is produced as a trial pump unit designed as actual size. The influence of pump depth size ratio R d (=D/B) and number of secondary cryopanels on the transmission probability P bc of the pump unit is calculated by Monte Carlo simulation, and the hydrogen pumping speed is measured by experiments. The following results are obtained. (1) The transmission probability of a cryopump designed with dimensional ratio of R d = 1.3 is calculated to be 0.66 at ratios of R c (=B/C) = 0.88, which means that hydrogen pumping speed of cryopumps of this size can attain 294 m 3 · s -1 /m 2 per opening area. (2) The real hydrogen pumping speed of the trial pump unit with 30 secondary cryopanels is measured as 295 m 3 · s -1 /m 2 . (author)

  16. Intelligent speed adaptation: Preliminary results of on-road study in Penang, Malaysia

    Directory of Open Access Journals (Sweden)

    S.M.R. Ghadiri

    2013-03-01

    Full Text Available The first field experiment with intelligent speed adaptation (ISA in Malaysia was held in December 2010 in the State of Penang. Eleven private cars were instrumented with an advisory system. The system used in the present study included a vocal warning message and a visual text message that is activated when the driver attempts to exceed the speed limit. When the driver decreases the speed, the warning stops; otherwise it is continuously repeated. The test drivers drove the vehicles for three months with the installed system, and the speed was continuously logged in all vehicles. The warning was however only activated in the second month of the three month period. The present study aimed to evaluate the effects of an advisory ISA on driving speed, traffic safety, and drivers' attitude, behavior, and acceptance of the system. To examine these effects, both the survey and the logged speed data were analyzed and explored. The results show a significant reduction in the mean, maximum and 85th percentile speed due to the use of the system. However, there was no long-lasting effect on the speed when the system was deactivated. In the post-trial survey, drivers declared that the system helped them well in following the speed limits and that it assisted them in driving more comfortably. Furthermore, the warning method was more accepted compared to a supportive system, such as active accelerator pedal (AAP. After the trial, most drivers were willing to keep an ISA system.

  17. Low speed phaselock speed control system. [for brushless dc motor

    Science.gov (United States)

    Fulcher, R. W.; Sudey, J. (Inventor)

    1975-01-01

    A motor speed control system for an electronically commutated brushless dc motor is provided which includes a phaselock loop with bidirectional torque control for locking the frequency output of a high density encoder, responsive to actual speed conditions, to a reference frequency signal, corresponding to the desired speed. The system includes a phase comparator, which produces an output in accordance with the difference in phase between the reference and encoder frequency signals, and an integrator-digital-to-analog converter unit, which converts the comparator output into an analog error signal voltage. Compensation circuitry, including a biasing means, is provided to convert the analog error signal voltage to a bidirectional error signal voltage which is utilized by an absolute value amplifier, rotational decoder, power amplifier-commutators, and an arrangement of commutation circuitry.

  18. System analysis of automated speed enforcement implementation.

    Science.gov (United States)

    2016-04-01

    Speeding is a major factor in a large proportion of traffic crashes, injuries, and fatalities in the United States. Automated Speed Enforcement (ASE) is one of many approaches shown to be effective in reducing speeding violations and crashes. However...

  19. Spatial layout affects speed discrimination

    Science.gov (United States)

    Verghese, P.; Stone, L. S.

    1997-01-01

    We address a surprising result in a previous study of speed discrimination with multiple moving gratings: discrimination thresholds decreased when the number of stimuli was increased, but remained unchanged when the area of a single stimulus was increased [Verghese & Stone (1995). Vision Research, 35, 2811-2823]. In this study, we manipulated the spatial- and phase relationship between multiple grating patches to determine their effect on speed discrimination thresholds. In a fusion experiment, we merged multiple stimulus patches, in stages, into a single patch. Thresholds increased as the patches were brought closer and their phase relationship was adjusted to be consistent with a single patch. Thresholds increased further still as these patches were fused into a single patch. In a fission experiment, we divided a single large patch into multiple patches by superimposing a cross with luminance equal to that of the background. Thresholds decreased as the large patch was divided into quadrants and decreased further as the quadrants were maximally separated. However, when the cross luminance was darker than the background, it was perceived as an occluder and thresholds, on average, were unchanged from that for the single large patch. A control experiment shows that the observed trend in discrimination thresholds is not due to the differences in perceived speed of the stimuli. These results suggest that the parsing of the visual image into entities affects the combination of speed information across space, and that each discrete entity effectively provides a single independent estimate of speed.

  20. Generalized Geometric Quantum Speed Limits

    Directory of Open Access Journals (Sweden)

    Diego Paiva Pires

    2016-06-01

    Full Text Available The attempt to gain a theoretical understanding of the concept of time in quantum mechanics has triggered significant progress towards the search for faster and more efficient quantum technologies. One of such advances consists in the interpretation of the time-energy uncertainty relations as lower bounds for the minimal evolution time between two distinguishable states of a quantum system, also known as quantum speed limits. We investigate how the nonuniqueness of a bona fide measure of distinguishability defined on the quantum-state space affects the quantum speed limits and can be exploited in order to derive improved bounds. Specifically, we establish an infinite family of quantum speed limits valid for unitary and nonunitary evolutions, based on an elegant information geometric formalism. Our work unifies and generalizes existing results on quantum speed limits and provides instances of novel bounds that are tighter than any established one based on the conventional quantum Fisher information. We illustrate our findings with relevant examples, demonstrating the importance of choosing different information metrics for open system dynamics, as well as clarifying the roles of classical populations versus quantum coherences, in the determination and saturation of the speed limits. Our results can find applications in the optimization and control of quantum technologies such as quantum computation and metrology, and might provide new insights in fundamental investigations of quantum thermodynamics.

  1. Dazzle camouflage affects speed perception.

    Directory of Open Access Journals (Sweden)

    Nicholas E Scott-Samuel

    Full Text Available Movement is the enemy of camouflage: most attempts at concealment are disrupted by motion of the target. Faced with this problem, navies in both World Wars in the twentieth century painted their warships with high contrast geometric patterns: so-called "dazzle camouflage". Rather than attempting to hide individual units, it was claimed that this patterning would disrupt the perception of their range, heading, size, shape and speed, and hence reduce losses from, in particular, torpedo attacks by submarines. Similar arguments had been advanced earlier for biological camouflage. Whilst there are good reasons to believe that most of these perceptual distortions may have occurred, there is no evidence for the last claim: changing perceived speed. Here we show that dazzle patterns can distort speed perception, and that this effect is greatest at high speeds. The effect should obtain in predators launching ballistic attacks against rapidly moving prey, or modern, low-tech battlefields where handheld weapons are fired from short ranges against moving vehicles. In the latter case, we demonstrate that in a typical situation involving an RPG7 attack on a Land Rover the reduction in perceived speed is sufficient to make the grenade miss where it was aimed by about a metre, which could be the difference between survival or not for the occupants of the vehicle.

  2. Variable Speed Rotor System, Phase I

    Data.gov (United States)

    National Aeronautics and Space Administration — Variable speed rotors will give helicopters several advantages: higher top speed, greater fuel efficiency, momentary emergency over-power, resonance detuning...

  3. High speed laser tomography system

    Science.gov (United States)

    Samsonov, D.; Elsaesser, A.; Edwards, A.; Thomas, H. M.; Morfill, G. E.

    2008-03-01

    A high speed laser tomography system was developed capable of acquiring three-dimensional (3D) images of optically thin clouds of moving micron-sized particles. It operates by parallel-shifting an illuminating laser sheet with a pair of galvanometer-driven mirrors and synchronously recording two-dimensional (2D) images of thin slices of the imaged volume. The maximum scanning speed achieved was 120000slices/s, sequences of 24 volume scans (up to 256 slices each) have been obtained. The 2D slices were stacked to form 3D images of the volume, then the positions of the particles were identified and followed in the consecutive scans. The system was used to image a complex plasma with particles moving at speeds up to cm/s.

  4. Instant PageSpeed optimization

    CERN Document Server

    Jaiswal, Sanjeev

    2013-01-01

    Filled with practical, step-by-step instructions and clear explanations for the most important and useful tasks. Instant PageSpeed Optimization is a hands-on guide that provides a number of clear, step-by-step exercises for optimizing your websites for better performance and improving their efficiency.Instant PageSpeed Optimization is aimed at website developers and administrators who wish to make their websites load faster without any errors and consume less bandwidth. It's assumed that you will have some experience in basic web technologies like HTML, CSS3, JavaScript, and the basics of netw

  5. Raising the speed limit from 75 to 80mph on Utah rural interstates: Effects on vehicle speeds and speed variance.

    Science.gov (United States)

    Hu, Wen

    2017-06-01

    In November 2010 and October 2013, Utah increased speed limits on sections of rural interstates from 75 to 80mph. Effects on vehicle speeds and speed variance were examined. Speeds were measured in May 2010 and May 2014 within the new 80mph zones, and at a nearby spillover site and at more distant control sites where speed limits remained 75mph. Log-linear regression models estimated percentage changes in speed variance and mean speeds for passenger vehicles and large trucks associated with the speed limit increase. Logistic regression models estimated effects on the probability of passenger vehicles exceeding 80, 85, or 90mph and large trucks exceeding 80mph. Within the 80mph zones and at the spillover location in 2014, mean passenger vehicle speeds were significantly higher (4.1% and 3.5%, respectively), as were the probabilities that passenger vehicles exceeded 80mph (122.3% and 88.5%, respectively), than would have been expected without the speed limit increase. Probabilities that passenger vehicles exceeded 85 and 90mph were non-significantly higher than expected within the 80mph zones. For large trucks, the mean speed and probability of exceeding 80mph were higher than expected within the 80mph zones. Only the increase in mean speed was significant. Raising the speed limit was associated with non-significant increases in speed variance. The study adds to the wealth of evidence that increasing speed limits leads to higher travel speeds and an increased probability of exceeding the new speed limit. Results moreover contradict the claim that increasing speed limits reduces speed variance. Although the estimated increases in mean vehicle speeds may appear modest, prior research suggests such increases would be associated with substantial increases in fatal or injury crashes. This should be considered by lawmakers considering increasing speed limits. Copyright © 2017 Elsevier Ltd and National Safety Council. All rights reserved.

  6. Hemostasis in pre-eclampsia.

    LENUS (Irish Health Repository)

    Ismail, Siti Khadijah

    2012-01-31

    Pre-eclampsia (P-EC) is a multisystem disorder exclusive to pregnancy. It complicates ~2 to 8% of all pregnancies and remains a major cause of maternal mortality. P-EC is characterized by a profound hypercoagulable state. The delicate hemostatic balance that must be maintained in the uteroplacental circulation during pregnancy makes this system vulnerable to perturbation. An abnormal hemostatic pattern occurs within the uteroplacental circulation in P-EC compared with normal pregnancy. Much recent research has focused on the epidemiological link between inherited thrombophilia and P-EC. The data suggest a weak statistical association, indicating an improbable primary role in the pathogenesis. Without clear evidence, low molecular weight heparins have been widely used to reduce recurrence of P-EC in thrombophilia-positive women. This practice now should be reviewed. Future research needs to focus on improving our basic scientific understanding of the role of the hemostatic system in human placentation.

  7. Hemostasis in pre-eclampsia.

    LENUS (Irish Health Repository)

    Ismail, Siti Khadijah

    2011-03-01

    Pre-eclampsia (P-EC) is a multisystem disorder exclusive to pregnancy. It complicates ~2 to 8% of all pregnancies and remains a major cause of maternal mortality. P-EC is characterized by a profound hypercoagulable state. The delicate hemostatic balance that must be maintained in the uteroplacental circulation during pregnancy makes this system vulnerable to perturbation. An abnormal hemostatic pattern occurs within the uteroplacental circulation in P-EC compared with normal pregnancy. Much recent research has focused on the epidemiological link between inherited thrombophilia and P-EC. The data suggest a weak statistical association, indicating an improbable primary role in the pathogenesis. Without clear evidence, low molecular weight heparins have been widely used to reduce recurrence of P-EC in thrombophilia-positive women. This practice now should be reviewed. Future research needs to focus on improving our basic scientific understanding of the role of the hemostatic system in human placentation.

  8. Thrombosis and Hemostasis in Surgery

    DEFF Research Database (Denmark)

    Hvas, Anne-Mette; Larsen, Julie Brogaard; Pasalic, Leonardo

    2017-01-01

    .g., bleeding disorders, cancer, or developmental hemostatic changes in pediatric patients), to anticoagulant medication or complications such as heparin-induced thrombocytopenia (HIT), or to inherent risks of a particular surgical procedure or affected organ (e.g., hepatobiliary surgery or renal...... transplantation). All of these factors can have a profound effect on expected outcomes....

  9. Clinical Trials

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    Full Text Available ... medical knowledge and practice. Why Clinical Trials Are Important Clinical trials are a key research tool for ... other for moderate persistent asthma. The results provided important treatment information for doctors and patients. The results ...

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    Full Text Available ... groups, companies, and organizations also sponsor clinical trials. Examples include Government Agencies, such as the U.S. Departments ... sponsor trials that test principles or strategies. For example, one NHLBI study explored whether the benefits of ...

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    Full Text Available ... Departments of Defense and Veterans Affairs; private companies; universities; and nonprofit organizations. NIH Institutes and Centers (including ... our campus or trials NIH has sponsored at universities, medical centers, and hospitals. ClinicalTrials.gov View a ...

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    Full Text Available ... Entire Site NHLBI Entire Site Health Topics News & Resources Intramural Research ... or device is safe and effective for humans. What Are Clinical Trials? Clinical trials are research ...

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    Full Text Available ... sponsor clinical trials. Many other groups, companies, and organizations also sponsor clinical trials. Examples include Government Agencies, ... and Veterans Affairs; private companies; universities; and nonprofit organizations. NIH Institutes and Centers (including the NHLBI) usually ...

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    Full Text Available ... decisionmaking. The purpose of clinical trials is research, so the studies follow strict scientific standards. These standards ... otherwise. The purpose of clinical trials is research, so the studies follow strict scientific standards. These standards ...

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    Full Text Available ... identified earlier than they would be in general medical practice. This is because late-phase trials have large ... supporting clinical trials that have not only shaped medical practice around the world, but have improved the health ...

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    Full Text Available ... Working at the NHLBI Contact and FAQs Accessible Search Form Search the NHLBI, use the drop down list to ... to learn more about clinical research and to search for clinical trials: NHLBI Clinical Trials Browse a ...

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    Full Text Available ... people who fit the patient traits for that study (the eligibility criteria). Eligibility criteria differ from trial to trial. They include factors such as a patient's age and gender, the type and stage of disease, and whether ...

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    Full Text Available ... medical strategy, treatment, or device is safe and effective for humans. What Are Clinical Trials? Clinical trials ... medical strategy, treatment, or device is safe and effective for humans. These studies also may show which ...

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    Full Text Available ... and treatments that work best. How Clinical Trials Work If you take part in a clinical trial, ... care providers might be part of your treatment team. They will monitor your health closely. You may ...

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    Full Text Available ... and treatments that work best. How Clinical Trials Work If you take part in a clinical trial, ... Center for Health Information Email Alerts Jobs and Careers Site Index About NHLBI National Institute of Health ...

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    Full Text Available ... to main content U.S. Department of Health & Human ... of people. Clinical trials produce the best data available for health care decisionmaking. The purpose of clinical trials is research, ...

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    Full Text Available ... and treatments that work best. How Clinical Trials Work If you take part in a clinical trial, ... include factors such as a patient's age and gender, the type and stage of disease, and whether ...

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    Full Text Available ... needed. For safety purposes, clinical trials start with small groups of patients to find out whether a ... phase I clinical trials test new treatments in small groups of people for safety and side effects. ...

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    Full Text Available ... trials are research studies that explore whether a medical strategy, treatment, or device is safe and effective ... trials are research studies that explore whether a medical strategy, treatment, or device is safe and effective ...

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    Full Text Available ... risks that outweigh any possible benefits. Clinical Trial Phases Clinical trials of new medicines or medical devices are done in phases. These phases have different purposes and help researchers ...

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    Full Text Available ... the past, clinical trial participants often were White men. Researchers assumed that trial results were valid for ... different ethnic groups sometimes respond differently than White men to the same medical approach. As a result, ...

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    Full Text Available ... and doctors' offices around the country. Benefits and Risks Possible Benefits Taking part in a clinical trial ... volunteer because they want to help others. Possible Risks Clinical trials do have risks and some downsides, ...

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    Full Text Available ... sponsored a trial of two different combinations of asthma treatments. The trial found that one of the ... much better than the other for moderate persistent asthma. The results provided important treatment information for doctors ...

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    Full Text Available ... Sponsors also may stop a trial, or part of a trial, early if the strategy or treatment is having harmful effects. Food and Drug Administration In the United States, the Food and Drug Administration (FDA) provides oversight ...

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  12. Clinical Trials

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    Full Text Available ... including the NHLBI) usually sponsor trials that test principles or strategies. For example, one NHLBI study explored ... risks. Other examples of clinical trials that test principles or strategies include studies that explore whether surgery ...

  13. Clinical Trials

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    Full Text Available ... and treatments that work best. How Clinical Trials Work If you take part in a clinical trial, ... Learn More Connect With Us Contact Us Directly Policies Privacy Policy Freedom of Information Act (FOIA) Accessibility ...

  14. Clinical Trials

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    Full Text Available ... and treatments that work best. How Clinical Trials Work If you take part in a clinical trial, ... your doctor about all of your treatment options. Together, you can make the best choice for you. ...

  15. Clinical Trials

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    Full Text Available ... medical knowledge and practice. Why Clinical Trials Are Important Clinical trials are a key research tool for ... and Usage No FEAR Act Grants and Funding Customer Service/Center for Health Information Email Alerts Jobs ...

  16. Clinical Trials

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    Full Text Available ... a Clinical Trial If you're interested in learning more about, or taking part in, clinical trials, ... Customer Service/Center for Health Information Email Alerts Jobs and Careers Site Index About NHLBI National Institute ...

  17. High-speed holographic camera

    International Nuclear Information System (INIS)

    Novaro, Marc

    The high-speed holographic camera is a disgnostic instrument using holography as an information storing support. It allows us to take 10 holograms, of an object, with exposures times of 1,5ns, separated in time by 1 or 2ns. In order to get these results easily, no mobile part is used in the set-up [fr

  18. Processing Determinants of Reading Speed.

    Science.gov (United States)

    Jackson, Mark D.; McClelland, James L.

    1979-01-01

    Two groups of undergraduates differing in reading ability were tested on a number of reaction-time tasks designed to determine the speed of encoding visual information at several different levels, tests of sensory functions, verbal and quantitative reasoning ability, short-term auditory memory span, and ability to comprehend spoken text.…

  19. The Speeding Car Design Challenge

    Science.gov (United States)

    Roman, Harry T.

    2009-01-01

    All too often, one reads about high-speed police chases in pursuit of stolen cars that result in death and injury to people and innocent bystanders. Isn't there another way to accomplish the apprehension of the thieves that does not put people at such great risk? This article presents a classroom challenge to use technology to remotely shutdown…

  20. Visual Processing Speeds in Children

    Directory of Open Access Journals (Sweden)

    Steve Croker

    2011-01-01

    Full Text Available The aim of this study was to investigate visual processing speeds in children. A rapid serial visual presentation (RSVP task with schematic faces as stimuli was given to ninety-nine 6–10-year-old children as well as a short form of the WISC-III. Participants were asked to determine whether a happy face stimulus was embedded in a stream of distracter stimuli. Presentation time was gradually reduced from 500 ms per stimulus to 100 ms per stimulus, in 50 ms steps. The data revealed that (i RSVP speed increases with age, (ii children aged 8 years and over can discriminate stimuli presented every 100 ms—the speed typically used with RSVP procedures in adult and adolescent populations, and (iii RSVP speed is significantly correlated with digit span and object assembly. In consequence, the RSVP paradigm presented here is appropriate for use in further investigations of processes of temporal attention within this cohort.

  1. NASA low speed centrifugal compressor

    Science.gov (United States)

    Hathaway, Michael D.

    1990-01-01

    The flow characteristics of a low speed centrifugal compressor were examined at NASA Lewis Research Center to improve understanding of the flow in centrifugal compressors, to provide models of various flow phenomena, and to acquire benchmark data for three dimensional viscous flow code validation. The paper describes the objectives, test facilities' instrumentation, and experiment preliminary comparisons.

  2. Perils of using speed zone data to assess real-world compliance to speed limits.

    Science.gov (United States)

    Chevalier, Anna; Clarke, Elizabeth; Chevalier, Aran John; Brown, Julie; Coxon, Kristy; Ivers, Rebecca; Keay, Lisa

    2017-11-17

    Real-world driving studies, including those involving speeding alert devices and autonomous vehicles, can gauge an individual vehicle's speeding behavior by comparing measured speed with mapped speed zone data. However, there are complexities with developing and maintaining a database of mapped speed zones over a large geographic area that may lead to inaccuracies within the data set. When this approach is applied to large-scale real-world driving data or speeding alert device data to determine speeding behavior, these inaccuracies may result in invalid identification of speeding. We investigated speeding events based on service provider speed zone data. We compared service provider speed zone data (Speed Alert by Smart Car Technologies Pty Ltd., Ultimo, NSW, Australia) against a second set of speed zone data (Google Maps Application Programming Interface [API] mapped speed zones). We found a systematic error in the zones where speed limits of 50-60 km/h, typical of local roads, were allocated to high-speed motorways, which produced false speed limits in the speed zone database. The result was detection of false-positive high-range speeding. Through comparison of the service provider speed zone data against a second set of speed zone data, we were able to identify and eliminate data most affected by this systematic error, thereby establishing a data set of speeding events with a high level of sensitivity (a true positive rate of 92% or 6,412/6,960). Mapped speed zones can be a source of error in real-world driving when examining vehicle speed. We explored the types of inaccuracies found within speed zone data and recommend that a second set of speed zone data be utilized when investigating speeding behavior or developing mapped speed zone data to minimize inaccuracy in estimates of speeding.

  3. Clinical Trials

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    Full Text Available ... resources to the strategies and treatments that work best. How Clinical Trials Work If you take part in a clinical trial, you may get tests or treatments in a hospital, clinic, or doctor's office. In some ways, taking part in a clinical trial is different ...

  4. Clinical Trials

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    Full Text Available ... Health Topics / About Clinical Trials About Clinical Trials Clinical trials are research studies that explore whether a medical strategy, treatment, ... tool for advancing medical knowledge and patient care. Clinical research is done only if doctors don't know ...

  5. Clinical Trials

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    Full Text Available ... about your health or fill out forms about how you feel. Some people will need to travel or stay in hospitals to take part in clinical trials. For example, the National Institutes of Health Clinical Center in Bethesda, Maryland, runs clinical trials. Many other clinical trials take place ...

  6. Clinical Trials

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    Full Text Available ... more screening tests to see which test produces the best results. Some companies and groups sponsor clinical trials that test the ... and Drug Administration (FDA) oversees these clinical trials. The NIH may partner with these companies or groups to help sponsor some trials. All ...

  7. Clinical Trials

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    Full Text Available ... child to enroll. Also, children aged 7 and older often must agree (assent) to take part in clinical trials. Clinical trials for children have the same scientific safeguards as clinical trials for adults. For more information, go to "How Do Clinical ...

  8. Clinical Trials

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    Full Text Available ... give permission for their child to enroll. Also, children aged 7 and older often must agree (assent) to take part in clinical trials. Find a Clinical Trial If you're interested in learning more about, or taking part in, clinical trials, ...

  9. Clinical Trials

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    Full Text Available ... part in a clinical trial is your decision. Talk with your doctor about all of your treatment options. Together, you can make the ... more about, or taking part in, clinical trials, talk with your doctor. He or she may know about ... clinical trials. NIH Clinical Research Studies ...

  10. Low Speed Control for Automatic Welding

    Science.gov (United States)

    Iceland, W. E.

    1982-01-01

    Amplifier module allows rotating positioner of automatic welding machine to operate at speeds below normal range. Low speeds are precisely regulated by a servomechanism as are normal-range speeds. Addition of module to standard welding machine makes it unnecessary to purchase new equipment for low-speed welding.

  11. Effective speed management through automatic enforcement.

    NARCIS (Netherlands)

    Oei, H.-l.

    1994-01-01

    This paper analyses several aspects of the Dutch experience of speed enforcement, and presents the results of some speed management experiments in The Netherlands, using automatic warning of speeders and enforcement of speeding. Traditional approaches to manage speed there have not resulted in

  12. Improving homogeneity by dynamic speed limit systems.

    NARCIS (Netherlands)

    Nes, N. van Brandenberg, S. & Twisk, D.A.M.

    2010-01-01

    Homogeneity of driving speeds is an important variable in determining road safety; more homogeneous driving speeds increase road safety. This study investigates the effect of introducing dynamic speed limit systems on homogeneity of driving speeds. A total of 46 subjects twice drove a route along 12

  13. Speed Optimization in Liner Shipping Network Design

    DEFF Research Database (Denmark)

    Brouer, Berit Dangaard; Karsten, Christian Vad; Pisinger, David

    In the Liner Shipping Network Design Problem (LSNDP) services sail at a given speed throughout a round trip. In reality most services operate with a speed differentiated head- and back-haul, or even individual speeds on every sailing between two ports. The speed of a service is decisive...

  14. Mobile app reading speed test.

    Science.gov (United States)

    Kingsnorth, Alec; Wolffsohn, James S

    2015-04-01

    To validate the accuracy and repeatability of a mobile app reading speed test compared with the traditional paper version. Twenty-one subjects wearing their full refractive correction glasses read 14 sentences of decreasing print size between 1.0 and -0.1 logMAR, each consisting of 14 words (Radner reading speed test) at 40 cm with a paper-based chart and twice on iPad charts. Time duration was recorded with a stop watch for the paper chart and on the App itself for the mobile chart allowing critical print size (CPS) and optimal reading speed (ORS) to be derived objectively. The ORS was higher for the mobile app charts (194±29 wpm; 195±25 wpm) compared with the paper chart (166±20 wpm; F=57.000, pmobile app charts (0.17±0.20 logMAR; 0.18±0.17 logMAR) compared with the paper chart (0.25±0.17 logMAR; F=5.406, p=0.009). The mobile app test had a mean difference repeatability of 0.30±22.5 wpm, r=0.917 for ORS, and a CPS of 0.0±0.2 logMAR, r=0.769. Repeatability of the app reading speed test is as good (ORS) or better (CPS) than previous studies on the paper test. While the results are not interchangeable with paper-based charts, mobile app tablet-based tests of reading speed are reliable and rapid to perform, with the potential to capture functional visual ability in research studies and clinical practice. 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.

  15. Circuit Regulates Speed Of dc Motor

    Science.gov (United States)

    Weaver, Charles; Padden, Robin; Brown, Floyd A., Jr.

    1990-01-01

    Driving circuit regulates speed of small dc permanent-magnet motor in tape recorder. Two nested feedback loops maintain speed within 1 percent of constant value. Inner loop provides coarse regulation, while outer loop removes most of variation in speed that remains in the presence of regulation by the inner loop. Compares speed of motor with commanded speed and adjusts current supplied to motor accordingly.

  16. Unconscious Local Motion Alters Global Image Speed

    Science.gov (United States)

    Khuu, Sieu K.; Chung, Charles Y. L.; Lord, Stephanie; Pearson, Joel

    2014-01-01

    Accurate motion perception of self and object speed is crucial for successful interaction in the world. The context in which we make such speed judgments has a profound effect on their accuracy. Misperceptions of motion speed caused by the context can have drastic consequences in real world situations, but they also reveal much about the underlying mechanisms of motion perception. Here we show that motion signals suppressed from awareness can warp simultaneous conscious speed perception. In Experiment 1, we measured global speed discrimination thresholds using an annulus of 8 local Gabor elements. We show that physically removing local elements from the array attenuated global speed discrimination. However, removing awareness of the local elements only had a small effect on speed discrimination. That is, unconscious local motion elements contributed to global conscious speed perception. In Experiment 2 we measured the global speed of the moving Gabor patterns, when half the elements moved at different speeds. We show that global speed averaging occurred regardless of whether local elements were removed from awareness, such that the speed of invisible elements continued to be averaged together with the visible elements to determine the global speed. These data suggest that contextual motion signals outside of awareness can both boost and affect our experience of motion speed, and suggest that such pooling of motion signals occurs before the conscious extraction of the surround motion speed. PMID:25503603

  17. Impact of infusion speed on the safety and effectiveness of prothrombin complex concentrate

    OpenAIRE

    Pabinger , Ingrid; Tiede , Andreas; Kalina , Uwe; Knaub , Sigurd; Germann , Reinhard; Ostermann , Helmut

    2009-01-01

    Abstract Prothrombin complex concentrate (PCC) infusion is preferred for emergency reversal of coumarin therapy. Rapid infusion can potentially save crucial time; however, the possible impact of high infusion speed on PCC safety and effectiveness has not been delineated. In a prospective multinational clinical trial with 43 patients receiving PCC (Beriplex? P/N) for emergency reversal of coumarin therapy, infusion speeds were selected by the investigators. In a two-phase statistica...

  18. Super high-speed magnetically levitated system approaches practical use

    Energy Technology Data Exchange (ETDEWEB)

    Matsuda, Shoji; Nakao, Hiroyuki; Takemasa, Hisashi

    1988-10-01

    The JR-MAGLEV, a super high-speed magnetically levitated system, has been under development since the inauguration with the manufacturing of a succession of trial vehicles. In 1987, the trial vehicle recorded a speed of 400 km/hr as a 2-car formation with passengers. As a participant in the Maglev project, Toshiba has been contributing to the development of superconducting magnets, the main element of the system, as well as auxiliary power sources and the cycloconverter to be used in the substations. A prototype vehicle for commercial service, MLU 002, was manufactured in March 1988 and is now under testing with the aim of achieving a target speed of 420km/hr. The main parameters of superconducting magnet are as follows; magnetomotive force of 700 kA and number of coils of 3 poles/2 trains/ 2 cars, and the magnets are light weight which is almost the limits with the weight ratio to rolling stock of 0.25. As measures to protect vaporization loss of helium for coil-cooling, a relicfaction process of the helium vapor by use of Claude cycle refrigerator was adopted. A circulating current cycloconverter with 16 MVA was developed for the travel motion. The cycloconverter enabled to receive power directly from an electric power company, the output current becomes complete sine wave, and the problems on traveling control were solved. 6 references, 8 figures, 3 tables.

  19. HIPPI-6400 -- Designing for speed

    Energy Technology Data Exchange (ETDEWEB)

    Tolmie, D.E.

    1998-03-01

    The emerging High Performance Parallel Interface 6400 Mbit/s interface (HIPPI-6400), is targeted as a local area network (LAN), or system area network (SAN), supporting data rates of 6400 Mbit/s (800 Mbyte/s). This is eight times the speed of Gigabit Ethernet. The features used, and the design choices made, for the data link and physical layers of HIPPI-6400, to achieve this unprecedented speed are the subject of this paper. HIPPI-6400 borrowed freely from other successful technologies such as ATM, Ethernet and the original HIPPI -- taking the best features of each and melding them with some new features. HIPPI-6400 is a cost effective reliable interconnect for distances up to 1 km; it intermixes large and small messages efficiently.

  20. High-speed parallel counter

    International Nuclear Information System (INIS)

    Gus'kov, B.N.; Kalinnikov, V.A.; Krastev, V.R.; Maksimov, A.N.; Nikityuk, N.M.

    1985-01-01

    This paper describes a high-speed parallel counter that contains 31 inputs and 15 outputs and is implemented by integrated circuits of series 500. The counter is designed for fast sampling of events according to the number of particles that pass simultaneously through the hodoscopic plane of the detector. The minimum delay of the output signals relative to the input is 43 nsec. The duration of the output signals can be varied from 75 to 120 nsec

  1. Utilization technique on variable speed device

    International Nuclear Information System (INIS)

    1989-12-01

    This reports of workshop on power technology describes using technique on variable speed device, which deals with alternating current situation and prospect of current variable speed device, technical trend and prospect of electronics, reduce expenses by variable speed device, control technique, measurement technology, high voltage variable speed device, recent trend of inverter technology, low voltage and high voltage variable speed device control device, operating variable speed device in cooling fan, FDF application and defect case of variable speed device, cooling pump application of water variable transformer, inverter application and energy effect of ventilation equipment, application of variable speed device and analysis of the result of operation and study for application of variable speed technology.

  2. Interaction torque contributes to planar reaching at slow speed

    Directory of Open Access Journals (Sweden)

    Hoshi Fumihiko

    2008-10-01

    Full Text Available Abstract Background How the central nervous system (CNS organizes the joint dynamics for multi-joint movement is a complex problem, because of the passive interaction among segmental movements. Previous studies have demonstrated that the CNS predictively compensates for interaction torque (INT which is arising from the movement of the adjacent joints. However, most of these studies have mainly examined quick movements, presumably because the current belief is that the effects of INT are not significant at slow speeds. The functional contribution of INT for multijoint movements performed in various speeds is still unclear. The purpose of this study was to examine the contribution of INT to a planer reaching in a wide range of motion speeds for healthy subjects. Methods Subjects performed reaching movements toward five targets under three different speed conditions. Joint position data were recorded using a 3-D motion analysis device (50 Hz. Torque components, muscle torque (MUS, interaction torque (INT, gravity torque (G, and net torque (NET were calculated by solving the dynamic equations for the shoulder and elbow. NET at a joint which produces the joint kinematics will be an algebraic sum of torque components; NET = MUS - G - INT. Dynamic muscle torque (DMUS = MUS-G was also calculated. Contributions of INT impulse and DMUS impulse to NET impulse were examined. Results The relative contribution of INT to NET was not dependent on speed for both joints at every target. INT was additive (same direction to DMUS at the shoulder joint, while in the elbow DMUS counteracted (opposed to INT. The trajectory of reach was linear and two-joint movements were coordinated with a specific combination at each target, regardless of motion speed. However, DMUS at the elbow was opposed to the direction of elbow movement, and its magnitude varied from trial to trial in order to compensate for the variability of INT. Conclusion Interaction torque was important at

  3. Systems and methods for vehicle speed management

    Science.gov (United States)

    Sujan, Vivek Anand; Vajapeyazula, Phani; Follen, Kenneth; Wu, An; Forst, Howard Robert

    2016-03-01

    Controlling a speed of a vehicle based on at least a portion of a route grade and a route distance divided into a plurality of route sections, each including at least one of a section grade and section length. Controlling the speed of the vehicle is further based on determining a cruise control speed mode for the vehicle for each of the plurality of route sections and determining a speed reference command of the vehicle based on at least one of the cruise control speed mode, the section length, the section grade, and a current speed.

  4. Intelligent Speed Adaptation in Company Vehicles

    DEFF Research Database (Denmark)

    Agerholm, Niels; Tradisauskas, Nerius; Waagepetersen, Rasmus

    2008-01-01

    This paper describes an intelligent speed adaptation project for company vehicles. The intelligent speed adaptation function in the project is both information and incentive, which means that the intelligent speed adaptation equipment gives a warning as well as penalty points if the driver...... is speeding. Each month the driver with that monthpsilas fewest points wins an award. The paper presents results concerning speed attitude on the first three of a planned 12 months test period. In all 26 vehicles and 51 drivers from six companies participate in the project. The key result is that speeding...

  5. Using neural networks to speed up optimization algorithms

    CERN Document Server

    Bazan, M

    2000-01-01

    The paper presents the application of radial-basis-function (RBF) neural networks to speed up deterministic search algorithms used for the design and optimization of superconducting LHC magnets. The optimization of the iron yoke of the main dipoles requires a number of numerical field computations per trial solution as the field quality depends on the excitation of the magnets. This results in computation times of about 30 minutes for each objective function evaluation (on a DEC-Alpha 600/333) and only the most robust (deterministic) optimization algorithms can be applied. Using a RBF function approximator, the achieved speed-up of the search algorithm is in the order of 25% for problems with two parameters and about 18% for problems with three and five design variables. (13 refs).

  6. Clinical Trials

    Medline Plus

    Full Text Available ... part. Randomization Most clinical trials that have comparison groups use randomization. This involves assigning patients to different comparison groups by chance, rather than choice. This ...

  7. Is it reliable that speed-calming solutions as ISA can reach the drivers, who needed it most?

    DEFF Research Database (Denmark)

    Agerholm, Niels

    A significant number of trials with Intelligent Speed Adaptation (ISA) have been carried out within the last two decades. Almost all with a promising result; the drivers reduce their proportion of speeding and are in general positive to ISA. However, two tings question this offhand success story; 1......: there has been no commercial break through for ISA so far, even though estimated has shown that ISA can reduce the n. of fatalities in traffic accidents with up to 59%, and 2: in the only ISA trial included drivers, who not participated voluntary in the trial, ISA had virtually no effect on these drivers...

  8. Accuracy and speed feedback: Global and local effects on strategy use

    Science.gov (United States)

    Touron, Dayna R.; Hertzog, Christopher

    2013-01-01

    Background Skill acquisition often involves a shift from an effortful algorithm-based strategy to more fluent memory-based performance. Older adults’ slower strategy transitions can be ascribed to both slowed learning and metacognitive factors. Experimenters often provide feedback on response accuracy; this emphasis may either inadvertently reinforce older adults’ conservatism or might highlight that retrieval is generally quite accurate. RT feedback can lead to more rapid shift to retrieval (Hertzog, Touron, & Hines, 2007). Methods This study parametrically varied trial-by-trial feedback to examine whether strategy shifts in the noun-pair task in younger (M = 19) and older adults (M = 67) were influenced by type of performance feedback: none, trial accuracy, trial RT, or both accuracy and RT. Results Older adults who received accuracy feedback retrieved more often, particularly on difficult rearranged trials, and participants who receive speed feedback performed the scanning strategy more quickly. Age differences were also obtained in local (trial-level) reactivity to task performance, but these were not affected by feedback. Conclusions Accuracy and speed feedback had distinct global (general) influences on task strategies and performance. In particular, it appears that the standard practice of providing trial-by-trial accuracy feedback might facilitate older adults’ use of retrieval strategies in skill acquisition tasks. PMID:24785594

  9. Blind haste: As light decreases, speeding increases.

    Science.gov (United States)

    de Bellis, Emanuel; Schulte-Mecklenbeck, Michael; Brucks, Wernher; Herrmann, Andreas; Hertwig, Ralph

    2018-01-01

    Worldwide, more than one million people die on the roads each year. A third of these fatal accidents are attributed to speeding, with properties of the individual driver and the environment regarded as key contributing factors. We examine real-world speeding behavior and its interaction with illuminance, an environmental property defined as the luminous flux incident on a surface. Drawing on an analysis of 1.2 million vehicle movements, we show that reduced illuminance levels are associated with increased speeding. This relationship persists when we control for factors known to influence speeding (e.g., fluctuations in traffic volume) and consider proxies of illuminance (e.g., sight distance). Our findings add to a long-standing debate about how the quality of visual conditions affects drivers' speed perception and driving speed. Policy makers can intervene by educating drivers about the inverse illuminance‒speeding relationship and by testing how improved vehicle headlights and smart road lighting can attenuate speeding.

  10. Changes in executive functions and self-efficacy are independently associated with improved usual gait speed in older women

    Directory of Open Access Journals (Sweden)

    Hsu Chun

    2010-05-01

    Full Text Available Abstract Background Improved usual gait speed predicts substantial reduction in mortality. A better understanding of the modifiable factors that are independently associated with improved gait speed would ensure that intervention strategies are developed based on a valid theoretical framework. Thus, we examined the independent association of change in executive functions and change in falls-related self-efficacy with improved gait speed among community-dwelling senior women. Methods A secondary analysis of the 135 senior women aged 65 to 75 years old who completed a 12-month randomized controlled trial of resistance training. Usual gait speed was assessed using a 4-meter walk. Three executive processes were assessed by standard neuropsychological tests: 1 set shifting; 2 working memory; and 3 selective attention and response inhibition. A linear regression model was constructed to determine the independent association of change in executive functions and falls-related self-efficacy with change in gait speed. Results Improved selective attention and conflict resolution, and falls-related self-efficacy, were independently associated with improved gait speed after accounting for age, global cognition, baseline gait speed, and change in quadriceps strength. The total variance explained was 24%. Conclusions Interventions that target executive functions and falls-related self-efficacy, in addition to physical functions, to improve gait speed may be more efficacious than those that do not. Trial Registration ClinicalTrials.gov Identifier: NCT00426881

  11. Thermoelasticity with Finite Wave Speeds

    CERN Document Server

    Ignaczak, Józef

    2009-01-01

    Generalized dynamic thermoelasticity is a vital area of research in continuum mechanics, free of the classical paradox of infinite propagation speeds of thermal signals in Fourier-type heat conduction. Besides that paradox, the classical dynamic thermoelasticity theory offers either unsatisfactory or poor descriptions of a solid's response at low temperatures or to a fast transient loading (say, due to short laser pulses). Several models have been developed and intensively studiedover the past four decades, yet this book, which aims to provide a point of reference in the field, is the first mo

  12. High speed computer assisted tomography

    International Nuclear Information System (INIS)

    Maydan, D.; Shepp, L.A.

    1980-01-01

    X-ray generation and detection apparatus for use in a computer assisted tomography system which permits relatively high speed scanning. A large x-ray tube having a circular anode (3) surrounds the patient area. A movable electron gun (8) orbits adjacent to the anode. The anode directs into the patient area xrays which are delimited into a fan beam by a pair of collimating rings (21). After passing through the patient, x-rays are detected by an array (22) of movable detectors. Detector subarrays (23) are synchronously movable out of the x-ray plane to permit the passage of the fan beam

  13. Factors affecting speed in human-powered vehicles.

    Science.gov (United States)

    White, A P

    1994-10-01

    It is shown how to derive the appropriate cubic equation relating power and the effects of friction, gradient and wind resistance on the speed of a human-powered vehicle (HPV). The effects of gradient and wind resistance are explored for parameters representing a typical racing cyclist. The principal conclusion may be summarized as follows: for optimum performance in a time trial, there should be no wind and the course should be level. Any deviation from these conditions will produce a decrement in performance.

  14. Controlling the speed of light

    DEFF Research Database (Denmark)

    Sigmund, Ole; Stainko, Roman

    Interesting phenomena of photonic crystals (PhCs), like bandgaps and waveguiding, have lead to a tremendous increase of research interest in this area. High-end functionalities in electro-optical circuts urge to optimize these structures. So far mostly trial and error methods have been applied to...... method to not only to create a bandgap around an a-priorily chosen guided mode, but also to control it's group-velocity under the light-line....

  15. Hanford Site peak gust wind speeds

    International Nuclear Information System (INIS)

    Ramsdell, J.V.

    1998-01-01

    Peak gust wind data collected at the Hanford Site since 1945 are analyzed to estimate maximum wind speeds for use in structural design. The results are compared with design wind speeds proposed for the Hanford Site. These comparisons indicate that design wind speeds contained in a January 1998 advisory changing DOE-STD-1020-94 are excessive for the Hanford Site and that the design wind speeds in effect prior to the changes are still appropriate for the Hanford Site

  16. Visual processing speed in old age

    DEFF Research Database (Denmark)

    Habekost, Thomas; vogel, asmus; Rostrup, Egill

    2013-01-01

    of the speed of a particular psychological process that are not confounded by the speed of other processes. We used Bundesen's (1990) Theory of Visual Attention (TVA) to obtain specific estimates of processing speed in the visual system controlled for the influence of response latency and individual variations...... dramatic aging effects were found for the perception threshold and the visual apprehension span. In the visual domain, cognitive aging seems to be most clearly related to reductions in processing speed....

  17. Wheel speed management control system for spacecraft

    Science.gov (United States)

    Goodzeit, Neil E. (Inventor); Linder, David M. (Inventor)

    1991-01-01

    A spacecraft attitude control system uses at least four reaction wheels. In order to minimize reaction wheel speed and therefore power, a wheel speed management system is provided. The management system monitors the wheel speeds and generates a wheel speed error vector. The error vector is integrated, and the error vector and its integral are combined to form a correction vector. The correction vector is summed with the attitude control torque command signals for driving the reaction wheels.

  18. Clinical Trials

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    Full Text Available ... trial found that one of the combinations worked much better than the other for moderate persistent asthma. The results provided important treatment information for doctors and patients. The results from other clinical trials show what doesn't work or may cause harm. For example, the NHLBI ...

  19. Clinical Trials

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    Full Text Available ... the clinical trial you take part in, the information gathered can help others and add to scientific knowledge. People who take part in clinical trials are vital to the process of improving medical care. Many people volunteer because ...

  20. Clinical Trials

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    Full Text Available ... from other clinical trials show what doesn't work or may cause harm. For example, the NHLBI Women's Health Initiative ... safe a treatment is or how well it works. Children (aged 18 and younger) get ... legal consent for their child to take part in a clinical trial. When ...

  1. Clinical Trials

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    Full Text Available ... other expenses (for example, travel and child care)? Who will be in charge of my care? What will happen after the trial? Taking part in a clinical trial is your decision. Talk with your doctor about all of your treatment ...

  2. Clinical Trials

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    Full Text Available ... for trials with cutting-edge approaches, such as gene therapy or new biological treatments. Health insurance and health ... trials that involve high-risk procedures (such as gene therapy) or vulnerable patients (such as children). A DSMB's ...

  3. Clinical Trials

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    Full Text Available ... to Expect During a clinical trial, doctors, nurses, social workers, and other health care providers might be part of your treatment ... clinical trials are vital to the process of improving medical care. Many people ... participants, it may not work for you. A new treatment may have side ...

  4. Clinical Trials

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    Full Text Available ... Expect During a clinical trial, doctors, nurses, social workers, and other health care providers might be part of your treatment ... phase II clinical trials. The risk of side effects might be even greater for ... treatments. Health insurance and health care providers don't always ...

  5. Clinical Trials

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    Full Text Available ... a Clinical Trial If you're interested in learning more about, or taking part in, clinical trials, talk with your doctor. He or she may know about studies going on in your area. You can visit the following website to learn more about ...

  6. Clinical Trials

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    Full Text Available ... benefits of lowering high blood pressure in the elderly outweighed the risks. Other examples of clinical trials ... child to enroll. Also, children aged 7 and older often must agree (assent) to ... as clinical trials for adults. For more information, go to "How Do Clinical ...

  7. Clinical Trials

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    Full Text Available ... products, such as medicines, and how well they work. The U.S. Food and Drug Administration (FDA) oversees these clinical trials. ... cancer also increased. As a result, the U.S. Food and Drug Administration now recommends never using HT ... Clinical Trials Work If you take ...

  8. Reading Speed of Contracted French Braille

    Science.gov (United States)

    Laroche, Louise; Boule, Jacinthe; Wittich, Walter

    2012-01-01

    This study was designed to address three hypotheses: (1) The reading speed of both readers of French braille and readers of French print will be faster in the silent condition; however, this gain in speed will be larger for print readers; (2) Individuals who acquired braille before age 10 will display faster reading speeds at lower error rates…

  9. Does Extensive Reading Promote Reading Speed?

    Science.gov (United States)

    He, Mu

    2014-01-01

    Research has shown a wide range of learning benefits accruing from extensive reading. Not only is there improvement in reading, but also in a wide range of language uses and areas of language knowledge. However, few research studies have examined reading speed. The existing literature on reading speed focused on students' reading speed without…

  10. Green maritime transportation: Speed and route optimization

    DEFF Research Database (Denmark)

    Psaraftis, Harilaos N.; Kontovas, Christos A.

    2015-01-01

    Among the spectrum of logistics-based measures for green maritime transportation, this chapter focuses on speed optimization. This involves the selection of an appropriate speed by the vessel, so as to optimize a certain objective. As ship speed is not fixed, depressed shipping markets and/or high...

  11. Wake flow characteristics at high wind speed

    DEFF Research Database (Denmark)

    Aagaard Madsen, Helge; Larsen, Torben J.; Larsen, Gunner Chr.

    2016-01-01

    Wake flow characteristic at high wind speeds is the main subject of this paper. Although the wake losses decrease at high wind speeds it has been found in a recent study that for multiple wake inflow the increase in loading due to wake effects are substantial even at wind speeds well above rated ...

  12. Inventive activity of the Department of Protein Structure and Function of the Palladin Institute of Biochemistry of NAS of Ukraine. Part I. Development of the diagnostic methods for detection of hemostasis disorders and characterization of certain blood coagulation factors

    Directory of Open Access Journals (Sweden)

    V. M. Danilova

    2016-04-01

    Full Text Available The practical aspects of inventive activity of the Department of Protein Structure and Function of the Palladin Institute of Biochemistry, NAS of Ukraine are highlighted in this article. Through years of fundamental and applied researches of blood coagulation system proteins, initiated by luminaries of the world biochemistry O. V. Palladin and V. O. Belitser, the Department staff have developed a considerable number of methods, techniques and tests for the assessment of the state of the hemostasis system, which were approved in many clinics. In the first part of this work the authors describe the development of the diagnostic methods for identifying the homeostasis system disorders in detail, as well as characterize certain coagulation factors.

  13. Unmanned Water Craft Identification and Adaptive Control in Low-Speed and Reversing Regions

    DEFF Research Database (Denmark)

    Theisen, Lukas Roy Svane; Galeazzi, Roberto; Blanke, Mogens

    2013-01-01

    This paper treats L1 adaptive hovering control of an unmanned surface vehicle in a station-keeping mode where a region of zero control authority and under-actuation are main challenges. Low-speed and reversing dynamics are identied from full scale sea trials, and parameter uncertainty is estimate...

  14. High-speed data search

    Science.gov (United States)

    Driscoll, James N.

    1994-01-01

    The high-speed data search system developed for KSC incorporates existing and emerging information retrieval technology to help a user intelligently and rapidly locate information found in large textual databases. This technology includes: natural language input; statistical ranking of retrieved information; an artificial intelligence concept called semantics, where 'surface level' knowledge found in text is used to improve the ranking of retrieved information; and relevance feedback, where user judgements about viewed information are used to automatically modify the search for further information. Semantics and relevance feedback are features of the system which are not available commercially. The system further demonstrates focus on paragraphs of information to decide relevance; and it can be used (without modification) to intelligently search all kinds of document collections, such as collections of legal documents medical documents, news stories, patents, and so forth. The purpose of this paper is to demonstrate the usefulness of statistical ranking, our semantic improvement, and relevance feedback.

  15. Electroweak bubble wall speed limit

    Energy Technology Data Exchange (ETDEWEB)

    Bödeker, Dietrich [Fakultät für Physik, Universität Bielefeld, 33501 Bielefeld (Germany); Moore, Guy D., E-mail: bodeker@physik.uni-bielefeld.de, E-mail: guymoore@ikp.physik.tu-darmstadt.de [Institut für Kernphysik, Technische Universität Darmstadt, Schlossgartenstraße 2, 64289 Darmstadt (Germany)

    2017-05-01

    In extensions of the Standard Model with extra scalars, the electroweak phase transition can be very strong, and the bubble walls can be highly relativistic. We revisit our previous argument that electroweak bubble walls can 'run away,' that is, achieve extreme ultrarelativistic velocities γ ∼ 10{sup 14}. We show that, when particles cross the bubble wall, they can emit transition radiation. Wall-frame soft processes, though suppressed by a power of the coupling α, have a significance enhanced by the γ-factor of the wall, limiting wall velocities to γ ∼ 1/α. Though the bubble walls can move at almost the speed of light, they carry an infinitesimal share of the plasma's energy.

  16. Human Kinematics of Cochlear Implant Surgery: An Investigation of Insertion Micro-Motions and Speed Limitations.

    Science.gov (United States)

    Kesler, Kyle; Dillon, Neal P; Fichera, Loris; Labadie, Robert F

    2017-09-01

    Objectives Document human motions associated with cochlear implant electrode insertion at different speeds and determine the lower limit of continuous insertion speed by a human. Study Design Observational. Setting Academic medical center. Subjects and Methods Cochlear implant forceps were coupled to a frame containing reflective fiducials, which enabled optical tracking of the forceps' tip position in real time. Otolaryngologists (n = 14) performed mock electrode insertions at different speeds based on recommendations from the literature: "fast" (96 mm/min), "stable" (as slow as possible without stopping), and "slow" (15 mm/min). For each insertion, the following metrics were calculated from the tracked position data: percentage of time at prescribed speed, percentage of time the surgeon stopped moving forward, and number of direction reversals (ie, going from forward to backward motion). Results Fast insertion trials resulted in better adherence to the prescribed speed (45.4% of the overall time), no motion interruptions, and no reversals, as compared with slow insertions (18.6% of time at prescribed speed, 15.7% stopped time, and an average of 18.6 reversals per trial). These differences were statistically significant for all metrics ( P implant electrode at 15 mm/min is not feasible for human operators. The lower limit of continuous forward insertion is 52 mm/min on average. Guidelines on manual insertion kinematics should consider this practical limit of human motion.

  17. Clinical Trials

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    Full Text Available ... Blood Safety Sleep Science and Sleep Disorders Lung Diseases Heart and Vascular Diseases Precision Medicine Activities Obesity, Nutrition, ... whether hormone therapy (HT) reduced the risk of heart disease in postmenopausal women. (When the trial began, HT ...

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    Full Text Available ... a laboratory (lab), where scientists first develop and test new ideas. If an approach seems promising, the ... Centers (including the NHLBI) usually sponsor trials that test principles or strategies. For example, one NHLBI study ...

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    Full Text Available ... treatment of menopausal symptoms. It also was increasingly being used for prevention of heart disease.) The study ... a trial are due to the different strategies being used, not to preexisting differences between the patients. ...

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  7. LigaSure Impact™ versus conventional dissection technique in pylorus-preserving pancreatoduodenectomy in clinical suspicion of cancerous tumours on the head of the pancreas: study protocol for a randomised controlled trial

    Directory of Open Access Journals (Sweden)

    Müller-Stich Beat P

    2011-06-01

    Full Text Available Abstract Background The pp-Whipple procedure requires extensive preparation. The conventional preparation technique is done with scissors for dissection and ligatures, and with clips and sutures for hemostasis. This procedure is very time-consuming and requires numerous changes of instruments. The LigaSure™ device allows dissection and hemostasis for preparation with one instrument. Up to now there has been no comparison of the two techniques with regard to operating time and the patients' outcome. It is still unclear which technique has the optimal benefit/risk ratio for the patient. Methods/Design A single-center, randomized, single-blinded, controlled superiority trial to compare two different techniques for dissection in a pp-Whipple procedure. 102 patients will be included and randomized pre-operatively. All patients aged 18 years or older scheduled for primary elective pp-Whipple procedure who signed the informed consent will be included. The primary endpoint is the operating time of the randomized technique. Control Intervention: Conventional dissection technique; experimental intervention: LigaSureTM dissection technique. Duration of study: Approximately 15 months; follow up time: 3 years. The trial is registered at German ClinicalTrials Register (DRKS00000166.

  8. Dynamic Speed Adaptation for Path Tracking Based on Curvature Information and Speed Limits.

    Science.gov (United States)

    Gámez Serna, Citlalli; Ruichek, Yassine

    2017-06-14

    A critical concern of autonomous vehicles is safety. Different approaches have tried to enhance driving safety to reduce the number of fatal crashes and severe injuries. As an example, Intelligent Speed Adaptation (ISA) systems warn the driver when the vehicle exceeds the recommended speed limit. However, these systems only take into account fixed speed limits without considering factors like road geometry. In this paper, we consider road curvature with speed limits to automatically adjust vehicle's speed with the ideal one through our proposed Dynamic Speed Adaptation (DSA) method. Furthermore, 'curve analysis extraction' and 'speed limits database creation' are also part of our contribution. An algorithm that analyzes GPS information off-line identifies high curvature segments and estimates the speed for each curve. The speed limit database contains information about the different speed limit zones for each traveled path. Our DSA senses speed limits and curves of the road using GPS information and ensures smooth speed transitions between current and ideal speeds. Through experimental simulations with different control algorithms on real and simulated datasets, we prove that our method is able to significantly reduce lateral errors on sharp curves, to respect speed limits and consequently increase safety and comfort for the passenger.

  9. A joint routing and speed optimization problem

    OpenAIRE

    Fukasawa, Ricardo; He, Qie; Santos, Fernando; Song, Yongjia

    2016-01-01

    Fuel cost contributes to a significant portion of operating cost in cargo transportation. Though classic routing models usually treat fuel cost as input data, fuel consumption heavily depends on the travel speed, which has led to the study of optimizing speeds over a given fixed route. In this paper, we propose a joint routing and speed optimization problem to minimize the total cost, which includes the fuel consumption cost. The only assumption made on the dependence between the fuel cost an...

  10. Speed checks on the CERN site

    CERN Multimedia

    2007-01-01

    In view of the significant number of speeding incidents that have been reported, CERN will shortly start to carry out speed checks on the site. The radar used for this purpose will show drivers the speed measured. The disciplinary measures taken against those exceeding the authorised limit (generally 50 k.p.h.) will include a ban from driving on the site for a minimum of one month. Maximilian Metzger
Secretary-General

  11. High-speed railways in Japan

    International Nuclear Information System (INIS)

    Kyotani, Y.

    1974-01-01

    This paper reviews the development of conventional railways in Japan, leading up to the Shinkansen line, which at present runs at speeds up to 210km/h, and will in the future be speeded up to 260km/h. It then goes on to review the development of a superconductive, magnetically levitated train, which will constitute the next generation of railways, running at speeds of up to 500km/h. (author)

  12. High speed rails. Fatigue behaviour

    International Nuclear Information System (INIS)

    Duart, J. M.; Pero-Sanz, J. A.; Verdeja, J. I.

    2005-01-01

    In recent years, passenger train speed and freight train load have increased to enhance efficiency of rail road transportation. These trends have increased the severity of rail service conditions, calling for rails with greater wear resistance, strength and fatigue behaviour. In the United Stated and Europe, track site weld rails are made entirely by aluminothermic process. This work describes the results of experimental study conducted on bending fatigue strength of plain rails and aluminothermic welded rails with preheating procedures (oxipropane and air-induced propane) approved by railways authorities. Compliance with the required fatigue strength shall be ascertained by 4 point pulsating bending test in accordance with European standards by aluminothermic welding in rails. The locati method, based in the empirical Miner's law about the cumulative damage on a fatigue tested material, allows, once known the Wohler curve of the welding process in use to settle the fatigue tensile limit at 50% with only one test. The values obtained at 2.10''6 cycles for plain rails (S f =353 MPa), oxipropane preheated aluminothermic weld rails (S f =225 MPa), and propane-air induced aluminothermic weld rails (S f =210 MPa) are very similar to those resulting from test method stated in the European Standard. From our point of view and due to its ease, speediness and savings, this is the most suitable test to check the quality and compare the aluminothermic processes in use. (Author) 15 refs

  13. Experimental high-speed network

    Science.gov (United States)

    McNeill, Kevin M.; Klein, William P.; Vercillo, Richard; Alsafadi, Yasser H.; Parra, Miguel V.; Dallas, William J.

    1993-09-01

    Many existing local area networking protocols currently applied in medical imaging were originally designed for relatively low-speed, low-volume networking. These protocols utilize small packet sizes appropriate for text based communication. Local area networks of this type typically provide raw bandwidth under 125 MHz. These older network technologies are not optimized for the low delay, high data traffic environment of a totally digital radiology department. Some current implementations use point-to-point links when greater bandwidth is required. However, the use of point-to-point communications for a total digital radiology department network presents many disadvantages. This paper describes work on an experimental multi-access local area network called XFT. The work includes the protocol specification, and the design and implementation of network interface hardware and software. The protocol specifies the Physical and Data Link layers (OSI layers 1 & 2) for a fiber-optic based token ring providing a raw bandwidth of 500 MHz. The protocol design and implementation of the XFT interface hardware includes many features to optimize image transfer and provide flexibility for additional future enhancements which include: a modular hardware design supporting easy portability to a variety of host system buses, a versatile message buffer design providing 16 MB of memory, and the capability to extend the raw bandwidth of the network to 3.0 GHz.

  14. High speed all optical networks

    Science.gov (United States)

    Chlamtac, Imrich; Ganz, Aura

    1990-01-01

    An inherent problem of conventional point-to-point wide area network (WAN) architectures is that they cannot translate optical transmission bandwidth into comparable user available throughput due to the limiting electronic processing speed of the switching nodes. The first solution to wavelength division multiplexing (WDM) based WAN networks that overcomes this limitation is presented. The proposed Lightnet architecture takes into account the idiosyncrasies of WDM switching/transmission leading to an efficient and pragmatic solution. The Lightnet architecture trades the ample WDM bandwidth for a reduction in the number of processing stages and a simplification of each switching stage, leading to drastically increased effective network throughputs. The principle of the Lightnet architecture is the construction and use of virtual topology networks, embedded in the original network in the wavelength domain. For this construction Lightnets utilize the new concept of lightpaths which constitute the links of the virtual topology. Lightpaths are all-optical, multihop, paths in the network that allow data to be switched through intermediate nodes using high throughput passive optical switches. The use of the virtual topologies and the associated switching design introduce a number of new ideas, which are discussed in detail.

  15. High Speed On-Wafer Characterization Laboratory

    Data.gov (United States)

    Federal Laboratory Consortium — At the High Speed On-Wafer Characterization Laboratory, researchers characterize and model devices operating at terahertz (THz) and millimeter-wave frequencies. The...

  16. Hourly wind speed analysis in Sicily

    Energy Technology Data Exchange (ETDEWEB)

    Bivona, S.; Leone, C. [Palermo Univ., Dip di Fisica e Technologie Relative, Palermo (Italy); Burlon, R. [Palermo Univ., Dip. di Ingegnaria Nucleare, Palermo (Italy)

    2003-07-01

    The hourly average wind speed data recorded by CNMCA (Centro Nazionale di Meteorologia e Climatologia Aeronautica) have been used to study the statistical properties of the wind speed at nine locations on Sicily. By grouping the observations month by month, we show that the hourly average wind speed, with calms omitted, is represented by a Weibull function. The suitability of the distribution is judged by the discrepancies between the observed and calculated values of the monthly average wind speed and of the standard deviation. (Author)

  17. Comprehensive analysis of the carbon impacts of vehicle intelligent speed control

    Science.gov (United States)

    Carslaw, David C.; Goodman, Paul S.; Lai, Frank C. H.; Carsten, Oliver M. J.

    2010-07-01

    In recent years sophisticated technologies have been developed to control vehicle speed based on the type of road the vehicle is driven on using Global Positioning Systems and in-car technology that can alter the speed of the vehicle. While reducing the speed of road vehicles is primarily of interest from a safety perspective, vehicle speed is also an important determinant of vehicle emissions and thus these technologies can be expected to have impacts on a range of exhaust emissions. This work analyses the results from a very large, comprehensive field trial that used 20 instrumented vehicles with and without speed control driven almost 500,000 km measuring vehicle speed at 10 Hz. We develop individual vehicle modal emissions models for CO 2 for 30 Euro III and Euro IV cars at a 1-Hz time resolution. Generalized Additive Models were used to describe how emissions from individual vehicles vary depending on their driving conditions, taking account of variable interactions and time-lag effects. We quantify the impact that vehicle speed control has on-vehicle emissions of CO 2 by road type, fuel type and driver behaviour. Savings in CO 2 of ≈6% were found on average for motorway-type roads when mandatory speed control was used compared with base case conditions. For most other types of road, speed control has very little effect on emissions of CO 2 and in some cases can result in increased emissions for low-speed limit urban roads. We also find that there is on average a 20% difference in CO 2 emission between the lowest and highest emitting driver, which highlights the importance of driver behaviour in general as a means of reducing emissions of CO 2.

  18. The compact Erlangen Active Simulator for Interventional Endoscopy: a prospective comparison in structured team-training courses on "endoscopic hemostasis" for doctors and nurses to the "Endo-Trainer" model.

    Science.gov (United States)

    Hochberger, J; Euler, K; Naegel, A; Hahn, E G; Maiss, J

    2004-09-01

    In 1997 Hochberger and Neumann presented the "Erlangen Biosimulation Model" (commercialized as the "Erlangen Endo-Trainer") at various national and international meetings. The new compactEASIE is a simplified version of the original "Biosimulation Model" (Endo-Trainer) and is specially designed for easy handling. CompactEASIE is reduced in its features, focusing exclusively on flexible endoscopy training. The acceptance of training in endoscopic hemostasis is accepted by workshop participants, as evaluated by a questionnaire on both models. Eleven structured courses on endoscopic hemostasis for doctors and nurses organized by the same endoscopists from 3/1998 to 5/1999 were evaluated using one of both models. The questionnaires were filled in by 207/291 trainees (71%). The Endo-Trainer was used in 4 (n = 103) and the compactEASIE in 7 courses (n = 104). Both simulators were equipped with identical types of specially prepared pig-organ packages consisting of esophagus, stomach and duodenum, including artificial sewn-in vessels, polyps and varices. Blood perfusion was done with a roller pump connected to the sewn-in vessels and blood surrogate. All workshops were identical concerning the course structure: a 30-min theoretical introduction on ulcer bleeding was followed by 2 h of practical training in injection techniques and hemoclip application. The second part of variceal therapy consisted of a 30-min theoretical introduction prior to 2 h of practical training on sclerotherapy, band ligation and cyanoacrylate application. Finally, a questionnaire on the trainees' pre-experience and their rating of the different workshop sections was handed out to each participant. Previous endoscopic experience was comparable in both groups. The training in both simulators was highly accepted by the trainees (compactEASIE 95% excellent and good versus EASIE (Endo-Trainer) 97%) and did not show any significant difference (P = 0.493). Even in the assessment of the single techniques

  19. Capacitated Vehicle Routing with Nonuniform Speeds

    DEFF Research Database (Denmark)

    Gørtz, Inge Li; Molinaro, Marco; Nagarajan, Viswanath

    2016-01-01

    is the distance traveled divided by its speed.Our algorithm relies on a new approximate minimum spanning tree construction called Level-Prim, which is related to but different from Light Approximate Shortest-path Trees. We also extend the widely used tour-splitting technique to nonuniform speeds, using ideas from...

  20. Kummer strikes back : new DH speed records

    NARCIS (Netherlands)

    Bernstein, D.J.; Chuengsatiansup, C.; Lange, T.; Schwabe, P.; Sarkar, P.; Iwata, T.

    2014-01-01

    This paper sets new speed records for high-security constant-time variable-base-point Diffie-Hellman software: 305395 Cortex-A8-slow cycles; 273349 Cortex-A8-fast cycles; 88916 Sandy Bridge cycles; 88448 Ivy Bridge cycles; 54389 Haswell cycles. There are no higher speeds in the literature for any of

  1. Variable Speed Limit (VSL) - Best Management Practice

    Science.gov (United States)

    2012-07-01

    The Variable Speed Limit (VSL) system on the I-4 corridor in Orlando was implemented by Florida Department of Transportation in 2008, and since its deployment, it was revealed that the majority of traffic exceeds the speed limit by more mph when the ...

  2. Maximum speed of dewetting on a fiber

    NARCIS (Netherlands)

    Chan, Tak Shing; Gueudre, Thomas; Snoeijer, Jacobus Hendrikus

    2011-01-01

    A solid object can be coated by a nonwetting liquid since a receding contact line cannot exceed a critical speed. We theoretically investigate this forced wetting transition for axisymmetric menisci on fibers of varying radii. First, we use a matched asymptotic expansion and derive the maximum speed

  3. 32 CFR 636.22 - Speed regulations.

    Science.gov (United States)

    2010-07-01

    ...). (d) The following special speed limits apply: (1) When passing troop formations, 10 miles per hour... vehicles and will obey the following off-road driving speeds: Day Driving: Trails, 16 MPH Cross County, 6 MPH Night Driving: Trails, 5 MPH (with headlights) Cross Country, 5 MPH Night Driving: Trails, 4 MPH...

  4. Neural mechanisms of speed perception: transparent motion

    NARCIS (Netherlands)

    Krekelberg, Bart; van Wezel, Richard Jack Anton

    2013-01-01

    Visual motion on the macaque retina is processed by direction- and speed-selective neurons in extrastriate middle temporal cortex (MT). There is strong evidence for a link between the activity of these neurons and direction perception. However, there is conflicting evidence for a link between speed

  5. High-Speed Videography Instrumentation And Procedures

    Science.gov (United States)

    Miller, C. E.

    1982-02-01

    High-speed videography has been an electronic analog of low-speed film cameras, but having the advantages of instant-replay and simplicity of operation. Recent advances have pushed frame-rates into the realm of the rotating prism camera. Some characteristics of videography systems are discussed in conjunction with applications in sports analysis, and with sports equipment testing.

  6. Speed scaling for weighted flow time

    NARCIS (Netherlands)

    Bansal, N.; Pruhs, K.R.; Stein, C.

    2007-01-01

    In addition to the traditional goal of efficiently managing time and space, many computers now need to efficiently manage power usage. For example, Intel's SpeedStep and AMD's PowerNOW technologies allow the Windows XP operating system to dynamically change the speed of the processor to prolong

  7. Intelligent Speed Adaptation for involuntary drivers

    DEFF Research Database (Denmark)

    Agerholm, Niels; Tradisauskas, Nerius; Juhl, Jens

    2012-01-01

    and warning, the ISA had an incentive in the form of rewards for speeding avoidance and social control - the latter, however, did not work sufficiently. When a key ID was used, the proportion of speeding was low while driving with ISA. Without key ID there was virtually no change in driving behaviour...

  8. Blind haste: As light decreases, speeding increases.

    Directory of Open Access Journals (Sweden)

    Emanuel de Bellis

    Full Text Available Worldwide, more than one million people die on the roads each year. A third of these fatal accidents are attributed to speeding, with properties of the individual driver and the environment regarded as key contributing factors. We examine real-world speeding behavior and its interaction with illuminance, an environmental property defined as the luminous flux incident on a surface. Drawing on an analysis of 1.2 million vehicle movements, we show that reduced illuminance levels are associated with increased speeding. This relationship persists when we control for factors known to influence speeding (e.g., fluctuations in traffic volume and consider proxies of illuminance (e.g., sight distance. Our findings add to a long-standing debate about how the quality of visual conditions affects drivers' speed perception and driving speed. Policy makers can intervene by educating drivers about the inverse illuminance‒speeding relationship and by testing how improved vehicle headlights and smart road lighting can attenuate speeding.

  9. DESIGN AND IMPLEMENTATION OF CONVEYOR LINE SPEED ...

    African Journals Online (AJOL)

    DESIGN AND IMPLEMENTATION OF CONVEYOR LINE SPEED SYNCHRONISER FOR INDUSTRIAL CONTROL APPLICATIONS: A CASE STUDY OF ... in bottles.Therefore a Proportional Integral Derivative(PID) controller was designed to act as a speed synchronizer in order to eliminate the above mentioned problems.

  10. Critical wind speed at which trees break

    Science.gov (United States)

    Virot, E.; Ponomarenko, A.; Dehandschoewercker, É.; Quéré, D.; Clanet, C.

    2016-02-01

    Data from storms suggest that the critical wind speed at which trees break is constant (≃42 m /s ), regardless of tree characteristics. We question the physical origin of this observation both experimentally and theoretically. By combining Hooke's law, Griffith's criterion, and tree allometry, we show that the critical wind speed indeed hardly depends on the height, diameter, and elastic properties of trees.

  11. Generation speed in Raven's Progressive Matrices Test

    NARCIS (Netherlands)

    Verguts, T.; Boeck, P. De; Maris, E.G.G.

    1999-01-01

    In this paper, we investigate the role of response fluency on a well-known intelligence test, Raven's (1962) Advanced Progressive Matrices (APM) test. Critical in solving this test is finding rules that govern the items. Response fluency is conceptualized as generation speed or the speed at which a

  12. Variable-speed, portable routing skate

    Science.gov (United States)

    Pesch, W. A.

    1967-01-01

    Lightweight, portable, variable-speed routing skate is used on heavy metal subassemblies which are impractical to move to a stationary machine. The assembly, consisting of the housing with rollers, router, and driving mechanism with transmission, weighs about forty pounds. Both speed and depth of cut are adjustable.

  13. High-speed Stochastic Fatigue Testing

    DEFF Research Database (Denmark)

    Brincker, Rune; Sørensen, John Dalsgaard

    1990-01-01

    Good stochastic fatigue tests are difficult to perform. One of the major reasons is that ordinary servohydraulic loading systems realize the prescribed load history accurately at very low testing speeds only. If the speeds used for constant amplitude testing are applied to stochastic fatigue...

  14. Parameter analysis for speed skating performance

    NARCIS (Netherlands)

    van der Kruk, E.

    2018-01-01

    Speed skating is a rather special form of locomotion. While in most types of human locomotion, humans generate forces by pushing against the environment in the opposite direction of motion, in speed skating the skater pushes sideward to propel himself forward; Insight in the details of the technique

  15. The temporal dynamics of speeded decision making

    NARCIS (Netherlands)

    Dutilh, G.

    2012-01-01

    This dissertation sheds light on the temporal dynamics of behavior in speeded decision making. Participants on reaction time (RT) tasks learn, get distracted, speed up, slow down, get confused, get bored, and eventually may start guessing. One can safely say that participants' behavior is dynamic.

  16. Critical wind speed at which trees break.

    Science.gov (United States)

    Virot, E; Ponomarenko, A; Dehandschoewercker, É; Quéré, D; Clanet, C

    2016-02-01

    Data from storms suggest that the critical wind speed at which trees break is constant (≃42m/s), regardless of tree characteristics. We question the physical origin of this observation both experimentally and theoretically. By combining Hooke's law, Griffith's criterion, and tree allometry, we show that the critical wind speed indeed hardly depends on the height, diameter, and elastic properties of trees.

  17. Wheelchair propulsion technique at different speeds

    NARCIS (Netherlands)

    Veeger, DirkJan (H. E. J.); van der Woude, L H; Rozendal, R H

    1989-01-01

    To study wheelchair propulsion technique at different speeds, five well-trained subjects propelled a wheelchair on a treadmill. Measurements were made at four belt speeds of 0.56-1.39 m/s and against slopes of 2 and 3 degrees. Cardiorespiratory data were collected. Three consecutive strokes were

  18. Reducing Heating In High-Speed Cinematography

    Science.gov (United States)

    Slater, Howard A.

    1989-01-01

    Infrared-absorbing and infrared-reflecting glass filters simple and effective means for reducing rise in temperature during high-speed motion-picture photography. "Hot-mirror" and "cold-mirror" configurations, employed in projection of images, helps prevent excessive heating of scenes by powerful lamps used in high-speed photography.

  19. "Defining Computer 'Speed': An Unsolved Challenge"

    CERN Multimedia

    CERN. Geneva

    2012-01-01

    Abstract: The reason we use computers is their speed, and the reason we use parallel computers is that they're faster than single-processor computers. Yet, after 70 years of electronic digital computing, we still do not have a solid definition of what computer 'speed' means, or even what it means to be 'faster'. Unlike measures in physics, where the definition of speed is rigorous and unequivocal, in computing there is no definition of speed that is universally accepted. As a result, computer customers have made purchases misguided by dubious information, computer designers have optimized their designs for the wrong goals, and computer programmers have chosen methods that optimize the wrong things. This talk describes why some of the obvious and historical ways of defining 'speed' haven't served us well, and the things we've learned in the struggle to find a definition that works. Biography: Dr. John Gustafson is a Director ...

  20. Study of speed endurance middle distance runners

    Directory of Open Access Journals (Sweden)

    R.V. Golovaschenko

    2013-12-01

    Full Text Available Purpose : To investigate the boost performance speed endurance runners who specialize in middle-distance running . Material and methods : The study involved team members Vinnytsia region in an amount of 44 people, whose average age was 20,2 ± 2,1 years. Classes are held during the 21-day mesocycle, 5 times a week, twice a day. Things were aimed at enhancing the development of indicators of special speed endurance. Results : The dynamics of the running speed of the model segments that characterize speed endurance athletes. Proved that the improved running 400 meter intervals helps reduce travel time competitive distance of 1500 meters. Conclusion : The use of the program contributes to higher speed endurance, which determines the result in the women's 1,500 meters.

  1. Clinical Trials

    Medline Plus

    Full Text Available ... an important gap in information and education for parents, clinicians, researchers, children, and the general public. What to Expect During a clinical trial, doctors, nurses, social workers, and other health care providers might be part of your treatment team. ...

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    Full Text Available ... taking the same treatment the same way. These patients are closely watched by Data and Safety Monitoring Boards. Even if you don't directly ... risk procedures (such as gene therapy) or vulnerable patients (such as ... trial for safety problems or differences in results among different groups. ...

  3. The Trial

    Science.gov (United States)

    Bryant, Jen

    2004-01-01

    Growing up in Flemington, New Jersey, put Jen Bryant in the heart of the lore behind the Lindbergh baby kidnapping. Family stories of the events of the day and extensive research led to "The Trial," a novel in verse. The first several parts of this novel are included here.

  4. Clinical Trials

    Medline Plus

    Full Text Available Skip to main content U.S. Department of Health & Human Services Health Topics Health Topics A-Z Clinical Trials Publications and Resources Health Education and Awareness The Science Science Home Blood Disorders and Blood Safety Sleep ...

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    Full Text Available ... treatments produce better results for certain illnesses or groups of people; look at the best age and frequency for doing screening tests, such as mammography; and compare two or more screening tests to see which test ... Some companies and groups sponsor clinical trials that test the safety of ...

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    Full Text Available ... patient has had certain treatments or has other health problems. Eligibility criteria ensure that new approaches are tested ... public. What to Expect During a clinical trial, doctors, nurses, social workers, and other health care providers might be part of your treatment ...

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    Full Text Available ... This shows how the approach affects a living body and whether it's harmful. However, an approach that works well in the lab or animals doesn't always work well in people. Thus, research in humans is needed. For safety purposes, clinical trials start ...

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    Full Text Available ... edge approaches, such as gene therapy or new biological treatments. Health insurance and health care providers don't ... of a trial, early if the strategy or treatment is having harmful effects. Food and Drug Administration In the United States, the Food and ...

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    Full Text Available ... U.S. Departments of Defense and Veterans Affairs; private companies; universities; and nonprofit organizations. NIH Institutes and Centers (including the NHLBI) usually sponsor trials that test principles or strategies. For example, one NHLBI study explored whether the ...

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    Full Text Available ... to main content U.S. Department of Health & Human Services Health Topics Health Topics A-Z Clinical Trials Publications and Resources Health Education and Awareness The Science Science Home Blood Disorders and Blood Safety Sleep Science and ...

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    Full Text Available ... protect patients and help produce reliable study results. Clinical trials are one of the final stages of a long and careful research process. The process often begins in a laboratory (lab), where scientists first develop and test new ...

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    Full Text Available ... benefits of lowering high blood pressure in the elderly outweighed the risks. Other examples of clinical trials ... child to enroll. Also, children aged 7 and older often must agree (assent) to take part ... about how you feel. Some people will need to travel or stay in hospitals ...

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    Full Text Available ... safe a treatment is or how well it works. Children (aged 18 and younger) get special protection as research subjects. Almost always, parents must give legal consent for their child to take part in a clinical trial. When ...

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    Full Text Available ... As a result, the U.S. Food and Drug Administration now recommends never using HT to prevent heart disease. When HT is used for menopausal symptoms, it should be taken only at the smallest dose and for the shortest time possible. Clinical trials, like the two described above, ...

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    Full Text Available ... Diseases Heart and Vascular Diseases Precision Medicine Activities Obesity, Nutrition, and Physical Activity Population and Epidemiology Studies ... include factors such as a patient's age and gender, the type and stage of disease, ... helps ensure that any differences observed during a trial are due to the ...

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    Full Text Available ... an important gap in information and education for parents, clinicians, researchers, children, and the general public. What to Expect During ... trial's potential risks are greater than minimal, both parents must give permission for their child to enroll. Also, children aged 7 and older ...

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    Full Text Available ... Wide Range of Audiences The Children and Clinical Studies Program has been successfully developed and evaluated to fill an important gap in information and education for parents, clinicians, researchers, children, and the general public. What to Expect During a clinical trial, doctors, ...

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    Full Text Available ... approach that works well in the lab or animals doesn't always work well in people. Thus, research in humans is needed. For safety purposes, clinical trials start with small groups of patients to find out whether a ...

  20. Using a High-Speed Camera to Measure the Speed of Sound

    Science.gov (United States)

    Hack, William Nathan; Baird, William H.

    2012-01-01

    The speed of sound is a physical property that can be measured easily in the lab. However, finding an inexpensive and intuitive way for students to determine this speed has been more involved. The introduction of affordable consumer-grade high-speed cameras (such as the Exilim EX-FC100) makes conceptually simple experiments feasible. Since the…