FREQUENCY RATE OF OBESITY AND LOW MOBILITY IN NORTH AMERICAN AND IRANIAN STROKE PATIENTS

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Kavian Ghandehari

2010-12-01

Full Text Available Abstract   INTRODUCTION: Obesity and low mobility are among the risk factors of stroke and cardiovascular diseases. A pilot double-center study evaluated frequency rate of obesity and low mobility in patients with ischemic stroke.   METHODS: This prospective clinical study was conducted on 100 consecutive stroke patients in Mackenzie hospital, Canada and 100 consecutive stroke patients in Ghaem hospital, Iran in 2007. The patients were age- and sex- matched. Diagnosis of ischemic stroke was made by stroke neurologists. Obesity and low mobility was detected based on the standard method in the two studied groups. Chi-Square and Fisher tests served for statistical analysis and P < 0.05 was declared as significant.   RESULTS: 92 males and 108 females with ischemic stroke were investigated. Obesity was present in 26% of the Canadians and 21% of Iranian stroke patients, df = 1, P = 0.403. Low mobility was reported in 29% of Canadian and 5% of Iranian stroke patients, df = 1, P < 0.0001. The frequency rate of obesity was not significantly different in the two groups and in each gender separately (P > 0.05, while the difference was significant for low mobility, P < 0.05.   CONCLUSIONS: There is no significant difference in frequency rate of obesity between Canadian and Iranian stroke patients. However, low mobility is significantly more frequent in the old Canadian individuals with stroke. Keywords: Obesity, Stroke, Race.

Frequency of inter-atrial blocks in patients with ischemic stroke

International Nuclear Information System (INIS)

Manzar, A.; Iftikhar, R.; Qadir, A.

2012-01-01

Objective: To determine the frequency and association of Interatrial block in hospitalized patients with Ischemic Stroke. Study Design: A case control study. Place and Duration of Study: Department of medicine, Military Hospital, Rawalpindi from 1 January 2009 to 30 December 2009. Methodology: It included 64 patients, 32 cases of diagnosed ischemic stroke and 32 patients were taken as controls not suffering from ischemic stroke or ischemic heart disease. ECG findings of both selected groups were evaluated for presence or absence of interatrial block. Results: Out of 32 ischemic stroke patients, 14 (43.85%) were found to have interatrial block on electrocardiogram (ECG). Whereas only 6 (18.80%) controls were found to have interatrial block on ECG. Odds ratio was 1.66. Conclusion: Interatrial block is more frequent in ischemic stroke patients and may represent a risk factor for such stroke. (author)

The Frequency Spectral Properties of Electrode-Skin Contact Impedance on Human Head and Its Frequency-Dependent Effects on Frequency-Difference EIT in Stroke Detection from 10Hz to 1MHz.

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Lin Yang

Full Text Available Frequency-difference electrical impedance tomography (fdEIT reconstructs frequency-dependent changes of a complex impedance distribution. It has a potential application in acute stroke detection because there are significant differences in impedance spectra between stroke lesions and normal brain tissues. However, fdEIT suffers from the influences of electrode-skin contact impedance since contact impedance varies greatly with frequency. When using fdEIT to detect stroke, it is critical to know the degree of measurement errors or image artifacts caused by contact impedance. To our knowledge, no study has systematically investigated the frequency spectral properties of electrode-skin contact impedance on human head and its frequency-dependent effects on fdEIT used in stroke detection within a wide frequency band (10 Hz-1 MHz. In this study, we first measured and analyzed the frequency spectral properties of electrode-skin contact impedance on 47 human subjects' heads within 10 Hz-1 MHz. Then, we quantified the frequency-dependent effects of contact impedance on fdEIT in stroke detection in terms of the current distribution beneath the electrodes and the contact impedance imbalance between two measuring electrodes. The results showed that the contact impedance at high frequencies (>100 kHz significantly changed the current distribution beneath the electrode, leading to nonnegligible errors in boundary voltages and artifacts in reconstructed images. The contact impedance imbalance at low frequencies (<1 kHz also caused significant measurement errors. We conclude that the contact impedance has critical frequency-dependent influences on fdEIT and further studies on reducing such influences are necessary to improve the application of fdEIT in stroke detection.

The Frequency Spectral Properties of Electrode-Skin Contact Impedance on Human Head and Its Frequency-Dependent Effects on Frequency-Difference EIT in Stroke Detection from 10Hz to 1MHz.

Science.gov (United States)

Yang, Lin; Dai, Meng; Xu, Canhua; Zhang, Ge; Li, Weichen; Fu, Feng; Shi, Xuetao; Dong, Xiuzhen

2017-01-01

Frequency-difference electrical impedance tomography (fdEIT) reconstructs frequency-dependent changes of a complex impedance distribution. It has a potential application in acute stroke detection because there are significant differences in impedance spectra between stroke lesions and normal brain tissues. However, fdEIT suffers from the influences of electrode-skin contact impedance since contact impedance varies greatly with frequency. When using fdEIT to detect stroke, it is critical to know the degree of measurement errors or image artifacts caused by contact impedance. To our knowledge, no study has systematically investigated the frequency spectral properties of electrode-skin contact impedance on human head and its frequency-dependent effects on fdEIT used in stroke detection within a wide frequency band (10 Hz-1 MHz). In this study, we first measured and analyzed the frequency spectral properties of electrode-skin contact impedance on 47 human subjects' heads within 10 Hz-1 MHz. Then, we quantified the frequency-dependent effects of contact impedance on fdEIT in stroke detection in terms of the current distribution beneath the electrodes and the contact impedance imbalance between two measuring electrodes. The results showed that the contact impedance at high frequencies (>100 kHz) significantly changed the current distribution beneath the electrode, leading to nonnegligible errors in boundary voltages and artifacts in reconstructed images. The contact impedance imbalance at low frequencies (<1 kHz) also caused significant measurement errors. We conclude that the contact impedance has critical frequency-dependent influences on fdEIT and further studies on reducing such influences are necessary to improve the application of fdEIT in stroke detection.

Frequency of hyper-homocysteinaemia in ischaemic stroke patients of Karachi

International Nuclear Information System (INIS)

Sadiq, M.

2014-01-01

Objective: To find out the frequency of hyper-homocysteinaemia in ischaemic stroke patients and its relation with other risk factors. Methods: The cross-sectional study based on convenience sampling was conducted at the Civil Hospital, Karachi, from May to July 2012. It comprised ischaemic stroke patients selected from the Out Patient Department and Emergency Department. An overnight 8-hour fasting venous blood sample (4 ml in ethylenediamminetetraacetate) was drawn for analysis. Rest of the data was collected through a structured proforma and was analysed using SPSS 17.0. Results: The mean age of the 96 patients in the study was 64.9+-10.9 years (range: 40-85).Overall, 56(58.3%) cases had hyper-homocysteinemia. The frequency was significantly high in the age 60-79 age group (p<0.007). Conclusion: Hyper-homocysteinaemia, a modifiable risk factor, is associated with a high number of ischaemic stroke patients. Hence, steps should be taken to minimise this risk factor by screening and early intervention. (author)

The frequency, characteristics and aetiology of stroke mimic presentations: a narrative review.

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McClelland, Graham; Rodgers, Helen; Flynn, Darren; Price, Christopher I

2018-05-01

A significant proportion of patients with acute stroke symptoms have an alternative 'mimic' diagnosis. A narrative review was carried out to explore the frequency, characteristics and aetiology of stroke mimics. Prehospital and thrombolysis-treated patients were described separately. Overall, 9972 studies were identified from the initial search and 79 studies were included with a median stroke mimic rate of 19% (range: 1-64%). The prehospital median was 27% (range: 4-43%) and the thrombolysis median 10% (range: 1-25%). Seizures, migraines and psychiatric disorders are the most frequently reported causes of stroke mimics. Several characteristics are consistently associated with stroke mimics; however, they do not fully exclude the possibility of stroke. Nineteen per cent of suspected stroke patients had a mimic condition. Stroke mimics were more common with younger age and female sex. The range of mimic diagnoses, a lack of clear differentiating characteristics and the short treatment window for ischaemic stroke create challenges for early identification.

Frequencies of circulating B- and T-lymphocytes as indicators for stroke outcomes

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Wang Y

2017-10-01

Full Text Available Yanling Wang,1 Jihong Liu,1 Xuemei Wang,1 Zongjian Liu,2 Fengwu Li,1 Fenghua Chen,3 Xiaokun Geng,1 Zhili Ji,2 Huishan Du,1 Xiaoming Hu1,3 1Department of Neurology, China-America Institute of Neuroscience, 2Central Laboratory, Beijing Luhe Hospital, Capital Medical University, Beijing, People’s Republic of China; 3Department of Neurology, Pittsburgh Institute of Brain Disorders and Recovery, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA Background: Stroke has high mortality and morbidity. Biomarkers are required for to predict stroke outcomes, which could help clinicians to provide rationale approaches for patient management. The dynamic changes in circulating immune cells have been reported in stroke patients and animal models of stroke.Aim: The aim of this study was to explore biomarkers to predict stroke outcomes by investigating the relationship between the frequencies of circulating immune cells and stroke outcomes.Methods: In all, 50 acute ischemic stroke (AIS patients were enrolled. Their blood samples were collected upon hospital admission and on day 1 and day 7 after stroke, and the leukocyte subsets were analyzed by flow cytometry. The dynamic changes in some types of immune cells in the AIS course and their correlation with clinical parameters were analyzed. Blood samples from 123 age- and gender-matched healthy subjects were used as controls.Results: The proportions of T-lymphocytes and NK cells in stroke patients were significantly lower than in healthy controls. The frequencies of B- and T-lymphocytes were negatively correlated with stroke severity at onset, including neurological deficits as assessed by National Institutes of Health Stroke Scale (NIHSS, and infarct volume as measured by the diffusion-weighted images (DWIs of magnetic resonance (MR. Logistic regression analysis showed that modified Rankin scale (mRs scores, a score system for the long-term neurological dysfunctions, were negatively correlated

Frequency-dependent changes in the regional amplitude and synchronization of resting-state functional MRI in stroke.

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Jianfang Zhu

Full Text Available Resting-state functional magnetic resonance imaging (R-fMRI has been intensively used to assess alterations of inter-regional functional connectivity in patients with stroke, but the regional properties of brain activity in stroke have not yet been fully investigated. Additionally, no study has examined a frequency effect on such regional properties in stroke patients, although this effect has been shown to play important roles in both normal brain functioning and functional abnormalities. Here we utilized R-fMRI to measure the amplitude of low-frequency fluctuations (ALFF and regional homogeneity (ReHo, two major methods for characterizing the regional properties of R-fMRI, in three different frequency bands (slow-5: 0.01-0.027 Hz; slow-4: 0.027-0.73 Hz; and typical band: 0.01-0.1 Hz in 19 stroke patients and 15 healthy controls. Both the ALFF and ReHo analyses revealed changes in brain activity in a number of brain regions, particularly the parietal cortex, in stroke patients compared with healthy controls. Remarkably, the regions with changed activity as detected by the slow-5 band data were more extensive, and this finding was true for both the ALFF and ReHo analyses. These results not only confirm previous studies showing abnormality in the parietal cortex in patients with stroke, but also suggest that R-fMRI studies of stroke should take frequency effects into account when measuring intrinsic brain activity.

The Frequency of Fabry Disease among Young Cryptogenic Stroke Patients in the City of Sakarya.

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Gündoğdu, Aslı Aksoy; Kotan, Dilcan; Alemdar, Murat

2017-06-01

Fabry disease (FD) is known as a rare cause of stroke. Recent studies suggested that FD is an underdiagnosed entity among young stroke patients. We aimed to investigate the frequency of FD in young cryptogenic stroke patients who lived in the City of Sakarya and to define the clinical features that help in recognizing patients with FD. Acute ischemic stroke patients aged 18-55 years who were admitted to our hospital between October 2013 and September 2016 were evaluated for inclusion. Patients with other recognized causes of stroke were excluded. The screening was performed for alpha-galactosidase A (α-Gal A) activity on dried blood spot, and DNA was sequenced for GLA mutation in patients with low plasma α-Gal A activity. Among the 484 acute ischemic stroke patients, 54 (24 male, 44.4%) young cryptogenic stroke patients were enrolled. The α-Gal A activity was detected as low in 3 patients. c.[680G > A] p.[R227Q] missense mutation was identified in 2 male patients. The frequency of FD was calculated as 3.7%. Our research is the first FD screening study in Turkish stroke patients. Our results underlined the importance of considering FD during the etiologic evaluation of young cryptogenic stroke patients as it is a rare but potentially treatable entity. Copyright © 2017 National Stroke Association. Published by Elsevier Inc. All rights reserved.

Frequency of cerebral infarction and haemorrhage in the patients of stroke

International Nuclear Information System (INIS)

Shah, A.N.; Ataullah, S.

2009-01-01

Stroke is rapidly developing phenomena of symptoms and signs of focal, and at times global, loss of cerebral function with no apparent cause other than that of vascular origin. The Objective was to know the frequency of cerebral infarction and haemorrhage in one hundred patients of stroke in a period of one year. Data was collected by consecutive sampling technique. Total one hundred patients of stroke were collected for the study. They were assessed through a detailed history of hypertension, diabetes mellitus, smoking, previous stroke, transient ischemic attack (TIA), previous myocardial infarction, angina, atrial fibrillation, alcohol intake, drugs used for hypertension/diabetes mellitus. Blood pressure was recorded at arrival and 24 hours after admission. There were 70% males and 30% females. Twenty percent of the patients were in the age range of 51-60 years, 26% of the patients were in the age range of 61-70 years and 18% were in the age range of 71-80 years. Cerebral infarction was present in 72% patients while cerebral haemorrhage was present in 28% patients. Hypertension was the most common risk factor among these stroke patients. Average blood pressure was 180/100 mmHg. Cerebral infarction is the commonest form of stroke. Hypertension is the leading risk factor in stroke patients. (author)

Spontaneous swallow frequency compared with clinical screening in the identification of dysphagia in acute stroke.

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Crary, Michael A; Carnaby, Giselle D; Sia, Isaac

2014-09-01

The aim of this study was to compare spontaneous swallow frequency analysis (SFA) with clinical screening protocols for identification of dysphagia in acute stroke. In all, 62 patients with acute stroke were evaluated for spontaneous swallow frequency rates using a validated acoustic analysis technique. Independent of SFA, these same patients received a routine nurse-administered clinical dysphagia screening as part of standard stroke care. Both screening tools were compared against a validated clinical assessment of dysphagia for acute stroke. In addition, psychometric properties of SFA were compared against published, validated clinical screening protocols. Spontaneous SFA differentiates patients with versus without dysphagia after acute stroke. Using a previously identified cut point based on swallows per minute, spontaneous SFA demonstrated superior ability to identify dysphagia cases compared with a nurse-administered clinical screening tool. In addition, spontaneous SFA demonstrated equal or superior psychometric properties to 4 validated, published clinical dysphagia screening tools. Spontaneous SFA has high potential to identify dysphagia in acute stroke with psychometric properties equal or superior to clinical screening protocols. Copyright © 2014 National Stroke Association. Published by Elsevier Inc. All rights reserved.

Hydroponic Feed With Suction

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Cox, William M.; Brown, Christopher S.; Dreschel, Thomas W.

1994-01-01

Placing nutrient solution under suction increases growth. Foam plug seals growing stem of plant, making it possible to maintain suction in nutrient liquid around roots. Jar wrapped in black tape to keep out light. Potential use in terrestrial applications in arid climates or in labor-intensive agricultural situations.

Dynamic stiffness of suction caissons - torsion, sliding and rocking

Energy Technology Data Exchange (ETDEWEB)

Ibsen, Lars Bo; Liingaard, M.; Andersen, Lars

2006-12-15

This report concerns the dynamic soil-structure interaction of steel suction caissons applied as foundations for offshore wind turbines. An emphasis is put on torsional vibrations and coupled sliding/rocking motion, and the influence of the foundation geometry and the properties of the surrounding soil is examined. The soil is simplified as a homogenous linear viscoelastic material and the dynamic stiffness of the suction caisson is expressed in terms of dimensionless frequency-dependent coefficients corresponding to the different degrees of freedom. The dynamic stiffness coefficients for the skirted foundation are evaluated by means of a three-dimensional coupled boundary element/finite element model. Comparisons with known analytical and numerical solutions indicate that the static and dynamic behaviour of the foundation are predicted accurately with the applied model. The analysis has been carried out for different combinations of the skirt length and the Poisson's ratio of the subsoil. Finally, the high-frequency impedance has been determined for future use in lumped-parameter models of wind turbine foundations in aero-elastic codes. (au)

Suction is kid's play: extremely fast suction in newborn seahorses

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Van Wassenbergh, Sam; Roos, Gert; Genbrugge, Annelies; Leysen, Heleen; Aerts, Peter; Adriaens, Dominique; Herrel, Anthony

2009-01-01

Ongoing anatomical development typically results in a gradual maturation of the feeding movements from larval to adult fishes. Adult seahorses are known to capture prey by rotating their long-snouted head extremely quickly towards prey, followed by powerful suction. This type of suction is powered by elastic recoil and requires very precise coordination of the movements of the associated feeding structures, making it an all-or-none phenomenon. Here, we show that newborn Hippocampus reidi are able to successfully feed using an extremely rapid and powerful snout rotation combined with a high-volume suction, surpassing that observed in adult seahorses. An inverse dynamic analysis shows that an elastic recoil mechanism is also used to power head rotation in newborn H. reidi. This illustrates how extreme levels of performance in highly complex musculoskeletal systems can be present at birth given a delayed birth and rapid development of functionally important structures. The fact that the head skeleton of newborn seahorses is still largely cartilaginous may not be problematic because the hydrodynamic stress on the rotating snout appeared considerably lower than in adult syngnathids. PMID:19324657

PERBEDAAN PARAMETER KARDIOPULMONAL SETELAH TINDAKAN OPEN SUCTION

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Muhamat Nofiyanto

2013-12-01

Full Text Available Background: Endotracheal suctioning is often performed by nurses and beneficial for critically ill patients. Suctioning is essential for removing secretions, maintaining airway patency and prevent unexpected complications. Open suctioning is performed by disconnecting patients with the ventilator. Suctioning not only removed secretions in the airway but also oxygen. Suctioning must be done correctly, safely, effectively and efficiently to prevent unexpected events in critically ill patients. Objective: This study aimed to determine differences on cardiopulmonary parameters after open suction in critically ill patients Methods: The study design was comparatif cross sectional analytic approach, using one group pre test and post test. The sample of the research amounted to 34 people, using purposive sampling technique. Catheter size 14 Fr on ETT number 7 mm used in this research to performed endotracheal suctioning. Cardiopulmonary parameters (Heart rate/ HR, respiratory rate/RR, oxygen saturation/SpO2, systolic blood pressure/ SBP and diastolic blood pressure/DBP measured by pulse oxymeter and bedside monitor before suction and immediately thereafter. Results: The results showed increase average heart rate 6.412 (from 106.62 into 113.03, Respiratory rate has increased 4.971 (from 20.62 into 25.59, SpO2 decreased 1.68 (from 99.09 into 97.41, and systolic blood pressure increased 5.71 (from 118.29 into 124.00 after performed open suction. The results of paired t-test statistical analysis (for RR, HR obtained a < 0.05 (0.000, whereas Wilcoxon statistical analysis (for SpO2, SBP obtained a < 0.05 (0.000 and 0.001. So it can be said that the difference cardiopulmonary parameters was statistically significant after perfomed open suction in critically ill patients.

Suction caissons subjected to monotonic combined loading

DEFF Research Database (Denmark)

Penzes, P.; Jensen, M.R.; Zania, Varvara

2016-01-01

Suction caissons are being increasingly used as offshore foundation solutions in shallow and intermediate water depths. The convenient installation method through the application of suction has rendered this type of foundation as an attractive alternative to the more traditional monopile foundation...... for offshore wind turbines. The combined loading imposed typically to a suction caisson has led to the estimation of their bearing capacity by means of 3D failure envelopes. This study aims to analyse the behaviour of suction caissons for offshore wind turbines subjected to combined loading. Finite element...

Scaled multiple holes suction tip for microneurosurgery; Technical note

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Abdolkarim Rahmanian, Associate Professor of Neurosurgery

2017-12-01

Conclusion: The new suction tip permits easy and precise adjustment of suction power in microneurosirgical operations. Our scaled 3 and 4-hole suction tip is a simple and useful device for controlling the suction power during the microneurosurgeical procedures.

Evaluation of hypopharyngeal suction to eliminate aspiration: the Retro-Esophageal Suction (REScue) catheter.

Science.gov (United States)

Belafsky, Peter C; Mehdizadeh, O B; Ledgerwood, L; Kuhn, M

2015-02-01

Profound oropharyngeal dysphagia (OPD) is common and costly. Treatment options are limited. The purpose of this investigation was to evaluate the utility of hypopharyngeal suction at the upper esophageal sphincter (UES) to eliminate aspiration. Five different catheters were passed retrograde up the esophagus and positioned at the UES in a cadaver model of profound OPD. Suction was affixed to each catheter. 10 cc of barium was administered into the pyriform sinus, and videofluoroscopy was utilized to evaluate the presence of aspiration. 6 trials were administered per catheter and for a no catheter control. The outcome measures were the incidence of aspiration, the NIH Swallow Safety Scale (NIH-SSS), and UES opening. Control trials with no suction resulted in an aspiration rate of 100 % (6/6 trials). Negative pressure through 16, 18, 24, and 30 Fr catheter resulted in an aspiration rate of 0 % (0/24 trials; p  0.05). The mean NIH-SSS improved from 7.0 (±0.0) in the control to 0 (±0.0) with hypopharyngeal suction (18 Fr nasogastric catheter; p 12 Fr) at the level of the UES reduced aspiration by 100 % and significantly increased UES opening in a cadaveric model of profound oropharyngeal dysphagia.

Ischemic stroke associated with radio frequency ablation for nodal reentry

International Nuclear Information System (INIS)

Diaz M, Juan C; Duran R, Carlos E; Perafan B, Pablo; Pava M, Luis F

2010-01-01

Atrioventricular nodal reentry tachycardia is the most common type of paroxysmal supraventricular tachycardia. In those patients in whom drug therapy is not effective or not desired, radio frequency ablation is an excellent therapeutic method. Although overall these procedures are fast and safe, several complications among which ischemic stroke stands out, have been reported. We present the case of a 41 year old female patient with repetitive episodes of tachycardia due to nodal reentry who was treated with radiofrequency ablation. Immediately after the procedure she presented focal neurologic deficit consistent with ischemic stroke in the right medial cerebral artery territory. Angiography with angioplastia and abxicimab was performed and then tissue plasminogen activator (rtPA) was locally infused, with appropriate clinical and angiographic outcome.

Place Atrium to Water Seal (PAWS): Assessing Wall Suction Versus No Suction for Chest Tubes After Open Heart Surgery.

Science.gov (United States)

Kruse, Tamara; Wahl, Sharon; Guthrie, Patricia Finch; Sendelbach, Sue

2017-08-01

Traditionally chest tubes are set to -20 cm H 2 O wall suctioning until removal to facilitate drainage of blood, fluid, and air from the pleural or mediastinal space in patients after open heart surgery. However, no clear evidence supports using wall suction in these patients. Some studies in patients after pulmonary surgery indicate that using chest tubes with a water seal is safer, because this practice decreases duration of chest tube placement and eliminates air leaks. To show that changing chest tubes to a water seal after 12 hours of wall suction (intervention) is a safe alternative to using chest tubes with wall suction until removal of the tubes (usual care) in patients after open heart surgery. A before-and-after quality improvement design was used to evaluate the differences between the 2 chest tube management approaches in chest tube complications, output, and duration of placement. A total of 48 patients received the intervention; 52 received usual care. The 2 groups (intervention vs usual care) did not differ significantly in complications (0 vs 2 events; P = .23), chest tube output (H 1 = 0.001, P = .97), or duration of placement (median, 47 hours for both groups). Changing chest tubes from wall suction to water seal after 12 hours of wall suction is a safe alternative to using wall suctioning until removal of the tubes. ©2017 American Association of Critical-Care Nurses.

Suction caissons subjected to monotonic combined loading

OpenAIRE

Penzes, P.; Jensen, M.R.; Zania, Varvara

2016-01-01

Suction caissons are being increasingly used as offshore foundation solutions in shallow and intermediate water depths. The convenient installation method through the application of suction has rendered this type of foundation as an attractive alternative to the more traditional monopile foundation for offshore wind turbines. The combined loading imposed typically to a suction caisson has led to the estimation of their bearing capacity by means of 3D failure envelopes. This study aims to anal...

LES-based characterization of a suction and oscillatory blowing fluidic actuator

Science.gov (United States)

Kim, Jeonglae; Moin, Parviz

2015-11-01

Recently, a novel fluidic actuator using steady suction and oscillatory blowing was developed for control of turbulent flows. The suction and oscillatory blowing (SaOB) actuator combines steady suction and pulsed oscillatory blowing into a single device. The actuation is based upon a self-sustained mechanism of confined jets and does not require any moving parts. The control output is determined by a pressure source and the geometric details, and no additional input is needed. While its basic mechanisms have been investigated to some extent, detailed characteristics of internal turbulent flows are not well understood. In this study, internal flows of the SaOB actuator are simulated using large-eddy simulation (LES). Flow characteristics within the actuator are described in detail for a better understanding of the physical mechanisms and improving the actuator design. LES predicts the self-sustained oscillations of the turbulent jet. Switching frequency, maximum velocity at the actuator outlets, and wall pressure distribution are in good agreement with the experimental measurements. The computational results are used to develop simplified boundary conditions for numerical experiments of active flow control. Supported by the Boeing company.

Circulating brain derived neurotrophic factor (BDNF) and frequency of BDNF positive T cells in peripheral blood in human ischemic stroke: Effect on outcome.

Science.gov (United States)

Chan, Adeline; Yan, Jun; Csurhes, Peter; Greer, Judith; McCombe, Pamela

2015-09-15

The aim of this study was to measure the levels of circulating BDNF and the frequency of BDNF-producing T cells after acute ischaemic stroke. Serum BDNF levels were measured by ELISA. Flow cytometry was used to enumerate peripheral blood leukocytes that were labelled with antibodies against markers of T cells, T regulatory cells (Tregs), and intracellular BDNF. There was a slight increase in serum BDNF levels after stroke. There was no overall difference between stroke patients and controls in the frequency of CD4(+) and CD8(+) BDNF(+) cells, although a subgroup of stroke patients showed high frequencies of these cells. However, there was an increase in the percentage of BDNF(+) Treg cells in the CD4(+) population in stroke patients compared to controls. Patients with high percentages of CD4(+) BDNF(+) Treg cells had a better outcome at 6months than those with lower levels. These groups did not differ in age, gender or initial stroke severity. Enhancement of BDNF production after stroke could be a useful means of improving neuroprotection and recovery after stroke. Copyright © 2015 Elsevier B.V. All rights reserved.

[Clinical research of post-stroke insomnia treated with low-frequency electric stimulation at acupoints in the patients].

Science.gov (United States)

Tang, Lei; You, Fei; Ma, Chao-Yang

2014-08-01

To compare the difference in the clinical efficacy on post-stroke insomnia between the low-frequency electric stimulation at the acupoints and the conventional western medication. One hundred and twenty patients of post-stroke insomnia were randomized into a low-frequency electric stimulation group, a medication group and a placebo group, 40 cases in each one. In the low-frequency electric stimulation group, the low-frequency electric-pulsing apparatus was used at Dazhui (GV 14) and Shenshu (BL 23), once a day; the treatment of 15 days made one session and 2 sessions were required. In the medication group, estazolam was taken orally, 1 mg each time. In the placebo group, starch capsules were taken orally, 1 capsule each time. All the drugs were taken before sleep every night, continuously for 15 days as one session, and 2 sessions were required. PSQI changes and clinical efficacy were observed before and after treatment in each group. Pitlsburgh sleep quality index (PSQI) score was reduced in every group after treatment (all P low-frequency electric stimulation group and medication group, the score was reduced much more significantly as compared with the placebo group (both P low-frequency electric stimulation group, medication group and placebo group separately. The efficacy in the low-frequency electric stimulation group and medication group was better apparently than that in the placebo group (both P low-frequency electric stimulation at the acupoints effectively and safely treats post-stroke insomnia and the efficacy of it is similar to that of estazolam.

Safety study of high-frequency transcranial magnetic stimulation in patients with chronic stroke.

Science.gov (United States)

Lomarev, M P; Kim, D Y; Richardson, S Pirio; Voller, B; Hallett, M

2007-09-01

Repetitive transcranial magnetic stimulation (rTMS) is a potential therapeutic tool to rehabilitate chronic stroke patients. In this study, the safety of high-frequency rTMS in stroke was investigated (Phase I). The safety of 20 and 25 Hz rTMS over the motor cortex (MC) of the affected hemisphere, with intensities of 110-130% of the motor threshold (MT), was evaluated using surface electromyography (EMG) of hand and arm muscles. Brief EMG bursts, possibly representing peripheral manifestations of after discharges, and spread of excitation to proximal muscles are considered to be associated with a high risk of seizure occurrence. These events were recorded after the rTMS trains. Neither increased MC excitability nor improved pinch force dynamometry was found after rTMS. Stimulation parameters for rTMS, which are safe for healthy volunteers, may lead to a higher risk for seizure occurrence in chronic stroke patients. rTMS at rates of 20 and 25 Hz using above threshold stimulation potentially increases the risk of seizures in patients with chronic stroke.

Boundary layer on a flat plate with suction

International Nuclear Information System (INIS)

Favre, A.; Dumas, R.; Verollet, E.

1961-01-01

This research done in wind tunnel concerns the turbulent boundary layer of a porous flat plate with suction. The porous wall is 1 m long and begins 1 m downstream of the leading edge. The Reynolds number based on the boundary layer thickness is of the order of 16.300. The suction rate defined as the ratio of the velocity perpendicular to the wall to the external flow velocity ranges from 0 to 2 per cent. The pressure gradient can be controlled. The mean velocity profiles have been determined for various positions and suction rates by means of total pressure probes together with the intensities of the turbulent velocity fluctuations components, energy spectra and correlations by means of hot wire anemometers, spectral analyser and correlator. The stream lines, the values of the viscous and turbulent shear stresses, of the local wall friction, of the turbulent energy production term, with some information on the dissipation of the energy have been derived from these measurements. For these data the integral of equation of continuity in boundary layer have been drawn. The suction effects on the boundary layer are important. The suction thoroughly alters the mean velocity profiles by increasing the viscous shear stresses near the wall and decreasing them far from the wall, it diminishes the longitudinal and transversal turbulence intensities, the turbulent shear stresses, and the production of energy of turbulence. These effects are much stressed in the inner part of the boundary layer. On the other hand the energy spectra show that the turbulence scale is little modified, the boundary layer thickness being not much diminished by the suction. The suction effects can be appreciated by comparing twice the suction rate to the wall friction coefficient (assumed airtight), quite noticeable as soon as the rate is about unity, they become very important when it reaches ten. (author) [fr

Overcoming the problem of residual microbial contamination in dental suction units left by conventional disinfection using novel single component suction handpieces in combination with automated flood disinfection.

Science.gov (United States)

Boyle, M A; O'Donnell, M J; Russell, R J; Galvin, N; Swan, J; Coleman, D C

2015-10-01

Decontaminating dental chair unit (DCU) suction systems in a convenient, safe and effective manner is problematic. This study aimed to identify and quantify the extent of the problems using 25 DCUs, methodically eliminate these problems and develop an efficient approach for reliable, effective, automated disinfection. DCU suction system residual contamination by environmental and human-derived bacteria was evaluated by microbiological culture following standard aspiration disinfection with a quaternary ammonium disinfectant or alternatively, a novel flooding approach to disinfection. Disinfection of multicomponent suction handpieces, assembled and disassembled, was also studied. A prototype manual and a novel automated Suction Tube Cleaning System (STCS) were developed and tested, as were novel single component suction handpieces. Standard aspiration disinfection consistently failed to decontaminate DCU suction systems effectively. Semi-confluent bacterial growth (101-500 colony forming units (CFU) per culture plate) was recovered from up to 60% of suction filter housings and from up to 19% of high and 37% of low volume suction hoses. Manual and automated flood disinfection of DCU suction systems reduced this dramatically (ranges for filter cage and high and low volume hoses of 0-22, 0-16 and 0-14CFU/plate, respectively) (P<0.0001). Multicomponent suction handpieces could not be adequately disinfected without prior removal and disassembly. Novel single component handpieces, allowed their effective disinfection in situ using the STCS, which virtually eliminated contamination from the entire suction system. Flood disinfection of DCU suction systems and single component handpieces radically improves disinfection efficacy and considerably reduces potential cross-infection and cross-contamination risks. DCU suction systems become heavily contaminated during use. Conventional disinfection does not adequately control this. Furthermore, multicomponent suction handpieces

Simulation of flow structure in the suction pipe of a hydroturbine by integral characteristics

DEFF Research Database (Denmark)

Kuibin, P.A.; Okulov, Valery; Pylev, I.M.

2006-01-01

Within the framework of a model of a twisted flow of an inviscid incompressible liquid, we solve the problem of determining the frequency and amplitude of oscillations caused by the precession of a helical vortex core in the suction tube of a hydroturbine from the specified integral characteristics...

Suction power output and the inertial cost of rotating the neurocranium to generate suction in fish.

Science.gov (United States)

Van Wassenbergh, Sam; Day, Steven W; Hernández, L Patricia; Higham, Timothy E; Skorczewski, Tyler

2015-05-07

To expand the buccal cavity, many suction-feeding fishes rely on a considerable contribution from dorsal rotation of the dorsal part of the head including the brains, eyes, and several bones forming the braincase and skull roof (jointly referred to as the neurocranium). As the neurocranium takes up a large part of the total mass of the head, this rotation may incur a considerable inertial cost. If so, this would suggest a significant selective pressure on the kinematics and mass distribution of the neurocranium of suction feeders. Here, an inverse dynamic model is formulated to calculate the instantaneous power required to rotate the neurocranium, approximated by a quarter ellipsoid volume of homogeneous density, as well as to calculate the instantaneous suction power based on intra-oral pressure and head volume quantifications. We applied this model to largemouth bass (Micropterus salmoides) and found that the power required to rotate the neurocranium accounts for only about 4% of the power required to suck water into the mouth. Furthermore, recovery of kinetic energy from the rotating neurocranium converted into suction work may be possible during the phase of neurocranial deceleration. Thus, we suggest that only a negligible proportion of the power output of the feeding muscles is lost as inertial costs in the largemouth bass. Consequently, the feeding performance of piscivorous suction feeders with generalised morphology, comparable to our model species, is not limited by neurocranial motion during head expansion. This suggests that it is thus not likely to be a factor of importance in the evolution of cranial shape and size. Copyright © 2015 Elsevier Ltd. All rights reserved.

Suction v. conventional curettage in incomplete abortion

African Journals Online (AJOL)

Suction v. conventional curettage in incomplete abortion. A randomised controlled trial. D. A. A. VERKUYL, C. A. CROWTHER .Abstract This randomised controlled trial of 357 patients who had had an incomplete abortion compared suction curettage with conventional curettage for evacuation ofthe uterus. The 179 patients ...

Dielectric elastomer actuators for octopus inspired suction cups.

Science.gov (United States)

Follador, M; Tramacere, F; Mazzolai, B

2014-09-25

Suction cups are often found in nature as attachment strategy in water. Nevertheless, the application of the artificial counterpart is limited by the dimension of the actuators and their usability in wet conditions. A novel design for the development of a suction cup inspired by octopus suckers is presented. The main focus of this research was on the modelling and characterization of the actuation unit, and a first prototype of the suction cup was realized as a proof of concept. The actuation of the suction cup is based on dielectric elastomer actuators. The presented device works in a wet environment, has an integrated actuation system, and is soft. The dimensions of the artificial suction cups are comparable to proximal octopus suckers, and the attachment mechanism is similar to the biological counterpart. The design approach proposed for the actuator allows the definition of the parameters for its development and for obtaining a desired pressure in water. The fabricated actuator is able to produce up to 6 kPa of pressure in water, reaching the maximum pressure in less than 300 ms.

Dielectric elastomer actuators for octopus inspired suction cups

International Nuclear Information System (INIS)

Follador, M; Tramacere, F; Mazzolai, B

2014-01-01

Suction cups are often found in nature as attachment strategy in water. Nevertheless, the application of the artificial counterpart is limited by the dimension of the actuators and their usability in wet conditions. A novel design for the development of a suction cup inspired by octopus suckers is presented. The main focus of this research was on the modelling and characterization of the actuation unit, and a first prototype of the suction cup was realized as a proof of concept. The actuation of the suction cup is based on dielectric elastomer actuators. The presented device works in a wet environment, has an integrated actuation system, and is soft. The dimensions of the artificial suction cups are comparable to proximal octopus suckers, and the attachment mechanism is similar to the biological counterpart. The design approach proposed for the actuator allows the definition of the parameters for its development and for obtaining a desired pressure in water. The fabricated actuator is able to produce up to 6 kPa of pressure in water, reaching the maximum pressure in less than 300 ms. (paper)

Does the suction drain diameter matter? Bleeding analysis after total knee replacement comparing different suction drain gauges

Directory of Open Access Journals (Sweden)

Marcos George de Souza Leao

Full Text Available ABSTRACT OBJECTIVES: To evaluate bleeding and the estimated blood loss in patients who underwent total knee replacement (TKR with different closed suction drains (3.2-mm and 4.8-mm gauge. METHODS: This was a randomized controlled trial with 22 patients who underwent TKR and were divided into two groups: Group I, with 11 patients in whom the 3.2-mm suction drain was used, and Group II, with 11 patients in whom the 4.8-mm suction drain was used. The hematocrit was measured after 24, 48 and 72 h after surgery in order to calculate the estimated blood loss. The drained volume was measured 3, 6, 12, 24, and 48 h after TKR, and thereafter both groups were compared. RESULTS: Regarding the hematocrit, there were no differences between groups in measured periods (24, 48, and 72 h after surgery. The total bleeding measured at the suction drains within 48 h was higher in Group II, with a statistically significant difference (p = 0.005; in the first 24 h, there was major bleeding in Group II (mean 893 mL, with a significant difference (p = 0.004. Between 24 and 48 h, there was no statistically significant difference in both groups (p = 0.710. The total estimated bleeding was higher in Group I, with mean of 463 mL, versus 409 mL in Group II, with no statistical significance (p = 0.394. CONCLUSIONS: Bleeding was higher in the group that used the 4.8 mm gauge suction drain, with no differences in hematocrit and estimated blood loss.

Frequency Of Hyperthermia In Acute Ischemic Stroke Patients Visiting A Tertiary Care Hospital

International Nuclear Information System (INIS)

Maheshwari, A. K.; Kumar, P.; Alam, M. T.; Aurangzeb, M.; Imran, K.; Masroor, M.; Parkash, J.

2016-01-01

Objective: To determine the frequency of hyperthermia in acute ischemic stroke patients visiting a tertiary care hospital in a developing country. Study Design: Cross-sectional, observational study. Place and Duration of Study: Medical Wards of Civil Hospital, Karachi, from January to June 2013. Methodology: Patients aged = 18 years of either gender with acute ischemic stroke presenting within 24 hours of onset of symptoms were included. Written informed consent was obtained from all participants as well as approval of ethical review committee of the institute. Axillary temperature by mercury thermometer was monitored at the time of admission and after every 6 hours for 3 days. The data was analyzed using SPSS version 17.0 (SPSS Inc., IL, Chicago, USA). Result: A total of 106 patients of ischemic stroke were included. The mean age of enrolled participants was 60.1 ±9.5 years. Among these, 61 (57.5 percentage) were males and 45 (42.5 percentage) females. Among all patients, 51.9 percentage presented with loss of consciousness, 30.2 percentage with slurred speech, 77.4 percentage with limb weakness, and 9.4 percentage with decrease vision. A total of 17 (16 percentage) patients with ischemic stroke developed hyperthermia. When the prevalence of hyperthermia was stratified according to age, among patients of < 60 years of age, 26 percentage developed hyperthermia compared to 7.1 percentage in patients of = 60 years of age (p=0.008). On gender stratification, among male patients, 14.8 percentage developed hyperthermia compared to 17.8 percentage in female patients (p=0.43). Conclusion: It is concluded from this study that the frequency of hyperthermia in ischemic stroke was 16 percentage and it should be looked for as it has significant impact on the outcome. The hyperthermia was significantly more common in younger adults as compared to older adults. However, gender had no influence on the prevalence rate of hyperthermia. (author)

Advances on development of suction and temperature controlled oedometer cell

International Nuclear Information System (INIS)

Ye Weimin; Zhang Yawei; Chen Bao; Wang Min

2010-01-01

Oedometer cells for unsaturated soils can be classified into two types, that is, conventional unsaturated oedometer cells (high-suction unsaturated oedometer cell, high-suction and high-pressure unsaturated oedometer cell) and temperature controlled unsaturated oedometer cells. Among them, the osmotic, vapor equilibrium and axis translation techniques are often employed for suction control. The thermostat bath method and thermostatically controlled heater method are commonly used for temperature control. The lever loading system, hydraulic loading system and air pressure loading system are commonly means used for vertical pressure. Combination of osmotic (or axis translation) technique with vapor equilibrium method employed for the full range suction control, thermostatically liquid temperature control method, and the hydraulic loading system, could be used for suction, temperature and loading control in the design for unsaturated oedometer cells in the future, which can be used for study of buffer/backfill materials under high-temperature, high pressure and full range suction conditions. (authors)

Investigation of suction anchor pullout capacity under undrained conditions

OpenAIRE

Jarand, Pollestad

2015-01-01

Master's thesis in Offshore technology Floating units are dependent on reliable mooring systems to ensure safety during marine operations. Suction anchors have proved to be a technologically viable and cost-effective concept. They are capable of precision installation, re-use, and provide large resistive capacity. This thesis investigates load capacity and failure modes of suction anchors subjected to vertical, horizontal (lateral), and incline loading. Suction anchor design co...

Enhanced effect of suction-cavitation on the ozonation of phenol

International Nuclear Information System (INIS)

Wu Zhilin; Franke, Marcus; Ondruschka, Bernd; Zhang, Yongchun; Ren Yanze; Braeutigam, Patrick; Wang, Weimin

2011-01-01

800 mL of 1.0 mM phenol-containing aqueous solution was circulated at 20 ° C for 30 min in a suction-reactor, while 3.2 mg min -1 ozone was introduced into the solution under the suction orifice. The removal rates of phenol vary polynomially with the orifice diameter as well as the suction pressure. The rate constant for the zero-order kinetics achieves the highest value at -0.070 MPa by using 5 mm orifice. Although the suction-cavitation alone cannot remove phenol in 30 min, it can considerably enhance the ozonation of phenol. The rate constants for the zero-order kinetics by the simple ozonation and the combined method are 0.018 and 0.028 min -1 , respectively. Furthermore, no ozone was observed in the tail gas during the first 15 min for the ozonation in the suction reactor, and then the concentration of unreacted ozone slowly increased, indicating that the utilization rate of ozone is significantly improved by the suction-cavitation. The increasing input concentration of ozone obviously accelerates the ozonation of phenol, but the total required quantities of ozone are very close by various ozone input concentrations to reach the same degradation rate, indicating the ozonation assisted by the suction-cavitation can be considered as a quantitative reaction.

Numerical simulation and experimental investigation on suction heating of a BOG compressor

International Nuclear Information System (INIS)

Jia, Xiaohan; Zhao, Bin; Feng, Jianmei; Zheng, Sulu; Peng, Xueyuan

2016-01-01

Highlights: • An investigation focusing on suction heating of a BOG compressor is carried out. • There is frost on the cylinder cover as the compressor at lower suction temperature. • The suction and discharge flow rate decrease with rising suction temperature. • The volumetric efficiency has a maximum value with increasing suction temperature. • The temperature coefficient increased with suction temperature or rotational speed. - Abstract: One of the key components of a liquefied natural gas (LNG) receiving terminal is the boil-off gas (BOG) compressor, which is used to pump out the BOG from the LNG storage tank to ensure safety in the transportation and receiving systems. Owing to the ultra-low suction temperature, the heat exchange between the intake gas and the cylinder, piston, and cylinder cover cannot be ignored as in normal conditions. This paper presents an investigation focusing on suction heating of the BOG compressor. A finite element model with dynamic mesh was established to simulate the suction process. At the same time, a performance test rig was built to study the characteristics of the BOG compressor under low suction temperature conditions and verify the numerical model. Consequently, the results of the simulation were in good agreement with experimental results. Both results implied that the temperature of cylinder surface increased starting from the cylinder cover to the crankcase. In addition, at lower suction temperature, the temperature difference between various points on the cylinder surface and cylinder cover was much larger than that at higher suction temperature. With increasing suction temperature, the temperature coefficient increased markedly, and the difference between gas temperatures at the beginning and end of the suction process, as well as the compressor flow rate, decreased significantly; however, the volumetric efficiency increased first and then decreased. Furthermore, the temperature coefficient clearly increased

Microsatellite marker analysis of peach-potato aphids (Myzus persicae, Homoptera: Aphididae) from Scottish suction traps.

Science.gov (United States)

Malloch, G; Highet, F; Kasprowicz, L; Pickup, J; Neilson, R; Fenton, B

2006-12-01

The peach-potato aphid Myzus persicae (Sulzer) is an important vector of plant viruses. A network of suction traps collects aerial samples of this aphid in order to monitor and help predict its spatial distribution and likely impact on virus transmission in crops. A suction trap catch is thought to be a good representation of the total aphid pool. Sensitive molecular markers have been developed that determine the genetic composition of the M. persicae population. In Scotland, UK, these were applied to field collections revealing a limited number of clones. Molecular markers are less successful when applied to specimens that have been preserved in an ethanol-based trap fluid designed to preserve morphology. An assessment of different DNA extraction and PCR techniques is presented and the most efficient are used to analyse M. persicae specimens caught in the Dundee suction trap in 2001, a year when exceptionally high numbers were caught. The results reveal that the majority of the M. persicae caught belonged to two highly insecticide resistant clones. In addition, it was possible to compare the relative frequencies of genotypes caught in the trap with those collected at insecticide treated and untreated field sites in the vicinity. These results indicate that, in addition to suction trap data, the ability to sample field sites provides valuable early warning data which have implications for pest control and virus management strategies.

On equations for the total suction and its matric and osmotic components

International Nuclear Information System (INIS)

Dao, Vinh N.T.; Morris, Peter H.; Dux, Peter F.

2008-01-01

A clear fundamental understanding of suctions is crucial for the study of the behaviour of plastic cement mortar and concrete, including plastic shrinkage cracking. In this paper, the expression relating the change in free energy of the pore water with an isothermal change in pressure is first derived. Based upon definitions of suctions, it is then shown that total, matric, and osmotic suctions can all be expressed in the same thermodynamic form. The widely accepted, but not yet satisfactorily validated, assumption that the total suction comprises matric and osmotic components is then confirmed theoretically. The well-known Kelvin equation for matric suction, and Morse and van't Hoff equations for osmotic suction are subsequently derived from the corresponding thermodynamic equations. The applicability of latter two equations in evaluating the osmotic suctions of cement mortar and concrete is highlighted

Frequency and significance of troponin T elevation in acute ischemic stroke

DEFF Research Database (Denmark)

Jensen, Jesper K.; Kristensen, Søren R.; Bak, Søren

2007-01-01

Elevated levels of troponin have been reported in patients with acute ischemic stroke. In this prospective study, the prevalence and characteristics of troponin elevation were examined in 244 patients with acute ischemic stroke but without overt ischemic heart disease. Troponin T (TnT) and creatine...... for a mean of 19 +/- 7 months, with all-cause mortality as the clinical end point. Elevated levels of TnT (>0.03 micro g/L) and creatine kinase-MB (> or =10 micro g/L) were observed in 10% and 9% of patients, respectively. Patients with elevated TnT had higher frequencies of heart and/or renal failure....... Perfusion abnormalities on myocardial perfusion scintigraphy at rest were not more frequent or pronounced in patients with TnT levels of > or =0.10 micro g/L than in the control group. Only 7 patients (3%) had elevations of TnT or creatine kinase-MB and electrocardiographic changes suggesting acute...

Suction v. conventional curettage in incomplete abortion A ...

African Journals Online (AJOL)

This randomised controlled trial of 357 patients who had had an incomplete abortion compared suction curettage with conventional curettage for evacuation ofthe uterus. The 179 patients undergoing suction curettage had a significantly lower intra-operative blood loss (P < 0,0001) and a significantly higher mean ...

Octopus-like suction cups: from natural to artificial solutions.

Science.gov (United States)

Tramacere, F; Follador, M; Pugno, N M; Mazzolai, B

2015-05-13

Octopus suckers are able to attach to all nonporous surfaces and generate a very strong attachment force. The well-known attachment features of this animal result from the softness of the sucker tissues and the surface morphology of the portion of the sucker that is in contact with objects or substrates. Unlike artificial suction cups, octopus suckers are characterized by a series of radial grooves that increase the area subjected to pressure reduction during attachment. In this study, we constructed artificial suction cups with different surface geometries and tested their attachment performances using a pull-off setup. First, smooth suction cups were obtained for casting; then, sucker surfaces were engraved with a laser cutter. As expected, for all the tested cases, the engraving treatment enhanced the attachment performance of the elastomeric suction cups compared with that of the smooth versions. Moreover, the results indicated that the surface geometry with the best attachment performance was the geometry most similar to octopus sucker morphology. The results obtained in this work can be utilized to design artificial suction cups with higher wet attachment performance.

Comparison the Effects of Shallow and Deep Endotracheal Tube Suctioning on Respiratory Rate, Arterial Blood Oxygen Saturation and Number of Suctioning in Patients Hospitalized in the Intensive Care Unit: A Randomized Controlled Trial

Directory of Open Access Journals (Sweden)

Mohammad Abbasinia

2014-09-01

Full Text Available Introduction: Endotracheal tube suctioning is essential for improve oxygenation in the patients undergoing mechanical ventilation. There are two types of shallow and deep endotracheal tube suctioning. This study aimed to evaluate the effect of shallow and deep suctioning methods on respiratory rate (RR, arterial blood oxygen saturation (SpO2 and number of suctioning in patients hospitalized in the intensive care units of Al-Zahra Hospital, Isfahan, Iran. Methods: In this randomized controlled trial, 74 patients who hospitalized in the intensive care units of Isfahan Al-Zahra Hospital were randomly allocated to the shallow and deep suctioning groups. RR and SpO2 were measured immediately before, immediately after, 1 and 3 minute after each suctioning. Number of suctioning was also noted in each groups. Data were analyzed using repeated measures analysis of variance (RMANOVA, chi-square and independent t-tests. Results: RR was significantly increased and SpO2 was significantly decreased after each suctioning in the both groups. However, these changes were not significant between the two groups. The numbers of suctioning was significantly higher in the shallow suctioning group than in the deep suctioning group. Conclusion: Shallow and deep suctioning had a similar effect on RR and SpO2. However, shallow suctioning caused further manipulation of patient’s trachea than deep suctioning method. Therefore, it seems that deep endotracheal tube suctioning method can be used to clean the airway with lesser manipulation of the trachea.

Comparison the effects of shallow and deep endotracheal tube suctioning on respiratory rate, arterial blood oxygen saturation and number of suctioning in patients hospitalized in the intensive care unit: a randomized controlled trial.

Science.gov (United States)

Abbasinia, Mohammad; Irajpour, Alireza; Babaii, Atye; Shamali, Mehdi; Vahdatnezhad, Jahanbakhsh

2014-09-01

Endotracheal tube suctioning is essential for improve oxygenation in the patients undergoing mechanical ventilation. There are two types of shallow and deep endotracheal tube suctioning. This study aimed to evaluate the effect of shallow and deep suctioning methods on respiratory rate (RR), arterial blood oxygen saturation (SpO2) and number of suctioning in patients hospitalized in the intensive care units of Al-Zahra Hospital, Isfahan, Iran. In this randomized controlled trial, 74 patients who hospitalized in the intensive care units of Isfahan Al-Zahra Hospital were randomly allocated to the shallow and deep suctioning groups. RR and SpO2 were measured immediately before, immediately after, 1 and 3 minute after each suctioning. Number of suctioning was also noted in each groups. Data were analyzed using repeated measures analysis of variance (RMANOVA), chi-square and independent t-tests. RR was significantly increased and SpO2 was significantly decreased after each suctioning in the both groups. However, these changes were not significant between the two groups. The numbers of suctioning was significantly higher in the shallow suctioning group than in the deep suctioning group. Conclusion : Shallow and deep suctioning had a similar effect on RR and SpO2. However, shallow suctioning caused further manipulation of patient's trachea than deep suctioning method. Therefore, it seems that deep endotracheal tube suctioning method can be used to clean the airway with lesser manipulation of the trachea.

Development of standard practice guidelines for open and closed system suctioning.

Science.gov (United States)

Özden, Dilek; Görgülü, R Selma

2012-05-01

This study was carried out to determine the knowledge and practice of nurses before and after training and the development of standard practice guidelines for open and closed system suctioning methods in patients with endotracheal tubes. Many life-threatening complications can occur when a suctioning procedure is not performed with the correct technique. It has been reported that standard practice guidelines for suctioning are insufficient in clinical practice. Non-participant structured observational study. We assessed a total of 48 nurses who were employed in the cardiovascular surgery intensive care unit of a state hospital in Turkey. We used a questionnaire and nurse observation forms to assess the use of the open and closed system suctioning. There was a significant difference between the mean scores of the answers ('true', 'wrong' and 'I do not know') for the use of open and closed system suctioning before and after training. In addition, all steps of both suctioning procedures were carried out correctly during the third observation. The compliance of the nurses to the standard practice guidelines for open and closed suctioning and their knowledge levels on the subject were increased after training, while the implementation of standards was satisfactory. The development of open and closed system suctioning standard practice guidelines directly contributed to the enhancement of patient safety and the quality of nursing care. It is suggested that, as in other nursing care practices, suctioning should be carried out in accordance with standard practice guidelines, and health institutions should develop their standard practice guidelines and work in accordance with them. © 2012 Blackwell Publishing Ltd.

Preliminary study of efficacy of cup suction in the correction of typical pectus excavatum.

Science.gov (United States)

Lopez, Manuel; Patoir, Arnaud; Costes, Frederic; Varlet, François; Barthelemy, Jean-Claude; Tiffet, Olivier

2016-01-01

duration of 9 months (2-22). Treatment using cup suction is a promising useful alternative in selected cases of symmetric and asymmetric PE, providing that the thorax is flexible. Treatment duration is directly linked to age, severity and the frequency of use. It is becoming a well-recognized therapy, which improves the self-image of those patients whose anterior chest wall is still pliable. The cup suction can be used for pediatrics and young adults waiting for a treatment, possibly surgery, however, the long-term effect of this procedure remains unclear. Copyright © 2016 Elsevier Inc. All rights reserved.

Suction generation in white-spotted bamboo sharks Chiloscyllium plagiosum.

Science.gov (United States)

Wilga, Cheryl D; Sanford, Christopher P

2008-10-01

After the divergence of chondrichthyans and teleostomes, the structure of the feeding apparatus also diverged leading to alterations in the suction mechanism. In this study we investigated the mechanism for suction generation during feeding in white-spotted bamboo sharks, Chiloscyllium plagiosum and compared it with that in teleosts. The internal movement of cranial elements and pressure in the buccal, hyoid and pharyngeal cavities that are directly responsible for suction generation was quantified using sonomicrometry and pressure transducers. Backward stepwise multiple linear regressions were used to explore the relationship between expansion and pressure, accounting for 60-96% of the variation in pressure among capture events. The progression of anterior to posterior expansion in the buccal, hyoid and pharyngeal cavities is accompanied by the sequential onset of subambient pressure in these cavities as prey is drawn into the mouth. Gape opening triggers the onset of subambient pressure in the oropharyngeal cavities. Peak gape area coincides with peak subambient buccal pressure. Increased velocity of hyoid area expansion is primarily responsible for generating peak subambient pressure in the buccal and hyoid regions. Pharyngeal expansion appears to function as a sink to receive water influx from the mouth, much like that of compensatory suction in bidirectional aquatic feeders. Interestingly, C. plagiosum generates large suction pressures while paradoxically compressing the buccal cavity laterally, delaying the time to peak pressure. This represents a fundamental difference from the mechanism used to generate suction in teleost fishes. Interestingly, pressure in the three cavities peaks in the posterior to anterior direction. The complex shape changes that the buccal cavity undergoes indicate that, as in teleosts, unsteady flow predominates during suction feeding. Several kinematic variables function together, with great variation over long gape cycles to

Massive aspiration past the tracheal tube cuff caused by closed tracheal suction system.

Science.gov (United States)

Dave, Mital H; Frotzler, Angela; Madjdpour, Caveh; Koepfer, Nelly; Weiss, Markus

2011-01-01

Aspiration past the tracheal tube cuff has been recognized to be a risk factor for the development of ventilator-associated pneumonia (VAP). This study investigated the effect of closed tracheal suctioning on aspiration of fluid past the tracheal tube cuff in an in vitro benchtop model. High-volume low pressure tube cuffs of 7.5 mm internal diameter (ID) were placed in a 22 mm ID artificial trachea connected to a test lung. Positive pressure ventilation (PPV) with 15 cm H₂O peak inspiratory pressure and 5 cm H₂O positive end-expiratory pressure (PEEP) was used. A closed tracheal suction system (CTSS) catheter (size 14Fr) was attached to the tracheal tube and suction was performed for 5, 10, 15, or 20 seconds under 200 or 300 cm H₂O suction pressures. Amount of fluid (mL) aspirated along the tube cuff and the airway pressure changes were recorded for each suction procedure. Fluid aspiration during different suction conditions was compared using Kruskal-Wallis and Mann-Whitney test (Bonferroni correction [α = .01]). During 10, 15, and 20 seconds suction, airway pressure consistently dropped down to -8 to -13 cm H₂O (P aspiration was never observed under PPV + PEEP but occurred always during suctioning. Aspiration along the tube cuff was higher with -300 cm H₂O than with -200 cm H₂O suction pressure (P aspiration of fluid occurs along the tracheal tube cuff during suction with the closed tracheal suction system. © SAGE Publications 2011.

Cavitation simulation and NPSH prediction of a double suction centrifugal pump

International Nuclear Information System (INIS)

Li, P; Huang, Y F; Li, J

2012-01-01

This paper illustrates the flow field numerical analysis of the double-suction centrifugal pump. For the study of the cavitation flow inside the double-suction centrifugal pump, the professional pump/motor simulation software PumpLinx and its Full Cavitation Model has been employed. According to the PumpLinx calculation result and the Cavitation damage index, the cavitation position, level and the cavitation characteristics of the double-suction centrifugal pump has been predicted. For the further objective, the simulation of the flow field in the double-suction centrifugal pump under different inlet conditions has been carried out. By the result analysis, NPSHr has been predicted; the reliability of the results has been verified by comparing with the experimental data. At the same time, this practice can provide guidance for the optimal design of double-suction pump.

The impact of soil suction variation on earthquake intensity indices

Directory of Open Access Journals (Sweden)

Biglari Mahnoosh

2016-01-01

Full Text Available Soil properties can completely change the ground motion characteristics as they travel from the bedrock to the surface because, soil as a low-pass filter, may amplify or deamplify seismic motions in some frequencies on the wave travelling path. Recent studies about the advanced unsaturated soil mechanics clearly shows that dynamic properties of soils, including small-strain shear modulus (Gmax, shear modulus reduction (G/Gmax, and damping ratio (D curves are affected by changes in the soil suction level. The current study present nonlinear time-dependent analysis of three different unsaturated soils available in the literature with different ranges of nonlinear behaviour that earlier have been studied on unsaturated dynamic models. Since, the earthquake intensity parameters can be used to describe the damage potential of an earthquake, the focus of this paper is to evaluate the impact of the suction variation on the engineering ground motion parameters, including peak values of strong motion, Vmax/Amax, root-mean-square acceleration, Arias intensity, characteristic intensity, cumulative absolute velocity, acceleration spectrum intensity, effective design acceleration, A95 parameter and predominant period separately under the near-field and the far-field seismicity categories.

Seepage Study for Suction Installation of Bucket Foundation in Different Soil Combinations

DEFF Research Database (Denmark)

Koteras, Aleksandra Katarzyna; Ibsen, Lars Bo; Clausen, Johan Christian

2016-01-01

Research has proven the bucket foundation to be a feasible and an attractive solution for offshore wind turbines. Its potential derives partly from the cost-effectiveness due to the suction-assisted installation. The suction applied under the bucket lid produces a downward driving force and addit......Research has proven the bucket foundation to be a feasible and an attractive solution for offshore wind turbines. Its potential derives partly from the cost-effectiveness due to the suction-assisted installation. The suction applied under the bucket lid produces a downward driving force...... around the bucket skirt. The exceedance of critical suction might lead to installation failure due to formation of piping channels, which break the hydraulic seal between the skirt and soil. The excess pore pressure arising due to applied suction changes the effective stress, hence the penetration...

[Effect of low frequency magnetic fields used in magnetotherapy and magnetostimulation on the rehabilitation results of patients after ischemic stroke].

Science.gov (United States)

Woldańska-Okońska, Marta; Czernicki, Jan

2007-01-01

New methods of rehabilitation should be introduced in order to reduce disability resulting from stroke. During the twelve months of follow-up, effect of low frequency magnetic field (If mf) on the course of patient rehabilitation following ischemic stroke was evaluated on in-patient (acute and subacute period of the stroke) and outpatient (chronic period) basis with the use of Mathew et al's and Barthel's scales. Lf mf (20 procedures of 20-min. duration) of magnetotherapy (I group--placebo, II--group 5.6 mT induction, 10 Hz frequency and sinusoidal shape, III group--2.8 mT induction, 10 Hz frequency and sinusoidal shape) and magnetostimulation (IV group--M1P1 program of Viofor JPS system, 16 min a day) was applied as early as in the subacute period of the stroke (1-8 weeks). The data obtained were presented in the form of percentage changes in the pain levels as well as in the form of the arithmetical mean and standard deviation (X +/- SD). The ANOVA test was used for a statistical evaluation of the data obtained in the tests. The results obtained indicate beneficial effects of If mf in the III and IV group of patients in the Barthel's scale and Mathew scale, which were observed during the examination 12 months after the stroke. The recommended doses of If mf seem to be adequate to obtain therapeutic effects and may be used in the early period of rehabilitation. The neurological and functional improvement persisted for a long-period of the out-patient treatment, which was confirmed during the control examination 12 months after the ischemic stroke. As no adverse effects (which could be attributed to If mf), were observed, this method of physical therapy can be recognized as a safe one and worth making popular in clinical practice.

Feeding kinematics, suction, and hydraulic jetting performance of harbor seals (Phoca vitulina.

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Christopher D Marshall

Full Text Available The feeding kinematics, suction and hydraulic jetting capabilities of captive harbor seals (Phoca vitulina were characterized during controlled feeding trials. Feeding trials were conducted using a feeding apparatus that allowed a choice between biting and suction, but also presented food that could be ingested only by suction. Subambient pressure exerted during suction feeding behaviors was directly measured using pressure transducers. The mean feeding cycle duration for suction-feeding events was significantly shorter (0.15±0.09 s; P<0.01 than biting feeding events (0.18±0.08 s. Subjects feeding in-water used both a suction and a biting feeding mode. Suction was the favored feeding mode (84% of all feeding events compared to biting, but biting comprised 16% of feeding events. In addition, seals occasionally alternated suction with hydraulic jetting, or used hydraulic jetting independently, to remove fish from the apparatus. Suction and biting feeding modes were kinematically distinct regardless of feeding location (in-water vs. on-land. Suction was characterized by a significantly smaller gape (1.3±0.23 cm; P<0.001 and gape angle (12.9±2.02°, pursing of the rostral lips to form a circular aperture, and pursing of the lateral lips to occlude lateral gape. Biting was characterized by a large gape (3.63±0.21 cm and gape angle (28.8±1.80°; P<0.001 and lip curling to expose teeth. The maximum subambient pressure recorded was 48.8 kPa. In addition, harbor seals were able to jet water at food items using suprambient pressure, also known as hydraulic jetting. The maximum hydraulic jetting force recorded was 53.9 kPa. Suction and hydraulic jetting where employed 90.5% and 9.5%, respectively, during underwater feeding events. Harbor seals displayed a wide repertoire of behaviorally flexible feeding strategies to ingest fish from the feeding apparatus. Such flexibility of feeding strategies and biomechanics likely forms the basis of their

Frequency and predictors of stroke after acute myocardial infarction: specific aspects of in-hospital and postdischarge events.

Science.gov (United States)

Hachet, Olivier; Guenancia, Charles; Stamboul, Karim; Daubail, Benoit; Richard, Carole; Béjot, Yannick; Yameogo, Valentin; Gudjoncik, Aurélie; Cottin, Yves; Giroud, Maurice; Lorgis, Luc

2014-12-01

Stroke is a serious complication after acute myocardial infarction (AMI) and is closely associated with decreased survival. This study aimed to investigate the frequency, characteristics, and factors associated with in-hospital and postdischarge stroke in patients with AMI. Eight thousand four hundred eighty-five consecutive patients admitted to a cardiology intensive care unit for AMI, between January 2001 and July 2010. Stroke/transient ischemic attack were collected during 1-year follow-up. One hundred twenty-three in-hospital strokes were recorded: 65 (52.8%) occurred on the first day after admission for AMI, and 108 (87%) within the first 5 days. One hundred six patients (86.2%-incidence rate 1.25%) experienced in-hospital ischemic stroke, and 14 patients (11.4%-incidence rate 0.16%) were diagnosed with an in-hospital hemorrhagic stroke. In-hospital ischemic stroke subtypes according to the Trial of Org 10 172 in Acute Stroke Treatment (TOAST) classification showed that only 2 types of stroke were identified more frequently. As expected, the leading subtype of in-hospital ischemic stroke was cardioembolic stroke (n=64, 60%), the second was stroke of undetermined pathogenesis (n=38, 36%). After multivariable backward regression analysis, female sex, previous transient ischemic attack (TIA)/stroke, new-onset atrial fibrillation, left ventricular ejection fraction (odds ratio per point of left ventricular ejection fraction), and C-reactive protein were independently associated with in-hospital ischemic stroke. When antiplatelet and anticoagulation therapy within the first 48 hours was introduced into the multivariable model, we found that implementing these treatments (≥1) was an independent protective factor of in-hospital stroke. In-hospital hemorrhagic stroke was dramatically increased (5-fold) when thrombolysis was prescribed as the reperfusion treatment. However, the different parenteral anticoagulants were not predictors of risk in univariable analysis

Bio-inspired Miniature Suction Cups Actuated by Shape Memory Alloy

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Hu Bing-shan

2010-02-01

Full Text Available Wall climbing robots using negative pressure suction always employ air pumps which have great noise and large volume. Two prototypes of bio-inspired miniature suction cup actuated by shape memory alloy (SMA are designed based on studying characteristics of biologic suction apparatuses, and the suction cups in this paper can be used as adhesion mechanisms for miniature wall climbing robots without air pumps. The first prototype with a two-way shape memory effect (TWSME extension TiNi spring imitates the piston structure of the stalked sucker; the second one actuated by a one way SMA actuator with a bias has a basic structure of stiff margin, guiding element, leader and elastic element. Analytical model of the second prototype is founded considering the constitutive model of the SMA actuator, the deflection of the thin elastic plate under compound load and the thermo-dynamic model of the sealed air cavity. Experiments are done to test their suction characteristics, and the analytical model of the second prototype is simulated on Matlab/simulink platform and validated by experiments.

Bio-inspired Miniature Suction Cups Actuated by Shape Memory Alloy

Directory of Open Access Journals (Sweden)

Hu Bing-Shan

2009-09-01

Full Text Available Wall climbing robots using negative pressure suction always employ air pumps which have great noise and large volume. Two prototypes of bio-inspired miniature suction cup actuated by shape memory alloy (SMA are designed based on studying characteristics of biologic suction apparatuses, and the suction cups in this paper can be used as adhesion mechanisms for miniature wall climbing robots without air pumps. The first prototype with a two-way shape memory effect (TWSME extension TiNi spring imitates the piston structure of the stalked sucker; the second one actuated by a one way SMA actuator with a bias has a basic structure of stiff margin, guiding element, leader and elastic element. Analytical model of the second prototype is founded considering the constitutive model of the SMA actuator, the deflection of the thin elastic plate under compound load and the thermo-dynamic model of the sealed air cavity. Experiments are done to test their suction characteristics, and the analytical model of the second prototype is simulated on Matlab/simulink platform and validated by experiments.

Bowel Movement Frequency, Laxative Use, and Mortality From Coronary Heart Disease and Stroke Among Japanese Men and Women: The Japan Collaborative Cohort (JACC Study

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Yasuhiko Kubota

2016-05-01

Full Text Available Background: The associations of bowel movement frequency and laxative use with cardiovascular disease (CVD are unclear. Methods: A total of 72 014 subjects (29 668 men and 42 346 women aged 40 to 79 years, without a history of CVD or cancer, completed a lifestyle questionnaire at baseline between 1988 and 1990 that included information on bowel movement frequency (daily, every 2–3 days, or once every 4 or more days and laxative use (yes or no, and were followed-up until 2009. Results: During the subjects’ 1 165 569 person-years of follow-up, we documented 977 deaths from coronary heart disease (561 men and 416 women, 2024 from total stroke (1028 men and 996 women, 1127 from ischemic stroke (606 men and 521 women, and 828 from hemorrhagic stroke (388 men and 440 women. The prevalence of CVD risk factors, such as diabetes, stress, depression, and physical inactivity, was higher in laxative users and in those with a lower frequency of bowel movements. The multivariable HRs (95% confidence intervals [CIs] of laxative users were as follows: 1.56 (95% CI, 1.21–2.03 for coronary heart disease and 1.37 (95% CI, 1.07–1.76 for ischemic stroke in men, and 1.27 (95% CI, 1.08–1.49 for total stroke, and 1.45 (95% CI, 1.17–1.79 for ischemic stroke in women. Similar results were observed even after the exclusion of deaths that occurred early in the follow-up period. A significant association between bowel movement frequency and mortality from CVD was not observed. Conclusions: Constipation could be a marker of exposure to CVD risk factors, and laxative use could be a risk factor for mortality from coronary heart disease and ischemic stroke.

Installation process of suction anchors in Gulf of Guinea clay : Centrifuge modelling

OpenAIRE

THOREL, Luc; GARNIER, Jacques; RAULT, Gérard; DENDANI, Hédi; COLLIAT, JL

2010-01-01

The preparation process of a deepwater Gulf of Guinea clay for modelling of 24 m long suction anchors at a scale of 1/100 in the LCPC centrifuge, the clay characteristics and the installation phase (self-weight and suction) are presented. Two types of caissons have been tested in each tub : one with stiffeners and the other without stiffener. The embedment ratio is close to the suction caisson's slenderness of 3. An analysis of the forces of suction and soil friction shows, as expected, hi...

Vortical and acoustical mode coupling inside a porous tube with uniform wall suction.

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Jankowskia, T A; Majdalani, J

2005-06-01

This paper considers the oscillatory motion of gases inside a long porous tube of the closed-open type. In particular, the focus is placed on describing an analytical solution for the internal acoustico-vortical coupling that arises in the presence of appreciable wall suction. This unsteady field is driven by longitudinal oscillatory waves that are triggered by small unavoidable fluctuations in the wall suction speed. Under the assumption of small amplitude oscillations, the time-dependent governing equations are linearized through a regular perturbation of the dependent variables. Further application of the Helmholtz vector decomposition theorem enables us to discriminate between acoustical and vortical equations. After solving the wave equation for the acoustical contribution, the boundary-driven vortical field is considered. The method of matched-asymptotic expansions is then used to obtain a closed-form solution for the unsteady momentum equation developing from flow decomposition. An exact series expansion is also derived and shown to coincide with the numerical solution for the problem. The numerically verified end results suggest that the asymptotic scheme is capable of providing a sufficiently accurate solution. This is due to the error associated with the matched-asymptotic expansion being smaller than the error introduced in the Navier-Stokes linearization. A basis for comparison is established by examining the evolution of the oscillatory field in both space and time. The corresponding boundary-layer behavior is also characterized over a range of oscillation frequencies and wall suction velocities. In general, the current solution is found to exhibit features that are consistent with the laminar theory of periodic flows. By comparison to the Sexl profile in nonporous tubes, the critically damped solution obtained here exhibits a slightly smaller overshoot and depth of penetration. These features may be attributed to the suction effect that tends to

Ethnic differences in ischemic stroke subtypes in young-onset stroke: the Stroke Prevention in Young Adults Study.

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Trivedi, Megh M; Ryan, Kathleen A; Cole, John W

2015-10-29

Prior studies indicate that young African-Americans (AA) have a greater frequency of ischemic stroke than similarly aged European-Americans (EA). We hypothesized that differences in stroke subtype frequency mediated through sex and differing risk factor profiles may play a role in ethnicity-specific stroke. Utilizing our biracial young-onset stroke population, we explored these relationships. Fifty nine hospitals in the Baltimore-Washington area participated in a population-based study of young-onset stroke in men (218-AA, 291-EA) and women (219-AA, 222-EA) aged 16-49. Data on age, sex, ethnicity and stroke risk factors (hypertension (HTN) and smoking) were gathered through standardized interview. A pair of vascular neurologists adjudicated each case to determine TOAST subtype. Logistic regression analyses evaluating for differences in stroke risk factors by TOAST subtype were performed. Analyses controlling for age and sex demonstrated that AA were more likely to have a lacunar stroke than EA (OR = 1.61; 95% CI = 1.12-2.32; p = 0.011) when utilizing the other TOAST subtypes as the reference group. This effect was mediated by HTN, which increases the risk of lacunar stroke (OR = 2.03; 95% CI = 1.38-2.98; p = 0.0003) and large artery stroke (OR = 1.70; 95% CI = 1.01-2.88; p = 0.048) when controlling for sex, ethnicity, and age. Cases below age 40 were more likely to have a cardioembolic stroke than those above age 40 (OR = 1.62; 95% CI = 1.15-2.27; p = 0.006), controlling for sex and ethnicity. Lastly, current smokers were more likely to have a large artery stroke than non-smokers (OR = 1.79; 95% CI = 1.08-2.98; p = 0.024). Our population-based data demonstrate ethnic differences in ischemic stroke subtypes. These findings may help clarify mechanisms of stroke in young adults which may in part be driven by ethnic-specific differences in early-onset traditional risk factors, thereby indicating differing emphasis on workup and prevention.

A discussion of the several types of two-stroke-cycle engines

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Venediger, Herbert J

1935-01-01

This report discusses different types of two-stroke engines as well as the three most important design factors: volume of scavenge and charge delivery, scavenging process (scavenging result), and result of charge. Some of the types of engines discussed include: single cylinder with crank-chamber scavenge pump and auxiliary suction piston linked to working connecting rod; and two cylinder engines with a rotary scavenge pump arrangement. Three and four cylinder engines are also discussed in various designs.

Effects of shallow and deep endotracheal tube suctioning on cardiovascular indices in patients in intensive care units.

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Irajpour, Alireza; Abbasinia, Mohammad; Hoseini, Abbas; Kashefi, Parviz

2014-07-01

Clearing the endotracheal tube through suctioning should be done to promote oxygenation. Depth of suctioning is one of the variables in this regard. In shallow suctioning method, the catheter passes to the tip of the endotracheal tube, and in deep suctioning method, it passes beyond the tip into the trachea or brunches. This study aimed to evaluate the effect of shallow and deep suctioning methods on cardiovascular indices in patients hospitalized in the intensive care units (ICUs). In this clinical trial, 74 patients were selected among those who had undergone mechanical ventilation in the ICU of Al-Zahra Hospital, Isfahan, Iran using convenience sampling method. The subjects were randomly allocated to shallow and deep suctioning groups. Heart rate (HR) and blood pressure (BP) were measured immediately before and 1, 2, and 3 min after each suctioning. Number of times of suctioning was also noted in both the groups. Data were analyzed using repeated measures analysis of variance (ANOVA), Chi-square and independent t-tests. HR and BP were significantly increased after suctioning in both the groups (P 0.05). The suctioning count was significantly higher in the shallow suctioning group than in the deep suctioning group. Shallow and deep suctioning were similar in their effects on HR and BP, but shallow suctioning caused further manipulation of patient's trachea than deep suctioning method. Therefore, in order to prevent complications, nurses are recommended to perform the endotracheal tube suctioning by the deep method.

Spinal cord electrophysiology II: extracellular suction electrode fabrication.

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Garudadri, Suresh; Gallarda, Benjamin; Pfaff, Samuel; Alaynick, William

2011-02-20

Development of neural circuitries and locomotion can be studied using neonatal rodent spinal cord central pattern generator (CPG) behavior. We demonstrate a method to fabricate suction electrodes that are used to examine CPG activity, or fictive locomotion, in dissected rodent spinal cords. The rodent spinal cords are placed in artificial cerebrospinal fluid and the ventral roots are drawn into the suction electrode. The electrode is constructed by modifying a commercially available suction electrode. A heavier silver wire is used instead of the standard wire given by the commercially available electrode. The glass tip on the commercial electrode is replaced with a plastic tip for increased durability. We prepare hand drawn electrodes and electrodes made from specific sizes of tubing, allowing consistency and reproducibility. Data is collected using an amplifier and neurogram acquisition software. Recordings are performed on an air table within a Faraday cage to prevent mechanical and electrical interference, respectively.

Water born pollutants sampling using porous suction samples

International Nuclear Information System (INIS)

Baig, M.A.

1997-01-01

The common standard method of sampling water born pollutants in the vadoze zone is core sampling and it is followed by extraction of pore fluid. This method does not allow sampling at the same location next time and again later on. There is an alternative approach for sampling fluids (water born pollutants) from both saturated and unsaturated regions of vadose zone using porous suction samplers. There are three types of porous suction samplers, vacuum-operated, pressure-vacuum lysimeters, high pressure vacuum samples. The suction samples are operated in the range of 0-70 centi bars and usually consist of ceramic and polytetrafluorethylene (PTFE). The operation range of PTFE is higher than ceramic cups. These samplers are well suited for in situ and repeated sampling form the same location. This paper discusses the physical properties and operating condition of such samplers to the utilized under our environmental sampling. (author)

Effect of suction on the mechanical characteristics of uniformly compacted rammed earth

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El Hajjar, A.; Chauhan, P.; Prime, N.; Plé, O.

2018-04-01

Rammed earth, in the current environmental situation, is an alternative construction technique which can help in reducing energy and raw material consumption owing to its “sustainable” characteristics. To fully understand its behavior and properties, recent scientific investigations consider it as a compacted unsaturated material with suction as its one of the main sources of strength. Eathern constructions face, over their lifetime, variations in the suction state which have a significant impact on their mechanical characteristics. In the present contribution, unconfined compression tests are performed, with and without unload-reload cycles, on homogeneously compacted samples subjected to various suction conditions. This study shows that both the unconfined compressive strength and Young modulus reduce with the reduction of suction states. Suction also seems to influence the amount of plastic strains and damage phenomenon. Indeed, the soils analyzed are slightly active and shows both plasticity behavior and damage phenomenon.

Deep versus shallow suction of endotracheal tubes in ventilated neonates and young infants.

Science.gov (United States)

Gillies, Donna; Spence, Kaye

2011-07-06

Mechanical ventilation is commonly used in Neonatal Intensive Care Units to assist breathing in a variety of conditions. Mechanical ventilation is achieved through the placement of an endotracheal tube (ETT) which is left in-situ. The ETT is suctioned to prevent a build-up of secretions and blockage of the airway. Methods of suctioning the endotracheal tube vary according to institutional practice and the individual clinician performing the task. The depth of suctioning is one of these variables. The catheter may be passed to the tip of the ETT or beyond the tip into the trachea or bronchi to facilitate removal of secretions. However, trauma to the lower airways may result from the suction catheter being passed into the airway beyond the tip of the endotracheal tube. To compare the effectiveness and complications of deep (catheter passed beyond the tip of the ETT) versus shallow (catheter passed to length of ETT only) suctioning of the endotracheal tube in ventilated infants. In this first update the searches were expanded to the Cochrane Central Register of Controlled Trials (The Cochrane Library, March 30), MEDLINE (from January 1966 to May 30 2011), CINAHL (from 1982 to May 30 2011) and EMBASE (1980 to May 2011) using text words and subject headings relevant to endotracheal suctioning. There were no language restrictions. Controlled trials using random or quasi-random allocation of neonates receiving ventilatory support via an endotracheal tube to either deep or shallow endotracheal suctioning. The updated search resulted in 149 potentially relevant references. Two of the studies from this search were identified as potentially relevant. We included one of the potentially relevant studies and the other was excluded because it did not fit the inclusion criteria. One small crossover trial (n = 27) of shallow versus deep suctioning met the criteria for inclusion in this review. The reported outcomes were oxygen saturation and heart rate, during and after suctioning

Numerical Buckling Analysis of Large Suction Caissons for Wind Turbines on Deep Water

DEFF Research Database (Denmark)

Madsen, Søren; Andersen, Lars Vabbersgaard; Ibsen, Lars Bo

2013-01-01

Using large suction caissons for offshore wind turbines is an upcoming cost-effective technology also referred to as bucket foundations. During operation, the monopod bucket foundation is loaded by a large overturning moment from the wind turbine and the wave loads. However, during installation...... the suction caisson is loaded by external pressure (internal suction) due to evacuation of water inside the bucket and vertical forces due to gravity. The risk of structural buckling during installation of large-diameter suction caissons is addressed using numerical methods. Initial imperfect geometries...

Comparison of frequency difference reconstruction algorithms for the detection of acute stroke using EIT in a realistic head-shaped tank

International Nuclear Information System (INIS)

Packham, B; Koo, H; Romsauerova, A; Holder, D S; Ahn, S; Jun, S C; McEwan, A

2012-01-01

Imaging of acute stroke might be possible using multi-frequency electrical impedance tomography (MFEIT) but requires absolute or frequency difference imaging. Simple linear frequency difference reconstruction has been shown to be ineffective in imaging with a frequency-dependant background conductivity; this has been overcome with a weighted frequency difference approach with correction for the background but this has only been validated for a cylindrical and hemispherical tank. The feasibility of MFEIT for imaging of acute stroke in a realistic head geometry was examined by imaging a potato perturbation against a saline background and a carrot-saline frequency-dependant background conductivity, in a head-shaped tank with the UCLH Mk2.5 MFEIT system. Reconstruction was performed with time difference (TD), frequency difference (FD), FD adjacent (FDA), weighted FD (WFD) and weighted FDA (WFDA) linear algorithms. The perturbation in reconstructed images corresponded to the true position to <9.5% of image diameter with an image SNR of >5.4 for all algorithms in saline but only for TD, WFDA and WFD in the carrot-saline background. No reliable imaging was possible with FD and FDA. This indicates that the WFD approach is also effective for a realistic head geometry and supports its use for human imaging in the future. (paper)

Vortex lift augmentation by suction on a 60 deg swept Gothic wing

Science.gov (United States)

Taylor, A. H.; Jackson, L. R.; Huffman, J. K.

1982-01-01

An experimental investigation was conducted in the Langley high-speed 7- by 10-foot wind tunnel to determine the aerodynamic performance of suction applied near the wing tips above the trailing edge of a 60 deg swept Gothic wing. Moveable suction inlets were symmetrically mounted in the proximity of the trailing edge, and the amount of suction was varied to maximize wing lift. Tests were conducted at Mach 0.15, 0.30, and 0.45, and the angle of attack was varied from -4 to 50 deg. The suction augmentation increases the lift coefficient over the entire range of angle of attack. The lift improvement exceeds the unaugmented wing lift by over 20%. Moreover, the augmented lift exceeds the lift predicted by vortex lattice theory to 30 deg angle of attack. Suction augmentation is postulated to strengthen the vortex system by increasing its velocity and making it more concentrated. This causes the vortex breakdown to be delayed to a higher angle of attack

Evaluation of Karl Storz CMAC TipTM Device Versus Traditional Airway Suction in a Cadaver Model

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Demis N. Lipe

2014-07-01

Full Text Available Introduction: We compared the efficacy of Karl Storz CMAC TipTM with inline suction to CMAC with traditional suction device in cadaveric models simulating difficult airways, using media mimicking pulmonary edema and vomit. Methods: This was a prospective, cohort study in which we invited emergency medicine faculty and residents to participate. Each participant intubated 2 cadavers (one with simulated pulmonary edema and one with simulated vomit, using CMAC with inline suction and CMAC with traditional suction. Thirty emergency medicine providers performed 4 total intubations each in a crossover trial comparing the CMAC with inline suction and CMAC with traditional suction. Two intubations were performed with simulated vomit and two with simulated pulmonary edema. The primary outcome was time to successful intubation; and the secondary outcome was proportion of successful intubation. Results: The median time to successful intubation using the CMAC with inline suction versus traditional suction in the pulmonary edema group was 29s and 30s respectively (p=0.54. In the vomit simulation, the median time to successful intubation was 40s using the CMAC with inline suction and 41s using the CMAC with traditional suction (p=0.70. There were no significant differences in time to successful intubation between the 2 devices. Similarly, the proportions of successful intubation were also not statistically significant between the 2 devices. The proportions of successful intubations using the inline suction were 96.7% and 73.3%, for the pulmonary edema and vomit groups, respectively. Additionally using the handheld suction device, the proportions for the pulmonary edema and vomit group were 100% and 66.7%, respectively. Conclusion: CMAC with inline suction was no different than CMAC with traditional suction and was associated with no statistically significant differences in median time to intubation or proportion of successful intubations. [West J Emerg Med

Factor V leiden and ischemic stroke risk: the Genetics of Early Onset Stroke (GEOS) study.

Science.gov (United States)

Hamedani, Ali G; Cole, John W; Cheng, Yuching; Sparks, Mary J; O'Connell, Jeffrey R; Stine, Oscar C; Wozniak, Marcella A; Stern, Barney J; Mitchell, Braxton D; Kittner, Steven J

2013-05-01

Factor V Leiden (FVL) has been associated with ischemic stroke in children but not in adults. Although the FVL mutation is associated with increased risk for venous thrombosis, its association with ischemic stroke in young adults remains uncertain. Therefore, we examined the association between FVL and ischemic stroke in participants of the Genetics of Early Onset Stroke (GEOS) study. A population-based case control study identified 354 women and 476 men 15 to 49 years of age with first-ever ischemic stroke and 907 controls. Participant-specific data included vascular risk factors, FVL genotype and, for cases, the ischemic stroke subtype by modified Trial of ORG 10172 in Acute Stroke criteria. Logistic regression was used to calculate odds ratios for the entire population and for subgroups stratified by risk factors and ischemic stroke subtype. The frequency of the FVL mutation was similar between ischemic stroke patients (3.6%; 95% confidence interval [CI] 2.5%-5.1%) and nonstroke controls (3.8%; 95% CI 2.7%-5.2%). This frequency did not change significantly when cases were restricted to patients with stroke of undetermined etiology (4.1%; 95% CI 2.6%-6.4%). Among young adults, we found no evidence for an association between FVL and either all ischemic stroke or the subgroup with stroke of undetermined etiology. Published by Elsevier Inc.

Absence of suction feeding ichthyosaurs and its implications for triassic mesopelagic paleoecology.

Science.gov (United States)

Motani, Ryosuke; Ji, Cheng; Tomita, Taketeru; Kelley, Neil; Maxwell, Erin; Jiang, Da-yong; Sander, Paul Martin

2013-01-01

Mesozoic marine reptiles and modern marine mammals are often considered ecological analogs, but the extent of their similarity is largely unknown. Particularly important is the presence/absence of deep-diving suction feeders among Mesozoic marine reptiles because this would indicate the establishment of mesopelagic cephalopod and fish communities in the Mesozoic. A recent study suggested that diverse suction feeders, resembling the extant beaked whales, evolved among ichthyosaurs in the Triassic. However, this hypothesis has not been tested quantitatively. We examined four osteological features of jawed vertebrates that are closely linked to the mechanism of suction feeding, namely hyoid corpus ossification/calcification, hyobranchial apparatus robustness, mandibular bluntness, and mandibular pressure concentration index. Measurements were taken from 18 species of Triassic and Early Jurassic ichthyosaurs, including the presumed suction feeders. Statistical comparisons with extant sharks and marine mammals of known diets suggest that ichthyosaurian hyobranchial bones are significantly more slender than in suction-feeding sharks or cetaceans but similar to those of ram-feeding sharks. Most importantly, an ossified hyoid corpus to which hyoid retractor muscles attach is unknown in all but one ichthyosaur, whereas a strong integration of the ossified corpus and cornua of the hyobranchial apparatus has been identified in the literature as an important feature of suction feeders. Also, ichthyosaurian mandibles do not narrow rapidly to allow high suction pressure concentration within the oral cavity, unlike in beaked whales or sperm whales. In conclusion, it is most likely that Triassic and Early Jurassic ichthyosaurs were 'ram-feeders', without any beaked-whale-like suction feeder among them. When combined with the inferred inability for dim-light vision in relevant Triassic ichthyosaurs, the fossil record of ichthyosaurs does not suggest the establishment of modern

Morphology, Kinematics, and Dynamics: The Mechanics of Suction Feeding in Fishes.

Science.gov (United States)

Day, Steven W; Higham, Timothy E; Holzman, Roi; Van Wassenbergh, Sam

2015-07-01

Suction feeding is pervasive among aquatic vertebrates, and our understanding of the functional morphology and biomechanics of suction feeding has recently been advanced by combining experimental and modeling approaches. Key advances include the visualization of the patterns of flow in front of the mouth of a feeding fish, the measurement of pressure inside their mouth cavity, and the employment of analytical and computational models. Here, we review the key components of the morphology and kinematics of the suction-feeding system of anatomically generalized, adult ray-finned fishes, followed by an overview of the hydrodynamics involved. In the suction-feeding apparatus, a strong mechanistic link among morphology, kinematics, and the capture of prey is manifested through the hydrodynamic interactions between the suction flows and solid surfaces (the mouth cavity and the prey). It is therefore a powerful experimental system in which the ecology and evolution of the capture of prey can be studied based on first principals. © The Author 2015. Published by Oxford University Press on behalf of the Society for Integrative and Comparative Biology. All rights reserved. For permissions please email: journals.permissions@oup.com.

Impedance of flexible suction caissons

DEFF Research Database (Denmark)

Liingaard, Morten; Andersen, Lars; Ibsen, Lars Bo

2007-01-01

The dynamic response of offshore wind turbines is affected by the properties of the foundation and the subsoil. The aim of this paper is to evaluate the dynamic soil-structure interaction of suction caissons for offshore wind turbines. The investigations include evaluation of the vertical and cou...

Power frequency spectrum analysis of surface EMG signals of upper limb muscles during elbow flexion - A comparison between healthy subjects and stroke survivors.

Science.gov (United States)

Angelova, Silvija; Ribagin, Simeon; Raikova, Rositsa; Veneva, Ivanka

2018-02-01

After a stroke, motor units stop working properly and large, fast-twitch units are more frequently affected. Their impaired functions can be investigated during dynamic tasks using electromyographic (EMG) signal analysis. The aim of this paper is to investigate changes in the parameters of the power/frequency function during elbow flexion between affected, non-affected, and healthy muscles. Fifteen healthy subjects and ten stroke survivors participated in the experiments. Electromyographic data from 6 muscles of the upper limbs during elbow flexion were filtered and normalized to the amplitudes of EMG signals during maximal isometric tasks. The moments when motion started and when the flexion angle reached its maximal value were found. Equal intervals of 0.3407 s were defined between these two moments and one additional interval before the start of the flexion (first one) was supplemented. For each of these intervals the power/frequency function of EMG signals was calculated. The mean (MNF) and median frequencies (MDF), the maximal power (MPw) and the area under the power function (APw) were calculated. MNF was always higher than MDF. A significant decrease in these frequencies was found in only three post-stroke survivors. The frequencies in the first time interval were nearly always the highest among all intervals. The maximal power was nearly zero during first time interval and increased during the next ones. The largest values of MPw and APw were found for the flexor muscles and they increased for the muscles of the affected arm compared to the non-affected one of stroke survivors. Copyright © 2017 Elsevier Ltd. All rights reserved.

Turbulent flow with suction in smooth and rough pipes

International Nuclear Information System (INIS)

Verdier, Andre.

1977-11-01

It concerns an experimental study of turbulent flow inside a pipe with rough and porous wall and suction applied through it. The first part recall the basic knowledge concerning the turbulent flow with roughness. In second part statistical equations of fluid wall stress are written in the case of a permeable rough wall, in order to underline the respective role played by viscosity and pressure terms. In the third part the dynamic equilibrium of the flow is experimentally undertaken in the smooth and rough range with and without wall suction. Some empirical formulae are proposed for the mean velocity profiles in the inertial range and for friction velocity with suction. In the case of the sand roughness used, it does not seem that critical Reynolds number of transition from smooth to rough range is varied [fr

A compliant underactuated hand with suction flow for underwater mobile manipulation

KAUST Repository

Stuart, Hannah S.

2014-05-01

© 2014 IEEE. Fingertip suction is investigated using a compliant, underactuated, tendon-driven hand designed for underwater mobile manipulation. Tendon routing and joint stiffnesses are designed to provide ease of closure while maintaining finger rigidity, allowing the hand to pinch small objects, as well as secure large objects, without diminishing strength. While the hand is designed to grasp a range of objects, the addition of light suction flow to the fingertips is especially effective for small, low-friction (slippery) objects. Numerical simulations confirm that changing suction parameters can increase the object acquisition region, providing guidelines for future versions of the hand.

A compliant underactuated hand with suction flow for underwater mobile manipulation

KAUST Repository

Stuart, Hannah S.; Wang, Shiquan; Gardineer, Bayard; Christensen, David L.; Aukes, Daniel M.; Cutkosky, Mark

2014-01-01

© 2014 IEEE. Fingertip suction is investigated using a compliant, underactuated, tendon-driven hand designed for underwater mobile manipulation. Tendon routing and joint stiffnesses are designed to provide ease of closure while maintaining finger rigidity, allowing the hand to pinch small objects, as well as secure large objects, without diminishing strength. While the hand is designed to grasp a range of objects, the addition of light suction flow to the fingertips is especially effective for small, low-friction (slippery) objects. Numerical simulations confirm that changing suction parameters can increase the object acquisition region, providing guidelines for future versions of the hand.

A multi-center study on low-frequency rTMS combined with intensive occupational therapy for upper limb hemiparesis in post-stroke patients

Directory of Open Access Journals (Sweden)

Kakuda Wataru

2012-01-01

Full Text Available Abstract Background Both low-frequency repetitive transcranial magnetic stimulation (rTMS and intensive occupational therapy (OT have been recently reported to be clinically beneficial for post-stroke patients with upper limb hemiparesis. Based on these reports, we developed an inpatient combination protocol of these two modalities for the treatment of such patients. The aims of this pilot study were to confirm the safety and feasibility of the protocol in a large number of patients from different institutions, and identify predictors of the clinical response to the treatment. Methods The study subjects were 204 post-stroke patients with upper limb hemiparesis (mean age at admission 58.5 ± 13.4 years, mean time after stroke 5.0 ± 4.5 years, ± SD from five institutions in Japan. During 15-day hospitalization, each patient received 22 treatment sessions of 20-min low-frequency rTMS and 120-min intensive OT daily. Low-frequency rTMS of 1 Hz was applied to the contralesional hemisphere over the primary motor area. The intensive OT, consisting of 60-min one-to-one training and 60-min self-exercise, was provided after the application of low-frequency rTMS. Fugl-Meyer Assessment (FMA and Wolf Motor Function Test (WMFT were performed serially. The physiatrists and occupational therapists involved in this study received training prior to the study to standardize the therapeutic protocol. Results All patients completed the protocol without any adverse effects. The FMA score increased and WMFT log performance time decreased significantly at discharge, relative to the respective values at admission (change in FMA score: median at admission, 47 points; median at discharge, 51 points; p Conclusions The 15-day inpatient rTMS plus OT protocol is a safe, feasible, and clinically useful neurorehabilitative intervention for post-stroke patients with upper limb hemiparesis. The response to the treatment was not influenced by age or time after stroke onset. The

Absence of suction feeding ichthyosaurs and its implications for triassic mesopelagic paleoecology.

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Ryosuke Motani

Full Text Available Mesozoic marine reptiles and modern marine mammals are often considered ecological analogs, but the extent of their similarity is largely unknown. Particularly important is the presence/absence of deep-diving suction feeders among Mesozoic marine reptiles because this would indicate the establishment of mesopelagic cephalopod and fish communities in the Mesozoic. A recent study suggested that diverse suction feeders, resembling the extant beaked whales, evolved among ichthyosaurs in the Triassic. However, this hypothesis has not been tested quantitatively. We examined four osteological features of jawed vertebrates that are closely linked to the mechanism of suction feeding, namely hyoid corpus ossification/calcification, hyobranchial apparatus robustness, mandibular bluntness, and mandibular pressure concentration index. Measurements were taken from 18 species of Triassic and Early Jurassic ichthyosaurs, including the presumed suction feeders. Statistical comparisons with extant sharks and marine mammals of known diets suggest that ichthyosaurian hyobranchial bones are significantly more slender than in suction-feeding sharks or cetaceans but similar to those of ram-feeding sharks. Most importantly, an ossified hyoid corpus to which hyoid retractor muscles attach is unknown in all but one ichthyosaur, whereas a strong integration of the ossified corpus and cornua of the hyobranchial apparatus has been identified in the literature as an important feature of suction feeders. Also, ichthyosaurian mandibles do not narrow rapidly to allow high suction pressure concentration within the oral cavity, unlike in beaked whales or sperm whales. In conclusion, it is most likely that Triassic and Early Jurassic ichthyosaurs were 'ram-feeders', without any beaked-whale-like suction feeder among them. When combined with the inferred inability for dim-light vision in relevant Triassic ichthyosaurs, the fossil record of ichthyosaurs does not suggest the

A Technique for Controlling Matric Suction on Filter Papers . GroWth ...

African Journals Online (AJOL)

'Abstract. Moist filter papers are widely usedfor seed gennination tests but their water confent and matric suction are not usually controlled. A technique for controlling filter paper matric suction is described and usedfor germination studies involving fresh and aged sorghum seed (Sorghummcolor (L) Moench). Filter papers ...

Investigation on compression behaviour of highly compacted GMZ01 bentonite with suction and temperature control

International Nuclear Information System (INIS)

Ye, W.M.; Zhang, Y.W.; Chen, B.; Zheng, Z.J.; Chen, Y.G.; Cui, Y.J.

2012-01-01

Highlights: ► Heating induced volumetric change of GMZ01 bentonite depends on suction. ► Suction has significant influence on compressibility. ► Temperature has slight influence on compressibility. - Abstract: In this paper, an oedometer with suction and temperature control was developed. Mechanical compaction tests have been performed on the highly compacted GMZ01 bentonite, which has been recognized as potential buffer/backfill material for construction of Chinese high-level radioactive waste (HLW) geological repository, under conditions of suction ranging from 0 to 110 MPa, temperature from 20 to 80 °C and vertical pressure from 0.1 to 80 MPa. Based on the test results, suction and temperature effects on compressibility parameters are investigated. Results reveal that: (1) at high suctions, heating induced an expansion, while contraction is induced by heating at low suctions. The thermal expansion coefficient of GMZ01 bentonite measured is 1 × 10 −4 °C −1 ; (2) with increasing suction, the elastic compressibility κ and the plastic compressibility λ(s) of the highly compacted GMZ01 bentonite decrease, while the pre-consolidation pressure increases markedly; (3) with increasing temperature, the elastic compressibility of compacted GMZ01 bentonite changes insignificantly, while the plastic compressibility λ(s) slightly decreases and the yield surface tends to shrink.

Effects of cervical low-frequency electrical stimulation with various waveforms and densities on body mass, liver and kidney function, and death rate in ischemic stroke rats

Institute of Scientific and Technical Information of China (English)

Yonghong Yang; Chengqi He; Lin Yang; Qiang Gao; Shasha Li; Jing He

2011-01-01

Low-frequency electrical stimulation has resulted in favorable effects in the treatment of post-stroke dysphagia. However, the safety of cervical low-frequency electrical stimulation remains unclear because of numerous nerves and blood vessels in the neck. In the present study, rats with ischemic stroke underwent low-frequency electrical stimulation, and systemic and local effects of electrical stimulation at different densities and waveforms were investigated. Electrical stimulation resulted in no significant effects on body mass, liver or kidney function, or mortality rate. In addition, no significant adverse reaction was observed, despite overly high intensity of low-frequency electrical stimulation, which induced laryngismus, results from the present study suggested that it is safe to stimulate the neck with a low-frequency electricity under certain intensities.

A Technique for Controlling Matric Suction on Filter Papers Used in ...

African Journals Online (AJOL)

Moist filter papers are widely usedfor seed gennination tests but their water confent and matric suction are not usually controlled. A technique for controlling filter paper matric suction is described and usedfor germination studies involving fresh and aged sorghum seed (Sorghummcolor (L) Moench). Filter papers wetted to ...

21 CFR 870.4270 - Cardiopulmonary bypass cardiotomy suction line blood filter.

Science.gov (United States)

2010-04-01

... blood filter. 870.4270 Section 870.4270 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF... Devices § 870.4270 Cardiopulmonary bypass cardiotomy suction line blood filter. (a) Identification. A cardiopulmonary bypass cardiotomy suction line blood filter is a device used as part of a gas exchange (oxygenator...

Functional Stroke Mimics: Incidence and Characteristics at a Primary Stroke Center in the Middle East

Science.gov (United States)

Wilkins, Stacy Schantz; Bourke, Paula; Salam, Abdul; Akhtar, Naveed; D'Souza, Atlantic; Kamran, Saadat; Bhutta, Zain; Shuaib, Ashfaq

2018-01-01

ABSTRACT Objective Approximately 30% of individuals who initially present with stroke are found to be stroke mimics (SM), with functional/psychological SM (FSM) accounting for up to 6.4% of all stroke presentations. Middle Eastern countries may have higher rates of somatization of emotional distress. The aim of this study was to evaluate the incidence and characteristics of FSM at a large general hospital in the Middle East. Methods All patients presenting with an initial diagnosis of stroke from June 2015 to September 2016 were eligible for this study. Clinical and sociodemographic data were obtained from the hospital's stroke database. All SM and strokes were diagnosed by Joint Commission International–certified stroke program neurologists. SM was defined as any discharge diagnosis (other than acute stroke) for symptoms that prompted initial admission for suspected stroke. FSM were compared with medical stroke mimics (MSM) and strokes (ischemic, hemorrhagic, and transient ischemic attacks). Results A total of 1961 patients were identified; 161 FSM (8.2%), 390 MSM (19.9%), and 1410 strokes (71.9%) (985 ischemic strokes, 196 transient ischemic attacks, 229 intracerebral hemorrhages). Admission with FSM was related to patients' nationality, with the highest frequency in Arabic (15.6%) and African (16.8%) patients. FSM patients were younger, more often female, and had fewer cardiovascular risk factors except for smoking compared with the strokes. FSM patients presented with more left-sided weakness and had more magnetic resonance imagings than the stroke and MSM groups. A total of 9.9% of FSM patients received thrombolysis versus only 0.5% of the MSM and 16.4% of ischemic strokes. Conclusions FSM frequencies varied by nationality, with Arab and African nationals being twice as prevalent. Stress, vulnerable status as expats, sociopolitical instability, and exposure to trauma are proposed as potential factors contributing to FSM. PMID:29394187

Reliability and criterion-related validity testing (construct) of the Endotracheal Suction Assessment Tool (ESAT©).

Science.gov (United States)

Davies, Kylie; Bulsara, Max K; Ramelet, Anne-Sylvie; Monterosso, Leanne

2018-05-01

To establish criterion-related construct validity and test-retest reliability for the Endotracheal Suction Assessment Tool© (ESAT©). Endotracheal tube suction performed in children can significantly affect clinical stability. Previously identified clinical indicators for endotracheal tube suction were used as criteria when designing the ESAT©. Content validity was reported previously. The final stages of psychometric testing are presented. Observational testing was used to measure construct validity and determine whether the ESAT© could guide "inexperienced" paediatric intensive care nurses' decision-making regarding endotracheal tube suction. Test-retest reliability of the ESAT© was performed at two time points. The researchers and paediatric intensive care nurse "experts" developed 10 hypothetical clinical scenarios with predetermined endotracheal tube suction outcomes. "Experienced" (n = 12) and "inexperienced" (n = 14) paediatric intensive care nurses were presented with the scenarios and the ESAT© guiding decision-making about whether to perform endotracheal tube suction for each scenario. Outcomes were compared with those predetermined by the "experts" (n = 9). Test-retest reliability of the ESAT© was measured at two consecutive time points (4 weeks apart) with "experienced" and "inexperienced" paediatric intensive care nurses using the same scenarios and tool to guide decision-making. No differences were observed between endotracheal tube suction decisions made by "experts" (n = 9), "inexperienced" (n = 14) and "experienced" (n = 12) nurses confirming the tool's construct validity. No differences were observed between groups for endotracheal tube suction decisions at T1 and T2. Criterion-related construct validity and test-retest reliability of the ESAT© were demonstrated. Further testing is recommended to confirm reliability in the clinical setting with the "inexperienced" nurse to guide decision-making related to endotracheal tube

Analisis Perubahan Nilai Suction Akibat Hujan Terhadap Kestabilan Lereng

OpenAIRE

Martini, Martini

2009-01-01

Infiltration of rainfall into slope will have an effect on to condition of slope hydrology and more specifically to characteristic of slope soils, for example pore water pressure value, level of saturation, weight contents of soil, shear strength of soil. Pore water pressure value at dry soil condition or wet condition called as with pore water pressure value negatife or value suction. This suction value will tend to declines and in the end becomes equal to zero or bigger than 0 ( positive po...

The diagnostic accuracy of multi-frequency bioelectrical impedance analysis in diagnosing dehydration after stroke

Science.gov (United States)

Kafri, Mohannad W.; Myint, Phyo Kyaw; Doherty, Danielle; Wilson, Alexander Hugh; Potter, John F.; Hooper, Lee

2013-01-01

Background Non-invasive methods for detecting water-loss dehydration following acute stroke would be clinically useful. We evaluated the diagnostic accuracy of multi-frequency bioelectrical impedance analysis (MF-BIA) against reference standards serum osmolality and osmolarity. Material/Methods Patients admitted to an acute stroke unit were recruited. Blood samples for electrolytes and osmolality were taken within 20 minutes of MF-BIA. Total body water (TBW%), intracellular (ICW%) and extracellular water (ECW%), as percentages of total body weight, were calculated by MF-BIA equipment and from impedance measures using published equations for older people. These were compared to hydration status (based on serum osmolality and calculated osmolarity). The most promising Receiver Operating Characteristics curves were plotted. Results 27 stroke patients were recruited (mean age 71.3, SD10.7). Only a TBW% cut-off at 46% was consistent with current dehydration (serum osmolality >300 mOsm/kg) and TBW% at 47% impending dehydration (calculated osmolarity ≥295–300 mOsm/L) with sensitivity and specificity both >60%. Even here diagnostic accuracy of MF-BIA was poor, a third of those with dehydration were wrongly classified as hydrated and a third classified as dehydrated were well hydrated. Secondary analyses assessing diagnostic accuracy of TBW% for men and women separately, and using TBW as a percentage of lean body mass showed some promise, but did not provide diagnostically accurate measures across the population. Conclusions MF-BIA appears ineffective at diagnosing water-loss dehydration after stroke and cannot be recommended as a test for dehydration, but separating assessment by sex, and using TBW as a percentage of lean body weight may warrant further investigation. PMID:23839255

Comparative study of the characteristics of some suction devices for gas sampling applications

International Nuclear Information System (INIS)

Donguy, R.; Drouet, J.

1959-06-01

Gas sampling (used to determine the characteristics of dusts or aerosols contained in a gas) needs a suction device. In order to select the right device and the right conditions of use, the characteristics and performances of various suction devices (helicoidal and centrifugal aspirators, air pumps, volumetric pumps) have been experimentally measured: flow rate, head loss, sampling volume and duration, aerosol and dust concentration, gas density, nature of the gas, suction circuit configuration, etc

Investigation on compression behaviour of highly compacted GMZ01 bentonite with suction and temperature control

Energy Technology Data Exchange (ETDEWEB)

Ye, W.M., E-mail: ye_tju@tongji.edu.cn [Key Laboratory of Geotechnical and Underground Engineering of Ministry of Education, Tongji University, Shanghai 200092 (China); United Research Center for Urban Environment and Sustainable Development, The Ministry of Education, Shanghai 200092 (China); Zhang, Y.W.; Chen, B.; Zheng, Z.J.; Chen, Y.G. [Key Laboratory of Geotechnical and Underground Engineering of Ministry of Education, Tongji University, Shanghai 200092 (China); Cui, Y.J. [Key Laboratory of Geotechnical and Underground Engineering of Ministry of Education, Tongji University, Shanghai 200092 (China); Ecole des Ponts ParisTech, UR Navier/CERMES 77455 (France)

2012-11-15

Highlights: Black-Right-Pointing-Pointer Heating induced volumetric change of GMZ01 bentonite depends on suction. Black-Right-Pointing-Pointer Suction has significant influence on compressibility. Black-Right-Pointing-Pointer Temperature has slight influence on compressibility. - Abstract: In this paper, an oedometer with suction and temperature control was developed. Mechanical compaction tests have been performed on the highly compacted GMZ01 bentonite, which has been recognized as potential buffer/backfill material for construction of Chinese high-level radioactive waste (HLW) geological repository, under conditions of suction ranging from 0 to 110 MPa, temperature from 20 to 80 Degree-Sign C and vertical pressure from 0.1 to 80 MPa. Based on the test results, suction and temperature effects on compressibility parameters are investigated. Results reveal that: (1) at high suctions, heating induced an expansion, while contraction is induced by heating at low suctions. The thermal expansion coefficient of GMZ01 bentonite measured is 1 Multiplication-Sign 10{sup -4} Degree-Sign C{sup -1}; (2) with increasing suction, the elastic compressibility {kappa} and the plastic compressibility {lambda}(s) of the highly compacted GMZ01 bentonite decrease, while the pre-consolidation pressure increases markedly; (3) with increasing temperature, the elastic compressibility of compacted GMZ01 bentonite changes insignificantly, while the plastic compressibility {lambda}(s) slightly decreases and the yield surface tends to shrink.

Identification of stroke mimics among clinically diagnosed acute strokes.

Science.gov (United States)

Tuntiyatorn, Lojana; Saksornchai, Pichaya; Tunlayadechanont, Supoch

2013-09-01

Stroke is a clinically syndrome of a sudden onset of neurological deficit in a vascular cause. Stroke mimics is the non-vascular disorders with stroke-like clinical symptoms. It is important to distinguish true stroke from mimics since treatment plan may differ To determine the incidence of the stroke mimics and identify their etiologies. All non-contrast head CT of the patients with clinically diagnosed stroke who immediately received imaging upon arrival at the emergency department of the university hospital were retrospectively reviewed in 12-month period between January 1 and December 31, 2008. Medical records, laboratory results, MRI, and 6-month clinical follow-up records were reviewed for final diagnosis. Seven hundred four patients were included in this study, including 363 (51.5%) men and 341 (48.5%) women with range in age from 24 to 108 years. Amongst those, 417 (59.2%) were ischemic stroke, 80 (11.40%) were hemorrhagic stroke, 186 (26.4%) were stroke-mimics, and 21 (3%) were inconclusive. The etiologies among stroke-mimics were metabolic/intoxication (35, 18.8%), sepsis (28, 15.0%), seizure (21, 11.3%), syncope (20, 10.8%), subdural hemorrhage (14, 7.5%), vertigo (11, 6.0%), brain tumor (10, 5.30%), central nervous system infection (5, 2.7%), others (26, 14.0%), and unspecified (16, 8.6%). Incidence rates and etiologies of the stroke mimics were similar to the western reports. However the frequency of each mimic was not.

Suction of MHD boundary layer flows

International Nuclear Information System (INIS)

Rao, B.N.

1985-01-01

The boundary layer growth with tensor electrical conductivity and the transpiration number has been examined using local nonsimilarity solutions method. It is found that suction will cause the increase in wall shearing stress and decrease in thicknesses of the boundary layer. (Auth.)

Volume of blood suctioned during vacuum-assisted breast biopsy predicts later hematoma formation

Directory of Open Access Journals (Sweden)

Panopoulou Effrosyni

2010-03-01

Full Text Available Abstract Background To evaluate whether the volume of blood suctioned during vacuum-assisted breast biopsy (VABB is associated with hematoma formation and progression, patient's age and histology of the lesion. Findings 177 women underwent VABB according to standardized protocol. The volume of blood suctioned and hematoma formation were noted at the end of the procedure, as did the subsequent development and progression of hematoma. First- and second-order logistic regression was performed, where appropriate. Cases with hematoma presented with greater volume of blood suctioned (63.8 ± 44.7 cc vs. 17.2 ± 32.9 cc; p Conclusion The likelihood of hematoma is increasing along with increasing amount of blood suctioned, reaching a plateau approximately at 80 cc of blood lost.

Pilot Study Comparing Closed Versus Open Tracheal Suctioning in Postoperative Neonates and Infants With Complex Congenital Heart Disease.

Science.gov (United States)

Tume, Lyvonne N; Baines, Paul B; Guerrero, Rafael; Hurley, Margaret A; Johnson, Robert; Kalantre, Atul; Ramaraj, Ram; Ritson, Paul C; Walsh, Laura; Arnold, Philip D

2017-07-01

To determine the hemodynamic effect of tracheal suction method in the first 36 hours after high-risk infant heart surgery on the PICU and to compare open and closed suctioning techniques. Pilot randomized crossover study. Single PICU in United Kingdom. Infants undergoing surgical palliation with Norwood Sano, modified Blalock-Taussig shunt, or pulmonary artery banding in the first 36 hours postoperatively. Infants were randomized to receive open or closed (in-line) tracheal suctioning either for their first or second study tracheal suction in the first 36 hours postoperatively. Twenty-four infants were enrolled over 18 months, 11 after modified Blalock-Taussig shunt, seven after Norwood Sano, and six after pulmonary artery banding. Thirteen patients received the open suction method first followed by the closed suction method second, and 11 patients received the closed suction method first followed by the open suction method second in the first 36 hours after their surgery. There were statistically significant larger changes in heart rate (p = 0.002), systolic blood pressure (p = 0.022), diastolic blood pressure (p = 0.009), mean blood pressure (p = 0.007), and arterial saturation (p = 0.040) using the open suction method, compared with closed suctioning, although none were clinically significant (defined as requiring any intervention). There were no clinically significant differences between closed and open tracheal suction methods; however, there were statistically significant greater changes in some hemodynamic variables with open tracheal suctioning, suggesting that closed technique may be safer in children with more precarious physiology.

Rekonstruksi pada Perforasi Palatum Akibat Pneggunaan Gigi Tiruan Lengkap Rahang Atas dengan Suction Cup

Directory of Open Access Journals (Sweden)

Cristiani Nadya Pramasari

2012-12-01

Full Text Available Latar belakang. Pemasangan suction cup pada gigi tiruan lengkap rahang atas merupakan salah satu cara untuk meningkatkan referensi. Kondisi vakum oleh karena suction cup ini dalam waktu jangka panjang dan tidak terkontrol mengakibatkan nekrosis jaringan yaitu adanya perforasi palatum. Tujuan. Melaporkan rekonstruksi penutupan perforasi palatum sebagai komplikasi penggunaan gigi tiruan lengkap rahang atas dengan suction cup. Laporan Kasus. Pada tanggal 11 September 2012 seorang pria berusia 64 tahun datang ke Poliklinik Bedah Mulut RSUP dr. Sardjito Yogyakarta dengan keluhan terdapat lubang pada langit-langit. Pasien menggunakan gigi palsu buatan tukang gigi dengan perekat berbahan karet pada langit-langit selama 5 tahun. Selama penggunaan gigi palsu pasien sering mengalami sakit dan pembengkakan di langit-langit sampai keluar nanah dan akhirnya terbentuk lubang sehingga jika minum air keluar dari hidung. Pemeriksaan rontgen oklusal rahang atas tampak adanya resorbsi regio palatum durum. Rekonstruksi menggunakan teknik push back modifikasi dilakukan untuk penutupan perforasi palatum di bawah anestesi umum. Kesimpulan. Suction cup pada gigi tiruan lengkap rahang atas mengakibatkan kerusakan jaringan lunak dan jaringan keras rongga mulut. Perforasi palatum yang diakibatkan oleh suction cup ini dapat dilakukan rekonstruksi dengan teknik push back dengan hasil yang cukup optimal.   Background. Suction cups are used to get retention of the complete dentures. The uncontrolled constant vacuum created by the suction cup induces necrosis of tissues and perforation ofpalate. Objective. To report reconstruction for palatal perforation closure as a complication due to prolonged use of maxillary denture with suction cup. Case Report. A 64 years old male patient came to the Department of Oral Surgery, Sardjito General Hospital Yogyakarta on September 11, 2012 with the complaint of hole in his palate. He was wearing dentures for the past 5 years. He also

MAXIMUM AIR SUCTION INTO HORIZONTAL OPEN ENDED CYLINDRICAL LOUVERED PIPE

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SAMEER RANJAN SAHU

2017-02-01

Full Text Available The main approach behind the present numerical investigation is to estimate the mass flow rate of air sucked into a horizontal open-ended louvered pipe from the surrounding atmosphere. The present numerical investigation has been performed by solving the conservation equations for mass, momentum and energy along with two equation based k-ɛ model for a louvered horizontal cylindrical pipe by finite volume method. It has been found from the numerical investigation that mass suction rate of air into the pipe increases with increase in louvered opening area and the number of nozzles used. Keeping other parameters fixed, for a given mass flow rate there exists an optimum protrusion of nozzle for highest mass suction into the pipe. It was also found from the numerical investigation that increasing the pipe diameter the suction mass flow rate of air was increased.

Bernoulli Suction Effect on Soap Bubble Blowing?

Science.gov (United States)

Davidson, John; Ryu, Sangjin

2015-11-01

As a model system for thin-film bubble with two gas-liquid interfaces, we experimentally investigated the pinch-off of soap bubble blowing. Using the lab-built bubble blower and high-speed videography, we have found that the scaling law exponent of soap bubble pinch-off is 2/3, which is similar to that of soap film bridge. Because air flowed through the decreasing neck of soap film tube, we studied possible Bernoulli suction effect on soap bubble pinch-off by evaluating the Reynolds number of airflow. Image processing was utilized to calculate approximate volume of growing soap film tube and the volume flow rate of the airflow, and the Reynolds number was estimated to be 800-3200. This result suggests that soap bubbling may involve the Bernoulli suction effect.

Breaststroke swimmers moderate internal work increases toward the highest stroke frequencies.

Science.gov (United States)

Lauer, Jessy; Olstad, Bjørn Harald; Minetti, Alberto Enrico; Kjendlie, Per-Ludvik; Rouard, Annie Hélène

2015-09-18

A model to predict the mechanical internal work of breaststroke swimming was designed. It allowed us to explore the frequency-internal work relationship in aquatic locomotion. Its accuracy was checked against internal work values calculated from kinematic sequences of eight participants swimming at three different self-chosen paces. Model predictions closely matched experimental data (0.58 ± 0.07 vs 0.59 ± 0.05 J kg(-1)m(-1); t(23)=-0.30, P=0.77), which was reflected in a slope of the major axis regression between measured and predicted total internal work whose 95% confidence intervals included the value of 1 (β=0.84, [0.61, 1.07], N=24). The model shed light on swimmers ability to moderate the increase in internal work at high stroke frequencies. This strategy of energy minimization has never been observed before in humans, but is present in quadrupedal and octopedal animal locomotion. This was achieved through a reduced angular excursion of the heaviest segments (7.2 ± 2.9° and 3.6 ± 1.5° for the thighs and trunk, respectively, Paquatic movements. Copyright © 2015 Elsevier Ltd. All rights reserved.

Effect of low-frequency rTMS on aphasia in stroke patients: a meta-analysis of randomized controlled trials.

Directory of Open Access Journals (Sweden)

Cai-Li Ren

Full Text Available Small clinical trials have reported that low-frequency repetitive transcranial magnetic stimulation (rTMS might improve language recovery in patients with aphasia after stroke. However, no systematic reviews or meta-analyses studies have investigated the effect of rTMS on aphasia. The objective of this study was to perform a meta-analysis of studies that explored the effects of low-frequency rTMS on aphasia in stroke patients.We searched PubMed, CENTRAL, Embase, CINAHL, ScienceDirect, and Journals@Ovid for randomized controlled trials published between January 1965 and October 2013 using the keywords "aphasia OR language disorders OR anomia OR linguistic disorders AND repetitive transcranial magnetic stimulation OR rTMS". We used fixed- and random-effects models to estimate the standardized mean difference (SMD and a 95% CI for the language outcomes.Seven eligible studies involving 160 stroke patients were identified in this meta-analysis. A significant effect size of 1.26 was found for the language outcome severity of impairment (95% CI = 0.80 to 1.71 without heterogeneity (I2 = 0%, P = 0.44. Further analyses demonstrated prominent effects for the naming subtest (SMD = 0.52, 95% CI = 0.18 to 0.87, repetition (SMD = 0.54, 95% CI = 0.16 to 0.92, writing (SMD = 0.70, 95% CI = 0.19 to 1.22, and comprehension (the Token test: SMD = 0.58, 95% CI = 0.07 to 1.09 without heterogeneity (I2 = 0%. The SMD of AAT and BDAE comprehension subtests was 0.32 (95% CI = -0.08 to 0.72 with moderate heterogeneity (I2 = 32%,P = 0.22. The effect size did not change significantly even when any one trial was eliminated. None of the patients from the 7 included articles reported adverse effects from rTMS.Low-frequency rTMS with a 90% resting motor threshold that targets the triangular part of the right inferior frontal gyrus (IFG has a positive effect on language recovery in patients with aphasia following

Hydrodynamics of suction feeding in fish

NARCIS (Netherlands)

Muller, M.

1983-01-01

1. Suction feeding is the dominant way to obtain food in teleosts. Its high demands on structures due to the required velocities and forces leads to the expectation that a biophysical analysis will aid to reveal the adaptive significance of head and body structures related to this

Suction forces generated by passive bile bag drainage on a model of post-subdural hematoma evacuation.

Science.gov (United States)

Tenny, Steven O; Thorell, William E

2018-05-05

Passive drainage systems are commonly used after subdural hematoma evacuation but there is a dearth of published data regarding the suction forces created. We set out to quantify the suction forces generated by a passive drainage system. We created a model of passive drainage after subdural hematoma evacuation. We measured the maximum suction force generated with a bile bag drain for both empty drain tubing and fluid-filled drain tube causing a siphoning effect. We took measurements at varying heights of the bile bag to analyze if bile bag height changed suction forces generated. An empty bile bag with no fluid in the drainage tube connected to a rigid, fluid-filled model creates minimal suction force of 0.9 mmHg (95% CI 0.64-1.16 mmHg). When fluid fills the drain tubing, a siphoning effect is created and can generate suction forces ranging from 18.7 to 30.6 mmHg depending on the relative position of the bile bag and filled amount of the bile bag. The suction forces generated are statistically different if the bile bag is 50 cm below, level with or 50 cm above the experimental model. Passive bile bag drainage does not generate significant suction on a fluid-filled rigid model if the drain tubing is empty. If fluid fills the drain tubing then siphoning occurs and can increase the suction force of a passive bile bag drainage system to levels comparable to partially filled Jackson-Pratt bulb drainage.

Study on the performance improvement of multiblade fans. Effects of suction cones; Tayoku fan no seino kaizen ni kansuru kenkyu. Suction cone no eikyo

Energy Technology Data Exchange (ETDEWEB)

Kuratani, F.; Ogawa, T. [Hyogo University of Teacher Education, Hyogo (Japan); Yamamoto, S.

1999-07-25

In order to improve the performance of a multiblade fan, the effects of three types of suction cones of the fan casing on the fan efficiency and noise are investigated experimentally. The first type of the suction cone is the insertion type, which is inserted into the inside of the fan impeller. The second type is the extrusion type, which extrudes outside from the casing surface. The third type is the combination type of two types. The results of those three types are compared with those of the commonly used suction cone. The followings are made clear: (1) The insertion type and the extrusion type are effective in improving the efficiency and reducing noise. (2) The optimal lengths of the insertion and the extrusion exist. (3) The combination type is more effective in improving the efficiency. (4) The combination type with the skewed cutoff of the fan casing shows the best effect. (author)

Special energies and special frequencies

International Nuclear Information System (INIS)

Endrullis, M.; Englisch, H.

1987-01-01

''Special frequencies'' have been asserted to be zeros of the density of frequencies corresponding to a random chain of coupled oscillators. Our investigation includes both this model and the random one-dimensional Schroedinger operator describing an alloy or its discrete analogue. Using the phase method we exactly determine a bilateral Lifsic asymptotic of the integrated density of states k(E) at special energies G s , which is not only of the classical type exp(-c/vertical strokeE-E s vertical stroke 1/2 ) but also exp(-c'/vertical strokeE-E s vertical stroke) is a typical behaviour. In addition, other asymptotics occur, e.g. vertical strokeE-E c vertical stroke c '', which show that k(E) need not be C ∞ . (orig.)

Scalp acupuncture plus low-frequency rTMS promotes repair of brain white matter tracts in stroke patients: A DTI study.

Science.gov (United States)

Zhao, Ning; Zhang, Jingna; Qiu, Mingguo; Wang, Chunrong; Xiang, Yun; Wang, Hui; Xie, Jingwen; Liu, Shu; Wu, Jing

2018-01-01

To study the clinical effects of scalp acupuncture plus low frequency rTMS in hemiplegic stroke patients. A total of 28 hemiplegic stroke patients were recruited and randomly assigned to the experimental group (scalp acupuncture + low frequency rTMS + routine rehabilitation treatment) or the control group (scalp acupuncture + routine rehabilitation treatment). All patients received a diffusion tensor imaging examination on the day of admission and on the fourteenth day. Compared with pre-treatment, the upper limb motor function score and ability of daily life score increased significantly in the two groups, and motor function improvement was much greater in the experimental group. Fractional anisotropy values significantly increased in white matter tracts, such as the corticospinal tract, forceps minor, superior longitudinal fasciculus and uncinate fasciculus in the two groups. Compared with pre-treatment, the fractional anisotropy values increased and mean diffusion values decreased synchronously in the forceps minor, left inferior fronto-occipital fasciculus, left inferior longitudinal fasciculus, left superior longitudinal fasciculus and left uncinate fasciculus in the experimental group. Before and after treatment, there were no significant differences in the changes of fractional anisotropy values between the two groups, but the changes of the mean diffusion values in the experimental group were much greater than those in the control group in the left superior longitudinal fasciculus and the left uncinate fasciculus (plow frequency rTMS can promote white matter tracts repair better than scalp acupuncture alone; the motor function improvement of the hemiplegic upper limb may be closely related to the rehabilitation of the forceps minor; the combination of scalp acupuncture and low frequency rTMS is expected to provide a more optimal rehabilitation protocol for stroke hemiplegic patients.

Characterization of zebrafish larvae suction feeding flow using μPIV and optical coherence tomography

OpenAIRE

Pekkan, Kerem; Uslu, Fazıl E.; Chang, Brain; Mani, Karthick; Chen, Chia-Yuan; Holzman, Roi

2016-01-01

The hydrodynamics of suction feeding is critical for the survival of fish larvae; failure to capture food during the onset of autonomous feeding can rapidly lead to starvation and mortality. Fluid mechanics experiments that investigate the suction feeding of suspended particles are limited to adult fishes, which operate at large Reynolds numbers. This manuscript presents the first literature results in which the external velocity fields generated during suction feeding of early zebrafish larv...

Effects of Lavender Inhalant on the Pain during Endotracheal Suctioning in Intensive Care Unit Patients

Directory of Open Access Journals (Sweden)

M. Taheri Rezgh Abadi

2017-09-01

Full Text Available Aims: Patients undergoing artificial ventilation require tracheal tube suction because of inability to clear their effective airways, which is usually a painful process for the patients. The aim of this study was to investigate the effect of spike lavender’s inhalant on pain during tracheal tube suctioning in ICU intubated patients. Materials & Methods: In this double-blinded randomized clinical trial, 60 intubated patients hospitalized in ICU of Shahid Modarres Hospital of Kashmar City, Iran, in 2017 were selected by available and simple sampling method, and were randomly divided into 2 control and case groups (each 30 individuals. Before the standard suctioning process, the test group patients received inhalant of 2% spike lavender for 5 minutes and the control group received inhalant of distilled water. The level of pain was recorded before and during tracheal tube suctioning. Data were analyzed by SPSS 16 software using independent T, paired T, Fisher and Mann-Whitney U tests. Findings: There was no significant difference in pain score before tracheal tube suction between 2 groups (p>0.05. However, there were significant differences between the level of pain during tracheal tube suctioning and the pain was increased in both groups, but this increase was significantly higher in the control group (p<0.001. Conclusion: Spike lavender’s inhalant is effective on pain reduction during suctioning process of ICU intubated patients.

Prototype bucket foundation for wind turbines - natural frequency estimation

Energy Technology Data Exchange (ETDEWEB)

Ibsen, Lars Bo; Liingaard, M.

2006-12-15

The first full scale prototype bucket foundation for wind turbines has been installed in October 2002 at Aalborg University offshore test facility in Frederikshavn, Denmark. The suction caisson and the wind turbine have been equipped with an online monitoring system, consisting of 15 accelerometers and a real-time data-acquisition system. The report concerns the in service performance of the wind turbine, with focus on estimation of the natural frequencies of the structure/foundation. The natural frequencies are initially estimated by means of experimental Output-only Modal analysis. The experimental estimates are then compared with numerical simulations of the suction caisson foundation and the wind turbine. The numerical model consists of a finite element section for the wind turbine tower and nacelle. The soil-structure interaction of the soil-foundation section is modelled by lumped-parameter models capable of simulating dynamic frequency dependent behaviour of the structure-foundation system. (au)

Device for the prehension by means of suction cups

International Nuclear Information System (INIS)

Gabillet, Maurice

1980-01-01

The difficulties encountered while utilising suction-cups, are mainly caused by the skirts. The skirts are more or less adaptable to the surface of the objects to be handled. The skirt of the device presented, is made out of a round supple elastic bag containing solid particles. By creating a vacuum in the bag, the particles become a solid entity. The bag filled with the particles becomes rigid and can take exactly the shape of the object to be lifted. By creating a second vacuum in the axis of the bag, the object can be lifted. Several suction-cups can be used simultaneously

Corner Separation Control by Boundary Layer Suction Applied to a Highly Loaded Axial Compressor Cascade

Directory of Open Access Journals (Sweden)

Yangwei Liu

2014-11-01

Full Text Available Control of corner separation has attracted much interest due to its improvement of performance and energy utilization in turbomachinery. Numerical studies have been performed under both design and off-design flow conditions to investigate the effects of boundary layer suction (BLS on corner separation in a highly loaded compressor cascade. Two new BLS slot configurations are proposed and a total of five suction slot configurations were studied and compared. Averaged static pressure rise, exit loss coefficient, passage blockage and flow turning angle have been given and compared systematically over a range of operation incidence angles. Distributions of significant loss removal, blade loading, exit deviation and total pressure loss at 3 degree and 7 degree incidence have also been studied. Under the same suction mass flows of 0.7% of the inlet mass flows, the pitchwise suction slot on the endwall shows a better optimal performance over the whole operation incidence among single suction slots. By using of the new proposed compound slot configuration with one spanwise slot on the blade suction side and one pitchwise slot on the endwall, the maximum reduction of total pressure loss at 7 degree incidence can be 39.4%.

Functional morphology of the feeding apparatus, feeding constraints, and suction performance in the nurse shark Ginglymostoma cirratum.

Science.gov (United States)

Motta, Philip J; Hueter, Robert E; Tricas, Timothy C; Summers, Adam P; Huber, Daniel R; Lowry, Dayv; Mara, Kyle R; Matott, Michael P; Whitenack, Lisa B; Wintzer, Alpa P

2008-09-01

The nurse shark, Ginglymostoma cirratum, is an obligate suction feeder that preys on benthic invertebrates and fish. Its cranial morphology exhibits a suite of structural and functional modifications that facilitate this mode of prey capture. During suction-feeding, subambient pressure is generated by the ventral expansion of the hyoid apparatus and the floor of its buccopharyngeal cavity. As in suction-feeding bony fishes, the nurse shark exhibits expansive, compressive, and recovery kinematic phases that produce posterior-directed water flow through the buccopharyngeal cavity. However, there is generally neither a preparatory phase nor cranial elevation. Suction is generated by the rapid depression of the buccopharyngeal floor by the coracoarcualis, coracohyoideus, and coracobranchiales muscles. Because the hyoid arch of G. cirratum is loosely connected to the mandible, contraction of the rectus cervicis muscle group can greatly depress the floor of the buccopharyngeal cavity below the depressed mandible, resulting in large volumetric expansion. Suction pressures in the nurse shark vary greatly, but include the greatest subambient pressures reported for an aquatic-feeding vertebrate. Maximum suction pressure does not appear to be related to shark size, but is correlated with the rate of buccopharyngeal expansion. As in suction-feeding bony fishes, suction in the nurse shark is only effective within approximately 3 cm in front of the mouth. The foraging behavior of this shark is most likely constrained to ambushing or stalking due to the exponential decay of effective suction in front of the mouth. Prey capture may be facilitated by foraging within reef confines and close to the substrate, which can enhance the effective suction distance, or by foraging at night when it can more closely approach prey.

Performance of high-area-ratio annular dump diffuser using suction-stabilized-vortex flow control

Science.gov (United States)

Juhasz, A. J.; Smith, J. M.

1977-01-01

A short annular dump diffuser having a geometry conductive to formation of suction stabilized toroidal vortices in the region of abrupt area change was tested. The overall diffuser area ratio was 4.0 and the length to inlet height ratio was 2.0. Performance data were obtained at near ambient temperature and pressure for inlet Mach numbers of 0.18 and 0.30 with suction rates ranging from 0 to 18 percent of total inlet mass flowrate. Results show that the exit velocity profile could be readily biased toward either wall by adjustment of inner and outer wall suction rates. Symmetric exit velocity profiles were inherently unstable with a tendency to revert to a hub or tip bias. Diffuser effectiveness was increased from about 38 percent without suction to over 85 percent at a total suction rate of 10 to 12 percent. At the same time diffuser total pressure loss was reduced from 3.1 percent to 1.1 percent at an inlet Mach number of 0.3.

Modulation method of scroll compressor based on suction gas bypass

International Nuclear Information System (INIS)

Wang Baolong; Han Linjun; Shi Wenxing; Li Xianting

2012-01-01

The air conditioners and heat pumps tend to work in much mild environments and part load situations rather than provide the rated full capacity under severe rated testing conditions. Both the capacity and inner compression ratio of the compressor should be regulated according to the working condition for higher energy efficiency and occupants’ comfort. A potential modulating technology of the scroll compressor, suction gas bypass, is investigated in this paper. The principle and operation method are illuminated and the adaptability is validated by experiments and simulations. As a conclusion, an appropriate suction gas bypass can reduce the inner compression loss of the scroll compressor under over compression conditions, enhance the system COP and also largely decrease the heating/cooling capacity of the refrigeration/heat pump system. - Highlights: ► Suction gas bypass (SGB) is an effective regulating method of scroll compressor. ► SGB reduces the inner compression loss under over compression conditions. ► SGB largely decreases the heating/cooling capacity of the refrigeration system.

Characterization of zebrafish larvae suction feeding flow using μPIV and optical coherence tomography

Science.gov (United States)

Pekkan, Kerem; Chang, Brian; Uslu, Fazil; Mani, Karthick; Chen, Chia-Yuan; Holzman, Roi

2016-07-01

The hydrodynamics of suction feeding is critical for the survival of fish larvae; failure to capture food during the onset of autonomous feeding can rapidly lead to starvation and mortality. Fluid mechanics experiments that investigate the suction feeding of suspended particles are limited to adult fishes, which operate at large Reynolds numbers. This manuscript presents the first literature results in which the external velocity fields generated during suction feeding of early zebrafish larvae (2500-20,000 μm total length) are reported using time-resolved microscopic particle image velocimetry. For the larval stages studied, the maximum peak suction velocity of the inflow bolus is measured at a finite distance from the mouth tip and ranges from 1 to 8 mm/s. The average pressure gradient and the velocity profile proximal to the buccal (mouth) cavity are calculated, and two distinct trends are identified. External recirculation regions and reverse flow feeding cycles are also observed and quantified. One of the unresolved questions in fish suction feeding is the shape and dynamics of the buccal cavity during suction feeding; optical coherence tomography imaging is found to be useful for reconstructing the mouth kinematics. The projected area of the mouth cavity during the feeding cycle varies up to 160 and 22 % for the transverse and mid-sagittal planes, respectively. These findings can inspire novel hydrodynamically efficient biomedical and microfluidic devices.

New approach to the suction force at the leading edge of a profile with zero thickness

NARCIS (Netherlands)

Sparenberg, JA; de Jager, EM

2004-01-01

This paper considers the suction force at the leading edge of a profile with zero thickness in an incompressible and inviscid fluid flow. The theory is linear, and the approach to the suction force is from the innerside of the profile. It is shown that the suction force can be considered as an

Pad for holding a load against a surface by suction

International Nuclear Information System (INIS)

Farmer, R.C.; Goldsmith, H.A.; Proudlove, M.J.

1981-01-01

This invention concerns suction pads for supporting loads. Specifically, the suction pad is part of a pair of pads located at the ends of a bridge forming a vehicle for transporting instruments for the non-destructive testing of a large vessel intended to contain a fuel assembly for a nuclear reactor immersed in a liquid metal coolant. For example, the vehicle is of the type described in the French patent application filed this day under the heading 'Vehicle for transporting instruments for testing against a wall' [fr

Stroke-induced immunodepression and dysphagia independently predict stroke-associated pneumonia - The PREDICT study.

Science.gov (United States)

Hoffmann, Sarah; Harms, Hendrik; Ulm, Lena; Nabavi, Darius G; Mackert, Bruno-Marcel; Schmehl, Ingo; Jungehulsing, Gerhard J; Montaner, Joan; Bustamante, Alejandro; Hermans, Marcella; Hamilton, Frank; Göhler, Jos; Malzahn, Uwe; Malsch, Carolin; Heuschmann, Peter U; Meisel, Christian; Meisel, Andreas

2017-12-01

Stroke-associated pneumonia is a frequent complication after stroke associated with poor outcome. Dysphagia is a known risk factor for stroke-associated pneumonia but accumulating evidence suggests that stroke induces an immunodepressive state increasing susceptibility for stroke-associated pneumonia. We aimed to confirm that stroke-induced immunodepression syndrome is associated with stroke-associated pneumonia independently from dysphagia by investigating the predictive properties of monocytic HLA-DR expression as a marker of immunodepression as well as biomarkers for inflammation (interleukin-6) and infection (lipopolysaccharide-binding protein). This was a prospective, multicenter study with 11 study sites in Germany and Spain, including 486 patients with acute ischemic stroke. Daily screening for stroke-associated pneumonia, dysphagia and biomarkers was performed. Frequency of stroke-associated pneumonia was 5.2%. Dysphagia and decreased monocytic HLA-DR were independent predictors for stroke-associated pneumonia in multivariable regression analysis. Proportion of pneumonia ranged between 0.9% in the higher monocytic HLA-DR quartile (≥21,876 mAb/cell) and 8.5% in the lower quartile (≤12,369 mAb/cell). In the presence of dysphagia, proportion of pneumonia increased to 5.9% and 18.8%, respectively. Patients without dysphagia and normal monocytic HLA-DR expression had no stroke-associated pneumonia risk. We demonstrate that dysphagia and stroke-induced immunodepression syndrome are independent risk factors for stroke-associated pneumonia. Screening for immunodepression and dysphagia might be useful for identifying patients at high risk for stroke-associated pneumonia.

INCOMPRESSIBLE LAMINAR BOUNDARY LAYER CONTROL BY BLOWING AND SUCTION

Directory of Open Access Journals (Sweden)

AZZEDINE NAHOUI

2013-12-01

Full Text Available A two-dimensional incompressible laminar boundary layer and its control using blowing and suction over a flat plate and around the NACA 0012 and 661012 profiles, is studied numerically. The study is based on the Prandtl boundary layer model using the finite differences method and the Crank-Nicolson scheme. The velocity distribution, the boundary layer thickness and the friction coefficient, are determined and presented with and without control. The application of the control technique, has demonstrated its positive effect on the transition point and the friction coefficient. Both control procedures are compared for different lengths, speeds and angles of blowing and suction.

Low-frequency rTMS with language therapy over a 3-month period for sensory-dominant aphasia: case series of two post-stroke Japanese patients.

Science.gov (United States)

Kakuda, Wataru; Abo, Masahiro; Uruma, Go; Kaito, Nobuyoshi; Watanabe, Motoi

2010-01-01

To examine the safety and feasibility of therapeutic application of low-frequency repetitive transcranial magnetic stimulation (rTMS) combined with language therapy for post-stroke patients with sensory-dominant aphasia. Two post-stroke Japanese patients with sensory-dominant aphasia were studied. In both patients, 10 sessions of 20-minute low-frequency rTMS with 1 Hz to the Wernicke's area were provided throughout 6-day hospitalization, followed by weekly outpatient rTMS treatment for 3 months. The language therapy was also provided through the period of in- and out-patient treatment. Language function was evaluated using the Token test and the Standard Language Test of Aphasia (SLTA) at the start and end of the in-patient treatment and the end of the outpatient treatment. The therapeutic protocol was well tolerated throughout the in- and out-patient treatments, without any adverse effects. The scores of the Token test and certain sub-categories of SLTA increased in both patients after the in-patient rTMS treatment. Persistent improvement of the score was noted over the 3-month post-discharge period. The proposed protocol of long-term application of low-frequency rTMS to the Wernicke's area and language therapy is considered a safe and feasible therapeutic approach for post-stroke patients with sensory-dominant aphasia.

Reliable site for suction blister induction and harvesting

Directory of Open Access Journals (Sweden)

Laxmisha Chandrashekar

2005-01-01

Full Text Available Background: Suction blister grafting is a useful modality of treatment of patients with resistant and stable vitiligo. However, there have been no detailed studies to find out the best donor site for blister formation. Methods: The study was conducted between the period of October 2004 and February 2005 in the dermatology department at a tertiary care center. Nine patients with vitiligo (focal vitiligo, 3; mucosal vitiligo, 2; acrofacial vitiligo, 2; vitiligo vulgaris, 1; and segmental vitiligo, 1 were selected for blister harvesting and grafting. The blisters were raised using the method described by Gupta et al. Results: Suction blisters were attempted to be raised at 52 sites, but only 38 blisters could be raised, 24 complete and 14 incomplete. Blisters were raised in all the three cases on the flexor aspect of the arm (100%, 15 of 17 cases (88.2% on the flexor aspect of the forearm, 4 of 5 cases (80% on the abdomen, 11 of 16 cases (68.7% on the anterolateral thigh, and less frequently over leg or foot. Complete blisters were formed in 13/15 cases (86.6% on the flexor aspect of the forearm, 6/11 cases (54.5% on the anterolateral thigh, and in all cases over leg. Conclusion: The flexor aspect of the forearm is a good site for suction blister harvesting.

Suppression of the secondary flow in a suction channel of a large centrifugal pump

International Nuclear Information System (INIS)

Torii, D; Nagahara, T; Okihara, T

2013-01-01

The suction channel configuration of a large centrifugal pump with a 90-degree bend was studied in detail to suppress the secondary flow at the impeller inlet for improving suction performance. Design of experiments (DOE) and computational fluid dynamics (CFD) were used to evaluate the sensitivity of several primary design parameters of the suction channel. A DOE is a powerful tool to clarify the sensitivity of objective functions to design parameters with a minimum of trials. An L9 orthogonal array was adopted in this study and nine suction channels were designed, through which the flow was predicted by steady state calculation. The results indicate that a smaller bend radius with a longer straight nozzle, distributed between the bend and the impeller, suppresses the secondary flow at the impeller inlet. An optimum ratio of the cross sectional areas at the bend inlet and outlet was also confirmed in relationship to the contraction rate of the downstream straight nozzle. These findings were obtained by CFD and verified by experiments. The results will aid the design of large centrifugal pumps with better suction performance and higher reliability

Does Diagnosis of Hypertension Prevent Stroke? A Preliminary ...

African Journals Online (AJOL)

Introduction: The present study was designed to determine the relative frequency of previously diagnosed and undiagnosed hypertension in first stroke in order to evaluate if previous diagnosis of hypertension can prevent stroke. Patients and Methods: One hundred and twenty nine first stroke patients presenting at the ...

Prospective randomized trial compares suction versus water seal for air leaks.

Science.gov (United States)

Cerfolio, R J; Bass, C; Katholi, C R

2001-05-01

Surgeons treat air leaks differently. Our goal was to evaluate whether it is better to place chest tubes on suction or water seal for stopping air leaks after pulmonary surgery. A second goal was to evaluate a new classification system for air leaks that we developed. Patients were prospectively randomized before surgery to receive suction or water seal to their chest tubes on postoperative day (POD) #2. Air leaks were described and quantified daily by a classification system and a leak meter. The air-leak meter scored leaks from 1 (least) to 7 (greatest). The group randomized to water seal stayed on water seal unless a pneumothorax developed. On POD #2, 33 of 140 patients had an air leak. Eighteen patients had been preoperatively randomized to water seal and 15 to suction. Air leaks resolved in 12 (67%) of the water seal patients by the morning of POD #3. All 6 patients whose air leak did not stop had a leak that was 4/7 or greater (p leak meter. Of the 15 patients randomized to suction, only 1 patient's air leak (7%) resolved by the morning of POD #3. The randomization aspect of the trial was ended and statistical analysis showed water seal was superior (p = 0.001). The remaining 14 patients were then placed to water seal and by the morning of POD #4, 13 patients' leaks had stopped. Of the 32 total patients placed to seal, 7 (22%) developed a pneumothorax and 6 of these 7 patients had leaks that were 4/7 or greater (p = 0.001). Placing chest tubes on water seal seems superior to wall suction for stopping air leaks after pulmonary resection. However, water seal does not stop expiratory leaks that are 4/7 or greater. Pneumothorax may occur when chest tubes are placed on seal with leaks this large.

Necessity of suction drains in gynecomastia surgery.

Science.gov (United States)

Keskin, Mustafa; Sutcu, Mustafa; Cigsar, Bulent; Karacaoglan, Naci

2014-05-01

The aim of gynecomastia surgery is to restore a normal chest contour with minimal signs of breast surgery. The authors examine the rate of complications in gynecomastia surgery when no closed-suction drains are placed. One hundred thirty-eight consecutive male patients who underwent gynecomastia surgery without drains were retrospectively analyzed to determine whether the absence of drains adversely affected patient outcomes. Patients were managed by ultrasonic-assisted liposuction both with and without the pull-through technique. The mean age of the patients was 29 years, and the mean volume of breast tissue aspirated was 350 mL per beast. Pull-through was needed in 23 cases. There was only 1 postoperative hematoma. These results are comparable with previously published data for gynecomastia surgery in which drains were placed, suggesting that the absence of drains does not adversely affect postoperative recovery. Routine closed-suction drainage after gynecomastia surgery is unnecessary, and it may be appropriate to omit drains after gynecomastia surgery.

CFD Analysis of a Centrifugal Fan for Performance Enhancement using Converging Boundary Layer Suction Slots

OpenAIRE

K. Vasudeva Karanth; N. Yagnesh Sharma

2009-01-01

Generally flow behavior in centrifugal fan is observed to be in a state of instability with flow separation zones on suction surface as well as near the front shroud. Overall performance of the diffusion process in a centrifugal fan could be enhanced by judiciously introducing the boundary layer suction slots. With easy accessibility of CFD as an analytical tool, an extensive numerical whole field analysis of the effect of boundary layer suction slots in discrete regions ...

Modelling suction instabilities in soils at varying degrees of saturation

Directory of Open Access Journals (Sweden)

Buscarnera Giuseppe

2016-01-01

Full Text Available Wetting paths imparted by the natural environment and/or human activities affect the state of soils in the near-surface, promoting transitions across different regimes of saturation. This paper discusses a set of techniques aimed at quantifying the role of hydrologic processes on the hydro-mechanical stability of soil specimens subjected to saturation events. Emphasis is given to the mechanical conditions leading to coupled flow/deformation instabilities. For this purpose, energy balance arguments for three-phase systems are used to derive second-order work expressions applicable to various regimes of saturation. Controllability analyses are then performed to relate such work input with constitutive singularities that reflect the loss of strength under coupled and/or uncoupled hydro-mechanical forcing. A suction-dependent plastic model is finally used to track the evolution of stability conditions in samples subjected to wetting, thus quantifying the growth of the potential for coupled failure modes upon increasing degree of saturation. These findings are eventually linked with the properties of the field equations that govern pore pressure transients, thus disclosing a conceptual link between the onset of coupled hydro-mechanical failures and the evolution of suction with time. Such results point out that mathematical instabilities caused by a non-linear suction dependent behaviour play an important role in the advanced constitutive and/or numerical tools that are commonly used for the analysis of geomechanical problems in the unsaturated zone, and further stress that the relation between suction transients and soil deformations is a key factor for the interpretation of runaway failures caused by intense saturation events.

21 CFR 878.5040 - Suction lipoplasty system.

Science.gov (United States)

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Suction lipoplasty system. 878.5040 Section 878.5040 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED...) Classification. Class II (special controls). Consensus standards and labeling restrictions. [63 FR 7705, Feb. 17...

Knowledge of stroke risk factors amongst black diabetic, hypertensive and stroke patients

Directory of Open Access Journals (Sweden)

G. Bogoshi

2003-01-01

knowledge of black patients diagnosed with hypertension, diabetes and stroke about the risk factors for stroke.  Four groups made up of 33 subjects (hypertensive, diabetic, stroke and control group were interviewed using open-ended questions and a structured questionnaire. Qualitative coding, frequencies and proportions were used to determine their knowledge.  Groups were compared with respect to percentage knowledge using the chi-square statistic at a 0.05 level of significance.  Stress was mentioned as the most important risk factor in all groups.  Although identification of stroke risk factors was  inadequate, the diabetic group was found to be significantly better in  identifying some of the risk factors (salt - p =0,05; sugar - p = 0,001; fat - p = 0,004; moderate smoking - p = 0,05; weight - p = 0,002

Numerical simulation and analysis of cavitation flows in a double suction centrifugal pump

International Nuclear Information System (INIS)

Meng, G; Tan, L; Cao, S L; Jian, W; Liu, W W; Jiang, D J

2015-01-01

Cavitation is an unsteady phenomenon, which is nearly inevitable in pumps. It would degrade the pump performance, generate vibrations and noises, and even erode pump flow passage components. The double suction centrifugal pump at design flow rate and large flow rate is numerically simulated using the k-ω turbulence model and the mass transport cavitation model. As a result, the calculated variation of pump head with pump inlet pressure agreed well with the experimental data. The results demonstrate that the numerical model and method can accurately predict the cavitation flows in a double suction centrifugal pump. The cavitation characteristics are analysed in great details. In addition, based on the calculation results, the reason that the plunge of pump head curve is revealed. It is found that the steep fall of pump head happens when the cavity reaches the blade to blade throat and the micro-vortex group appears at the back of the blade suction side. At the same time, this practice can provide guidance for the optimal design of double suction pumps

External suction versus water seal after selective pulmonary resection for lung neoplasm: a systematic review.

Directory of Open Access Journals (Sweden)

Tong Qiu

Full Text Available OBJECTIVE: To evaluate whether external suction is more advantageous than water seal in patients undergoing selective pulmonary resection (SPR for lung neoplasm. SUMMARY OF BACKGROUND DATA: Whether external suction should be routinely applied in postoperative chest drainage is still unclear, particularly for lung neoplasm patients. To most surgeons, the decision is based on their clinical experience. METHODS: Randomized control trials were selected. The participants were patients undergoing SPR with lung neoplasm. Lung volume reduction surgery and pneumothorax were excluded. Suction versus non-suction for the intervention. The primary outcome was the incidence of persistent air leak (PAL. The definition of PAL was air leak for more than 3-7 days. The secondary outcomes included air leak duration, time of drainage, postoperative hospital stay and the incidence of postoperative pneumothorax. Studies were identified from literature collections through screening. Bias was analyzed and meta-analysis was used. RESULTS: From the 1824 potentially relevant trials, 6 randomized control trials involving 676 patients were included. There was no difference between external suction and water seal in decreasing the incidence of PAL [95% confidence interval (CI 0.81-2.16; z = 1.10; P = 0.27]. Regarding secondary outcomes, there were no differences in time of drainage (95% CI-0.36-1.56, P = 0.22, postoperative hospital stay (95% CI -.31-.54, P = 0.87 or incidence of postoperative pneumothorax (95% CI 0.18-.02, P = 0.05 between external suction and water seal. CONCLUSIONS: For participants, no differences are identified in terms of PAL incidence, drainage time, length of postoperative hospital stay or incidence of postoperative pneumothorax between external suction and water seal. The bias analysis should be emphasized. To the limitations of the bias and methodological differences among the included studies, we have no recommendation on

Sudden unexpected death caused by stroke

DEFF Research Database (Denmark)

Ågesen, Frederik Nybye; Risgaard, Bjarke; Zachariasardóttir, Sára

2017-01-01

Background Stroke is the fifth leading cause of death in young individuals globally. Data on the burden of sudden death by stroke are sparse in the young. Aims The aim of this study was to report mortality rates, cause of death, stroke subtype, and symptoms in children and young adults who suffered....... There was a male predominance (56%) and the median age was 33 years. The incidence of sudden death by stroke in individuals aged 1-49 years was 0.19 deaths per 100,000 person-years. Stroke was hemorrhagic in 94% of cases, whereof subarachnoid hemorrhage was the cause of death in 63% of cases. Seventeen (33%) cases...... contacted the healthcare system because of neurological symptoms, whereof one was suspected of having a stroke (6%). Conclusions Sudden death by stroke in children and young adults occurs primarily due to hemorrhagic stroke. We report a high frequency of neurological symptoms prior to sudden death by stroke...

Frequency of and Factors Associated With Obstructive Sleep Apnea and Periodic Limb Movements in Stroke and TIA Patients.

Science.gov (United States)

Gadodia, Gaurav; Rangaraju, Srikant; Raza, Syed A; Razzak, Ammar; Marmarchi, Labib; Davis, Brittaine; Henriquez, Laura; Trotti, Lynn M; Rye, David; Nahab, Fadi

2018-03-01

Obstructive sleep apnea (OSA) and periodic limb movements (PLMs) have been associated with an increased risk of cardiovascular disease. There is limited data on the relationship between OSA and PLMs with atrial fibrillation and resistant hypertension in stroke and transient ischemic attack (TIA) patients. Consecutive stroke and TIA patients referred by a vascular neurologist for diagnostic polysomnography (PSG) from September 1, 2012 to August 31, 2015 were included in a retrospective analysis. Baseline clinical characteristics, PSG results and outcomes were collected to identify the frequency of and factors associated with PLMs (mild 5 to 10/h; severe ≥15/h), PLM arousals (≥5/h) and moderate-severe OSA (apna-hypopnea Index ≥15) including atrial fibrillation and resistant hypertension. Among 103 patients (mean age, 60±15 y; 50% female; 61% nonwhites; 77% ischemic stroke; 23% resistant hypertension) who underwent PSG, 20% had mild PLMs, 28% had severe PLMs, 14% had PLM arousals, and 22% had moderate-severe OSA. Factors associated with moderate-severe OSA included older age (odds ratio, 1.06; 95% confidence interval, 1.02-1.11) and presence of atrial fibrillation (odds ratio, 4.26; 95% confidence interval, 1.17-15.44). Nonwhite race was associated with lower likelihood of mild and severe PLMs, whereas female sex was associated with lower likelihood of PLM arousals. OSA and PLMs were not associated with resistant hypertension. A significant number of stroke and TIA patients who underwent PSG have PLMs and moderate-severe OSA. Stroke and TIA patients with atrial fibrillation are more likely to have moderate-severe OSA and may benefit from PSG evaluation.

Assessment of Feasibility of Suction Pile/Anchor Installation and Pullout Testing through Field Tests

Directory of Open Access Journals (Sweden)

R. Vijaya

2014-09-01

Full Text Available Suction pile anchors are large cylindrical (inverted bucket type structure open at the bottom and closed at the top and largely used for mooring of offshore platforms, exploratory vessels etc. Prediction of the mooring capacity of suction piles is a critical issue faced by the design engineers and rational methods are required to produce reliable designs. Tests have been conducted in an existing natural pond within NIOT campus with the objective of developing methodology of deployment, design and logistics for suction pile installation and testing of mooring capacity under static pullout. Small size suction piles with varying diameters and lengths have been used in the tests. The tests have been carried out in the natural pond with constant water depth of 1.5 m with the top 1.5 m layer of bed comprising soft marine clay. It is found that pile geometry, aspect ratio and angle of pullout have a significant influence on the response to pullout. As angle of mooring load application changes from vertical to horizontal the reaction offered by the suction pile changes from skin friction to passive soil resistance. Resistance offered by the internal plug of soil is found to vary according to dimension of the anchor piles.

21 CFR 878.4780 - Powered suction pump.

Science.gov (United States)

2010-04-01

...) Identification. A powered suction pump is a portable, AC-powered or compressed air-powered device intended to be used to remove infectious materials from wounds or fluids from a patient's airway or respiratory support system. The device may be used during surgery in the operating room or at the patient's bedside...

Time management and nectar flow: flower handling and suction feeding in long-proboscid flies (Nemestrinidae: Prosoeca)

Science.gov (United States)

Karolyi, Florian; Morawetz, Linde; Colville, Jonathan F.; Handschuh, Stephan; Metscher, Brian D.; Krenn, Harald W.

2013-11-01

A well-developed suction pump in the head represents an important adaptation for nectar-feeding insects, such as Hymenoptera, Lepidoptera and Diptera. This pumping organ creates a pressure gradient along the proboscis, which is responsible for nectar uptake. The extremely elongated proboscis of the genus Prosoeca (Nemestrinidae) evolved as an adaptation to feeding from long, tubular flowers. According to the functional constraint hypothesis, nectar uptake through a disproportionately elongated, straw-like proboscis increases flower handling time and consequently lowers the energy intake rate. Due to the conspicuous length variation of the proboscis of Prosoeca, individuals with longer proboscides are hypothesised to have longer handling times. To test this hypothesis, we used field video analyses of flower-visiting behaviour, detailed examinations of the suction pump morphology and correlations of proboscis length with body length and suction pump dimensions. Using a biomechanical framework described for nectar-feeding Lepidoptera in relation to proboscis length and suction pump musculature, we describe and contrast the system in long-proboscid flies. Flies with longer proboscides spent significantly more time drinking from flowers. In addition, proboscis length and body length showed a positive allometric relationship. Furthermore, adaptations of the suction pump included an allometric relationship between proboscis length and suction pump muscle volume and a combination of two pumping organs. Overall, the study gives detailed insight into the adaptations required for long-proboscid nectar feeding, and comparisons with other nectar-sucking insects allow further considerations of the evolution of the suction pump in insects with sucking mouthparts.

Half versus full vacuum suction drainage after modified radical mastectomy for breast cancer- a prospective randomized clinical trial[ISRCTN24484328

Directory of Open Access Journals (Sweden)

Singh JP

2005-01-01

Full Text Available Abstract Background Suction drains are routinely used after modified radical mastectomy and are an important factor contributing to increased hospital stay as the patients are often discharged only after their removal. Amongst various factors that influence the amount of postoperative drainage, the negative suction pressure applied to the drain has been reported to be of great significance. While a high negative suction pressure is expected to drain the collection and reduce the dead space promptly, it may also prevent the leaking lymphatics from closing and lead to increased drainage from the wound. Against this background a prospective randomized clinical study was conducted to compare the amount and duration of drainage between a half negative suction and full vacuum suction drainage in patients following modified radical mastectomy. The associated postoperative morbidity was also compared between the two groups. Methods 85 FNAC (fine needle aspiration cytology proven cases of locally advanced breast cancer were randomized. (Using randomly ordered sealed envelops, which were opened immediately before the closure of the wound in to 50 patients with full vacuum suction (pressure = 700 g/m2 and 35 cases in to half vacuum suction drainage (pressure = 350 g/m2 groups. The two groups were comparable in respect of age, weight, and technique of operation and extent of axillary dissection. Surgery was performed by the same surgical team comprising of five surgeons (two senior and three resident surgeons using a standardized technique with electrocautery. External compression dressing was provided over the axilla for first 48 hrs and following that patients were encouraged to do active and passive shoulder exercises. The outcomes measured were postoperative morbidity and the length of hospital stay. Statistical methods used: Descriptive studies were performed with SPSS version 10 and group characteristics were compared using student t-test. Results

Effects of suction-dredging for cockles on non-target fauna in the Wadden Sea

NARCIS (Netherlands)

Hiddink, JG

2003-01-01

Suction dredging for cockles removes large cockles from tidal flats and may also cause mortality of non-target fauna and make the habitat less suitable for some species. This study examines whether suction dredging for cockles on tidal flats of the Dutch Wadden Sea had affected densities of

Primary Total Knee Replacement: Is Suction a Portal of Infection?

Science.gov (United States)

Budnar, Vijaya M; Amirfeyz, Rouin; Ng, Michael; Bannister, Gordon C; Blom, Ashley W

2009-01-01

INTRODUCTION Pulsed lavage during a total knee replacement usually leaves a pool of fluid on the surgical drapes. It is common practice to suck away this fluid using the same suction device used intra-operatively. This could be a cause of direct wound contamination. We hypothesised that bacteria contaminate fluid that collects around the foot in total knee replacement surgery and that suction equipment could be a portal of contamination. We also hypothesised that bacterial count in the fluid is lower if chlorhexidine, rather than saline, is used in the pulsed lavage. PATIENTS AND METHODS Forty patients undergoing primary total knee replacement were divided into two groups. The first group had pulsed lavage with normal saline and the second with 0.05% chlorhexidine. RESULTS At the end of the operation, 20 ml of fluid, pooled on the surgical drapes was aspirated and cultured for bacterial growth. None of the fluid samples showed bacterial growth. CONCLUSIONS Suction device used peri-operatively during knee replacement is unlikely to be a cause of wound contamination. Pulsed lavage with normal saline is as effective as lavage with chlorhexidine. PMID:19335972

Magnetohydrodynamic peristaltic motion of a Newtonian fluid through porous walls through suction and injection

Science.gov (United States)

Sivaiah, R.; Hemadri Reddy, R.

2017-11-01

In this paper, we investigate the peristaltic transport of a conducting Newtonian fluid bounded by permeable walls with suction and injection moving with constant velocity of the wave in the wave frame of reference under the consideration of long wavelength and low Reynolds number. The analytical solution for the velocity field, pressure gradient and the frictional force are obtained. The effect of suction/injection parameter, amplitude ratio and the permeability parameter including slip on the flow quantities are discussed graphically. It is found that the greater the suction/injection parameter, the smaller the pressure rise against the pump works. Further, the pressure rise increases with increasing Magnetic parameter.

Present knowledge about Laboratory Testing of Axial Loading on Suction Caissons

DEFF Research Database (Denmark)

Manzotti, E.; Vaitkunaite, Evelina; Ibsen, Lars Bo

Offshore wind turbines are increasing in both efficiency and size. More economical foundations for such light structures are under investigation, and suction caisson was shown to be particularly suitable for this purpose. In multi-pod foundation configuration, the overturning moment given by loads...... on the structure is resisted by push-pull loads on the vertical axis of each suction caisson. Relevant works where this situation is examined by means of laboratory testing are summarized in this article, then different conclusions are followed by discussion and comparison. In the initial theoretical section...

Effects of vacuum suctioning and strategic drape tenting on oxygen concentration in a simulated surgical field.

Science.gov (United States)

Kung, Theodore A; Kong, Sarah W; Aliu, Oluseyi; Azizi, Jahan; Kai, Salim; Cederna, Paul S

2016-02-01

To investigate the isolated and combined effects of vacuum suctioning and strategic drape tenting on oxygen concentration in an experimental setting. Experimental. Clinical simulation center of a university-affiliated hospital. Mannequin simulation of a patient undergoing facial surgery under sedation anesthesia. Supplemental oxygen was delivered via nasal cannula. Vacuum suctioning and strategic drape tenting. The experimental trials entailed measuring oxygen concentration around the nasal cannula continuously either in the presence or absence of a standard operating room vacuum suction system and strategic tenting of surgical drapes. The primary outcome was the time required for oxygen concentration to reach 21%. In the control group (without suction or strategic tenting), a mean time of 180 seconds elapsed until the measured oxygen concentration reached 21% after cessation of oxygen delivery. Use of a vacuum suction device alone (110 seconds; P strategic tenting (110 seconds; P strategic tenting of surgical drapes has a theoretical benefit to decreasing the pooling of oxygen around the surgical site, further investigation is necessary before its routine use is recommended. Copyright © 2016 Elsevier Inc. All rights reserved.

Hypercholesterolemia in patients of ischemic stroke

International Nuclear Information System (INIS)

Saeed, E.; Ali, R.; Din, M.J.U.; Saeed, A.; Jadoon, R.J.

2015-01-01

Background: Stroke is a common neurological disease that results in significant mortality and morbidity globally. Several risk factors have been identified for stroke among which hyperlipidaemia is one of the modifiable risk factors. Recent clinical trials have shown a reduction in ischemic stroke for patients taking lipid lowering medications. Therefore, the aim of this study was to find out the frequency of hypercholesterolemia in patients of ischemic stroke in Hazara region. Method: This cross sectional study was carried out in the Medical Department of Ayub Teaching Hospital, Abbottabad. Ninety patients of stroke confirmed as ischemic by CT scan brain were enrolled in the study after informed consent. The frequency of hypercholesterolemia in patients was recorded. Results: There were 55 (61.1 percentage) males. The mean age of patients was 64.4±11.5 years. The mean serum cholesterol in all patients was 4.16±1.1 mmol/l. The mean serum cholesterol of male patients was 4.3±1.2 mmol/l and 4.0±10.9 mmol/l in the case of females. Conclusions: Hypercholesterolemia could not be established as a major risk factor for stroke in our setup through this study that allude to the fact that other risk factors might be contributing more to the incidence of cerebrovascular accident in our population. (author)

Controls on shallow landslide initiation: Diverse hydrologic pathways, 3D failure geometries, and unsaturated soil suctions

Science.gov (United States)

Reid, Mark; Iverson, Richard; Brien, Dianne; Iverson, Neal; LaHusen, Richard; Logan, Matthew

2017-04-01

pressures. Using coupled 2D variably saturated groundwater flow modeling and 3D limit-equilibrium analyses, we simulated the observed hydrologic behaviors and the time evolution of changes in factors of safety. Our measured parameters successfully reproduced pore pressure observations without calibration. We also quantified the mechanical effects of 3D geometry and unsaturated soil suction on stability. Although suction effects appreciably increased the stability of drier sediment, they were dampened (to effects from the lateral margins consistently increased factors of safety by >20% in wet or dry sediment. Importantly, both 3D and suction effects enabled more accurate simulation of failure times. Without these effects, failure timing and/or back-calculated shear strengths would be markedly incorrect. Our results indicate that simplistic models could not consistently predict the timing of slope failure given diverse hydrologic pathways. Moreover, high frequency monitoring (with sampling periods effects of rapid hydrologic triggers, such as intense rain bursts.

A new suction mask to reduce leak during neonatal resuscitation: a manikin study.

Science.gov (United States)

Lorenz, Laila; Maxfield, Dominic A; Dawson, Jennifer A; Kamlin, C Omar F; McGrory, Lorraine; Thio, Marta; Donath, Susan M; Davis, Peter G

2016-09-01

Leak around the face mask is a common problem during neonatal resuscitation. A newly designed face mask using a suction system to enhance contact between the mask and the infant's face might reduce leak and improve neonatal resuscitation. The aim of the study is to determine whether leak is reduced using the suction mask (Resusi-sure mask) compared with a conventional mask (Laerdal Silicone mask) in a manikin model. Sixty participants from different professional categories (neonatal consultants, fellows, registrars, nurses, midwives and students) used each face mask in a random order to deliver 2 min of positive pressure ventilation to a manikin. Delivered airway pressures were measured using a pressure line. Inspiratory and expiratory flows were measured using a flow sensor, and expiratory tidal volumes and mask leaks were derived from these values. A median (IQR) leak of 12.1 (0.6-39.0)% was found with the conventional mask compared with 0.7 (0.2-4.6)% using the suction mask (p=0.002). 50% of the participants preferred to use the suction mask and 38% preferred to use the conventional mask. There was no correlation between leak and operator experience. A new neonatal face mask based on the suction system reduced leak in a manikin model. Clinical studies to test the safety and effectiveness of this mask are needed. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Auditory Hallucinations in Acute Stroke

Directory of Open Access Journals (Sweden)

Yair Lampl

2005-01-01

Full Text Available Auditory hallucinations are uncommon phenomena which can be directly caused by acute stroke, mostly described after lesions of the brain stem, very rarely reported after cortical strokes. The purpose of this study is to determine the frequency of this phenomenon. In a cross sectional study, 641 stroke patients were followed in the period between 1996–2000. Each patient underwent comprehensive investigation and follow-up. Four patients were found to have post cortical stroke auditory hallucinations. All of them occurred after an ischemic lesion of the right temporal lobe. After no more than four months, all patients were symptom-free and without therapy. The fact the auditory hallucinations may be of cortical origin must be taken into consideration in the treatment of stroke patients. The phenomenon may be completely reversible after a couple of months.

Final Report: Summary of Findings and Recommendations for Suction Devices for Management of Prehospital Combat Casualty Care Injuries

Science.gov (United States)

2017-11-13

Airway Final Report: Summary of Findings and Recommendations for Suction Devices for Management of Prehospital Combat Casualty Care Injuries...Consumer Style Comparison Table of Suction Pump Devices ............................. 103 Appendix H – Web Links for Images for Consumer- Style ...0022 pg. 6 Executive Summary Suction is a critical component of airway management , which is the second leading cause of preventable

COMPARISON OF THE EFFECTIVENESS OF TWO LEVELS OF SUCTION PRESSURE ON OXYGEN SATURATION IN PATIENTS WITH ENDOTRACHEAL TUBE

Directory of Open Access Journals (Sweden)

Muhaji

2017-12-01

Full Text Available Background: Endotracheal suctioning is one of the common supportive measures in intensive care units (ICU, which may be related to complications such as hypoxia. However, a questionable efficacy is still identified to choose suctioning pressure between 130 mmHg and 140 mmHg that is effective for patients with endotracheal tube. Objective: To compare the effectiveness of 130 mmHg and 140 mmHg suctioning pressure on oxygen saturation in patients with endotracheal tube. Methods: This research used a quasy experimental design with pretest and posttest group. The study was conducted from 31 January to 1 March 2017 in the Hospital of Panti Wilasa Citarum and Hospital of Roemani Muhammadiyah Semarang. There were 30 samples recruited using consecutive sampling, with 15 assigned in the 130 mmHg and 140 mmHg suctioning pressure group. Pulse oximetry was used to measure oxygen saturation. Paired t-test and Independent t-test were used for data analysis. Results: Findings showed that there was a statistically significant effect of 130 and 140 mmHg suctioning pressure on oxygen saturation in patients with ETT with p-value <0.05. There was a significant mean difference of oxygen saturation between 130 mmHg and 140 mmHg suctioning pressure group with p-value 0.004 (<0.05. The mean difference of oxygen saturation between both groups was 13.157. Conclusion: The 140 mmHg suctioning pressure is more effective compared with 130 mmHg suctioning pressure in increasing oxygen saturation in patients with ETT.

Stroke code improves intravenous thrombolysis administration in acute ischemic stroke.

Directory of Open Access Journals (Sweden)

Chih-Hao Chen

Full Text Available Timely intravenous (IV thrombolysis for acute ischemic stroke is associated with better clinical outcomes. Acute stroke care implemented with "Stroke Code" (SC may increase IV tissue plasminogen activator (tPA administration. The present study aimed to investigate the impact of SC on thrombolysis.The study period was divided into the "pre-SC era" (January 2006 to July 2010 and "SC era" (August 2010 to July 2013. Demographics, critical times (stroke symptom onset, presentation to the emergency department, neuroimaging, thrombolysis, stroke severity, and clinical outcomes were recorded and compared between the two eras.During the study period, 5957 patients with acute ischemic stroke were admitted; of these, 1301 (21.8% arrived at the emergency department within 3 h of stroke onset and 307 (5.2% received IV-tPA. The number and frequency of IV-tPA treatments for patients with an onset-to-door time of <3 h increased from the pre-SC era (n = 91, 13.9% to the SC era (n = 216, 33.3% (P<0.001. SC also improved the efficiency of IV-tPA administration; the median door-to-needle time decreased (88 to 51 min, P<0.001 and the percentage of door-to-needle times ≤60 min increased (14.3% to 71.3%, P<0.001. The SC era group tended to have more patients with good outcome (modified Rankin Scale ≤2 at discharge (49.5 vs. 39.6%, P = 0.11, with no difference in symptomatic hemorrhage events or in-hospital mortality.The SC protocol increases the percentage of acute ischemic stroke patients receiving IV-tPA and decreases door-to-needle time.

External Suction and Fluid Output in Chest Drains After Lobectomy

DEFF Research Database (Denmark)

Lijkendijk, Marike; Neckelmann, Kirsten; Licht, Peter B

2018-01-01

influences the amount of fluid. METHODS: We randomly assigned (1:1) 106 patients who underwent lobectomy to either low (-5 cm H2O) or high (-20 cm H2O) external suction using an electronic chest drainage system. Only one chest drain was allowed, and we used strict algorithms for chest drain removal, which...... was delegated to staff nurses: air leakage less than 20 mL/min for 6 hours regardless of fluid output, provided it was serous. The primary end point was fluid output after 24 and 48 hours. RESULTS: Mean fluid output was significantly higher with high suction after both 24 (338 ± 265 mL versus 523 ± 215 m...

Vortex cavitation and oscillation in a double-suction volute pump

International Nuclear Information System (INIS)

Sato, T; Nagahara, T; Tanaka, K; Fuchiwaki, M; Shimizu, F

2010-01-01

In recent years, Computational Fluid Dynamics (CFD) codes have been utilized actively in the early part of the product development cycle. Numerical analysis models have also been developed rapidly and have added cavitation flow analysis functions peculiar to hydraulic machines, in which the flow analysis has been developed remarkably with high-precision and high-reliability. On the other hand, it is well known that three kinds of cavitation, such as vortex cavitation, reverse flow cavitation and cloud cavitation appear in a double-suction volute pump. We have much interest in a relationship among the cavitating flows, pump oscillation and noise. In this study, full 3D numerical simulations have been performed using a commercial code inside the pump from the inlet of suction duct to the outlet of delivery duct. The numerical model is based on a combination of multiphase flow equations with the truncated version of the Rayleigh-Plesset model predicting the complicated growth and collapse process of cavity bubbles. This study highlights especially the mechanism of vortex cavitation occurrence from the end of the suction duct in the pump and pump oscillation which causes cavitation noise from the pump. The experimental investigations have also been performed on the cavitating flow with flow visualization to evaluate the numerical results.

Effect of Reynolds Number and Periodic Unsteady Wake Flow Condition on Boundary Layer Development, Separation, and Intermittency Behavior Along the Suction Surface of a Low Pressure Turbine Blade

Science.gov (United States)

Schobeiri, M. T.; Ozturk, B.; Ashpis, David E.

2007-01-01

The paper experimentally studies the effects of periodic unsteady wake flow and different Reynolds numbers on boundary layer development, separation and re-attachment along the suction surface of a low pressure turbine blade. The experimental investigations were performed on a large scale, subsonic unsteady turbine cascade research facility at Turbomachinery Performance and Flow Research Laboratory (TPFL) of Texas A&M University. The experiments were carried out at Reynolds numbers of 110,000 and 150,000 (based on suction surface length and exit velocity). One steady and two different unsteady inlet flow conditions with the corresponding passing frequencies, wake velocities, and turbulence intensities were investigated. The reduced frequencies chosen cover the operating range of LP turbines. In addition to the unsteady boundary layer measurements, surface pressure measurements were performed. The inception, onset, and the extent of the separation bubble information collected from the pressure measurements were compared with the hot wire measurements. The results presented in ensemble-averaged, and the contour plot forms help to understand the physics of the separation phenomenon under periodic unsteady wake flow and different Reynolds number. It was found that the suction surface displayed a strong separation bubble for these three different reduced frequencies. For each condition, the locations defining the separation bubble were determined carefully analyzing and examining the pressure and mean velocity profile data. The location of the boundary layer separation was dependent of the Reynolds number. It is observed that starting point of the separation bubble and the re-attachment point move further downstream by increasing Reynolds number from 110,000 to 150,000. Also, the size of the separation bubble is smaller when compared to that for Re=110,000.

Response of skirted suction caissons to monotonic lateral loading in saturated medium sand

Science.gov (United States)

Li, Da-yong; Zhang, Yu-kun; Feng, Ling-yun; Guo, Yan-xue

2014-08-01

Monotonic lateral load model tests were carried out on steel skirted suction caissons embedded in the saturated medium sand to study the bearing capacity. A three-dimensional continuum finite element model was developed with Z_SOIL software. The numerical model was calibrated against experimental results. Soil deformation and earth pressures on skirted caissons were investigated by using the finite element model to extend the model tests. It shows that the "skirted" structure can significantly increase the lateral capacity and limit the deflection, especially suitable for offshore wind turbines, compared with regular suction caissons without the "skirted" at the same load level. In addition, appropriate determination of rotation centers plays a crucial role in calculating the lateral capacity by using the analytical method. It was also found that the rotation center is related to dimensions of skirted suction caissons and loading process, i.e. the rotation center moves upwards with the increase of the "skirted" width and length; moreover, the rotation center moves downwards with the increase of loading and keeps constant when all the sand along the caisson's wall yields. It is so complex that we cannot simply determine its position like the regular suction caisson commonly with a specified position to the length ratio of the caisson.

Supermarket refrigeration. Optimization of suction pressure in existing refrigerators; Supermarktkaelte. Saugdruck optimieren in Bestandskaelteanlagen

Energy Technology Data Exchange (ETDEWEB)

Berg, Philipp; Mueller, Markus [Eckelmann AG, Wiesbaden (Germany)

2012-06-15

The new E*LDS firmware E*COP{sup +} from Eckelmann AG (Wiesbaden, Federal Republic of Germany) for the optimization of the suction pressure supplies a demand-oriented adaptation of the suction pressure. The new feature is ideal for an update of existing systems with thermostatic expansion valves. Using this update operators of supermarket operators may save about 10% energy with little effort.

Natural convection boundary layer with suction and mass transfer in a porous medium

International Nuclear Information System (INIS)

Bestman, A.R.

1989-03-01

The free convection boundary layer flow with simultaneous heat and mass transfer in a porous medium is studied when the boundary wall moves in its own plane with suction. The study also incorporates chemical reaction for the very simple model of a binary reaction with Arrhenius activation energy. For large suction asymptotic approximate solutions are obtained for the flow variables for various values of the activation energy. (author). 10 refs, 2 figs

The effect of intraoral suction on oxygen-enriched surgical environments: a mechanism for reducing the risk of surgical fires.

Science.gov (United States)

VanCleave, Andrea M; Jones, James E; McGlothlin, James D; Saxen, Mark A; Sanders, Brian J; Vinson, LaQuia A

2014-01-01

In this study, a mechanical model was applied in order to replicate potential surgical fire conditions in an oxygen-enriched environment with and without high-volume suction typical for dental surgical applications. During 41 trials, 3 combustion events were measured: an audible pop, a visible flash of light, and full ignition. In at least 11 of 21 trials without suction, all 3 conditions were observed, sometimes with an extent of fire that required early termination of the experimental trial. By contrast, in 18 of 20 with-suction trials, ignition did not occur at all, and in the 2 cases where ignition did occur, the fire was qualitatively a much smaller, candle-like flame. Statistically comparing these 3 combustion events in the no-suction versus with-suction trials, ignition (P = .0005), audible pop (P = .0211), and flash (P = .0092) were all significantly more likely in the no-suction condition. These results suggest a possible significant and new element to be added to existing surgical fire safety protocols toward making surgical fires the "never-events" they should be.

Protein consumptions in stroke patients

Directory of Open Access Journals (Sweden)

Zahra Maghsoudi

2013-01-01

Full Text Available Background : Stroke is one of the most common causes of disabilities and death all over the world. The mortality rate of stroke is predicted to be doubled by 2030 in the Middle East countries. Nutrition is an effective strategy in prevention and management of stroke. This study assessed the relationship between various protein types and stroke risk. Materials and Methods: This hospital-based case-control study was performed in a University hospital. The data regarding consumption of usual food intake of 69 cases (46 men and 23 women and 60 controls (30 men and 30 women was collected with a food frequency questionnaire (FFQ. The mean consumption of red and white meat and vegetable and processed proteins consumption were compared between two groups. Results: The percent of total of daily protein intake were lower in patients with stroke in both sexes (25.92% vs 30.55% in men and 30.7% vs 31.14% in women. Conclusion: Lower protein consumption may be observed in patients with stroke patients in both sex.

Endoscopic en bloc resection of an exophytic gastrointestinal stromal tumor with suction excavation technique

Science.gov (United States)

Choi, Hyuk Soon; Chun, Hoon Jai; Kim, Kyoung-Oh; Kim, Eun Sun; Keum, Bora; Jeen, Yoon-Tae; Lee, Hong Sik; Kim, Chang Duck

2016-01-01

Here, we report the first successful endoscopic resection of an exophytic gastrointestinal stromal tumor (GIST) using a novel perforation-free suction excavation technique. A 49-year-old woman presented for further management of a gastric subepithelial tumor on the lesser curvature of the lower body, originally detected via routine upper gastrointestinal endoscopy. Abdominal computed tomography and endoscopic ultrasound showed a 4-cm extraluminally protruding mass originating from the muscularis propria layer. The patient firmly refused surgical resection owing to potential cardiac problems, and informed consent was obtained for endoscopic removal. Careful dissection and suction of the tumor was repeated until successful extraction was achieved without serosal injury. We named this procedure the suction excavation technique. The tumor’s dimensions were 3.5 cm × 2.8 cm × 2.5 cm. The tumor was positive for C-KIT and CD34 by immunohistochemical staining. The mitotic count was 6/50 high-power fields. The patient was followed for 5 years without tumor recurrence. This case demonstrated the use of endoscopic resection of an exophytic GIST using the suction excavation technique as a potential therapy without surgical resection. PMID:27340363

Theoretical Analysis of Effects of Wall Suction on Entropy Generation Rate in Laminar Condensate Layer on Horizontal Tube

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Tong-Bou Chang

2014-01-01

Full Text Available The effects of wall suction on the entropy generation rate in a two-dimensional steady film condensation flow on a horizontal tube are investigated theoretically. In analyzing the liquid flow, the effects of both the gravitational force and the viscous force are taken into account. In addition, a film thickness reduction ratio, Sf, is introduced to evaluate the effect of wall suction on the thickness of the condensate layer. The analytical results show that, the entropy generation rate depends on the Jakob number Ja, the Rayleigh number Ra, the Brinkman number Br, the dimensionless temperature difference ψ, and the wall suction parameter Sw. In addition, it is shown that in the absence of wall suction, a closed-form correlation for the Nusselt number can be derived. Finally, it is shown that the dimensionless entropy generation due to heat transfer, NT, increases with an increasing suction parameter Sw, whereas the dimensionless entropy generation due to liquid film flow friction, NF, decreases.

The application of suction caisson technology to offshore wind turbines

Energy Technology Data Exchange (ETDEWEB)

NONE

2005-09-15

A mathematical model describing the behaviour of caisson foundations for offshore wind turbines has been developed. The model has been verified and calibrated through laboratory and field work. Simultaneously, conceptual designs of wind turbine foundations incorporating suction caissons were studied using the same model. It was concluded that much of the seabed around Britain is well suited to the use of caissons and monopod and quadropod structures are superior to tripods. Although suction caissons are vulnerable to scour, rock dumping can largely eliminate this potential problem. The next phase will be to install a fully instrumented full-scale prototype to monitor the effects of wind and waves. The main contractor was SLP Engineering Limited and about 75 per cent of the funding came from the DTI.

Fluid Model of Sliding Suction Cup of Wall-climbing Robots

Directory of Open Access Journals (Sweden)

Fu Zhuang

2008-11-01

Full Text Available The adhering capability, one of the most important performance indexes of wall-climbing robots(WCRs, should be taken into account when a WCR is designed. This paper proposes a novel approach for investigating the adhering characteristics of the sliding suction cup (SSCs using fluid network theory to enhance the adhering capability of WCRs. The fluid models of the SSCs of two WCRs are developed and equivalent circuits in three cases are presented. The dynamic responses of negative pressure in SSCs are obtained and validated by a set of experiments. It indicated that the theoretical analysis is reasonable and can give some valuable design criteria on the structure parameters of SSCs and control strategies of suction force of SSCs.

The effects of suction and pin/lock suspension systems on transtibial amputees' gait performance.

Directory of Open Access Journals (Sweden)

Hossein Gholizadeh

Full Text Available BACKGROUND: The suction sockets that are commonly prescribed for transtibial amputees are believed to provide a better suspension than the pin/lock systems. Nevertheless, their effect on amputees' gait performance has not yet been fully investigated. The main intention of this study was to understand the potential effects of the Seal-in (suction and the Dermo (pin/lock suspension systems on amputees' gait performance. METHODOLOGY/PRINCIPAL FINDINGS: Ten unilateral transtibial amputees participated in this prospective study, and two prostheses were fabricated for each of them. A three-dimensional motion analysis system was used to evaluate the temporal-spatial, kinematics and kinetics variables during normal walking. We also asked the participants to complete some part of Prosthesis Evaluation Questionnaire (PEQ regarding their satisfaction and problems with both systems. The results revealed that there was more symmetry in temporal-spatial parameters between the prosthetic and sound limbs using the suction system. However, the difference between two systems was not significant (p<0.05. Evaluation of kinetic data and the subjects' feedback showed that the participants had more confidence using the suction socket and the sockets were more fit for walking. Nevertheless, the participants had more complaints with this system due to the difficulty in donning and doffing. CONCLUSION: It can be concluded that even though the suction socket could create better suspension, fit, and gait performance, overall satisfaction was higher with the pin/lock system due to easy donning and doffing of the prosthesis. TRIAL REGISTRATION: irct.ir IRCT2014012816395N1.

Numerical Study of Piping Limits for Suction Installation of Offshore Skirted Foundations an Anchors in Layered Sand

DEFF Research Database (Denmark)

Ibsen, Lars Bo; Thilsted, C. L.

2010-01-01

Skirted foundations and anchors have proved to be competitive solutions for various types of fixed offshore platforms, subsea systems and an attractive foundation alternative for offshore wind turbines. One main design challenge for skirted structures in sand is to penetrate the skirted deep enough...... to obtain the required capacity. In order to overcome the high penetration resistance in sand suction assisted penetration is needed. Suction installation may cause the formation of piping channels, which break down the hydraulic seal and prevent further installation. This paper presents a numerical study...... of failure limits during suction installation in respect to both homogenous and layered soil profile. A numerical flow analysis is performed to determine the hydraulic gradients developing in response to the suction applied, and the results are presented as simple closed form solutions useful for evaluation...

[Impacts of the low-frequency electric stimulation at the acupoints on the content of plasma 5-HT and NE in the patients with post-stroke insomnia].

Science.gov (United States)

Tang, Lei; Ma, Chaoyan; You, Fei; Ding, Lin

2015-08-01

To compare the clinical efficacy on post-stroke insomnia between the low-frequency electric stimulation at the acupoints and the conventional western medication in the patients so as to explore the effect mechanism. One hundred and twenty patients of post-stroke insomnia were randomized into a low-frequency electric stimulation group, a medication group and a placebo group, 40 cases in each one. In the low-frequency electric stimulation group, the low-frequency pulse electric apparatus was applied to stimulate Dazhui (GV 14) and Shenshu (BL 23), once every day. The treatment for 15 days made one session and 2 sessions were required. In the medication group, estazolam was taken orally, 1 mg each time; and in the placebo group, the starch capsules were taken, one capsule each time; in the two groups the treatment was adopted before sleep every night, continuously for 15 days as one session, and 2 sessions were required. The levels of plasma 5-hydroxytryptamine (5-HT) and norepinephrine (NE) were compared before and after treatment in the patients of the three groups and: the efficacy was compared. In the placebo group, 1 case was dropped out. The total effective rate was 95. 0% (38/40), 92. 5% (37/40) and 17. 9% (7/39) in the low-frequency electric stimulation group, the medication group and the placebo group respectively. The effects in the low-frequency electric stimulation group and the medication group were better apparently than that in the placebo group (both Plow-frequency electric stimulation group and the medication group (P>0. 05). The levels of plasma 5-HT and NE were not different significantly between before and after treatment in the placebo group. The level of plasma 5-HT was increased (both Plow-frequency electric stimulation group and the medication group. But the differences were not significant between the two groups (P>0. 05). The low-frequency electric stimlaton a the acupoints is safe and effective in the treatment of post-stroke insomnia, which

Influence of saturation degree and role of suction in unsaturated soils behaviour: application to liquefaction

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Vernay Mathilde

2016-01-01

Full Text Available The effect of the pore fluid compressibility on liquefaction has been studied by various authors. But few papers have been published about the role of suction in cyclic behavior of unsaturated soils. Most of these works use Skempton coefficient B as a reference in terms of saturation degree to analyze their results. The use of B in experimental conditions is convenient, but is not accurate when studying liquefaction behavior, since effects of suction are neglected. In this paper, the influence of saturation degree on mechanical behavior of a soil under dynamic loads is studied. Cyclic undrained triaxial tests were performed on sand samples, under various levels of saturation. Soil-water characteristic curve was used, in order to study influence of suction. The first results confirm that when the degree of saturation decreases, the resistance increases. Initial positive suction tends to stiffen the soil. It also appears that the presence of air delays the occurrence of liquefaction, but doesn’t prevent it. Indeed, liquefaction is observed, whether the soil is saturated or not.

Gravity separation of pericardial fat in cardiotomy suction blood: an in vitro model.

Science.gov (United States)

Kinard, M Rhett; Shackelford, Anthony G; Sistino, Joseph J

2009-06-01

Fat emboli generated during cardiac surgery have been shown to cause neurologic complications in patients postoperatively. Cardiotomy suction has been known to be a large generator of emboli. This study will examine the efficacy of a separation technique in which the cardiotomy suction blood is stored in a cardiotomy reservoir for various time intervals to allow spontaneous separation of fat from blood by density. Soybean oil was added to heparinized porcine blood to simulate the blood of a patient with hypertriglyceridemia (> 150 mg/dL). Roller pump suction was used to transfer the room temperature blood into the cardiotomy reservoir. Blood was removed from the reservoir in 200-mL aliquots at 0, 15, 30 45, and 60 minutes. Samples were taken at each interval and centrifuged to facilitate further separation of liquid fat. Fat content in each sample was determined by a point-of-care triglyceride analyzer. Three trials were conducted for a total of 30 samples. The 0-minute group was considered a baseline and was compared to the other four times. Fat concentration was reduced significantly in the 45- and 60-minute groups compared to the 0-, 15-, and 30-minute groups (p Gravity separation of cardiotomy suction blood is effective; however, it may require retention of blood for more time than is clinically acceptable during a routing coronary artery bypass graft surgery.

78 FR 20316 - Final Issuance of General NPDES Permits (GP) for Small Suction Dredges in Idaho

Science.gov (United States)

2013-04-04

... System (NPDES) General Permit (IDG-37-0000) to placer mining operations in Idaho for small suction... Small Suction Dredges in Idaho AGENCY: Environmental Protection Agency, Region 10. ACTION: Final notice... significant economic impact on a substantial number of small entities.'' EPA has concluded that NPDES general...

Development of advanced stability theory suction prediction techniques for laminar flow control. [on swept wings

Science.gov (United States)

Srokowski, A. J.

1978-01-01

The problem of obtaining accurate estimates of suction requirements on swept laminar flow control wings was discussed. A fast accurate computer code developed to predict suction requirements by integrating disturbance amplification rates was described. Assumptions and approximations used in the present computer code are examined in light of flow conditions on the swept wing which may limit their validity.

A Report on Deliverable Three: Determine a Standard Performance Test for Military Suction Device Use

Science.gov (United States)

2017-09-20

evaluating device suction while either wetted or completely immersed is highly important to predict performance in battlefield scenarios. Summary...mechanical, electrical, and environmental. OBJECTIVE: Research and review current test methods outlined in ISO 10079 and published journal articles...of contemporary oropharyngeal suction. The American journal of emergency medicine 17, 611- 613 (1999). 4. Hodgetts, T., Mahoney, P., Evans, G

The use of IV-tubing as a closed-suction drainage system during neurosurgical cases in Tanzania.

Science.gov (United States)

Bonfield, Christopher M; Shabani, Hamisi K; Kanumba, Emmanuel S; Ellegala, Dilantha B; Nicholas, Joyce

2013-01-01

Commercial closed-suctions drainage systems are commonly used in the United States and many other countries for use in neurosurgical cases. However, in Tanzania and other developing nations with fewer resources, these are not available. This report explores another option for a closed-system drainage system utilizing inexpensive supplies found commonly in hospitals around the world. Sterile IV-tubing is cut, inserted into the wound, and brought out through an adjacent puncture incision. For suction, an empty plastic bottle can be attached to the tubing. The IV-tubing closed-suction drainage system was applied in both cranial and spinal neurosurgical procedures, including as subdural, subgaleal, epidural, and suprafacial drains. It maintained suction and was an adequate substitute when commercial drains are unavailable. This report illustrates how sterile IV-tubing can be adapted for use as a closed-drainage system. It utilizes inexpensive supplies commonly found in many hospitals throughout the world and can be applied to both cranial and spinal neurosurgical procedures.

Ischemic stroke risk, smoking, and the genetics of inflammation in a biracial population: the stroke prevention in young women study

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Sorkin John D

2008-08-01

Full Text Available Abstract Background Although cigarette smoking is a well-established risk factor for vascular disease, the genetic mechanisms that link cigarette smoking to an increased incidence of stroke are not well understood. Genetic variations within the genes of the inflammatory pathways are thought to partially mediate this risk. Here we evaluate the association of several inflammatory gene single nucleotide polymorphisms (SNPs with ischemic stroke risk among young women, further stratified by current cigarette smoking status. Methods A population-based case-control study of stroke among women aged 15–49 identified 224 cases of first ischemic stroke (47.3% African-American and 211 age-comparable control subjects (43.1% African-American. Several inflammatory candidate gene SNPs chosen through literature review were genotyped in the study population and assessed for association with stroke and interaction with smoking status. Results Of the 8 SNPs (across 6 genes analyzed, only IL6 SNP rs2069832 (allele C, African-American frequency = 92%, Caucasian frequency = 55% was found to be significantly associated with stroke using an additive model, and this was only among African-Americans (age-adjusted: OR = 2.2, 95% CI = 1.0–5.0, p = 0.049; risk factor adjusted: OR = 2.5, 95% CI = 1.0–6.5, p = 0.05. When stratified by smoking status, two SNPs demonstrated statistically significant gene-environment interactions. First, the T allele (frequency = 5% of IL6 SNP rs2069830 was found to be protective among non-smokers (OR = 0.30, 95% CI = 0.11–.082, p = 0.02, but not among smokers (OR = 1.63, 95% CI = 0.48–5.58, p = 0.43; genotype by smoking interaction (p = 0.036. Second, the C allele (frequency = 39% of CD14 SNP rs2569190 was found to increase risk among smokers (OR = 2.05, 95% CI = 1.09–3.86, p = 0.03, but not among non-smokers (OR = 0.93, 95% CI = 0.62–1.39, p = 0.72; genotype by smoking interaction (p = 0.039. Conclusion This study demonstrates

Deriving the suction stress of unsaturated soils from water retention curve, based on wetted surface area in pores

Science.gov (United States)

Greco, Roberto; Gargano, Rudy

2016-04-01

The evaluation of suction stress in unsaturated soils has important implications in several practical applications. Suction stress affects soil aggregate stability and soil erosion. Furthermore, the equilibrium of shallow unsaturated soil deposits along steep slopes is often possible only thanks to the contribution of suction to soil effective stress. Experimental evidence, as well as theoretical arguments, shows that suction stress is a nonlinear function of matric suction. The relationship expressing the dependence of suction stress on soil matric suction is usually indicated as Soil Stress Characteristic Curve (SSCC). In this study, a novel equation for the evaluation of the suction stress of an unsaturated soil is proposed, assuming that the exchange of stress between soil water and solid particles occurs only through the part of the surface of the solid particles which is in direct contact with water. The proposed equation, based only upon geometric considerations related to soil pore-size distribution, allows to easily derive the SSCC from the water retention curve (SWRC), with the assignment of two additional parameters. The first parameter, representing the projection of the external surface area of the soil over a generic plane surface, can be reasonably estimated from the residual water content of the soil. The second parameter, indicated as H0, is the water potential, below which adsorption significantly contributes to water retention. For the experimental verification of the proposed approach such a parameter is considered as a fitting parameter. The proposed equation is applied to the interpretation of suction stress experimental data, taken from the literature, spanning over a wide range of soil textures. The obtained results show that in all cases the proposed relationships closely reproduces the experimental data, performing better than other currently used expressions. The obtained results also show that the adopted values of the parameter H0

Strokes attributable to underuse of warfarin and antiplatelets

DEFF Research Database (Denmark)

Olsen, Tom Skyhøj; Rasmussen, Berit Hammershaimb; Kammersgaard, Lars Peter

2007-01-01

Despite their proven efficacy in stroke prevention, warfarin and antiplatelets remain underused. We determined the frequency of ischemic strokes attributable to underuse of warfarin and antiplatelets for stroke prevention in a Danish community. We included all patients with ischemic stroke...... in a Copenhagen community with 302,000 inhabitants admitted to the hospital between September 1999 and May 2000 (n = 426). Patients who did not receive warfarin or antiplatelet medication even though they were at known risk for cardiovascular disease before the incident stroke were identified; they had known...... not received warfarin or antiplatelets on admission, 27 had not received warfarin but had received antiplatelets, and 11 had received warfarin. Assuming that warfarin and antiplatelets reduces the risk of stroke by 66% and 25%, respectively, it was calculated that between 6 and 12 of these strokes with atrial...

Stroke in tuberculous meningitis.

Science.gov (United States)

Misra, Usha Kant; Kalita, Jayantee; Maurya, Pradeep Kumar

2011-04-15

Stroke in tuberculous meningitis (TBM) occurs in 15-57% of patients especially in advance stage and severe illness. The majority of strokes may be asymptomatic because of being in a silent area, deep coma or associated pathology such as spinal arachnoiditis or tuberculoma. Methods of evaluation also influence the frequency of stroke. MRI is more sensitive in detecting acute (DWI) and chronic (T2, FLAIR) stroke. Most of the strokes in TBM are multiple, bilateral and located in the basal ganglia especially the 'tubercular zone' which comprises of the caudate, anterior thalamus, anterior limb and genu of the internal capsule. These are attributed to the involvement of medial striate, thalamotuberal and thalamostriate arteries which are embedded in exudates and likely to be stretched by a coexistent hydrocephalus. Cortical stroke can also occur due to the involvement of proximal portion of the middle, anterior and posterior cerebral arteries as well as the supraclinoid portion of the internal carotid and basilar arteries which are documented in MRI, angiography and autopsy studies. Arteritis is more common than infarction in autopsy study. The role of cytokines especially tumor necrosis factor (TNFα), vascular endothelial growth factor (VEGF) and matrix metaloproteineases (MMPs) in damaging the blood brain barrier, attracting leucocytes and release of vasoactive autocoids have been suggested. The prothrombotic state may also contribute to stroke in TBM. Corticosteroids with antitubercular therapy were thought to reduce mortality and morbidity but their role in reducing strokes has not been proven. Aspirin also reduces mortality and its role in reducing stroke in TBM needs further studies. Copyright © 2010 Elsevier B.V. All rights reserved.

Experimental study on occurrence-time ratio measurements of air entrainment in a suction sump

International Nuclear Information System (INIS)

Inagaki, K; Funaki, J; Hirata, K

2009-01-01

In order to get accurate measurements of air entrainment in a suction sump, we design some new simple bubble sensors, which can detect the existence of air bubbles inside a suction pipe with no disturbances by the sensors and with a fine spatial resolution. We force on an intermittency factor γ, that is, an occurrence-time ratio of the air entrainment, and compare the result by the present sensor with those by conventional two methods; namely, visual and auditory ones. As a result, we show the criteria which specify lower-accuracy conditions in the conventional methods. By the visual method, the accuracy of the γ becomes low, when γ is less than 0.05. By the auditory method, the accuracy of γ becomes low, when the submergence depth S of the suction pipe is close to the critical one S c .

Neuroserpin polymorphisms and stroke risk in a biracial population: the stroke prevention in young women study

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Stern Barney J

2007-10-01

Full Text Available Abstract Background Neuroserpin, primarily localized to CNS neurons, inhibits the adverse effects of tissue-type plasminogen activator (tPA on the neurovascular unit and has neuroprotective effects in animal models of ischemic stroke. We sought to evaluate the association of neuroserpin polymorphisms with risk for ischemic stroke among young women. Methods A population-based case-control study of stroke among women aged 15–49 identified 224 cases of first ischemic stroke (47.3% African-American and 211 age-matched control subjects (43.1% African-American. Neuroserpin single nucleotide polymorphisms (SNPs chosen through HapMap were genotyped in the study population and assessed for association with stroke. Results Of the five SNPs analyzed, the A allele (frequency; Caucasian = 0.56, African-American = 0.42 of SNP rs6797312 located in intron 1 was associated with stroke in an age-adjusted dominant model (AA and AT vs. TT among Caucasians (OR = 2.05, p = 0.023 but not African-Americans (OR = 0.71, p = 0.387. Models adjusting for other risk factors strengthened the association. Race-specific haplotype analyses, inclusive of SNP rs6797312, again demonstrated significant associations with stroke among Caucasians only. Conclusion This study provides the first evidence that neuroserpin is associated with early-onset ischemic stroke among Caucasian women.

Improved Suction Technique for the Characterization of Construction Materials

DEFF Research Database (Denmark)

Thygesen, Lisbeth Garbrecht; Hansen, Kurt Kielsgaard

2007-01-01

The suction technique is a method from soil science that is used for the study of moisture storage capacity in porous construction materials at high relative humidity levels (above approximately 93%). The samples to be studied are placed in a pressurized container (an extractor) on a water...

Risk factors in various subtypes of ischemic stroke according to TOAST criteria.

Science.gov (United States)

Aquil, Nadia; Begum, Imtiaz; Ahmed, Arshia; Vohra, Ejaz Ahmed; Soomro, Bashir Ahmed

2011-05-01

To identify the frequency of risk factors in various subtypes of acute ischemic stroke according to TOAST criteria. Cross-sectional, observational study. Ziauddin Hospital, Karachi, from January to December 2007. Patients with acute ischemic stroke were enrolled. Studied variables included demographic profile, history of risk factors, physical and neurological examination, and investigations relevant with the objectives of the study. Findings were described as frequency percentages. Proportions of risk factors against subtypes was compared using chi-square test with significance at p dyslipedemia in 22%, smoking in 9%, atrial fibrillation in 5%, and previous history of stroke in 29%. The various subtypes of acute ischemic stroke were lacunar infarct in 43%, large artery atherosclerosis in 31%, cardioembolic type in 8%, stroke of other determined etiology in 1% and stroke of undetermined etiology in 18%. Hypertension and Diabetes were the most important risk factors in both large and small artery atherosclerosis. In patients with cardio-embolic stroke significant association was found with ischemic heart disease (p=0.01). Importance and relevance of risk factors evaluated for subtypes rather than ischemic stroke as a whole should be reflected in preventive efforts against the burden of ischemic stroke.

Effects of stroke education of junior high school students on stroke knowledge of their parents: Tochigi project.

Science.gov (United States)

Matsuzono, Kosuke; Yokota, Chiaki; Takekawa, Hidehiro; Okamura, Tomonori; Miyamatsu, Naomi; Nakayama, Hirofumi; Nishimura, Kunihiro; Ohyama, Satoshi; Ishigami, Akiko; Okumura, Kosuke; Toyoda, Kazunori; Miyamoto, Yoshihiro; Minematsu, Kazuo

2015-02-01

Educating the youth about stroke is a promising approach for spreading stroke knowledge. The aim of this study was to verify communication of stroke knowledge to parents by educating junior high school students about stroke. We enrolled 1127 junior high school students (age, 13-15 years) and their parents in the Tochigi prefecture, Japan. All students received a stroke lesson, watched an animated cartoon, and read the related Manga comic as educational aids. The students took back home the Manga and discussed what they learned with their parents. Questionnaires on stroke knowledge were given to all at baseline and immediately after the lesson. A total of 1125 students and 915 parents answered the questionnaires. In the students, the frequency of correct answers increased significantly for all questions on stroke symptoms except for headache, and for all questions on risk factors after the lesson. In the parents, the correct answer rates increased for stroke symptoms except for headache and numbness in one side of the body, and for all questions on risk factors except for hypertension. Ninety-one percent of students and 92.7% of parents correctly understood the Face, Arm, Speech, and Time (FAST) mnemonic after the lesson. Improvement of stroke knowledge immediately after the stroke lesson was observed in parents as well as their children, which indicated that our teaching materials using the Manga was effective in delivering the stroke knowledge to parents through their children. © 2014 American Heart Association, Inc.

Radon Sub-slab Suctioning System Integrated in Insulating Layer

DEFF Research Database (Denmark)

Rasmussen, Torben Valdbjørn

2013-01-01

This poster presents a new radon sub-slab suctioning system. This system makes use of a grid of horizontal pressurised air ducts located within the lower part of the rigid insulation layer of the ground floor slab. For this purpose a new system of prefabricated lightweight elements is introduced...

Alternative Shape of Suction Caisson to Reduce Risk of Buckling under high Pressure

DEFF Research Database (Denmark)

Madsen, Søren; Andersen, Lars Vabbersgaard; Ibsen, Lars Bo

2013-01-01

Using large suction caissons for offshore wind turbines is an upcoming technology also referred to as bucket foundations. During operation the bucket foundation is loaded by a large overturning moment from the wind turbine and the wave loads. However, during installation the bucket is loaded...... cylindrical monopod foundation made of steel. In this paper, an alternative design/shape of the suction caisson, having a smaller risk of buckling under high pressure is presented. The risk of structural buckling is addressed using numerical methods to determine the buckling pressures of the re...

Evaluation of the combination of radio frequency, infrared energy and mechanical rollers with suction to improve skin surface irregularities (cellulite) in a limited treatment area.

Science.gov (United States)

Kulick, Michael

2006-12-01

This IRB-approved (Institutional Review Board) study evaluated the efficacy of a device that combines radio frequency, infrared energy and mechanical rollers/suction (ELOS technology) to reduce skin surface irregularities in a limited treatment zone. Sixteen patients were enrolled and received two treatments per week for 4 consecutive weeks. Treatments were limited to a 20.53 cm x 33.02 cm area of the posterior or lateral thigh and lasted for 15 minutes. Maximum machine settings were used for all but one individual at every treatment. Evaluations consisted of a patient questionnaire and photographic assessment of skin contour by three physicians at 3 and 6 months after the last session who were blind to the treatment each patient received. Physician evaluators determined that all patients were improved at both post-treatment periods. The average improvement at 3 and 6 months was 62% and 50%, respectively. All patients felt they were improved. One patient described the treatment as painful and required reduced treatment parameters after the initial treatment. Bruising within the treatment area was observed in five patients following the initial sessions but this did not alter the treatment protocol and did not occur in subsequent treatments. One patient had a superficial skin burn due to poor electrode contact that did not require corrective treatment.

Dietary patterns are associated with incident stroke and contribute to excess risk of stroke in Black Americans

Science.gov (United States)

Judd, Suzanne E; Gutiérrez, Orlando M.; Newby, PK; Howard, George; Howard, Virginia J; Locher, Julie L; Kissela, Brett M; Shikany, James M

2014-01-01

Background and Purpose Black Americans and residents of the Southeastern United States, are at increased risk of stroke. Diet is one of many potential factors proposed that might explain these racial and regional disparities. Methods Between 2003–2007, the REasons for Geographic and Racial Differences in Stroke (REGARDS) cohort study enrolled 30,239 black and white Americans aged 45 years or older. Dietary patterns were derived using factor analysis and foods from food frequency data. Incident strokes were adjudicated using medical records by a team of physicians. Cox proportional hazards models were used to examine risk of stroke. Results Over 5.7 years, 490 incident strokes were observed. In a multivariable-adjusted analysis, greater adherence to the Plant-based pattern was associated with lower stroke risk (HR=0.71; 95% CI=0.56–0.91; ptrend=0.005). This association was attenuated after addition of income, education, total energy intake, smoking, and sedentary behavior. Participants with a higher adherence to the Southern pattern experienced a 39% increased risk of stroke (HR=1.39; 95% CI=1.05, 1.84), with a significant (p = 0.009) trend across quartiles. Including Southern pattern in the model mediated the black-white risk of stroke by 63%. Conclusions These data suggest that adherence to a Southern style diet may increase the risk of stroke while adherence to a more plant-based diet may reduce stroke risk. Given the consistency of finding a dietary impact on stroke risk across studies, discussing nutrition patterns during risk screening may be an important step in reducing stroke. PMID:24159061

Process improvement methodologies uncover unexpected gaps in stroke care.

Science.gov (United States)

Kuner, Anthony D; Schemmel, Andrew J; Pooler, B Dustin; Yu, John-Paul J

2018-01-01

Background The diagnosis and treatment of acute stroke requires timed and coordinated effort across multiple clinical teams. Purpose To analyze the frequency and temporal distribution of emergent stroke evaluations (ESEs) to identify potential contributory workflow factors that may delay the initiation and subsequent evaluation of emergency department stroke patients. Material and Methods A total of 719 sentinel ESEs with concurrent neuroimaging were identified over a 22-month retrospective time period. Frequency data were tabulated and odds ratios calculated. Results Of all ESEs, 5% occur between 01:00 and 07:00. ESEs were most frequent during the late morning and early afternoon hours (10:00-14:00). Unexpectedly, there was a statistically significant decline in the frequency of ESEs that occur at the 14:00 time point. Conclusion Temporal analysis of ESEs in the emergency department allowed us to identify an unexpected decrease in ESEs and through process improvement methodologies (Lean and Six Sigma) and identify potential workflow elements contributing to this observation.

A Constitutive Model for Unsaturated soils based on a Compressibility Framework dependent on Suction and Degree of Saturation

Directory of Open Access Journals (Sweden)

Sitarenios Panagiotis

2016-01-01

Full Text Available The Modified Cam Clay model is extended to account for the behaviour of unsaturated soils using Bishop’s stress. To describe the Loading – Collapse behaviour, the model incorporates a compressibility framework with suction and degree of saturation dependent compression lines. For simplicity, the present paper describes the model in the triaxial stress space with characteristic simulations of constant suction compression and triaxial tests, as well as wetting tests. The model reproduces an evolving post yield compressibility under constant suction compression, and thus, can adequately describe a maximum of collapse.

Numerical Investigation of Wall Cooling and Suction Effects on Supersonic Flat-Plate Boundary Layer Transition Using Large Eddy Simulation

Directory of Open Access Journals (Sweden)

Suozhu Wang

2015-02-01

Full Text Available Reducing friction resistance and aerodynamic heating has important engineering significance to improve the performances of super/hypersonic aircraft, so the purpose of transition control and turbulent drag reduction becomes one of the cutting edges in turbulence research. In order to investigate the influences of wall cooling and suction on the transition process and fully developed turbulence, the large eddy simulation of spatially evolving supersonic boundary layer transition over a flat-plate with freestream Mach number 4.5 at different wall temperature and suction intensity is performed in the present work. It is found that the wall cooling and suction are capable of changing the mean velocity profile within the boundary layer and improving the stability of the flow field, thus delaying the onset of the spatial transition process. The transition control will become more effective as the wall temperature decreases, while there is an optimal wall suction intensity under the given conditions. Moreover, the development of large-scale coherent structures can be suppressed effectively via wall cooling, but wall suction has no influence.

Analysis of Infiltration-Suction Response in Unsaturated Residual Soil Slope in Gelugor, Penang

Science.gov (United States)

Ashraf Mohamad Ismail, Mohd; Hasliza Hamzah, Nur; Min, Ng Soon; Hazreek Zainal Abidin, Mohd; Tajudin, Saiful Azhar Ahmad; Madun, Aziman

2018-04-01

Rainfall infiltration on residual soil slope may impair slope stability by altering the pore-water pressure in the soil. A study has been carried out on unsaturated residual soil slope in Gelugor, Penang to determine the changes in matric suction of residual soils at different depth due to rainwater infiltration. The sequence of this study includes the site investigation, field instrumentation, laboratory experiment and numerical modeling. Void ratio and porosity of soil were found to be decreasing with depth while the bulk density and dry density of soil increased due to lower porosity of soil at greater depth. Soil infiltration rate and matric suction of all depths decrease with the increase of volumetric water content as well as the degree of saturation. Numerical modeling was used to verify and predict the relationship between infiltration-suction response and degree of saturation. Numerical models can be used to integrate the rainfall scenarios into quantitative landslide hazard assessments. Thus, development plans and mitigation measures can be designed for estimated impacts from hazard assessments based on collected data.

[Elements of system semiotics of the brain and head with cranial vessels of patients with stroke and with risk of stroke development].

Science.gov (United States)

Makomela, N M

2007-01-01

By means of a multispiral computer and magnetic resonance tomography 211 patients with an ischemic stroke, 109 patients with hemorrhagic stroke, 41 patients with an arterial hypertensia, 43 patients with aneurism, 58 patients with discirculation encephalopathy, 125 patients with ischemic illness of heart, practically healthy 62 have been observed. The author found high frequency of pathological deformations of carotid and vertebral arteries of not closed arterial circle, calcification of the pineal body and vascular plexus of lateral ventricles. cysts of maxillary sinuses of patients with stroke in comparison with patients at risk of the development of stroke and practically healthy subjects.

MHD flow over a permeable stretching/shrinking sheet of a nanofluid with suction/injection

Directory of Open Access Journals (Sweden)

Sandeep Naramgari

2016-06-01

Full Text Available In this study we analyzed the influence of thermal radiation and chemical reaction on two dimensional steady magnetohydrodynamic flow of a nanofluid past a permeable stretching/shrinking sheet in the presence of suction/injection. We considered nanofluid volume fraction on the boundary is submissive controlled, which makes the present study entirely different from earlier studies and physically more realistic. The equations governing the flow are solved numerically. Effects of non-dimensional governing parameters on velocity, temperature and concentration profiles are discussed and presented through graphs. Also, coefficient of skin friction and local Nusselt number is investigated for stretching/shrinking and suction/injection cases separately and presented through tables. Comparisons with existed results are presented. Present results have an excellent agreement with the existed studies under some special assumptions. Results indicate that the enhancement in Brownian motion and thermophoresis parameters depreciates the nanoparticle concentration and increases the mass transfer rate. Dual solutions exist only for certain range of stretching/shrinking and suction/injection parameters.

Tube suction test for evaluating durability of cementitiously stabilized soils.

Science.gov (United States)

2011-06-01

In a comprehensive laboratory study, different tests namely, unconfined compressive strength (UCS) at the end of freeze-thaw/wet-dry (F-T/W-D) cycles, resilient modulus (Mr) at the end of F-T/W-D cycles, vacuum saturation, tube suction, and moisture ...

Tube suction test for evaluating durability of cementitiously stabilized soils.

Science.gov (United States)

2011-06-01

In a comprehensive laboratory study, different tests namely, unconfined compressive strength (UCS) at the end of freeze-thaw/wet-dry (FT/ : W-D) cycles, resilient modulus (Mr) at the end of F-T/W-D cycles, vacuum saturation, tube suction, and moistur...

Evaluation of stroke services in Anglia stroke clinical network to examine the variation in acute services and stroke outcomes

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George Abraham

2011-02-01

Full Text Available Abstract Background Stroke is the third leading cause of death in developed countries and the leading cause of long-term disability worldwide. A series of national stroke audits in the UK highlighted the differences in stroke care between hospitals. The study aims to describe variation in outcomes following stroke and to identify the characteristics of services that are associated with better outcomes, after accounting for case mix differences and individual prognostic factors. Methods/Design We will conduct a cohort study in eight acute NHS trusts within East of England, with at least one year of follow-up after stroke. The study population will be a systematically selected representative sample of patients admitted with stroke during the study period, recruited within each hospital. We will collect individual patient data on prognostic characteristics, health care received, outcomes and costs of care and we will also record relevant characteristics of each provider organisation. The determinants of one year outcome including patient reported outcome will be assessed statistically with proportional hazards regression models. Self (or proxy completed EuroQol (EQ-5D questionnaires will measure quality of life at baseline and follow-up for cost utility analyses. Discussion This study will provide observational data about health service factors associated with variations in patient outcomes and health care costs following hospital admission for acute stroke. This will form the basis for future RCTs by identifying promising health service interventions, assessing the feasibility of recruiting and following up trial patients, and provide evidence about frequency and variances in outcomes, and intra-cluster correlation of outcomes, for sample size calculations. The results will inform clinicians, public, service providers, commissioners and policy makers to drive further improvement in health services which will bring direct benefit to the patients.

Safety System for Controlling Fluid Flow into a Suction Line

Science.gov (United States)

England, John Dwight (Inventor); Kelley, Anthony R. (Inventor); Cronise, Raymond J. (Inventor)

2018-01-01

A safety system includes a sleeve fitted within a pool's suction line at its inlet. The sleeve terminates with a plate that resides within the suction line. The plate has holes formed therethrough. A housing defining distinct channels is fitted in the sleeve so that the distinct channels lie within the sleeve. Each of the distinct channels has a first opening on one end thereof and a second opening on another end thereof. The second openings reside in the sleeve. The first openings are in fluid communication with the water in the pool, and are distributed around a periphery of an area of the housing that prevents coverage of all the first openings when a human interacts therewith. A first sensor is coupled to the sleeve to sense pressure therein, and a second pressure sensor is coupled to the plate to sense pressure in one of the plates' holes.

Stroke and sleep-disordered breathing: A relationship under construction.

Science.gov (United States)

Parra, Olga; Arboix, Adrià

2016-02-16

The association between sleep-disordered breathing (SDB) and cardiovascular risk has been the focus of attention in recent years. Sleep disorders are emerging risk factors for cardiovascular disease and have been related to the whole spectrum of stroke, including transient ischemic attack, ischemic cerebral infarction and intracerebral haemorrhage. It has been shown that lacunar stroke or lacunar infarctions affecting the internal capsule or the protuberance are associated with a higher frequency of SDB. Acute stroke patients with associated SDB have a worse prognosis and a higher mortality as compared to patients with first-ever stroke without SDB. Preliminary studies provide evidence of the usefulness of treatment with continuous positive airway pressure when SDB is present in stroke patients.

Vapor pressure lowering effects due to salinity and suction pressure in the depletion of vapor-dominated geothermal reservoirs

Energy Technology Data Exchange (ETDEWEB)

Battistelli, A. [Aquater S.p.A., Pisa (Italy); Calore, C. [Istituto Internazionale per le Ricerche Geotermiche-CNR, Pisa (Italy); Pruess, K. [Lawrence Berkeley Lab., Berkeley, CA (United States)

1995-03-01

The equation-of-state module able to handle saline brines with non-condensible gas, developed for the TOUGH2 simulator, has been improved to include vapor pressure lowering (VPL) due to suction pressure as represented by Kelvin`s equation. In this equation the effects of salt are considered whereas those of non-condensible gas have currently been neglected. Numerical simulations of fluid production from tight matrix blocks have been performed to evaluate the impact of VPL effects due to salinity and suction pressure on the depletion behaviour of vapor-dominated geothermal reservoirs. Previous studies performed neglected VPL due to suction pressure showed that for initial NaCl mass fractions above threshold values, {open_quotes}sealing{close_quotes} of the block occurs and large amounts of liquid fluid may not be recovered. On the other hand, below the threshold value the matrix block dries out due to fluid production. The inclusion of VPL due to suction pressure does not allow complete vaporization of the liquid phase. As a result, the threshold NaCl concentration above which sealing of the matrix block occurs is increased. Above the {open_quotes}critical{close_quotes} NaCl concentration, block depletion behaviour with and without the VPL due to suction pressure is almost identical, as liquid phase saturation remains high even after long production times. As the VPL due to suction pressure depends mainly on capillary pressure, the shape of capillary pressure functions used in numerical simulations is important in determining VPL effects on block depletion.

Stroke Incidence by Major Pathological Type and Ischemic Subtypes in the Auckland Regional Community Stroke Studies: Changes Between 2002 and 2011.

Science.gov (United States)

Krishnamurthi, Rita V; Barker-Collo, Suzanne; Parag, Varsha; Parmar, Priyakumari; Witt, Emma; Jones, Amy; Mahon, Susan; Anderson, Craig S; Barber, P Alan; Feigin, Valery L

2018-01-01

Major pathological stroke types (ischemic stroke [IS], primary intracerebral hemorrhage [ICH], and subarachnoid hemorrhage) and IS subtypes, have differing risk factors, management, and prognosis. We report changes in major stroke types and IS subtypes incidence during 10 years using data from the ARCOS (Auckland Regional Community Stroke Study) III performed during 12 months in 2002 to 2003 and the fourth ARCOS study (ARCOS-IV) performed in 2011 to 2012. ARCOS-III and ARCOS-IV were population-based registers of all new strokes in the greater Auckland region (population aged >15 years, 1 119 192). Strokes were classified into major pathological types (IS, ICH, subarachnoid hemorrhage, and undetermined type). Crude annual age-, sex-, and ethnic-specific stroke incidence with 95% confidence intervals was calculated. ISs were subclassified using TOAST (Trial of ORG 10172 in Acute Stroke Treatment) criteria into 5 etiologic groups. Rate ratios with 95% confidence intervals were calculated for differences in age-standardized rates between the 2 studies. In ARCOS-IV, there were 1329 (81%) ISs, 211 (13%) ICHs, 79 (5%) subarachnoid hemorrhages, and 24 (1%) undetermined type strokes. The proportional distribution of IS subtypes was 29% cardioembolism, 21% small-vessel occlusion, 15% large-artery atherosclerosis, 5% other determined etiology, and 31% undetermined type. Between 2002 and 2011, age-standardized incidence decreased for subarachnoid hemorrhage (rate ratios, 0.73; 95% confidence intervals, 0.54-0.99) and undetermined type (rate ratios, 0.14; 95% confidence intervals, 0.09-0.22). Rates were stable for IS and ICH. Among IS subtypes, large-artery atherosclerosis and small-vessel occlusion rates increased significantly. The frequency of all risk factors increased in IS. Ethnic differences were observed for both stroke subtype rates and their risk factor frequencies. A lack of change in IS and ICH incidence may reflect a trend toward increased incidence of younger

Dysphagia in Patients with Acute Ischemic Stroke: Early Dysphagia Screening May Reduce Stroke-Related Pneumonia and Improve Stroke Outcomes.

Science.gov (United States)

Al-Khaled, Mohamed; Matthis, Christine; Binder, Andreas; Mudter, Jonas; Schattschneider, Joern; Pulkowski, Ulrich; Strohmaier, Tim; Niehoff, Torsten; Zybur, Roland; Eggers, Juergen; Valdueza, Jose M; Royl, Georg

2016-01-01

Dysphagia is associated with poor outcome in stroke patients. Studies investigating the association of dysphagia and early dysphagia screening (EDS) with outcomes in patients with acute ischemic stroke (AIS) are rare. The aims of our study are to investigate the association of dysphagia and EDS within 24 h with stroke-related pneumonia and outcomes. Over a 4.5-year period (starting November 2007), all consecutive AIS patients from 15 hospitals in Schleswig-Holstein, Germany, were prospectively evaluated. The primary outcomes were stroke-related pneumonia during hospitalization, mortality, and disability measured on the modified Rankin Scale ≥2-5, in which 2 indicates an independence/slight disability to 5 severe disability. Of 12,276 patients (mean age 73 ± 13; 49% women), 9,164 patients (74%) underwent dysphagia screening; of these patients, 55, 39, 4.7, and 1.5% of patients had been screened for dysphagia within 3, 3 to 72 h following admission. Patients who underwent dysphagia screening were likely to be older, more affected on the National Institutes of Health Stroke Scale score, and to have higher rates of neurological symptoms and risk factors than patients who were not screened. A total of 3,083 patients (25.1%; 95% CI 24.4-25.8) had dysphagia. The frequency of dysphagia was higher in patients who had undergone dysphagia screening than in those who had not (30 vs. 11.1%; p dysphagia had a higher rate of pneumonia than those without dysphagia (29.7 vs. 3.7%; p dysphagia was associated with increased risk of stroke-related pneumonia (OR 3.4; 95% CI 2.8-4.2; p dysphagia was independently correlated with an increase in mortality (OR 3.2; 95% CI 2.4-4.2; p Dysphagia exposes stroke patients to a higher risk of pneumonia, disability, and death, whereas an EDS seems to be associated with reduced risk of stroke-related pneumonia and disability. © 2016 S. Karger AG, Basel.

Timer switch to convert suction apparatus for negative pressure wound therapy application

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Surath Amarnath

2014-01-01

Full Text Available Background: Negative pressure wound therapy (NPWT is an established modality in the treatment of chronic wounds, open fractures, and post-operative wound problems. This method has not been widely used due to the high cost of equipment and consumables. This study demonstrates an indigenously developed apparatus which gives comparable results at a fraction of the cost. Readily available materials are used for the air-tight dressing. Materials and Methods: Equipment consists of suction apparatus with adjustable pressure valve set to a pressure 125-150 mmHg. An electronic timer switch with a sequential working time of 5 min and a standby time of 3 min provides the required intermittent negative pressure. Readily available materials such as polyvinyl alcohol sponge, suction drains and steridrapes were used to provide an air tight wound cover. Results: A total of 90 cases underwent 262 NPWT applications from 2009 to 2014. This series, comprised of 30 open fractures, 21 post-operative and 39 chronic wounds. The wound healing rate in our study was comparable to other published studies using NPWT. Conclusion: The addition of electronic timer switch will convert a suction apparatus into NPWT machine, and the results are equally effective compared to more expensive counter parts. The use of indigenous dressing materials reduces the cost significantly.

A Comparison of delO18 Composition of Water Extracted from Suction Lysimeters, Centrifugation, and Azeotropic Distillation

Science.gov (United States)

Figueroa, A.; Tindall, J. A.; Friedel, M. J.

2005-12-01

Concentration of delO18 in water samples extracted by suction lysimeters is compared to samples obtained by methods of centrifugation and azeotropic distillation. Intact soil cores (30 cm diameter by 40 cm height) were extracted from two different sites. Site 1 was rapid infiltration basin number 50, near Altamonte Springs in Seminole County, Florida on properties belonging to the Walt Disney World Resort Complex. Site 2 was the Missouri Management System Evaluation Area (MSEA) near Centralia in Boone County, Missouri. The delO18 water was analyzed on a mass spectrophotometer. Potassium Bromide (KBr) was also used as a tracer and analyzed by ion chromatography. A portion of the data obtained was modeled using CXTFIT. Water collected by centrifugation and azeotropic distillation data were about 2-5% more negative than that collected by suction lysimeter values from the Florida (sandy) soil and about 5-7 % more negative from the Missouri (well structured clay) soil. Results indicate that the majority of soil water in well structured soil is strongly bound to soil grain surfaces and is not easily sampled by suction lysimeters. Also, it is plausible that evaporation caused some delO18 enrichment in the suction lysimeters. Suction lysimeters preferentially sampled water held at lower matric potentials, which may not represent total soil water. In cases where a sufficient volume of water has passed through the soil profile and displaced all previous pore water, suction lysimeters will however collect a representative sample of all the water at that depth interval. It is suggested that for stable isotope studies monitoring precipitation and soil water, suction lysimeters be installed at shallow depths (10 cm). Samples should also be coordinated with precipitation events. The CXTFIT program worked well for Florida soils (a more homogeneous sand), but gave poor performance for Missouri soils (well structured clays) except for deeper depths where clay structure was less

Perturbation of Brain Oscillations after Ischemic Stroke: A Potential Biomarker for Post-Stroke Function and Therapy

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Gratianne Rabiller

2015-10-01

Full Text Available Brain waves resonate from the generators of electrical current and propagate across brain regions with oscillation frequencies ranging from 0.05 to 500 Hz. The commonly observed oscillatory waves recorded by an electroencephalogram (EEG in normal adult humans can be grouped into five main categories according to the frequency and amplitude, namely δ (1–4 Hz, 20–200 μV, θ (4–8 Hz, 10 μV, α (8–12 Hz, 20–200 μV, β (12–30 Hz, 5–10 μV, and γ (30–80 Hz, low amplitude. Emerging evidence from experimental and human studies suggests that groups of function and behavior seem to be specifically associated with the presence of each oscillation band, although the complex relationship between oscillation frequency and function, as well as the interaction between brain oscillations, are far from clear. Changes of brain oscillation patterns have long been implicated in the diseases of the central nervous system including ischemic stroke, in which the reduction of cerebral blood flow as well as the progression of tissue damage have direct spatiotemporal effects on the power of several oscillatory bands and their interactions. This review summarizes the current knowledge in behavior and function associated with each brain oscillation, and also in the specific changes in brain electrical activities that correspond to the molecular events and functional alterations observed after experimental and human stroke. We provide the basis of the generations of brain oscillations and potential cellular and molecular mechanisms underlying stroke-induced perturbation. We will also discuss the implications of using brain oscillation patterns as biomarkers for the prediction of stroke outcome and therapeutic efficacy.

Thopaz Portable Suction Systems in Thoracic Surgery: An end user assessment and feedback in a tertiary unit

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Cantlin Teresa

2011-04-01

Full Text Available Abstract Background Thoracic surgical patients have chest drains inserted to enable re-expansion of lungs, to clear contents from the pleural cavity which sometimes require negative suction. Suction impedes mobility, may have variable suction delivery and increases risk of infection. Assessment of air-leak in conventional drains is not scientific and is subjective. Thopaz chest drain system is a portable suction unit which allows mobilization of the patient, with scientific digital flow recordings and an in built alarm system. Methods We evaluated the utility, staff and patient feedback of this device in a pilot evaluation in a regional thoracic unit in a structured format over a period of two months. Staff responses were graded on a scale of 1 to 6 [1 Excellent to 6 Poor]. Results 120 patients who underwent elective bullectomy/pleurectomy, VATS lung biopsies, VATS metastectomy and lung resections were evaluated. The staff feedback forms were positive. The staff liked the system as it was more scientific and accurately recordable. It made nursing and physiotherapy easier as they could mobilise patients early. The patients liked the compact design, weightlessness and the silence. It enabled mobilisation of the patients and scientific removal of chest drain. Conclusions Thopaz digital suction units were found to be user friendly and were liked by the staff and patients. The staff feedback stated the devices to be objective and scientific in making decisions about removal and enabled mobilisation.

Temperature measurement in WTE boilers using suction pyrometers.

Science.gov (United States)

Rinaldi, Fabio; Najafi, Behzad

2013-11-15

The temperature of the flue-gas in the post combustion zone of a waste to energy (WTE) plant has to be maintained within a fairly narrow range of values, the minimum of which is prescribed by the European Waste Directive 2000/76/CE, whereas the maximum value must be such as to ensure the preservation of the materials and the energy efficiency of the plant. A high degree of accuracy in measuring and controlling the aforementioned temperature is therefore required. In almost the totality of WTE plants this measurement process is carried out by using practical industrial thermometers, such as bare thermocouples and infrared radiation (IR) pyrometers, even if affected by different physical contributions which can make the gas temperature measurements incorrect. The objective of this paper is to analyze errors and uncertainties that can arise when using a bare thermocouple or an IR pyrometer in a WTE plant and to provide a method for the in situ calibration of these industrial sensors through the use of suction pyrometers. The paper describes principle of operation, design, and uncertainty contributions of suction pyrometers, it also provides the best estimation of the flue-gas temperature in the post combustion zone of a WTE plant and the estimation of its expanded uncertainty.

Temperature Measurement in WTE Boilers Using Suction Pyrometers

Directory of Open Access Journals (Sweden)

Fabio Rinaldi

2013-11-01

Full Text Available The temperature of the flue-gas in the post combustion zone of a waste to energy (WTE plant has to be maintained within a fairly narrow range of values, the minimum of which is prescribed by the European Waste Directive 2000/76/CE, whereas the maximum value must be such as to ensure the preservation of the materials and the energy efficiency of the plant. A high degree of accuracy in measuring and controlling the aforementioned temperature is therefore required. In almost the totality of WTE plants this measurement process is carried out by using practical industrial thermometers, such as bare thermocouples and infrared radiation (IR pyrometers, even if affected by different physical contributions which can make the gas temperature measurements incorrect. The objective of this paper is to analyze errors and uncertainties that can arise when using a bare thermocouple or an IR pyrometer in a WTE plant and to provide a method for the in situ calibration of these industrial sensors through the use of suction pyrometers. The paper describes principle of operation, design, and uncertainty contributions of suction pyrometers, it also provides the best estimation of the flue-gas temperature in the post combustion zone of a WTE plant and the estimation of its expanded uncertainty.

Blood loss associated with Ring uncemented total knee replacement: comparison between continuous and intermittent suction drainage.

Science.gov (United States)

Wittmann, F W; Ring, P A

1984-01-01

In a retrospective comparison of blood loss following uncemented total knee replacement, in which either continuous or intermittent suction drainage was used, measured blood loss was significantly greater with continuous drainage. However, a method of calculating actual blood loss demonstrated no significant difference. With intermittent drainage, more blood remains undetected around the knee joint; this technique should therefore be abandoned in favour of continuous suction drainage. PMID:6747978

Risk factors in various subtypes of ischemic stroke according to toast criteria

International Nuclear Information System (INIS)

Aquil, N.; Begum, I.; Ahmed, A.; Vohra, E.A.

2011-01-01

To identify the frequency of risk factors in various subtypes of acute ischemic stroke according to TOAST criteria. Study Design: Cross-sectional, observational study. Place and Duration of Study: Ziauddin Hospital, Karachi, from January to December 2007. Methodology: Patients with acute ischemic stroke were enrolled. Studied variables included demographic profile, history of risk factors, physical and neurological examination, and investigations relevant with the objectives of the study. Findings were described as frequency percentages. Proportions of risk factors against subtypes was compared using chi-square test with significance at p < 0.05. Results: Out of the 100 patients with acute ischemic stroke, mean age at presentation was 63.5 years. Risk factor distribution was hypertension in 85%, Diabetes mellitus in 49%, ischemic heart disease in 30%, dyslipedemia in 22%, smoking in 9%, atrial fibrillation in 5%, and previous history of stroke in 29%. The various subtypes of acute ischemic stroke were lacunar infarct in 43%, large artery atherosclerosis in 31%, cardioembolic type in 8%, stroke of other determined etiology in 1% and stroke of undetermined etiology in 18%. Hypertension and Diabetes were the most important risk factors in both large and small artery atherosclerosis. In patients with cardio-embolic stroke significant association was found with ischemic heart disease (p=0.01). Conclusion: Importance and relevance of risk factors evaluated for subtypes rather than ischemic stroke as a whole should be reflected in preventive efforts against the burden of ischemic stroke. (author)

Hydrogenation study of suction-cast Ti{sub 40}Zr{sub 40}Ni{sub 20} quasicrystal

Energy Technology Data Exchange (ETDEWEB)

Huang, Huogen; Li, Rong; Yin, Chen; Zheng, Shaotao; Zhang, Pengcheng [National Key Laboratory for Surface Physics and Chemistry, P.O. Box 718-35, Mian Yang 621907, Sichuan (China)

2008-09-15

Suction casting was predicted to be an usable method for improving the hydriding kinetics of Ti/Zr-based icosahedral quasicrystals (IQCs) in our previous work. To further determine it, a suction-cast Ti{sub 40}Zr{sub 40}Ni{sub 20} IQC alloy was used for hydrogenation studies by Pressure Composition Isotherm (PCI) and Temperature Programmed Desorption (TPD) techniques. The results showed that, this alloy absorbed hydrogen rapidly with obvious hydrogen pressure plateau and some reversibility, however, displayed very limited hydrogen capacity (about 0.7 wt.%) and low equilibrium pressure. After several hydrogenation/dehydrogenation cycles, the IQC structure transformed into two hydride phases, ZrH{sub 2-x} and one unknown, both of which decomposed at above 600 C, suggesting high thermo-stability for them. On the whole, indeed the suction-casting method can increase the hydrogen absorption rate of Ti/Zr-based IQCs, however, the hydrogenation properties of the Ti{sub 40}Zr{sub 40}Ni{sub 20} IQC alloy still need a mighty advancement. (author)

Silent cooling system with a double suction type centrifugal fan with backward blades; Ryosuikomi turbo fan wo mochiita teisoon engine reikyaku system no kaihatsu

Energy Technology Data Exchange (ETDEWEB)

Funabashi, S. [Hitachi, Ltd., Tokyo (Japan); Nakamura, K. [Hitachi Construction Machinery Co. Ltd., Tokyo (Japan)

2000-04-25

We have developed a new cooling system for the engine of construction machinery. This system produces two different air flow routes by a double suction type centrifugal fan with backward blades. We first measured aerodynamic performance and sound level of the double suction type fan, which consists of two single suction type fans of different design, and compared these measurements to those of single suction type fans. Next, we installed the fan in a scale model of the new cooling system. The performance of this double suction type fan was different to that of a single suction type. It is considered that the effect of interaction of the exit flows from the two different fans caused this performance change. The test model installed in an engine compartment showed that this cooling system reduced the area of air inlets and outlets around the engine and did not cause re-circulation of cooling air. (author)

Heat-transfer and pressure distributions for laminar separated flows downstream of rearward-facing steps with and without mass suction

Science.gov (United States)

Brown, R. D.; Jakubowski, A. K.

1974-01-01

Heat-transfer and pressure distributions were measured for laminar separated flows downstream of rearward-facing steps with and without mass suction. The flow conditions were such that the boundary-layer thickness was comparable to or larger than the step height. For both suction and no-suction cases, an increase in the step height resulted in a sharp decrease in the initial heat-transfer rates behind the step. Downstream, however, the heat transfer gradually recovered back to less than or near attached-flow values. Mass suction from the step base area increased the local heat-transfer rates; however, this effect was relatively weak for the laminar flows considered. Even removal of the entire approaching boundary layer raised the post-step heat-transfer rates only about 10 percent above the flatplate values. Post-step pressure distributions were found to depend on the entrainment conditions at separation. In the case of the solid-faced step, a sharp pressure drop behind the step was followed by a very short plateau and relatively fast recompression. For the slotted-step connected to a large plenum but without suction, the pressure drop at the base was much smaller and the downstream recompression more gradual than that for solid-faced step.

Active technique by suction to control the flow structure over a van model

Science.gov (United States)

Harinaldi, Budiarso, Warjito, Kosasih, Engkos A.; Tarakka, Rustan; Simanungkalit, Sabar P.

2012-06-01

Today research trend in car aerodynamics are carried out from the point of view of the durable development. Some car companies have the objective to develop control solution that enable to reduce the aerodynamic drag of vehicle. It provides the possibility to modify the flow separation to reduce the development of the swirling structures around the vehicle. In this study, a family van is modeled with a modified form of Ahmed's body by changing the orientation of the flow from its original form (modified/reversed Ahmed Body). This model is equipped with a suction on the rear side to comprehensively examine the pressure field modifications that occur. The investigation combines computational and experimental work. The computational simulation used is k-epsilon flow turbulence model. The reversed Ahmed body used in the investigation has slant angle (φ) 35° at the front part. In the computational work, meshing type is tetra/hybrid element with hex core type and the grid number is more than 1.7 million in order to ensure detail discretization and more accurate calculation results. The boundary condition is upstream velocity of 11.1 m/s. Mean free stream at far upstream region is assumed in a steady state condition and uniform. The suction velocity is set at 1 m/s. Meanwhile in the experimental work a reversed Ahmed model is tested in a controlled wind tunnel experiments. The main measurement is the drag aerodynamic measurement at rear of the body of the model using strain gage. The results show that the application of a suction in the rear part of the van model give the effect of reducing the wake and the vortex is formed. Aerodynamic drag reduction close to 24% for the computational approach and 14.8% for the experimental approach by introducing a suction have been obtained.

Mediterranean Diet in patients with acute ischemic stroke: Relationships between Mediterranean Diet score, diagnostic subtype, and stroke severity index.

Science.gov (United States)

Tuttolomondo, Antonino; Casuccio, Alessandra; Buttà, Carmelo; Pecoraro, Rosaria; Di Raimondo, Domenico; Della Corte, Vittoriano; Arnao, Valentina; Clemente, Giuseppe; Maida, Carlo; Simonetta, Irene; Miceli, Giuseppe; Lucifora, Benedetto; Cirrincione, Anna; Di Bona, Danilo; Corpora, Francesca; Maugeri, Rosario; Iacopino, Domenico Gerardo; Pinto, Antonio

2015-11-01

Adherence to a Mediterranean Diet appears to reduce the risk of cardiovascular disease, cancer, Alzheimer's disease, and Parkinson's disease, as well as the risk of death due to cardiovascular disease. No study has addressed the association between diagnostic subtype of stroke and its severity and adherence to a Mediterranean Diet in subjects with acute ischemic stroke. To evaluate the association between Mediterranean Diet adherence, TOAST subtype, and stroke severity by means of a retrospective study. The type of acute ischemic stroke was classified according to the TOAST criteria. All patients admitted to our ward with acute ischemic stroke completed a 137-item validated food-frequency questionnaire adapted to the Sicilian population. A scale indicating the degree of adherence to the traditional Mediterranean Diet was used (Me-Di score: range 0-9). 198 subjects with acute ischemic stroke and 100 control subjects without stroke. Stroke subjects had a lower mean Mediterranean Diet score compared to 100 controls without stroke. We observed a significant positive correlation between Me-Di score and SSS score, whereas we observed a negative relationship between Me-Di score and NIHSS and Rankin scores. Subjects with atherosclerotic (LAAS) stroke subtype had a lower mean Me-Di score compared to subjects with other subtypes. Multinomial logistic regression analysis in a simple model showed a negative relationship between MeDi score and LAAS subtype vs. lacunar subtype (and LAAS vs. cardio-embolic subtype). Patients with lower adherence to a Mediterranean Diet are more likely to have an atherosclerotic (LAAS) stroke, a worse clinical presentation of ischemic stroke at admission and a higher Rankin score at discharge. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Suction blister lesions and epithelialization monitored by optical coherence tomography

DEFF Research Database (Denmark)

Ahlström, M G; Gjerdrum, L M R; Larsen, H F

2018-01-01

suction blister was raised on each buttock, and the blister roof was excised. Lesions were covered with moisture-retaining dressing. In Study 1, the lesions were OCT-scanned on day 0 (D0), D2 and D4 and excised for histological examination. In Study 2, the progress of epithelialization and skin barrier...

Frequency of depression among hypertensive patients who ...

African Journals Online (AJOL)

The purpose of this study is therefore to determine the frequency of major depression among patients who developed stroke from hypertension. Methods: This is a retrospective study. Thirty four patients who developed stroke from severe hypertension were included. Using Diagnostic Statistical Manual (DSM) IV criteria, the ...

Hospital: With Emphasis on Stroke in the Young

African Journals Online (AJOL)

frequencies of these potential risk factors among stroke in the young and ... type of valve involved rather than severity of disease is related to occurrence of stroke. ... analysis. The mean (+ 5D) age for the whole patient group was 52+16 years ... 2(8). 19(39.6). 21(28.8). 0. 0. 0. 21(8 I). Diabetes. 2(8). 1(2.1). 3(4.1). 9(8.7).

Effects of low-frequency repetitive transcranial magnetic stimulation on upper extremity motor recovery and functional outcomes in chronic stroke patients: A randomized controlled trial.

Science.gov (United States)

Aşkın, Ayhan; Tosun, Aliye; Demirdal, Ümit Seçil

2017-06-01

Repetitive transcranial magnetic stimulation (rTMS) was suggested as a preconditioning method that would increase brain plasticity and that it would be optimal to combine rTMS with intensive rehabilitation. To assess the efficacy of inhibitory rTMS on upper extremity motor recovery and functional outcomes in chronic ischemic stroke patients. In this randomized controlled trial, experimental group received low-frequency (LF) rTMS to the primary motor cortex of the unaffected side + physical therapy (PT), and control group received PT. No statistically significant difference was found in baseline demographical and clinical characteristics of the subjects including stroke severity or severity of paralysis prior to intervention. There were statistically significant improvements in all clinical outcome measures except for the Brunnstrom Recovery Stages. Fugl-Meyer Assessment, Box and Block test, motor and total scores of Functional Independence Measurement (FIM), and Functional Ambulation Scale (FAS) scores were significantly increased in both groups, however, these changes were significantly greater in the rTMS group except for FAS score. FIM cognitive scores and standardized mini-mental test scores were significantly increased and distal and hand Modified Ashworth Scale scores were significantly decreased only in the rTMS group (p functional, and cognitive deficits in chronic stroke. Further studies with a larger number of patients with longer follow-up periods are needed to establish its effectiveness in stroke rehabilitation.

Increased risk of stroke in contact dermatitis patients

Science.gov (United States)

Chang, Wei-Lun; Hsu, Min-Hsien; Lin, Cheng-Li; Chan, Po-Chi; Chang, Ko-Shih; Lee, Ching-Hsiao; Hsu, Chung-Yi; Tsai, Min-Tein; Yeh, Chung-Hsin; Sung, Fung-Chang

2017-01-01

Abstract Dermatologic diseases are not traditional risk factors of stroke, but recent studies show atopic dermatitis, psoriasis, and bullous skin disease may increase the risk of stroke and other cardiovascular diseases. No previous studies have focused on the association between contact dermatitis and stroke. We established a cohort comprised of 48,169 contact dermatitis patients newly diagnosed in 2000–2003 and 96,338 randomly selected subjects without the disorder, frequency matched by sex, age, and diagnosis year, as the comparison cohort. None of them had a history of stroke. Stroke incidence was assessed by the end of 2011 for both cohorts. The incidence stroke was 1.1-fold higher in the contact dermatitis cohort than in the comparison cohort (5.93 vs 5.37 per 1000 person-years, P contact dermatitis cohort increased with age, from 1.14 (95% CI, 1.03–1.27) for 65 to 74 years; to 1.27 (95% CI, 1.15–1.42) for 75 years and older. The aHR of stroke were 1.16 (95% CI, 1.07–1.27) and 1.09 (95% CI, 1.00–1.18) for men and women, respectively. This study suggests that patients with contact dermatitis were at a modestly increased risk of stroke, significant for ischemic stroke but not for hemorrhagic stroke. Comorbidity, particularly hypertension, increased the hazard of stroke further. PMID:28272195

Closed suction drainage using Lichtenstein technique in preventing wound complications following inguinal hernioplasty: brief report

Directory of Open Access Journals (Sweden)

Hamid Reza Hemmati

2015-03-01

Results: No adverse event including hematoma, seroma or wound infection occurred in either group with or without closed suction drainage in the first 10 days after surgery. Only one patient carried wound infection during days 10 to 15 following operation who was in the group with closed drainage (P=1.00. Conclusion: In this study, Seroma and hematoma was not observed in patients with and without closed suction drainage. To avoid drains' complications, indiscriminate use of antibiotics, prolonged hospital stay, we do not recommend the use of drains in this type of surgery.

Systematic review and meta-analysis of closed suction drainage versus non-drainage in primary hip arthroplasty.

LENUS (Irish Health Repository)

Kelly, Enda G

2014-03-01

The routine use of drains in surgery has been dogmatically instituted in some disciplines. Orthopaedic surgery is one such sub-speciality. The use of postoperative closed suction drainage in total hip arthroplasty (THA) has become increasingly controversial with multiple randomised control trials performed to assess the benefit to outcome in THA. The hypothesis of this systematic review is that closed suction drainage does not infer a benefit and increase transfusion requirements of primary total hip arthroplasty patients. A systematic review and meta-analysis was conducted adhering to the PRISMA guidelines. A search of the available literature was performed on PubMed, Cochrane Central Registry of Controlled Trials, MEDLINE (OVID) and EMBASE using a combination of MeSH terms and Boolean operators. All data analysis was performed using the Cochrane Collaboration\\'s Review Manager 5.1. Sixteen studies (n=2705) were included in the analysis. Post-operative closed suction drainage was found to increase total blood loss and blood transfusion requirements (p<0.05). Surgical site infection demonstrated no significant difference between the two groups (p=0.82). No significant difference in haematoma formation between groups (p=0.19) was elicited. The routine use of closed suction drainage systems post primary hip arthroplasty is not supported by this meta-analysis. However, the heterogeneity between studies does limit the accuracy of the meta-analysis.

Diagnostic Error in Stroke-Reasons and Proposed Solutions.

Science.gov (United States)

Bakradze, Ekaterina; Liberman, Ava L

2018-02-13

We discuss the frequency of stroke misdiagnosis and identify subgroups of stroke at high risk for specific diagnostic errors. In addition, we review common reasons for misdiagnosis and propose solutions to decrease error. According to a recent report by the National Academy of Medicine, most people in the USA are likely to experience a diagnostic error during their lifetimes. Nearly half of such errors result in serious disability and death. Stroke misdiagnosis is a major health care concern, with initial misdiagnosis estimated to occur in 9% of all stroke patients in the emergency setting. Under- or missed diagnosis (false negative) of stroke can result in adverse patient outcomes due to the preclusion of acute treatments and failure to initiate secondary prevention strategies. On the other hand, the overdiagnosis of stroke can result in inappropriate treatment, delayed identification of actual underlying disease, and increased health care costs. Young patients, women, minorities, and patients presenting with non-specific, transient, or posterior circulation stroke symptoms are at increased risk of misdiagnosis. Strategies to decrease diagnostic error in stroke have largely focused on early stroke detection via bedside examination strategies and a clinical decision rules. Targeted interventions to improve the diagnostic accuracy of stroke diagnosis among high-risk groups as well as symptom-specific clinical decision supports are needed. There are a number of open questions in the study of stroke misdiagnosis. To improve patient outcomes, existing strategies to improve stroke diagnostic accuracy should be more broadly adopted and novel interventions devised and tested to reduce diagnostic errors.

Racial Differences by Ischemic Stroke Subtype: A Comprehensive Diagnostic Approach

Directory of Open Access Journals (Sweden)

Sarah Song

2012-01-01

Full Text Available Background. Previous studies have suggested that black populations have more small-vessel and fewer cardioembolic strokes. We sought to analyze racial differences in ischemic stroke subtype employing a comprehensive diagnostic workup with magnetic resonance-imaging-(MRI- based evaluation including diffusion-weighted imaging (DWI. Methods. 350 acute ischemic stroke patients admitted to an urban hospital with standardized comprehensive diagnostic evaluations were retrospectively analyzed. Ischemic stroke subtype was determined by three Trial of Org 10172 in Acute Stroke Treatment (TOAST classification systems. Results. We found similar proportions of cardioembolic and lacunar strokes in the black and white cohort. The only subtype category with a significant difference by race was “stroke of other etiology,” more common in whites. Black stroke patients were more likely to have an incomplete evaluation, but this did not reach significance. Conclusions. We found similar proportions by race of cardioembolic and lacunar strokes when employing a full diagnostic evaluation including DWI MRI. The relatively high rate of cardioembolism may have been underappreciated in black stroke patients when employing a CT approach to stroke subtype diagnosis. Further research is required to better understand the racial differences in frequency of “stroke of other etiology” and explore disparities in the extent of diagnostic evaluations.

Cardioembolism and Involvement of the Insular Cortex in Patients with Ischemic Stroke.

Directory of Open Access Journals (Sweden)

Jihoon Kang

Full Text Available To evaluate whether topographical characteristics of insular involvement in ischemic stroke are associated with cardioembolism.A consecutive series of patients hospitalized for ischemic stroke within 7 days of symptom onset were identified. Based on diffusion-weighted imaging, we included those who had ischemic lesions in the middle cerebral artery (MCA territory. Each patient was assigned to one of two groups based on the presence or absence of insular involvement. The primary outcome was the frequency of cardioembolism, which was compared based on insular involvement. Of 1,311 patients with ischemic stroke in the MCA territory, 112 had insular involvement (8.5%. The frequency of cardioembolism in patients with insular involvement (52.7% was significantly higher than that in patients without insular involvement (30.4%, P < 0.001. Although insular involvement was associated with a severe baseline National Institutes of Health Stroke Scale score (13 vs. 4, it did not independently affect the 3-month functional outcome.In cases of stroke in the MCA territory, involvement of the insular cortex may be associated with a risk of cardioembolism.

[Pain assessment of tracheal suctioning on brain injury patients by pain behavioral indicator scale (ESCID)].

Science.gov (United States)

López-López, C; Murillo-Pérez, M A; Morales-Sánchez, C; Torrente-Vela, S; Orejana-Martín, M; García-Iglesias, M; Cuenca-Solanas, M; Alted-López, E

2014-01-01

To assess pain response on patients with moderate to severe head injury before a common nursing procedure: tracheal suctioning. An observational longitudinal pilot study with consecutive sampling performed from September to December of 2012. Pain was assessed by a pain behavioral indicator scale 5 minutes before, meanwhile and 15 minutes after tracheal suctioning the days 1, 3 and 6 of their intensive care unit (ICU) stay, as well as a non-painful procedure: rubbing with gauze the forearm of the patient. Pseudo-analgesia and hemodynamic variables were also recorded. Descriptive analysis of the variables, inferential statistics with t-student and Anova with SPSS 17.0; statistical tests were considered significant if the critical level observed was less than 5% (P.05) were shown. Data for the painless procedure were significantly different on day 6 (P<.05) CONCLUSION: During tracheal suctioning in patients with head injury in the first 6 days in the ICU, objective mild-moderate pain according to ESCID scale has been detected. Copyright © 2013 Elsevier España, S.L.U. y SEEIUC. All rights reserved.

Impact of Spasticity on Balance Control during Quiet Standing in Persons after Stroke

Directory of Open Access Journals (Sweden)

Reza Rahimzadeh Khiabani

2017-01-01

Full Text Available Background. Balance impairments, falls, and spasticity are common after stroke, but the effect of spasticity on balance control after stroke is not well understood. Methods. In this cross-sectional study, twenty-seven participants with stroke were divided into two groups, based on ankle plantar flexor spasticity level. Fifteen individuals with high spasticity (Modified Ashworth Scale (MAS score of ≥2 and 12 individuals with low spasticity (MAS score <2 completed quiet standing trials with eyes open and closed conditions. Balance control measures included centre of pressure (COP root mean square (RMS, COP velocity, and COP mean power frequency (MPF in anterior-posterior and mediolateral (ML directions. Trunk sway was estimated using a wearable inertial measurement unit to measure trunk angle, trunk velocity, and trunk velocity frequency amplitude in pitch and roll directions. Results. The high spasticity group demonstrated greater ML COP velocity, trunk roll velocity, trunk roll velocity frequency amplitude at 3.7 Hz, and trunk roll velocity frequency amplitude at 4.9 Hz, particularly in the eyes closed condition (spasticity by vision interaction. ML COP MPF was greater in the high spasticity group. Conclusion. Individuals with high spasticity after stroke demonstrated greater impairment of balance control in the frontal plane, which was exacerbated when vision was removed.

The radontechnical process of the sub-slab suction system in detached, semi-detached and terraced houses; Imupistejaerjestelmaen radontekninen toiminta eri tyyppisissae pien- ja rivitaloissa

Energy Technology Data Exchange (ETDEWEB)

Kettunen, A.V.; Rissanen, R.; Viljanen, M. [Helsinki Univ. of Technology, Otaniemi (Finland). Lab. of Structural Engineering and Building Physics; Arvela, H. [Finnish Centre for Radiation and Nuclear Safety, Helsinki (Finland)

1997-12-31

The sub-slab suction system is a repair method for decreasing radon transfer from soil to indoor air in houses. The sub-slab suction system changes the flow field with the aim to reduce the radon content under the ground slab or/and changes the flow direction from indoor air to foundation soil. The study is divided into the theoretical and experimental part. The theoretical part concentrates on solving the factors affecting the sub-slab suction system taking into consideration features of old houses. The experimental part uses the results of the theoretical part when the level and the type of the suction point had been chosen. The effect of the sub-slab suction system was tested with pressure difference experiments and the radon content measurements in 26 different, typical Finnish detached, semi-detached and terrace houses.

Suction/inspiration against resistance or standardized Mueller maneuver: a new breathing technique to improve contrast density within the pulmonary artery: a pilot CT study

Energy Technology Data Exchange (ETDEWEB)

Gutzeit, Andreas [Paracelsus Medical University Salzburg, Department of Radiology, Salzburg (Austria); Hirslanden Hospital St. Anna, Institute of Radiology and Nuclear Medicine, Clinical Research Unit, Lucerne (Switzerland); Kantonsspital Winterthur, Department of Radiology, Winterthur (Switzerland); Froehlich, Johannes M.; Weymarn, Constantin von; Goyen, Matthias [Hirslanden Hospital St. Anna, Institute of Radiology and Nuclear Medicine, Clinical Research Unit, Lucerne (Switzerland); Waelti, Stephan [Cantonal Hospital St. Gallen, Department of Radiology and Nuclear Medicine, St. Gallen (Switzerland); Roos, Justus E. [Duke University Medical Center, Department of Radiology, Durham, NC (United States); Meissnitzer, Matthias; Hergan, Klaus [Paracelsus Medical University Salzburg, Department of Radiology, Salzburg (Austria); Czell, David [Cantonal Hospital Winterthur, Department of Neurology, Winterthur (Switzerland); Reischauer, Carolin [Paracelsus Medical University Salzburg, Department of Radiology, Salzburg (Austria); Hirslanden Hospital St. Anna, Institute of Radiology and Nuclear Medicine, Clinical Research Unit, Lucerne (Switzerland)

2015-11-15

Our aim was to prospectively investigate whether the recently introduced suction/inspiration against resistance breathing method leads to higher computed tomography (CT) contrast density in the pulmonary artery compared to standard breathing. The present study was approved by the Medical Ethics committee and all subjects gave written informed consent. Fifteen patients, each without suspicious lung emboli, were randomly assigned to four different groups with different breathing maneuvers (suction against resistance, Valsalva, inspiration, expiration) during routine CT. Contrast enhancement in the central and peripheral sections of the pulmonary artery were measured and compared with one another. Peripheral enhancement during suction yielded increased mean densities of 138.14 Hounsfield units (HU) (p = 0.001), compared to Valsalva and a mean density of 67.97 HU superior to inspiration (p = 0.075). Finally, suction in comparison to expiration resulted in a mean increase of 30.51 HU (p = 0.42). Central parts of pulmonary arteries presented significantly increased enhancement values (95.74 HU) for suction versus the Valsalva technique (p = 0.020), while all other mean densities were in favour of suction (versus inspiration: p = 0.201; versus expiration: p = 0.790) without reaching significance. Suction/Inspiration against resistance is a promising technique to improve contrast density within pulmonary vessels, especially in the peripheral parts, in comparison to other breathing maneuvers. (orig.)

Air suctioning during colon biopsy forceps removal reduces bacterial air contamination in the endoscopy suite.

Science.gov (United States)

Vavricka, S R; Tutuian, R; Imhof, A; Wildi, S; Gubler, C; Fruehauf, H; Ruef, C; Schoepfer, A M; Fried, M

2010-09-01

Bacterial contamination of endoscopy suites is of concern; however studies evaluating bacterial aerosols are lacking. We aimed to determine the effectiveness of air suctioning during removal of biopsy forceps in reducing bacterial air contamination. This was a prospective single-blinded trial involving 50 patients who were undergoing elective nontherapeutic colonoscopy. During colonoscopy, endoscopists removed the biopsy forceps first without and then with suctioning following contact with the sigmoid mucosa. A total of 50 L of air was collected continuously for 30 seconds at 30-cm distance from the biopsy channel valve of the colonoscope, with time starting at forceps removal. Airborne bacteria were collected by an impactor air sampler (MAS-100). Standard Petri dishes with CNA blood agar were used to culture Gram-positive bacteria. Main outcome measure was the bacterial load in endoscopy room air. At the beginning and end of the daily colonoscopy program, the median (and interquartile [IQR] range) bioaerosol burden was 4 colony forming units (CFU)/m (3) (IQR 3 - 6) and 16 CFU/m (3) (IQR 13 - 18), respectively. Air suctioning during removal of the biopsy forceps reduced the bioaerosol burden from a median of 14 CFU/m (3) (IQR 11 - 29) to a median of 7 CFU/m (3) (IQR 4 - 16) ( P = 0.0001). Predominantly enterococci were identified on the agar plates. The bacterial aerosol burden during handling of biopsy forceps can be reduced by applying air suction while removing the forceps. This simple method may reduce transmission of infectious agents during gastrointestinal endoscopies. Copyright Georg Thieme Verlag KG Stuttgart . New York.

Laboratory determined suction potential of Topopah Spring tuff at high temperatures

International Nuclear Information System (INIS)

Daily, W.; Lin, Wunan.

1991-01-01

The purpose of this work is to experimentally determine the capillary suction potential of Topopah Spring tuff from Yucca Mountain, Nye County, Nevada. This data can be used to help characterize the unsaturated hydraulic properties of the densely welded tuff at this site. 7 refs., 4 figs., 1 tab

Instruction Workbook for Tracheostomy Suctioning and Misting in a School Setting.

Science.gov (United States)

Wolf, Karen McKinney; Roach, Antionette Andolfatto

The handbook presents California guidelines for training school personnel to provide skilled nursing procedures such as tracheostomy suctioning and misting for students with special health needs. The workbook begins with an overview of the anatomy and function of the respiratory system, specifically breathing mechanics. Part 2 considers the…

A wet-tolerant adhesive patch inspired by protuberances in suction cups of octopi

Science.gov (United States)

Baik, Sangyul; Kim, Da Wan; Park, Youngjin; Lee, Tae-Jin; Ho Bhang, Suk; Pang, Changhyun

2017-06-01

Adhesion strategies that rely on mechanical interlocking or molecular attractions between surfaces can suffer when coming into contact with liquids. Thus far, artificial wet and dry adhesives have included hierarchical mushroom-shaped or porous structures that allow suction or capillarity, supramolecular structures comprising nanoparticles, and chemistry-based attractants that use various protein polyelectrolytes. However, it is challenging to develop adhesives that are simple to make and also perform well—and repeatedly—under both wet and dry conditions, while avoiding non-chemical contamination on the adhered surfaces. Here we present an artificial, biologically inspired, reversible wet/dry adhesion system that is based on the dome-like protuberances found in the suction cups of octopi. To mimic the architecture of these protuberances, we use a simple, solution-based, air-trap technique that involves fabricating a patterned structure as a polymeric master, and using it to produce a reversed architecture, without any sophisticated chemical syntheses or surface modifications. The micrometre-scale domes in our artificial adhesive enhance the suction stress. This octopus-inspired system exhibits strong, reversible, highly repeatable adhesion to silicon wafers, glass, and rough skin surfaces under various conditions (dry, moist, under water and under oil). To demonstrate a potential application, we also used our adhesive to transport a large silicon wafer in air and under water without any resulting surface contamination.

Abdominal drainage following cholecystectomy: high, low, or no suction?

OpenAIRE

McCormack, T. T.; Abel, P. D.; Collins, C. D.

1983-01-01

A prospective trial to assess the effect of suction in an abdominal drain following cholecystectomy was carried out. Three types of closed drainage system were compared: a simple tube drain, a low negative pressure drain, and a high negative pressure drain: 120 consecutive patients undergoing cholecystectomy were randomly allocated to one of the three drainage groups. There was no significant difference in postoperative pyrexia, wound infection, chest infection, or hospital stay. This study f...

Is impaired control of reactive stepping related to falls during inpatient stroke rehabilitation?

Science.gov (United States)

Mansfield, Avril; Inness, Elizabeth L; Wong, Jennifer S; Fraser, Julia E; McIlroy, William E

2013-01-01

Individuals with stroke fall more often than age-matched controls. Although many focus on the multifactorial nature of falls, the fundamental problem is likely the ability for an individual to generate reactions to recover from a loss of balance. Stepping reactions to recover balance are particularly important to balance recovery, and individuals with stroke have difficulty executing these responses to prevent a fall following a loss of balance. The purpose of this study is to determine if characteristics of balance recovery steps are related to falls during inpatient stroke rehabilitation. We conducted a retrospective review of individuals with stroke attending inpatient rehabilitation (n = 136). Details of falls experienced during inpatient rehabilitation were obtained from incident reports, nursing notes, and patient interviews. Stepping reactions were evoked using a "release-from-lean" postural perturbation. Poisson regression was used to determine characteristics of stepping reactions that were related to increased fall frequency relative to length of stay. In all, 20 individuals experienced 29 falls during inpatient rehabilitation. The characteristics of stepping reactions significantly related to increased fall rates were increased frequency of external assistance to prevent a fall to the floor, increased frequency of no-step responses, increased frequency of step responses with inadequate foot clearance, and delayed time to initiate stepping responses. Impaired control of balance recovery steps is related to increased fall rates during inpatient stroke rehabilitation. This study informs the specific features of stepping reactions that can be targeted with physiotherapy intervention during inpatient rehabilitation to improve dynamic stability control and potentially prevent falls.

Frequency of discriminative sensory loss in the hand after stroke in a rehabilitation setting.

Science.gov (United States)

Carey, Leeanne M; Matyas, Thomas A

2011-02-01

Somatosensory loss following stroke is common, with negative consequences for functional outcome. However, existing studies typically do not include quantitative measures of discriminative sensibility. The aim of this study was to quantify the proportion of stroke patients presenting with discriminative sensory loss of the hand in the post-acute rehabilitation phase. Prospective cohort study of stroke survivors presenting for rehabilitation. Fifty-one consecutive patients admitted to a metropolitan rehabilitation centre over a continuous 12-month period who met selection criteria. Quantitative measures of touch discrimination and limb position sense, with high re-test reliability, good discriminative test properties and objective criteria of abnormality, were employed. Both upper limbs were tested, in counterbalanced order. Impaired touch discrimination was identified in the hand contralateral to the lesion in 47% of patients, and in the ipsilesional hand in 16%. Forty-nine percent showed impaired limb position sense in the contralesional limb and 20% in the ipsilesional limb. Sixty-seven percent demonstrated impairment of at least one modality in the contralesional limb. Ipsilesional impairment was less severe. Discriminative sensory impairment was quantified in the contralesional hand in approximately half of stroke patients presenting for rehabilitation. A clinically significant number also experienced impairment in the ipsilesional "unaffected" hand.

Atrial fibrillation is not uncommon among patients with ischemic stroke and transient ischemic stroke in China.

Science.gov (United States)

Yang, Xiaomeng; Li, Shuya; Zhao, Xingquan; Liu, Liping; Jiang, Yong; Li, Zixiao; Wang, Yilong; Wang, Yongjun

2017-12-04

Atrial fibrillation (AF) is reported to be a less frequent cause of ischemic stroke in China than in Europe and North America, but it is not clear whether this is due to underestimation. Our aim was to define the true frequency of AF-associated stroke, to determine the yield of 6-day Holter ECG to detect AF in Chinese stroke patients, and to elucidate predictors of newly detected AF. Patients with acute ischemic stroke or transient ischemic attack (TIA) were enrolled in a prospective, multicenter cohort study of 6-day Holter monitoring within 7 days after stroke onset at 20 sites in China between 2013 and 2015. Independent predictors of newly-detected AF were determined by multivariate analysis. Among 1511 patients with ischemic stroke and TIA (mean age 63 years, 33.1% women), 305 (20.2%) had either previously known (196, 13.0%) or AF newly-detected by electrocardiography (53, 3.5%) or by 6-day Holter monitoring (56/1262, 4.4%). A history of heart failure (OR = 4.70, 95%CI, 1.64-13.5), advanced age (OR = 1.06, 95%CI, 1.04-1.09), NIHSS at admission (OR = 1.06, 95%CI, 1.02-1.10), blood high density lipoprotein (HDL) (OR = 1.52, 95%CI, 1.09-2.13), together with blood triglycerides (OR = 0.64, 95%CI, 0.45-0.91) were independently associated with newly-detected AF. Contrary to previous reports, AF-associated stroke is frequent (20%) in China if systemically sought. Prolonged noninvasive cardiac rhythm monitoring importantly increases AF detection in patients with recent ischemic stroke and TIA in China. Advanced age, history of heart failure, and higher admission NIHSS and higher level of HDL were independent indicators of newly-detected AF. NCT02156765 (June 5, 2014).

The post-stroke depression and its impact on functioning in young and adult stroke patients of a rehabilitation unit.

Science.gov (United States)

Amaricai, Elena; Poenaru, Dan V

2016-01-01

Stroke is a leading cause of disability and a major public health problem. To determine frequency and degree of post-stroke depression (PSD) and its impact on functioning in young and adult stroke patients in a rehabilitation unit. The study included 72 stroke patients (aged 29-59 years) who were attending rehabilitation. The patients were assessed for depressive symptoms by Beck Depression Inventory (BDI), and their functioning by using the Stroke Impact Scale (SIS) and the Barthel Index of Activities of Daily Living (ADL). Forty-eight patients had different degrees of depression: borderline clinical depression (13.8%), moderate depression (34.7%), severe depression (15.2%) or extreme depression (2.9%). There were no significant differences of BDI scores in 30-39, 40-49 and 50-59 years groups. Statistically significant correlations were between BDI score and SIS score, between BDI score and ADL index, and between SIS score and ADL index in men, women and total study patients. More than half of the PSD patients had a moderate degree of depression. Significant correlations were noticed between depressive symptoms and functional status evaluated both by an instrument of assessing stroke impact upon general health and an instrument for assessing the everyday activities.

Dysphagia in the patient after stroke: consequences and nurse intervention

Directory of Open Access Journals (Sweden)

Ana Frias

2015-12-01

Full Text Available Objectives: to check the consequences of poststroke dysphagia and to reflect on the nurse’s intervention in dysphagia rehabilitation. Methodology: it was performed a systematic literature review of the topic in question; research based on international databases EBSCOhost, LILACS, SciELO.We were able to identify some studies publications between 2006 and 2014. We intend to answer the guiding question: What are the consequences of dysphagia in the patient after stroke? » Results vs. Discussion: after a thorough analysis, we have selected 11 articles and found that the most frequent consequences of dysphagia are the pulmonary complications by saliva and/or food suction. The nurse specialist still has a barely visible role, but his/her interventions are critical in these patients rehabilitation. Conclusions: rehabilitation is essential to avoid the consequences of poststroke dysphagia. The rehabilitation process must go through a multidisciplinary team of which nurses are an integral and essential part.

Fabricating Zr-Based Bulk Metallic Glass Microcomponent by Suction Casting Using Silicon Micromold

Directory of Open Access Journals (Sweden)

Zhijing Zhu

2014-08-01

Full Text Available A suction casting process for fabricating Zr55Cu30Al10Ni5 bulk metallic glass microcomponent using silicon micromold has been studied. A complicated BMG microgear with 50 μm in module has been cast successfully. Observed by scanning electron microscopy and laser scanning confocal microscopy, we find that the cast microgear duplicates the silicon micromold including the microstructure on the surface. The amorphous state of the microgear is confirmed by transmission election microscopy. The nanoindentation hardness and elasticity modulus of the microgear reach 6.5 GPa and 94.5 GPa. The simulation and experimental results prove that the suction casting process with the silicon micromold is a promising one-step method to fabricate bulk metallic glass microcomponents with high performance for applications in microelectromechanical system.

Magnetohydrodynamics effect on three-dimensional viscous incompressible flow between two horizontal parallel porous plates and heat transfer with periodic injection/suction

Directory of Open Access Journals (Sweden)

R. C. Chaudhary

2004-11-01

Full Text Available We investigate the hydromagnetic effect on viscous incompressible flow between two horizontal parallel porous flat plates with transverse sinusoidal injection of the fluid at the stationary plate and its corresponding removal by periodic suction through the plate in uniform motion. The flow becomes three dimensional due to this injection/suction velocity. Approximate solutions are obtained for the flow field, the pressure, the skin-friction, the temperature field, and the rate of heat transfer. The dependence of solution on M (Hartmann number and λ (injection/suction is investigated by the graphs and tables.

Effects of a sexual rehabilitation intervention program on stroke patients and their spouses.

Science.gov (United States)

Song, HoSook; Oh, HyunSoo; Kim, HwaSoon; Seo, WhaSook

2011-01-01

The present study was conducted to examine whether a sexual rehabilitation intervention program, which was developed during the present study and designed for stroke patients and their spouses, was effective in terms of sexual knowledge and satisfaction and frequency of sexual activity at 1 month after intervention. The study subjects were conveniently selected from stroke patients admitted to the neurology department at a university hospital located in Incheon, South Korea. A total of 46 subjects (12 couples for the experimental group and 11 couples for the control group) were included. Sexual knowledge, sexual satisfaction, frequency of sexual activity, level of cognitive function, and performance with respect to daily living activities were measured. The results obtained demonstrated that the devised sexual rehabilitation intervention program significantly increased sexual satisfaction and frequency of sexual activity, but that it did not promote sexual knowledge. The present study has meaning because the intervention program could be used as a practical guideline for post-stroke sexual rehabilitation. In addition, the findings of this study provide evidence regarding the usefulness of sexual education and counseling on the sexual health of post-stroke patients and their spouses.

Suction removal of sediment from between armour blocks. Part 2. Waves

DEFF Research Database (Denmark)

Dixen, Figen Hatipoglu; Sumer, B. Mutlu; Fredsøe, Jørgen

2008-01-01

When a stone/armor layer on a sand bed is exposed to flow, the sand underneath will be agitated by the flow turbulence. When the flow velocity reaches a critical value, the sand will be sucked (winnowed out) from between the armor blocks. In a previous investigation, we studied suction removal of...

mStroke: "Mobile Stroke"-Improving Acute Stroke Care with Smartphone Technology.

Science.gov (United States)

Andrew, Benjamin Y; Stack, Colleen M; Yang, Julian P; Dodds, Jodi A

2017-07-01

This study aimed to evaluate the effect of method and time of system activation on clinical metrics in cases utilizing the Stop Stroke (Pulsara, Inc.) mobile acute stroke care coordination application. A retrospective cohort analysis of stroke codes at 12 medical centers using Stop Stroke from March 2013 to May 2016 was performed. Comparison of metrics (door-to-needle time [DTN] and door-to-CT time [DTC], and rate of DTN ≤ 60 minutes [goal DTN]) was performed between subgroups based on method (emergency medical service [EMS] versus emergency department [ED]) and time of activation. Effects were adjusted for confounders (age, sex, National Institutes of Health Stroke Scale [NIHSS] score) using multiple linear and logistic regression. The final dataset included 2589 cases. Cases activated by EMS were more severe (median NIHSS score 8 versus 4, P technology provides unique insight into acute stroke codes. Activation of mobile electronic stroke coordination in the field appears to promote a more expedited and successful care process. Copyright © 2017 National Stroke Association. Published by Elsevier Inc. All rights reserved.

Cancer in young adults with ischemic stroke.

Science.gov (United States)

Aarnio, Karoliina; Joensuu, Heikki; Haapaniemi, Elena; Melkas, Susanna; Kaste, Markku; Tatlisumak, Turgut; Putaala, Jukka

2015-06-01

Cancer is a risk factor for ischemic stroke. Little is known about cancer among young adults with ischemic stroke. We studied the frequency of cancer and its association with long-term risk of death among young patients with first-ever ischemic stroke. 1002 patients aged 15 to 49 years, registered in the Helsinki Young Stroke Registry, and with a median follow-up of 10.0 years (interquartile range 6.5-13.8) after stroke were included. Historical and follow-up data were derived from the Finnish Care Register and Statistics Finland. Survival between groups was compared with the Kaplan-Meier life-table method, and Cox proportional hazard models were used to identify factors associated with mortality. One or more cancer diagnosis was made in 77 (7.7%) patients, of whom 39 (3.9%) had cancer diagnosed prestroke. During the poststroke follow-up, 41 (53.2%) of the cancer patients died. Median time from prestroke cancer to stroke was 4.9 (1.0-9.5) years and from stroke to poststroke cancer was 6.7 (2.7-10.9) years. Poststroke cancer was associated with age>40 years, heavy drinking, and cigarette smoking. The cumulative mortality was significantly higher among the cancer patients (68.6%, 95% confidence interval 52.0%-85.3%) compared with patients without cancer (19.7%, 95% confidence interval 16.3%-23.2%). Active cancer at index stroke, melanoma, and lung/respiratory tract cancer had the strongest independent association with death during the follow-up when adjusted for known poststroke mortality prognosticators. Cancer, and especially active cancer and no other apparent cause for stroke, is associated with unfavorable survival among young stroke patients. © 2015 American Heart Association, Inc.

INCOMPRESSIBLE LAMINAR BOUNDARY LAYER CONTROL BY BLOWING AND SUCTION

OpenAIRE

AZZEDINE NAHOUI; LAKHDAR BAHI

2013-01-01

A two-dimensional incompressible laminar boundary layer and its control using blowing and suction over a flat plate and around the NACA 0012 and 661012 profiles, is studied numerically. The study is based on the Prandtl boundary layer model using the finite differences method and the Crank-Nicolson scheme. The velocity distribution, the boundary layer thickness and the friction coefficient, are determined and presented with and without control. The application of the control technique, has de...

A Constitutive Model for Unsaturated soils based on a Compressibility Framework dependent on Suction and Degree of Saturation

OpenAIRE

Sitarenios Panagiotis; Kavvadas Michael

2016-01-01

The Modified Cam Clay model is extended to account for the behaviour of unsaturated soils using Bishop’s stress. To describe the Loading – Collapse behaviour, the model incorporates a compressibility framework with suction and degree of saturation dependent compression lines. For simplicity, the present paper describes the model in the triaxial stress space with characteristic simulations of constant suction compression and triaxial tests, as well as wetting tests. The model reproduces an evo...

Pediatric Stroke

Science.gov (United States)

... and Patient Resources Home » Patients & Families » About Stroke » Pediatric Stroke » Introduction Introduction What is a Stroke? Ischemic Stroke Intracerebral Hemorrhage Subarachnoid Hemorrhage Pediatric Stroke Introduction Types of Stroke Diagnosis and Treatment ...

Investigation on creep behavior of geo-materials with suction control technique

Directory of Open Access Journals (Sweden)

Nishimura Tomoyoshi

2016-01-01

Full Text Available The compacted bentonite which has typical couple problem associated to thermal - hydration - mechanical – chemical (THMC consist of one component of engineered barrier. Recently, the couple THMC formulation modelling suggested by some researchers can be predicted basically phenomena for engineered barrier that approach to correct evaluate satisfied facilities. The compacted bentonite is essentially unsaturated condition, some behaviors for bentonite has similar or close with generally expansive unsaturated soils. Therefore, hydrations have given significant influence on deformation of compacted bentonite such as swelling. There are many researches for swelling behavior of compacted bentonite within soaking. Extended theoretical or experimental investigations for unsaturated soil mechanics are possible to describe the strength-deformation behavior of compacted bentonite with suction controlling principle. A new method of determining the failure phase such as great axis deformation and destructions like strip of surface in the laboratory is described and the creep behavior of compacted bentonite is considered under maintain of high relative humidity environment. The creep deformation measured using improved cyclic relative humidity control apparatus in terms of specific suction control technique.

Slower EEG alpha generation, synchronization and "flow"-possible biomarkers of cognitive impairment and neuropathology of minor stroke.

Science.gov (United States)

Petrovic, Jelena; Milosevic, Vuk; Zivkovic, Miroslava; Stojanov, Dragan; Milojkovic, Olga; Kalauzi, Aleksandar; Saponjic, Jasna

2017-01-01

We investigated EEG rhythms, particularly alpha activity, and their relationship to post-stroke neuropathology and cognitive functions in the subacute and chronic stages of minor strokes. We included 10 patients with right middle cerebral artery (MCA) ischemic strokes and 11 healthy controls. All the assessments of stroke patients were done both in the subacute and chronic stages. Neurological impairment was measured using the National Institute of Health Stroke Scale (NIHSS), whereas cognitive functions were assessed using the Montreal Cognitive Assessment (MoCA) and MoCA memory index (MoCA-MIS). The EEG was recorded using a 19 channel EEG system with standard EEG electrode placement. In particular, we analyzed the EEGs derived from the four lateral frontal (F3, F7, F4, F8), and corresponding lateral posterior (P3, P4, T5, T6) electrodes. Quantitative EEG analysis included: the group FFT spectra, the weighted average of alpha frequency (αAVG), the group probability density distributions of all conventional EEG frequency band relative amplitudes (EEG microstructure), the inter- and intra-hemispheric coherences, and the topographic distribution of alpha carrier frequency phase potentials (PPs). Statistical analysis was done using a Kruskal-Wallis ANOVA with a post-hoc Mann-Whitney U two-tailed test, and Spearman's correlation. We demonstrated transient cognitive impairment alongside a slower alpha frequency ( α AVG) in the subacute right MCA stroke patients vs. the controls. This slower alpha frequency showed no amplitude change, but was highly synchronized intra-hemispherically, overlying the ipsi-lesional hemisphere, and inter-hemispherically, overlying the frontal cortex. In addition, the disturbances in EEG alpha activity in subacute stroke patients were expressed as a decrease in alpha PPs over the frontal cortex and an altered "alpha flow", indicating the sustained augmentation of inter-hemispheric interactions. Although the stroke induced slower alpha was a

Evidence-based evaluation of the primary prevention of stroke in migraineurs

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Yan LIN

2015-01-01

Full Text Available Objective To evaluate the evidence of migraine increasing the risk of stroke, so as to provide evidence-based foundation for primary prevention of stroke in patients with migraine.  Methods Taking migraine or migraine with aura, prevention and control, ischemia, hemorrhagic stroke, treatment or therapy as search terms, retrieve in databases such as PubMed and ScienceDirect, assisted by manual searching, in order to collect relevant literatures including clinical guidelines, systematic reviews, Meta-analysis, randomized controlled trials, clinical controlled trials, retrospective case analysis, case-observation studies and reviews. Jadad Scale was used to evaluate the quality of literature.  Results Twenty-four related articles were finally selected, including 5 clinical guidelines, 2 systematic reviews, 4 Meta-analyses, 2 randomized controlled trials, 10 case-observation studies and 1 review. Among them 20 were of high quality, while 4 were of low quality. The results were as follows: 1 migraine, particularly migraine with aura, significantly increased the risk of ischemic stroke, and the risk of women was higher than men. Smoking and oral contraceptives further increased the risk of stroke. 2 The risk of hemorrhagic stroke in migraine with aura patients was higher than that in general population. Migraine without aura did not appear to increase the risk of hemorrhagic stroke, and migraine was an independent risk factor for aneurysm rupture. 3 Frequency of migraine attacks, especially migraine with aura, and risk of ischemic stroke was positively correlated. 4 Patent foramen ovale (PFO was more common in young patients with cryptogenic stroke and migraineurs. However, closure of PFO was not indicated for preventing stroke in migraineurs. 5 Triptans, which was used to treat acute migraine, with a vasoconstrictor effect, may increase the risk of stroke, therefore prophylactic treatment of migraine was very important.  Conclusions Smoking

Eligibility and Predictors for Acute Revascularization Procedures in a Stroke Center.

Science.gov (United States)

Vanacker, Peter; Lambrou, Dimitris; Eskandari, Ashraf; Mosimann, Pascal J; Maghraoui, Ali; Michel, Patrik

2016-07-01

Endovascular treatment (EVT) is a new standard of care for selected, large vessel occlusive strokes. We aimed to determine frequency of potentially eligible patients for intravenous thrombolysis (IVT) and EVT in comprehensive stroke centers. In addition, predictors of EVT eligibility were derived. Patients from a stroke center-based registry (2003-2014), admitted within 24 hours of last proof of usual health, were selected if they had all data to determine IVT and EVT eligibility according to American Heart Association/American Stroke Association (AHA/ASA) guidelines (class I-IIa recommendations). Moreover, less restrictive criteria adapted from randomized controlled trials and clinical practice were tested. Maximum onset-to-door time windows for IVT eligibility were 3.5 hours (allowing door-to-needle delay of ≤60 minutes) and 4.5 hours for EVT eligibility (door-to-groin delay ≤90 minutes). Demographic and clinical information were used in logistic regression analysis to derive variables associated with EVT eligibility. A total of 2704 patients with acute ischemic stroke were included, of which 26.8% were transfers. Of all patients with stroke arriving at our comprehensive stroke center, a total proportion of 12.4% patients was eligible for IVT. Frequency of EVT eligibility differed between AHA/ASA guidelines and less restrictive approach: 2.9% versus 4.9%, respectively, of all patients with acute ischemic stroke and 10.5% versus 17.7%, respectively, of all patients arriving within <6 hours. Predictors for AHA-EVT eligibility were younger, shorter onset-to-admission delays, higher National Institutes of Health Stroke Scale (NIHSS), decreased vigilance, hemineglect, absent cerebellar signs, atrial fibrillation, smoking, and decreasing glucose levels (area under the curve=0.86). Of patients arriving within 6 hours at a comprehensive stroke center, 10.5% are EVT eligible according to AHA/ASA criteria, 17.7% according to criteria resembling randomized controlled

Comparison of numerical formulations for the modeling of tensile loaded suction buckets

DEFF Research Database (Denmark)

Sørensen, Emil Smed; Clausen, Johan Christian; Damkilde, Lars

2017-01-01

The tensile resistance of a suction bucket is investigated using three different numerical formulations. The first formulation utilizes the three-field u-p-U formulation accounting for solid and fluid displacements, u and U, as well as the pore-fluid pressure, p. The two other formulations compri...

Long term effects of cyclic loading on suction caisson foundations in sand

NARCIS (Netherlands)

Lupea, C.; Thijssen, R.; Van Tol, A.F.

2014-01-01

Offshore wind turbine projects have been characterised by an increase in costs, sizes and distances from shore, EWEA 2012 This created a need of investigating the adequacy of alternative and more fìnancially attractive foundation types such as suction caissons. Within a multi-footing configuration,

Factors Delaying Hospital Arrival Aftr Acute Stroke Onset

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Ghiasian M

2017-03-01

Full Text Available Introduction: Optimal time of referral aftr stroke and the use of new therapies, such as r-tPA and blood pressure control, could accelerate symptoms recovery aftr stroke. Th aim of this study was to investigate factors contributing to the delay in referral to hospitals aftr the occurrence of acute stroke. Methods: Ths analytic-descriptive study included 425 patients, who had referred to the Hamadan Farshchian hospital during years 2015 and 2016. Demographic data, time of referring to medical center, the time of occurrence of stroke, risk factors, clinical symptoms of stroke, way of referring, distance from medical center and type of stroke by using a questionnaire and checklist were recorded. Th SPSS (version 16 softare was used for all calculations. Results: Th mean age of patients in this study was 70.12 years old. Overall, 260 patients (61.2% were male and 85.6% had ischemic stroke. Mean time of referral to fist treatment center and Farshchian hospital was 2.06 and 4.77 hours, respectively. A total of 36.2% patients arrived to Farshchian hospital, within less than 2 hours. Factors that prolonged time to presentation were male gender, ischemic stroke, low education, being at a location far from the medical center, referral from other medical centers, being single, having no witness during stroke, and having a stroke at home, and during night. Th most common symptoms in patients who were referred within less than two hours were confusion and loss of consciousness with frequency of 29.2%. Th most common risk factor in 61.4% of patients, who were referred within less than 2 hours, was high blood pressure. Conclusion: Ths study showed mean time of referral for treatment aftr stroke was high. Inflential elements that could possibly delay hospital arrival include, being at a location far from the medical center, no adequate knowledge about stroke symptom, having stroke at night, not referring directly to the medical center, being single, and no

The profile of risk factors and in-patient outcomes of stroke in ...

African Journals Online (AJOL)

We therefore conducted this study to evaluate the frequencies of the traditional risk factors and outcomes of stroke at the main tertiary referral centre in the middle belt of Ghana in a prospective observational study. Methods and results: Patients with a clinical diagnosis of stroke were consecutively recruited and vascular risk ...

Kinematics of suction feeding in the seahorse Hippocampus reidi.

Science.gov (United States)

Roos, Gert; Van Wassenbergh, Sam; Herrel, Anthony; Aerts, Peter

2009-11-01

Fish typically use a rostro-caudal wave of head expansion to generate suction, which is assumed to cause a uni-directional, anterior-to-posterior flow of water in the expanding head. However, compared with typical fish, syngnathid fishes have a remarkably different morphology (elongated snout, small hyoid, immobile pectoral girdle) and feeding strategy (pivot feeding: bringing the small mouth rapidly close to the prey by neurocranial dorsorotation). As a result, it is unclear how suction is generated in Syngnathidae. In this study, lateral and ventral expansions of the head were quantified in Hippocampus reidi and linked to the kinematics of the mouth, hyoid and neurocranium. In addition, the flow velocities inside the bucco-pharyngeal cavity and in front of the mouth were calculated. Our data suggest that the volume changes caused by lateral expansion are dominant over ventral expansion. Maximum gape, neurocranium rotation and hyoid depression are all reached before actual volume increase and before visible prey movement. This implies that, unlike previously studied teleosts, hyoid rotation does not contribute to ventral expansion by lowering the floor of the mouth during prey capture in H. reidi. The lateral volume changes show a rostro-caudal expansion, but the maximal flow velocity is not near the mouth aperture (as has been demonstrated for example in catfish) but at the narrow region of the buccal cavity, dorsal to the hyoid.

Successful Laparoscopically Assisted Transcervical Suction Evacuation of Interstitial Pregnancy following Failed Methotrexate Injection in a Community Hospital Setting

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Rani B. Fritz

2014-01-01

Full Text Available We report on a case of a patient with an early diagnosed cornual ectopic pregnancy following failed methotrexate treatment. The patient was subsequently taken to the operating room for a laparoscopic guided transcervical suction curettage of the cornual ectopic. The surgery was successful and the patient was followed up until her urine pregnancy test was negative. We conclude that in properly selected patients, cornual ectopic pregnancy may be treated with transcervical suction curettage.

Recovery of slow-5 oscillations in a longitudinal study of ischemic stroke patients.

Science.gov (United States)

La, C; Nair, V A; Mossahebi, P; Stamm, J; Birn, R; Meyerand, M E; Prabhakaran, V

2016-01-01

Functional networks in resting-state fMRI are identified by characteristics of their intrinsic low-frequency oscillations, more specifically in terms of their synchronicity. With advanced aging and in clinical populations, this synchronicity among functionally linked regions is known to decrease and become disrupted, which may be associated with observed cognitive and behavioral changes. Previous work from our group has revealed that oscillations within the slow-5 frequency range (0.01-0.027 Hz) are particularly susceptible to disruptions in aging and following a stroke. In this study, we characterized longitudinally the changes in the slow-5 oscillations in stroke patients across two different time-points. We followed a group of ischemic stroke patients (n = 20) and another group of healthy older adults (n = 14) over two visits separated by a minimum of three months (average of 9 months). For the stroke patients, one visit occurred in their subacute window (10 days to 6 months after stroke onset), the other took place in their chronic window (> 6 months after stroke). Using a mid-order group ICA method on 10-minutes eyes-closed resting-state fMRI data, we assessed the frequency distributions of a component's representative time-courses for differences in regards to slow-5 spectral power. First, our stroke patients, in their subacute stage, exhibited lower amplitude slow-5 oscillations in comparison to their healthy counterparts. Second, over time in their chronic stage, those same patients showed a recovery of those oscillations, reaching near equivalence to the healthy older adult group. Our results indicate the possibility of an eventual recovery of those initially disrupted network oscillations to a near-normal level, providing potentially a biomarker for stroke recovery of the cortical system. This finding opens new avenues in infra-slow oscillation research and could serve as a useful biomarker in future treatments aimed at recovery.

Recovery of slow-5 oscillations in a longitudinal study of ischemic stroke patients

Directory of Open Access Journals (Sweden)

C. La

2016-01-01

Full Text Available Functional networks in resting-state fMRI are identified by characteristics of their intrinsic low-frequency oscillations, more specifically in terms of their synchronicity. With advanced aging and in clinical populations, this synchronicity among functionally linked regions is known to decrease and become disrupted, which may be associated with observed cognitive and behavioral changes. Previous work from our group has revealed that oscillations within the slow-5 frequency range (0.01–0.027 Hz are particularly susceptible to disruptions in aging and following a stroke. In this study, we characterized longitudinally the changes in the slow-5 oscillations in stroke patients across two different time-points. We followed a group of ischemic stroke patients (n = 20 and another group of healthy older adults (n = 14 over two visits separated by a minimum of three months (average of 9 months. For the stroke patients, one visit occurred in their subacute window (10 days to 6 months after stroke onset, the other took place in their chronic window (>6 months after stroke. Using a mid-order group ICA method on 10-minutes eyes-closed resting-state fMRI data, we assessed the frequency distributions of a component's representative time-courses for differences in regards to slow-5 spectral power. First, our stroke patients, in their subacute stage, exhibited lower amplitude slow-5 oscillations in comparison to their healthy counterparts. Second, over time in their chronic stage, those same patients showed a recovery of those oscillations, reaching near equivalence to the healthy older adult group. Our results indicate the possibility of an eventual recovery of those initially disrupted network oscillations to a near-normal level, providing potentially a biomarker for stroke recovery of the cortical system. This finding opens new avenues in infra-slow oscillation research and could serve as a useful biomarker in future treatments aimed at recovery.

Differential Effects of Endotracheal Suctioning on Gas Exchanges in Patients with Acute Respiratory Failure under Pressure-Controlled and Volume-Controlled Ventilation

Directory of Open Access Journals (Sweden)

Xiao-Wei Liu

2015-01-01

Full Text Available This study was conducted to evaluate the effects of open endotracheal suctioning on gas exchange and respiratory mechanics in ARF patients under the modes of PCV or VCV. Ninety-six ARF patients were treated with open endotracheal suctioning and their variations in respiratory mechanics and gas exchange after the suctions were compared. Under PCV mode, compared with the initial level of tidal volume (VT, ARF patients showed 30.0% and 27.8% decrease at 1 min and 10 min, respectively. Furthermore, the initial respiratory system compliance (Crs decreased by 29.6% and 28.5% at 1 min and 10 min, respectively. Under VCV mode, compared with the initial level, 38.6% and 37.5% increase in peak airway pressure (PAP were found at 1 min and 10 min, respectively. Under PCV mode, the initial PaO2 increased by 6.4% and 10.2 % at 3 min and 10 min, respectively, while 18.9% and 30.6% increase of the initial PaO2 were observed under VCV mode. Summarily, endotracheal suctioning may impair gas exchange and decrease lung compliance in ARF patients receiving mechanical ventilation under both PCV and VCV modes, but endotracheal suctioning effects on gas exchange were more severe and longer-lasting under PCV mode than VCV.

Aerosol distribution during open suctioning and long-term surveillance of air quality in a respiratory care center within a medical center.

Science.gov (United States)

Chung, Fen-Fang; Lin, Hui-Ling; Liu, Hsueh-Erh; Lien, Angela Shin-Yu; Hsiao, Hsiu-Feng; Chou, Lan-Ti; Wan, Gwo-Hwa

2015-01-01

The investigation of hospital air quality has been conducted in wards, ICUs, operating theaters, and public areas. Few studies have assessed air quality in respiratory care centers (RCCs), especially in mechanically ventilated patients with open suctioning. The RCC air quality indices (temperature, relative humidity, levels of CO2, total volatile organic compounds, particulate matter [PM], bacteria, and fungi) were monitored over 1 y. The air around the patient's head was sampled during open suctioning to examine the probability of bioaerosol exposure affecting health-care workers. This investigation found that the levels of indoor air pollutants (CO2, PM, bacteria, and fungi) were below the indoor air quality standard set by the Taiwan Environmental Protection Agency. Meanwhile, the levels of total volatile organic compounds sometimes exceeded the indoor air quality standard, particularly in August. The identified bacterial genera included Micrococcus species, Corynebacterium species, and Staphylococcus species, and the predominant fungal genera included yeast, Aspergillus species, Scopulariopsis species, and Trichoderma species. Additionally, airborne PM2.5, PM1, and bacteria were clearly raised during open suctioning in mechanically ventilated patients. This phenomenon demonstrated that open suctioning may increase the bacterial exposure risk of health-care workers. RCC air quality deserves long-term monitoring and evaluation. Health-care workers must implement self-protection strategies during open suctioning to ensure their occupational health and safety in health-care settings. Copyright © 2015 by Daedalus Enterprises.

Stroke mimic diagnoses presenting to a hyperacute stroke unit.

Science.gov (United States)

Dawson, Ang; Cloud, Geoffrey C; Pereira, Anthony C; Moynihan, Barry J

2016-10-01

Stroke services have been centralised in several countries in recent years. Diagnosing acute stroke is challenging and a high proportion of patients admitted to stroke units are diagnosed as a non-stroke condition (stroke mimics). This study aims to describe the stroke mimic patient group, including their impact on stroke services. We analysed routine clinical data from 2,305 consecutive admissions to a stroke unit at St George's Hospital, London. Mimic groupings were derived from 335 individual codes into 17 groupings. From 2,305 admissions, 555 stroke mimic diagnoses were identified (24.2%) and 72% of stroke mimics had at least one stroke risk factor. Common mimic diagnoses were headache, seizure and syncope. Medically unexplained symptoms and decompensation of underlying conditions were also common. Median length of stay was 1 day; a diagnosis of dementia (p=0.028) or needing MRI (p=0.006) was associated with a longer stay. Despite emergency department assessment by specialist clinicians and computed tomography brain, one in four suspected stroke patients admitted to hospital had a non-stroke diagnosis. Stroke mimics represent a heterogeneous patient group with significant impacts on stroke services. Co-location of stroke and acute neurology services may offer advantages where service reorganisation is being considered. © Royal College of Physicians 2016. All rights reserved.

Development in corrosion resistance by microstructural refinement in Zr-16 SS 304 alloy using suction casting technique

Energy Technology Data Exchange (ETDEWEB)

Das, N., E-mail: nirupamd@barc.gov.in; Sengupta, P.; Abraham, G.; Arya, A.; Kain, V.; Dey, G.K.

2016-08-15

Highlights: • Grain refinement was made in Zr–16 wt.% SS alloy while prepared by suction casting process. • Distribution of Laves phase, e.g., Zr{sub 2}(Fe, Cr) was raised in suction cast (SC) Zr–16 wt.% SS. • Corrosion resistance was improved in SC alloy compared to that of arc-melt-cast alloy. • Grain refinement in SC alloy assisted for an increase in its corrosion resistance. - Abstract: Zirconium (Zr)-stainless steel (SS) hybrid alloys are being considered as baseline alloys for developing metallic-waste-form (MWF) with the motivation of disposing of Zr and SS base nuclear metallic wastes. Zr–16 wt.% SS, a MWF alloy optimized from previous studies, exhibit significant grain refinement and changes in phase assemblages (soft phase: Zr{sub 2}(Fe, Cr)/α-Zr vs. hard phase: Zr{sub 3}(Fe, Ni)) when prepared by suction casting (SC) technique in comparison to arc-cast-melt (AMC) route. Variation in Cr-distribution among different phases are found to be low in suction cast alloy, which along with grain refinement restricted Cr-depletion at the Zr{sub 2}(Fe, Cr)/Zr interfaces, prone to localized attack. Hence, SC alloy, compared to AMC alloy, showed lower current density, higher potential at the breakdown of passivity and higher corrosion potential during polarization experiments (carried out under possible geological repository environments, viz., pH 8, 5 and 1) indicating its superior corrosion resistance.

A Nonlinear Dynamic Approach Reveals a Long-Term Stroke Effect on Cerebral Blood Flow Regulation at Multiple Time Scales

Science.gov (United States)

Hu, Kun; Lo, Men-Tzung; Peng, Chung-Kang; Liu, Yanhui; Novak, Vera

2012-01-01

Cerebral autoregulation (CA) is an important vascular control mechanism responsible for relatively stable cerebral blood flow despite changes of systemic blood pressure (BP). Impaired CA may leave brain tissue unprotected against potentially harmful effects of BP fluctuations. It is generally accepted that CA is less effective or even inactive at frequencies >∼0.1 Hz. Without any physiological foundation, this concept is based on studies that quantified the coupling between BP and cerebral blood flow velocity (BFV) using transfer function analysis. This traditional analysis assumes stationary oscillations with constant amplitude and period, and may be unreliable or even invalid for analysis of nonstationary BP and BFV signals. In this study we propose a novel computational tool for CA assessment that is based on nonlinear dynamic theory without the assumption of stationary signals. Using this method, we studied BP and BFV recordings collected from 39 patients with chronic ischemic infarctions and 40 age-matched non-stroke subjects during baseline resting conditions. The active CA function in non-stroke subjects was associated with an advanced phase in BFV oscillations compared to BP oscillations at frequencies from ∼0.02 to 0.38 Hz. The phase shift was reduced in stroke patients even at > = 6 months after stroke, and the reduction was consistent at all tested frequencies and in both stroke and non-stroke hemispheres. These results provide strong evidence that CA may be active in a much wider frequency region than previously believed and that the altered multiscale CA in different vascular territories following stroke may have important clinical implications for post-stroke recovery. Moreover, the stroke effects on multiscale cerebral blood flow regulation could not be detected by transfer function analysis, suggesting that nonlinear approaches without the assumption of stationarity are more sensitive for the assessment of the coupling of nonstationary

On the influence of buoyancy and suction/injection In Heat and Mass ...

African Journals Online (AJOL)

In this paper, we examined the influence of buoyancy and suction/injection in the problem of unsteady convection with chemical reaction and radiative heat transfer past a flat porous plate moving through a binary mixture in an optically thin environment is presented. The dimensionless governing equations for this ...

Measuring stroke patients’ exercise preferences using a discrete choice experiment

Directory of Open Access Journals (Sweden)

Wolfgang Geidl

2018-03-01

Full Text Available Physical activity post stroke improves health, yet physical inactivity is highly prevalent. Tailored exercise programs considering physical activity preferences are a promising approach to promote physical activity. Therefore, this study seeks to measure exercise preferences of stroke survivors. Stroke survivors conducted a discrete choice experiment (DCE. DCE was presented in a face-to-face interview where patients had to choose eight times between two different exercise programs. Exercise programs differed by characteristics, with the six attributes under consideration being social situation, location, type of exercise, intensity, frequency, and duration. Utilities of the exercise attributes were estimated with a logit choice model. Stroke survivors (n=103, mean age: 67, SD=13.0; 60% male show significant differences in the rated utilities of the exercise attributes (P<0.001. Participants had strong preferences for light and moderate intense physical activity and favored shorter exercise sessions. Stroke survivors have remarkable exercise preferences especially for intensity and duration of exercise. Results contribute to the tailoring of physical activity programs after stroke thereby facilitating maintenance of physical activity.

The Effects of Visual Complexity for Japanese Kanji Processing with High and Low Frequencies

Science.gov (United States)

Tamaoka, Katsuo; Kiyama, Sachiko

2013-01-01

The present study investigated the effects of visual complexity for kanji processing by selecting target kanji from different stroke ranges of visually simple (2-6 strokes), medium (8-12 strokes), and complex (14-20 strokes) kanji with high and low frequencies. A kanji lexical decision task in Experiment 1 and a kanji naming task in Experiment 2…

Determinations of vertical stroke V{sub cb} vertical stroke and vertical stroke V{sub ub} vertical stroke from baryonic Λ{sub b} decays

Energy Technology Data Exchange (ETDEWEB)

Hsiao, Y.K. [Shanxi Normal University, School of Physics and Information Engineering, Linfen (China); National Tsing Hua University, Department of Physics, Hsinchu (China); Geng, C.Q. [Shanxi Normal University, School of Physics and Information Engineering, Linfen (China); National Tsing Hua University, Department of Physics, Hsinchu (China); Hunan Normal University, Synergetic Innovation Center for Quantum Effects and Applications (SICQEA), Changsha (China)

2017-10-15

We present the first attempt to extract vertical stroke V{sub cb} vertical stroke from the Λ{sub b} → Λ{sub c}{sup +}l anti ν{sub l} decay without relying on vertical stroke V{sub ub} vertical stroke inputs from the B meson decays. Meanwhile, the hadronic Λ{sub b} → Λ{sub c}M{sub (c)} decays with M = (π{sup -},K{sup -}) and M{sub c} =(D{sup -},D{sup -}{sub s}) measured with high precisions are involved in the extraction. Explicitly, we find that vertical stroke V{sub cb} vertical stroke =(44.6 ± 3.2) x 10{sup -3}, agreeing with the value of (42.11 ± 0.74) x 10{sup -3} from the inclusive B → X{sub c}l anti ν{sub l} decays. Furthermore, based on the most recent ratio of vertical stroke V{sub ub} vertical stroke / vertical stroke V{sub cb} vertical stroke from the exclusive modes, we obtain vertical stroke V{sub ub} vertical stroke = (4.3 ± 0.4) x 10{sup -3}, which is close to the value of (4.49 ± 0.24) x 10{sup -3} from the inclusive B → X{sub u}l anti ν{sub l} decays. We conclude that our determinations of vertical stroke V{sub cb} vertical stroke and vertical stroke V{sub ub} vertical stroke favor the corresponding inclusive extractions in the B decays. (orig.)

Review of pump suction reducer selection: Eccentric or concentric reducers

OpenAIRE

Mahaffey, R M; van Vuuren, S J

2014-01-01

Eccentric reducers are traditionally recommended for the pump suction reducer fitting to allow for transportation of air through the fitting to the pump. The ability of a concentric reducer to provide an improved approach flow to the pump while still allowing air to be transported through the fitting is investigated. Computational fluid dynamics (CFD) were utilised to analyse six concentric and six eccentric reducer geometries at four different inlet velocities to determine the flow velocity ...

Comparison of tissue plasminogen activator administration management between Telestroke Network hospitals and academic stroke centers: the Telemedical Pilot Project for Integrative Stroke Care in Bavaria/Germany.

Science.gov (United States)

Audebert, Heinrich J; Kukla, Christian; Vatankhah, Bijan; Gotzler, Berthold; Schenkel, Johannes; Hofer, Stephan; Fürst, Andrea; Haberl, Roman L

2006-07-01

Systemic thrombolysis is the only therapy proven to be effective for ischemic stroke. Telemedicine may help to extend its use. However, concerns remain whether management and safety of tissue plasminogen activator (tPA) administration after telemedical consultation are equivalent in less experienced hospitals compared with tPA administration in academic stroke centers. During the second year of the ongoing Telemedical Pilot Project for Integrative Stroke Care, all systemic thrombolyses in stroke patients of the 12 regional clinics and the 2 stroke centers were recorded prospectively. Patients' demographics, stroke severity (National Institutes of Health Stroke Scale), frequency of administration, time management, protocol violations, and safety were included in the analysis. In 2004, 115 of 4727 stroke or transient ischemic attack patients (2.4%) in the community hospitals and 110 of 1889 patients in the stroke centers (5.8%) received systemic thrombolysis. Prehospital latencies were shorter in the regional hospitals despite longer distances. Door to needle times were shorter in the stroke centers. Although blood pressure was controlled more strictly in community hospitals, symptomatic intracerebral hemorrhage rate (7.8%) was higher (P=0.14) than in stroke centers (2.7%) but still within the range of the National Institute of Neurological Disorders and Stroke trial. In-hospital mortality rate was low in community hospitals (3.5%) and in stroke centers (4.5%). Although with a lower rate of systemic thrombolysis, there was no evidence of lower treatment quality in the remote hospitals. With increasing numbers of tPA administration and growing training effects, the telestroke concept promises better coverage of systemic thrombolysis in nonurban areas.

Cryptogenic Stroke

Directory of Open Access Journals (Sweden)

Mohammad Saadatnia

2017-02-01

Full Text Available Cryptogenic stroke is defined as brain infarction that is not attributable to a source of definite embolism, large artery atherosclerosis, or small artery disease despite a thorough vascular, cardiac, and serologic evaluation. Despite many advances in our understanding of ischemic stroke, cryptogenic strokes remain a diagnostic and therapeutic challenge. The pathophysiology of cryptogenic stroke is likely various. Probable mechanisms include cardiac embolism secondary to occult paroxysmal atrial fibrillation, aortic atheromatous disease or other cardiac sources, paradoxical embolism from atrial septal abnormalities such as patent foramen ovale, hypercoagulable states, and preclinical or subclinical cerebrovascular disease.  Cryptogenic stroke is one-fourth among cerebral infarction, but most of them could be ascribed to embolic stroke. A significant proportion of cryptogenic strokes adhere to embolic infarct topography on brain imaging and improvement in our ability to detect paroxysmal atrial fibrillation in patients with cryptogenic stroke has strengthened the idea that these strokes are embolic in nature. a significant proportion of cryptogenic strokes adhere to embolic infarct topography on brain imaging.embolic stroke of undetermined sources(ESUS was planned for unifying embolic stroke of undetermined source.  The etiologies underlying ESUS included minor-risk potential cardioembolic sources, covert paroxysmal atrial fibrillation, cancer-associated coagulopathy and embolism, arteriogenic emboli, and paroxysmal embolism. Extensive evaluation including transesophageal echocardiography and cardiac monitoring for long time could identify the etiology of these patients. Therefore cryptogenic stroke is a diagnosis of exclusion. Compared with other stroke subtypes, cryptogenic stroke tends to have a better prognosis and lower long-term risk of recurrence.

Boundary layer on a flat plate with suction; Couche limite sur paroi plane poreuse avec aspiration

Energy Technology Data Exchange (ETDEWEB)

Favre, A; Dumas, R; Verollet, E [Commissariat a l' Energie Atomique, Saclay (France). Centre d' Etudes Nucleaires; Institut de Mecanique Statistique de la Turbulence, Faculte des Sciences de Marseille, 13 (France)

1961-07-01

This research done in wind tunnel concerns the turbulent boundary layer of a porous flat plate with suction. The porous wall is 1 m long and begins 1 m downstream of the leading edge. The Reynolds number based on the boundary layer thickness is of the order of 16.300. The suction rate defined as the ratio of the velocity perpendicular to the wall to the external flow velocity ranges from 0 to 2 per cent. The pressure gradient can be controlled. The mean velocity profiles have been determined for various positions and suction rates by means of total pressure probes together with the intensities of the turbulent velocity fluctuations components, energy spectra and correlations by means of hot wire anemometers, spectral analyser and correlator. The stream lines, the values of the viscous and turbulent shear stresses, of the local wall friction, of the turbulent energy production term, with some information on the dissipation of the energy have been derived from these measurements. For these data the integral of equation of continuity in boundary layer have been drawn. The suction effects on the boundary layer are important. The suction thoroughly alters the mean velocity profiles by increasing the viscous shear stresses near the wall and decreasing them far from the wall, it diminishes the longitudinal and transversal turbulence intensities, the turbulent shear stresses, and the production of energy of turbulence. These effects are much stressed in the inner part of the boundary layer. On the other hand the energy spectra show that the turbulence scale is little modified, the boundary layer thickness being not much diminished by the suction. The suction effects can be appreciated by comparing twice the suction rate to the wall friction coefficient (assumed airtight), quite noticeable as soon as the rate is about unity, they become very important when it reaches ten. (author) [French] Ces recherches, effectuees en soufflerie, concernent la couche limite turbulente d

Late night activity regarding stroke codes: LuNAR strokes.

Science.gov (United States)

Tafreshi, Gilda; Raman, Rema; Ernstrom, Karin; Rapp, Karen; Meyer, Brett C

2012-08-01

There is diurnal variation for cardiac arrest and sudden cardiac death. Stroke may show a similar pattern. We assessed whether strokes presenting during a particular time of day or night are more likely of vascular etiology. To compare emergency department stroke codes arriving between 22:00 and 8:00 hours (LuNAR strokes) vs. others (n-LuNAR strokes). The purpose was to determine if late night strokes are more likely to be true strokes or warrant acute tissue plasminogen activator evaluations. We reviewed prospectively collected cases in the University of California, San Diego Stroke Team database gathered over a four-year period. Stroke codes at six emergency departments were classified based on arrival time. Those arriving between 22:00 and 8:00 hours were classified as LuNAR stroke codes, the remainder were classified as 'n-LuNAR'. Patients were further classified as intracerebral hemorrhage, acute ischemic stroke not receiving tissue plasminogen activator, acute ischemic stroke receiving tissue plasminogen activator, transient ischemic attack, and nonstroke. Categorical outcomes were compared using Fisher's Exact test. Continuous outcomes were compared using Wilcoxon's Rank-sum test. A total of 1607 patients were included in our study, of which, 299 (19%) were LuNAR code strokes. The overall median NIHSS was five, higher in the LuNAR group (n-LuNAR 5, LuNAR 7; P=0·022). There was no overall differences in patient diagnoses between LuNAR and n-LuNAR strokes (P=0·169) or diagnosis of acute ischemic stroke receiving tissue plasminogen activator (n-LuNAR 191 (14·6%), LuNAR 42 (14·0%); P=0·86). Mean arrival to computed tomography scan time was longer during LuNAR hours (n-LuNAR 54·9±76·3 min, LuNAR 62·5±87·7 min; P=0·027). There was no significant difference in 90-day mortality (n-LuNAR 15·0%, LuNAR 13·2%; P=0·45). Our stroke center experience showed no difference in diagnosis of acute ischemic stroke between day and night stroke codes. This

Child-Mediated Stroke Communication: findings from Hip Hop Stroke.

Science.gov (United States)

Williams, Olajide; DeSorbo, Alexandra; Noble, James; Gerin, William

2012-01-01

Low thrombolysis rates for acute ischemic stroke are linked to delays in seeking immediate treatment due to low public stroke awareness. We aimed to assess whether "Child-Mediated Stroke Communication" could improve stroke literacy of parents of children enrolled in a school-based stroke literacy program called Hip Hop Stroke. Parents of children aged 9 to 12 years from 2 public schools in Harlem, New York City, were recruited to participate in stroke literacy questionnaires before and after their child's participation in Hip Hop Stroke, a novel Child-Mediated Stroke Communication intervention delivered in school auditoriums. Parental recall of stroke information communicated through their child was assessed 1-week after the intervention. Fifth and sixth grade students (n=182) were enrolled into Hip Hop Stroke. One hundred two parents were approached in person to participate; 75 opted to participate and 71 completed both the pretest and post-test (74% response rate and 95% retention rate). Parental stroke literacy improved after the program; before the program, 3 parents of 75 (3.9%) were able to identify the 5 cardinal stroke symptoms, distracting symptom (chest pains), and had an urgent action plan (calling 911) compared with 21 of 71 parents (29.6%) postintervention (P<0.001). The FAST mnemonic was known by 2 (2.7%) of participants before the program versus 29 (41%) after program completion (P<0.001). Knowledge of stroke signs and symptoms remains low among residents of this high-risk population. The use of Child-Mediated Stroke Communication suggests that school children aged 9 to 12 years may be effective conduits of critical stroke knowledge to their parents.

Upper limb function and functional independence in patients with shoulder pain after stroke

OpenAIRE

Nickel, Renato; Lange, Marcos; Stoffel, Diane Priscila; Navarro, Elaine Janeczko; Zetola, Viviane F

2017-01-01

ABSTRACT Objective To examine the frequency of shoulder pain following stroke. Methods Stroke patient function was evaluated using the Functional Independence Measure (FIM) and Scale for Upper Limb Function in Stroke (SULFS). Function scores were examined and compared between the shoulder pain group (SPG) and the no shoulder pain group (No-SPG). Results A total of 58 patients, 22 women (37.9%), were included in this study. The mean patient age was 49.2±10.8 years and study evaluations w...

Saline instillation before tracheal suctioning decreases the incidence of ventilator-associated pneumonia.

Science.gov (United States)

Caruso, Pedro; Denari, Silvia; Ruiz, Soraia A L; Demarzo, Sergio E; Deheinzelin, Daniel

2009-01-01

To compare the incidence of ventilator-associated pneumonia (VAP) with or without isotonic saline instillation before tracheal suctioning. As a secondary objective, we compared the incidence of endotracheal tube occlusion and atelectasis. Randomized clinical trial. The study was conducted in a medical surgical intensive care unit of an oncologic hospital. We selected consecutive patients needing mechanical ventilation for >72 hrs. Patients were allocated into two groups: a saline group that received instillation of 8 mL of saline before tracheal suctioning and a control group which did not. VAP was diagnosed based on clinical suspicion and confirmed by bronchoalveolar lavage quantitative culture. The incidence of atelectasis on daily chest radiography and endotracheal tube occlusions were recorded. The sample size was calculated to a power of 80% and a type I error probability of 5%. One hundred thirty patients were assigned to the saline group and 132 to the control group. The baseline demographic variables were similar between groups. The rate of clinically suspected VAP was similar in both groups. The incidence of microbiological proven VAP was significantly lower in the saline group (23.5% x 10.8%; p = 0.008) (incidence density/1.000 days of ventilation 21.22 x 9.62; p < 0.01). Using the Kaplan-Meier curve analysis, the proportion of patients remaining without VAP was higher in the saline group (p = 0.02, log-rank test). The relative risk reduction of VAP in the saline instillation group was 54% (95% confidence interval, 18%-74%) and the number needed to treat was eight (95% confidence interval, 5-27). The incidence of atelectases and endotracheal tube occlusion were similar between groups. Instillation of isotonic saline before tracheal suctioning decreases the incidence of microbiological proven VAP.

Self-reported stress and risk of stroke: the Copenhagen City Heart Study

DEFF Research Database (Denmark)

Truelsen, Thomas; Nielsen, Naja; Boysen, Gudrun

2003-01-01

BACKGROUND AND PURPOSE: Lay people often mention stress as one of the most important risk factors for stroke. Stress might trigger a cerebrovascular event directly or could be associated with higher levels of blood pressure or an unfavorable lifestyle. To examine these possibilities, we analyzed...... the association between self-reported stress frequency and intensity and risk of stroke. METHODS: Data from the second examination, 1981 to 1983, of participants in the Copenhagen City Heart Study were analyzed with Cox regression after a mean of 13 years of follow-up. A total of 5604 men and 6970 women were...... included, and 929 first-ever strokes occurred, of which 207 (22%) were fatal within 28 days after onset of symptoms. The stress frequency categories were never/hardly ever, monthly, weekly, or daily. The stress intensity categories were never/hardly ever, light, moderate, or high. RESULTS: Subjects...

Screening for Fabry's disease in young patients with ischemic stroke in a Chinese population.

Science.gov (United States)

Song, Xiaowei; Xue, Sufang; Zhao, Jingyan; Wu, Jian

2017-04-01

Fabry disease is an X-linked lysosomal storage disorder frequently associated with cerebrovascular disease. Data regarding Fabry disease and ischemic stroke has been lacking in China. In this study, we investigated the prevalence of Fabry disease and the distribution of the alpha-galactosidase A (α-GalA) gene - GLA mutations in young stroke patients in the Chinese population and its association with stroke subtypes. A total of 357 ischemic stroke patients admitted to Xuanwu Hospital of Capital Medical University, aged 18-55 years old, including 293 patients with cerebral infarction and 64 patients with transient ischemic attack, were enrolled in this study. Mutations in the GLA gene were screened by Sanger sequencing. Enzyme levels were measured to further confirm the disease in patients with the gene mutation. The mutation frequency was compared among different stroke subtypes and further compared with the control group individually. No pathogenic mutations in the coding regions of the GLA gene were identified in this group of patients and thus no Fabry disease was found in our study. However, the frequency of an intronic polymorphism c.-10C>T was significantly different among different Trial of Org 10172 in Acute Stroke Treatment subtypes (p T polymorphism in patients with stroke due to other causes and undetermined causes was much higher than that in the control group (OR = 3.18, 95% CI: 1.29-7.83, p stroke patients. In addition, our results suggested that the c.-10C>T polymorphism may be a risk factor for ischemic stroke of other and undetermined causes. Further study is required to confirm our findings.

Forelimb posture in dinosaurs and the evolution of the avian flapping flight-stroke.

Science.gov (United States)

Nudds, Robert L; Dyke, Gareth J

2009-04-01

Ontogenetic and behavioral studies using birds currently do not document the early evolution of flight because birds (including juveniles) used in such studies employ forelimb oscillation frequencies over 10 Hz, forelimb stroke-angles in excess of 130 degrees , and possess uniquely avian flight musculatures. Living birds are an advanced morphological stage in the development of flapping flight. To gain insight into the early stages of flight evolution (i.e., prebird), in the absence of a living analogue, a new approach using Strouhal number was used. Strouhal number is a nondimensional number that describes the relationship between wing-stroke amplitude (A), wing-beat frequency (f), and flight speed (U). Calculations indicated that even moderate wing movements are enough to generate rudimentary thrust and that a propulsive flapping flight-stroke could have evolved via gradual incremental changes in wing movement and wing morphology. More fundamental to the origin of the avian flapping flight-stroke is the question of how a symmetrical forelimb posture-required for gliding and flapping flight-evolved from an alternating forelimb motion, evident in all extant bipeds when running except birds.

Weather types and strokes in the Augsburg region (Southern Germany)

Science.gov (United States)

Beck, Christoph; Ertl, Michael; Giemsa, Esther; Jacobeit, Jucundus; Naumann, Markus; Seubert, Stefanie

2017-04-01

Strokes are one of the leading causes of morbidity and mortality worldwide and the main reason for longterm care dependency in Germany. Concerning the economical impact on patients and healthcare systems it is of particular importance to prevent this disease as well as to improve the outcome of the affected persons. Beside the primary well-known risk factors like hypertension, cigarette smoking, physical inactivity and others, also weather seems to have pronounced influence on the occurrence and frequency of strokes. Previous studies most often focused on effects of singular meteorological variables like ambient air temperature, air pressure or humidity. An advanced approach is to link the entire suite of daily weather elements classified to air mass- or weather types to cerebrovascular morbidity or mortality. In a joint pilot study bringing together climatologists, environmental scientists and physicians from the University of Augsburg and the clinical centre Augsburg, we analysed relationships between singular meteorological parameters as well as combined weather effects (e.g. weather types) and strokes in the urban area of Augsburg and the surrounding rural region. A total of 17.501 stroke admissions to Neurological Clinic and Clinical Neurophysiology at Klinikum Augsburg between 2006 and 2015 are classified to either "ischaemic" (16.354) or "haemorrhagic" (1.147) subtype according to etiology (based on the International Classification of Diseases - 10th Revision). Spearman correlations between daily frequencies of ischaemic and haemorrhagic strokes and singular atmospheric parameters (T, Tmin, Tmax, air pressure, humidity etc.) measured at the DWD (German weather service) meteorological station at Augsburg Muehlhausen are rather low. However, higher correlations are achieved when considering sub-samples of "homogenous weather conditions" derived from synoptic circulation classifications: e.g. within almost all of 10 types arising from a classification of

Boundary layer development on turbine airfoil suction surfaces

Science.gov (United States)

Sharma, O. P.; Wells, R. A.; Schlinker, R. H.; Bailey, D. A.

1981-01-01

The results of a study supported by NASA under the Energy Efficient Engine Program, conducted to investigate the development of boundary layers under the influence of velocity distributions that simulate the suction sides of two state-of-the-art turbine airfoils, are presented. One velocity distribution represented a forward loaded airfoil ('squared-off' design), while the other represented an aft loaded airfoil ('aft loaded' design). These velocity distributions were simulated in a low-speed, high-aspect-ratio wind tunnel specifically designed for boundary layer investigations. It is intended that the detailed data presented in this paper be used to develop improved turbulence model suitable for application to turbine airfoil design.

Measuring lip force by oral screens Part 2: The importance of screen design, instruction and suction.

Science.gov (United States)

Wertsén, Madeleine; Stenberg, Manne

2017-10-01

The aim of this study was to find a reliable method for measuring lip force and to find the most important factors that influence the measurements in terms of magnitude and variability. The hypothesis tested was that suction is involved and thus the instruction and the design of the oral screen are of importance when measuring lip force. This is a methodological study in a healthy population. This study was conducted in a general community. The designs of the screens were soft and hard prefabricated screens and 2 semi-individually made with a tube allowing air to pass. The screens and the instructions squeeze or suck were tested on 29 healthy adults, one at a time and on 4 occasions. The test order of the screens was randomized. Data were collected during 4 consecutive days, and the procedure was repeated after 1 month. The participants were 29 healthy adult volunteers. The instruction was an important mean to distinguish between squeezing and sucking. The design of the screen affected the lip force so that it increases in relation to the projected area of the screen. A screen design with a tube allowing air to pass made it possible to avoid suction when squeezing. By measuring with and without allowing air to pass, it was possible to distinguish between suction related and not suction related lip force. The additional screen pressure when sucking was related to the ability to produce a negative intraoral pressure. In conclusion lip force increases in relation to the projected area of the screen, sucking generally increases the measured lip force and the additional screen pressure when sucking is related to the ability to produce a negative intraoral pressure.

Influence of statin therapy at time of stroke onset on functional outcome among patients with atrial fibrillation.

Science.gov (United States)

Ko, Darae; Thigpen, Jonathan L; Otis, James A; Forster, Kristen; Henault, Lori; Quinn, Emily; Tripodis, Yorghos; Berger, Peter B; Limdi, Nita; Hylek, Elaine M

2017-01-15

Statin pretreatment has been associated with reduced infarct volume in nonlacunar strokes. The effect of statins on functional outcomes of strokes related to atrial fibrillation (AF) is unknown. We aimed to define the influence of prestroke statin use on functional outcome in AF. We assembled a cohort of consecutive ischemic stroke patients from 2006 to 2010. All patients underwent CT or MRI and were adjudicated by site investigators. AF was confirmed by electrocardiogram in 100% of patients. Site neurologists blinded to the study hypothesis affirmed the type of stroke and assessed the severity of disability at the time of hospital discharge. The frequency of death at 30-days was calculated. Ischemic stroke (n=1030) resulted in a severe neurological deficit or death (modified Rankin scale ≥4) at 30days in 711 patients (69%). Using multivariable logistic regression models adjusting for factors associated with statin treatment and factors associated with functional outcome, prestroke statin use was associated with a 32% reduction in frequency of severe stroke (odds ratio [OR], 0.68; 95% confidence interval [CI], 0.50-0.92; P=0.011). Other independent factors associated with severe stroke included older age, female sex, non-White race, diabetes mellitus, prior ischemic stroke, prior venous thromboembolism, and dementia. Ischemic strokes in AF are associated with high mortality and morbidity. Statin use at time of stroke onset among patients with AF was associated in this study with less severe stroke and warrant validation. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Stroke Treatments

Science.gov (United States)

... Stroke Association.org Professionals for Stroke Association.org Shop for Stroke Association.org Support for Stroke Association. ... works by dissolving the clot and improving blood flow to the part of the brain being deprived ...

MHD Boundary Layer Flow of Dilatant Fluid in a Divergent Channel with Suction or Blowing

International Nuclear Information System (INIS)

Bhattacharyya, Krishnendu; Layek, G. C.

2011-01-01

An analysis is carried out to study a steady magnetohydrodynamic (MHD) boundary layer flow of an electrically conducting incompressible power-law non-Newtonian fluid through a divergent channel. The channel walls are porous and subjected to either suction or blowing of equal magnitude of the same kind of fluid on both walls. The fluid is permeated by a magnetic field produced by electric current along the line of intersection of the channel walls. The governing partial differential equation is transformed into a self-similar nonlinear ordinary differential equation using similarity transformations. The possibility of boundary layer flow in a divergent channel is analyzed with the power-law fluid model. The analysis reveals that the boundary layer flow (without separation) is possible for the case of the dilatant fluid model subjected to suitable suction velocity applied through its porous walls, even in the absence of a magnetic field. Further, it is found that the boundary layer flow is possible even in the presence of blowing for a suitable value of the magnetic parameter. It is found that the velocity increases with increasing values of the power-law index for the case of dilatant fluid. The effects of suction/blowing and magnetic field on the velocity are shown graphically and discussed physically. (fundamental areas of phenomenology(including applications))

Post-stroke depression among stroke survivors attending two ...

African Journals Online (AJOL)

Background: The burden of stroke worldwide is increasing rapidly. There is paucity of data on post-stroke depression (PSD) among stroke survivors in Uganda, despite the high prevalence of PSD reported elsewhere. Methods: In a cross-sectional study, we assessed adult participants with confirmed first stroke with a ...

ExStroke Pilot Trial of the effect of repeated instructions to improve physical activity after ischaemic stroke: a multinational randomised controlled clinical trial

DEFF Research Database (Denmark)

Boysen, Gudrun; Krarup, Lars-Henrik; Zeng, Xianrong

2009-01-01

training programme before discharge and at five follow-up visits during 24 months. Control patients had follow-up visits with the same frequency but without instructions in physical activity. MAIN OUTCOME MEASURES: Physical activity assessed with the Physical Activity Scale for the Elderly (PASE) at each......OBJECTIVES: To investigate if repeated verbal instructions about physical activity to patients with ischaemic stroke could increase long term physical activity. DESIGN: Multicentre, multinational, randomised clinical trial with masked outcome assessment. SETTING: Stroke units in Denmark, China...... infarction, or falls and fractures. CONCLUSION: Repeated encouragement and verbal instruction in being physically active did not lead to a significant increase in physical activity measured by the PASE score. More intensive strategies seem to be needed to promote physical activity after ischaemic stroke...

Reduction of the suction pressure of a liquid ring vacuum pump with a supersonic gas ejector

Directory of Open Access Journals (Sweden)

Olšiak Róbert

2018-01-01

Full Text Available A supersonic gas ejector in conjunction with a liquid ring vacuum pump is used for creating and maintaining vacuum in a chamber for technological purposes. In this paper the authors submit an overview about the problematics of suction pressure reduction with a supersonic gas ejector used as a pre-stage of a liquid ring vacuum pump. This system has also the function of a cavitation protection due to the higher pressure present at the suction throat of the vacuum pump. A part of this paper is devoted to the governing equations used at the definition of the flow through an ejector. The experimental studies are then carried out in or own laboratory for verification purposes.

Early management and outcome of acute stroke in Auckland

Energy Technology Data Exchange (ETDEWEB)

Anderson, N.E. [Auckland Hospital, Auckland, (New Zealand); Bonita, R.; Broad, J.B. [University of Auckland, Auckland, (New Zealand). Faculty of Medicine and Health Science

1997-10-01

Studies of acute stroke management in stroke units and tertiary referral hospitals may not accurately reflect practice within the population. Reliable information on the management of stroke within a population is sparse. The aims of this study was to compare clinical practice in acute stroke management in Auckland with guidelines for the management and treatment of stroke in other countries; to provide a baseline measure against which future changes in management can be evaluated. All new stroke events in Auckland residents in 12 months were traced through multiple case finding sources. For each patient, a record of investigations and treatment during the first week of hospital admission was kept. One thousand eight hundred and three stroke events (including subarachnoid haemorrhages) occurred in 1761 patients in one year. Twenty-seven per cent of all events were managed outside hospital and 73% of the stroke events were treated in an acute hospital. Of the 1242 stroke events admitted to an acute hospital in the first week, only 6% were managed on the neurology and neurosurgery ward, 83% were managed by a general physician or geriatrician and 42% had computed tomography (CT). Of 376 validated ischaemic strokes, 44% were treated with aspirin and 12% with intravenous heparin. Of the 690 unspecified strokes (no CT or autopsy), 38% received aspirin and 0.5% heparin. The 28 day in-hospital case fatality for all stroke events admitted to an acute hospital during the first week was 25%. It was concluded that in Auckland, management of acute stroke differed from clinical guidelines in the high proportion of patients managed in the community, the low rate of neurological consultation, and the low frequency of CT scanning. Despite these deficiencies in management, the 28 day hospital case fatality in Auckland was similar to other comparable studies which had a high proportion of cases evaluated by a neurologist and CT. (authors). 34 refs., 4 tabs., 2 figs.

Early management and outcome of acute stroke in Auckland

International Nuclear Information System (INIS)

Anderson, N.E.; Bonita, R.; Broad, J.B.

1997-01-01

Studies of acute stroke management in stroke units and tertiary referral hospitals may not accurately reflect practice within the population. Reliable information on the management of stroke within a population is sparse. The aims of this study was to compare clinical practice in acute stroke management in Auckland with guidelines for the management and treatment of stroke in other countries; to provide a baseline measure against which future changes in management can be evaluated. All new stroke events in Auckland residents in 12 months were traced through multiple case finding sources. For each patient, a record of investigations and treatment during the first week of hospital admission was kept. One thousand eight hundred and three stroke events (including subarachnoid haemorrhages) occurred in 1761 patients in one year. Twenty-seven per cent of all events were managed outside hospital and 73% of the stroke events were treated in an acute hospital. Of the 1242 stroke events admitted to an acute hospital in the first week, only 6% were managed on the neurology and neurosurgery ward, 83% were managed by a general physician or geriatrician and 42% had computed tomography (CT). Of 376 validated ischaemic strokes, 44% were treated with aspirin and 12% with intravenous heparin. Of the 690 unspecified strokes (no CT or autopsy), 38% received aspirin and 0.5% heparin. The 28 day in-hospital case fatality for all stroke events admitted to an acute hospital during the first week was 25%. It was concluded that in Auckland, management of acute stroke differed from clinical guidelines in the high proportion of patients managed in the community, the low rate of neurological consultation, and the low frequency of CT scanning. Despite these deficiencies in management, the 28 day hospital case fatality in Auckland was similar to other comparable studies which had a high proportion of cases evaluated by a neurologist and CT. (authors)

Effects of Navigated Repetitive Transcranial Magnetic Stimulation After Stroke.

Science.gov (United States)

Chervyakov, Alexander V; Poydasheva, Alexandra G; Lyukmanov, Roman H; Suponeva, Natalia A; Chernikova, Ludmila A; Piradov, Michael A; Ustinova, Ksenia I

2018-03-01

The purpose of this study was to test the effects of navigated repetitive transcranial magnetic stimulation, delivered in different modes, on motor impairments and functional limitations after stroke. The study sample included 42 patients (58.5 ± 10.7 years; 26 males) who experienced a single unilateral stroke (1-12 months previously) in the area of the middle cerebral artery. Patients completed a course of conventional rehabilitation, together with 10 sessions of navigated repetitive transcranial magnetic stimulation or sham stimulation. Stimulation was scheduled five times a week over two consecutive weeks in an inpatient clinical setting. Patients were randomly assigned to one of four groups and received sham stimulation (n = 10), low-frequency (1-Hz) stimulation of the nonaffected hemisphere (n = 11), high-frequency (10-Hz) stimulation of the affected hemisphere (n = 13), or sequential combination of low- and high-frequency stimulations (n = 8). Participants were evaluated before and after stimulation with clinical tests, including the arm and hand section of the Fugl-Meyer Assessment Scale, modified Ashworth Scale of Muscle Spasticity, and Barthel Index of Activities of Daily Living. Participants in the three groups receiving navigated repetitive transcranial magnetic stimulation showed improvements in arm and hand functions on the Fugl-Meyer Stroke Assessment Scale. Ashworth Scale of Muscle Spasticity and Barthel Index scores were significantly reduced in groups receiving low- or high-frequency stimulation alone. Including navigated repetitive transcranial magnetic stimulation in a conventional rehabilitation program positively influenced motor and functional recovery in study participants, demonstrating the clinical potential of the method. The results of this study will be used for designing a large-scale clinical trial.

Effect of inflow discharges on the development of matric suction and volumetric water content for dike during overtopping tests

Science.gov (United States)

Hassan, Marwan A.; Ismail, Mohd A. M.

2017-10-01

The point of this review is to depict the impact of various inflow discharge rate releases on the instruments of matric suction and volumetric water content during an experimental test of spatial overtopping failure at school of civil engineering in universiti Sains of Malaysia. A dry sand dike was conducted inside small flume channel with twelve sensors of tensiometer and Time-Domain Reflectometer (TDR). Instruments are installed in the soil at different locations in downstream and upstream slopes of the dike for measuring the response of matric suction and volumetric water content, respectively. Two values of inflow discharge rates of 30 and 40 L/min are utilized as a part of these experiments to simulate the effectiveness of water reservoirs in erosion mechanism. The outcomes demonstrate that the matric suction and volumetric water content are decreased and increased, respectively for both inflow discharges. The higher inflow discharges accelerate the saturation of dike soil and the erosion process faster than that for the lower inflow discharges.

ACE Gene in Egyptian Ischemic Stroke Patients.

Science.gov (United States)

Mostafa, Magdy A; El-Nabiel, Lobna M; Fahmy, Nagia Aly; Aref, Hany; Shreef, Edrees; Abd El-Tawab, Fathy; Abdulghany, Osama M

2016-09-01

Angiotensin-1-converting enzyme (ACE) is a crucial player in vascular homeostasis and in the pathogenesis of atherosclerosis and hypertension. The present study was conducted to determine whether there is an association between the ACE insertion/deletion (I/D) polymorphism and ischemic stroke in Egyptian population. Also, we analyzed the ACE gene I/D polymorphism as a risk factor for small-vessel (SV) versus large-vessel (LV) disease. Sixty patients with ischemic stroke were included: 30 with SV disease and 30 with LV disease. In addition, a control group of 30 apparent healthy subjects were studied. Clinical assessment, computed tomography, magnetic resonance imaging brain, and genetic study using the polymerase chain reaction of ACE gene were done for all subjects. We found that the distribution of ACE gene polymorphism frequency was significantly different between the 3 groups. The DD genotype was far more common in stroke patients compared to controls. It was also significantly more common in each of the patient groups compared to controls but rather similar in the 2 patient groups with SV and LV diseases. We found that the ACE gene deletion/deletion genotype is common in Egyptian patients with non-cardioembolic ischemic stroke but does not appear to be specific neither to SV nor to LV disease. Copyright © 2016 National Stroke Association. Published by Elsevier Inc. All rights reserved.

Sexual dysfunction in Nigerian stroke survivors | Akinpelu | African ...

African Journals Online (AJOL)

Methods: Participants were 77 stroke survivors (60 males; 17 females) recruited consecutively from a teaching hospital. Participants completed the Beck ... Decline in libido and coital frequency were reported by >70% and in erection, ejaculation and orgasm by >60% of participants. Participants' with erectile dysfunction ...

Treatment of herniated lumbar disc by percutaneous laser disc decompression combined with synchronous suction technique through syringe

Institute of Scientific and Technical Information of China (English)

Dhir B. Gurung; Gaojian Tao; Hongyi Lin; Yanning Qian; Jian Lin

2007-01-01

Objective: To compare the outcomes of percutaneous laser disc decompression (PLDD) and PLDD with synchronous suction through syringe in the patients with herniated lumbar disc (HLD). Methods: Forty-two patients with HLD on MRI and those who did not respond to conservative treatment for 6 weeks were randomly divided into group A and group B. In group A, the patients were treated with PLDD and those in group B with PLDD and synchronous suction through syringe. GaAIAS diode laser at 810 nm was used for the ablation in both groups. The treatment effect was evaluated by modified MacNab's criteria on the 7th, 30th and 90th day. Results: Evaluated by modified MacNab's criteria, the percentages of the excellent and good cases in total patients treated for group B and A were 80.95% and 57.14% on the 7th follow-up day, 85.71% and 66.67% on the 30th follow-up day, and 95.24% and 71.43% on the 90th follow-up day, respectively. Conclusion: Synchronous suction technique through syringe during PLDD improves the overall outcome in the treatment of herniated lumbar disc.

Risk Factors and Stroke Characteristic in Patients with Postoperative Strokes.

Science.gov (United States)

Dong, Yi; Cao, Wenjie; Cheng, Xin; Fang, Kun; Zhang, Xiaolong; Gu, Yuxiang; Leng, Bing; Dong, Qiang

2017-07-01

Intravenous thrombolysis and intra-arterial thrombectomy are now the standard therapies for patients with acute ischemic stroke. In-house strokes have often been overlooked even at stroke centers and there is no consensus on how they should be managed. Perioperative stroke happens rather frequently but treatment protocol is lacking, In China, the issue of in-house strokes has not been explored. The aim of this study is to explore the current management of in-house stroke and identify the common risk factors associated with perioperative strokes. Altogether, 51,841 patients were admitted to a tertiary hospital in Shanghai and the records of those who had a neurological consult for stroke were reviewed. Their demographics, clinical characteristics, in-hospital complications and operations, and management plans were prospectively studied. Routine laboratory test results and risk factors of these patients were analyzed by multiple logistic regression model. From January 1, 2015, to December 31, 2015, over 1800 patients had neurological consultations. Among these patients, 37 had an in-house stroke and 20 had more severe stroke during the postoperative period. Compared to in-house stroke patients without a procedure or operation, leukocytosis and elevated fasting glucose levels were more common in perioperative strokes. In multiple logistic regression model, perioperative strokes were more likely related to large vessel occlusion. Patients with perioperative strokes had different risk factors and severity from other in-house strokes. For these patients, obtaining a neurological consultation prior to surgery may be appropriate in order to evaluate the risk of perioperative stroke. Copyright © 2017. Published by Elsevier Inc.

Analysis Of Primary Coolant Suction Side Pressure In The Delay Chamber Of The RSG-GAS

International Nuclear Information System (INIS)

Dibyo, Sukmanto

2000-01-01

Delay chamber is a tank to delay flow that located in the primary cooling suction side of RSG-GAS. A void occurred when operation reactor caused by too high the delta P at inlet suction pump. The condition may be avoided by using one line mode of the cooling flow. The analysis show that void volume in the delay chamber is occurred because the coolant negative pressure lowers the saturation pressure should be avoided though decreasing the delta P until about 0.1 bar at about 45 exp 0 C. Solution suggested are to use bypass flow from the spent fuel to the delay chamber. Coolant temperature can be also decreased by decreasing the power level of the reactor as well as improving the heat exchanger and cooling tower performances

Vascular Pathology in the Extracranial Vertebral Arteries in Patients with Acute Ischemic Stroke

DEFF Research Database (Denmark)

Bentsen, L; Nygård, A; Ovesen, C

2014-01-01

INTRODUCTION: Vascular pathology in the extracranial vertebral arteries remains among the possible causes in cryptogenic stroke. However, the diagnosis is challenged by the great variety in the anatomy of the vertebral arteries, clinical symptoms and difficulties in the radiological assessments....... The aim of this study was to assess the prevalence of CT angiography (CTA)-detected pathological findings in the extracranial vertebral arteries in an acute stroke population and secondly to determine the frequency of posterior pathology as probable cause in patients with otherwise cryptogenic stroke....... METHOD: The analysis was based on 657 consecutive patients with symptoms of acute stroke and a final diagnosis of ischemic stroke or transient ischemic attack. On admission, a noncontrast CT cerebrum and CTA were performed. A senior consultant neuroradiologist, blinded to clinical data, reviewed all CTA...

Bacteremia during adenoidectomy: a comparison of suction diathermy adenoid ablation and adenoid curettage.

LENUS (Irish Health Repository)

Casserly, Paula

2010-08-01

Transient bacteremia is induced by adenoidectomy when the integrity of the nasopharyngeal membrane is broken. The aim of this study was to determine the incidence of bacteremia in patients undergoing adenoidectomy, to identify the causative organisms, and to compare the incidences of bacteremia between the two techniques suction diathermy and curettage.

Suppression of secondary flows in a double suction centrifugal pump with different loading distributions

International Nuclear Information System (INIS)

Leng, H F; Wang, F J; Zhang, Z C; Yao, Z F; Zhou, P J

2013-01-01

Secondary flow is one of the main reasons for low efficiency in double suction centrifugal pump. In a 3-D inverse design method, the pump blade could be designed by a specified loading distribution to control the flow field in pump. In order to study the influence of loading distribution on secondary flow of a double suction centrifugal pump, the external characteristics and the internal flow field of the pump with three kinds of loading distributions are analysed by using CFD approach. According to the simulation results, it is found that the form of fore-loading distribution at shroud and aft-loading distribution at hub could improve the optimal efficiency and broaden the high efficiency area of the pump. Furthermore, the secondary flow in impeller exit region and volute could be significantly suppressed if the slope of loading distribution curve of shroud is set to be −0.7

Migraine as a risk factor for young patients with ischemic stroke: a case-control study.

Science.gov (United States)

Abanoz, Yasin; Gülen Abanoz, Yeşim; Gündüz, Ayşegül; Uludüz, Derya; İnce, Birsen; Yavuz, Burcu; Göksan, Baki

2017-04-01

Studies have suggested a possible association of migraine and increased risk of ischemic stroke in young adults, particularly in smokers and in women who use oral contraceptive drugs. We aimed to analyze the association between migraine and ischemic stroke in young population in a hospital-based cohort. We included 202 consecutive patients with the diagnosis of ischemic stroke who were between 15 and 50 years and age- and gender-matched 250 volunteers with no history of stroke. All participants were interviewed using a questionnaire for migraine. Localization of ischemic lesion was classified as anterior and posterior circulation according to neuroimaging findings. The cause of ischemic lesion and all risk factors were recorded. Undetermined etiology was the most frequent (43.1%) and the most common determined cause was cardioembolism (22.3%) in young stroke patients. Frequency of migraine was 30.2% among patients with stroke whereas 16.8% of healthy subjects had migraine (p = 0.001). Migraine with aura was significantly more common among patients with stroke compared to healthy subjects (18.3 vs 4.4%; p = 0.000) whereas the frequency of migraine without aura was similar in both groups (11.9 vs 12.4%). Using logistic regression, migraine with aura was shown to be an independent risk factor for ischemic stroke in young population (p = 0.000) and separate analysis for gender demonstrated that it was only a risk factor for women (p = 0.009) but not for men (p = 0.107). Migraine with aura was found to be more common in ischemic stroke in young patients. It was an independent risk factor in women.

Extremely low frequency electromagnetic field (ELF-EMF) reduces oxidative stress and improves functional and psychological status in ischemic stroke patients.

Science.gov (United States)

Cichoń, Natalia; Bijak, Michał; Miller, Elżbieta; Saluk, Joanna

2017-07-01

As a result of ischaemia/reperfusion, massive generation of reactive oxygen species occurs, followed by decreased activity of antioxidant enzymes. Extremely low frequency electromagnetic fields (ELF-EMF) can modulate oxidative stress, but there are no clinical antioxidant studies in brain stroke patients. The aim of our study was to investigate the effect of ELF-EMF on clinical and antioxidant status in post-stroke patients. Fifty-seven patients were divided into two groups: ELF-EMF and non-ELF-EMF. Both groups underwent the same 4-week rehabilitation program. Additionally, the ELF-EMF group was exposed to an ELF-EMF field of 40 Hz, 7 mT for 15 min/day for 4 weeks (5 days a week). The activity of catalase and superoxide dismutase was measured in hemolysates, and total antioxidant status (TAS) determined in plasma. Functional status was assessed before and after the series of treatments using Activities of Daily Living (ADL), Mini-Mental State Examination (MMSE), and Geriatric Depression Scale (GDS). Applied ELF-EMF significantly increased enzymatic antioxidant activity; however, TAS levels did not change in either group. Results show that ELF-EMF induced a significant improvement in functional (ADL) and mental (MMSE, GDS) status. Clinical parameters had positive correlation with the level of enzymatic antioxidant protection. Bioelectromagnetics. 38:386-396, 2017. © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

[Association Between SNP rs6007897 of CELSR1 and Acute Ischemic Stroke in Western China Han Population: a Case-control Study].

Science.gov (United States)

Qin, Feng-qin; Yu, Li-hua; Hu, Wen-ting; Guo, Jian; Chen, Ning; Guo, Jiang; Fang, Jing-huan; He, Li

2015-07-01

To investigate the relationship between single nucleotide polymorphism (SNP) rs6007897 of CELSR1 and acute ischemic stroke in Western China Han population. All subjects (759 acute ischemic stroke patients and 786 controls) were genotyped using ligation detection reaction (LDR). We analyzed the differences between SNP rs6007897 genotypes and allele frequencies between two groups. Two genotypes (AA, AG) of rs6007897 were found in both stroke and control group. There was no statistically significance between two groups about genotype and allele frequency. After adjusting for risk factors, we found there was no significant association between rs6007897 and ischemic stroke CP = 0.797, odds ratio (OR) = 0.886, 95% confidence interval (CI) = 0.352-2.227). SNP rs6007897 of CELSR1 was not significantly associated with ischemic stroke in Western China Han population.

Slower EEG alpha generation, synchronization and “flow”—possible biomarkers of cognitive impairment and neuropathology of minor stroke

Directory of Open Access Journals (Sweden)

Jelena Petrovic

2017-09-01

Full Text Available Background We investigated EEG rhythms, particularly alpha activity, and their relationship to post-stroke neuropathology and cognitive functions in the subacute and chronic stages of minor strokes. Methods We included 10 patients with right middle cerebral artery (MCA ischemic strokes and 11 healthy controls. All the assessments of stroke patients were done both in the subacute and chronic stages. Neurological impairment was measured using the National Institute of Health Stroke Scale (NIHSS, whereas cognitive functions were assessed using the Montreal Cognitive Assessment (MoCA and MoCA memory index (MoCA-MIS. The EEG was recorded using a 19 channel EEG system with standard EEG electrode placement. In particular, we analyzed the EEGs derived from the four lateral frontal (F3, F7, F4, F8, and corresponding lateral posterior (P3, P4, T5, T6 electrodes. Quantitative EEG analysis included: the group FFT spectra, the weighted average of alpha frequency (αAVG, the group probability density distributions of all conventional EEG frequency band relative amplitudes (EEG microstructure, the inter- and intra-hemispheric coherences, and the topographic distribution of alpha carrier frequency phase potentials (PPs. Statistical analysis was done using a Kruskal–Wallis ANOVA with a post-hoc Mann–Whitney U two-tailed test, and Spearman’s correlation. Results We demonstrated transient cognitive impairment alongside a slower alpha frequency (αAVG in the subacute right MCA stroke patients vs. the controls. This slower alpha frequency showed no amplitude change, but was highly synchronized intra-hemispherically, overlying the ipsi-lesional hemisphere, and inter-hemispherically, overlying the frontal cortex. In addition, the disturbances in EEG alpha activity in subacute stroke patients were expressed as a decrease in alpha PPs over the frontal cortex and an altered “alpha flow”, indicating the sustained augmentation of inter-hemispheric interactions

Conceptual Design of Portable Filtered Air Suction Systems For Prevention of Released Radioactive Gas under Severe Accidents of NPP

Energy Technology Data Exchange (ETDEWEB)

Gu, Beom W.; Choi, Su Y.; Yim, Man S.; Rim, Chun T. [Korea Advanced Institute of Science and Technology, Daejeon (Korea, Republic of)

2014-05-15

It becomes evident that severe accidents may occur by unexpected disasters such as tsunami, heavy flood, or terror. Once radioactive material is released from NPP through severe accidents, there are no ways to prevent the released radioactive gas spreading in the air. As a remedy for this problem, the idea on the portable filtered air suction system (PoFASS) for the prevention of released radioactive gas under severe accidents was proposed. In this paper, the conceptual design of a PoFASS focusing on the number of robot fingers and robot arm rods are proposed. In order to design a flexible robot suction nozzle, mathematical models for the gaps which represent the lifted heights of extensible covers for given convex shapes of pipes and for the covered areas are developed. In addition, the system requirements for the design of the robot arms of PoFASS are proposed, which determine the accessible range of leakage points of released radioactive gas. In this paper, the conceptual designs of the flexible robot suction nozzle and robot arm have been conducted. As a result, the minimum number of robot fingers and robot arm rods are defined to be four and three, respectively. For further works, extensible cover designs on the flexible robot suction nozzle and the application of the PoFASS to the inside of NPP should be studied because the radioactive gas may be released from connection pipes between the containment building and auxiliary buildings.

Mapping the rehabilitation interventions of a community stroke team to the extended International Classification of Functioning, Disability and Health Core Set for Stroke.

Science.gov (United States)

Evans, Melissa; Hocking, Clare; Kersten, Paula

2017-12-01

This study aim was to evaluate whether the Extended International Classification of Functioning, Disability and Health Core Set for Stroke captured the interventions of a community stroke rehabilitation team situated in a large city in New Zealand. It was proposed that the results would identify the contribution of each discipline, and the gaps and differences in service provision to Māori and non-Māori. Applying the Extended International Classification of Functioning, Disability and Health Core Set for Stroke in this way would also inform whether this core set should be adopted in New Zealand. Interventions were retrospectively extracted from 18 medical records and linked to the International Classification of Functioning, Disability and Health and the Extended International Classification of Functioning, Disability and Health Core Set for Stroke. The frequencies of linked interventions and the health discipline providing the intervention were calculated. Analysis revealed that 98.8% of interventions provided by the rehabilitation team could be linked to the Extended International Classification of Functioning, Disability and Health Core Set for Stroke, with more interventions for body function and structure than for activities and participation; no interventions for emotional concerns; and limited interventions for community, social and civic life. Results support previous recommendations for additions to the EICSS. The results support the use of the Extended International Classification of Functioning, Disability and Health Core Set for Stroke in New Zealand and demonstrates its use as a quality assurance tool that can evaluate the scope and practice of a rehabilitation service. Implications for Rehabilitation The Extended International Classification of Functioning Disability and Health Core Set for Stroke appears to represent the stroke interventions of a community stroke rehabilitation team in New Zealand. As a result, researchers and clinicians may have

Cyclosporin A levels in suction-blister fluid of patients with psoriasis treated systemically

NARCIS (Netherlands)

Meinardi, M. M.; van Eendenburg, J. P.; Oosting, J.; van Boxtel, C. J.; de Rie, M. A.; Bos, J. D.

1990-01-01

Oral cyclosporin A (CyA) is highly effective in the treatment of psoriasis. The long-term use is limited by dose-dependent side-effects, and the local concentration of CyA is a determining factor in treatment. The concentration of CyA in suction-blister fluid (SBF) and in whole blood was assessed

In situ sampling of small volumes of soil solution using modified micro-suction cups

NARCIS (Netherlands)

Shen, Jianbo; Hoffland, E.

2007-01-01

Two modified designs of micro-pore-water samplers were tested for their capacity to collect unbiased soil solution samples containing zinc and citrate. The samplers had either ceramic or polyethersulfone (PES) suction cups. Laboratory tests of the micro-samplers were conducted using (a) standard

CHARACTERISTICS OF PATIENTS WITH CEREBRAL STROKE OR TRANSIENT ISCHEMIC ATTACK, INCLUDED INTO THE LIS-2 REGISTER (LYUBERTSY STUDY OF MORTALITY IN PATIENTS AFTER STROKE

Directory of Open Access Journals (Sweden)

S. Yu. Martsevich

2015-01-01

Full Text Available Aim. To provide final data on the three-year period of the inclusion of patients; to give most accurate "portrait" of patients hospitalized with a brain stroke within the framework of the LIS-2 register (Lyubertsy study of mortality in patients after stroke.Material and methods. All patients (n=960 admitted to the Lyubertsy district hospital №2 with stroke for the period from 01.2009 to 12.2011 were included into the study.Results. Men accounted for 37.5%, women - 62.5%, mean age was 71.1±9.8 years. The history of hypertension was present in 833 patients (86.8%, atrial fibrillation in 252 (26.8% patients, 199 (20.7% patients had previously undergone stroke. In-hospital mortality was 21.6% (207 patients had died; mean age 72.9±9.8 years. Low frequency of the antihypertensive therapy (34.5%, lipid-lowering therapy (0.7%, antiplatelet agents (5.7%, anticoagulation therapy prescription in patients with atrial fibrillation was detected.Conclusion. Insufficient assignment of drugs with a proven effect on the prognosis in patients with risk factors prior to the development of the reference stroke draws attention. High incidence of recurrent strokes indicates an underactive secondary prevention.

Hemispheric distribution of middle cerebral artery ischemic strokes in patients admitted to military hospital rawalpindi

International Nuclear Information System (INIS)

Tariq, M.; Ishtiaq, S.; Zulfiqar, S.O.

2016-01-01

Objective: To determine the difference in the frequency of middle cerebral artery (MCA) ischemic strokes between left and right cerebral hemispheres in the adult patients admitted to the Military Hospital (MH) Rawalpindi. Study Design: A descriptive study. Place and Duration of Study: MH Rawalpindi from 01 Dec 2013 to 30 Mar 2014. Patients and Methods: Seventy eight adult patients admitted to MH Rawalpindi with neurologic deficits consistent with MCA strokes and having no evidence of intracerebral haemorrhage on Computed Tomographic (CT) scan of brain. Descriptive Statistics were calculated using SPSS version 17. Results: A total of 78 patients met the inclusion criteria of the study; 35 (45 percent) patients had right MCA stroke while 43 (55 percent) had left MCA stroke. Conclusion: Left MCA ischemic strokes are more common than right MCA ischemic strokes. (author)

STROKE IN YOUNG ADULTS: A RETROSPECTIVE STUDY OF 68 CASES

Directory of Open Access Journals (Sweden)

M. H. Harirchian

2006-06-01

Full Text Available Numerous etiologies are responsible for cases of stroke in young adults. This study reviews the causes of two types of stroke (ischemic and intracerebral hemorrhage in young adults aged 15 to 40years, admitted to our center (a tertiary care center from 1997 to 2002. The purpose of this study is to determine the relative frequency of causes of stroke in young adults and compare this with published data in the literature. Using the codes 46.0 to 46.8 of the International Classification of Diseases- 10th Edition (ICD-10, cases were identified from the records of the stroke patients admitted in Imam Khomeini Hospital and the data were collected from their files using a comprehensive questionnaire. Forty-two cases of ischemic stroke (62% and 26 cases of intracerebral hemorrhage (38% were identified. The leading cause of ischemic stroke was cardioembolism (38.1%, followed by atherosclerosis in 5 cases (11.9%. Among cardiac causes infarction was attributable to consequences of rheumatic heart disease in 8 cases. In 3 cases a cessation or decrease in dose of warfarin was followed directly by an ischemic stroke. The most leading cause of intracerebral hemorrhage was hypertension (30.8%. Other causes were anticoagulant therapy, intratumoral hemorrhage, aplastic anemia, leukemia, arteriovenous malformations, and chronic active hepatitis. In conclusion, cardioembolism and hypertension were the most leading causes of ischemic and hemorrhagic stroke in young adults admitted in our hospital.

Knowledge of Stroke Risk Factors among Stroke Survivors in Nigeria

OpenAIRE

Grace Vincent-Onabajo; Taritei Moses

2016-01-01

Background. Knowledge of stroke risk factors is expected to reduce the incidence of stroke?whether first-ever or recurrent. This study examined knowledge of stroke risk factors and its determinants among stroke survivors. Methods. A cross-sectional survey of consenting stroke survivors at two physiotherapy facilities in Nigeria was carried out. Sociodemographic and clinical data were obtained and knowledge of stroke risk factors (defined as the ability to mention at least one correct risk fac...

A comparison of the disconnection technique with continuous bronchial suction for lung deflation when using the Arndt endobronchial blocker during video-assisted thoracoscopy: A randomised trial.

Science.gov (United States)

El-Tahan, Mohamed R

2015-06-01

The use of the Arndt endobronchial blocker has not gained widespread acceptance during video-assisted thoracoscopic surgery (VATS) because of its high cost and longer time to operative lung collapse especially in patients with chronic obstructive pulmonary disease (COPD). The use of a ventilator disconnection technique has been shown to produce a comparable degree of lung collapse when used with either a double-lumen tube or an Arndt endobronchial blocker. We hypothesised that the use of bronchial suction through the suction port of the endobronchial blocker would be associated with a comparable time to achieve optimum lung collapse as the disconnection technique. A randomised, double-blind study. Single university hospital. Fifty-eight patients with spontaneous pneumothorax scheduled for elective VATS using the Arndt endobronchial blocker for one-lung ventilation (OLV). Patients were randomly assigned to one of two groups (n = 29 per group) to deflate the operative lung with either disconnection of the endotracheal tube from the ventilator for 60 s prior to inflation of the endobronchial blocker or connection of a suction pressure of -30 cmH2O to the suction port of the endobronchial blocker through the barrel of a 1 ml syringe. The primary outcome was the time to total lung collapse. Secondary outcomes included surgeon rating of lung collapse, overall surgeon satisfaction, need for further fibreoptic bronchial suction manoeuvres and intraoperative hypoxaemia. The bronchial suction technique was associated with a significantly shorter time to total lung collapse than the disconnection method [93 (95% confidence interval, 95% CI 81.3 to 103.7) vs. 197 (95% CI 157.4 to 237) s respectively; P < 0.001]. Both the disconnection and bronchial suction groups had a comparable surgical rating of excellent lung collapse 40 min after the start of OLV (65.5 vs. 79.3%, respectively; P = 0.24), overall surgeon satisfaction [median (interquartile range, IQR) 9 (8 to 10) vs. 9 (8

ANALYSIS OF RELATIONSHIPS BETWEEN THE LEVEL OF ERRORS IN LEG AND MONOFIN MOVEMENT AND STROKE PARAMETERS IN MONOFIN SWIMMING

Directory of Open Access Journals (Sweden)

Marek Rejman

2013-03-01

Full Text Available The aim of this study was to analyze the error structure in propulsive movements with regard to its influence on monofin swimming speed. The random cycles performed by six swimmers were filmed during a progressive test (900m. An objective method to estimate errors committed in the area of angular displacement of the feet and monofin segments was employed. The parameters were compared with a previously described model. Mutual dependences between the level of errors, stroke frequency, stroke length and amplitude in relation to swimming velocity were analyzed. The results showed that proper foot movements and the avoidance of errors, arising at the distal part of the fin, ensure the progression of swimming speed. The individual stroke parameters distribution which consists of optimally increasing stroke frequency to the maximal possible level that enables the stabilization of stroke length leads to the minimization of errors. Identification of key elements in the stroke structure based on the analysis of errors committed should aid in improving monofin swimming technique

A retrospective study of the use of active suction wound drains in dogs and cats.

Science.gov (United States)

Bristow, P C; Halfacree, Z J; Baines, S J

2015-05-01

To report indications for use and complications associated with commonly used closed active suction wound drains in a large number of clinical cases. Retrospective review of medical case records (from 2004 to 2010) for dogs and cats that had a closed active suction drain placed into a wound. Only the four most common drain types were included: Mini Redovac®, Redovac®, Jackson Pratt® and Wound Evac®. Two hundred and fifty-three drains were placed in 33 cats and 195 dogs. Mini Redovac drains were used most frequently in cats (76 · 5%) and Redovac drains in dogs (54 · 3%). The infection rate for clean surgeries in dogs was 15 · 6% (unattainable in cats). Major complications occurred in four dogs; minor complications occurred in 12 drains in cats (35 · 3%), and in 74 drains in dogs (33 · 8%). There was no statistically significant association between the type of drain and complication rate for either species. Although closed active suction drains can be used with low risk of major complications, they lead to a high rate of infection in clean surgeries in dogs. It is recommended that such drains are kept in place for the shortest time possible and that strict asepsis is adhered to both during placement and management. © 2015 British Small Animal Veterinary Association.

Prevention Of Stroke

Directory of Open Access Journals (Sweden)

Nagaraja D

2005-01-01

Full Text Available Stroke is an important cause for neurological morbidity and mortality. Prevention of ischemic stroke involves identification and prevention of risk factors and optimal use of pharmacotherapy. Risk factors have been classified as modifiable and non-modifiable; control of modifiable factors should prevent stroke occurrence. Stroke prevention has been described at three levels: primary, secondary and tertiary. Prolonged hypertension increases an individual′s risk for developing fatal or nonfatal stroke by three times and its control has been shown to prevent stroke. Diabetes mellitus is an important cause for microangiopathy and predisposes to stroke. Statin trials have shown significant reduction in stroke in those who were treated with statins. Stroke risk can be reduced by avoiding tobacco use, control of obesity and avoiding sedentary life style. Anti platelet medications are effective for secondary prevention of stroke. Educating society regarding modifiable risk factors and optimal use of pharmacotherapy form the cornerstone for the prevention of stroke.

Determination of Matric Suction and Saturation Degree for Unsaturated Soils, Comparative Study - Numerical Method versus Analytical Method

Science.gov (United States)

Chiorean, Vasile-Florin

2017-10-01

Matric suction is a soil parameter which influences the behaviour of unsaturated soils in both terms of shear strength and permeability. It is a necessary aspect to know the variation of matric suction in unsaturated soil zone for solving geotechnical issues like unsaturated soil slopes stability or bearing capacity for unsaturated foundation ground. Mathematical expression of the dependency between soil moisture content and it’s matric suction (soil water characteristic curve) has a powerful character of nonlinearity. This paper presents two methods to determine the variation of matric suction along the depth included between groundwater level and soil level. First method is an analytical approach to emphasize one direction steady state unsaturated infiltration phenomenon that occurs between the groundwater level and the soil level. There were simulated three different situations in terms of border conditions: precipitations (inflow conditions on ground surface), evaporation (outflow conditions on ground surface), and perfect equilibrium (no flow on ground surface). Numerical method is finite element method used for steady state, two-dimensional, unsaturated infiltration calculus. Regarding boundary conditions there were simulated identical situations as in analytical approach. For both methods, was adopted the equation proposed by van Genuchten-Mualen (1980) for mathematical expression of soil water characteristic curve. Also for the unsaturated soil permeability prediction model was adopted the equation proposed by van Genuchten-Mualen. The fitting parameters of these models were adopted according to RETC 6.02 software in function of soil type. The analyses were performed in both methods for three major soil types: clay, silt and sand. For each soil type were concluded analyses for three situations in terms of border conditions applied on soil surface: inflow, outflow, and no flow. The obtained results are presented in order to highlight the differences

Stroke risk perception among participants of a stroke awareness campaign

Science.gov (United States)

Kraywinkel, Klaus; Heidrich, Jan; Heuschmann, Peter U; Wagner, Markus; Berger, Klaus

2007-01-01

Background Subjective risk factor perception is an important component of the motivation to change unhealthy life styles. While prior studies assessed cardiovascular risk factor knowledge, little is known about determinants of the individual perception of stroke risk. Methods Survey by mailed questionnaire among 1483 participants of a prior public stroke campaign in Germany. Participants had been informed about their individual stroke risk based on the Framingham stroke risk score. Stroke risk factor knowledge, perception of lifetime stroke risk and risk factor status were included in the questionnaire, and the determinants of good risk factor knowledge and high stroke risk perception were identified using logistic regression models. Results Overall stroke risk factor knowledge was good with 67–96% of the participants recognizing established risk factors. The two exceptions were diabetes (recognized by 49%) and myocardial infarction (57%). Knowledge of a specific factor was superior among those affected by it. 13% of all participants considered themselves of having a high stroke risk, 55% indicated a moderate risk. All major risk factors contributed significantly to the perception of being at high stroke risk, but the effects of age, sex and education were non-significant. Poor self-rated health was additionally associated with high individual stroke risk perception. Conclusion Stroke risk factor knowledge was high in this study. The self perception of an increased stroke risk was associated with established risk factors as well as low perception of general health. PMID:17371603

The effect of high frequency sound on Culicoides numbers collected with suction light traps

Directory of Open Access Journals (Sweden)

Gert J. Venter

2012-04-01

Full Text Available Culicoides midges (Diptera: Ceratopogonidae, are involved in the transmission of various pathogens that cause important diseases of livestock worldwide. The use of insect repellents to reduce the attack rate of these insects on livestock could play an important role as part of an integrated control programme against diseases transmitted by these midges. The objective of this study was to determine whether high frequency sound has any repellent effect on Culicoides midges. The number of midges collected with 220 V Onderstepoort white light traps fitted with electronic mosquito repellents (EMRs, emitting 5-20 KHz multi-frequency sound waves, was compared with that of two untreated traps. Treatments were rotated in two replicates of a 4 x 4 randomised Latin square design. Although fewer midges were collected in the two traps fitted with EMRs, the average number collected over eight consecutive nights was not significantly different. The EMRs also had no influence on any of the physiological groups of Culicoides imicola Kieffer or the species composition of the Culicoides population as determined with light traps. The results indicate that high frequency sound has no repellent effect on Culicoides midges. There is therefore no evidence to support their promotion or use in the protection of animals against pathogens transmitted by Culicoides midges.

[Stroke in young adults: incidence and clinical picture in 280 patients according to their aetiological subtype].

Science.gov (United States)

Arboix, Adrià; Massons, Joan; García-Eroles, Luís; Oliveres, Montserrat

2016-03-04

To assess the clinical features and incidence rate of stroke in young adults (less than 55 years of age). Hospital-based descriptive study of 280 young inpatients consecutively admitted for stroke over a period of 24 years. We conducted a comparison with the remaining 4,312 patients admitted for stroke. Stroke in young adults represented 6.1% of all strokes, 5.7% of transient ischaemic attacks, 5.8% of cerebral infarctions and 8.4% of brain haemorrhages. However, reported minimal frequency of cardioembolic (2.1%) and atherothrombotic (3.4%) infarctions, accounted for 5.9% of lacunar and for 10.7% of essential infarctions and showed a maximum frequency in those infarctions of unusual aetiology (36%). Factors independently associated with stroke in young adults were cigarette smoking (OR 4.23; 95% CI 3.02-5.93; P=.000), unusual aetiology (OR 4.97; 95% CI 3.15-7.84; P=.000), headache (OR 4.57; 95% CI 2.59-8.07; P=.000), alcohol abuse (OR 3.93; 95% CI 2.46-6.29; P=.000), oral contraceptives (OR 14.07; 95% CI 2.37-83.40; P=.004), atrial fibrillation (OR 0.15; 95% CI 0.08-0.28; P=.000), arterial hypertension (OR 0.43; 95% CI 0.33-0.57; P=.000), COPD (OR 0.20; 95% CI 0.09-0.44; P=.000), atherothrombotic infarction (OR 0.51; 95% CI 0.34-0.77; P=.001), female sex (OR 0.71; 95% CI 0.52-0.97; P=.029), diabetes mellitus (OR 0.66; 95% CI 0.46-0.98; P=.030), ischaemic heart disease (OR 0.56; 95% CI 0.33-0.95; P=.032) and intermittent claudication (OR 0.48; 95% CI 0.24-0.94; P=.033). Stroke in young adults is infrequent (6.1% of the total), but represents the highest frequency of cerebral infarcts of unusual aetiology (36%). We conclude that stroke in younger patients presents its own and differentiated clinical profile. Copyright © 2015 Elsevier España, S.L.U. All rights reserved.

Set-up and Test Procedure for Suction Installation and Uninstallation of Bucket Foundation

DEFF Research Database (Denmark)

Koteras, Aleksandra Katarzyna

This technical report describes the set-up and the test procedures for installation and uninstallation of medium-scale model of bucket foundation that can be performed in the geotechnical part of laboratory in Aalborg University. The installation of bucket foundation can be tested with the use of......) and loading frame used for those tests have been already used for axially static and cyclic loading of piles (Thomassen, 2015a) and for axially static and cyclic loading of bucket foundation (Vaitkunaite et al., 2015).......This technical report describes the set-up and the test procedures for installation and uninstallation of medium-scale model of bucket foundation that can be performed in the geotechnical part of laboratory in Aalborg University. The installation of bucket foundation can be tested with the use...... of suction under the bucket lid or by applying additional force through the hydraulic piston, forcing the bucket to penetrate into the soil. Tests for uninstallation are performed also with the use of water pressure, as a reverse process to the suction installation. Both installation and uninstallation tests...

75 FR 70112 - Medical Devices; General and Plastic Surgery Devices; Classification of Non-Powered Suction...

Science.gov (United States)

2010-11-17

.... FDA-2010-N-0513] Medical Devices; General and Plastic Surgery Devices; Classification of Non-Powered... risks. Adverse tissue reaction Material degradation Improper function of suction apparatus (e.g., reflux.... Material degradation Section 8. Stability and Shelf Life. [[Page 70113

Blood Pressure Control: Stroke and Stroke Prevention

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Hans-Christoph Diener

2005-03-01

Full Text Available Hypertension is the most important modifiable risk factor for primary and secondary stroke prevention.All antihypertensive drugs are effective in primary prevention: the risk reduction for stroke is 30—42%. However, not all classes of drugs have the same effects: there is some indication that angiotensin receptor blockers may be superior to other classes of antihypertensive drugs in stroke prevention.Seventy-five percent of patients who present to hospital with acute stroke have elevated blood pressure within the first 24—48 hours. Extremes of systolic blood pressure (SBP increase the risk of death or dependency. The aim of treatment should be to achieve and maintain the SBP in the range 140—160 mmHg. However, fast and drastic blood pressure lowering can have adverse consequences.The PROGRESS trial of secondary prevention with perindopril + indapamide versus placebo + placebo showed a decrease in numbers of stroke recurrences in patients given both active antihypertensive agents, more impressive for cerebral haemorrhage.There were also indications that active treatment might decrease the development of post-stroke dementia.

Hemorrhagic and ischemic strokes compared: stroke severity, mortality, and risk factors.

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Andersen, Klaus Kaae; Olsen, Tom Skyhøj; Dehlendorff, Christian; Kammersgaard, Lars Peter

2009-06-01

Stroke patients with hemorrhagic (HS) and ischemic strokes were compared with regard to stroke severity, mortality, and cardiovascular risk factors. A registry started in 2001, with the aim of registering all hospitalized stroke patients in Denmark, now holds information for 39,484 patients. The patients underwent an evaluation including stroke severity (Scandinavian Stroke Scale), CT, and cardiovascular risk factors. They were followed-up from admission until death or censoring in 2007. Independent predictors of death were identified by means of a survival model based on 25,123 individuals with a complete data set. Of the patients 3993 (10.1%) had HS. Stroke severity was almost linearly related to the probability of having HS (2% in patients with the mildest stroke and 30% in those with the most severe strokes). Factors favoring ischemic strokes vs HS were diabetes, atrial fibrillation, previous myocardial infarction, previous stroke, and intermittent arterial claudication. Smoking and alcohol consumption favored HS, whereas age, sex, and hypertension did not herald stroke type. Compared with ischemic strokes, HS was associated with an overall higher mortality risk (HR, 1.564; 95% CI, 1.441-1.696). The increased risk was, however, time-dependent; initially, risk was 4-fold, after 1 week it was 2.5-fold, and after 3 weeks it was 1.5-fold. After 3 months stroke type did not correlate to mortality. Strokes are generally more severe in patients with HS. Within the first 3 months after stroke, HS is associated with a considerable increase of mortality, which is specifically associated with the hemorrhagic nature of the lesion.

Efficacy of intermittent sub-glottic suctioning in prevention of ventilator-associated pneumonia- A preliminary study of 100 patients

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M N Vijai

2016-01-01

Full Text Available Background and Aims: Oropharyngeal colonisation followed by aspiration of contaminated secretions is the major cause for ventilator-associated pneumonia (VAP. Pooled secretions present in the sub-glottic area above inflated endotracheal tube cuff may be aspirated into the lower airways. It was hypothesised that intermittent suctioning of sub-glottic secretions would prevent VAP. Methods: Group I (n = 50 patients were intubated with HiLo Evac™ endotracheal (ET tube with facility for sub-glottic suctioning, and Group II (n = 50 patients were intubated with HiLo Contour™ ET tube without such facility. In the Group I, sub-glottic suctioning was performed every 2 h. Incidence of VAP, mean ventilator days, Intensive Care Unit (ICU stay and mortality were compared. Qualitative variables were reported as percentages and were compared by Chi-square test or unpaired two-tailed, Fisher′s exact test, as appropriate, to analyse the significance of difference between the two groups. Results: The two groups were similar with respect to demographic characteristics. VAP was seen in 6% of patients in Group I and 22% of patients in Group II (P = 0.021. Both early- and late-onset VAPs were significantly reduced in Group I. Both ventilator days (8.0 vs. 6.45; P = 0.001 and ICU stay (8.33 vs. 6.33; P = 0.001 on the day of onset of VAP were significantly more in the Group I. Total ventilator days were significantly less (6.52 vs. 8.32; P = 0.006 with lower incidence of mortality (36% vs. 48%; P = 0.224 in the Group I. Conclusion: Intermittent sub-glottic suctioning reduces the incidence of VAP including late-onset VAP.

Efficacy of intermittent sub-glottic suctioning in prevention of ventilator-associated pneumonia- A preliminary study of 100 patients.

Science.gov (United States)

Vijai, M N; Ravi, Parli R; Setlur, Rangaraj; Vardhan, Harsh

2016-05-01

Oropharyngeal colonisation followed by aspiration of contaminated secretions is the major cause for ventilator-associated pneumonia (VAP). Pooled secretions present in the sub-glottic area above inflated endotracheal tube cuff may be aspirated into the lower airways. It was hypothesised that intermittent suctioning of sub-glottic secretions would prevent VAP. Group I (n = 50) patients were intubated with HiLo Evac™ endotracheal (ET) tube with facility for sub-glottic suctioning, and Group II (n = 50) patients were intubated with HiLo Contour™ ET tube without such facility. In the Group I, sub-glottic suctioning was performed every 2 h. Incidence of VAP, mean ventilator days, Intensive Care Unit (ICU) stay and mortality were compared. Qualitative variables were reported as percentages and were compared by Chi-square test or unpaired two-tailed, Fisher's exact test, as appropriate, to analyse the significance of difference between the two groups. The two groups were similar with respect to demographic characteristics. VAP was seen in 6% of patients in Group I and 22% of patients in Group II (P = 0.021). Both early- and late-onset VAPs were significantly reduced in Group I. Both ventilator days (8.0 vs. 6.45; P = 0.001) and ICU stay (8.33 vs. 6.33; P = 0.001) on the day of onset of VAP were significantly more in the Group I. Total ventilator days were significantly less (6.52 vs. 8.32; P = 0.006) with lower incidence of mortality (36% vs. 48%; P = 0.224) in the Group I. Intermittent sub-glottic suctioning reduces the incidence of VAP including late-onset VAP.

Stroke Care 2: Stroke rehabilitation

NARCIS (Netherlands)

Langhorne, P.; Bernhardt, J.; Kwakkel, G.

2011-01-01

Stroke is a common, serious, and disabling global health-care problem, and rehabilitation is a major part of patient care. There is evidence to support rehabilitation in well coordinated multidisciplinary stroke units or through provision of early supported provision of discharge teams. Potentially

Stability analysis on the flow and heat transfer of nanofluid past a stretching/shrinking cylinder with suction effect

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Bakar, Nor Ashikin Abu; Bachok, Norfifah; Arifin, Norihan Md.; Pop, Ioan

2018-06-01

The steady boundary layer flow over a stretching/shrinking cylinder with suction effect is numerically studied. Using a similarity transformations, the governing partial differential equations are transformed into a set of nonlinear differential equations and have been solved numerically using a bvp4c code in Matlab software. The nanofluid model used is taking into account the effects of Brownian motion and thermophoresis. The influences of the governing parameters namely the curvature parameter γ, mass suction parameter S, Brownian motion parameter Nb and thermophoresis parameter Nt on the flow, heat and mass transfers characteristics are presented graphically. The numerical results obtained for the skin friction coefficient, local Nusselt number and local Sherwood number are thoroughly determined and presented graphically for several values of the governing parameters. From our investigation, it is found that the non-unique (dual) solutions exist for a certain range of mass suction parameter. It is observed that as curvature parameter increases, the skin friction coefficient and heat transfer rate decrease, meanwhile the mass transfer rates increase. Moreover, the stability analysis showed that the first solution is linearly stable, while the second solution is linearly unstable.

Airplane stroke syndrome.

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Humaidan, Hani; Yassi, Nawaf; Weir, Louise; Davis, Stephen M; Meretoja, Atte

2016-07-01

Only 37 cases of stroke during or soon after long-haul flights have been published to our knowledge. In this retrospective observational study, we searched the Royal Melbourne Hospital prospective stroke database and all discharge summaries from 1 September 2003 to 30 September 2014 for flight-related strokes, defined as patients presenting with stroke within 14days of air travel. We hypothesised that a patent foramen ovale (PFO) is an important, but not the only mechanism, of flight-related stroke. We describe the patient, stroke, and flight characteristics. Over the study period, 131 million passengers arrived at Melbourne airport. Our centre admitted 5727 stroke patients, of whom 42 (0.73%) had flight-related strokes. Flight-related stroke patients were younger (median age 65 versus 73, p<0.001), had similar stroke severity, and received intravenous thrombolysis more often than non-flight-related stroke patients. Seven patients had flight-related intracerebral haemorrhage. The aetiology of the ischaemic strokes was cardioembolic in 14/35 (40%), including seven patients with confirmed PFO, one with atrial septal defect, four with atrial fibrillation, one with endocarditis, and one with aortic arch atheroma. Paradoxical embolism was confirmed in six patients. Stroke related to air travel is a rare occurrence, less than one in a million. Although 20% of patients had a PFO, distribution of stroke aetiologies was diverse and was not limited to PFO and paradoxical embolism. Copyright © 2016 Elsevier Ltd. All rights reserved.

The short-term effects of plantar vibration on balance disorder after stroke

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Soofia Naghdi

2013-05-01

Full Text Available Background: Balance disorders are common in patients following stroke. There are a number of physiotherapy modalities to treat balance impairments, one of which is vibration. The effects of vibration on balance disorders after stroke have not been investigated. This case report demonstrates the short-term effects of plantar vibration on the balance impairment of a patient with stroke. Case presentation: A 72-years-old man with right hemiplegia resulted from stroke was admitted for vibration therapy after not responding to standard rehabilitation interventions. He complained of balance problems despite walking independently. Main studied outcomes were timed up and go test and posturography. Foot sensation, ankle plantar flexor spasticity, and the passive range of ankle dorsiflexion were assessed, as well. Vibration with a frequency of 100 Hz was introduced to the sole of the affected foot for 5 minutes. After intervention, all tests were improved compared to the baselines. Conclusion: This case showed that the vibration was effective for improving balance disorder after stroke.

77 FR 25717 - Proposed Issuance of a General NPDES Permit for Small Suction Dredging

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2012-05-01

...) General Permit (IDG-37-0000) to placer mining operations in Idaho for small suction dredges (intake nozzle... ENVIRONMENTAL PROTECTION AGENCY [FRL-9666-1] Proposed Issuance of a General NPDES Permit for Small... certifies ``will not, if promulgated, have a significant economic impact on a substantial number of small...

Sensory impairments of the lower limb after stroke: a pooled analysis of individual patient data.

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Tyson, Sarah F; Crow, J Lesley; Connell, Louise; Winward, Charlotte; Hillier, Susan

2013-01-01

To obtain more generalizable information on the frequency and factors influencing sensory impairment after stroke and their relationship to mobility and function. A pooled analysis of individual data of stroke survivors (N = 459); mean (SD) age = 67.2 (14.8) years, 54% male, mean (SD) time since stroke = 22.33 (63.1) days, 50% left-sided weakness. Where different measurement tools were used, data were recorded. Descriptive statistics described frequency of sensory impairments, kappa coefficients investigated relationships between sensory modalities, binary logistic regression explored the factors influencing sensory impairments, and linear regression assessed the impact of sensory impairments on activity limitations. Most patients' sensation was intact (55%), and individual sensory modalities were highly associated (κ = 0.60, P sensory impairment (P analysis showed sensation of the lower limb is grossly preserved in most stroke survivors but, when present, it affects function. Sensory modalities are highly interrelated; interventions that treat the motor system during functional tasks may be as effective at treating the sensory system as sensory retraining alone.

Short-snouted toothless ichthyosaur from China suggests Late Triassic diversification of suction feeding ichthyosaurs.

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P Martin Sander

Full Text Available BACKGROUND: Ichthyosaurs were an important group of Mesozoic marine reptiles and existed from the Early Triassic to the early Late Cretaceous. Despite a great diversity in body shapes and feeding adaptations, all share greatly enlarged eyes, an elongated rostrum with numerous conical teeth, and a streamlined body. METHODOLOGY/PRINCIPAL FINDINGS: Based on new material from China and the restudy of Shastasaurus pacificus, we here reinterpret the classical large-bodied Late Triassic ichthyosaur genus Shastasaurus to differ greatly from the standard ichthyosaurian body plan, indicating much greater morphological diversity and range of feeding adaptations in ichthyosaurs than previously recognized. Phylogenetic analysis indicates a monophyletic clade consisting of the giant Shonisaurus sikanniensis, Guanlingsaurus liangae, and Shastasaurus pacificus to which the genus name Shastasaurus is applied. Shastasaurus liangae comb. nov. is from the Late Triassic (Carnian Xiaowa Formation of Guizhou Province, southwestern China. The species combines a diminutive head with an entirely toothless and greatly reduced snout. The species also has by far the highest vertebral count among ichthyosaurs (86 presacral vertebrae and >110 caudal vertebrae, a count that is also very high for tetrapods in general. A reduced toothless snout and a diminutive head is also apparently present in the giant S. sikanniensis and presumably in S. pacificus. CONCLUSIONS/SIGNIFICANCE: In analogy to many modern odontocetes, Shastasaurus is interpreted as a specialized suction feeder on unshelled cephalopods and fish, suggesting a unique but widespread Late Triassic diversification of toothless, suction-feeding ichthyosaurs. Suction feeding has not been hypothesized for any of the other diverse marine reptiles of the Mesozoic before, but in Shastasaurus may be linked to the Late Triassic minimum in atmospheric oxygen.

Risk factors associated with injury attributable to falling among elderly population with history of stroke.

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Divani, Afshin A; Vazquez, Gabriela; Barrett, Anna M; Asadollahi, Marjan; Luft, Andreas R

2009-10-01

Stroke survivors are at high risk for falling. Identifying physical, clinical, and social factors that predispose stroke patients to falls may reduce further disability and life-threatening complications, and improve overall quality of life. We used 5 biennial waves (1998-2006) from the Health and Retirement Study to assess risk factors associated with falling accidents and fall-related injuries among stroke survivors. We abstracted demographic data, living status, self-evaluated general health, and comorbid conditions. We analyzed the rate ratio (RR) of falling and the OR of injury within 2 follow-up years using a multivariate random effects model. We identified 1174 stroke survivors (mean age+/-SD, 74.4+/-7.2 years; 53% female). The 2-year risks of falling, subsequent injury, and broken hip attributable to fall were 46%, 15%, and 2.1% among the subjects, respectively. Factors associated with an increased frequency of falling were living with spouse as compared to living alone (RR, 1.4), poor general health (RR, 1.1), time from first stroke (RR, 1.2), psychiatric problems (RR, 1.7), urinary incontinence (RR, 1.4), pain (RR, 1.4), motor impairment (RR, 1.2), and past frequency of > or = 3 falls (RR, 1.3). Risk factors associated with fall-related injury were female gender (OR, 1.5), poor general health (OR, 1.2), past injury from fall (OR, 3.2), past frequency of > or = 3 falls (OR, 3.1), psychiatric problems (OR, 1.4), urinary incontinence (OR, 1.4), impaired hearing (OR, 1.6), pain (OR, 1.8), motor impairment (OR, 1.3), and presence of multiple strokes (OR, 3.2). This study demonstrates the high prevalence of falls and fall-related injuries in stroke survivors, and identifies factors that increase the risk. Modifying these factors may prevent falls, which could lead to improved quality of life and less caregiver burden and cost in this population.

Active Flow Control in a Radial Vaned Diffuser for Surge Margin Improvement: A Multislot Suction Strategy

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Aurélien Marsan

2017-01-01

Full Text Available This work is the final step of a research project that aims at evaluating the possibility of delaying the surge of a centrifugal compressor stage using a boundary-layer suction technique. It is based on Reynolds-Averaged Navier-Stokes numerical simulations. Boundary-layer suction is applied within the radial vaned diffuser. Previous work has shown the necessity to take into account the unsteady behavior of the flow when designing the active flow control technique. In this paper, a multislot strategy is designed according to the characteristics of the unsteady pressure field. Its implementation results in a significant increase of the stable operating range predicted by the unsteady RANS numerical model. A hub-corner separation still exists further downstream in the diffuser passage but does not compromise the stability of the compressor stage.

The influence of stroke mechanics into energy cost of elite swimmers.

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Barbosa, Tiago M; Fernandes, R J; Keskinen, K L; Vilas-Boas, J P

2008-05-01

The purpose of this study was to analyze the relationships between energy cost (C), swimming velocity (v), stroke frequency (SF) and stroke length (SL) in top-level swimmers. Eighteen elite swimmers (four freestylers, five backstrokers, five breaststrokers and four butterflyers) performed an intermittent set of nx200 m swims (nSprings, OH, USA). At Backstroke, Breaststroke and Butterfly strokes, increases of SF were associated to increases of C, even when controlling the v. The increases in SL only promoted significant decreases in the C in Breaststroke. There was a significant and polynomial relationship between v and SF for all competitive swimming techniques. The polynomial relationship between v and SL was significant only in Freestyle and Butterfly stroke. Partial correlations between v and SF controlling the effect of SL and between v and SL controlling the effect of SF, were positive and significant for all techniques. It is concluded that manipulation of stroke mechanics variables (SF and SL) may be one of the factors through which C in competitive swimming can be altered for a given v.

Stroke Rehabilitation.

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Belagaje, Samir R

2017-02-01

Rehabilitation is an important aspect of the continuum of care in stroke. With advances in the acute treatment of stroke, more patients will survive stroke with varying degrees of disability. Research in the past decade has expanded our understanding of the mechanisms underlying stroke recovery and has led to the development of new treatment modalities. This article reviews and summarizes the key concepts related to poststroke recovery. Good data now exist by which one can predict recovery, especially motor recovery, very soon after stroke onset. Recent trials have not demonstrated a clear benefit associated with very early initiation of rehabilitative therapy after stroke in terms of improvement in poststroke outcomes. However, growing evidence suggests that shorter and more frequent sessions of therapy can be safely started in the first 24 to 48 hours after a stroke. The optimal amount or dose of therapy for stroke remains undetermined, as more intensive treatments have not been associated with better outcomes compared to standard intensities of therapy. Poststroke depression adversely affects recovery across a variety of measures and is an important target for therapy. Additionally, the use of selective serotonin reuptake inhibitors (SSRIs) appears to benefit motor recovery through pleiotropic mechanisms beyond their antidepressant effect. Other pharmacologic approaches also appear to have a benefit in stroke rehabilitation. A comprehensive rehabilitation program is essential to optimize poststroke outcomes. Rehabilitation is a process that uses three major principles of recovery: adaptation, restitution, and neuroplasticity. Based on these principles, multiple different approaches, both pharmacologic and nonpharmacologic, exist to enhance rehabilitation. In addition to neurologists, a variety of health care professionals are involved in stroke rehabilitation. Successful rehabilitation involves understanding the natural history of stroke recovery and a

Stall margin improvement of an axial flow fan with end wall injection and suction; Hekimen fukidashi suidashi ni yoru han'yo jikuryu sofuki no shissoku kaizen

Energy Technology Data Exchange (ETDEWEB)

Nishioka, K.; Kuroda, H.; Obata, S.; Chimura, O. [National Defense Academy, Kanagawa (Japan)

1999-06-25

The experimental studies are conducted to reveal the mechanism of stall margin improvement of an axial flow fan by injection or suction from the end wall. In case of injection, the largest improvement is obtained by the injection at about 0. 14 {approx} 0 .21 times axial chord length downstream from leading edge. The reason for large improvement is that stall vortex, shed intermittent separation vortex and tip leakage vortex are dissipated by this injection, and also that this blowing suppresses the separation of boundary layer. In case of suction, the largest improvement is found for the suction from the end wall near leading edge. The amplitude of periodic static pressure after stall inception becomes smaller in comparison with injection cases. These effects are increased with the increase of suction flow rate, because the discharge of the vortex occurs more easily. On the other hand, the suction from the upstream of leading edge reduces the axial velocity near rotor tip, and then it induces stall. Also we tried to visualize the tip region flow, The suppression mechanism is discussed based on the visualization. The suppression of stall is successfully photographed. (author)

Indications and applications of arterial stents for stroke prevention in atherosclerotic intracranial stenosis.

Science.gov (United States)

Fields, Jeremy D; Liu, Kenneth C; Barnwell, Stanley L; Clark, Wayne M; Lutsep, Helmi L

2010-01-01

Intracranial stenosis accounts for 8-10% of all ischemic strokes in North America, a frequency slightly less than that of extracranial carotid stenosis. Among patients presenting with transient ischemic attack or stroke due to intracranial stenosis, the risk of recurrent stroke in the first year after initial symptoms is about 14%. Those with high-risk features (recent stroke and severe stenosis) have up to a 23% rate of recurrent stroke in the year after their initial event. Angioplasty with stenting has emerged as a potential treatment strategy, particularly in high-risk patients, although evidence is currently limited to uncontrolled prospective trials and retrospective case series. In this article, we critically review the clinical results supporting the use of stenting and highlight some key considerations in the application of this technology, including patient selection, procedural management, technical issues, and risk factors for complications and in-stent restenosis.

Comparative study of the characteristics of some suction devices for gas sampling applications; Etude comparative des caracteristiques de quelques dispositifs d'aspiration a l'usage des prelevements de gaz

Energy Technology Data Exchange (ETDEWEB)

Donguy, R.; Drouet, J.

1959-06-15

Gas sampling (used to determine the characteristics of dusts or aerosols contained in a gas) needs a suction device. In order to select the right device and the right conditions of use, the characteristics and performances of various suction devices (helicoidal and centrifugal aspirators, air pumps, volumetric pumps) have been experimentally measured: flow rate, head loss, sampling volume and duration, aerosol and dust concentration, gas density, nature of the gas, suction circuit configuration, etc.

Hyponatremia And Disability, Prevalence And Prognosis In Babol Stroke Patients.

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Alijan Ahmadi Ahangar

2017-02-01

Full Text Available Background: Stroke is the leading cause of serious long-term disability. In recent studies hyponatremia as a risk factor for stroke. Methods: This cross-sectional descriptive study was to evaluate serum zinc level in serum sodium over the first 24 hours after the onset of stroke. Different intensities were determined on Stroke Scale NIH (National Institute of Health (mild 4-1 and (average moderate 15-5 and (moderate to severe 20-16 and (extreme severe 42- 21. Determination intensity of stroke after admission and discharge with Modified Rankin Scale and Barthel index. Blood serum concentrations of sodium 0.5 mL of venous blood were taken and sodium serum level was performed with Latex particle agglutination test in Ayatollah Rouhani Hospital. That normal range was defined 136-146 meq / L Findings: 125 patients were entered into this study; the prevalence of hyponatremia in female was 70% vs 60% in male. Of stroke patients included in this study 66% of them had hyponatremia and the frequency of hyponatremia in ischemic and hemorrhagic was 82% and 63%, respectively. Increase in hyponatremia with disability period of admission had statistically significant (10(12 mild vs 40(32 moderate, 32(25.6 severe, p=0.01 also with disability before discharge (24(19.2 mild, 26(20.8 moderate, 32(25.6 severe, p=0.03. Conclusions: Hyponatremia can effect on severity of the stroke and can be considered as a predictor of increased stroke severity and disability at admission and discharge.

Outcome Determinants of Stroke in a Brazilian Primary Stroke Center

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Gustavo W. Kuster

2014-01-01

Full Text Available Background. Stroke mortality in Brazil is one of the highest among Western countries. Nonetheless, stroke outcome determinants are still poorly known in this country. In this study we evaluate outcome determinants of stroke in a primary stroke center in São Paulo, Brazil. Methods. We evaluated demographic, clinical, and outcome data of patients with ischemic stroke (IS, transient ischemic attack (TIA, and intracerebral hemorrhage (ICH admitted at “Hospital Paulistano,” São Paulo, Brazil. In-hospital mortality and functional outcome determinants were assessed. Univariate and binary logistic regression analysis were performed. Results. Three hundred forty-one patients were included in the study, 52.2% being male with 66.8±15.7 years. The stroke type distribution was IS: 59.2%, TIA: 29.6%, and ICH: 11.1%. ICH was associated with greater severity and poorer functional outcome. The determinants of poorer functional outcome were higher NIHSS, lower Glasgow score, and lower oxygen saturation level. The most important mortality determinant was the presence of visual symptoms. Conclusions. The stroke mortality and stroke outcome determinants found in the present study do not remarkably differ from studies carried out in developed countries. Stroke prognosis studies are crucial to better understand the high burden of stroke in Brazil.

Functional organization and restoration of the brain motor-execution network after stroke and rehabilitation

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Sahil eBajaj

2015-03-01

Full Text Available Multiple cortical areas of the human brain motor system interact coherently in the low frequency range (< 0.1 Hz, even in the absence of explicit tasks. Following stroke, cortical interactions are functionally disturbed. How these interactions are affected and how the functional organization is regained from rehabilitative treatments as people begin to recover motor behaviors has not been systematically studied. We recorded the intrinsic functional magnetic resonance imaging (fMRI signals from 30 participants: 17 young healthy controls and 13 aged stroke survivors. Stroke participants underwent mental practice (MP or both mental practice and physical therapy (MP + PT within 14-51 days following stroke. We investigated the network activity of five core areas in the motor-execution network, consisting of the left primary motor area (LM1, the right primary motor area (RM1, the left pre-motor cortex (LPMC, the right pre-motor cortex (RPMC and the supplementary motor area (SMA. We discovered that (i the network activity dominated in the frequency range 0.06 Hz – 0.08 Hz for all the regions, and for both able-bodied and stroke participants (ii the causal information flow between the regions: LM1 and SMA, RPMC and SMA, RPMC and LM1, SMA and RM1, SMA and LPMC, was reduced significantly for stroke survivors (iii the flow did not increase significantly after MP alone and (iv the flow among the regions during MP+PT increased significantly. We also found that sensation and motor scores were significantly higher and correlated with directed functional connectivity measures when the stroke-survivors underwent MP+PT but not MP alone. The findings provide evidence that a combination of mental practice and physical therapy can be an effective means of treatment for stroke survivors to recover or regain the strength of motor behaviors, and that the spectra of causal information flow can be used as a reliable biomarker for evaluating rehabilitation in stroke

Study protocol: ICONS: Identifying continence options after stroke: A randomised trial

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Leathley Michael J

2011-05-01

Full Text Available Abstract Background Urinary incontinence following acute stroke is common, affecting between 40%-60% of people in hospital after a stroke. Despite the availability of clinical guidelines for urinary incontinence and urinary incontinence after stroke, national audit data suggest incontinence is often poorly managed. Conservative interventions (e.g. bladder training, pelvic floor muscle training and prompted voiding have been shown to have some effect with participants in Cochrane systematic reviews, but have not had their effectiveness demonstrated with stroke patients. Methods/Design A cluster randomised controlled pilot trial designed to assess the feasibility of a full-scale cluster randomised trial and to provide preliminary evidence of the effectiveness and cost-effectiveness of a systematic voiding programme for the management of continence after stroke. Stroke services will be randomised to receive the systematic voiding programme, the systematic voiding programme plus supported implementation, or usual care. The trial aims to recruit at least 780 participants in 12 stroke services (4 per arm. The primary outcome is presence/absence of incontinence at six weeks post-stroke. Secondary outcomes include frequency and severity of incontinence, quality of life and cost-utility. Outcomes will be measured at six weeks, three months and (for participants recruited in the first three months twelve months after stroke. Process data will include rates of recruitment and retention and fidelity of intervention delivery. An integrated qualitative evaluation will be conducted in order to describe implementation and assist in explaining the potential mediators and modifiers of the process. Trial Registration ISRCTN: ISRCTN08609907

Intake of antioxidants and B vitamins is inversely associated with ischemic stroke and cerebral atherosclerosis

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Choe, Hansaem; Hwang, Ji-Yun; Yun, Jin A; Kim, Ji-Myung; Song, Tae-Jin; Chang, Namsoo; Kim, Yong-Jae

2016-01-01

BACKGROUND/OBJECTIVES This study was conducted to examine relationships between dietary habits and intakes of antioxidants and B vitamins and the risk of ischemic stroke, and to compare dietary factors according to the presence of cerebral artery atherosclerosis and stroke subtypes. SUBJECTS/METHODS A total of 147 patients and 144 control subjects were recruited consecutively in the metropolitan area of Seoul, Korea. Sixty participants each in the case and control groups were included in analyses after 1:1 frequency matching. In addition, 117 acute ischemic stroke patients were classified into subtypes according to the Trial of Org 10172 in Acute Stroke Treatment (TOAST) guidelines. Dietary intake was measured using a semi-quantitative food frequency questionnaire composed of 111 food items and plasma lipid and homocysteine levels were analyzed. RESULTS When compared with control subjects, stroke patients had unfavorable dietary behaviors and lower intakes of fruits (73.1 ± 83.2 g vs. 230.9 ± 202.1 g, P < 0.001), vegetables (221.1 ± 209.0 g vs. 561.7 ± 306.6 g, P < 0.001), and antioxidants, including vitamins C, E, B6, β-carotene, and folate. The intakes of fruits, vegetables, vitamin C, and folate were inversely associated with the risk of ischemic stroke after adjusting for confounding factors. Intakes of vegetables, vitamins C, B6, B12, and folate per 1,000 kcal were lower in ischemic stroke with cerebral atherosclerosis than in those without. Overall vitamin B12 intake per 1,000 kcal differed according to the TOAST classification (P = 0.004), but no differences among groups existed based on the post-hoc test. CONCLUSIONS When compared with control subjects, ischemic stroke patients, particularly those with cerebral atherosclerosis, had unfavorable dietary intake, which may have contributed to the development of ischemic stroke. These results indicate that proper dietary recommendations are important for the prevention of ischemic stroke. PMID:27698959

Free Convection from a Semi-Infinite Vertical Plate with Discontinuous Blowing or Suction.

Science.gov (United States)

1981-03-01

SCHIESSR UNCLASSIFIED; EhEllllEllEE EE[E]hEEEIllIEllhlEEIl EEEEEIIIEEEEI EEEIIIIIIIIII EIIIEIIEEEEII EEEIIIIIIIIIIE LVEL NAVAL POSTGRADUATE SCHOOL Monterey...the unsteady free convective flow past a simi-infinite porous plate with constant suction were studied through mathematical analysis by Soundalgekar...boundary-layers and; therefore, will often indicate a preferred method of analytical solution. Although there are several possible mathematical techniques

Atherosclerosis and Stroke

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... Stroke Association.org Professionals for Stroke Association.org Shop for Stroke Association.org Support for Stroke Association. ... endothelium significantly. The artery’s diameter shrinks and blood flow decreases, reducing oxygen supply. How atherosclerotic plaque causes ...

Hemorrhagic and Ischemic Strokes Compared Stroke Severity, Mortality, and Risk Factors

DEFF Research Database (Denmark)

Andersen, Klaus Kaae; Olsen, T. S.; Dehlendorff, Christian

2009-01-01

were diabetes, atrial fibrillation, previous myocardial infarction, previous stroke, and intermittent arterial claudication. Smoking and alcohol consumption favored HS, whereas age, sex, and hypertension did not herald stroke type. Compared with ischemic strokes, HS was associated with an overall...... higher mortality risk (HR, 1.564; 95% CI, 1.441-1.696). The increased risk was, however, time-dependent; initially, risk was 4-fold, after 1 week it was 2.5-fold, and after 3 weeks it was 1.5-fold. After 3 months stroke type did not correlate to mortality. Conclusion-Strokes are generally more severe...... based on 25 123 individuals with a complete data set. Results-Of the patients 3993 (10.1%) had HS. Stroke severity was almost linearly related to the probability of having HS (2% in patients with the mildest stroke and 30% in those with the most severe strokes). Factors favoring ischemic strokes vs HS...

Stroke etiology and collaterals: atheroembolic strokes have greater collateral recruitment than cardioembolic strokes.

Science.gov (United States)

Rebello, L C; Bouslama, M; Haussen, D C; Grossberg, J A; Dehkharghani, S; Anderson, A; Belagaje, S R; Bianchi, N A; Grigoryan, M; Frankel, M R; Nogueira, R G

2017-06-01

Chronic hypoperfusion from athero-stenotic lesions is thought to lead to better collateral recruitment compared to cardioembolic strokes. It was sought to compare collateral flow in stroke patients with atrial fibrillation (AF) versus stroke patients with cervical atherosclerotic steno-occlusive disease (CASOD). This was a retrospective review of a prospectively collected endovascular database. Patients with (i) anterior circulation large vessel occlusion stroke, (ii) pre-treatment computed tomography angiography (CTA) and (iii) intracranial embolism from AF or CASOD were included. CTA collateral patterns were evaluated and categorized into two groups: absent/poor collaterals (CTA collateral score 0-1) versus moderate/good collaterals (CTA collateral score 2-4). CT perfusion was also utilized for baseline core volume and evaluation of infarct growth. A total of 122 patients fitted the inclusion criteria, of whom 88 (72%) had AF and 34 (27%) CASOD. Patients with AF were older (P Collateral scores were lower in the AF group (P = 0.01) with patients having poor collaterals in 28% of cases versus 9% in the CASOD group (P = 0.03). Mortality rates (20% vs. 0%; P = 0.02) were higher in the AF patients whilst rates of any parenchymal hemorrhage (6% vs. 26%; P collaterals (odds ratio 4.70; 95% confidence interval 1.17-18.79; P = 0.03). Atheroembolic strokes seem to be associated with better collateral flow compared to cardioembolic strokes. This may in part explain the worse outcomes of AF-related stroke. © 2017 EAN.

Effect of Prior Atorvastatin Treatment on the Frequency of Hospital Acquired Pneumonia and Evolution of Biomarkers in Patients with Acute Ischemic Stroke: A Multicenter Prospective Study

Directory of Open Access Journals (Sweden)

Yuetian Yu

2017-01-01

Full Text Available Objective. To investigate whether prior treatment of atorvastatin reduces the frequency of hospital acquired pneumonia (HAP. Methods. Totally, 492 patients with acute ischemic stroke and Glasgow Coma Scale ≤ 8 were enrolled in this study. Subjects were assigned to prior atorvastatin treatment group (n=268, PG and no prior treatment group (n=224, NG. All the patients were given 20 mg atorvastatin every night during their hospital stay. HAP frequency and 28-day mortality were measured. Levels of inflammatory biomarkers [white blood cell (WBC, procalcitonin (PCT, tumor necrosis factor-alpha (TNF-α, and interleukin-6 (IL-6] were tested. Results. There was no significant difference in the incidence of HAP between PG and NG (25.74% versus. 24.55%, p>0.05 and 28-day mortality (50.72% versus 58.18%, p>0.05. However, prior statin treatment did modify the mortality of ventilator associated pneumonia (VAP (36.54% versus 58.14%, p=0.041 and proved to be a protective factor (HR, 0.564; 95% CI, 0.310~0.825, p=0.038. Concentrations of TNF-α and IL-6 in PG VAP cases were lower than those in NG VAP cases (p<0.01. Conclusions. Prior atorvastatin treatment in patients with ischemic stroke was associated with a lower concentration of IL-6 and TNF-α and improved the outcome of VAP. This clinical study has been registered with ChiCTR-ROC-17010633 in Chinese Clinical Trial Registry.

Using Brain Oscillations and Corticospinal Excitability to Understand and Predict Post-Stroke Motor Function

Directory of Open Access Journals (Sweden)

Aurore Thibaut

2017-05-01

Full Text Available What determines motor recovery in stroke is still unknown and finding markers that could predict and improve stroke recovery is a challenge. In this study, we aimed at understanding the neural mechanisms of motor function recovery after stroke using neurophysiological markers by means of cortical excitability (transcranial magnetic stimulation—TMS and brain oscillations (electroencephalography—EEG. In this cross-sectional study, 55 subjects with chronic stroke (62 ± 14 yo, 17 women, 32 ± 42 months post-stroke were recruited in two sites. We analyzed TMS measures (i.e., motor threshold—MT—of the affected and unaffected sides and EEG variables (i.e., power spectrum in different frequency bands and different brain regions of the affected and unaffected hemispheres and their correlation with motor impairment as measured by Fugl-Meyer. Multiple univariate and multivariate linear regression analyses were performed to identify the predictors of good motor function. A significant interaction effect of MT in the affected hemisphere and power in beta bandwidth over the central region for both affected and unaffected hemispheres was found. We identified that motor function positively correlates with beta rhythm over the central region of the unaffected hemisphere, while it negatively correlates with beta rhythm in the affected hemisphere. Our results suggest that cortical activity in the affected and unaffected hemisphere measured by EEG provides new insights on the association between high-frequency rhythms and motor impairment, highlighting the role of an excess of beta in the affected central cortical region in poor motor function in stroke recovery.

Resting Heart Rate Predicts Depression and Cognition Early after Ischemic Stroke: A Pilot Study.

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Tessier, Arnaud; Sibon, Igor; Poli, Mathilde; Audiffren, Michel; Allard, Michèle; Pfeuty, Micha

2017-10-01

Early detection of poststroke depression (PSD) and cognitive impairment (PSCI) remains challenging. It is well documented that the function of autonomic nervous system is associated with depression and cognition. However, their relationship has never been investigated in the early poststroke phase. This pilot study aimed at determining whether resting heart rate (HR) parameters measured in early poststroke phase (1) are associated with early-phase measures of depression and cognition and (2) could be used as new tools for early objective prediction of PSD or PSCI, which could be applicable to patients unable to answer usual questionnaires. Fifty-four patients with first-ever ischemic stroke, without cardiac arrhythmia, were assessed for resting HR and heart rate variability (HRV) within the first week after stroke and for depression and cognition during the first week and at 3 months after stroke. Multiple regression analyses controlled for age, gender, and stroke severity revealed that higher HR, lower HRV, and higher sympathovagal balance (low-frequency/high-frequency ratio of HRV) were associated with higher severity of depressive symptoms within the first week after stroke. Furthermore, higher sympathovagal balance in early phase predicted higher severity of depressive symptoms at the 3-month follow-up, whereas higher HR and lower HRV in early phase predicted lower global cognitive functioning at the 3-month follow-up. Resting HR measurements obtained in early poststroke phase could serve as an objective tool, applicable to patients unable to complete questionnaires, to help in the early prediction of PSD and PSCI. Copyright © 2017 National Stroke Association. Published by Elsevier Inc. All rights reserved.

Frequency of MELAS main mutation in a phenotype-targeted young ischemic stroke patient population.

Science.gov (United States)

Tatlisumak, Turgut; Putaala, Jukka; Innilä, Markus; Enzinger, Christian; Metso, Tiina M; Curtze, Sami; von Sarnowski, Bettina; Amaral-Silva, Alexandre; Jungehulsing, Gerhard Jan; Tanislav, Christian; Thijs, Vincent; Rolfs, Arndt; Norrving, Bo; Fazekas, Franz; Suomalainen, Anu; Kolodny, Edwin H

2016-02-01

Mitochondrial diseases, predominantly mitochondrial encephalomyopathy, lactic acidosis, and stroke-like episodes (MELAS), may occasionally underlie or coincide with ischemic stroke (IS) in young and middle-aged individuals. We searched for undiagnosed patients with MELAS in a target subpopulation of unselected young IS patients enrolled in the Stroke in Young Fabry Patients study (sifap1). Among the 3291 IS patients aged 18-55 years recruited to the sifap1 study at 47 centers across 14 European countries, we identified potential MELAS patients with the following phenotypic features: (a) diagnosed cardiomyopathy or (b) presence of two of the three following findings: migraine, short stature (≤165 cm for males; ≤155 cm for females), and diabetes. Identified patients' blood samples underwent analysis of the common MELAS mutation, m.3243A>G in the MTTL1 gene of mitochondrial DNA. Clinical and cerebral MRI features of the mutation carriers were reviewed. We analyzed blood samples of 238 patients (177 with cardiomyopathy) leading to identification of four previously unrecognized MELAS main mutation carrier-patients. Their clinical and MRI characteristics were within the expectation for common IS patients except for severe hearing loss in one patient and hyperintensity of the pulvinar thalami on T1-weighted MRI in another one. Genetic testing for the m.3243A>G MELAS mutation in young patients with IS based on phenotypes suggestive of mitochondrial disease identifies previously unrecognized carriers of MELAS main mutation, but does not prove MELAS as the putative cause.

Stroke treatment outcomes in hospitals with and without Stroke Units.

Science.gov (United States)

Masjuan, J; Gállego Culleré, J; Ignacio García, E; Mira Solves, J J; Ollero Ortiz, A; Vidal de Francisco, D; López-Mesonero, L; Bestué, M; Albertí, O; Acebrón, F; Navarro Soler, I M

2017-10-23

Organisational capacity in terms of resources and care circuits to shorten response times in new stroke cases is key to obtaining positive outcomes. This study compares therapeutic approaches and treatment outcomes between traditional care centres (with stroke teams and no stroke unit) and centres with stroke units. We conducted a prospective, quasi-experimental study (without randomisation of the units analysed) to draw comparisons between 2 centres with stroke units and 4 centres providing traditional care through the neurology department, analysing a selection of agreed indicators for monitoring quality of stroke care. A total of 225 patients participated in the study. In addition, self-administered questionnaires were used to collect patients' evaluations of the service and healthcare received. Centres with stroke units showed shorter response times after symptom onset, both in the time taken to arrive at the centre and in the time elapsed from patient's arrival at the hospital to diagnostic imaging. Hospitals with stroke units had greater capacity to respond through the application of intravenous thrombolysis than centres delivering traditional neurological care. Centres with stroke units showed a better fit to the reference standards for stroke response time, as calculated in the Quick study, than centres providing traditional care through the neurology department. Copyright © 2017 Sociedad Española de Neurología. Publicado por Elsevier España, S.L.U. All rights reserved.

Beat-by-beat analysis of cardiac output and blood pressure responses to short-term barostimulation in different body positions

Science.gov (United States)

Hildebrandt, Wulf; Schütze, Harald; Stegemann, J.

Rapid quantification of the human baro-reflex control of heart rate has been achieved on a beat-by-beat basis using a neck-chamber with quick ECG-triggered pressure changes. Referring to recent findings on heart rate and stroke volume, the present study uses this technique to compare cardiac output as well as blood pressure changes in supine and upright position to investigate feedback effects and to confirm postural reflex modifications not revealed by RR-interval changes. A suction profile starting at +40 mmHg and running 7 steps of pressure decrease down to -65 mmHg was examined in 0° and 90° tilting position while beat-by-beat recordings were done of heart rate, stroke volume (impedance-cardiography) and blood pressure (Finapres tm) (n=16). The percentual heart rate decrease failed to be significantly different between positions. A suction-induced stroke volume increase led to a cardiac output almost maintained when supine and significantly increased when upright. A decrease in all blood pressure values was found during suction, except for systolic values in upright position which increased. Conclusively, (a) it is confirmed that different inotropy accounts for the seen gravitational effect on the cardiac output not represented by heart rate; (b) identical suction levels in different positions lead to different stimuli at the carotid receptor. This interference has to be considered in microgravity studies by beat-by-beat measurement of cardiac output and blood pressure.

The Disability Rate of 5-Year Post-Stroke and Its Correlation Factors: A National Survey in China.

Science.gov (United States)

Yang, Yang; Shi, Yu-Zhi; Zhang, Ning; Wang, Shuo; Ungvari, Gabor S; Ng, Chee H; Wang, Yi-Long; Zhao, Xing-Quan; Wang, Yong-Jun; Wang, Chun-Xue; Xiang, Yu-Tao

2016-01-01

Few studies on long-term functional outcome have been conducted in post-stroke patients in China. The objective of this study was to conduct a nationwide survey in China to investigate the 5-year prevalence of post-stroke disability and its correlation factors. A total of 893 patients with ischemic stroke were included. Demographic, clinical and neuro-imaging information were collected with standardized instruments that assessed stroke severity, depression, cognitive impairment, stroke recurrence and physical disability. Disability was assessed with the modified Ranking Score (mRS), of which a cutoff score ≥2 indicates disability. Statistical analysis included chi-square tests, two independent samples t-tests, Mann-Whitney U test and multiple logistic regression analysis. The frequency of disability in this study population was 45%. Multivariate analyses revealed that older age, lower education level, previous history of stroke, stroke severity at admission, depression, cognitive impairment at 3 months, and stroke recurrence within 5 years follow up were all significantly associated with post-stroke disability. The disability rate in 5-year post-stroke was high in Chinese patients. Treatment of depression, secondary prevention of stroke and rehabilitation may benefit disabled patients with stroke in China.

Application of the time dependent suction to free convection laminar flow in the presence of transverse magnetic field

International Nuclear Information System (INIS)

Agrawal, H.L.; Ram, P.C.

1980-01-01

The laminar unsteady free convection and heat transfer of an electrically conducting fluid past a porous vertical flat plate in the presence of uniform transverse magnetic field is investigated when the free stream velocity and suction at the plate are oscillatory functions of time, viscous dissipation term and Joul's dissipation term have been neglected at low velocity. Expressions for velocity and temperature distributions have been obtained in the non-dimensional forms and the skin-friction has been calculated. The skin-friction decreases by increasing Hartmann number. The suction is applied to check the growth of the boundary layer. This study is likely to have bearing on the problem of boundary layer control and transpiration cooling. (author)

Stroke: advances in medical therapy and acute stroke intervention.

Science.gov (United States)

Barrett, Kevin M; Lal, Brajesh K; Meschia, James F

2015-10-01

Evidence-based therapeutic options for stroke continue to emerge based on results from well-designed clinical studies. Ischemic stroke far exceeds hemorrhagic stroke in terms of prevalence and incidence, both in the USA and worldwide. The public health effect of reducing death and disability related to ischemic stroke justifies the resources that have been invested in identifying safe and effective treatments. The emergence of novel oral anticoagulants for ischemic stroke prevention in atrial fibrillation has introduced complexity to clinical decision making for patients with this common cardiac arrhythmia. Some accepted ischemic stroke preventative strategies, such as carotid revascularization for asymptomatic carotid stenosis, require reassessment, given advances in risk factor management, antithrombotic therapy, and surgical techniques. Intra-arterial therapy, particularly with stent retrievers after intravenous tissue plasminogen activator, has recently been demonstrated to improve functional outcomes and will require investment in system-based care models to ensure that effective treatments are received by patients in a timely fashion. The purpose of this review is to describe recent advances in medical and surgical approaches to ischemic stroke prevention and acute treatment. Results from recently published clinical trials will be highlighted along with ongoing clinical trials addressing key questions in ischemic stroke management and prevention where equipoise remains.

Care for post-stroke patients at Malaysian public health centres: self-reported practices of family medicine specialists.

Science.gov (United States)

Abdul Aziz, Aznida F; Mohd Nordin, Nor Azlin; Abd Aziz, Noor; Abdullah, Suhazeli; Sulong, Saperi; Aljunid, Syed M

2014-03-02

Provision of post stroke care in developing countries is hampered by discoordination of services and limited access to specialised care. Albeit shortcomings, primary care continues to provide post-stroke services in less than favourable circumstances. This paper aimed to review provision of post-stroke care and related problems among Family Medicine Specialists managing public primary health care services. A semi-structured questionnaire was distributed to 121 Family Physicians servicing public funded health centres in a pilot survey focused on improving post stroke care provision at community level. The questionnaire assessed respondents background and practice details i.e. estimated stroke care burden, current service provision and opinion on service improvement. Means and frequencies described quantitative data. For qualitative data, constant comparison method was used until saturation of themes was reached. Response rate of 48.8% was obtained. For every 100 patients seen at public healthcentres each month, 2 patients have stroke. Median number of stroke patients seen per month is 5 (IQR 2-10). 57.6% of respondents estimated total stroke patients treated per year at each centre was less than 40 patients. 72.4% lacked a standard care plan although 96.6% agreed one was needed. Patients seen were: discharged from tertiary care (88.1%), shared care plan with specialists (67.8%) and patients who developed stroke during follow up at primary care (64.4%). Follow-ups were done at 8-12 weekly intervals (60.3%) with 3.4% on 'as needed' basis. Referrals ranked in order of frequency were to physiotherapy services, dietitian and speech and language pathologists in public facilities. The FMS' perceived 4 important 'needs' in managing stroke patients at primary care level; access to rehabilitation services, coordinated care between tertiary centres and primary care using multidisciplinary care approach, a standardized guideline and family and caregiver support. Post discharge

Dysphagia in Acute Stroke: Incidence, Burden and Impact on Clinical Outcome

Science.gov (United States)

Broeg-Morvay, Anne; Meisterernst, Julia; Schlager, Markus; Mono, Marie-Luise; El-Koussy, Marwan; Kägi, Georg; Jung, Simon; Sarikaya, Hakan

2016-01-01

Background Reported frequency of post-stroke dysphagia in the literature is highly variable. In view of progress in stroke management, we aimed to assess the current burden of dysphagia in acute ischemic stroke. Methods We studied 570 consecutive patients treated in a tertiary stroke center. Dysphagia was evaluated by using the Gugging Swallowing Screen (GUSS). We investigated the relationship of dysphagia with pneumonia, length of hospital stay and discharge destination and compared rates of favourable clinical outcome and mortality at 3 months between dysphagic patients and those without dysphagia. Results Dysphagia was diagnosed in 118 of 570 (20.7%) patients and persisted in 60 (50.9%) at hospital discharge. Thirty-six (30.5%) patients needed nasogastric tube because of severe dysphagia. Stroke severity rather than infarct location was associated with dysphagia. Dysphagic patients suffered more frequently from pneumonia (23.1% vs. 1.1%, pdysphagia. At 3 months, dysphagic patients less often had a favourable outcome (35.7% vs. 69.7%; pdysphagia to be an independent predictor of discharge destination and institutionalization at 3 months, while severe dysphagia requiring tube placement was strongly associated with mortality. Conclusion Dysphagia still affects a substantial portion of stroke patients and may have a large impact on clinical outcome, mortality and institutionalization. PMID:26863627

The use of suction blisters to measure sunscreen protection against UVR-induced DNA damage.

Science.gov (United States)

Josse, Gwendal; Douki, Thierry; Le Digabel, Jimmy; Gravier, Eleonore; Questel, Emmanuel

2018-02-01

The formation of DNA photoproducts caused by solar UVR exposure needs to be investigated in-vivo and in particular in order to assess sunscreens' level of protection against solar genotoxicity. The study's purposes were: i) to evaluate if the roof of suction blisters is an appropriate sampling method for measuring photoproducts, and ii) to measure in-vivo sunscreen protection against cyclobutane pyrimidine dimers. Skin areas on the interior forearms of eight healthy volunteers were exposed in-vivo to 2 MED of simulated solar radiation (SSR) and to 15 MED on a sunscreen protected area. After irradiation, six suction blisters were induced and the blister roofs were collected. Analysis of SSR-induced CPDs was performed by two independent methods: a chromatography coupled to mass spectroscopy (HPLC-MS/MS) approach and a 3D-imaging of CPD immunostaining by multiphoton microscopy on floating epidermal sheets. HPLC-MS/MS analyses showed that SSR-unexposed skin presented no CPD dimers, whereas 2 MED SSR-exposed skin showed a significant number of TT-CPD. The sunscreen covered skin exposed to 15 MED appeared highly protected from DNA damage, as the amount of CPD-dimers remained below the detection limit. The multiphoton-immunostaining analysis consistently showed that no CPD staining was observed on the non-SSR-exposed skin. A significant increase of CPD staining intensity and number of CPD-positive cells were observed on the 2 MED SSR-exposed skin. Sunscreen protected skin presented a very low staining intensity and the number of CPD-positive cells remained very close to non-SSR-exposed skin. This study showed that suction blister samples are very appropriate for measuring CPD dimers in-vivo, and that sunscreens provide high protection against UVR-induced DNA damage. Copyright © 2017 Elsevier B.V. All rights reserved.

Gage for gas flow measurement especially in gas-suction pipes

International Nuclear Information System (INIS)

Renner, K.; Stegmanns, W.

1978-01-01

The gage utilizes the differential pressure given by a differential pressure producer to generate, in a bypass, a partial gas flow measured by means of a direct-reading anemometer of windmill type. The partial gas flow is generated between pressure pick-up openings in the gas-suction pipe in front of a venturi insert and pressure pick-up openings at the bottleneck of the venturi insert. The reading of the anemometer is proportional to the main gas flow and independent of the variables of state and the properties of the gases to be measured. (RW) [de

Entropy Generation in a Rotating Couette Flow with Suction/Injection

Directory of Open Access Journals (Sweden)

S. Das

2015-05-01

Full Text Available The present paper is concerned with an analytical study of entropy generation in viscous incompressible Couette flow with suction/injection in a rotating frame of reference. One of the plate is held at rest and the other one moves with an uniform velocity.The flow induced by the moving plate. An exact solution of governing equations has been obtained in closed form. The entropy generation number and the Bejan number are also obtained. The influences of each of the governing parameters on velocity, temperature, entropy generation and Bejan number are discussed with the help of graphs.

Analgesic efficacy of lidocaine for suction-assisted lipectomy with tumescent technique under general anesthesia: a randomized, double-masked, controlled trial.

Science.gov (United States)

Danilla, Stefan; Fontbona, Montserrat; de Valdés, Victoria Diaz; Dagnino, Bruno; Sorolla, Juan Pablo; Israel, Guillermo; Searle, Susana; Norambuena, Hernán; Cabello, Rodrigo

2013-08-01

Suction-assisted lipectomy is one of the most common procedures performed in plastic surgery. To minimize blood loss and to obtain adequate analgesia, a liquid solution is infiltrated into the subcutaneous plane before suction. The objective of this study was to determine whether the use of lidocaine in the infiltration solution reduces postoperative pain. A prospective, randomized, double-masked, clinical trial was designed. Each side of patients' body zones to be treated with suction-assisted lipectomy was randomized to receive infiltration solution with or without lidocaine. Treatment allocation was performed using computer-generated random numbers in permuted blocks of eight. Pain was assessed using the visual analogue scale and registered 1, 6, 12, 18, and 24 hours after the procedure. The trial was stopped after a first interim analysis. The use of lidocaine in the dilute solution reduced pain by 0.5 point on the visual analogue scale (95 percent CI, 0.3 to 0.8; p<0.001). The effect was independent of the suctioned body zone (p=0.756), and lasted until 18 hours after surgery. Its analgesic effect was lost at the 24-hour postoperative control. Pain increased an average of 0.018 point on the visual analogue scale per hour (95 percent CI, 0.001 to 0.036; p=0.043). The use of lidocaine in the infiltration solution is effective in postoperative pain control until 18 hours after surgery. Nevertheless, its clinical effect is limited and clinically irrelevant, and therefore it is no longer used by the authors. Therapeutic, I.

85,000-GPM, single-stage, single-suction LMFBR intermediate centrifugal pump

International Nuclear Information System (INIS)

Fair, C.E.; Cook, M.E.; Huber, K.A.; Rohde, R.

1983-01-01

The mechanical and hydraulic design features of the 85,000-gpm, single-stage, single-suction pump test article, which is designed to circulate liquid-sodium coolant in the intermediate heat-transport system of a Large-Scale Liquid Metal Fast Breeder Reactor (LS-LMFBR), are described. The design and analytical considerations used to satisfy the pump performance and operability requirements are presented. The validation of pump hydraulic performance using a hydraulic scale-model pump is discussed, as is the featute test for the mechanical-shaft seal system

A comparison of commercial light-emitting diode baited suction traps for surveillance of Culicoides in northern Europe.

Science.gov (United States)

Hope, Andrew; Gubbins, Simon; Sanders, Christopher; Denison, Eric; Barber, James; Stubbins, Francesca; Baylis, Matthew; Carpenter, Simon

2015-04-22

The response of Culicoides biting midges (Diptera: Ceratopogonidae) to artificial light sources has led to the use of light-suction traps in surveillance programmes. Recent integration of light emitting diodes (LED) in traps improves flexibility in trapping through reduced power requirements and also allows the wavelength of light used for trapping to be customized. This study investigates the responses of Culicoides to LED light-suction traps emitting different wavelengths of light to make recommendations for use in surveillance. The abundance and diversity of Culicoides collected using commercially available traps fitted with Light Emitting Diode (LED) platforms emitting ultraviolet (UV) (390 nm wavelength), blue (430 nm), green (570 nm), yellow (590 nm), red (660 nm) or white light (425 nm - 750 nm with peaks at 450 nm and 580 nm) were compared. A Centre for Disease Control (CDC) UV light-suction trap was also included within the experimental design which was fitted with a 4 watt UV tube (320-420 nm). Generalised linear models with negative binomial error structure and log-link function were used to compare trap abundance according to LED colour, meteorological conditions and seasonality. The experiment was conducted over 49 nights with 42,766 Culicoides caught in 329 collections. Culicoides obsoletus Meigen and Culicoides scoticus Downes and Kettle responded indiscriminately to all wavelengths of LED used with the exception of red which was significantly less attractive. In contrast, Culicoides dewulfi Goetghebuer and Culicoides pulicaris Linnaeus were found in significantly greater numbers in the green LED trap than in the UV LED trap. The LED traps collected significantly fewer Culicoides than the standard CDC UV light-suction trap. Catches of Culicoides were reduced in LED traps when compared to the standard CDC UV trap, however, their reduced power requirement and small size fulfils a requirement for trapping in logistically challenging areas or where many

Microalbuminuria could improve risk stratification in patients with TIA and minor stroke.

Science.gov (United States)

Elyas, Salim; Shore, Angela C; Kingwell, Hayley; Keenan, Samantha; Boxall, Leigh; Stewart, Jane; James, Martin A; Strain, William David

2016-09-01

Transient ischemic attacks (TIA) and minor strokes are important risk factors for recurrent strokes. Current stroke risk prediction scores such as ABCD2, although widely used, lack optimal sensitivity and specificity. Elevated urinary albumin excretion predicts cardiovascular disease, stroke, and mortality. We explored the role of microalbuminuria (using albumin creatinine ratio (ACR)) in predicting recurrence risk in patients with TIA and minor stroke. Urinary ACR was measured on a spot sample in 150 patients attending a daily stroke clinic with TIA or minor stroke. Patients were followed up at day 7, 30, and 90 to determine recurrent stroke, cardiovascular events, or death. Eligible patients had a carotid ultrasound Doppler investigation. High-risk patients were defined as those who had an event within 90 days or had >50% internal carotid artery (ICA) stenosis. Fourteen (9.8%) recurrent events were reported by day 90 including two deaths. Fifteen patients had severe ICA stenosis. In total, 26 patients were identified as high risk. These patients had a higher frequency of previous stroke or hypercholesterolemia compared to low-risk patients (P = 0.04). ACR was higher in high-risk patients (3.4 [95% CI 2.2-5.2] vs. 1.7 [1.5-2.1] mg/mmol, P = 0.004), independent of age, sex, blood pressure, diabetes, and previous stroke. An ACR greater than 1.5 mg/mmol predicted high-risk patients (Cox proportional hazard ratio 3.5 (95% CI 1.3-9.5, P = 0.01). After TIA or minor stroke, a higher ACR predicted recurrent events and significant ICA stenosis. Incorporation of urinary ACR from a spot sample in the acute setting could improve risk stratification in patients with TIA and minor stroke.

The Danish Prostatic Symptom Score (DAN-PSS-1) questionnaire is reliable in stroke patients

DEFF Research Database (Denmark)

Tibaek, Sigrid; Jensen, Rigmor; Klarskov, Peter

2006-01-01

. The questionnaire consists of 12 questions related to lower urinary tract symptoms (LUTS). The participants were asked to state the frequency and severity of their symptoms (symptom score) and its impact on their daily life (bother score). Seventy-one stroke patients were included and 59 (83%) answered...... the questionnaire twice. The reliability test was done in two aspects: (a) detecting the frequency of each symptom and its bother factor, the scores were reduced to a two-category scale (=0, >0) and simple kappa statistics was used; (b) detecting the severity of each symptom and its bother factor, the total scale...... (kappa(w) = 0.48) to good (kappa(w) = 0.68). CONCLUSIONS: The DAN-PSS-1 questionnaire had acceptable test-retest reliability and may be suitable for measuring the frequency and severity of LUTS and its bother factor in stroke patients....

"EMMA Study: a Brazilian community-based cohort study of stroke mortality and morbidity".

Science.gov (United States)

Goulart, Alessandra Carvalho

2016-01-01

Stroke has a high burden of disability and mortality. The aim here was to evaluate epidemiology, risk factors and prognosis for stroke in the EMMA Study (Study of Stroke Mortality and Morbidity). Prospective community-based cohort carried out in Hospital Universitário, University of São Paulo, 2006-2014. Stroke data based on fatal and non-fatal events were assessed, including sociodemographic data, mortality and predictors, which were evaluated by means of logistic regression and survival analyses. Stroke subtype was better defined in the hospital setting than in the local community. In the hospital phase, around 70% were first events and the ischemic subtype. Among cerebrovascular risk factors, the frequency of alcohol intake was higher in hemorrhagic stroke (HS) than in ischemic stroke (IS) cases (35.4% versus 12.3%, P hemorrhagic stroke was greater than for ischemic stroke and reached its maximum 10 days after the event (OR: 3.31; 95% CI: 1.55-7.05). Four-year survival analysis on 665 cases of first stroke (82.6% ischemic and 17.4% hemorrhagic) showed an overall survival rate of 48%. At four years, the highest risks of death were in relation to ischemic stroke and illiteracy (hazard ratio, HR: 1.83; 95% CI: 1.26-2.68) and diabetes (HR: 1.45; 95% CI: 1.07-1.97). Major depression presented worse one-year survival (HR: 4.60; 95% CI: 1.36-15.55). Over the long term, the EMMA database will provide additional information for planning resources destined for the public healthcare system.

Acute stroke unit improves stroke management-four years on from INASC.

Science.gov (United States)

Shanahan, E; Keenan, R; Cunningham, N; O'Malley, G; O'Connor, M; Lyons, D; Peters, C

2015-02-01

The Irish Heart Foundation carried out the Irish National Audit of Stroke Care (INASC) in 2008. Management practices were significantly poorer than those in the UK Sentinel audits. Since then an acute stroke unit has been established in University Hospital Limerick. A stroke database was established. 12 key indicators of stroke management audited by INASC were identified. Results were compared to those in INASC. 89 stroke patients were admitted. 8 of the 12 key indicators scored significantly better than in INASC. 92.5% had a brain scan within 24hrs (INASC-40%, p = strokes received anti-thrombotics (INASC-85%, p = 0.001). 94% had rehab goals agreed by MDT (22% in INASC p = 0.0000). 55% were treated in stroke unit (2% in INASC, p = 0.0000). MDT input improved with regard to physiotherapy (87% vs 43% in INASC, p = Stroke management has significantly improved from 2008, however some deficiencies remain.

Association of nNOS Gene Polymorphism with Ischemic Stroke in Han Chinese of North China

Directory of Open Access Journals (Sweden)

Yingjie Dai

2013-01-01

Full Text Available Nitric oxide (NO is an important messenger molecule and effector molecule. This study aimed to investigate the relation of neuronal nitric oxide synthase (nNOS gene polymorphism with ischemic stroke in Han Chinese of North China. This was a case-control study. A total of 413 patients with ischemic stroke were recruited from Han Chinese of North China. There were 201 males and 212 females. In addition, 477 healthy subjects served as controls including 224 males and 253 females. Multiplex SNaPshot was employed to detect nNOS gene polymorphism (rs2293050, rs2139733, rs7308402, and rs1483757. Results showed that the rs1483757, rs2139733, and rs2293050 genotypes and allele frequencies were comparable between patients and controls. However, ischemic stroke patients had significantly reduced AG genotype and A allele frequency when compared with controls (P=0.037, P=0.041. After adjusting confounding factors (gender, age, smoking, history of drinking, hypertension, and diabetes, AG genotype and A allele were still related to ischemic stroke (OR=0.572, 95% CI: 0.335–0.978, P=0.041; OR=0.611, 95% C: 0.378–0.985, and P=0.041 and both were found to be protective factors. Our results showed that rs7308402 gene polymorphism of nNOS is related to ischemic stroke in Han Chinese of North China.

Analysis of Relationships between the Level of Errors in Leg and Monofin Movement and Stroke Parameters in Monofin Swimming

Science.gov (United States)

Rejman, Marek

2013-01-01

The aim of this study was to analyze the error structure in propulsive movements with regard to its influence on monofin swimming speed. The random cycles performed by six swimmers were filmed during a progressive test (900m). An objective method to estimate errors committed in the area of angular displacement of the feet and monofin segments was employed. The parameters were compared with a previously described model. Mutual dependences between the level of errors, stroke frequency, stroke length and amplitude in relation to swimming velocity were analyzed. The results showed that proper foot movements and the avoidance of errors, arising at the distal part of the fin, ensure the progression of swimming speed. The individual stroke parameters distribution which consists of optimally increasing stroke frequency to the maximal possible level that enables the stabilization of stroke length leads to the minimization of errors. Identification of key elements in the stroke structure based on the analysis of errors committed should aid in improving monofin swimming technique. Key points The monofin swimming technique was evaluated through the prism of objectively defined errors committed by the swimmers. The dependences between the level of errors, stroke rate, stroke length and amplitude in relation to swimming velocity were analyzed. Optimally increasing stroke rate to the maximal possible level that enables the stabilization of stroke length leads to the minimization of errors. Propriety foot movement and the avoidance of errors arising at the distal part of fin, provide for the progression of swimming speed. The key elements improving monofin swimming technique, based on the analysis of errors committed, were designated. PMID:24149742

Platelet glycoprotein IaC807T polymorphisms and ischemic stroke in young Chinese Han population.

Science.gov (United States)

Zhang, J; Huang, D; Yang, J; An, H; Ojha, R; DU, C; Liu, R

2012-11-01

The objective of this study was to investigate the association between platelet glycoprotein (GP) Ia C807T polymorphisms and ischemic stroke in young Chinese Han Population. We conducted a case-control study in 92 consecutive young (ischemic stroke inpatients and outpatients, 86 elder ischemic stroke control (> 50 years), and 160 age- and sex-matched healthy control. Genotyping of platelet GP Ia C807Tpolymorphisms was performed by polymerase chain reaction followed by sequencing nucleic acid with dideoxy chain-termination method and an ABI PRISM3100 (Perkin-Elmer Co) genetic analyzer. Student's t-test, chi-square test, and logistic regression modeling were used for data significance analyses. Hypertension and smoking were found to be the independent risk factors for ischemic stroke patients (aged ischemic stroke patients (aged > 50 years). There was no significant difference observed in the T allele frequency of GPIa C807T polymorphisms between young stroke patients and corresponding controls. These findings suggest that there is no role of GPIa C807T polymorphisms in the development of young first-ever ischemic stroke in Chinese Han Population.

A Prospective Randomized Study Comparing Manual and Wall Suction in the Performance of Bronchoalveolar Lavage.

Science.gov (United States)

Seijo, Luis M; Flandes, Javier; Somiedo, Maria V; Naya, Alba; Manjón, Josefina; Álvarez, Susana; Fernández-Navamuel, Iker

2016-01-01

Bronchoalveolar lavage (BAL) may be performed using a hand-held syringe or wall suction. The aim was to study BAL volume and diagnostic yields based on BAL technique. A total of 220 consecutive patients undergoing BAL at our center were included. Manual aspiration was performed in 115 patients (group 1), and wall suction (<50 mm Hg of negative pressure) was used in 105 patients (group 2). All bronchoscopies were performed under conscious sedation applying topical anesthesia with lidocaine. Three 50-ml sterile saline aliquots were instilled in all patients. The mean total amount of fluid recovered was 67 ± 20 ml in group 1 and 55 ± 22 ml in group 2 (p < 0.001). More patients in the manual aspiration group met American Thoracic Society criteria (recovery of ≥30% of instilled fluid) for an optimal BAL (81 vs. 59%; p < 0.001). The quantity of recovered fluid was also related to BAL location (p < 0.001) and radiologic findings (p = 0.002). Forty-eight (22%) BALs were diagnostic (23 in group 1 and 25 in group 2), including 37 positive bacterial cultures, 6 positive stains for Pneumocystis, and 5 cases of malignancy. No statistically significant difference in diagnostic yield was observed between the two groups. A BAL diagnosis was more likely in patients with certain radiologic (p = 0.033) and endoscopic findings (p = 0.001). When taking into account all bronchoscopic techniques performed during the procedure (e.g. biopsies, brushing, etc.), bronchoscopy was diagnostic in 37% of patients. Manual aspiration is superior to wall suction during BAL yielding a larger quantity of aspirate. Diagnostic yields are similar for both techniques. © 2016 S. Karger AG, Basel.

Measuring of vertical stroke Vub vertical stroke in the forthcoming decade

International Nuclear Information System (INIS)

Kim, C.S.

1997-01-01

I first introduce the importance of measuring V ub precisely. Then, from a theoretician's point of view, I review (a) past history, (b) present trials, and (c) possible future alternatives on measuring vertical stroke V ub vertical stroke and/or vertical stroke V ub /V cb vertical stroke. As of my main topic, I introduce a model-independent method, which predicts Γ(B→X u lν)/Γ(B→X c lν)≡(γ u /γ c ) x vertical stroke V ub /V cb vertical stroke 2 ≅(1.83±0.28) x vertical stroke V ub /V cb vertical stroke 2 and vertical stroke V ub /V cb vertical stroke ≡(γ c /γ u ) 1/2 x [B(B→X u lν)/B(B→ X c lν]) 1/2 ≅(0.74±0.06) x [B(B→X u lν/)B(B→X c lν)] 1/2 , based on the heavy quark effective theory I also explore the possible experimental options to separate B→X u lν from the dominant B→X c lν: the measurement of inclusive hadronic invariant mass distributions, and the 'D-π' (and 'K-π') separation conditions I also clarify the relevant experimental backgrounds. (orig.)

Stroke

Science.gov (United States)

... doctor Preventing falls Stroke - discharge Swallowing problems Images Brain Carotid stenosis, x-ray of the left artery Carotid stenosis, x-ray of the right artery Stroke Brainstem function Cerebellum - function Circle of Willis Left cerebral hemisphere - ...

Stroke prevention in atrial fibrillation: findings from Tuscan FADOI Stroke Registry

Directory of Open Access Journals (Sweden)

Luca Masotti

2014-06-01

Full Text Available Despite vitamin K antagonists (VKAs are considered the first choice treatment for stroke prevention in atrial fibrillation (AF, literature shows their underuse in this context. Since data about VKAs use prior and after acute stroke lack, the aim of this study was to focus on management of anticoagulation with VKAs in this context. Data were retrieved from Tuscan FADOI Stroke Registry, an online data bank aimed to report on characteristics of stroke patients consecutively admitted in Internal Medicine wards in 2010 and 2011. In this period 819 patients with mean age 76.5±12.3 years were enrolled. Data on etiology were available for 715 of them (88.1%, 87% being ischemic and 13% hemorrhagic strokes. AF was present in 238 patients (33%, 165 (69.3% having a known AF before hospitalization, whereas 73 patients (31.7% received a new diagnosis of AF. A percentage of 89% of strokes in patients with known AF were ischemic and 11% hemorrhagic. A percentage of 86.7% of patients with known AF had a CHADS2 ≥2, but only 28.3% were on VKAs before hospitalization. A percentage of 78.8% of patients treated with VKAs before stroke had an international normalized ratio (INR ≤2.0; 68.7% of patients with VKAs-related hemorrhagic strokes had INR ≤3.0. Combined endpoint mortality or severe disability in patients with ischemic stroke associated with AF was present in 47%, while it was present in 19.30% and 19.20% of atherothrombotic and lacunar strokes, respectively. At hospital discharge, VKAs were prescribed in 25.9% of AF related ischemic stroke patients. AF related strokes are burdened by severe outcome but VKAs are dramatically underused in patients with AF, even in higher risk patients. Efforts to improve anticoagulation in this stroke subtype are warranted.

Hydrodynamic interactions in metachronal paddling: effects of varying stroke kinematics

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Samaee, Milad; Kasoju, Vishwa; Lai, Hong Kuan; Santhanakrishnan, Arvind

2017-11-01

Crustaceans such as shrimp and krill use a drag-based technique for propulsion, in which multiple pairs of limbs are paddled rhythmically from the tail to the head. Each limb is phase-shifted in time relative to its neighbor. Most studies of this type of metachronal swimming have focused on the jet formed in the animal's wake. However, synergistic hydrodynamic interactions between adjacent limbs in metachrony have received minimal attention. We used a dynamically scaled robotic model to experimentally investigate how variations in stroke kinematics impact inter-paddle hydrodynamic interactions and thrust generation. Physical models of limbs were fitted to the robot and paddled with two different motion profiles (MPs)-1) MP1: metachronal power stroke (PS) and metachronal recovery stroke (RS); and 2) MP2: metachronal PS and synchronous RS. Stroke frequency and amplitude were maintained constant across both MPs. Our results show that MP2 produced faster jets in the thrust-generating direction as compared to MP1. The necessity for a pause in MP2 after completion of PS by the paddles leading the motion, prior to executing the synchronous RS, aided in further downstream flow propagation. The effect of using asymmetric stroke kinematics on thrust generated will be discussed.

Adherence to a Healthy Nordic Diet and Risk of Stroke: A Danish Cohort Study.

Science.gov (United States)

Hansen, Camilla Plambeck; Overvad, Kim; Kyrø, Cecilie; Olsen, Anja; Tjønneland, Anne; Johnsen, Søren Paaske; Jakobsen, Marianne Uhre; Dahm, Christina Catherine

2017-02-01

Specific dietary patterns, including the Mediterranean diet, have been associated with stroke prevention. Our aim was to investigate whether adherence to a healthy Nordic diet, including fish, apples and pears, cabbages, root vegetables, rye bread, and oatmeal, was associated with risk of stroke. Incident cases of stroke among 55 338 men and women from the Danish Diet, Cancer and Health cohort were identified from the Danish National Patient Register and verified by review of records. Cases of ischemic stroke were further subclassified based on etiology according to the TOAST classification system (Trial of Org 10172 in Acute Stroke Treatment). Information on diet was collected at baseline (1993-1997) using a semiquantitative food-frequency questionnaire. Cox proportional hazards models were used to estimate hazards ratios of total stroke and subtypes of ischemic and hemorrhagic stroke. During a median follow-up of 13.5 years, 2283 cases of incident stroke were verified, including 1879 ischemic strokes. Adherence to a healthy Nordic diet, as reflected by a higher Healthy Nordic Food Index score, was associated with a lower risk of stroke. The hazards ratio comparing an index score of 4 to 6 (high adherence) with an index score of 0 to 1 (low adherence) was 0.86 (95% confidence interval 0.76-0.98) for total stroke. Inverse associations were observed for ischemic stroke, including large-artery atherosclerosis. No trend was observed for hemorrhagic stroke; however, a statistically insignificant trend was observed for intracerebral hemorrhage. Our findings suggest that a healthy Nordic diet may be recommended for the prevention of stroke. © 2017 American Heart Association, Inc.

Stroke in Saudi children

International Nuclear Information System (INIS)

Salih, Mustafa A.; Al-Jarallah, Ahmed A.; Kentab, Anal Y.; Al-Nasser, Mohammad N.; Bahakim, Hassan M.; Kurban, Khadija M.; Zahraa, Jihad N.; Nasir, Ali A.; Abdel-Gader, Abdel-Galil M.; Alorainy, Ibrahim A.; Hassan, Hamdy H.; Kabiraj, Mohammad M.; Khoja, Waleed A.

2006-01-01

To describe the epidemiology and clinical features of stroke in a prospective and retrospective cohort of Saudi children and ascertain the causes, pathogenesis, and risk factors. The Retrospective Study Group (RSG) included children with stroke who were evaluated at the Division of Pediatric Neurology, or admitted to King Khalid University Hospital, College of Medicine, King Saud University, Riyadh, Kingdom of Saudi Arabia during the period July 1992 to February 2001. The Prospective Study Group (PSG) included those seen between February 2001 and March 2003. During the combined study periods of 10 years and 7 months, 117 children (61 males and 56 females, aged one month-12 years) were evaluated; the majority (89%) of these were Saudis. The calculated annual hospital frequency rate of stroke was 27.1/100,000 of the pediatric (1month-12 years) population The mean age at onset of the initial stroke in the 104 Saudi children was 27.1 months (SD=39.3 months) median and median was 6 months. Ischemic strokes accounted for the majority of cases (76%). Large-vessel infarcts (LVI, 51.9%) were more common than small-vessel lacunar lesions (SVLL, 19.2%). Five patients (4.8%) had combined LVI and SVLL. Intracranial hemorrhage was less common (18.2%), whereas sinovenous thrombosis was diagnosed in 6 (5.8%) patients. A major risk factor was identified in 94 of 104 (89.4%) Saudi children. Significantly more hematologic disorders and coagulopathies were identified in the PSG compared to the RSG (p=0.001), reflecting a better yield following introduction of more comprehensive hematologic and cogulation laboratory tests during the prospective study period. Hematologic disorders were the most common risk factor (46.2%); presumed perinatal ischemic cerebral injury was risk factor in 23 children (22.1) and infectious and inflammatory disorders of the circulatory system in 18 (17.3%). Congenital and genetic cerebrovascular anomalies were the underlying cause in 7 patients (6.7%) and

Acute stroke unit improves stroke management-four years on from INASC.

LENUS (Irish Health Repository)

Shanahan, E

2015-02-01

The Irish Heart Foundation carried out the Irish National Audit of Stroke Care (INASC) in 2008. Management practices were significantly poorer than those in the UK Sentinel audits. Since then an acute stroke unit has been established in University Hospital Limerick. A stroke database was established. 12 key indicators of stroke management audited by INASC were identified. Results were compared to those in INASC. 89 stroke patients were admitted. 8 of the 12 key indicators scored significantly better than in INASC. 92.5% had a brain scan within 24hrs (INASC-40%, p = < 0.001). 100% of ischaemic strokes received anti-thrombotics (INASC-85%, p = 0.001). 94% had rehab goals agreed by MDT (22% in INASC p = 0.0000). 55% were treated in stroke unit (2% in INASC, p = 0.0000). MDT input improved with regard to physiotherapy (87% vs 43% in INASC, p = < 0.02) and SALT (74% vs 26%, p = < 0.02). Stroke management has significantly improved from 2008, however some deficiencies remain.

Stroke scale score and early prediction of outcome after stroke

International Nuclear Information System (INIS)

Ahmed, R.; Zuberi, F.Z.; Afsar, S.

2004-01-01

Objective: To evaluate the baseline National Institute of Health Stroke Scale (NIHSS) score as a predictor of functional outcome after ischemic stroke. Subjects and Methods: The study included 50 patients who presented to Civil Hospital, Karachi, during the study period with acute stroke and were evaluated with CT scan of brain. Only those patients were enrolled in the study that had acute ischemic stroke. The enrolled subjects were then evaluated for the neurological impairment using National Institute of Health Stroke Scale (NIHSS). The subjects were followed-up and their functional outcome was assessed using Barthel index (BI) on the 7th day of their admission. Results: Of the fifty patients enrolled in the study, 31 (62%) were males and 19 (38%) were females, with age ranging from 45 years to 95 years and a mean age of 59.9 years. Neurological impairment at presentation was assessed by NIHSS. The score ranged between 2 and 28. The functional outcome was evaluated on the 7th day using Barthel index (BI), which ranged from 0 to 80. NIHSS score was found to be a good predictor of functional outcome in patients with ischemic stroke (p<0.001). Other factors like gender, hypertension and heart disease did not affect the functional recovery in such patients. Various factors were found to be significant for early prediction of stroke recovery. The NIHSS score was the strongest predictor of outcome after ischemic stroke. Age at the time of the event was also found to be an important predictor for stroke recovery. Conclusion: The NIHSS score is a good predictor of patient's recovery after stroke. Assessing the patient's neurological impairment at first presentation of ischemic stroke can guide the physician regarding the prognosis and management plan. (author)

Does use of the recognition of stroke in the emergency room stroke assessment tool enhance stroke recognition by ambulance clinicians?

Science.gov (United States)

Fothergill, Rachael T; Williams, Julia; Edwards, Melanie J; Russell, Ian T; Gompertz, Patrick

2013-11-01

U.K ambulance services assess patients with suspected stroke using the Face Arm Speech Test (FAST). The Recognition Of Stroke In the Emergency Room (ROSIER) tool has been shown superior to the FAST in identifying strokes in emergency departments but has not previously been tested in the ambulance setting. We investigated whether ROSIER use by ambulance clinicians can improve stroke recognition. Ambulance clinicians used the ROSIER in place of the FAST to assess patients with suspected stroke. As the ROSIER includes all FAST elements, we calculated a FAST score from the ROSIER to enable comparisons between the two tools. Ambulance clinicians' provisional stroke diagnoses using the ROSIER and calculated FAST were compared with stroke consultants' diagnosis. We used stepwise logistic regression to compare the contribution of individual ROSIER and FAST items and patient demographics to the prediction of consultants' diagnoses. Sixty-four percent of strokes and 78% of nonstrokes identified by ambulance clinicians using the ROSIER were subsequently confirmed by a stroke consultant. There was no difference in the proportion of strokes correctly detected by the ROSIER or FAST with both displaying excellent levels of sensitivity. The ROSIER detected marginally more nonstroke cases than the FAST, but both demonstrated poor specificity. Facial weakness, arm weakness, seizure activity, age, and sex predicted consultants' diagnosis of stroke. The ROSIER was not better than the FAST for prehospital recognition of stroke. A revised version of the FAST incorporating assessment of seizure activity may improve stroke identification and decision making by ambulance clinicians.

Holmes' tremor as a delayed complication of thalamic stroke.

Science.gov (United States)

Martins, William Alves; Marrone, Luiz Carlos Porcello; Fussiger, Helena; Vedana, Viviane Maria; Cristovam, Rafael do Amaral; Taietti, Marjorye Z; Marrone, Antonio Carlos Huf

2016-04-01

Movement disorders are not commonly associated with stroke. Accordingly, thalamic strokes have rarely been associated with tremor, pseudo-athetosis and dystonic postures. We present a 75-year-old man who developed a disabling tremor 1 year after a posterolateral thalamic stroke. This tremor had low frequency (3-4 Hz), did not disappear on focus and was exacerbated by maintaining a static posture and on target pursuit, which made it very difficult to perform basic functions. MRI demonstrated an old ischemic lesion at the left posterolateral thalamus. Treatment with levodopa led to symptom control. Lesions in the midbrain, cerebellum and thalamus may cause Holmes' tremor. Delayed onset of symptoms is usually seen, sometimes appearing 2 years after the original injury. This may be due to maturation of a complex neuronal network, leading to slow dopaminergic denervation. Further studies are needed to improve our understanding of this unique disconnection syndrome. Copyright © 2015 Elsevier Ltd. All rights reserved.

Effect of Chinese herbal medicine on stroke patients with type 2 diabetes.

Science.gov (United States)

Tsai, Fuu-Jen; Ho, Tsung-Jung; Cheng, Chi-Fung; Liu, Xiang; Tsang, Hsinyi; Lin, Ting-Hsu; Liao, Chiu-Chu; Huang, Shao-Mei; Li, Ju-Pi; Lin, Cheng-Wen; Lin, Jaung-Geng; Lin, Jung-Chun; Lin, Chih-Chien; Liang, Wen-Miin; Lin, Ying-Ju

2017-03-22

Complications of type 2 diabetes (T2D) include stroke, which is a cerebrovascular disturbance characterized by reduced blood flow in the brain, leading to death or physical disability. Chinese herbal medicine (CHM) has been widely used in ancient China for the treatment of diabetes and stroke by supplementing Qi and activating blood circulation. This study aimed to investigate the frequencies and patterns of CHM treatment for stroke patients with T2D and the outcomes of long-term use in Taiwan. We identified 3079 stroke patients (ICD-9-CM: 430-438) with T2D. We allocated 618 stroke patients, matched for age, gender, and T2D-to-stroke duration, to both CHM and non-CHM groups. Chi-square test, conditional multivariable logistic regression, Kaplan-Meier method, and the log-rank test were used in this study. The CHM group was characterized by more cases of chronic obstructive pulmonary disease, ulcer disease, hyperlipidemia, tobacco use, and higher income. The cumulative survival probability was higher in the CHM group (Pherbs, respectively. The use of CHM as adjunctive therapy may improve the overall survival (OS) of stroke patients with T2D. The list of the comprehensive herbal medicines that they used might be useful in future large-scale, randomized clinical investigations of agent effectiveness, safety, and potential interactions with conventional treatments in stroke patients with T2D. Copyright © 2017 Elsevier Ireland Ltd. All rights reserved.

The Relationship between Stroke Patients Characteristics and Family Support with Compliance Rehabilitation

Directory of Open Access Journals (Sweden)

Irma Okta Wardhani

2015-01-01

Full Text Available Stroke is a cerebrovascular disease, it is brain function disorders associated with the disease of the blood vessels that supply the brain. The impact of stroke is paralysis. Family support is things that are needed to be considered in the treatment of stroke patients. It is very involved in the compliance rehabilitation of patients to prevent the re-occurrence of stroke. Characteristics of stroke patients may also affect the compliance rehabilitation. The purpose of this research is to determine the relationship between stroke patients characteristics and family support to compliance rehabilitation at the Medical Rehabilitation Unit RSU Haji Surabaya. This research was an analytic observational research with cross sectional design. The subjects of this research are taken using total population technique. The independent variables in this research is family support. The dependent variable is compliance rehabilitation. The results of this research are presented in the form of frequency distributions and calculate the strength of the relationship with Phi coefficient. The result of this research shows that there is a strong relationship between family support and compliance rehabilitation (r=0.582. There are weak relationship between ages (r=-0,027, gender (r=0,092, level of education (r= -0,295, work (r=0,098, and marital status (r=0,319. The conclusion is family support may affect compliance rehabilitation of stroke patients. It is recommended for health workers to provide counseling to improve family support in curing stroke patients. Keywords: depression, family support, compliance rehabilitation

Antihypertensive treatment and stroke prevention: are angiotensin receptor blockers superior to other antihypertensive agents?

Science.gov (United States)

Armario, Pedro; de la Sierra, Alejandro

2009-06-01

Stroke remains a common vascular event with high mortality and morbidity. After heart disease, stroke is the second leading cause of death worldwide in adult persons. Silent or subclinical stroke is likely to occur with even greater frequency than clinical stroke and increases the risk of subsequent cerebrovascular events. Hypertension is by far the single most important controllable risk factor for stroke. The relationship between blood pressure (BP) and stroke mortality is strong, linear, and continuous in subjects with levels of BP higher than 115/75 mm Hg. Blood pressure reduction by antihypertensive treatment is clearly efficacious in the prevention of stroke (both primary and secondary). Although meta-analyses suggest that BP reduction, per se, is the most important determinant for stroke risk reduction, the question is if specific classes of antihypertensive drugs offer special protection against stroke is still controversial. Some studies have suggested that angiotensin receptors blockers (ARBs) appear to offer additional protection against stroke. This has been hypothesized in studies in hypertensives, such as LIFE and SCOPE, and especially in the only comparative trial focused on secondary stroke prevention. In the MOSES trial, the comparison of eprosartan versus nitrendipine in patients with a previous stroke resulted, despite a similar BP reduction, in a significant reduction in the primary composite endpoint of total mortality plus cardiovascular and cerebrovascular events, including recurrent events. These results may suggest a blood pressure-independent effect of ARBs, which can be mediated through several mechanisms, including their ability to counteract other markers of target organ damage, but also through a direct neuroprotective effect.

Dispersion of suspended material from an operating sand suction dredge in the Øresund (Denmark)

DEFF Research Database (Denmark)

Kiørboe, Thomas; Møhlenberg, F.

1981-01-01

The concentration of suspended material in the immediate vicinity of an operating sand suction dredge in the Oresund was 3-5000mg/l. Concentrations > 100 mg/l were restricted to a downstream distance of .apprx. 150m and ambient levels were reached within .apprx. 1 km of the dredge. The natural...

Capillary Suction Time. Operational Control Tests for Wastewater Treatment Facilities. Instructor's Manual [and] Student Workbook.

Science.gov (United States)

Wooley, John F.

Capillary suction time is time required for the liquid phase of a treated sludge to travel through 1 centimeter of media (blotter or filter paper). Designed for individuals who have completed National Pollutant Discharge Elimination System (NPDES) level 1 laboratory training skills, this module provides waste water treatment plant operators with…

Potential risk for bacterial contamination in conventional reused ventilator systems and disposable closed ventilator-suction systems.

Science.gov (United States)

Li, Ya-Chi; Lin, Hui-Ling; Liao, Fang-Chun; Wang, Sing-Siang; Chang, Hsiu-Chu; Hsu, Hung-Fu; Chen, Sue-Hsien; Wan, Gwo-Hwa

2018-01-01

Few studies have investigated the difference in bacterial contamination between conventional reused ventilator systems and disposable closed ventilator-suction systems. The aim of this study was to investigate the bacterial contamination rates of the reused and disposable ventilator systems, and the association between system disconnection and bacterial contamination of ventilator systems. The enrolled intubated and mechanically ventilated patients used a conventional reused ventilator system and a disposable closed ventilator-suction system, respectively, for a week; specimens were then collected from the ventilator circuit systems to evaluate human and environmental bacterial contamination. The sputum specimens from patients were also analyzed in this study. The detection rate of bacteria in the conventional reused ventilator system was substantially higher than that in the disposable ventilator system. The inspiratory and expiratory limbs of the disposable closed ventilator-suction system had higher bacterial concentrations than the conventional reused ventilator system. The bacterial concentration in the heated humidifier of the reused ventilator system was significantly higher than that in the disposable ventilator system. Positive associations existed among the bacterial concentrations at different locations in the reused and disposable ventilator systems, respectively. The predominant bacteria identified in the reused and disposable ventilator systems included Acinetobacter spp., Bacillus cereus, Elizabethkingia spp., Pseudomonas spp., and Stenotrophomonas (Xan) maltophilia. Both the reused and disposable ventilator systems had high bacterial contamination rates after one week of use. Disconnection of the ventilator systems should be avoided during system operation to decrease the risks of environmental pollution and human exposure, especially for the disposable ventilator system. ClinicalTrials.gov PRS / NCT03359148.

Neuroanatomic correlates of stroke-related myocardial injury.

Science.gov (United States)

Ay, H; Koroshetz, W J; Benner, T; Vangel, M G; Melinosky, C; Arsava, E M; Ayata, C; Zhu, M; Schwamm, L H; Sorensen, A G

2006-05-09

Myocardial injury can occur after ischemic stroke in the absence of primary cardiac causes. The neuroanatomic basis of stroke-related myocardial injury is not well understood. To identify regions of brain infarction associated with myocardial injury using a method free of the bias of an a priori hypothesis as to any specific location. Of 738 consecutive patients with acute ischemic stroke, the authors identified 50 patients in whom serum cardiac troponin T (cTnT) elevation occurred in the absence of any apparent cause within 3 days of symptom onset. Fifty randomly selected, age- and sex-matched patients with ischemic stroke without cTnT elevation served as controls. Diffusion-weighted images with outlines of infarction were co-registered to a template, averaged, and then subtracted to find voxels that differed between the two groups. Voxel-wise p values were determined using a nonparametric permutation test to identify specific regions of infarction that were associated with cTnT elevation. The study groups were well balanced with respect to stroke risk factors, history of coronary artery disease, infarction volume, and frequency of right and left middle cerebral artery territory involvement. Brain regions that were a priori associated with cTnT elevation included the right posterior, superior, and medial insula and the right inferior parietal lobule. Among patients with right middle cerebral artery infarction, the insular cluster was involved in 88% of patients with and 33% without cTnT elevation (odds ratio: 15.00; 95% CI: 2.65 to 84.79). Infarctions in specific brain regions including the right insula are associated with elevated serum cardiac troponin T level indicative of myocardial injury.

Anxiety After Stroke: The Importance of Subtyping.

Science.gov (United States)

Chun, Ho-Yan Yvonne; Whiteley, William N; Dennis, Martin S; Mead, Gillian E; Carson, Alan J

2018-03-01

Anxiety after stroke is common and disabling. Stroke trialists have treated anxiety as a homogenous condition, and intervention studies have followed suit, neglecting the different treatment approaches for phobic and generalized anxiety. Using diagnostic psychiatric interviews, we aimed to report the frequency of phobic and generalized anxiety, phobic avoidance, predictors of anxiety, and patient outcomes at 3 months poststroke/transient ischemic attack. We followed prospectively a cohort of new diagnosis of stroke/transient ischemic attack at 3 months with a telephone semistructured psychiatric interview, Fear Questionnaire, modified Rankin Scale, EuroQol-5D5L, and Work and Social Adjustment Scale. Anxiety disorder was common (any anxiety disorder, 38 of 175 [22%]). Phobic disorder was the predominant anxiety subtype: phobic disorder only, 18 of 175 (10%); phobic and generalized anxiety disorder, 13 of 175 (7%); and generalized anxiety disorder only, 7 of 175 (4%). Participants with anxiety disorder reported higher level of phobic avoidance across all situations on the Fear Questionnaire. Younger age (per decade increase in odds ratio, 0.64; 95% confidence interval, 0.45-0.91) and having previous anxiety/depression (odds ratio, 4.38; 95% confidence interval, 1.94-9.89) were predictors for anxiety poststroke/transient ischemic attack. Participants with anxiety disorder were more dependent (modified Rankin Scale score 3-5, [anxiety] 55% versus [no anxiety] 29%; P anxiety] 19.5, 10-27 versus [no anxiety] 0, 0-5; P Anxiety after stroke/transient ischemic attack is predominantly phobic and is associated with poorer patient outcomes. Trials of anxiety intervention in stroke should consider the different treatment approaches needed for phobic and generalized anxiety. © 2018 The Authors.

Blood markers of coagulation, fibrinolysis, endothelial dysfunction and inflammation in lacunar stroke versus non-lacunar stroke and non-stroke: systematic review and meta-analysis.

Science.gov (United States)

Wiseman, Stewart; Marlborough, Fergal; Doubal, Fergus; Webb, David J; Wardlaw, Joanna

2014-01-01

The cause of cerebral small vessel disease is not fully understood, yet it is important, accounting for about 25% of all strokes. It also increases the risk of having another stroke and contributes to about 40% of dementias. Various processes have been implicated, including microatheroma, endothelial dysfunction and inflammation. A previous review investigated endothelial dysfunction in lacunar stroke versus mostly non-stroke controls while another looked at markers of inflammation and endothelial damage in ischaemic stroke in general. We have focused on blood markers between clinically evident lacunar stroke and other subtypes of ischaemic stroke, thereby controlling for stroke in general. We systematically assessed the literature for studies comparing blood markers of coagulation, fibrinolysis, endothelial dysfunction and inflammation in lacunar stroke versus non-stroke controls or other ischaemic stroke subtypes. We assessed the quality of included papers and meta-analysed results. We split the analysis on time of blood draw in relation to the stroke. We identified 1,468 full papers of which 42 were eligible for inclusion, including 4,816 ischaemic strokes, of which 2,196 were lacunar and 2,500 non-stroke controls. Most studies subtyped stroke using TOAST. The definition of lacunar stroke varied between studies. Markers of coagulation/fibrinolysis (tissue plasminogen activator (tPA), plasminogen activator inhibitor (PAI), fibrinogen, D-dimer) were higher in lacunar stroke versus non-stroke although fibrinogen was no different to non-stroke in the acute phase. tPA and PAI were no different between lacunar and non-lacunar stroke. Fibrinogen and D-dimer were significantly lower in lacunar stroke compared to other ischaemic strokes, both acutely and chronically. Markers of endothelial dysfunction (homocysteine, von Willebrand Factor (vWF), E-selectin, P-selectin, intercellular adhesion molecule-1 (ICAM), vascular cellular adhesion molecule-1 (VCAM)) were higher or

Management Of Post Stroke Seizures

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Kavian Ghandehari

2017-02-01

Full Text Available The incidence of seizures in relation to stroke is 8.9%, with a frequency of 10.6 and 8.6% in haemorrhagic and ischaemic stroke, respectively. In subarachnoid haemorrhage the incidence is 8.5%. Due to the fact that infarcts are significantly more frequent than haemorrhages, seizures are mainly related to occlusive vascular disease of the brain. The general view is to consider stroke-related seizures as harmless complications in the course of a prolonged vascular disease involving the heart and brain. Seizures can be classified as those of early and those of late onset in a paradigm comparable to post-traumatic epilepsy, with an arbitrary dividing point of two weeks after the event. Most early-onset seizures occur during the first day after the stroke. Late-onset seizures occur three times more often than early-onset ones. A first late-onset epileptic event is most likely to take place between six months and two years after the stroke. However, up to 28% of patients develop their first seizure several years later. Simple partial seizures, with or without secondary generalisation, account for about 50% of total seizures, while complex partial spells, with or without secondary generalisation, and primary generalised tonic–clonic insults account for approximately 25% each. Status epilepticus occurs in 12% of stroke patients, but the recurrence rate after an initial status epilepticus is not higher than after a single seizure. Inhibitory seizures, mimicking transient ischaemic attacks, are observed in 7.1% of cases. The only clinical predictor of late-onset seizures is the initial presentation of partial anterior circulation syndrome due to a territorial infarct. Patients with total anterior circulation syndrome have less chance of developing epileptic spells, not only due to their shorter life expectancy but also due to the fact that the large infarcts are sharply demarcated in these patients. The optimal timing and type of antiepileptic drug

Spontaneous low-frequency oscillations in cerebral vessels

DEFF Research Database (Denmark)

Schytz, Henrik W; Hansson, Andreas; Phillip, Dorte

2010-01-01

). Analysis of CA by measurement of spontaneous oscillations in the low-frequency spectrum in cerebral vessels might be a useful tool for assessing risk and investigating different treatment strategies in carotid artery disease (CAD) and stroke. We reviewed studies exploring spontaneous oscillations...

Organizational issues in stroke treatment: The Swiss paradigm - Stroke units

Directory of Open Access Journals (Sweden)

Georgios K Matis

2013-01-01

Full Text Available Stroke represents the leading cause of acquired disability in adults and poses a tremendous socioeconomic burden both on patients and the society. In this sense, prompt diagnosis and urgent treatment are needed in order to radically reduce the devastating consequences of this disease. Herein the authors present the new guidelines recently adopted by the Swiss Stroke Society concerning the establishment of stroke units. Standardized treatment and allocation protocols along with an acute rehabilitation concept seem to be the core of the Swiss stroke management system. Coordinated multidisciplinary care provided by specialized medical, nursing and therapy staff is of utmost importance for achieving a significant dependency and death reduction. It is believed that the implementation of these guidelines in the stroke care system would be beneficial not only for the stroke patients, but also for the health system.

In vivo bioimpedance measurement of healthy and ischaemic rat brain: implications for stroke imaging using electrical impedance tomography

International Nuclear Information System (INIS)

Dowrick, T; Blochet, C; Holder, D

2015-01-01

In order to facilitate the imaging of haemorrhagic and ischaemic stroke using frequency difference electrical impedance tomography (EIT), impedance measurements of normal and ischaemic brain, and clotted blood during haemorrhage, were gathered using a four-terminal technique in an in vivo animal model, a first for ischaemic measurements. Differences of 5–10% in impedance were seen between the frequency spectrums of healthy and ischaemic brain, over the frequency range 0–3 kHz, while the spectrum of blood was predominately uniform. The implications of imaging blood/ischaemia in the brain using electrical impedance tomography are discussed, supporting the notion that it will be possible to differentiate stroke from haemorrhage. (paper)

Lower uric acid is associated with poor short-term outcome and a higher frequency of posterior arterial involvement in ischemic stroke.

Science.gov (United States)

Liu, Hanxiang; Reynolds, Gavin P; Wang, Wenmin; Wei, Xianwen

2018-03-06

Uric acid has neuroprotective properties in experimental and clinical studies of neurodegenerative disease. It is, however, associated with increased risk of stroke, yet, despite some inconsistent findings, increasing evidence suggests it may also be related to improved stroke outcomes. We have determined whether there is an effect of plasma uric acid on the short-term outcome of stroke patients in a general hospital setting using the modified Rankin Scale (mRS). We also investigated the relationship of uric acid with other clinical correlates. Plasma uric acid was determined in 108 acute ischemic stroke patients and their mRS scores measured. Patients with a poor outcome (mRS > 2) had significantly lower uric acid than those with a better outcome; this remained after correcting for the effect of sex on uric acid concentrations. There was no significant association with other epidemiological factors or with cognitive function determined by Mini-Mental State Examination. An association between uric acid and the cerebral circulation was also found in which lower uric acid occurs with posterior artery involvement. These findings demonstrate in a naturalistic cohort of patients the association of uric acid with short-term disability following ischemic stroke. They also raise the question of whether uric acid may influence the regional brain involvement in stroke.

Numerical simulation of effects of a non-ionized fluid injection and suction on the MHD flow in a circular channel

International Nuclear Information System (INIS)

Rahimi Eosboee, M.; Pourmahmoud, N.; Mirzaie, I.; Mohajeri Khameneh, P.; Majidyfar, S.

2012-01-01

Control of a fluid flow velocity profile by injection and suction of a non-ionized fluid in presence of a uniform steady magnetic field has important technical applications. In this paper, the unsteady incompressible and viscous conducting fluid flow has been investigated in a circular channel. The channel walls are assumed to be non-conducting and porous. They are subjected to a uniform steady magnetic field which is perpendicular to the axis of channel, then and suction and injection are applied at the walls. The well known equations of Magnetohydrodynamics are governed to the motion of an electrically conducting fluid flow that is subjected to magnetic field. The numerical solution is carried out by finite difference approach. The results of present numerical simulation shown that the flow injection and suction through the wall can be controlled effectively, the main flow in channel especially in industrial purposes. The results are obtained for different values of the injected and sucked non-ionized flow rate and the effect of Hartman number on the velocity profile is investigated. Finally, a good agreement is seen between the presented results and the corresponding data of finite element method.

A call for formal telemedicine training during stroke fellowship

Science.gov (United States)

Jia, Judy; Gildersleeve, Kasey; Ankrom, Christy; Cai, Chunyan; Rahbar, Mohammad; Savitz, Sean I.; Wu, Tzu-Ching

2016-01-01

During the 20 years since US Food and Drug Administration approval of IV tissue plasminogen activator for acute ischemic stroke, vascular neurology consultation via telemedicine has contributed to an increased frequency of IV tissue plasminogen activator administration and broadened geographic access to the drug. Nevertheless, a growing demand for acute stroke coverage persists, with the greatest disparity found in rural communities underserved by neurologists. To provide efficient and consistent acute care, formal training in telemedicine during neurovascular fellowship is warranted. Herein, we describe our experiences incorporating telestroke into the vascular neurology fellowship curriculum and propose recommendations on integrating formal telemedicine training into the Accreditation Council for Graduate Medical Education vascular neurology fellowship. PMID:27016522

Stroke survivors' endorsement of a "stress belief model" of stroke prevention predicts control of risk factors for recurrent stroke.

Science.gov (United States)

Phillips, L Alison; Tuhrim, Stanley; Kronish, Ian M; Horowitz, Carol R

2014-01-01

Perceptions that stress causes and stress-reduction controls hypertension have been associated with poorer blood pressure (BP) control in hypertension populations. The current study investigated these "stress-model perceptions" in stroke survivors regarding prevention of recurrent stroke and the influence of these perceptions on patients' stroke risk factor control. Stroke and transient ischemic attack survivors (N=600) participated in an in-person interview in which they were asked about their beliefs regarding control of future stroke; BP and cholesterol were measured directly after the interview. Counter to expectations, patients who endorsed a "stress-model" but not a "medication-model" of stroke prevention were in better control of their stroke risk factors (BP and cholesterol) than those who endorsed a medication-model but not a stress-model of stroke prevention (OR for poor control=.54, Wald statistic=6.07, p=.01). This result was not explained by between group differences in patients' reported medication adherence. The results have implications for theory and practice, regarding the role of stress belief models and acute cardiac events, compared to chronic hypertension.

What about self-management post-stroke? Challenges for stroke survivors, spouses and professionals

NARCIS (Netherlands)

Satink, A.J.H.

2016-01-01

Self-management post-stroke is challenging for many persons after a stroke. In this thesis is explored how stroke survivors, spouses and professionals perceived self-management post-stroke and how the process of self-management post-stroke evolved over time. The following studies are conducted: a

Stroke among young adults at the LAUTECH Teaching Hospital, Osogbo, Nigeria.

Science.gov (United States)

Mustapha, A F; Sanya, E O; Bello, T O

2012-01-01

Stroke in young adults is relatively rare and there are very few hospital reports about it in Nigeria. The aetiologic mechanisms of stoke among young adults are quite distinct from those of the adults' populations. The purpose of this retrospective study was to determine the frequency, aetiologic mechanisms and prognosis of stroke among young adults at the LAUTECH Teaching Hospital Osogbo Nigeria. The study was both retrospective and descriptive. Case notes of stroke patients aged 16-45 years managed at the LAUTECH Teaching Hospital Osogbo from June 2005 till February 2008 were retrieved. Demographic data, clinical profile of stroke, laboratory investigation results and treatment outcomes were collated. Clinical diagnosis and classification of stroke was mainly clinical using the WHO clinical criteria. Only 3 patients had cranial CT scan. Out of the total number of 208 stroke patients managed during this period, 27(12.9%) were aged 45 years and below. This comprised of 17 males and 10 females. The age range was between 23-45 years. Using the WHO clinical criteria, there were 14 cases of heamorrhagic CVD and 13 cases of ischaemic CVD. The three cranial CT scan that were done revealed cerebral infarction which was consistent with the clinical diagnosis. Severe hypertension was found in 16 (59.2%) patients on admission. 3 patients had clinical and electrocardiographic evidence of rheumatic heart disease with infective endocarditis. Other risk factors included Sickle cell disease, cardiac arrhythmias etc. 8 out of the 27 patients died giving a percentage mortality of 29.6% and 7 patients were discharged against medical advice. Heamorrhagic stroke was slightly more frequent than ischaemic CVD. Systemic hypertension was also found to be prevalent among these young Nigerian adults with stroke. However, it was difficult to unravel the aetiologic mechanisms of stroke in this study because of paucity of investigations.

Stroke characterization in Sun Saharan Africa: Congolese population.

Science.gov (United States)

Limbole, Emmanuel Bakilo; Magne, Julien; Lacroix, Philippe

2017-08-01

Stroke is the second cause of death worldwide and over than 80% of deaths occurs in developing countries. However, its characteristics in the Democratic Republic of Congo (DRC) are poorly defined. This study aimed to describe the key features of stroke in a hospital population of Kinshasa in DRC and to assess the frequency of cardiovascular risk factors and their impact on target organs. A descriptive study was carried out from three hospitals in Kinshasa between January and April 2013. Cardiovascular risk factors, clinical and biological data were collected during the study period. The study involved 166 patients aged 18years and over. The mean age of patients was 59.6±12.3years, the sex ratio for male of 1.9. Stroke was ischemic in 66% of cases. Hypertension was the most frequent cardiovascular risk factor (84.3%), followed by high blood cholesterol (45.2%).The etiologies of ischemic stroke (TOAST classification) were dominated by lacunas (38.5%) and embolic heart diseases (12.8%). The origin was unknown in 45.9% of cases. Coma was observed in 37% of patients on admission and was the main independent prognostic factor of mortality, which was 19.3%. Left ventricular hypertrophy and renal failure were found respectively in 64.7% and 34% of patients. This study found a growing increase of ischemic stroke in a society where hemorrhagic type used to be the most common, a high rate of hypertension, hypercholesterolemia and diabetes, indicative of a fast epidemiological transition. Copyright © 2017 Elsevier B.V. All rights reserved.

Impeller radial force evolution in a large double-suction centrifugal pump during startup at the shut-off condition

International Nuclear Information System (INIS)

Zou, Zhichao; Wang, Fujun; Yao, Zhifeng; Tao, Ran; Xiao, Ruofu; Li, Huaicheng

2016-01-01

Highlights: • Conclude the characteristics of transient radial force in the startup process for a large double-suction centrifugal pump. • The overall direction of the radial force during startup process is also confirmed. • A formula used to calculate the transient radial force during startup process is proposed. • A relationship between radial force variation and axial vortex development in blade channel during the startup process is established. The mechanism of the radial force evolution is revealed. - Abstract: Double-suction centrifugal pumps play an important role in the main feedwater systems of nuclear power plant. The impeller radial force in a centrifugal pump varies dramatically during startup at the shut-off condition. In this study, the startup process of a large double-suction centrifugal pump is investigated using CFD. During testing, the impeller speed is accelerated from zero to its rated speed in 1.0 s (marked as t_0) and is then maintained at the rated speed. The results show that the radial force increase lags behind the impeller speed increase. At 0–0.4t_0, the radial force is small (approaching zero). At 0.4–1.4t_0, the radial force increases rapidly. After 1.4t_0, the average radial force stabilizes and reaches its maximum value of 55,619 N. The observed maximum radial force value during startup is approximately nine times as high as the radial force under rated condition. During startup, the overall radial force direction is proximate to the radial line located 25° from the volute tongue along circumferential direction. A transient radial force formula is proposed to evaluate the changes in radial force during startup. The streamline distribution in impeller passages and the impeller outlet pressure profile varying over time are produced. The relationship between radial force evolution and the varying axial-to-spiral vortex structure is analyzed. The radial force change mechanism is revealed. This research provides a scientific

Impeller radial force evolution in a large double-suction centrifugal pump during startup at the shut-off condition

Energy Technology Data Exchange (ETDEWEB)

Zou, Zhichao [College of Water Resources and Civil Engineering, China Agricultural University, Beijing 100083 (China); Wang, Fujun, E-mail: wangfj@cau.edu.cn [College of Water Resources and Civil Engineering, China Agricultural University, Beijing 100083 (China); Beijing Engineering Research Center of Safety and Energy Saving Technology for Water Supply Network System, China Agricultural University, Beijing 100083 (China); Yao, Zhifeng [College of Water Resources and Civil Engineering, China Agricultural University, Beijing 100083 (China); Beijing Engineering Research Center of Safety and Energy Saving Technology for Water Supply Network System, China Agricultural University, Beijing 100083 (China); Tao, Ran [College of Water Resources and Civil Engineering, China Agricultural University, Beijing 100083 (China); Xiao, Ruofu [College of Water Resources and Civil Engineering, China Agricultural University, Beijing 100083 (China); Beijing Engineering Research Center of Safety and Energy Saving Technology for Water Supply Network System, China Agricultural University, Beijing 100083 (China); Li, Huaicheng [Shanghai Liancheng (Group) Co., Ltd., Shanghai 201812 (China)

2016-12-15

Highlights: • Conclude the characteristics of transient radial force in the startup process for a large double-suction centrifugal pump. • The overall direction of the radial force during startup process is also confirmed. • A formula used to calculate the transient radial force during startup process is proposed. • A relationship between radial force variation and axial vortex development in blade channel during the startup process is established. The mechanism of the radial force evolution is revealed. - Abstract: Double-suction centrifugal pumps play an important role in the main feedwater systems of nuclear power plant. The impeller radial force in a centrifugal pump varies dramatically during startup at the shut-off condition. In this study, the startup process of a large double-suction centrifugal pump is investigated using CFD. During testing, the impeller speed is accelerated from zero to its rated speed in 1.0 s (marked as t{sub 0}) and is then maintained at the rated speed. The results show that the radial force increase lags behind the impeller speed increase. At 0–0.4t{sub 0}, the radial force is small (approaching zero). At 0.4–1.4t{sub 0}, the radial force increases rapidly. After 1.4t{sub 0}, the average radial force stabilizes and reaches its maximum value of 55,619 N. The observed maximum radial force value during startup is approximately nine times as high as the radial force under rated condition. During startup, the overall radial force direction is proximate to the radial line located 25° from the volute tongue along circumferential direction. A transient radial force formula is proposed to evaluate the changes in radial force during startup. The streamline distribution in impeller passages and the impeller outlet pressure profile varying over time are produced. The relationship between radial force evolution and the varying axial-to-spiral vortex structure is analyzed. The radial force change mechanism is revealed. This research

Bottom Feeding and Beyond: How the Premaxillary Protrusion of Cypriniforms Allowed for a Novel Kind of Suction Feeding.

Science.gov (United States)

Hernandez, L Patricia; Staab, Katie Lynn

2015-07-01

While much of the functional work on suction feeding has involved members of Acanthopterygii, an earlier cypriniform radiation led to over 3200 species filling nearly every freshwater trophic niche. Within the great majority of acanthomorph clades that have been investigated suction feeding and the underlying morphology responsible for the generation of rapid suction have been largely conserved. This conserved feeding-apparatus is often associated with increasing the force experienced by the prey item, thus making a strike on elusive prey more effective. Cypriniforms' trophic anatomy is comprised of a number of novelties used for benthic feeding, which characterized early members of this clade. The modified cypriniform structure of the oral jaws represents a situation in which a particular type of suction feeding allowed for probing the benthos with a more functionally maneuverable anatomy. Requisite evolutionary modifications included origin and elongation of a median kinethmoid, duplications of certain divisions of the muscles of the adductor mandibulae, and origin of a dorsal, intra-buccal muscular palatal organ used in winnowing detritus. The elongated kinethmoid (coupled with modified adductor muscles) allowed for a type of premaxillary protrusion that decoupled the upper and lower jaws, enabled premaxillary protrusions with a closed mouth, and facilitated benthic feeding by increasing functional flexibility. The resultant flow of fluid generated by cypriniforms is also quite flexible, with multiple instances of peak flow in a single feeding event. This greatly modified morphology allowed for a degree of kinematic maneuverability not seen within most acanthomorphs. Later cypriniform radiations into piscivorous, insectivorous, or planktivorous feeding guilds were associated with shortening of the kinethmoid and with simplified morphology of the adductor, likely involving an emphasis on ram feeding. Although this suite of morphological novelties seemingly

Non-Invasive Airway Cleansing with Application of Expulsion Effect of HFJV (High Frequency Jet Ventilation

Directory of Open Access Journals (Sweden)

A. Hermely

2010-01-01

Full Text Available The aim of this study was to demonstrate the effectiveness of the use of expulsion and impulsion nozzle high frequency ventilation (VFDV for cleansing respiratory system during long-term mechanical ventilation. Material and methods. Retrospective study. In the group of 198 patients presenting its own procedures and the application of inpulsive and expulsive effect of the nozzle frequency ventilation (VFDV for cleansing and maintaining a patent airway. They used high frequency jet ventilation with the possibility of expulsion and epulsion programming and assessed a total of over 8000 expulsion procedures. Changes in lung mechanics, hemodynamics, effectiveness of expulsion and the need for suction beforeexpulsion and in regular application of VFDV were monitored. Results. We statistically compared and evaluated the effectiveness of expulsion in the VFDV group of 198 patients on long-term UVP, which was effective in average of 94.9% of patients. The impact of expulsion regime on circulatory, ventilation systems and gas exchange in the lungs, including lung mechanics, were analyzed. The authors found that the application of VFDV had a substantial and statistically significant effect on hemodynamics. Application of expulsion and lavage (a technique is described statistically significantly reduced airway resistance Raw (p<0.01 and improved the levels of lung static compliance (p<0.01 compared with the prior expulsion. Changes in blood gases during the expulsion itself did not have a major impact on gas exchange in the lungs or on the pH in this group, but there was a statistically significant increase in PaO2 (p<0.05. A key finding was that when comparing the number of manipulations in the airways (suction, a radical reduction in the number of pumping was observed, if expulsion was used regularly. A statistically significant difference in the application of expulsion was detected when compared to most groups of patients (p<0.01. The number of

Laterally Loaded Single Pile Response Considering the Influence of Suction and Non-Linear Behaviour of Reinforced Concrete Sections

Directory of Open Access Journals (Sweden)

Stefano Stacul

2017-12-01

Full Text Available A hybrid BEM-p-y curves approach was developed for the single pile analysis with free/fixed head restraint conditions. The method considers the soil non-linear behaviour by means of p-y curves in series to a multi-layered elastic half-space. The non-linearity of reinforced concrete pile sections, also considering the influence of tension-stiffening, has been considered. The model reproduces the influence of suction by increasing the stress state and hence the stiffness of shallow soil-layers. Suction is modeled using the Modified-Kovacs model. The hybrid BEM-py curves method was validated by comparing results from data of 22 load tests on single piles. In addition, a detailed comparison is presented between measured and computed data on a large-diameter reinforced concrete bored single pile.

Measurement of vertical stroke Vub vertical stroke using b hadron semileptonic decay

International Nuclear Information System (INIS)

Abbiendi, G.; Aakesson, P.F.

2001-01-01

The magnitude of the CKM matrix element vertical stroke V ub vertical stroke is determined by measuring the inclusive charmless semileptonic branching fraction of beauty hadrons at OPAL based on b → X u lν event topology and kinematics. This analysis uses OPAL data collected between 1991 and 1995, which correspond to about four million hadronic Z decays. We measure Br(b → X u lν) to be (1.63 ±0.53 +0.55 -0.62 ) x 10 -3 . The first uncertainty is the statistical error and the second is the systematic error. From this analysis, vertical stroke V ub vertical stroke is determined to be: vertical stroke V ub vertical stroke =(4.00±0.65(stat) +0.67 -0.76 (sys)±0.19(HQE)) x 10 -3 . The last error represents the theoretical uncertainties related to the extraction of vertical stroke V ub vertical stroke from Br(b→X u l ν) using the Heavy Quark Expansion. (orig.)

Seizure development after stroke.

Science.gov (United States)

Misirli, H; Ozge, A; Somay, G; Erdoğan, N; Erkal, H; Erenoğlu, N Y

2006-12-01

Although there have been many studies on seizures following stroke, there is still much we do not know about them. In this study, we evaluated the characteristics of seizures in stroke patients. There were 2267 patients with a first-ever stroke, and after excluding 387 patients, 1880 were available for analysis. Of these 1880 patients, we evaluated 200 patients with seizures and 400 patients without seizures. We investigated the seizures according to age, gender, stroke type, the aetiology of ischaemic stroke and the localisation of the lesion. The seizures were classified as early onset and late onset and the seizure type as partial, generalised or secondarily generalised. Seizures occurred in 200 (10.6%) of 1880 strokes. The number of patients with seizures were 138 (10.6%) in ischaemic stroke group and 62 (10.7%) in haemorrhagic stroke group. Patients with ischaemic strokes had 41 embolic (29.7%) and 97 thrombotic (70.3%) origin, and these were not statistically significant in comparison with controls. Cortical involvement for the development of seizures was the most important risk factor (odds ratios = 4.25, p < 0.01). It was concluded that embolic strokes, being younger than 65 years old, and cortical localisation of stroke were important risks for developing seizures.

Clinical Epidemiology Of Stroke

Directory of Open Access Journals (Sweden)

Nagaraja D

2005-01-01

Full Text Available Stroke is a huge public health problem because of its high morbidity and disability. The epidemiology of stroke is of relevance to construct practical paradigms to tackle this major health issue in the community. Recent data have shown that about 72-86% of strokes are ischemic, 9-18% are due to hemorrhage (intracerebral of subarachnoid and the rest are undefined. The risk factors for stroke are multiple and combined. At present, stroke is no more considered as unavoidable and untreatable. It is an emergency and specialized units and teams improve outcome and lower costs. Death related to stroke is declining in many countries and in both sexes. This decrease in multifactorial. The detection and more effective treatment of hypertension may play an important factor, as well as the improved medical care and improvement in diagnostic procedures. While stroke incidence appears stable and stroke mortality is slowly declining, the absolute magnitude of stroke is likely to grow over the next 30 years. as the population ages, the absolute number of stroke victims and demands on healthcare and other support systems is likely to increase substantially in the future. Keeping this in perspective, this chapter shall focus on the epidemiology of stroke in the world and in Indian, in particular.

Report on technical measurements concerning measurement of the suction of tanks at Fangel biomass conversion plant

International Nuclear Information System (INIS)

1992-05-01

The inconveniences caused by the odours emerging from the biomass conversion plant in Fangel, Denmark, and the actions taken in an attempt to reduce them, are described. The plant has on several occasions been threatened with being closed down because of the smell. Airtight coverings have been fixed on all the open tanks, and the suction element has been tested to see if it is airtight. Ozone has been added in order to help get rid of the smell. Measurements have shown that it is possible to attain a small vacuum in the storage tank under normal operation, if there is a surfeit of pumping there will be too high pressure. In relation to pumping-in the pressure can be too high in the first and medium tank. Flow, pressure, hydrogen sulphide and methane concentration changes significantly in relation to the various pumping frequences. The level of hydrogen sulphide removal in the biofilter was 70-85%. The flow of hydrogen sulphide becomes less after the addition of ozone. Measurements implied that the tanks were airtight. Larger vacuums can be achieved by changing the shape of the pipe system and increasing the flow. (AB)

Stroke in Commercial Flights.

Science.gov (United States)

Álvarez-Velasco, Rodrigo; Masjuan, Jaime; DeFelipe, Alicia; Corral, Iñigo; Estévez-Fraga, Carlos; Crespo, Leticia; Alonso-Cánovas, Araceli

2016-04-01

Stroke on board aircraft has been reported in retrospective case series, mainly focusing on economy class stroke syndrome. Data on the actual incidence, pathogenesis, and prognosis of stroke in commercial flights are lacking. A prospective registry was designed to include all consecutive patients referred from an international airport (40 million passengers a year) to our hospital with a diagnosis of ischemic stroke or transient ischemic attack and onset of symptoms during a flight or immediately after landing. Forty-four patients (32 ischemic strokes and 12 transient ischemic attacks) were included over a 76-month period (January 2008 to April 2014). The estimated incidence of stroke was 1 stroke in 35 000 flights. Pathogeneses of stroke or transient ischemic attack were atherothrombotic in 16 (36%), economy class stroke syndrome in 8 (18%), cardioembolic in 7 (16%), arterial dissection in 4 (9%), lacunar stroke in 4 (9%), and undetermined in 5 (12%) patients. Carotid stenosis >70% was found in 12 (27%) of the patients. Overall prognosis was good, and thrombolysis was applied in 44% of the cases. The most common reason for not treating patients who had experienced stroke onset midflight was the delay in reaching the hospital. Only 1 patient with symptom onset during the flight prompted a flight diversion. We found a low incidence of stroke in the setting of air travel. Economy class stroke syndrome and arterial dissection were well represented in our sample. However, the main pathogenesis was atherothrombosis with a high proportion of patients with high carotid stenosis. © 2016 American Heart Association, Inc.

Stroke care: Experiences and clinical research in stroke units in Chennai

Directory of Open Access Journals (Sweden)

Gobindram Arjundas

2006-01-01

Full Text Available Background: S troke is the second commonest cause of death in India with crude overall prevalence rate of 220 per 100,000. With an increasing aging population at risk, the stroke burden in India can be expected to reach epidemic proportions. Materials and Methods: The first protocol-based prospective studies, funded by private agencies was conducted in Madras Institute of Neurology in 1984-86. The results led to establishment of the first stroke unit in Tamil Nadu state, in the institute. The first all-India hospital-based studies in acute stroke was completed as INDIAN COOPERATIVE ACUTE STROKE STUDIES (ICASS I and ICASS II with WHO STEP ONE by members of the Indian Stroke Association between 2000-2005. This has generated very useful data for our country. Results: Mortality in 1984-86 was 40%. Stroke unit in the institute dropped it to 12%. About 10 years later, ICASS studies showed a further fall of mortality to 8%, which is the current international figure in the west. Morbidity pattern showed about half return to their original activities. But about one third are left totally disabled needing prolonged care, for which fiscal, social and rehab provisions have to be done on a national basis. Conclusions: The progress and success of care of Stroke in the last three decades, from treatment in medical and neurology wards to specialized stroke units is presented. The main risk factors are hypertension, diabetes and ischemic heart disease across the country. Hypertension alone or with the other two diseases was present in 72% of cases. Prevention and treatment of these factors will reduce the stroke burden, mortality and morbidity of strokes. The Stroke-team concept can be extended to the smallest hospitals in our country.

Stimulation of the mesencephalic locomotor region for gait recovery after stroke.