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Sample records for target controlled infusion

  1. The History of Target-Controlled Infusion

    NARCIS (Netherlands)

    Struys, Michel M. R. F.; De Smet, Tom; Glen, John (Iain) B.; Vereecke, Hugo E. M.; Absalom, Anthony R.; Schnider, Thomas W.

    Target-controlled infusion (TCI) is a technique of infusing IV drugs to achieve a user-defined predicted (target) drug concentration in a specific body compartment or tissue of interest. In this review, we describe the pharmacokinetic principles of TCI, the development of TCI systems, and technical

  2. [EEG-adjusted target-controlled infusion : Propofol target concentration with different doses of remifentanil].

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    Büttner, N; Schultz, B; Grouven, U; Schultz, A

    2010-02-01

    The aim of this study was to examine to what extent the use of electroencephalography (EEG) monitoring leads to an adaptation of the target-controlled infusion (TCI) concentration of propofol during propofol anaesthesia with different doses of remifentanil. With ethics committee approval 60 patients (27-69 years old) with American Society of Anesthesiologists classification (ASA) I-III received anaesthestics with propofol (TCI, Diprifusor, AstraZeneca, Wedel, Deutschland) and 0.2, 0.4, or 0.6 microg/kg body weight remifentanil, respectively (groups 1-3). Anaesthesia was maintained at a level of deep hypnosis (EEG stages D(2)/E(0), EEG monitor: Narcotrend, version 2.0/5.0, manufacturer: MT MonitorTechnik, Bad Bramstedt, Germany). During the steady state the propofol concentration in groups 1-3 was 3.02+/-0.86, 1.93+/-0.53 and 1.60+/-0.55 microg/ml, respectively (p<0.001). Women had a higher propofol consumption than men (p<0.05). Dreams during anaesthesia were more often reported by women than by men (p<0.05). The need for postoperative analgesia decreased with an increasing intraoperative remifentanil dose (p<0.05). The study demonstrates that remifentanil has both analgetic and hypnotic effects. With increasing remifentanil dose the propofol requirement decreased and in this context EEG monitoring is useful to adapt the target concentrations of propofol to the patients' age and gender.

  3. Model-based drug administration : current status of target-controlled infusion and closed-loop control

    NARCIS (Netherlands)

    Kuizenga, Merel H.; Vereecke, Hugo E. M.; Struys, Michel M. R. F.

    Purpose of review Drug administration might be optimized by incorporating pharmacokinetic-dynamic (PK/PD) principles and control engineering theories. This review gives an update of the actual status of target-controlled infusion (TCI) and closed-loop computer-controlled drug administration and the

  4. [Incorrect programming of a target controlled infusion pump. Case SENSAR of the trimester].

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    2014-10-01

    We report the case of a patient who underwent surgical aortic valve replacement. During general anaesthesia maintenance, the patient received a remifentanyl infusion via a target controlled infusion (TCI) system. The infusion pump that was prepared to deliver the infusion showed malfunction at the beginning of the surgery, so it was quickly replaced with a second pump. After a few minutes into the surgery, the patient presented with hypotension refractory to treatment. The remifentanyl syringe also emptied faster than expected. On reviewing the TCI pump, it was found that it was erroneously programmed for propofol instead of remifentanyl, thus the patient had received a very high dose of remifentanyl that was probably the cause of the haemodynamic disturbances. The incident was an error in equipment use, facilitated by hurry, lack of checking of the equipment prior to its use, and the complex and unclear design of the devices' screens. After analysis of this incident, all TCI pumps were reviewed, and all the programs for infrequently used drugs were deleted. Furthermore, 2 pumps were selected for exclusive use in the cardiac surgery theatre, one with propofol-only programming, and the other with remifentanyl-only programming, both clearly marked and situated in fixed places in that theatre. Copyright © 2014 Sociedad Española de Anestesiología, Reanimación y Terapéutica del Dolor. Published by Elsevier España. All rights reserved.

  5. Manual versus target-controlled infusion remifentanil administration in spontaneously breathing patients.

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    Moerman, Annelies T; Herregods, Luc L; De Vos, Martine M; Mortier, Eric P; Struys, Michel M R F

    2009-03-01

    The combination of propofol-remifentanil for procedural deep sedation in spontaneously breathing patients is characterized by the frequent incidence of side effects, especially respiratory depression. These side effects may be due to either the drug combination or the drug delivery technique. Target-controlled infusion (TCI) might optimize drug delivery. In this prospective, randomized, double-blind study in patients undergoing elective colonoscopy, we thus tried to answer two questions: first, if adding remifentanil to propofol surpasses the disadvantages of the combination of these two products, and second, if administration of remifentanil via TCI decreases the incidence of side effects, compared to manually controlled administration. Patients undergoing elective colonoscopy were randomly assigned to receive remifentanil via manually controlled continuous infusion (MCI) (0.125 microg x kg(-1) x min(-1) for 2 min followed by a continuous infusion of 0.05 microg x kg(-1) x min(-1)), TCI remifentanil (1 ng/mL), or placebo (normal saline either as TCI or manual infusion of equivalent rate). All patients received TCI propofol, adjusted to a target concentration level that provided deep sedation in which patients were not responsive to verbal commands, but maintained spontaneous ventilation without assistance. Significantly more patients in the placebo group showed movement, cough and hiccup, which transiently interfered with the examination. There were no clinically significant differences in hemodynamic or recovery variables among all groups. Remifentanil administered via TCI resulted in a decrease in propofol requirements. The incidence of hypopnea and apnea was less frequent when remifentanil was administered via TCI compared to MCI (TCI n = 7, MCI n = 16, P n = 7, MCI n = 16, P < 0.05), compared to manually controlled administration of remifentanil.

  6. Combination of propofol and remifentanil target-controlled infusion for laryngeal mask airway insertion in children.

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    Kim, H S; Park, H J; Kim, C S; Lee, J R

    2011-07-01

    The addition of remifentanil to propofol administration can improve the conditions for insertion of laryngeal mask airways (LMAs). However, the extent to which remifentanil reduces propofol requirements when both drugs are administered concomitantly via target-controlled infusion (TCI) in pediatric patients has not been adequately demonstrated. The purpose of this study was to determine the target concentration of propofol that is required for LMA insertion at three different remifentanil target concentrations (0, 2.5, and 5 ng kg(-1) min(-1)) during TCI in children. A total of 67 children, aged 2 to 12 years, were included, and anesthesia was conducted with TCI of propofol and remifentanil using the STELPUMP program. The children were assigned to three groups in a randomized, double-blind manner: propofol with saline (control group), propofol with 2.5 ng mL(-1) of remifentanil (low-remifentanil group), and propofol with 5.0 ng ml(-1) of remifentanil (high-remifentanil group). The EC(50) of propofol for LMA insertion at each target-concentration of remifentanil was determined using Dixon's up-and-down method, and the EC(50) of propofol in each group was compared using the Kruskal-Wallis ANOVA by rank test. The EC(50) for propofol was 5.18 mcg mL(-1) in the control group, 4.81 mcg ml(-1) in the low-remifentanil group, and 4.36 mcg mL(-1) in the high-remifentanil group, which was significantly different between the control group and the high-remifentanil group only (Pinsertion during TCI of both drugs in children, but low concentrations of remifentanil failed to reduce the propofol requirement.

  7. Antinociceptive effects, metabolism and disposition of ketamine in ponies under target-controlled drug infusion

    International Nuclear Information System (INIS)

    Knobloch, M.; Portier, C.J.; Levionnois, O.L.; Theurillat, R.; Thormann, W.; Spadavecchia, C.; Mevissen, M.

    2006-01-01

    Ketamine is widely used as an anesthetic in a variety of drug combinations in human and veterinary medicine. Recently, it gained new interest for use in long-term pain therapy administered in sub-anesthetic doses in humans and animals. The purpose of this study was to develop a physiologically based pharmacokinetic (PBPk) model for ketamine in ponies and to investigate the effect of low-dose ketamine infusion on the amplitude and the duration of the nociceptive withdrawal reflex (NWR). A target-controlled infusion (TCI) of ketamine with a target plasma level of 1 μg/ml S-ketamine over 120 min under isoflurane anesthesia was performed in Shetland ponies. A quantitative electromyographic assessment of the NWR was done before, during and after the TCI. Plasma levels of R-/S-ketamine and R-/S-norketamine were determined by enantioselective capillary electrophoresis. These data and two additional data sets from bolus studies were used to build a PBPk model for ketamine in ponies. The peak-to-peak amplitude and the duration of the NWR decreased significantly during TCI and returned slowly toward baseline values after the end of TCI. The PBPk model provides reliable prediction of plasma and tissue levels of R- and S-ketamine and R- and S-norketamine. Furthermore, biotransformation of ketamine takes place in the liver and in the lung via first-pass metabolism. Plasma concentrations of S-norketamine were higher compared to R-norketamine during TCI at all time points. Analysis of the data suggested identical biotransformation rates from the parent compounds to the principle metabolites (R- and S-norketamine) but different downstream metabolism to further metabolites. The PBPk model can provide predictions of R- and S-ketamine and norketamine concentrations in other clinical settings (e.g. horses)

  8. Prediction of Bispectral Index during Target-controlled Infusion of Propofol and Remifentanil: A Deep Learning Approach.

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    Lee, Hyung-Chul; Ryu, Ho-Geol; Chung, Eun-Jin; Jung, Chul-Woo

    2018-03-01

    The discrepancy between predicted effect-site concentration and measured bispectral index is problematic during intravenous anesthesia with target-controlled infusion of propofol and remifentanil. We hypothesized that bispectral index during total intravenous anesthesia would be more accurately predicted by a deep learning approach. Long short-term memory and the feed-forward neural network were sequenced to simulate the pharmacokinetic and pharmacodynamic parts of an empirical model, respectively, to predict intraoperative bispectral index during combined use of propofol and remifentanil. Inputs of long short-term memory were infusion histories of propofol and remifentanil, which were retrieved from target-controlled infusion pumps for 1,800 s at 10-s intervals. Inputs of the feed-forward network were the outputs of long short-term memory and demographic data such as age, sex, weight, and height. The final output of the feed-forward network was the bispectral index. The performance of bispectral index prediction was compared between the deep learning model and previously reported response surface model. The model hyperparameters comprised 8 memory cells in the long short-term memory layer and 16 nodes in the hidden layer of the feed-forward network. The model training and testing were performed with separate data sets of 131 and 100 cases. The concordance correlation coefficient (95% CI) were 0.561 (0.560 to 0.562) in the deep learning model, which was significantly larger than that in the response surface model (0.265 [0.263 to 0.266], P < 0.001). The deep learning model-predicted bispectral index during target-controlled infusion of propofol and remifentanil more accurately compared to the traditional model. The deep learning approach in anesthetic pharmacology seems promising because of its excellent performance and extensibility.

  9. Manual versus target-controlled infusion of balanced propofol during diagnostic colonoscopy: A prospective randomized controlled trial

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    Vučićević Vera

    2016-01-01

    Full Text Available Introduction. There is an increasing interest in balanced propofol sedation (BPS for colonoscopy in outpatient settings. Propofol is a potent anesthetic agent for this purpose and has a narrow therapeutic range, which increases a risk of cardiovascular and respiratory complications in case of improper administration. Objective. The aim of this study was to compare patients’ safety and comfort of endoscopists in two methods of BPS targeting deep sedation - propofol target-controlled infusion (TCI and manual intravenous titration technique (MT - during colonoscopy. Methods. This prospective randomized controlled trial included 90 patients (class I or II of the American Society of Anesthesiologists deeply sedated with propofol, coadministered with small doses of midazolam and fentanyl. Propofol was given by MT technique (45 patients or by TCI (45 patients. The following adverse effects were recorded: hypotension, hypertension, bradycardia, tachycardia, hypoxemia, bradypnea, apnea, hiccupping, and coughing, as well as endoscopist’s comfort during colonoscopy by means of a questionnaire. Results. The MT group compared to the TCI group had a lower mean arterial pressure in the 10th minute after the beginning (p = 0.017, and at the end of colonoscopy (p = 0.006, higher oxygen saturation in the fifth minute (p = 0.033, and in the 15th minute (p = 0.008 after the beginning of colonoscopy, and lower heart rate at the beginning of the procedure (p = 0.001. There were no statistically significant differences in adverse events. Endoscopist’s comfort during colonoscopy was high 95.6% in the TCI group vs. 88.9% in the MT group (p = 0.069. Conclusion. MT is clinically as stable as TCI of propofol for deep sedation during colonoscopy, and endoscopists experienced the same comfort during colonoscopy in both groups. Thus, both combinations are suitable for deep sedation during diagnostic colonoscopy.

  10. A Model for the Application of Target-Controlled Intravenous Infusion for a Prolonged Immersive DMT Psychedelic Experience

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    Andrew Robert Gallimore

    2016-07-01

    Full Text Available The state of consciousness induced by N,N-dimethyltryptamine (DMT is one of the most extraordinary of any naturally-occurring psychedelic substance. Users consistently report the complete replacement of normal subjective experience with a novel alternate universe, often densely populated with a variety of strange objects and other highly complex visual content, including what appear to be sentient beings. The phenomenology of the DMT state is of great interest to psychology and calls for rigorous academic enquiry. The extremely short duration of DMT effects—less than 20 minutes—militates against single dose administration as the ideal model for such enquiry. Using pharmacokinetic modelling and DMT blood sampling data, we demonstrate that the unique pharmacological characteristics of DMT, which also include a rapid onset and lack of acute tolerance to its subjective effects, make it amenable to administration by target-controlled intravenous infusion. This is a technology developed to maintain a stable brain concentration of anaesthetic drugs during surgery. Simulations of our model demonstrate that this approach will allow research subjects to be induced into a stable and prolonged DMT experience, making it possible to carefully observe its psychological contents, and provide more extensive accounts for subsequent analyses. This model would also be valuable in performing functional neuroimaging, where subjects are required to remain under the influence of the drug for extended periods. Finally, target-controlled intravenous infusion of DMT may aid the development of unique psychotherapeutic applications of this psychedelic agent.

  11. An evaluation of a target-controlled infusion of propofol or propofol-alfentanil admixture for sedation in dogs.

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    Montefiori, F; Pawson, P; Auckburally, A; Scott, M; Flaherty, D

    2016-04-01

    To evaluate sedation quality and cardiorespiratory variables in dogs sedated using a target-controlled infusion of propofol or propofol-alfentanil admixture. A total of 60 dogs undergoing diagnostic imaging were randomly assigned to one of three sedation protocols: propofol alone; propofol with a low concentration of 12 µg of alfentanil per mL of propofol; or propofol with a higher concentration of 24 µg of alfentanil per mL of propofol. Target-controlled infusion was initiated at a propofol target concentration of 1·5 µg/mL and increased until lateral recumbency was achieved. Times to adopt lateral recumbency and recover, pulse rate, respiratory rate, oscillometric mean arterial pressure and oxygen saturation were recorded. Quality of sedation onset and recovery were scored. Propofol target at lateral recumbency differed significantly (P=0·01) between groups with median (range) values of 3·0 (1·5 to 5·5), 2·0 (2 to 4·5) and 2·25 (1·5 to 3·5) µg/mL for propofol alone, propofol with the lower concentration of alfentanil and propofol with the higher concentration of alfentanil groups, respectively. Time to lateral recumbency was longer and quality of onset less smooth for the propofol group. Pulse rate change differed significantly (Pdogs, in the propofol group, the low concentration alfentanil group and the higher concentration of alfentanil group, respectively (Pbenefits and, at the higher concentration, alfentanil increased the incidence of hypoxaemia. © 2016 British Small Animal Veterinary Association.

  12. [Comparison between propofol and propofol-remifentanil sedation under target-controlled infusion for impacted supernumerary teeth extraction surgery for children].

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    Hao, Zhang; Yali, Hou; Xiangjun, Li; Fusheng, Dong; Ruihua, Lin

    2017-08-01

    Objective The aim of this study is to compare sedation titrated under target-controlled infusion of propofol and propofol-remifentanil for impacted supernumerary teeth extraction surgery for children. Methods A total of 60 children with anterior maxillary region impacted supernumerary teeth extraction surgery were divided randomly into two groups, namely, propofol group (group P, n=30) and propofol-remifentanil group (group PR, n=30). In group P, a titrated infusion of propofol was started until the modified observer's assessment of alertness/sedation (OAA/S) scale reached level 3 before the actual surgery. In group PR, a remifentanil infusion with a target plasma concentration of 1 ng·mL⁻¹ was started until the operation was finished. A titrated infusion of propofol was also started until the modified OAA/S score reached level 3 before the actual surgery. The Houpt behavior scale was adopted to evaluate the cooperation of each patient in both groups. The heart rate, blood pressure, respiratory rate, oxyhemoglobin saturation, and Narcotrend index, complications, adverse reactions and propofol infusion of all patients were recorded during the operation. Results The Houpt behavior scales in group PR were better than those in group P (P0.05). The incidence of respiratory depression and anterograde amnesia in group PR were higher than that in group P (Psupernumerary teeth extraction surgery for children are safe. The sedation titrated under target-controlled infusion of propofol-remifentanil is better than sedation by propofol when inhaling oxygen.

  13. The potential regimen of target-controlled infusion of propofol in flexible bronchoscopy sedation: a randomized controlled trial.

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    Ting-Yu Lin

    Full Text Available Target-controlled infusion (TCI provides precise pharmacokinetic control of propofol concentration in the effect-site (Ce, eg. brain. This pilot study aims to evaluate the feasibility and optimal TCI regimen for flexible bronchoscopy (FB sedation.After alfentanil bolus, initial induction Ce of propofol was targeted at 2 μg/ml. Patients were randomized into three titration groups (i.e., by 0.5, 0.2 and 0.1 μg/ml, respectively to maintain stable sedation levels and vital signs. Adverse events, frequency of adjustments, drug doses, and induction and recovery times were recorded.The study was closed early due to significantly severe hypoxemia events (oxyhemoglobin saturation <70% in the group titrated at 0.5 μg/ml. Forty-nine, 49 and 46 patients were enrolled into the 3 respective groups before study closure. The proportion of patients with hypoxemia events differed significantly between groups (67.3 vs. 46.9 vs. 41.3%, p = 0.027. Hypotension events, induction and recovery time and propofol doses were not different. The Ce of induction differed significantly between groups (2.4±0.5 vs. 2.1±0.4 vs. 2.1±0.3 μg/ml, p = 0.005 and the Ce of procedures was higher at 0.5 μg/ml titration (2.4±0.5 vs. 2.1±0.4 vs. 2.2±0.3 μg/ml, p = 0.006. The adjustment frequency tended to be higher for titration at 0.1 μg/ml but was not statistically significant (2 (0∼6 vs. 3 (0∼6 vs. 3 (0∼11. Subgroup analysis revealed 14% of all patients required no further adjustment during the whole sedation. Comparing patients requiring at least one adjustment with those who did not, they were observed to have a shorter induction time (87.6±34.9 vs. 226.9±147.9 sec, p<0.001, a smaller induction dose and Ce (32.5±4.1 vs. 56.8±22.7 mg, p<0.001; 1.76±0.17 vs. 2.28 ±0.41, p<0.001, respectively, and less hypoxemia and hypotension (15.8 vs.56.9%, p = 0.001; 0 vs. 24.1%, p = 0.008, respectively.Titration at 0.5 μg/ml is risky for FB sedation. A

  14. A comparison of the predictive performance of three pharmacokinetic models for propofol using measured values obtained during target-controlled infusion

    NARCIS (Netherlands)

    Glen, J. B.; White, M.

    2014-01-01

    We compared the predictive performance of the existing Diprifusor and Schnider models, used for target-controlled infusion of propofol, with a new modification of the Diprifusor model (White) incorporating age and sex covariates. The bias and inaccuracy (precision) of each model were determined

  15. Allometric or lean body mass scaling of propofol pharmacokinetics: towards simplifying parameter sets for target-controlled infusions.

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    Coetzee, Johan Francois

    2012-03-01

    Uncertainty exists as to the most suitable pharmacokinetic parameter sets for propofol target-controlled infusions (TCI). The pharmacokinetic parameter sets currently employed are clearly not universally applicable, particularly when patient attributes differ from those of the subjects who participated in the original research from which the models were derived. Increasing evidence indicates that the pharmacokinetic parameters of propofol can be scaled allometrically as well as in direct proportion to lean body mass (LBM). Appraisal of hitherto published studies suggests that an allometrically scaled pharmacokinetic parameter set may be applicable to a wide range of patients ranging from children to obese adults. On the other hand, there is evidence that propofol pharmacokinetic parameters, scaled linearly to LBM, provide improved dosing in normal and obese adults. The 'Schnider' pharmacokinetic parameter set that has been programmed into commercially available TCI pumps cannot be employed at present for morbidly obese patients (body mass index >40 kg/m2), because of anomalous behaviour of the equation used to calculate LBM, resulting in administration of excessive amounts of propofol. Simulations of TCI using improved equations to calculate LBM indicate that the Schnider model delivers similar amounts of propofol to morbidly obese patients as do the allometrically scaled pharmacokinetic parameter sets. These hypotheses deserve further investigation. To facilitate further investigation, researchers are encouraged to make their data freely available to the WorldSIVA Open TCI Initiative (http://opentci.org).

  16. Usefulness of Intravenous Anesthesia Using a Target-controlled Infusion System with Local Anesthesia in Submuscular Breast Augmentation Surgery

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    Kyu-Jin Chung

    2012-09-01

    Full Text Available Background Patients have anxiety and fear of complications due to general anesthesia.Through new instruments and local anesthetic drugs, a variety of anesthetic methods havebeen introduced. These methods keep hospital costs down and save time for patients. Inparticular, the target-controlled infusion (TCI system maintains a relatively accurate level ofplasma concentration, so the depth of anesthesia can be adjusted more easily. We conductedthis study to examine whether intravenous anesthesia using the TCI system with propofol andremifentanil would be an effective method of anesthesia in breast augmentation.Methods This study recruited 100 patients who underwent breast augmentation surgeryfrom February to August 2011. Intravenous anesthesia was performed with 10 mg/mLpropofol and 50 μg/mL remifentanil simultaneously administered using two separate modulesof a continuous computer-assisted TCI system. The average target concentration was set at2 μg/mL and 2 ng/mL for propofol and remifentanil, respectively, and titrated against clinicaleffect and vital signs. Oxygen saturation, electrocardiography, and respiratory status werecontinuously measured during surgery. Blood pressure was measured at 5-minute intervals.Information collected includes total duration of surgery, dose of drugs administered duringsurgery, memory about surgery, and side effects.Results Intraoperatively, there was transient hypotension in two cases and hypoxia in threecases. However, there were no serious complications due to anesthesia such as respiratorydifficulty, deep vein thrombosis, or malignant hypertension, for which an endotrachealintubation or reversal agent would have been needed. All the patients were discharged on theday of surgery and able to ambulate normally.Conclusions Our results indicate that anesthetic methods, where the TCI of propofol andremifentanil is used, might replace general anesthesia with endotracheal intubation in breastaugmentation surgery.

  17. Usefulness of Intravenous Anesthesia Using a Target-controlled Infusion System with Local Anesthesia in Submuscular Breast Augmentation Surgery

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    Kyu-Jin Chung

    2012-09-01

    Full Text Available BackgroundPatients have anxiety and fear of complications due to general anesthesia. Through new instruments and local anesthetic drugs, a variety of anesthetic methods have been introduced. These methods keep hospital costs down and save time for patients. In particular, the target-controlled infusion (TCI system maintains a relatively accurate level of plasma concentration, so the depth of anesthesia can be adjusted more easily. We conducted this study to examine whether intravenous anesthesia using the TCI system with propofol and remifentanil would be an effective method of anesthesia in breast augmentation.MethodsThis study recruited 100 patients who underwent breast augmentation surgery from February to August 2011. Intravenous anesthesia was performed with 10 mg/mL propofol and 50 µg/mL remifentanil simultaneously administered using two separate modules of a continuous computer-assisted TCI system. The average target concentration was set at 2 µg/mL and 2 ng/mL for propofol and remifentanil, respectively, and titrated against clinical effect and vital signs. Oxygen saturation, electrocardiography, and respiratory status were continuously measured during surgery. Blood pressure was measured at 5-minute intervals. Information collected includes total duration of surgery, dose of drugs administered during surgery, memory about surgery, and side effects.ResultsIntraoperatively, there was transient hypotension in two cases and hypoxia in three cases. However, there were no serious complications due to anesthesia such as respiratory difficulty, deep vein thrombosis, or malignant hypertension, for which an endotracheal intubation or reversal agent would have been needed. All the patients were discharged on the day of surgery and able to ambulate normally.ConclusionsOur results indicate that anesthetic methods, where the TCI of propofol and remifentanil is used, might replace general anesthesia with endotracheal intubation in breast

  18. Usefulness of Intravenous Anesthesia Using a Target-controlled Infusion System with Local Anesthesia in Submuscular Breast Augmentation Surgery.

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    Chung, Kyu-Jin; Cha, Kyu-Ho; Lee, Jun-Ho; Kim, Yong-Ha; Kim, Tae-Gon; Kim, Il-Guk

    2012-09-01

    Patients have anxiety and fear of complications due to general anesthesia. Through new instruments and local anesthetic drugs, a variety of anesthetic methods have been introduced. These methods keep hospital costs down and save time for patients. In particular, the target-controlled infusion (TCI) system maintains a relatively accurate level of plasma concentration, so the depth of anesthesia can be adjusted more easily. We conducted this study to examine whether intravenous anesthesia using the TCI system with propofol and remifentanil would be an effective method of anesthesia in breast augmentation. This study recruited 100 patients who underwent breast augmentation surgery from February to August 2011. Intravenous anesthesia was performed with 10 mg/mL propofol and 50 µg/mL remifentanil simultaneously administered using two separate modules of a continuous computer-assisted TCI system. The average target concentration was set at 2 µg/mL and 2 ng/mL for propofol and remifentanil, respectively, and titrated against clinical effect and vital signs. Oxygen saturation, electrocardiography, and respiratory status were continuously measured during surgery. Blood pressure was measured at 5-minute intervals. Information collected includes total duration of surgery, dose of drugs administered during surgery, memory about surgery, and side effects. Intraoperatively, there was transient hypotension in two cases and hypoxia in three cases. However, there were no serious complications due to anesthesia such as respiratory difficulty, deep vein thrombosis, or malignant hypertension, for which an endotracheal intubation or reversal agent would have been needed. All the patients were discharged on the day of surgery and able to ambulate normally. Our results indicate that anesthetic methods, where the TCI of propofol and remifentanil is used, might replace general anesthesia with endotracheal intubation in breast augmentation surgery.

  19. Low fresh gas flow balanced anesthesia versus target controlled intravenous infusion anesthesia in laparoscopic cholecystectomy: a cost-minimization analysis.

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    Stevanovic, Predrag D; Petrova, Guenka; Miljkovic, Branislava; Scepanovic, Radisav; Perunovic, Radoslav; Stojanovic, Dragos; Dobrasinovic, Janja

    2008-09-01

    Laparoscopic surgery is widely recognized as a well-tolerated and effective method for cholecystectomy. It is also considered cost saving because it has been associated with a decreased hospital length of stay. Variables that might lead to increased costs in laparoscopic surgery are the technique and drugs used in anesthesia. The goal of this study was to compare the costs of 2 anesthetic techniques used in laparoscopic cholecystectomy (LC)--balanced versus IV anesthesia--from the standpoint of an outpatient surgical department, with a time horizon of 1 year. Patients scheduled to undergo elective LC were enrolled in this prospective case study. Patients were randomly allocated to receive balanced anesthesia, administered as low fresh gas flow (LFGF) with inhalational sevoflurane and IV sufentanil in a target controlled infusion (LFGF SS group), or IV anesthesia, administered as IV propofol/sufentanil in a target controlled infusion (TCI group). We used a microcosting procedure to measure health care resource utilization in individual patients to detect treatment differences. The costs of medications used for the induction and maintenance of anesthesia during surgery were considered for LFGF SS and TCI. Other end points included duration of anesthesia; mean times to early emergence, tracheal extubation, orientation, and postanesthesia discharge (PAD); pain intensity before first analgesia; number of analgesics required in the first 24 hours after surgery; and prevalences of nausea, vomiting, and agitation. A total of 60 patients were included in this analysis (male/female ratios in the LFGF SS and TCI groups: 11/19 and 12/18, respectively; mean [SD] ages, 48 [7.9] and 47 [8.6] years; and mean [SD] body mass indexes, 26 [2.0] and 26 [3.0] kg/m2). The costs of anesthetics were significantly lower with LFGF SS compared with TCI (euro17.40 [euro2.66] vs euro22.01 [euro2.50] [2006 euros]). Times to early emergence and tracheal extubation were significantly shorter with

  20. Propofol target-controlled infusion for sedated gastrointestinal endoscopy: A comparison of propofol alone versus propofol–fentanyl–midazolam

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    Chiung-Dan Hsu

    2015-11-01

    Full Text Available Gastrointestinal (GI endoscopy is the major technique for diagnosis of GI disease and treatment. Various sedation and analgesia regimens such as midazolam, fentanyl, and propofol can be used during GI endoscopy. The purpose of the study was to compare propofol alone and propofol combination with midazolam and fentanyl in moderate sedation for GI endoscopy. One hundred patients undergoing GI endoscopy were enrolled in this study. All patients received a propofol target-controlled infusion (TCI to maintain sedation during the procedure. Patients were randomly allocated into either Group P (propofol TCI alone or Group C (combination of propofol TCI plus midazolam and fentanyl. Dermographic data, anesthetic parameters (sedation regimen, blood pressure, heart rate, and oxygen saturation, procedure parameters (procedure time, colonoscopy, or panendoscopy, propofol consumption, and adverse events (hypoxia, hypotension, and bradycardia were all recorded. Postprocedural records included recovery time, postoperative adverse events (nausea, vomiting, dizziness, recall, and pain and satisfaction. The average propofol consumption was 251 ± 83 mg in Group P and 159 ± 73 mg in Group C (p < 0.001. The incidence of transient hypotension was higher in Group P (p = 0.009. The recovery time and discharge time were both shorter in Group C (p < 0.001 and p = 0.006 respectively. Overall, postprocedural adverse events were similar in both groups. The postanesthetic satisfaction was comparable in both groups. TCI of propofol combined with midazolam and fentanyl achieved sedation with fewer hypotension episodes and shorter recovery and discharge time than propofol TCI alone in patients undergoing GI endoscopy.

  1. Comparative study between fast and slow induction of propofol given by target-controlled infusion: expected propofol concentration at the effect site. Randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Ricardo Francisco Simoni

    2015-04-01

    Full Text Available BACKGROUND AND OBJECTIVE: Studies have shown that the rate of propofol infusion may influence the predicted propofol concentration at the effect site (Es. The aim of this study was to evaluate the Es predicted by the Marsh pharmacokinetic model (ke0 0.26 min-1 in loss of consciousness during fast or slow induction. METHOD: The study included 28 patients randomly divided into two equal groups. In slow induction group (S, target-controlled infusion (TCI of propofol with plasma, Marsh pharmacokinetic model (ke0 0.26 min-1 with target concentration (Tc at 2.0-µg mL-1 were administered. When the predicted propofol concentration at the effect site (Es reached half of Es value, Es was increased to previous Es + 1 µg mL-1, successively, until loss of consciousness. In rapid induction group (R, patients were induced with TCI of propofol with plasma (6.0 µg mL-1 at effect site, and waited until loss of consciousness. RESULTS: In rapid induction group, Tc for loss of consciousness was significantly lower compared to slow induction group (1.67 ± 0.76 and 2.50 ± 0.56 µg mL-1, respectively, p = 0.004. CONCLUSION: The predicted propofol concentration at the effect site for loss of consciousness is different for rapid induction and slow induction, even with the same pharmacokinetic model of propofol and the same balance constant between plasma and effect site.

  2. Effects of target-controlled infusion of high-dose naloxone on pain and hyperalgesia in a human thermal injury model

    DEFF Research Database (Denmark)

    Springborg, Anders D; Jensen, Elisabeth K; Taylor, Bradley K

    2016-01-01

    injury has demonstrated reinstatement of nociceptive hypersensitivity indicating unmasking of latent sensitization. In a recent human study, pain hypersensitivity assessed as secondary hyperalgesia area (SHA), was reinstated 7 days after a mild thermal injury, in 4 out of 12 subjects after a naloxone...... infusion.The aims of the present study are first, to replicate our previous findings in a larger-sized study; second, to examine if high sensitizers (subjects presenting with large SHA after a thermal injury) develop a higher degree of hypersensitivity after naloxone challenge than low sensitizers...... (subjects presenting with restricted SHA after a thermal injury); and third to examine a dose-response relationship between 3 stable naloxone concentrations controlled by target-controlled infusion, and the unmasking of latent sensitization.Healthy participants (n = 80) underwent a screening day (day 0...

  3. Effect of open-chest surgery in the lateral position on blood propofol concentration during target-controlled infusion of propofol.

    Science.gov (United States)

    Tan, L H; Cokis, C J; Weightman, W M; Manopas, A R; Paech, M J; Nazirt, H S; Hackett, L P

    2008-11-01

    Our research hypothesis was that single lung ventilation during thoracic surgery in the lateral position increases the blood concentration of propofol during target-controlled infusion. Thirty adult patients in two tertiary referral hospitals undergoing open-chest surgery were studied. Anaesthesia was induced and maintained with propofol using a Diprifusor (Graseby 3500) computer-controlled pump set to deliver a blood concentration of 4 tg.ml(-1). Blood samples were taken with the patient positioned in (1) the supine position 20 minutes after induction (supine); (2) the lateral position just prior to one-lung ventilation (lateral); (3) the lateral position five minutes after commencing one-lung ventilation (OLV5) and (4) the lateral position 20 minutes after commencing one-lung ventilation (OLV20). Propofol concentrations were determined by high performance liquid chromatography. The target-controlled infusion target level was maintained at 4 microg.ml(-1) during the study period for all cases. The mean (SD) propofol blood concentration (microg.ml(-1)) at each stage was 5.5 (1.5) supine, 5.3 (1.1) lateral, 5.3 (1.2) OLV5 and 5.1 (1.2) OLV20. Repeated measures ANOVA showed an F value 1.9, lambda 5.5 and P value 0.15. Post hoc analysis did not identify a significant difference between the sample times. During target-controlled infusion of propofol, mean blood propofol concentrations did not change significantly from those obtained with the patient supine after up to 50 minutes in the lateral position during thoracic surgery, or 20 minutes after commencing one-lung ventilation.

  4. [Comparative study between fast and slow induction of propofol given by target-controlled infusion: expected propofol concentration at the effect site. Randomized controlled trial].

    Science.gov (United States)

    Simoni, Ricardo Francisco; Miziara, Luiz Eduardo de Paula Gomes; Esteves, Luis Otávio; Silva, Diógenes de Oliveira; Ribeiro, Cristina Alves; Smith, Mariana Oki; Paula, Leonardo Ferreira de; Cangiani, Luis Henrique

    2015-01-01

    studies have shown that rate of propofol infusion may influence the predicted propofol concentration at the effect site (Es). The aim of this study was to evaluate the Es predicted by the Marsh pharmacokinetic model (ke0 0.26min(-1)) in loss of consciousness during fast or slow induction. the study included 28 patients randomly divided into two equal groups. In slow induction group (S), target-controlled infusion (TCI) of propofol with plasma, Marsh pharmacokinetic model (ke0 0.26min(-1)) with target concentration (Tc) at 2.0-μg.mL(-1) were administered. When the predicted propofol concentration at the effect site (Es) reached half of Es value, Es was increased to previous Es + 1μg.mL(-1), successively, until loss of consciousness. In rapid induction group (R), patients were induced with TCI of propofol with plasma (6.0μg.ml(-1)) at Es, and waited until loss of consciousness. in rapid induction group, Tc for loss of consciousness was significantly lower compared to slow induction group (1.67±0.76 and 2.50±0.56μg.mL(-1), respectively, p=0.004). the predicted propofol concentration at the effect site for loss of consciousness is different for rapid induction and slow induction, even with the same pharmacokinetic model of propofol and the same balance constant between plasma and effect site. Copyright © 2014 Sociedade Brasileira de Anestesiologia. Publicado por Elsevier Editora Ltda. All rights reserved.

  5. Comparative study between target-controlled-infusion and continuous-infusion anesthesia in dogs treated with methotrimeprazine and treated with propofol and remifentanil Estudo comparativo entre anestesia venosa total alvo-controlada e por infusão contínua em cães pré-tratados com levomepromazina e tratados com propofol e remifentanila

    Directory of Open Access Journals (Sweden)

    Eduardo Hatschbach

    2008-02-01

    Full Text Available PURPOSE: To compare two propofol infusion techniques in bitches subjected to ovaryhisterectomy by estimating the efficiency of the propofol target-dose, evaluating the cardiorespiratory and hemogasimetric attributes, and the bispectral scale index (BIS as well as the recovery period characteristics. METHODS: Twenty anesthetized bitches were divided into two groups of 10 each (G1, G2. Animals of G1 were pre-treated with methotrimeprazine and anesthetized with target-controlled propofol infusion by means of a Harvard infusion pump combined to remifentanil through a syringe pump. RESULTS: Bradycardia and light hypotension, hemogasimetric and respiratory stability besides a good myorelaxation, more evident during continuous infusion and good hypnosis. CONCLUSIONS: Dosis used in both techniques, after methotrimeprazine pre-treatment and combined to the opioid, were efficient for the surgery. The target-controlled anesthesia required a smaller anesthetic consumption (propofol with faster recovery periods.OBJETIVO: Comparar duas técnicas de infusão de propofol em cadelas submetidas à ovariohisterectomia, estudando a eficácia da dose alvo de propofol, avaliando os atributos cardiorrespiratórios, hemogasométricos e escala do índice bispectral, (BIS bem como as características do período de recuperação. MÉTODOS: Foram anestesiadas 20 cadelas, distribuídos em dois grupos (GI e GII. Em GI, os animais foram pré-tratados com levomepromazina e anestesiados com propofol por infusão alvo controlada, através de bomba de infusão Harvard pump, associado com remifentanila, através de bomba de seringa. Em GII, os animais receberam o mesmo tratamento de GI, só que ao invés de receberem o propofol por infusão alvo controlada, receberam o propofol em infusão contínua de velocidade fixa. RESULTADOS: Bradicardia e discreta hipotensão, estabilidade hemogasométrica e respiratória, além de um bom miorrelaxamento, mais evidente na infusão cont

  6. A comparison of the effects of propofol and midazolam on memory during two levels of sedation by using target-controlled infusion.

    Science.gov (United States)

    de Roode, A; van Gerven, J M; Schoemaker, R C; Engbers, F H; Olieman, W; Kroon, J R; Cohen, A F; Bovill, J G

    2000-11-01

    We examined memory during sedation with target-controlled infusions of propofol and midazolam in a double-blinded five-way, cross-over study in 10 volunteers. Each active drug infusion was targeted to sedation level 1 (asleep) and level 4 (lethargic) as determined with the Observer Assessment of Alertness/Sedation scale. At the target level of sedation, drug concentration was clamped for 30 min, during which time neutral words were presented. After 2 h, explicit memory was assessed by recall, and implicit memory by using a wordstem completion test. Venous drug concentrations (mean +/- SD) were 1350 ng/mL (+/-332 ng/mL) for propofol and 208 ng/mL (+/-112 ng/mL) for midazolam during Observer Assessment of Alertness/Sedation scale level 4; and 1620 ng/mL (+/-357 ng/mL) and 249 ng/mL (+/-82 ng/mL) respectively during level 1. The wordstem completion test frequencies at low level sedation were significantly higher than spontaneous frequencies (8.7% + 2.4%; P: sedation were accompanied by small differences in venous propofol or midazolam concentrations. This indicates steep concentration-effect relationships. Neutral information is still memorized during low-level sedation with both drugs. The memory effect of propofol and midazolam did not differ significantly. Implicit memory can occur during different states of consciousness and might lead to psychological damage. In 10 volunteers, implicit memory was investigated during sedation with propofol and midazolam in a double-blinded, placebo-controlled study. To compare the effects of both drugs, they were titrated using a computer-controlled infusion system to produce similar high and low levels of sedation.

  7. Perbandingan antara Sevofluran dan Propofol Menggunakan Total Intravenous Anesthesia Target Controlled Infusion terhadap Waktu Pulih Sadar dan Pemulangan Pasien pada Ekstirpasi Fibroadenoma Payudara

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    Arvianto

    2017-04-01

    Full Text Available Total intravenous anesthesia (TIVA with propofol is increasingly used, because it is easy to control, has rapid onset, short duration, minimal adverse effects, and rapid recovery of the psychomotor and cognitive functions. This study was conducted to compare the emergence and discharge time between patients receiving sevoflurane and propofol with TCI. A single blind randomized controlled clinical trial was conducted on 36 female patients aged 18–65 years with American Society of Anesthesiologists (ASA physical status I–II, who underwent breast fibroadenoma extirpation biopsy at the outpatient surgical unit in Dr. Hasan Sadikin General Hospital Bandung. The subjects were randomized and divided into two groups: sevoflurane group receiving inhalation anesthesia with sevoflurane and target controlled infusion (TCI group receiving propofol TCI Schnider’s Effect Concentration (ec. The mergence time and discharge time were recorded for each group and analysis was performed using Mann Whitney test, t-test and chi-square/Fisher’s exact with 95% confidence interval. This study showed that the emergence time in sevoflurane group and TCI group were 7.429±0.763 minutes and 9.356±2.331 minutes, respectively. The result showed that sevoflurane provides shorter emergence time while TIVA with TCI propofol provides shorter discharge time.

  8. A bispectral index guided comparison of target-controlled versus manually-controlled infusion of propofol and remifentanil for attenuation of pressor response to laryngoscopy and tracheal intubation in non cardiac surgery

    Directory of Open Access Journals (Sweden)

    Naser Yeganeh

    2006-12-01

    Full Text Available BACKGROUND: Target-controlled infusion is a new delivery system for intravenous anesthetic agents with which the anesthetist targets a plasma or effect-site drug concentration to achieve a predetermined effect. With this system, the tedious task of calculating the amount of administered drug required to achieve the target concentration is left in charge of a microprocessor which commands the infusion device. In this prospective study we compared alterations in blood pressure and heart rate from initiation of induction of anesthesia until 3 minutes after tracheal intubation in two methods of drug infusion, target-controlled infusion (TCI and manually controlled infusion (MCI. Total anesthetic drug used until 3 minutes after intubation and level of produced hypnosis also were compared between two methods. METHODS: 40 patients were enrolled in this clinical trial study and were allocated randomly in two groups, each group consisting of 20 patients. In TCI group, patients received propofol and remifentanil with TCI pump to achieve 7 µg/ml and 4 ng/ml as plasmatic target drug levels, respectively. In MCI group, patients received propofol 2 mg/kg and remifentanil 1 µg/kg of body weight with manually controlled infusion. Both groups received succinylcholine as muscle relaxant to facilitate laryngoscopy and tracheal intubation. Bispectral index (BIS was passively recorded in two groups to compare the level of hypnosis. Blood pressure (BP and heart rate (HR were recorded at 5 different times (T-1, T0, T1, T2 and T3. Independent t-test and paired t-test were used for data analysis. RESULTS: Systolic arterial pressure (SAP was not different at T-1 between two groups but systolic hypotension was seen in MCI group more than TCI group at T0 (P<0.05. Systolic hypertension was more common in MCI group after intubation; i.e. SAP showed significant differences in T1, T2 and T3 between two groups (P<0.05. Mean arterial pressure (MAP showed significant

  9. Comparison of the hemodynamic response to induction and intubation during a target-controlled infusion of propofol with 2 different pharmacokinetic models. A prospective ramdomized trial.

    Science.gov (United States)

    Ramos Luengo, A; Asensio Merino, F; Castilla, M S; Alonso Rodriguez, E

    2015-11-01

    Determine the best propofol pharmacokinetic model that meets patient requirements and is devoid of major haemodynamic side effects. Prospective, randomised, open-label, clinical trial was performed on an intention to treat basis. It included 280 patients with ASA physical status i-iii, aged 18 to 80 years and weight range between 45 to 100kg, scheduled for surgery under general anaesthesia. They were randomized into 2 groups according to the pharmacokinetic model: Modified Marsh group and Schnider group. The haemodynamic changes that occurred during the induction and intubation were analysed. A propofol target controlled infusion was started to achieve and maintain a bispectral index value between 35 and 55. At minute 6, orotracheal intubation was performed and the study finished at minute 11. Heart rate, mean arterial pressure and their product (HR×MAP) were measured and recorded every minute throughout the study. Every HR×MAP value was compared to its baseline value to determine the minimum value before intubation, the maximum value after intubation, the maximum variation after intubation, and its final value. The GRADIENTE (MIN, MAX) variable (primary endpoint of this study) analyses the difference between maximal and minimal values related to intubation. Propofol doses and calculated concentrations and any hypotensive events were also recorded. No differences were found between groups regarding haemodynamic performance. GRADIENTE (MIN, MAX) values and the percentage of hypotensive events were: Modified Marsh group median 77.41% vs. Schnider group 84.86% (p= 0.821) and 17.3% vs. 12.8% (p = 0.292), respectively. The study failed to demonstrate any haemodynamic difference between the 2 groups, even though the Modified Marsh group received a larger dose of propofol. Copyright © 2014 Sociedad Española de Anestesiología, Reanimación y Terapéutica del Dolor. Publicado por Elsevier España, S.L.U. All rights reserved.

  10. Low effect-site concentration of propofol target-controlled infusion reduces the risk of hypotension during endoscopy in a Taiwanese population.

    Science.gov (United States)

    Hsu, Wen-Hung; Wang, Sophie S W; Shih, Hsiang-Yao; Wu, Meng-Chieh; Chen, Yi-Yu; Kuo, Fu-Chen; Yang, Hui-Ying; Chiu, Shun-Li; Chu, Koung-Shing; Cheng, Kuang-I; Wu, Deng-Chyang; Lu, I-Cheng

    2013-03-01

    Target-controlled infusion (TCI) of propofol is an effective way of delivering propofol during endoscopy. However, the ideal effect-site concentration (Ce) of propofol has not yet been defined in an Asian population. This study aimed to determine the ideal Ce of propofol in painless gastrointestinal endoscopy in a Taiwanese population. A total of 121 consecutive patients undergoing diagnostic endoscopy were recruited for this study. The endoscopic procedure was carried out within 1 h. TCI of propofol was utilized during the procedure. All patients received the same regimen to induce conscious sedation, including a bolus of midazolam (0.04 mg/kg) and fentanyl (0.5 μg/kg). The Ce of propofol was calculated using the Schneider model. Patients were randomly assigned to either the low Ce group (1.5-2.5 μg/mL) or high Ce group (3.0-4.0 μg/mL). Their cardiovascular and respiratory events were monitored during the procedure and the patients' post-procedure satisfaction was evaluated. The mean requirement for propofol was 232.02 mg in the low Ce group and 329.56 mg in the high Ce group, respectively (P hypotension were observed in the high Ce group (P = 0.026). The post-procedure satisfaction rate between the two groups was comparable. A low Ce of propofol TCI (1.5-2.5 μg/mL) achieved adequate anesthesia, reduced the risk of hypotension, and attained a high satisfaction rate in a Taiwanese population undergoing diagnostic painless endoscopy. © 2012 The Authors. Journal of Digestive Diseases © 2012 Chinese Medical Association Shanghai Branch, Chinese Society of Gastroenterology, Renji Hospital Affiliated to Shanghai Jiaotong University School of Medicine and Wiley Publishing Asia Pty Ltd.

  11. Control Law Design for Propofol Infusion to Regulate Depth of Hypnosis: A Nonlinear Control Strategy

    OpenAIRE

    Khaqan, Ali; Bilal, Muhammad; Ilyas, Muhammad; Ijaz, Bilal; Ali Riaz, Raja

    2016-01-01

    Maintaining the depth of hypnosis (DOH) during surgery is one of the major objectives of anesthesia infusion system. Continuous administration of Propofol infusion during surgical procedures is essential but increases the undue load of an anesthetist in operating room working in a multitasking setup. Manual and target controlled infusion (TCI) systems are not good at handling instabilities like blood pressure changes and heart rate variability arising due to interpatient variability. Patient ...

  12. Effect of a high-dose target-controlled naloxone infusion on pain and hyperalgesia in patients following groin hernia repair: study protocol for a randomized controlled trial

    DEFF Research Database (Denmark)

    Pereira, Manuel Pedro; Utke Werner, Mads; Berg Dahl, Joergen

    2015-01-01

    transition from supine to standing position, and evoked by pressure algometry) and the secondary outcomes (secondary hyperalgesia/allodynia, pressure pain thresholds, assessed at the surgical site and at the mirror-site in the contralateral groin, and, opioid withdrawal symptoms) will be assessed......BACKGROUND: Central sensitization is modulated by the endogenous opioid system and plays a major role in the development and maintenance of pain. Recent animal studies performed following resolution of inflammatory pain showed reinstatement of tactile hypersensitivity induced by administration...... of a mu-opioid-antagonist, suggesting latent sensitization is mediated by endogenous opioids. In a recent crossover study in healthy volunteers, following resolution of a first-degree burn, 4 out of 12 volunteers developed large secondary areas of hyperalgesia areas after a naloxone infusion, while...

  13. Effects of target-controlled infusion of high-dose naloxone on pain and hyperalgesia in a human thermal injury model: a study protocol: A randomized, double-blind, placebo-controlled, crossover trial with an enriched design.

    Science.gov (United States)

    Springborg, Anders D; Jensen, Elisabeth K; Taylor, Bradley K; Werner, Mads U

    2016-11-01

    Mu-opioid-receptor antagonists have been extensively studied in experimental research as pharmacological tools uncovering mechanisms of pain modulation by the endogenous opioid system. In rodents, administration of high doses of mu-opioid-receptor antagonists after the resolution of an inflammatory injury has demonstrated reinstatement of nociceptive hypersensitivity indicating unmasking of latent sensitization. In a recent human study, pain hypersensitivity assessed as secondary hyperalgesia area (SHA), was reinstated 7 days after a mild thermal injury, in 4 out of 12 subjects after a naloxone infusion.The aims of the present study are first, to replicate our previous findings in a larger-sized study; second, to examine if high sensitizers (subjects presenting with large SHA after a thermal injury) develop a higher degree of hypersensitivity after naloxone challenge than low sensitizers (subjects presenting with restricted SHA after a thermal injury); and third to examine a dose-response relationship between 3 stable naloxone concentrations controlled by target-controlled infusion, and the unmasking of latent sensitization.Healthy participants (n = 80) underwent a screening day (day 0) with induction of a thermal skin injury (47°C, 420 seconds, 12.5 cm). Assessment of SHA was performed 1 and 2 hours after the injury. Using an enriched design, only participants belonging to the upper quartile of SHA (Q4, high sensitizers; n = 20) and the lower quartile of SHA (Q1, low sensitizers; n = 20) continued the study, comprising 4 consecutive days-days 1 to 4. Thermal skin injuries were repeated on day 1 and day 3, whereas day 2 and day 4 (7 days after day 1 and day 3, respectively) were target-controlled infusion days in which the subjects were randomly allocated to receive either naloxone (3.25 mg/kg, 4 mg/mL) or placebo (normal saline) intravenous. The primary outcome was SHA assessed by weighted-pin instrument (128 mN) 0, 1, 2, and 165 to 169

  14. Effect of fentanyl target-controlled infusions on isoflurane minimum anaesthetic concentration and cardiovascular function in red-tailed hawks (Buteo jamaicensis).

    Science.gov (United States)

    Pavez, Juan C; Hawkins, Michelle G; Pascoe, Peter J; Knych, Heather K DiMaio; Kass, Philip H

    2011-07-01

    To determine the impact of three different target plasma concentrations of fentanyl on the minimum anaesthetic concentration (MAC) for isoflurane in the red-tailed hawk and the effects on the haemodynamic profile. Experimental study. Six healthy adult red-tailed hawks (Buteo jamaicensis) of unknown sex with body weights (mean ± SD) of 1.21 ± 0.15 kg. This study was undertaken in two phases. In the first phase anaesthesia was induced with isoflurane in oxygen via facemask and maintained with isoflurane delivered in oxygen via a Bain circuit. Following instrumentation baseline determination of the MAC for isoflurane was made for each animal using the bracketing method and a supramaximal electrical stimulus. End-tidal isoflurane concentration (E'Iso) was then set at 0.75 × MAC and after an appropriate equilibration period a bolus of fentanyl (20 μg kg(-1)) was administered intravenously (IV) in order to determine the pharmacokinetics of fentanyl in the isoflurane-anaesthetized red-tailed hawk. During the second phase anaesthesia was induced in a similar manner and E'Iso was set at 0.75 × MAC for each individual. Fentanyl was infused IV to achieve target plasma concentrations between 8 and 32 ng mL(-1). At each fentanyl plasma concentration, the MAC for isoflurane and cardiovascular variables were determined. Data were analyzed by use of repeated-measures anova. Mean ± SD fentanyl plasma concentrations and isoflurane MACs were 0 ± 0, 8.51 ± 4, 14.85 ± 4.82 and 29.25 ± 11.52 ng mL(-1), and 2.05 ± 0.45%, 1.42 ± 0.53%, 1.14 ± 0.31% and 0.93 ± 0.32% for the target concentrations of 0, 8, 16 and 32 ng mL(-1), respectively. At these concentrations fentanyl significantly (p = 0.0016) decreased isoflurane MAC by 31%, 44% and 55%, respectively. Dose had no significant effect on heart rate, systolic, diastolic or mean arterial blood pressure. Fentanyl produced a dose-related decrease of isoflurane MAC with minimal effects on measured cardiovascular parameters in

  15. Control Law Design for Propofol Infusion to Regulate Depth of Hypnosis: A Nonlinear Control Strategy

    Directory of Open Access Journals (Sweden)

    Ali Khaqan

    2016-01-01

    Full Text Available Maintaining the depth of hypnosis (DOH during surgery is one of the major objectives of anesthesia infusion system. Continuous administration of Propofol infusion during surgical procedures is essential but increases the undue load of an anesthetist in operating room working in a multitasking setup. Manual and target controlled infusion (TCI systems are not good at handling instabilities like blood pressure changes and heart rate variability arising due to interpatient variability. Patient safety, large interindividual variability, and less postoperative effects are the main factors to motivate automation in anesthesia. The idea of automated system for Propofol infusion excites the control engineers to come up with a more sophisticated and safe system that handles optimum delivery of drug during surgery and avoids postoperative effects. In contrast to most of the investigations with linear control strategies, the originality of this research work lies in employing a nonlinear control technique, backstepping, to track the desired hypnosis level of patients during surgery. This effort is envisioned to unleash the true capabilities of this nonlinear control technique for anesthesia systems used today in biomedical field. The working of the designed controller is studied on the real dataset of five patients undergoing surgery. The controller tracks the desired hypnosis level within the acceptable range for surgery.

  16. Control Law Design for Propofol Infusion to Regulate Depth of Hypnosis: A Nonlinear Control Strategy.

    Science.gov (United States)

    Khaqan, Ali; Bilal, Muhammad; Ilyas, Muhammad; Ijaz, Bilal; Ali Riaz, Raja

    2015-01-01

    Maintaining the depth of hypnosis (DOH) during surgery is one of the major objectives of anesthesia infusion system. Continuous administration of Propofol infusion during surgical procedures is essential but increases the undue load of an anesthetist in operating room working in a multitasking setup. Manual and target controlled infusion (TCI) systems are not good at handling instabilities like blood pressure changes and heart rate variability arising due to interpatient variability. Patient safety, large interindividual variability, and less postoperative effects are the main factors to motivate automation in anesthesia. The idea of automated system for Propofol infusion excites the control engineers to come up with a more sophisticated and safe system that handles optimum delivery of drug during surgery and avoids postoperative effects. In contrast to most of the investigations with linear control strategies, the originality of this research work lies in employing a nonlinear control technique, backstepping, to track the desired hypnosis level of patients during surgery. This effort is envisioned to unleash the true capabilities of this nonlinear control technique for anesthesia systems used today in biomedical field. The working of the designed controller is studied on the real dataset of five patients undergoing surgery. The controller tracks the desired hypnosis level within the acceptable range for surgery.

  17. Anestesia venosa total em regime de infusão alvo-controlada: uma análise evolutiva Anestesia venosa total en régimen de infusión objeto controlada: un análisis evolutivo Total intravenous anesthesia as a target-controlled infusion: an evolutive analysis

    Directory of Open Access Journals (Sweden)

    Fernando Squeff Nora

    2008-04-01

    ón objeto controlada (IOC. El primer modelo farmacocinético descrito para uso en IOC, fue descrito por Schwilden en 1981. Quedó demostrado a partir de entonces, que era posible mantener la concentración plasmática deseada de un fármaco utilizando bomba de infusión por computador. CONTENIDO: Este artigo quiso dejar sentadas las bases teóricas de la IOC, presentar una propuesta de desarrollo de un vocabulario común en IOC todavía no publicado en Brasil y hacer un análisis crítico de los aspectos actuales de la IOC en el mundo y en Brasil. CONCLUSIONES: La llegada de nuevas bombas de infusión dotadas de los modelos farmacocinéticos del remifentanil, sufentanil y propofol inaugura otro capítulo de la AVT y coloca a Brasil a tono con la tendencia mundial en IOC. Esos sistemas facilitarán la IOC de hipnóticos y opioides concomitantemente. La conclusión más importante, sin embargo, se refiere a la economía en la medida en que los fármacos utilizados en esas bombas no quedarán restrictos a solamente una empresa farmacéutica, como por ejemplo lo que ocurrió con el propofol. Hoy ya disponemos de equipos para la utilización de propofol y opioides en IOC, que aceptan cualquier presentación farmacéutica con la ventaja de poder alterar la concentración del fármaco en la jeringuilla de acuerdo con la dilución que se desee.BACKGROUND AND DOBJECTIVES: Total intravenous anesthesia (TIVA has seen several developments since it was first used. Since the synthesis of the first intravenous anesthetics, with the introduction of barbiturates (1921 and thiopental (1934, TIVA has evolved until the development of TIVA with target-controlled infusion pumps (TCI. The first pharmacokinetic model for the use of TCI was described by Schwilden in 1981. From that moment on, it was demonstrated that it is possible to maintain the desired plasma concentration of a drug using an infusion pump managed by a computer. CONTENTS: The objective of this report was to describe the

  18. A Feedback Control Approach to Organic Drug Infusions Using Electrochemical Measurement.

    Science.gov (United States)

    Myers, Mark H; Li, Yaqin; Kivlehan, Francine; Lindner, Ernö; Chaum, Edward

    2016-03-01

    Target-controlled infusion of anesthesia is a closed-loop automated drug delivery method with a computer-aided control. Our goal is to design and test an automated drug infusion platform for propofol delivery in total intravenous anesthesia (TIVA) administration. In the proposed method, a dilution chamber with first-order exponential decay characteristics was used to model the pharmacodynamics decay of a drug. The dilution chamber was connected to a flow system through an electrochemical cell containing an organic film-coated glassy carbon electrode as working electrode. To set up the feedback-controlled delivery platform and optimize its parameters, ferrocene methanol was used as a proxy of the propofol. The output signal of the sensor was connected to a PI controller, which prompted a syringe pump for feedback-controlled drug infusion. The result is a bench-top drug infusion platform to automate the delivery of a propofol based on the measurement of concentration with an organic film-coated voltammetric sensor. To evaluate the performance characteristics of the infusion platform, the propofol concentration in the dilution chamber was monitored with the organic film-coated glassy carbon electrode and the difference between the set and measured concentrations was assessed. The feasibility of measurement-based feedback-controlled propofol delivery is demonstrated and confirmed. This platform will contribute to high-performance TIVA application of intravenous propofol anesthesia.

  19. Online feedback-controlled renal constant infusion clearances in rats.

    Science.gov (United States)

    Schock-Kusch, Daniel; Shulhevich, Yury; Xie, Qing; Hesser, Juergen; Stsepankou, Dzmitry; Neudecker, Sabine; Friedemann, Jochen; Koenig, Stefan; Heinrich, Ralf; Hoecklin, Friederike; Pill, Johannes; Gretz, Norbert

    2012-08-01

    Constant infusion clearance techniques using exogenous renal markers are considered the gold standard for assessing the glomerular filtration rate. Here we describe a constant infusion clearance method in rats allowing the real-time monitoring of steady-state conditions using an automated closed-loop approach based on the transcutaneous measurement of the renal marker FITC-sinistrin. In order to optimize parameters to reach steady-state conditions as fast as possible, a Matlab-based simulation tool was established. Based on this, a real-time feedback-regulated approach for constant infusion clearance monitoring was developed. This was validated by determining hourly FITC-sinistrin plasma concentrations and the glomerular filtration rate in healthy and unilaterally nephrectomized rats. The transcutaneously assessed FITC-sinistrin fluorescence signal was found to reflect the plasma concentration. Our method allows the precise determination of the onset of steady-state marker concentration. Moreover, the steady state can be monitored and controlled in real time for several hours. This procedure is simple to perform since no urine samples and only one blood sample are required. Thus, we developed a real-time feedback-based system for optimal regulation and monitoring of a constant infusion clearance technique.

  20. Feasibility of automated titration of vasopressor infusions using a novel closed-loop controller.

    Science.gov (United States)

    Rinehart, Joseph; Ma, Michael; Calderon, Michael-David; Cannesson, Maxime

    2018-02-01

    Blood pressure management is a central concern in critical care patients. For a variety of reasons, titration of vasopressor infusions may be an ideal use-case for computer assistance. Using our previous experience gained in the bench-to-bedside development of a computer-assisted fluid management system, we have developed a novel controller for this purpose. The aim of this preliminary study was to assess the feasibility of using this controller in simulated patients to maintain a target blood pressure in both stable and variable blood-pressure scenarios. We tested the controller in two sets of simulation scenarios: one with stable underlying blood pressure and a second with variable underlying blood pressure. In addition, in the variable phase of the study, we tested infusion-line delays of 8-60 s. The primary outcome for both testing conditions (stable and variable) was % case time in target range. We determined a priori that acceptable performance on the first phase of the protocol would require greater than 95% case-time in-target given the simple nature of the protocol, and for the second phase of the study 80% or greater given the erratic nature of the blood pressure changes taking place. 250 distinct cases for each simulation condition, both managed and unmanaged, were run over 4 days. In the stable hemodynamic conditions, the unmanaged group had an MAP of 57.5 ± 4.6 mmHg and spent only 5.6% of case time in-target. The managed group had an MAP of 70.3 ± 2.6 and spent a total of 99.5% of case time in-target (p controller for vasopressor administration is able to main a target mean arterial pressure in a simulated physiologic model in the face of random disturbances and infusion-line lag.

  1. Developing a System for Integraded Automatic Control of Mutiple Infusion Pumps : The Multiplex infusion system

    NARCIS (Netherlands)

    Doesburg, Frank

    2013-01-01

    Most errors in ICUs are related to intravenous (IV) therapy. Previous studies suggested that hard to operate infusion pumps and the high cognitive workload for ICU nurses contribute to these errors. Conventional IV therapy requires separate lumens for incompatible IV drugs. This often requires the

  2. Anestesia venosa total com infusão alvo-controlada de remifentanil e propofol para ablação de fibrilação atrial Anestesia venosa total con infusión objeto-controlada de remifentanil y propofol para ablación de la fibrilación atrial Total intravenous anesthesia with target-controlled infusion of remifetanil and propofol for ablation of atrial fibrillation

    Directory of Open Access Journals (Sweden)

    Fernando Squeff Nora

    2009-12-01

    choice of anesthesia, monitors, and anesthesiologic care for this procedure performed outside the surgical center has not been described. The objective of this report was to describe an anesthesia technique for ablation of AF. CASE REPORT: This is a 49-year old female weighing 73 kg, 155 cm, and ASA II due to hypertension. The patient was monitored with a 12-lead ECG, pulse oximetry, heart rate, bispectral electroencephalography for BIS measurement, suppression rate (SR, and SEF95, and mean arterial pressure (MAP. Intravenous target-controlled infusion (TCI of propofol with a target of 4 µg.mL-1, intravenous TCI of remifentanil with a target of 3 ng.mL-1, and intravenous bolus of rocuronium 0.2 mg.kg-1 were used for induction of anesthesia. The pharmacokinetic model of propofol described by Marsh was used and incorporated into the propofol PFS pump®. The pharmacokinetic model of remifentanil described by Minto was incorporated into the Alaris PK® infusion pump. Local effector, or biophase, concentrations corresponded to the information obtained from the infusion pumps and represented predictive measurements of the concentrations of both drugs on their sites of action. The concentrations of propofol and remifentanil were regulated according to BIS and MAP, respectively. CONCLUSIONS: Total intravenous anesthesia for ablation of AF can be a safe option considering the lack of electrophysiological changes in accessory pathways. The literature on this subject is scarce and new publications could justify, or not, this type of anesthesia during ablation of AF.

  3. The Effect of an Amino Acid Infusion on Central Thermoregulatory Control in Humans

    Science.gov (United States)

    Nakajima, Yasufumi; Takamata, Akira; Matsukawa, Takashi; Sessler, Daniel I.; Kitamura, Yoshihiro; Ueno, Hiroshi; Tanaka, Yoshifumi; Mizobe, Toshiki

    2005-01-01

    Background Administration of protein or amino acids enhances thermogenesis, presumably by stimulating oxidative metabolism. However, hyperthermia results even when thermoregulatory responses are intact, suggesting that amino acids also alter central thermoregulatory control. We thus tested the hypothesis that amino acid infusion increases the thermoregulatory setpoint. Methods Nine male volunteers each participated on four study days in randomized order: 1) intravenous amino acids infused at 4 kJ·kg−1·hr−1 for 2.5 h combined with skin-surface warming; 2) amino acid infusion combined with cutaneous cooling; 3) a saline infusion combined with skin-surface warming; and, 4) saline infusion combined with cutaneous cooling. Results Amino acid infusion increased resting core temperature by 0.3 ± 0.1°C (mean ± SD) and oxygen consumption by 18 ± 12%. Furthermore, amino acid infusion increased the calculated core temperature threshold (triggering core temperature at a designated mean-skin temperature of 34°C) for active cutaneous vasodilation by 0.3 ± 0.3°C, for sweating by 0.2 ± 0.2°C, for thermoregulatory vasoconstriction by 0.3 ± 0.3°C, and for thermogenesis by 0.4 ± 0.5°C. Amino acid infusion did not alter the incremental response intensity (i.e., gain) of thermoregulatory defenses. Conclusions Amino acid infusion increased the metabolic rate and resting core temperature. However, amino acids also produced a synchronous increase in all major autonomic thermoregulatory defense thresholds; the increase in core temperature was identical to the setpoint increase — even in a cold environment with amble potential to dissipate heat. In subjects with intact thermoregulatory defenses, amino acid-induced hyperthermia appears to result from an elevated setpoint increase rather than increased metabolic rate per se. PMID:15108979

  4. A randomised controlled trial of oxytocin 5IU and placebo infusion versus oxytocin 5IU and 30IU infusion for the control of blood loss at elective caesarean section--pilot study. ISRCTN 40302163.

    LENUS (Irish Health Repository)

    Murphy, Deirdre J

    2012-02-01

    OBJECTIVE: To compare the blood loss at elective lower segment caesarean section with administration of oxytocin 5IU bolus versus oxytocin 5IU bolus and oxytocin 30IU infusion and to establish whether a large multi-centre trial is feasible. STUDY DESIGN: Women booked for an elective caesarean section were recruited to a pilot randomised controlled trial and randomised to either oxytocin 5IU bolus and placebo infusion or oxytocin 5IU bolus and oxytocin 30IU infusion. We wished to establish whether the study design was feasible and acceptable and to establish sample size estimates for a definitive multi-centre trial. The outcome measures were total estimated blood loss at caesarean section and in the immediate postpartum period and the need for an additional uterotonic agent. RESULTS: A total of 115 women were randomised and 110 were suitable for analysis (5 protocol violations). Despite strict exclusion criteria 84% of the target population were considered eligible for study participation and of those approached only 15% declined to participate and 11% delivered prior to the planned date. The total mean estimated blood loss was lower in the oxytocin infusion arm compared to placebo (567 ml versus 624 ml) and fewer women had a major haemorrhage (>1000 ml, 14% versus 17%) or required an additional uterotonic agent (5% versus 11%). A sample size of 1500 in each arm would be required to demonstrate a 3% absolute reduction in major haemorrhage (from baseline 10%) with >80% power. CONCLUSION: An additional oxytocin infusion at elective caesarean section may reduce blood loss and warrants evaluation in a large multi-centre trial.

  5. Next Generation Target Control System

    National Research Council Canada - National Science Library

    1995-01-01

    Our objective was to evaluate the allegations concerning the Next Generation Target Control System Program and to determine whether the Program is the most cost effective solution to meet the target...

  6. Nova target diagnostics control system

    International Nuclear Information System (INIS)

    Severyn, J.R.

    1985-01-01

    During the past year the Nova target diagnostics control system was finished and put in service. The diagnostics loft constructed to the north of the target room provides the environmental conditions required to collect reliable target diagnostic data. These improvements include equipment cooling and isolation of the power source with strict control of instrumentation grounds to eliminate data corruption due to electromagnetic pulses from the laser power-conditioning system or from target implosion effects

  7. Assessment of quality of glycemic control in intensive care patients treated with an insulin infusion at a teaching hospital.

    Science.gov (United States)

    Gauthier, Lyne; Ferguson, Jessica; Dubé, Anne-Isabelle; Nguyen, Patrick Viet-Quoc; Beauchesne, Marie-France; Boutin, Jean-Marie

    2014-04-01

    To describe the quality of glycemic control in patients in intensive care units (ICUs) treated with an intravenous (IV) insulin infusion at a teaching hospital. This retrospective study included patients admitted to the ICU and treated with an IV insulin infusion for at least 12 h between August 1 and November 30, 2011. Medical charts were reviewed. The primary quality indicator for glycemic control was the mean percent of blood glucose values per patient in the 6.1 to 8 mmol/L target range. A total of 351 patients were included; 61.5% of subjects had no known diabetes. Admissions were mainly for surgery (61.3%). The mean Acute Physiology and Chronic Health Evaluation (APACHE) II score was 16.8±7.3. The mean percent of blood glucose values per patient in the 6.1 to 8 mmol/L range was 35% for all subjects and 26.2% for patients with diabetes. If a target of 6.1 to 10 mmol/L was considered, those values became 63% and 54.6%. At least 1 episode of hyperglycemia (>10 mmol/L), hypoglycemia (quality of glycemic control in patients in the ICU at our hospital needs to be improved. A new computerized IV insulin protocol is currently being tested. Copyright © 2014 Canadian Diabetes Association. Published by Elsevier Inc. All rights reserved.

  8. Lower dose basal insulin infusion has positive effect on glycaemic control for children with type I diabetes on continuous subcutaneous insulin infusion therapy

    NARCIS (Netherlands)

    Schulten, Ron J; Piet, Jessica; Bruijning-Verhagen, Patricia; de Waal, Wouter J

    2017-01-01

    Objective: The aim of our study was to explore a possible relationship between proportion of basal insulin dose (%BD/T) and glycaemic control in children with type I diabetes on continuous subcutaneous insulin infusion (CSII) therapy. Methods: All patients under the age of 18 with type I diabetes

  9. Influence of hypoxia on the domiciliation of Mesenchymal Stem Cells after infusion into rats: possibilities of targeting pulmonary artery remodeling via cells therapies?

    Directory of Open Access Journals (Sweden)

    Domenech Jorge

    2005-10-01

    Full Text Available Abstract Background Bone marrow (BM cells are promising tools for vascular therapies. Here, we focused on the possibility of targeting the hypoxia-induced pulmonary artery hypertension remodeling with systemic delivery of BM-derived mesenchymal stem cells (MSCs into non-irradiated rats. Methods Six-week-old Wistar rats were exposed to 3-week chronic hypoxia leading to pulmonary artery wall remodeling. Domiciliation of adhesive BM-derived CD45- CD73+ CD90+ MSCs was first studied after a single intravenous infusion of Indium-111-labeled MSCs followed by whole body scintigraphies and autoradiographies of different harvested organs. In a second set of experiments, enhanced-GFP labeling allowed to observe distribution at later times using sequential infusions during the 3-week hypoxia exposure. Results A 30% pulmonary retention was observed by scintigraphies and no differences were observed in the global repartition between hypoxic and control groups. Intrapulmonary radioactivity repartition was homogenous in both groups, as shown by autoradiographies. BM-derived GFP-labeled MSCs were observed with a global repartition in liver, in spleen, in lung parenchyma and rarely in the adventitial layer of remodeled vessels. Furthermore this global repartition was not modified by hypoxia. Interestingly, these cells displayed in vivo bone marrow homing, proving a preservation of their viability and function. Bone marrow homing of GFP-labeled MSCs was increased in the hypoxic group. Conclusion Adhesive BM-derived CD45- CD73+ CD90+ MSCs are not integrated in the pulmonary arteries remodeled media after repeated intravenous infusions in contrast to previously described in systemic vascular remodeling or with endothelial progenitor cells infusions.

  10. Effect of amino acid infusion on potassium serum levels in neuroendocrine tumour patients treated with targeted radiopeptide therapy.

    Science.gov (United States)

    Giovacchini, Giampiero; Nicolas, Guillaume; Freidank, Heike; Mindt, Thomas L; Forrer, Flavio

    2011-09-01

    Administration of positively charged amino acids has been introduced to reduce the nephrotoxicity of targeted radiopeptide therapy (TRT). However, the amino acid solution may have side effects, including hyperkalaemia. The aim of this study was to evaluate the frequency and the magnitude of hyperkalaemia in neuroendocrine tumour (NET) patients undergoing TRT. Enrolled in the study were 31 patients with NET eligible for TRT with [(90)Y-DOTA(0),Tyr(3)]octreotide ((90)Y-DOTATOC). Their mean age was 54 ± 14 years. Of these 31 patients, 21 (67%) were referred for the first treatment cycle, while 10 (33%) were referred for a subsequent therapy cycle. Patients were treated with therapeutic doses of (90)Y-DOTATOC ranging from 7,030 to 35,520 MBq. To inhibit tubular reabsorption of (90)Y-DOTATOC, 1 l of physiological saline solution containing 25 g of arginine hydrochloride and 25 g of lysine hydrochloride was given over 4 h starting 1 h before (90)Y-DOTATOC injection. All patients underwent a standard biochemical blood analysis at baseline, and 4 h and 24 h after the beginning of the amino acid infusion. ANOVA repeated measures showed a significant overall effect on K(+) levels over time (F = 118.2, df = 2, P 0.05) to baseline K(+) levels. Intravenous administration of 40 mg furosemide 1 h after the beginning of the amino acid infusion did not have a significant effect on K(+) levels (P>0.05). No clinical characteristic was predictive for the increase in K(+) levels (chi-squared test, P > 0.05). Hyperkalaemia is a frequent, potentially life-threatening side effect of basic amino acid infusion during TRT. K(+) levels 4 h after the beginning of the infusion should be monitored in patients at risk of complications, such as those with heart disease and those with risk factors for nephrotoxicity.

  11. The effect of magnesium infusion on rest cramps: randomized controlled trial.

    Science.gov (United States)

    Garrison, Scott R; Birmingham, C Laird; Koehler, Barry E; McCollom, Robert A; Khan, Karim M

    2011-06-01

    Rest cramps (also known as nocturnal leg cramps) are very common in a geriatric population. Oral magnesium supplements are marketed for prophylaxis of such cramps but clinical trials exploring the efficacy of oral magnesium conflict. A therapeutic trial of intravenous magnesium overcomes the limited oral bioavailability of magnesium and better assesses its therapeutic potential. A double blind, placebo controlled randomized controlled trial was conducted on 46 community-dwelling older adult (69.3 ± 7.7 years) rest cramp sufferers to determine whether 5 consecutive days infusion of 20-mmol (5 g) magnesium sulfate would reduce the frequency of leg cramps per week in the 30 days immediately pre and post infusions. It was also determined whether the response to treatment varied with the extent to which infused magnesium was retained (as measured by 24-hour urinary magnesium excretion). The study population averaged 8.0 cramps per week at baseline. The mean change in number of cramps per week, magnesium versus placebo arms, was -2.4 versus -1.7, p = .51, 95% confidence interval of the difference -3.1 to 1.7. Magnesium retention did not correlate with treatment response. Intravenous magnesium infusion did not reduce the frequency of leg cramps in a group of older adult rest cramp sufferers regardless of the extent to which infused magnesium was retained. Although oral magnesium is widely marketed to older adults for the prophylaxis of leg cramps, our data suggest that magnesium therapy is not indicated for the treatment of rest cramps in a geriatric population.

  12. Integration of a blood pressure controller and an infusion toolbox system using client-server technology.

    Science.gov (United States)

    Meijers, R H; Coussaert, E J; Cantraine, F R

    1998-05-01

    This paper shortly describes an Infusion Toolbox and a blood pressure (BP) control application. It explains how we applied an agent model and client-server technology to integrate them. We show that by using this framework and object oriented technologies the necessary changes to the existing applications are reduced. Many elements of the tested original systems could be re-used, which enhances safe development.

  13. A clinical evaluation of the intraluminal bronchial artery infusion with reptilase or plus additional target artery embolization in treatment of severe hemoptysis in patients with pulmonary tuberculosis

    International Nuclear Information System (INIS)

    Lu Puxuan; Cai Xiongmao; Cao Mairui; Yu Weiye; Yang Gendong; Chen Xinchun; Sun Yanzhi; Liu Jinqing; Gong Xiaolong; Fu Xiangdong; Deng Yongcong; Liu Zhi; Zheng Guangping

    2003-01-01

    Objective: To investigate the effect of bronchial artery infusion with Reptilase or plus additional target artery embolization in treatment of massive hemoptysis in patients with pulmonary tuberculosis. Methods: Among 34 patients with massive hemoptysis (≥600 ml/24 hours) resultant from pulmonary tuberculosis, 21 cases (group 1) received by bronchial artery infusion with Reptilase (1-3KU) plus target artery embolization with gelfoam sponge. In the rest 13 cases (group 2) a simple bronchial artery infusion with Reptilase (1-3KU) was performed because the bleeding target arteries were inaccessible. Results: In total 32 cases out of 34 (94.1%) the hemoptysis ceased after the intervention, while 1 case in each group respectively needed further surgery. Among the cured 34 cases, single treatment was done in 32 cases, twice interventions were performed in 1 case and triple intraluminal therapies were done in 1 case. There is no significant difference between the efficiency of the treatment applied in group 1 and group 2 (P>0.05). Conclusion: Bronchial artery infusion with Reptilase or plus additional target artery embolization is effective and safe method in the management of massive hemoptysis in patients with pulmonary tuberculosis. When the target the bleed artery is inaccessible, local intraluminal infusion with Reptilase (1-3KU) is an acceptable option

  14. Feasibility of bispectral index-guided propofol infusion for flexible bronchoscopy sedation: a randomized controlled trial.

    Directory of Open Access Journals (Sweden)

    Yu-Lun Lo

    Full Text Available There are safety issues associated with propofol use for flexible bronchoscopy (FB. The bispectral index (BIS correlates well with the level of consciousness. The aim of this study was to show that BIS-guided propofol infusion is safe and may provide better sedation, benefiting the patients and bronchoscopists.After administering alfentanil bolus, 500 patients were randomized to either propofol infusion titrated to a BIS level of 65-75 (study group or incremental midazolam bolus based on clinical judgment to achieve moderate sedation. The primary endpoint was safety, while the secondary endpoints were recovery time, patient tolerance, and cooperation.The proportion of patients with hypoxemia or hypotensive events were not different in the 2 groups (study vs. control groups: 39.9% vs. 35.7%, p = 0.340; 7.4% vs. 4.4%, p = 0.159, respectively. The mean lowest blood pressure was lower in the study group. Logistic regression revealed male gender, higher American Society of Anesthesiologists physical status, and electrocautery were associated with hypoxemia, whereas lower propofol dose for induction was associated with hypotension in the study group. The study group had better global tolerance (p<0.001, less procedural interference by movement or cough (13.6% vs. 36.1%, p<0.001; 30.0% vs. 44.2%, p = 0.001, respectively, and shorter time to orientation and ambulation (11.7±10.2 min vs. 29.7±26.8 min, p<0.001; 30.0±18.2 min vs. 55.7±40.6 min, p<0.001, respectively compared to the control group.BIS-guided propofol infusion combined with alfentanil for FB sedation provides excellent patient tolerance, with fast recovery and less procedure interference.ClinicalTrials. gov NCT00789815.

  15. Study of Cisatracurium and Sufentanil Consumption Using a Closed Loop Computer Control Infusion System

    Science.gov (United States)

    2013-02-06

    The Intraoperative Effect of Dexmedetomidine on Cisatracurium Infusion Consumption and Its Recovery Index.; Effect of Dexmedetomidine on Sufentanil Consumption.; Quantitative Analysis of Cisatracurium Infusion Requirements, Sufentanil Consumption and Recovery Index in Different Age Groups.

  16. Fuzzy control of mean arterial pressure in postsurgical patients with sodium nitroprusside infusion.

    Science.gov (United States)

    Ying, H; McEachern, M; Eddleman, D W; Sheppard, L C

    1992-10-01

    We developed a fuzzy control system to provide closed-loop control of mean arterial pressure (MAP) in postsurgical patients in a cardiac surgical intensive care unit setting by regulating sodium nitroprusside (SNP) infusion. The fuzzy controller, originally expert-system-based, was analytically converted to ten nonfuzzy control algorithms, which reduced execution time dramatically. The core of the control algorithms was a nonlinear proportional-integral (PI) controller whose proportional gain and integral gain adjusted continuously according to error and rate change of error of the process output. The gains became larger when process output was far from desired setpoint and smaller when process output was close to desired setpoint, resulting in more dynamic and stable control performance than the regular PI controller, especially when a linear process with time-delay or a nonlinear process was involved. The control algorithms, encoded in C programming language, were implemented to control MAP in patients. Preliminary clinical results showed that the average percentage of time in which MAP stayed between 90% and 110% of the MAP setpoint was 89.31%, with a standard deviation of 4.96%. These were calculated based on 12 patient trials, with total trial time of 95 and 13 min.

  17. Paramedic Initiation of Neuroprotective Agent Infusions: Successful Achievement of Target Blood Levels and Attained Level Effect on Clinical Outcomes in the FAST-MAG Pivotal Trial (Field Administration of Stroke Therapy - Magnesium).

    Science.gov (United States)

    Shkirkova, Kristina; Starkman, Sidney; Sanossian, Nerses; Eckstein, Marc; Stratton, Samuel; Pratt, Frank; Conwit, Robin; Hamilton, Scott; Sharma, Latisha; Liebeskind, David; Restrepo, Lucas; Valdes-Sueiras, Miguel; Saver, Jeffrey L

    2017-07-01

    Paramedic use of fixed-size lumen, gravity-controlled tubing to initiate intravenous infusions in the field may allow rapid start of neuroprotective therapy for acute stroke. In a large, multicenter trial, we evaluated its efficacy in attaining target serum levels of candidate neuroprotective agent magnesium sulfate and the relation of achieved magnesium levels to outcome. The FAST-MAG phase 3 trial (Field Administration of Stroke Therapy - Magnesium) randomized 1700 patients within 2 hours of onset to paramedic-initiated, a 15-minute loading intravenous infusion of magnesium or placebo followed by a 24-hour maintenance dose. The drug delivery strategy included fixed-size lumen, gravity-controlled tubing for field drug administration, and a shrink-wrapped ambulance kit containing both the randomized field loading and hospital maintenance doses for seamless continuation. Among patient randomized to active treatment, magnesium levels in the first 72 hours were assessed 987 times in 572 patients. Mean patient age was 70 years (SD±14 years), and 45% were women. During the 24-hour period of active infusion, mean achieved serum level was 3.91 (±0.8), consistent with trial target. Mg levels were increased by older age, female sex, lower weight, height, body mass index, and estimated glomerular filtration rate, and higher blood urea nitrogen, hemoglobin, and higher hematocrit. Adjusted odds for clinical outcomes did not differ by achieved Mg level, including disability at 90 days, symptomatic hemorrhage, or death. Paramedic infusion initiation using gravity-controlled tubing permits rapid achievement of target serum levels of potential neuroprotective agents. The absence of association of clinical outcomes with achieved magnesium levels provides further evidence that magnesium is not biologically neuroprotective in acute stroke. © 2017 American Heart Association, Inc.

  18. Comparison between prostaglandin E1, and esmolol infusions in controlled hypotension during scoliosis correction surgery a clinical trial.

    Science.gov (United States)

    Goma, Hala Mostafa

    2012-02-01

    scoliosis correction surgery is common in children, and adolescents. Deliberate hypotension is indicated in scoliosis correction procedures, because bloodless field is needed for exposure of the nerve roots, and to decrease the need for blood transfusion. Protection of the kidneys during deliberate hypotension is essential. The ideal hypotensive drug maintains the renal function and the urine output during the period of hypotension. Aim of this study is to compare Prostaglandin E1, and Esmolol hypotensive effects, bleeding score, and their effects on the serum creatnine, and urine output. Twenty patients under went hypotensive anesthesia during scoliosis correction procedure, were enrolled in this clinical trial. In group 1 (n = 10) (Esmolol infusion), group 2 (n = 10) (prostaglandin E1 infusion), Parameters were measured: Mean arterial blood pressure, Heart rate, (preoperative, just after induction, 15 minutes, 30 minutes, 60 minutes after starting the infusions, and 15 minutes after discontinuation of infusions). The bleeding score was assessed at (15 minutes, 30 minutes, 60 minutes after starting the infusions). heart rate was significantly higher in prostaglandin E1 group than Esmolol group at 15, 30, 45, and 60 minutes. There was significant difference in the bleeding score only after 30 minutes, The target mean blood pressure (50 mmHg) was achieved at 30 minutes in group 2 (prostaglandin E1), while it was achieved at 60 minutes in group 1 (Esmolol group). There were significant differences in Mean blood pressure between both groups at 15, 30, 45, 60 minutes after starting the infusions. Creatnine level was significantly lower in prostaglandin E1 group, while the introperative urine output was significantly higher in prostaglandin E1 group. Prostaglandin E1 hypotensive effects started earlier than Esmolol and its bleeding score is better than esmolol especially at thirty minutes after initiation of the infusion. Prostaglandin E1 can maintain renal function and

  19. Avaliação farmacodinâmica e análise físico-química de duas formulações de propofol usadas em infusão alvo-controlada Evaluación farmacodinámica y análisis físico-químico de dos formulaciones de propofol usadas en infusión objeto-controlada Pharmacodynamic evaluation and physical/chemical analysis of two formulations of propofol used in target-controlled infusion

    Directory of Open Access Journals (Sweden)

    Ricardo Francisco Simoni

    2013-02-01

    equivalence of the reference drug propofol as well as a similar formulation. METHOD: Sixteen volunteers were enrolled in this randomized, double-blind, and paired study of Diprivan® and Propovan® formulations. Formulations were given as target-controlled infusion with target concentration of 3.0 μg.mL-1 for 15 minutes. Variables studied were the area under the curve (AUC of the bispectral index (BIS graph regarding time, minimum BIS reached and time to reach it, and recovery time. The two formulations were sent to analysis of particle size of lipid emulsion, surface potential, and active principle quantification. RESULTS: There was no difference between the formulations when comparing AUC, minimum BIS reached and time to reach it. The similar formulation recovery time was lower compared to the reference formulation (eight and 10 min, respectively, p = 0.014. Mean particle size of lipid emulsion, surface potential, and active ingredient quantification were similar for both formulations. CONCLUSION: There was no clinically significant difference between the use of propofol, reference Diprivan®, and the similar Propovan® during infusion. However, the recovery time was longer with the reference drug. Although analysis of both formulations studied show similar results regarding its physicochemical characterization, further studies should be conducted to justify this difference.

  20. Internal Targeting and External Control: Phototriggered Targeting in Nanomedicine.

    Science.gov (United States)

    Arrue, Lily; Ratjen, Lars

    2017-12-07

    The photochemical control of structure and reactivity bears great potential for chemistry, biology, and life sciences. A key feature of photochemistry is the spatiotemporal control over secondary events. Well-established applications of photochemistry in medicine are photodynamic therapy (PDT) and photopharmacology (PP). However, although both are highly localizable through the application of light, they lack cell- and tissue-specificity. The combination of nanomaterial-based drug delivery and targeting has the potential to overcome limitations for many established therapy concepts. Even more privileged seems the merger of nanomedicine and cell-specific targeting (internal targeting) controlled by light (external control), as it can potentially be applied to many different areas of medicine and pharmaceutical research, including the aforementioned PDT and PP. In this review a survey of the interface of photochemistry, medicine and targeted drug delivery is given, especially focusing on phototriggered targeting in nanomedicine. © 2017 Wiley-VCH Verlag GmbH & Co. KGaA, Weinheim.

  1. Comparison between Infusion Pumps: Fentanyl/Ketamine and Fentanyl/Paracetamol in Pain control Following Tight and Leg Surgeries

    Directory of Open Access Journals (Sweden)

    Behnam Mahmoodiyeh

    2016-08-01

    Full Text Available Background: Adjuvants such as ketamine, promethazine and paracetamol could bring up patients satisfaction and control harmful effects of opioids besides lessening their needed doses, as seen by fentanyl/paracetamol and fentanyl/ketamine combination before. The current study headed to compare paracetamol and ketamine in addition to fentanyl applied by infusion pumps in order to pain relief following major surgery.Methods: Through a double blinded randomized clinical trial, patients between18 and 65 with elective surgery for tight or leg fractures with ASA Class 1 and 2 referring to a university hospital in Arak, a town in central region of Iran, were recruited and used infusion pump for their postoperative pain control. The participants were divided into cases and controls regarding using ketamine/fentanyl (KF or paracetamol/fentanyl (PF infusion pumps.Results: The mean pain score was totally 3.87 with higher value in KF (5.06 and lower in PF (4.5 immediately after finishing surgery and getting conscious when started using infusion pump. There was no statistical difference between the groups in this regard. Concerning the side effects of the applied medications, blood pressure and heart rate had no differences comparing the groups.Conclusion: This study showed that paracetamol used in infusion pump can be brilliant in pain control after major surgeries like what done in lower extremities and joint replacement while lessens opioid use. Although paracetamol was more effective than ketamine in the current trial, more qualified studies at bigger size and in other fields of surgery beside orthopedic ones would be useful to support the effects if applicable.Keywords: Infusion pump, Ketamine, Paracetamol, Fentanyl, Postoperative pain

  2. COMPARISON OF THE EFFECTS OF INTERCOSTAL NERVE BLOCK WITH ROPIVACAINE AND INTRAVENOUS PARACETAMOL INFUSION TO INTRAVENOUS PARACETAMOL INFUSION ALONE FOR PAIN CONTROL AFTER OPEN CHOLECYSTECTOMY

    Directory of Open Access Journals (Sweden)

    Somnath Dey

    2017-11-01

    Full Text Available BACKGROUND Postoperative pain after open cholecystectomy is associated with respiratory dysfunction, increased stress response and prolonged hospital stay. We compare intravenous paracetamol (7.5 mg/kg plus intercostal nerve block with local anaesthetic ropivacaine 0.5% to intravenous paracetamol (15 mg/kg on pain control after open cholecystectomy. MATERIALS AND METHODS 140 patients, who underwent for open cholecystectomy, were randomly divided into two groups of 70. The patients were randomly allocated to any of the following two groups depending upon the drug used for analgesia (Group P or Group I Intravenous paracetamol 15 mg/kg was given to patients of group P and paracetamol 7.5 mg/kg with Intercostal nerve block in right side 6-10 intercostal nerves with 2 ml local anaesthetic ropivacaine 0.5% in each space was given to patients of group I just after intubation before incision. When the patients were transferred to postoperative recovery room, intensity of pain was recorded by response from the patients using 100 mm linear visual analogue scale ranging from 0 to 100. The pain scoring was done in the immediate postoperative period (when the patient was able to communicate in the post anaesthesia care unit, at 30 minutes, 1 hr. then hourly up to 24 hrs. till patient complained of pain with VAS score 40 or more. RESULTS The severity of pain in VAS score was lower in immediate postoperative period, at 30 minutes, 1 hour and 2 hours postoperatively in group I than the group P and those were statistically significant (p<0.001. Duration of analgesia also significantly lower in group I. Mean duration of analgesia in group P is 161.9 ± 42.6 min and in group I is 241.3 ± 44.2 min (p<0.001. CONCLUSION Adding Intercostal nerve block to intravenous infusion of Paracetamol infusion (7.5 mg/kg is better than sole intravenous infusion of Paracetamol (15 mg/kg in controlling pain severity even after reducing dose of paracetamol after open

  3. Infusion cisternography

    International Nuclear Information System (INIS)

    Magnaes, B.; Rootwelt, K.; Sjaastad, O.

    1976-01-01

    A source of error in cerebrospinal fluid (CSF) infusion tests is leakage at the dural puncture site. The addition of a bolus of radionuclide to the infusion fluid was helpful in detecting the existence of leakage as shown by increased infusion pressure in six of eight patients studied with and without scintigraphic evidence of leakage. Comparison of CSF dynamics in 26 patients studied by infusion cisternography and conventional cisternography showed similar patterns, suggesting no alteration of CSF dynamics by the artificial CSF infusion. Combining the two tests, therefore, resulted in simple identification of the leakage and saved the patient time and discomfort

  4. Associations between bolus infusion of hydrocortisone, glycemic variability and insulin infusion rate variability in critically Ill patients under moderate glycemic control

    NARCIS (Netherlands)

    van Hooijdonk, Roosmarijn T. M.; Binnekade, Jan M.; Bos, Lieuwe D. J.; Horn, Janneke; Juffermans, Nicole P.; Abu-Hanna, Ameen; Schultz, Marcus J.

    2015-01-01

    We retrospectively studied associations between bolus infusion of hydrocortisone and variability of the blood glucose level and changes in insulin rates in intensive care unit (ICU) patients. 'Glycemic variability' and 'insulin infusion rate variability' were calculated from and expressed as the

  5. In silico evaluation of a control system and algorithm for automated insulin infusion in the ICU setting

    Directory of Open Access Journals (Sweden)

    Olmos Pablo R

    2010-07-01

    Full Text Available Abstract Background It is known that tight control of glucose in the Intensive Care Unit reduces morbidity and mortality not only in diabetic patients but also in those non-diabetics who become transiently hyperglycemic. Taking advantage of a recently marketed subcutaneous glucose sensor we designed an Automatic Insulin Infusion System (AIIS for inpatient treatment, and tested its stability under simulated clinical conditions. Methods The system included: reference glucose, glucose sensor, insulin and glucose infusion controllers and emergency infusion logic. We carried out computer simulations using Matlab/Simulink®, in both common and worst-case conditions. Results The system was capable of controlling glucose levels without entering in a phase of catastrophic instability, even under severe simulated challenges. Care was taken to include in all simulations the 5-10 minute delay of the subcutaneous glucose signal when compared to the real-time serum glucose signal, a well-known characteristic of all subcutaneous glucose sensors. Conclusions When tested in-Silico, a commercially available subcutaneous glucose sensor allowed the stable functioning of a proportional-derivative Automatic Insulin Infusion System, which was able to maintain glucose within acceptable limits when using a well-established glucose response model simulating a patient. Testing of the system in vivo using animal models is now warranted.

  6. Continuous subcutaneous insulin infusion (CSII) therapy at Derby Teaching Hospitals: sustained benefits in glucose control.

    Science.gov (United States)

    Anyanwagu, U; Olaoye, H; Jennings, P; Ashton-Cleary, S; Sugunendran, S; Hughes, D; Idris, I; Wilmot, E G

    2017-08-01

    In the short term, continuous subcutaneous insulin infusion (CSII) has been associated with improved glycaemic control, reduced hypoglycaemia and improved quality of life (QOL). However, limited data are available on its long-term benefits, particularly in the UK. We aimed to assess the impact of CSII on longer term outcomes. Patient-level data were obtained for CSII users at Derby Teaching Hospitals, UK. Patient confidence and satisfaction questionnaires using the Likert scale were used to assess confidence in self-management. Comparative statistics were conducted using Pearson's chi-square and Student's t-tests. Some 258 CSII users were identified (60.1% female, mean age 43.9 ± 13.4 years). Overall, there was significant decrease in HbA 1c from 78 mmol/mol (9.3 ± 2.0%) at baseline, to 69 mmol/mol (8.5 ± 1.3%) at 6 months [mean difference (md): -0.64; 95% confidence interval (95% CI): -0.91 to -0.37; P quality of care received in the insulin pump service. CSII therapy led to a sustained long-term improvement in glycaemic control in addition to a reduction in self-reported hypoglycaemia. © 2017 Diabetes UK.

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

    DEFF Research Database (Denmark)

    Andersen, Karen V; Bak, Marie; Christensen, Birgitte V

    2010-01-01

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

  8. An insulin infusion advisory system for type 1 diabetes patients based on non-linear model predictive control methods.

    Science.gov (United States)

    Zarkogianni, Konstantia; Mougiakakou, Stavroula G; Prountzou, Aikaterini; Vazeou, Andriani; Bartsocas, Christos S; Nikita, Konstantina S

    2007-01-01

    In this paper, an Insulin Infusion Advisory System (IIAS) for Type 1 diabetes patients, which use insulin pumps for the Continuous Subcutaneous Insulin Infusion (CSII) is presented. The purpose of the system is to estimate the appropriate insulin infusion rates. The system is based on a Non-Linear Model Predictive Controller (NMPC) which uses a hybrid model. The model comprises a Compartmental Model (CM), which simulates the absorption of the glucose to the blood due to meal intakes, and a Neural Network (NN), which simulates the glucose-insulin kinetics. The NN is a Recurrent NN (RNN) trained with the Real Time Recurrent Learning (RTRL) algorithm. The output of the model consists of short term glucose predictions and provides input to the NMPC, in order for the latter to estimate the optimum insulin infusion rates. For the development and the evaluation of the IIAS, data generated from a Mathematical Model (MM) of a Type 1 diabetes patient have been used. The proposed control strategy is evaluated at multiple meal disturbances, various noise levels and additional time delays. The results indicate that the implemented IIAS is capable of handling multiple meals, which correspond to realistic meal profiles, large noise levels and time delays.

  9. Effect of intragastric FODMAP infusion on upper gastrointestinal motility, gastrointestinal, and psychological symptoms in irritable bowel syndrome vs healthy controls.

    Science.gov (United States)

    Masuy, I; Van Oudenhove, L; Tack, J; Biesiekierski, J R

    2018-01-01

    The low fermentable oligo-, di-, mono-saccharides and polyol (FODMAP) diet is a treatment strategy to reduce symptoms of irritable bowel syndrome (IBS). Acute effects of FODMAPs on upper gastrointestinal motility are incompletely understood. Our objectives were to assess the acute effects of intragastric FODMAP infusions on upper gastrointestinal motility and gastrointestinal and psychological symptoms in healthy controls (HC) and IBS patients. A high-resolution solid-state manometry probe and an infusion tube were positioned into the stomach. Fructans, fructose, FODMAP mix, or glucose was intragastrically administered to HC, and fructans or glucose was administered to IBS patients until full satiation (score 0-5), in a randomized crossover fashion. Manometric measurements continued for 3 hours. Gastrointestinal and psychological symptoms were assessed by questionnaires at predefined time points. The study was registered on www.clinicaltrials.gov (NCT02980406). Twenty HC and 20 IBS patients were included. Fructans induced higher postprandial gastric pressures compared with glucose over both groups (Panger (P=.030) and a stronger decrease in positive affect (P=.021). The upper gastrointestinal motility response varies between carbohydrates. Irritable bowel syndrome patients are more sensitive to fructan infusion, reflected in their higher gastrointestinal symptom scores. Acute carbohydrate infusion can have differential psychological effects in IBS and HC. © 2017 John Wiley & Sons Ltd.

  10. A randomised controlled trial of two infusion rates to decrease reactions to antivenom.

    Directory of Open Access Journals (Sweden)

    Geoffrey K Isbister

    Full Text Available BACKGROUND: Snake envenoming is a major clinical problem in Sri Lanka, with an estimated 40,000 bites annually. Antivenom is only available from India and there is a high rate of systemic hypersensitivity reactions. This study aimed to investigate whether the rate of infusion of antivenom reduced the frequency of severe systemic hypersensitivity reactions. METHODS AND FINDINGS: This was a randomized comparison trial of two infusion rates of antivenom for treatment of non-pregnant adult patients (>14 y with snake envenoming in Sri Lanka. Snake identification was by patient or hospital examination of dead snakes when available and confirmed by enzyme-immunoassay for Russell's viper envenoming. Patients were blindly allocated in a 11 randomisation schedule to receive antivenom either as a 20 minute infusion (rapid or a two hour infusion (slow. The primary outcome was the proportion with severe systemic hypersensitivity reactions (grade 3 by Brown grading system within 4 hours of commencement of antivenom. Secondary outcomes included the proportion with mild/moderate hypersensitivity reactions and repeat antivenom doses. Of 1004 patients with suspected snakebites, 247 patients received antivenom. 49 patients were excluded or not recruited leaving 104 patients allocated to the rapid antivenom infusion and 94 to the slow antivenom infusion. The median actual duration of antivenom infusion in the rapid group was 20 min (Interquartile range[IQR]:20-25 min versus 120 min (IQR:75-120 min in the slow group. There was no difference in severe systemic hypersensitivity reactions between those given rapid and slow infusions (32% vs. 35%; difference 3%; 95%CI:-10% to +17%;p = 0.65. The frequency of mild/moderate reactions was also similar. Similar numbers of patients in each arm received further doses of antivenom (30/104 vs. 23/94. CONCLUSIONS: A slower infusion rate would not reduce the rate of severe systemic hypersensitivity reactions from current high

  11. Patient Controlled Epidural Analgesia during Labour: Effect of Addition of Background Infusion on Quality of Analgesia & Maternal Satisfaction

    Directory of Open Access Journals (Sweden)

    Uma Srivastava

    2009-01-01

    Full Text Available Patient controlled epidural analgesia (PCEA is a well established technique for pain relief during labor. But the inclusion of continuous background infusion to PCEA is controversial. The aim of this study was to assess whether the use of continuous infusion along with PCEA was beneficial for laboring women with regards to quality of analgesia, maternal satisfaction and neonatal outcome in comparison to PCEA alone. Fifty five parturients received epidural bolus of 10ml solution containing 0.125% bupivacaine +2 ìg.ml-1 of fentanyl. For maintenance of analgesia the patients of Group PCEA self administered 8 ml bolus with lockout interval of 20 minutes of above solution on demand with no basal infusion. While the patients of Group PCEA + CI received continuous epidural infusion at the rate of 10 ml.hr-1 along with self administered boluses of 3 ml with lockout interval of 10 minutes of similar epidural solution. Patients of both groups were given rescue boluses by the anaesthetists for distressing pain. Verbal analogue pain scores, incidence of distressing pain, need of supplementary/rescue boluses, dose of bupivacaine consumed, maternal satisfaction and neonatal Apgar scores were recorded. No significant difference was observed between mean VAS pain scores during labor, maternal satisfaction, mode of delivery or neonatal Apgar scores. But more patients (n=8 required rescue boluses in PCEA group for distressing pain. The total volume consumed of bupivacaine and opioid was slightly more in PCEA + CI group. In both the techniques the highest sensory level, degree of motor block were comparable& prolongation of labor was not seen. It was concluded that both the techniques provided equivalent labor analgesia, maternal satisfaction and neonatal Apgar scores. PCEA along with continuous infusion at the rate of 10 ml/ hr resulted in lesser incidence of distressing pain and need for rescue analgesic. Although this group consumed higher dose of bupivacaine

  12. The haemodynamic effects of the perioperative terlipressin infusion in living donor liver transplantation: A randomised controlled study

    Directory of Open Access Journals (Sweden)

    Nagwa Ibrahim

    2015-01-01

    Full Text Available Background and Aims: Liver disease is usually accompanied with a decline in systemic vascular resistance (SVR. We decided to assess effects of the peri-operative terlipressin infusion on liver donor liver transplantation recipients with respect to haemodynamics and renal parameters. Methods: After Ethical Committee approval for this prospective randomised controlled study, 50 recipients were enrolled and allotted to control (n = 25 or terlipressin group (n = 25 with simple randomisation method. Terlipressin was infused at 1.0 μg/kg/h and later titrated 1.0-4.0 μg/kg/h to maintain mean arterial pressure (MAP >65 mmHg and SVR index 0.05 and was sustained post-operatively. Conclusion: Terlipressin improved SVR and MAP with less need for catecholamines particularly post-reperfusion. Terlipressin reduced PPV without hepatic artery vasoconstriction and improved post-operative UOP.

  13. Constrained target controllability of complex networks

    Science.gov (United States)

    Guo, Wei-Feng; Zhang, Shao-Wu; Wei, Ze-Gang; Zeng, Tao; Liu, Fei; Zhang, Jingsong; Wu, Fang-Xiang; Chen, Luonan

    2017-06-01

    It is of great theoretical interest and practical significance to study how to control a system by applying perturbations to only a few driver nodes. Recently, a hot topic of modern network researches is how to determine driver nodes that allow the control of an entire network. However, in practice, to control a complex network, especially a biological network, one may know not only the set of nodes which need to be controlled (i.e. target nodes), but also the set of nodes to which only control signals can be applied (i.e. constrained control nodes). Compared to the general concept of controllability, we introduce the concept of constrained target controllability (CTC) of complex networks, which concerns the ability to drive any state of target nodes to their desirable state by applying control signals to the driver nodes from the set of constrained control nodes. To efficiently investigate the CTC of complex networks, we further design a novel graph-theoretic algorithm called CTCA to estimate the ability of a given network to control targets by choosing driver nodes from the set of constrained control nodes. We extensively evaluate the CTC of numerous real complex networks. The results indicate that biological networks with a higher average degree are easier to control than biological networks with a lower average degree, while electronic networks with a lower average degree are easier to control than web networks with a higher average degree. We also show that our CTCA can more efficiently produce driver nodes for target-controlling the networks than existing state-of-the-art methods. Moreover, we use our CTCA to analyze two expert-curated bio-molecular networks and compare to other state-of-the-art methods. The results illustrate that our CTCA can efficiently identify proven drug targets and new potentials, according to the constrained controllability of those biological networks.

  14. A Comparative Analysis of PID, Lead, Lag, Lead-Lag, and Cascaded Lead Controllers for a Drug Infusion System

    Science.gov (United States)

    Jadoon, Zuwwar Khan; Shakeel, Sobia; Saleem, Abeera; Shuja, Sana; ul-Hasan, Qadeer; Ali Riaz, Raja

    2017-01-01

    Goal The aim of this paper is to conduct a comprehensive comparative analysis between five different controllers for a drug infusion system in total intravenous anesthesia (TIVA) administration. Methods The proposed method models a dilution chamber with first order exponential decay characteristics to represent the pharmacokinetic decay of a drug. The dilution chamber is integrated with five different control techniques with a simulation-based comparative analysis performed between them. The design process is conducted using MATLAB SISOTOOL. Results The findings show that each controller has its own merits and demerits. The results generated using MATLAB signify and confirm the effectiveness of PI and cascaded lead controllers, with cascaded lead controller as the best control technique to automate and control the propofol delivery. Conclusion In this paper, different control techniques for measurement-based feedback-controlled propofol delivery is confirmed with promising results. Significance The comparative analysis showed that this drug infusion platform, merged with the proper control technique, will perform eminently in the field of total intravenous anesthesia. PMID:29312654

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

    DEFF Research Database (Denmark)

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

    2010-01-01

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

  16. Efficacy and Safety of Continuous Micro-Pump Infusion of 3% Hypertonic Saline combined with Furosemide to Control Elevated Intracranial Pressure.

    Science.gov (United States)

    Li, Yuqian; Li, Zhihong; Li, Min; Yang, Yanlong; Wang, Bao; Gao, Li; Zhang, Xingye; Cheng, Hongyu; Fang, Wei; Zhao, Bo; Wang, Boliang; Gao, Guodong; Li, Lihong

    2015-06-17

    Elevated intracranial pressure is one of the most common problems in patients with diverse intracranial disorders, leading to increased morbidity and mortality. Effective management for increased intracranial pressure is based mainly on surgical and medical techniques with hyperosmolar therapy as one of the core medical treatments. The study aimed to explore the effects of continuous micro-pump infusions of 3% hypertonic saline combined with furosemide on intracranial pressure control. We analyzed data on 56 eligible participants with intracranial pressure >20 mmHg from March 2013 to July 2014. The target was to increase and maintain plasma sodium to a level between 145 and 155 mmol/L and osmolarity to a level of 310 to 320 mOsmol/kg. Plasma sodium levels significantly increased from 138±5 mmol/L at admission to 151±3 mmol/L at 24 h (PIntracranial pressure significantly decreased from 32±7 mmHg to 15±6 mmHg at 24 h (Ppressure, mean arterial pressure, and Glasgow Coma Scale slightly increased. However, these changes were not statistically significant. Continuous infusion of 3% hypertonic saline + furosemide is effective and safe for intracranial pressure control.

  17. Effect of programmed intermittent epidural boluses and continuous epidural infusion on labor analgesia and obstetric outcomes: a randomized controlled trial.

    Science.gov (United States)

    Ferrer, Leopoldo E; Romero, David J; Vásquez, Oscar I; Matute, Ednna C; Van de Velde, Marc

    2017-11-01

    Continuous epidural infusion and programmed intermittent epidural boluses are analgesic techniques routinely used for pain relief in laboring women. We aimed to assess both techniques and compare them with respect to labor analgesia and obstetric outcomes. After Institutional Review Board approval, 132 laboring women aged between 18 and 45 years were randomized to epidural analgesia of 10 mL of a mixture of 0.1% bupivacaine plus 2 µg/mL of fentanyl either by programmed intermittent boluses or continuous infusion (66 per group). Primary outcome was quality of analgesia. Secondary outcomes were duration of labor, total drug dose used, maternal satisfaction, sensory level, motor block level, presence of unilateral motor block, hemodynamics, side effects, mode of delivery, and newborn outcome. Patients in the programmed intermittent epidural boluses group received statistically less drug dose than those with continuous epidural infusion (24.9 vs 34.4 mL bupivacaine; P = 0.01). There was no difference between groups regarding pain control, characteristics of block, hemodynamics, side effects, and Apgar scores. Our study evidenced a lower anesthetic consumption in the programmed intermittent boluses group with similar labor analgesic control, and obstetric and newborn outcomes in both groups.

  18. Remifentanil for labour analgesia: a double-blinded, randomised controlled trial of maternal and neonatal effects of patient-controlled analgesia versus continuous infusion.

    Science.gov (United States)

    Shen, M K; Wu, Z F; Zhu, A B; He, L L; Shen, X F; Yang, J J; Feng, S W

    2013-03-01

    This trial aimed to compare the maternal and neonatal effects of remifentanil given by patient-controlled analgesia (PCA) or continuous infusion for labour analgesia. Patient controlled analgesia was administered using increasing stepwise boluses from 0.1 to 0.4 μg.kg(-1) (0.1 μg.kg(-1) increment, 2 min lockout, n = 30). Continuous infusion used rates from 0.05 to 0.2 μg.kg(-1) .min(-1) (0.05 μg.kg(-1) .min(-1) increment, n = 30). Dose increments were given on request. Women reported lowest pain scores (median (IQR [range]) of 3 (2-4 [2-5]) for PCA and 4 (3-5.25 [3-7]) for continuous infusion (p = 0.004) at 60 min after the beginning of analgesia. The mean (SD) remifentanil umbilical vein/maternal artery ratio in the PCA and infusion groups were 0.74 (0.45) vs 0.70 (0.52), respectively (p = 0.776). The mean (SD) umbilical artery/umbilical vein ratios were 0.31 (0.12) vs 0.26 (0.07), respectively (p = 0.088). Maternal and neonatal adverse reactions of remifentanil were similar between the two groups. The total remifentanil consumption (median (IQR [range]) during PCA administration was lower than continuous infusion, 1.34 (1.22-1.48 [0.89-1.69]) mg vs 1.49 (1.35-1.61 [1.12-1.70] mg; p = 0.011). The results suggest that remifentanil PCA provides better pain relief and similar placental transfer compared with continuous infusion. Anaesthesia © 2013 The Association of Anaesthetists of Great Britain and Ireland.

  19. Temperature-controlled irrigated tip radiofrequency catheter ablation: comparison of in vivo and in vitro lesion dimensions for standard catheter and irrigated tip catheter with minimal infusion rate

    DEFF Research Database (Denmark)

    Petersen, H H; Chen, X; Pietersen, A

    1998-01-01

    In patients with ventricular tachycardias due to structural heart disease, catheter ablation cures radiofrequency ablation. Irrigated tip radiofrequency ablation using power control and high infusion rates enlarges lesion size, but has...

  20. Efficacy and safety of continuous infusion of fentanyl for pain control in preterm newborns on mechanical ventilation.

    Science.gov (United States)

    Ancora, Gina; Lago, Paola; Garetti, Elisabetta; Pirelli, Anna; Merazzi, Daniele; Mastrocola, Maura; Pierantoni, Luca; Faldella, Giacomo

    2013-09-01

    To evaluate the analgesic superiority and the safety equivalence of continuous fentanyl infusions versus fentanyl boluses in preterm infants on mechanical ventilation. In this multicenter, double-blind, randomized controlled trial, mechanically ventilated newborns (≤ 32(+6) weeks gestational age) were randomized to fentanyl (continuous infusion of fentanyl plus open-label boluses of fentanyl) or placebo (continuous infusion of placebo plus open-label boluses of fentanyl). The primary endpoint was analgesic efficacy, as evaluated by the Echelle Douleur Inconfort Nouveau-Né (EDIN) and Premature Infant Pain Profile scales. Safety variables were evaluated as well. Sixty-four infants were allocated to the fentanyl group, and 67 were allocated to the placebo group. The need for open-label boluses of fentanyl was similar in the 2 groups (P = .949). EDIN scores were comparable in the 2 groups; 65 of 961 (6.8%) EDIN scores were >6 in the fentanyl group and 91 of 857 (10.6%) in the placebo group (P = .003). The median Premature Infant Pain Profile score was clinically and statistically higher in the placebo group compared with the fentanyl group on days 1, 2, and 3 of treatment (P pain, but does reduce acute pain and increase side effects compared with open-label boluses of fentanyl alone. Copyright © 2013 Mosby, Inc. All rights reserved.

  1. Sodium bicarbonate infusion in patients undergoing orthotopic liver transplantation: a single center randomized controlled pilot trial.

    Science.gov (United States)

    Weinberg, Laurence; Broad, Jeremy; Pillai, Param; Chen, Guangjun; Nguyen, Micheline; Eastwood, Glenn M; Scurrah, Nick; Nikfarjam, Mehrdad; Story, David; McNicol, Larry; Bellomo, Rinaldo

    2016-05-01

    Liver transplantation-associated acute kidney injury (AKI) carries significant morbidity and mortality. We hypothesized that sodium bicarbonate would reduce the incidence and/or severity of liver transplantation-associated AKI. In this double-blinded pilot RCT, adult patients undergoing orthotopic liver transplantation were randomized to an infusion of either 8.4% sodium bicarbonate (0.5 mEq/kg/h for the first hour; 0.15 mEq/kg/h until completion of surgery); (n = 30) or 0.9% sodium chloride (n = 30). AKI within the first 48 h post-operatively. There were no significant differences between the two treatment groups with regard to baseline characteristics, model for end-stage liver disease and acute physiology and chronic health evaluation (APACHE) II scores, and pre-transplantation renal function. Intra-operative factors were similar for duration of surgery, blood product requirements, crystalloid and colloid volumes infused and requirements for vasoactive therapy. Eleven patients (37%) in the bicarbonate group and 10 patients (33%) in the sodium chloride group developed a post-operative AKI (p = 0.79). Bicarbonate infusion attenuated the degree of immediate post-operative metabolic acidosis; however, this effect dissipated by 48 h. There were no significant differences in ventilation hours, ICU or hospital length of stay, or mortality. The intra-operative infusion of sodium bicarbonate did not decrease the incidence of AKI in patients following orthotopic liver transplantation. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  2. Magnesium sulfate infusion prevents shivering during transurethral prostatectomy with spinal anesthesia: a randomized, double-blinded, controlled study.

    Science.gov (United States)

    Gozdemir, Muhammet; Usta, Burhanettin; Demircioglu, Ruveyda Irem; Muslu, Bunyamin; Sert, Huseyin; Karatas, Omer Faruk

    2010-05-01

    To determine whether magnesium sulfate (MgSO(4)) infusion during surgery reduces shivering during spinal anesthesia. Double-blinded placebo-controlled, randomized trial. Operation room of a university hospital. 60 patients, aged 40 to 70 years, scheduled for elective transurethral resection of the prostate (TURP) during spinal anesthesia. Subarachnoid anesthesia consisting of hyperbaric bupivacaine three mL 0.5% was injected using a 25-G Quincke spinal needle. Patients received either saline (Group C, n = 30) or MgSO(4) (Group Mg, n = 30). Group Mg received an intravenous (IV) bolus of MgSO(4) 80 mg/kg via syringe pump over a 30-minute period, followed by a two g/hr infusion during the intraoperative period. Group C received an equal volume of saline. Motor blockade was evaluated by Bromage motor scale. Sensory block level was assessed by pinprick test. Shivering was assessed after the completion of subarachnoid drug injection. Side effects were recorded. Hypothermia was observed in all patients (100%) in Group Mg and in 24 patients (80%) in Group C (P = 0.024). The decrease in core temperature in Group Mg was significantly greater (P Shivering was observed in two patients (6.7%) in Group Mg and 20 patients (66.7%) in Group C (P = 0.0001). MgSO(4) infusion in the perioperative period significantly reduced shivering during TURP with spinal anesthesia. MgSO(4) infusion prevents shivering in patients receiving spinal anesthesia but increases the risk of hypothermia. (c) 2010 Elsevier Inc. All rights reserved.

  3. Blood glucose control in healthy subject and patients receiving intravenous glucose infusion or total parenteral nutrition using glucagon-like peptide 1

    DEFF Research Database (Denmark)

    Nauck, Michael A; Walberg, Jörg; Vethacke, Arndt

    2004-01-01

    It was the aim of the study to examine whether the insulinotropic gut hormone GLP-1 is able to control or even normalise glycaemia in healthy subjects receiving intravenous glucose infusions and in severely ill patients hyperglycaemic during total parenteral nutrition.......It was the aim of the study to examine whether the insulinotropic gut hormone GLP-1 is able to control or even normalise glycaemia in healthy subjects receiving intravenous glucose infusions and in severely ill patients hyperglycaemic during total parenteral nutrition....

  4. The Efficacy of Postoperative Wound Infusion with Bupivacaine for Pain Control after Cesarean Delivery: Randomized Double Blind Clinical Trial

    Directory of Open Access Journals (Sweden)

    Azin Alavi

    2007-06-01

    Full Text Available Objective: This study investigated the efficacy of bupivacaine wound infusion for pain control and opioid sparing effect after cesarean delivery.Materials and methods: We conducted a randomized double blind, placebo controlled clinical trial on 60 parturients undergoing cesarean section at a university hospital in Tehran. Patients were randomized to receive a pump infusion system that was filled with either 0.25% bupivacaine or equal volume of distilled water. A catheter was placed above the fascia and connected to electronic pump for 24 hours. Postoperative analog pain scores and morphine consumption were assessed at 6, 12 and 24 hours. Also time interval to first ambulation, length of hospitalization, complications and patient satisfaction were recorded. Data were analyzed using the SPSS software and P < 0.05 was considered statistically significant. Mann-Whitney u-test, student t-test and chi-square were used. Results: There were no differences in patient demographics and length of hospitalization and patient-generated resting pain scores between the two groups. Pain scores after coughing and leg raise during the first 6 postoperative hours were significantly less in the Bupivacaine group (P<0.001. The total dose of morphine consumption during the 24 hours study period was 2.5 ± 2.5 mg vs. 7.3 ± 2.7 mg for the bupivacaine and control groups, respectively (P<0.001. Compared with the control group, time to first ambulation was shorter in the bupivacaine group (11± 5h vs. 16 ± 4h (P< 0.01. Conclusion: Bupivacaine wound infusion was a simple and safe technique that provides effective analgesia and reduces morphine requirements after cesarean delivery.

  5. The analgesic efficacy of intravenous lidocaine infusion after laparoscopic fundoplication: a prospective, randomized, double-blind, placebo-controlled trial

    Directory of Open Access Journals (Sweden)

    Dale GJ

    2016-12-01

    Full Text Available Gregory J Dale,1 Stephanie Phillips,2 Gregory L Falk3 1Westmead Hospital Clinical School, The University of Sydney, 2Sydney Adventist Hospital Clinical School, The University of Sydney, 3Concord Clinical School, The University of Sydney, Sydney, Australia Abstract: This study aimed to determine if intravenous lidocaine infusion reduces postoperative pain intensity following laparoscopic fundoplication surgery and to also validate the safety of intravenous lidocaine at the dose tested. This was an equally randomized, double-blind, placebo-controlled, parallel-group, single center trial. Adult patients undergoing laparoscopic fundoplication were recruited. The intervention group received 1 mg/kg intravenous lidocaine bolus prior to induction of anesthesia, then an intravenous infusion at 2 mg/kg/h for 24 hours. The primary outcome was pain, measured using a numeric rating scale for 30 hours postoperatively. Secondary outcomes were nausea and vomiting, opioid requirements, adverse events, serum lidocaine concentration, and length of hospital stay. The study was terminated after an interim analysis of 24 patients showed evidence of futility. There was no difference in postoperative pain scores (lidocaine versus control, mean ± standard deviation at rest (2.0 ± 2.7 vs 2.1 ± 2.4, P=0.286 or with movement (2.0 ± 2.6 vs 2.6 ± 2.7, P=0.487. Three adverse events occurred in the lidocaine group (25% of patients. Intravenous lidocaine did not provide clinically significant analgesia to patients undergoing laparoscopic fundoplication. The serum lidocaine concentration of patients who experienced adverse events were within the therapeutic range. This trial cannot confirm the safety of intravenous lidocaine at the dose tested. Keywords: analgesia, local anesthetics, intravenous infusions, pharmacokinetics

  6. Perioperative prostaglandin e1 infusion in living donor liver transplantation: A double-blind, placebo-controlled randomized trial.

    Science.gov (United States)

    Bharathan, Viju Kumar; Chandran, Biju; Gopalakrishnan, Unnikrishnan; Varghese, Christi Titus; Menon, Ramachandran N; Balakrishnan, Dinesh; Sudheer, O V; Dhar, Puneet; Surendran, Sudhindran

    2016-08-01

    The role of prostaglandin E1 (PGE1) infusion in improving early graft function has not been well defined, especially in the scenario of living donor liver transplantation (LDLT). We designed a randomized, double-blind, placebo-controlled trial to evaluate the role of perioperative PGE1 infusion in LDLT. Patients in the study arm received PGE1 (alprostadil) at the rate of 0.25 μg/kg/hour, starting at 1 hour after portal venous reperfusion, and continued for 96 hours. The primary endpoint was early allograft dysfunction (EAD). We analyzed multiple secondary endpoints including postoperative liver function and renal function parameters, acute kidney injury (AKI), hepatic artery thrombosis (HAT), postoperative bleeding, overall mortality, and posttransplant hospital stay. The incidence of EAD was lower in the PGE1 arm, although the difference did not reach statistical significance (22.4% versus 36%; P = 0.21). Among the secondary endpoints, the incidence of AKI was significantly lower in the PGE1 arm (8.2% versus 28%; P = 0.02), as were the peak and mean postoperative creatinine levels. The need for renal replacement therapy was similar between the 2 groups. Among the postoperative graft function parameters, postoperative alanine aminotransferase level was significantly lower in the PGE1 arm (P = 0.04), whereas the remaining parameters including serum bilirubin, aspartate aminotransferase, and international normalized ratio were similar between the 2 arms. There was no difference in the incidence of HAT and postoperative bleeding, in-hospital mortality, and posttransplant hospital stay between the 2 arms. Perioperative PGE1 infusion reduces the incidence of posttransplant renal dysfunction in patients undergoing LDLT. Liver Transplantation 22 1067-1074 2016 AASLD. © 2016 American Association for the Study of Liver Diseases.

  7. Continuous radioisotope infusion

    International Nuclear Information System (INIS)

    Soederborg, B.; Asaba, H.; Gunnarsson, B.; Jekell, K.; Kiibus, A.; Sandqvist, S.

    1978-01-01

    Continuous infusion of a radioactive marker was used instead of a conventional bolus injection to improve haemodynamic studies. Tc-99m was infused into the blood circulation at a constant rate for 100-300 seconds and the activity in the target structure was measured by a gamma camera with a computer system or by a single detector. The concentration of the marker increased linearly at the same rate throughout the circulating system. Due to variations in transport time from infusion site to different parts of the system the rise of activity occurred at different times. A theory for the calculations was presented and consequently confirmed in a model study. Blood flow patterns in artificial kidneys and alterations in renal blood flow induced by angiotensin were studied. The results are presented as time-function curves or as computer images. This technique can be used to evaluate distributions and alterations of flow in separate parts of a complex circulating system. (author)

  8. Glucose control in mobile type 1 (insulin-dependent) diabetic patients by means of a semi-automatic feedback controlled insulin infusion system.

    Science.gov (United States)

    Piwernetz, K; Renner, R; Hepp, K D

    1982-09-01

    A portable insulin dosing device (Siemens) was used together with a programmable pocket calculator and a glucose analyzer for short-term adaptation of continuous intravenous insulin infusion to blood glucose alterations. A special algorithm was developed which utilizes a given blood glucose value and the glucose rate of change obtained from two to four consecutive samples as input variables. In contrast to current techniques of feedback-regulation, which require continuous glucose monitoring, intermittent blood sampling allows greater mobility of patients. With the semi-automatic feedback system, euglycaemic control was obtained for 12-h periods in ten Type 1 (insulin-dependent) diabetic patients (maximum value 9.50 mmol/l, minimum value 2.83 mmol/l). Severe hypoglycaemia occurred in no case and additional control by glucose infusion appeared to be unnecessary. Light exercise after termination of insulin dose for standard meals led to glycaemic excursions with a rapid decrease (mean 1.08 +/- 0.09 mmol/l), followed by a rebound (0.59 +/- 0.07 mmol/l) in each patient. The amplitude of these excursions decreased with increasing distance from the peak of the meal dose. Comparison of feedback-control alone with feedback by glucose plus preprogrammed dose (4 U/h) at the onset of the test meal revealed lower post-prandial glucose levels (post-prandial maximum +/- SEM: 6.49 +/- 0.18 versus 7.71 +/- 0.79 mmol/l) and a lower infusion rate of insulin for the combined regimen (mean post-prandial maximum +/- SEM: 8.4 +/- 1.2 versus 12.0 +/- 0 IU/h). The system is useful for programming of portable infusion devices and studies based on euglycaemic control in unrestrained patients.

  9. Effect of carbohydrate counting using bolus calculators on glycemic control in type 1 diabetes patients during continuous subcutaneous insulin infusion.

    Science.gov (United States)

    Yamada, Eijiro; Okada, Shuichi; Nakajima, Yasuyo; Bastie, Claire C; Tagaya, Yuko; Osaki, Aya; Shimoda, Yoko; Shibusawa, Ryo; Saito, Tsugumichi; Ozawa, Atsushi; Yamada, Masanobu

    2017-07-01

    The present study examined the long-term efficacy of insulin pump therapy for type 1 diabetes patients when carried out using carbohydrate counting with bolus calculators for 1 year. A total of 22 type 1 diabetes patients who had just started continuous subcutaneous insulin infusion were examined and divided into two groups: one that was educated about carbohydrate counting using bolus calculators (n = 14); and another that did not use bolus calculators (n = 8). After 1 year, the hemoglobin A1c levels of the patient group that used bolus calculators decreased persistently and significantly (P = 0.0297), whereas those of the other group did not. The bodyweight, total daily dose of insulin and bolus percentage of both groups did not change. Carbohydrate counting using bolus calculators is necessary to achieve optimal and persistent glycemic control in patients undergoing continuous subcutaneous insulin infusion. © 2016 The Authors. Journal of Diabetes Investigation published by Asian Association for the Study of Diabetes (AASD) and John Wiley & Sons Australia, Ltd.

  10. Computer control of the SMC polarized target

    Energy Technology Data Exchange (ETDEWEB)

    Le Goff, J.M. [CEA Centre d`Etudes Nucleaires de Saclay, 91 - Gif-sur-Yvette (France). Dept. d`Astrophysique, de Physique des Particules, de Physique Nucleaire et de l`Instrumentation Associee]|[CERN, CH-1211 Geneve 23 (Switzerland); Azoulay, R. [CEA, DAPNIA/SIG, CE Saclay, 91191 Gif-sur-Yvette (France); Berglund, P. [Low Temperature Laboratory, Helsinki University of Technology, SF-02150 Espoo (Finland); Dulya, C. [University of California, Department of Physics, Los Angeles, 90024 CA (United States); Gournay, J.F. [CEA, DAPNIA/SIG, CE Saclay, 91191 Gif-sur-Yvette (France); Hayashi, N. [Nagoya University, Department of Physics, Furo-Cho, Chikusa-Ku, 464 Nagoya (Japan); Kyynaeraeinen, J. [CERN, CH-1211 Geneve 23 (Switzerland); Magnon, A. [CEA Centre d`Etudes Nucleaires de Saclay, 91 - Gif-sur-Yvette (France). Dept. d`Astrophysique, de Physique des Particules, de Physique Nucleaire et de l`Instrumentation Associee; Matichard, G. [CEA, DAPNIA/SIG, CE Saclay, 91191 Gif-sur-Yvette (France); Niinikoski, T.O. [CERN, CH-1211 Geneve 23 (Switzerland); Trentalange, S. [University of California, Department of Physics, Los Angeles, 90024 CA (United States)

    1995-03-01

    The SMC polarized target is controlled through VME crates driven by CPUs working under the VxWorks operating system. The CPUs are connected to a SUN workstation which provides the user interface due to a graphical package named SL-GMS. This results in user friendliness, high modularity and flexibility. The system allows the control of: (1) the superconductive solenoid and the transverse dipole: control of the power supplies; automatic reversal of the spin direction by field rotation; acquisition, display and storage of the electric and cryogenic parameters; generation of alarms; and (2) the dilution refrigerator: evaporator level control; acquisition, display and storage of {approx}100 cryogenic parameters; and generation of alarms. ((orig.))

  11. Prophylactic phenylephrine infusion for the prevention of hypotension after spinal anesthesia in the elderly: a randomized controlled clinical trial.

    Science.gov (United States)

    Ferré, Fabrice; Marty, Philippe; Bruneteau, Laura; Merlet, Virgine; Bataille, Benoît; Ferrier, Anne; Gris, Claude; Kurrek, Matt; Fourcade, Olivier; Minville, Vincent; Sommet, Agnes

    2016-12-01

    Hypotension frequently occurs during spinal anesthesia (SA), especially in the elderly. Phenylephrine is effective to prevent SA-induced hypotension during cesarean delivery. The objective of this study was to evaluate the efficacy and safety of prophylactic infusion of phenylephrine after SA for orthopedic surgery in the elderly. This prospective, randomized, double-blind, and placebo-controlled study included 54 patients older than 60 years undergoing elective lower limb surgery under SA (injection of 10 mg of isobaric bupivacaine with 5 μg of sufentanyl). Patients were randomized to group P (100-μg/mL solution of phenylephrine solution at 1 mL/min after placement of SA) or the control group C (0.9% isotonic sodium chloride solution). The flow of the infusion was stopped if the mean arterial blood pressure (MAP) was higher than the baseline MAP and maintained or restarted at 1 mL/min if MAP was equal to or lower than the baseline MAP. Heart rate and MAP were collected throughout the case. Hypotension was defined by a 20% decrease and hypertension as a 20% increase from baseline MAP. Bradycardia was defined as a heart rate lower than 50 beats per minute. Twenty-eight patients were randomized to group P and 26 patients to group C. MAP was higher in group P than in group C (92 ± 2 vs 82 ± 2 mm Hg, mean ± SD, Phypotensive episodes per patient was higher in group C compared with group P (9 [0-39] vs 1 [0-10], median [extremes], Phypotensive patients was similar between groups (19 [73%] vs 20 [71%], P= 1). The time to onset of the first hypotension was shorter in group C (3 [1-13] vs 15 [1-95] minutes, P= .004). The proportion of patients without hypotension (cumulative survival) was better in group P (P= .04). The number of hypertensive episodes per patient and the number of bradycardic episodes per patient were similar between groups (P= not significant). Prophylactic phenylephrine infusion is an effective method of reducing SA-induced hypotension in the elderly

  12. Targeting deregulated epigenetic control in cancer.

    Science.gov (United States)

    Zaidi, Sayyed K; Van Wijnen, Andre J; Lian, Jane B; Stein, Janet L; Stein, Gary S

    2013-11-01

    Cancer is a multifaceted disease that involves acquisition of genetic mutations, deletions, and amplifications as well as deregulation of epigenetic mechanisms that fine-tune gene regulation. Key epigenetic mechanisms that include histone modifications, DNA methylation, and non-coding RNA-mediated gene silencing are often deregulated in a variety of cancers. Subnuclear localization of key proteins in the interphase nucleus and bookmarking of genes by lineage commitment factors in mitosis-a new dimension to epigenetic control of fundamental biological processes-is also modified in cancer. In this review, we discuss the various aspects of epigenetic control that are operative in a variety of cancers and their potential for risk assessment, early detection, targeted therapy, and personalized medicine. Copyright © 2013 Wiley Periodicals, Inc.

  13. Design and performance evaluation of the "iTIVA" algorithm for manual infusion of intravenous anesthetics based on effect-site target

    NARCIS (Netherlands)

    D.E. Ramírez (David Eduardo); J.A. Calvache (Jose Andrés)

    2016-01-01

    textabstractIntroduction: Remifentanil and propofol infusion using TCI pumps has proven to be beneficial for the practice of anesthesia but the availability of these systems is limited. Objective: Designing a pharmacokinetic model-based algorithm for calculating manual infusion regimens to achieve

  14. Targeting antibiotics to households for trachoma control.

    Directory of Open Access Journals (Sweden)

    Isobel M Blake

    2010-11-01

    Full Text Available Mass drug administration (MDA is part of the current trachoma control strategy, but it can be costly and results in many uninfected individuals receiving treatment. Here we explore whether alternative, targeted approaches are effective antibiotic-sparing strategies.We analysed data on the prevalence of ocular infection with Chlamydia trachomatis and of active trachoma disease among 4,436 individuals from two communities in The Gambia (West Africa and two communities in Tanzania (East Africa. An age- and household-structured mathematical model of transmission was fitted to these data using maximum likelihood. The presence of active inflammatory disease as a marker of infection in a household was, in general, significantly more sensitive (between 79% [95%CI: 60%-92%] and 86% [71%-95%] across the four communities than as a marker of infection in an individual (24% [16%-33%]-66% [56%-76%]. Model simulations, under the best fit models for each community, showed that targeting treatment to households has the potential to be as effective as and significantly more cost-effective than mass treatment when antibiotics are not donated. The cost (2007US$ per incident infection averted ranged from 1.5 to 3.1 for MDA, from 1.0 to 1.7 for household-targeted treatment assuming equivalent coverage, and from 0.4 to 1.7 if household visits increased treatment coverage to 100% in selected households. Assuming antibiotics were donated, MDA was predicted to be more cost-effective unless opportunity costs incurred by individuals collecting antibiotics were included or household visits improved treatment uptake. Limiting MDA to children was not as effective in reducing infection as the other aforementioned distribution strategies.Our model suggests that targeting antibiotics to households with active trachoma has the potential to be a cost-effective trachoma control measure, but further work is required to assess if costs can be reduced and to what extent the approach

  15. Model Reference Adaptive Scheme for Multi-drug Infusion for Blood Pressure Control

    OpenAIRE

    Enbiya, Saleh; Mahieddine, Fatima; Hossain, Alamgir

    2011-01-01

    Using multiple interacting drugs to control both the mean arterial pressure (MAP) and cardiac output (CO) of patients with different sensitivity to drugs is a challenging task which this paper attempts to address. A multivariable model reference adaptive control (MRAC) algorithm is developed using a two-input, two-output patient model. The control objective is to maintain the homodynamic variables MAP and CO at the normal values by simultaneously administering two drugs; sodium nitroprusside ...

  16. Dexmedetomidine versus labetalol infusions for controlling emergence hypertension in cranial surgeries for supratentorial tumors

    Directory of Open Access Journals (Sweden)

    Tarek Ahmed Mostafa Radwan

    2016-10-01

    Conclusion: Both dexmedetomidine and labetalol had favorable effects on hemodynamics at time of emergence from anesthesia in comparison with control group without prolongation of the time of extubation.

  17. 21 CFR 880.5725 - Infusion pump.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Infusion pump. 880.5725 Section 880.5725 Food and... Infusion pump. (a) Identification. An infusion pump is a device used in a health care facility to pump fluids into a patient in a controlled manner. The device may use a piston pump, a roller pump, or a...

  18. The Opioid-Sparing Effect of Perioperative Dexmedetomidine Combined with Oxycodone Infusion during Open Hepatectomy: A Randomized Controlled Trial

    Directory of Open Access Journals (Sweden)

    Benhou Zhang

    2018-01-01

    Full Text Available Background: A large right subcostal incision performed by open hepatectomy is associated with significant post-operative pain and distress. However, post-operative analgesia solutions still need to be devised. We investigated the effects of intra- and post-operative infusion of dexmedetomidine (Dex combined with oxycodone during open hepatectomy.Methods: In this prospective, randomized and double-blind investigation, 52 patients undergoing selective open hepatectomy were divided into Dex group (DEX infusion at an initial loading dose of 0.5 μg⋅kg-1 over 10 min before intubation then adjusted to a maintenance dose of 0.3 μg⋅kg-1⋅h-1 until incision suturing or control (Con group (0.9% sodium chloride was administered. Patient-controlled analgesia was administered for 48 h after surgery (Dex group: 60 mg oxycodone and 360 μg DEX diluted to 120 ml and administered at a bolus dose of 2 ml, with 5 min lockout interval and a 1 h limit of 20 ml. Con group: 60 mg oxycodone alone with the same regimen. The primary outcome was post-operative oxycodone consumption. The secondary outcomes included requirement of narcotic and vasoactive drugs, hemodynamics, incidence of adverse effects, satisfaction, first exhaust time, pain intensity, and the Ramsay Sedation Scale.Results: Post-operative oxycodone consumption was significantly reduced in Dex group from 4 to 48 h after surgery (P < 0.05. Heart rate in Dex group was statistically decreased from T1 (just before intubation to T6 (20 min after arriving at the post-anesthesia care unit, while mean arterial pressure was significantly decreased from T1 to T3 (during surgical incision; P < 0.05. The consumption of propofol and remifentanil were significantly decreased in Dex group (P < 0.05. The VAS scores at rest at 1, 4, and 8 h and with cough at 24, and 48 h after surgery were lower, the first exhaust time were shorter, satisfaction with pain control was statistically higher and the incidence of nausea

  19. Strontium-rubidium infusion pump with in-line dosimetry

    International Nuclear Information System (INIS)

    Barker, S.L.; Loberg, M.D.

    1986-01-01

    A strontium-rubidium infusion system is described which consists of: (a) means for generating rubidium 82 in a solution which can be infused into a patient; (b) means for infusing the solution into a patient; (c) means for measuring the radioactivity present in the solution as it is infused into the patient; and (d) means for controlling the means for infusing in response to the amount of radioactivity which has been infused into the patient

  20. Local infiltration analgesia followed by continuous infusion of local anesthetic solution for total hip arthroplasty: a prospective, randomized, double-blind, placebo-controlled study.

    Science.gov (United States)

    Solovyova, Olga; Lewis, Courtland G; Abrams, Jonathan H; Grady-Benson, John; Joyce, Michael E; Schutzer, Steven F; Arumugam, Sivasenthil; Caminiti, Stephanie; Sinha, Sanjay K

    2013-11-06

    We studied the efficacy of local infiltration analgesia in surgical wounds with 0.2% ropivacaine (50 mL), ketorolac (15 mg), and adrenaline (0.5 mg) compared with that of local infiltration analgesia combined with continuous infusion of 0.2% ropivacaine as a method of pain control after total hip arthroplasty. We hypothesized that as a component of multimodal analgesia, local infiltration analgesia followed by continuous infusion of ropivacaine would result in reduced postoperative opioid consumption and lower pain scores compared with infiltration alone, and that both of these techniques would be superior to placebo. In this prospective, double-blind, placebo-controlled study, 105 patients were randomized into three groups: Group I, in which patients received infiltration with ropivacaine, ketorolac, and adrenaline followed by continuous infusion of 0.2% ropivacaine at 5 mL/hr; Group II, in which patients received infiltration with ropivacaine, ketorolac, and adrenaline followed by continuous infusion of saline solution at 5 mL/hr; and Group III, in which patients received infiltration with saline solution followed by continuous infusion of saline solution at 5 mL/hr.All patients received celecoxib, pregabalin, and acetaminophen perioperatively and patient-controlled analgesia; surgery was performed under general anesthesia. Before wound closure, the tissues and periarticular space were infiltrated with ropivacaine, ketorolac, and adrenaline or saline solution and a fenestrated catheter was placed. The catheter was attached to a pump prefilled with either 0.2% ropivacaine or saline solution set to infuse at 5 mL/hr.The primary outcome measure was postoperative opioid consumption and the secondary outcome measures were pain scores, adverse side effects, and patient satisfaction. There were no differences between groups in the administration of opioids in the operating room, in the recovery room, or on the surgical floor. The pain scores on recovery room admission

  1. Goal-directed diuresis: A case - control study of continuous furosemide infusion in critically ill trauma patients

    Directory of Open Access Journals (Sweden)

    Daniel Dante Yeh

    2015-01-01

    Full Text Available Background: Excessive crystalloid administration is common and associated with negative outcomes in critically ill trauma patients. Continuous furosemide infusion (CFI to remove excessive fluid has not been previously described in this population. We hypothesized that a goal-directed CFI is more effective for fluid removal than intermittent bolus injection (IBI diuresis without excess incidence of hypokalemia or renal failure. Materials and Methods: CFI cases were prospectively enrolled between November 2011 and August 2012, and matched to historic IBI controls by age, gender, Injury Severity Score (ISS, and net fluid balance (NFB at diuresis initiation. Paired and unpaired analyses were performed to compare groups. The primary endpoints were net fluid balance, potassium and creatinine levels. Secondary endpoints included intensive care unit (ICU and hospital length of stay (LOS, ventilator-free days (VFD, and mortality. Results: 55 patients were included, with 19 cases and 36 matched controls. Mean age was 54 years, mean ISS was 32.7, and mean initial NFB was +7.7 L. After one day of diuresis with CFI vs. IBI, net 24 h fluid balance was negative (−0.55 L vs. +0.43 L, P = 0.026 only for the CFI group, and there was no difference in potassium and creatinine levels. Cumulative furosemide dose (59.4mg vs. 25.4mg, P < 0.001 and urine output (4.2 L vs. 2.8 L, P < 0.001 were also significantly increased with CFI vs. IBI. There were no statistically significant differences in ICU LOS, hospital LOS, VFD, or mortality. Conclusions: Compared to IBI, goal-directed diuresis by CFI is more successful in achieving net negative fluid balance in patients with fluid overload with no detrimental side effects on renal function or patient outcome.

  2. Experimental targeting of chaos via controlled symbolic dynamics

    International Nuclear Information System (INIS)

    Corron, Ned J.; Pethel, Shawn D.

    2003-01-01

    In this Letter, we report experimental targeting in a chaotic system by controlling symbolic dynamics. We acquire and control an electronic circuit using small perturbations to elicit a desired objective state starting from an arbitrary, uncontrolled state. The control perturbations are calculated using a symbolic targeting sequence and applied using dynamic limiting control

  3. Hypoglycaemia secondary to labetalol infusion.

    Science.gov (United States)

    Immanni, Sudhir; Khan, Ehtesham Izhar; Staunton, Michael

    2011-05-01

    A 42-year-old multigravida with severe pre-eclampsia had an emergency caesarean section under spinal anaesthesia. Peri-operatively, her arterial pressure was controlled with oral methyldopa and an intravenous infusion of labetalol. Postoperatively, in the Intensive Care Unit, she had recurrent episodes of hypoglycaemia which required treatment with intravenous glucose. These episodes resolved when the labetalol infusion was stopped. Clinicians should be aware of the potential of labetalol to cause hypoglycaemia.

  4. Direct effects of locally administered lipopolysaccharide on glucose, lipid, and protein metabolism in the placebo-controlled, bilaterally infused human leg

    DEFF Research Database (Denmark)

    Buhl, Mads; Bosnjak, Ermina; Vendelbo, Mikkel H.

    2013-01-01

    Context: Accumulating evidence suggests that chronic exposure to lipopolysaccharide (LPS, endotoxin) maycreate a constant low-grade inflammation, leading to insulin resistance and diabetes. All previous human studies assessing the metabolic actions of LPS have used systemic administration, making...... discrimination between direct and indirect effects impossible. Objective: We sought to define the direct, placebo-controlled effects of LPS on insulin resistance and protein and lipid metabolism in the infused human leg without systemic interference from cytokines and stress hormones. Design......: This was a randomized, placebo-controlled, single-blinded study. Participants and Intervention: We studied 8 healthy volunteers with bilateral femoral vein and artery catheters during a 3-hour basal and 3-hour hyperinsulinemic-euglycemic clamp period with bilateral muscle biopsies in each period during infusion...

  5. Study protocol. ECSSIT - Elective Caesarean Section Syntocinon Infusion Trial. A multi-centre randomised controlled trial of oxytocin (Syntocinon) 5 IU bolus and placebo infusion versus oxytocin 5 IU bolus and 40 IU infusion for the control of blood loss at elective caesarean section.

    LENUS (Irish Health Repository)

    Murphy, Deirdre J

    2009-01-01

    BACKGROUND: Caesarean section is one of the most commonly performed major operations in women throughout the world. Rates are escalating, with studies from the United States of America, the United Kingdom, China and the Republic of Ireland reporting rates between 20% and 25%. Operative morbidity includes haemorrhage, anaemia, blood transfusion and in severe cases, maternal death. The value of routine oxytocics in the third stage of vaginal birth has been well established and it has been assumed that these benefits apply to caesarean delivery as well. A slow bolus dose of oxytocin is recommended following delivery of the baby at caesarean section. Some clinicians use an additional infusion of oxytocin for a further period following the procedure. Intravenous oxytocin has a very short half-life (4-10 minutes) therefore the potential advantage of an oxytocin infusion is that it maintains uterine contractility throughout the surgical procedure and immediate postpartum period, when most primary haemorrhages occur. The few trials to date addressing the optimal approach to preventing haemorrhage at caesarean section have been under-powered to evaluate clinically important outcomes. There has been no trial to date comparing the use of an intravenous slow bolus of oxytocin versus an oxytocin bolus and infusion. METHODS AND DESIGN: A multi-centre randomised controlled trial is proposed. The study will take place in five large maternity units in Ireland with collaboration between academics and clinicians in the disciplines of obstetrics and anaesthetics. It will involve 2000 women undergoing elective caesarean section after 36 weeks gestation. The main outcome measure will be major haemorrhage (blood loss >1000 ml). A study involving 2000 women will have 80% power to detect a 36% relative change in the risk of major haemorrhage with two-sided 5% alpha. DISCUSSION: It is both important and timely that we evaluate the optimal approach to the management of the third stage at

  6. Study protocol. ECSSIT - Elective Caesarean Section Syntocinon Infusion Trial. A multi-centre randomised controlled trial of oxytocin (Syntocinon) 5 IU bolus and placebo infusion versus oxytocin 5 IU bolus and 40 IU infusion for the control of blood loss at elective caesarean section.

    LENUS (Irish Health Repository)

    Murphy, Deirdre J

    2012-02-01

    BACKGROUND: Caesarean section is one of the most commonly performed major operations in women throughout the world. Rates are escalating, with studies from the United States of America, the United Kingdom, China and the Republic of Ireland reporting rates between 20% and 25%. Operative morbidity includes haemorrhage, anaemia, blood transfusion and in severe cases, maternal death. The value of routine oxytocics in the third stage of vaginal birth has been well established and it has been assumed that these benefits apply to caesarean delivery as well. A slow bolus dose of oxytocin is recommended following delivery of the baby at caesarean section. Some clinicians use an additional infusion of oxytocin for a further period following the procedure. Intravenous oxytocin has a very short half-life (4-10 minutes) therefore the potential advantage of an oxytocin infusion is that it maintains uterine contractility throughout the surgical procedure and immediate postpartum period, when most primary haemorrhages occur. The few trials to date addressing the optimal approach to preventing haemorrhage at caesarean section have been under-powered to evaluate clinically important outcomes. There has been no trial to date comparing the use of an intravenous slow bolus of oxytocin versus an oxytocin bolus and infusion. METHODS AND DESIGN: A multi-centre randomised controlled trial is proposed. The study will take place in five large maternity units in Ireland with collaboration between academics and clinicians in the disciplines of obstetrics and anaesthetics. It will involve 2000 women undergoing elective caesarean section after 36 weeks gestation. The main outcome measure will be major haemorrhage (blood loss >1000 ml). A study involving 2000 women will have 80% power to detect a 36% relative change in the risk of major haemorrhage with two-sided 5% alpha. DISCUSSION: It is both important and timely that we evaluate the optimal approach to the management of the third stage at

  7. Study Protocol. ECSSIT – Elective Caesarean Section Syntocinon® Infusion Trial. A multi-centre randomised controlled trial of oxytocin (Syntocinon® 5 IU bolus and placebo infusion versus oxytocin 5 IU bolus and 40 IU infusion for the control of blood loss at elective caesarean section

    Directory of Open Access Journals (Sweden)

    Montgomery Alan A

    2009-08-01

    Full Text Available Abstract Background Caesarean section is one of the most commonly performed major operations in women throughout the world. Rates are escalating, with studies from the United States of America, the United Kingdom, China and the Republic of Ireland reporting rates between 20% and 25%. Operative morbidity includes haemorrhage, anaemia, blood transfusion and in severe cases, maternal death. The value of routine oxytocics in the third stage of vaginal birth has been well established and it has been assumed that these benefits apply to caesarean delivery as well. A slow bolus dose of oxytocin is recommended following delivery of the baby at caesarean section. Some clinicians use an additional infusion of oxytocin for a further period following the procedure. Intravenous oxytocin has a very short half-life (4–10 minutes therefore the potential advantage of an oxytocin infusion is that it maintains uterine contractility throughout the surgical procedure and immediate postpartum period, when most primary haemorrhages occur. The few trials to date addressing the optimal approach to preventing haemorrhage at caesarean section have been under-powered to evaluate clinically important outcomes. There has been no trial to date comparing the use of an intravenous slow bolus of oxytocin versus an oxytocin bolus and infusion. Methods and design A multi-centre randomised controlled trial is proposed. The study will take place in five large maternity units in Ireland with collaboration between academics and clinicians in the disciplines of obstetrics and anaesthetics. It will involve 2000 women undergoing elective caesarean section after 36 weeks gestation. The main outcome measure will be major haemorrhage (blood loss >1000 ml. A study involving 2000 women will have 80% power to detect a 36% relative change in the risk of major haemorrhage with two-sided 5% alpha. Discussion It is both important and timely that we evaluate the optimal approach to the management

  8. Study Protocol. ECSSIT – Elective Caesarean Section Syntocinon® Infusion Trial. A multi-centre randomised controlled trial of oxytocin (Syntocinon®) 5 IU bolus and placebo infusion versus oxytocin 5 IU bolus and 40 IU infusion for the control of blood loss at elective caesarean section

    Science.gov (United States)

    Murphy, Deirdre J; Carey, Michael; Montgomery, Alan A; Sheehan, Sharon R

    2009-01-01

    Background Caesarean section is one of the most commonly performed major operations in women throughout the world. Rates are escalating, with studies from the United States of America, the United Kingdom, China and the Republic of Ireland reporting rates between 20% and 25%. Operative morbidity includes haemorrhage, anaemia, blood transfusion and in severe cases, maternal death. The value of routine oxytocics in the third stage of vaginal birth has been well established and it has been assumed that these benefits apply to caesarean delivery as well. A slow bolus dose of oxytocin is recommended following delivery of the baby at caesarean section. Some clinicians use an additional infusion of oxytocin for a further period following the procedure. Intravenous oxytocin has a very short half-life (4–10 minutes) therefore the potential advantage of an oxytocin infusion is that it maintains uterine contractility throughout the surgical procedure and immediate postpartum period, when most primary haemorrhages occur. The few trials to date addressing the optimal approach to preventing haemorrhage at caesarean section have been under-powered to evaluate clinically important outcomes. There has been no trial to date comparing the use of an intravenous slow bolus of oxytocin versus an oxytocin bolus and infusion. Methods and design A multi-centre randomised controlled trial is proposed. The study will take place in five large maternity units in Ireland with collaboration between academics and clinicians in the disciplines of obstetrics and anaesthetics. It will involve 2000 women undergoing elective caesarean section after 36 weeks gestation. The main outcome measure will be major haemorrhage (blood loss >1000 ml). A study involving 2000 women will have 80% power to detect a 36% relative change in the risk of major haemorrhage with two-sided 5% alpha. Discussion It is both important and timely that we evaluate the optimal approach to the management of the third stage at

  9. Effect of Perioperative Intravenous Lidocaine Infusion on Acute and Chronic Pain after Breast Surgery: A Meta-Analysis of Randomized Controlled Trials.

    Science.gov (United States)

    Chang, Yuan-Ching; Liu, Chien-Liang; Liu, Tsang-Pai; Yang, Po-Sheng; Chen, Ming-Jen; Cheng, Shih-Ping

    2017-03-01

    Intravenous lidocaine infusion has been shown to reduce postoperative pain among patients undergoing abdominal surgery. This study aimed to evaluate the effects of perioperative lidocaine administration in breast surgery. A meta-analysis of randomized controlled trials comparing lidocaine infusion vs. placebo/routine treatment was performed. Standardized mean difference (SMD) or risk ratio (RR) with 95% confidence intervals (CIs) was calculated from pooled data. Random-effects models were used, and heterogeneity was assessed. A total of 4 reports (3 primary studies and 1 extension) with 84 patients randomized to the lidocaine group and 83 patients randomized to the control group were included. There was no difference in pain scores at rest or during activity between the 2 groups from postoperative 2 hours to 3 days. At postoperative 72 hours, the lidocaine group had fewer analgesics consumed (SMD, -0.479; 95% CI, -0.914 to -0.043; P = 0.031). Chronic pain was assessed 3 to 6 months after breast surgery in 51 patients of the lidocaine group and 46 patients of the control group. Patients in the lidocaine group had significantly lower risk for the development of chronic pain (RR, 0.332; 95% CI, 0.141 to 0.781; P = 0.012). The results indicate no significant benefits of intravenous lidocaine infusion in terms of acute postoperative pain. Although lidocaine seems to attenuate the risk of chronic pain after breast surgery, there is insufficient evidence to conclude that lidocaine infusion is of proved benefit because the results were based on a limited number of small trials. © 2016 World Institute of Pain.

  10. Follow-up at the corrected age of 24 months of preterm newborns receiving continuous infusion of fentanyl for pain control during mechanical ventilation.

    Science.gov (United States)

    Ancora, Gina; Lago, Paola; Garetti, Elisabetta; Pirelli, Anna; Merazzi, Daniele; Pierantoni, Luca; Ferrari, Fabrizio; Faldella, Giacomo

    2017-05-01

    The neurodevelopmental impact of fentanyl given to preterm newborns for pain control is still unknown. The aim of this study was to assess the neurodevelopmental impact of 2 regimens of fentanyl administration by a prospective follow-up evaluation. In our previous multicenter, double-blind, randomized controlled trial, 131 mechanically ventilated newborns (gestational age ≤32 weeks) were randomized to fentanyl (continuous infusion of fentanyl + open label boluses of fentanyl) or placebo (continuous infusion of placebo + open label boluses of fentanyl). Infant development was evaluated using Griffiths Mental Developmental Scales (Griffiths, 1996) until 24 months of corrected age by trained psychologists who were not aware of the group allocation. 106/131 infants survived at discharge; 3 died after discharge, 25 were lost to follow-up (12 in the fentanyl and 13 in the placebo group). Seventy-eight patients were evaluated at 2 years of corrected age. Children in the fentanyl group, compared with those in the placebo group, obtained significantly lower Griffiths general developmental quotient (mean [SD]: 89.95 [13.64] vs 97.18 [12.72], P = 0.024) together with the scores on the eye-hand coordination (mean [SD]: 89.09 [12.13] vs 99.19 [13.19], P = 0.002) and performance skills (mean [SD]: 79.71 [15.80] vs 90.09 [15.28], P = 0.009) scales. After adjustment for clinical confounders (gestational age, CRIB score, and sex) only eye-hand co-ordination was associated with fentanyl infusion. This study demonstrates that continuous infusion of fentanyl in very preterm infants, given at 1 mcg·kg·h during mechanical ventilation, is associated with a significant decrease in eye and hand co-ordination skills. Longer follow-up is needed to evaluate the impact on future motor, cognitive, and behavioral functions.

  11. DMLC leaf-pair optimal control for mobile, deforming target

    International Nuclear Information System (INIS)

    Papiez, Lech; Rangaraj, Dharanipathy

    2005-01-01

    Existing algorithms of dynamic control of independent pairs of leaves allow optimal DMLC delivery of IMRT to rigid targets translating parallel to leaf trajectories. However, in numerous cases of radiotherapy treatments simplifying assumptions of rigid-like motions of targets and surrounding tissues are clearly not satisfied. Therefore algorithms have to be developed that allow one to control MLC so that predetermined intensities are delivered to various points in targets that experience compression and expansion at the time of irradiation. Moreover, it is desirable for such algorithms to ensure that delivery of modulated intensity map will be done with minimal expense of monitor units. Derivation of the algorithm that optimizes the DMLC IMRT to mobile, deforming target is presented in this paper. [To illustrate the general algorithm two representative examples of DMLC IMRT delivery to deforming targets are presented in full detail.] Finally, similarities and differences between solutions for immobile targets, for moving, rigid targets and for moving, deforming targets are discussed

  12. Vancomycin pharmacokinetic parameters in patients with acute brain injury undergoing controlled normothermia, therapeutic hypothermia, or pentobarbital infusion.

    Science.gov (United States)

    Morbitzer, Kathryn A; Jordan, J Dedrick; Rhoney, Denise H

    2015-04-01

    Therapeutic strategies that cause an alteration in patient temperature, such as controlled normothermia (CN), therapeutic hypothermia (TH), and pentobarbital infusion (PI), are often used to manage complications caused by acute brain injury. The purpose of this study was to evaluate pharmacokinetic (PK) parameters of vancomycin in patients with acute brain injury undergoing temperature modulation. This was a retrospective cohort study of adult patients with acute brain injury admitted between May 2010 and March 2014 who underwent CN, TH, or PI and received vancomycin. Predicted PK parameters based on population data were compared with calculated PK parameters based on serum concentrations. Seventeen CN patients and 10 TH/PI patients met inclusion criteria. Traumatic brain injury and aneurysmal subarachnoid hemorrhage accounted for the majority of admitting diagnoses. In the CN group, the median dose was 16.7 (15.5-18.4) mg/kg. The median calculated elimination rate constant [0.155 (0.108-0.17) vs. 0.103 (0.08-0.142) hr(-1); p = 0.04] was significantly higher than the predicted value. The median measured trough concentration [8.9 (7.7-11.1) vs. 17.1 (10.8-22.3) υg/mL; p = 0.004] was significantly lower than predicted. In the TH/PI group, the median dose was 15.4 (14.7-17.2) mg/kg. No significant differences were found between the median calculated and predicted elimination rate constant [0.107 (0.097-0.109) vs. 0.112 (0.102-0.127) hr(-1); p = 0.41] and median measured and predicted trough concentration [14.2 (12.7-17.1) vs. 13.1 (11-17.8) υg/mL; p = 0.71]. Patients who underwent TH/PI did not exhibit PK alterations when compared to predicted PK parameters based on population data, while patients who underwent CN experienced PK alterations favoring an increased elimination of vancomycin.

  13. Low-dose ketamine infusion for labor analgesia: A double-blind, randomized, placebo controlled clinical trial

    Directory of Open Access Journals (Sweden)

    Sam Joel

    2014-01-01

    Full Text Available Background: Most primary and secondary level hospitals in developing countries provide inadequate labor analgesia due to various medical, technical and economic reasons. This clinical trial was an effort to study the efficacy, safety and feasibility of intravenous (IV ketamine to provide labor analgesia. Materials and Methods: A total of 70 parturients were consented and randomly assigned to receive either IV ketamine or 0.9% saline. A loading dose of ketamine (0.2 mg/kg was followed-by an infusion (0.2 mg/kg/h until the delivery of the neonate. Similar volume of saline was infused in the placebo-group. Intramuscular meperidine was the rescue analgesic in both groups. The pain score, hemodynamic parameters of mother and fetus and the anticipated side-effects of ketamine were observed for. The newborn was assessed by the Neonatologist. Results: The pain score showed a decreasing trend in the ketamine group and after the 1 st h more than 60% of women in the ketamine group had pain relief, which was statistically significant. There was no significant clinical change in the maternal hemodynamics and fetal heart rate. However, 17 (48.5% of them had transient light headedness in the ketamine group. All the neonates were breast fed and the umbilical cord blood pH was between 7.1 and 7.2. The overall satisfaction was significantly high in the intervention group (P = 0.028. Conclusion: A low-dose ketamine infusion (loading dose of 0.2 mg/kg delivered over 30 min, followed-by an infusion at 0.2 mg/kg/h could provide acceptable analgesia during labor and delivery.

  14. Effect of steel and teflon infusion catheters on subcutaneous adipose tissue blood flow and infusion counter pressure in humans

    DEFF Research Database (Denmark)

    Højbjerre, Lise; Skov-Jensen, Camilla; Kaastrup, Peter

    2009-01-01

    BACKGROUND: Subcutaneous tissue is an important target for drug deposition or infusion. A local trauma may induce alterations in local microcirculation and diffusion barriers with consequences for drug bioavailability. We examined the influence of infusion catheters' wear time on local...... microcirculation and infusion counter pressure. METHODS: One steel catheter and one Teflon (Dupont, Wilmington, DE) catheter were inserted in subcutaneous, abdominal adipose tissue (SCAAT) in 10 healthy, lean men. The catheters were infused with isotonic saline at a rate of 10 microL/h for 48 h. Another steel...... catheter and a Teflon catheter were inserted contralateral to the previous catheters after 48 h. The infusion counter pressure was measured during a basal infusion rate followed by a bolus infusion. The measurements during a basal rate infusion were repeated after the bolus infusion. Adipose tissue blood...

  15. Kinetic controlled affinity labeling of target enzyme with thioester chemistry.

    Science.gov (United States)

    Tomohiro, Takenori; Nakabayashi, Masahiro; Sugita, Yuka; Morimoto, Shota

    2016-08-01

    High specificity has been an important feature in affinity labeling for target profiling. Especially, to label targets via rapidly progressing reactions with consumption of ligand (probe), high specificity of reaction with common functional groups of target protein should be achieved without reactions with similar groups of non-target proteins. Herein, we demonstrate the kinetic controlled affinity labeling of acyl CoA synthetase using a fatty acid analogue containing a phenylthioester linkage. High specificity was attained by accelerating the labeling rate in the binding pocket. This approach could be useful for profiling a series of target enzymes and transporters in signal transduction pathways. Copyright © 2016 Elsevier Ltd. All rights reserved.

  16. Shrub control by browsing: Targeting adult plants

    Science.gov (United States)

    da Silveira Pontes, Laíse; Magda, Danièle; Gleizes, Benoît; Agreil, Cyril

    2016-01-01

    Reconciling the well known benefits of shrubs for forage with environmental goals, whilst preventing their dominance, is a major challenge in rangeland management. Browsing may be an economical solution for shrubby rangelands as herbivore browsing has been shown to control juvenile shrub growth. Less convincing results have been obtained for adult plants, and long-term experiments are required to investigate the cumulative effects on adult plants. We therefore assessed the impact of different levels of browsing intensity on key demographic parameters for a major dominant shrub species (broom, Cytisus scoparius), focusing on adult plants. We assigned individual broom plants to one of three age classes: 3-5 years (young adults); 5-7 years (adults); and 7-9 years (mature adults). These plants were then left untouched or had 50% or 90% of their total edible stem biomass removed in simulated low-intensity and high-intensity browsing treatments, respectively. Morphological, survival and fecundity data were collected over a period of four years. Browsing affected the morphology of individual plants, promoting changes in subsequent regrowth, and decreasing seed production. The heavily browsed plants were 17% shorter, 32% narrower, and their twigs were 28% shorter. Light browsing seemed to control the growth of young adult plants more effectively than that of older plants. Reproductive output was considerably lower than for control plants after light browsing, and almost 100% lower after heavy browsing. High-intensity browsing had a major effect on survival causing high levels of plant mortality. We conclude that suitable browsing practices could be used to modify adult shrub demography in the management of shrub dominance and forage value.

  17. A Randomized Controlled Trial of Foley Catheter, Extra-Amniotic Saline Infusion and Prostaglandin E2 Suppository for Labor Induction

    Science.gov (United States)

    Ghanaie, Mandana Mansour; Jafarabadi, Mina; Asgary, Seyed Alaedin; Karkan, Morteza Fallah

    2013-01-01

    Objective The aim of this study is to further compare the efficacy of PGE2 suppository, the intracervical foley catheter and extra-amniotic saline infusion in nulliparous women referred for labor induction. Materials and methods Totally 368 nulliparous women with a Bishop score ≤ 4 with singleton gestation, vertex presentation and intact membrane referred for labor induction were randomly assigned to 3 groups; Foley catheter alone, Extra-amniotic saline infusion (EASI) and PGE2 suppository. All women received concurrent dilute oxytocine infusion. The change in the Bishop Score, labor progress, various labor endpoints and outcomes of labor were assessed. Results From 363 women studied after exclusion of 5, 119 were assigned to EASI, 121 to Foley and 118 to PGE2. Patients’ demographics did not differ significantly between three groups nor did indication for induction (P = 0.0001). The EASI group had a significant improvement in Bishop Score 6 hours after induction. The mean time to active phase was 357±135min for EASI,457±178 for Foley and 609±238 min for PGE2 group respectively (P < 0.05).rate of spontaneous rupture of membranes was higher in the EASI group (P = 0.0001) and the mean time from the start of induction up to spontaneous rupture of membranes in the EASI group was shorter than other group(P < 0.05). The mean time to vaginal delivery was 14.8±6.1 in EASI group,11.4±4.8 in Foley and 18.9±6.4 in PGE2 group(P < 0.05).there were no differences in Apgar scores, mean neonatal birth weight and neonatal morbidity. Conclusion Our study showed that pre-induction cervical ripening by EASI with concurrent oxytocin is better than Foley and PGE2 in Bishop score and various labor end point and outcomes. PMID:24971103

  18. A randomized controlled trial of foley catheter, extra-amniotic saline infusion and prostaglandin e2 suppository for labor induction.

    Directory of Open Access Journals (Sweden)

    Mandana Mansour Ghanaie

    2013-06-01

    Full Text Available The aim of this study is to further compare the efficacy of PGE2 suppository, the intracervical foley catheter and extra-amniotic saline infusion in nulliparous women referred for labor induction.Totally 368 nulliparous women with a Bishop score ≤ 4 with singleton gestation, vertex presentation and intact membrane referred for labor induction were randomly assigned to 3 groups; Foley catheter alone, Extra-amniotic saline infusion (EASI and PGE2 suppository. All women received concurrent dilute oxytocine infusion. The change in the Bishop Score, labor progress, various labor endpoints and outcomes of labor were assessed.From 363 women studied after exclusion of 5, 119 were assigned to EASI, 121 to Foley and 118 to PGE2. Patients' demographics did not differ significantly between three groups nor did indication for induction (P = 0.0001. The EASI group had a significant improvement in Bishop Score 6 hours after induction. The mean time to active phase was 357±135min for EASI,457±178 for Foley and 609±238 min for PGE2 group respectively (P < 0.05.rate of spontaneous rupture of membranes was higher in the EASI group (P = 0.0001 and the mean time from the start of induction up to spontaneous rupture of membranes in the EASI group was shorter than other group(P < 0.05. The mean time to vaginal delivery was 14.8±6.1 in EASI group,11.4±4.8 in Foley and 18.9±6.4 in PGE2 group(P < 0.05.there were no differences in Apgar scores, mean neonatal birth weight and neonatal morbidity.Our study showed that pre-induction cervical ripening by EASI with concurrent oxytocin is better than Foley and PGE2 in Bishop score and various labor end point and outcomes.

  19. A prospective, randomized, blinded-endpoint, controlled study - continuous epidural infusion versus programmed intermittent epidural bolus in labor analgesia

    Directory of Open Access Journals (Sweden)

    Joana Nunes

    Full Text Available Abstract Background: There is evidence that administration of a programmed intermittent epidural bolus (PIEB compared to continuous epidural infusion (CEI leads to greater analgesia efficacy and maternal satisfaction with decreased anesthetic interventions. Methods: In this study, 166 women with viable pregnancies were included. After an epidural loading dose of 10 mL with Ropivacaine 0.16% plus Sufentanil 10 µg, parturient were randomly assigned to one of three regimens: A - Ropivacaine 0.15% plus Sufentanil 0.2 µg/mL solution as continuous epidural infusion (5 mL/h, beginning immediately after the initial bolus; B - Ropivacaine 0.1% plus Sufentanil 0.2 µg/mL as programmed intermittent epidural bolus and C - Same solution as group A as programmed intermittent epidural bolus. PIEB regimens were programmed as 10 mL/h starting 60 min after the initial bolus. Rescue boluses of 5 mL of the same solution were administered, with the infusion pump. We evaluated maternal satisfaction using a verbal numeric scale from 0 to 10. We also evaluated adverse, maternal and neonatal outcomes. Results: We analyzed 130 pregnants (A = 60; B = 33; C = 37. The median verbal numeric scale for maternal satisfaction was 8.8 in group A; 8.6 in group B and 8.6 in group C (p = 0.83. We found a higher caesarean delivery rate in group A (56.7%; p = 0.02. No differences in motor block, instrumental delivery rate and neonatal outcomes were observed. Conclusions: Maintenance of epidural analgesia with programmed intermittent epidural bolus is associated with a reduced incidence of caesarean delivery with equally high maternal satisfaction and no adverse outcomes.

  20. A prospective, randomized, blinded-endpoint, controlled study - continuous epidural infusion versus programmed intermittent epidural bolus in labor analgesia.

    Science.gov (United States)

    Nunes, Joana; Nunes, Sara; Veiga, Mariano; Cortez, Mara; Seifert, Isabel

    2016-01-01

    There is evidence that administration of a programmed intermittent epidural bolus (PIEB) compared to continuous epidural infusion (CEI) leads to greater analgesia efficacy and maternal satisfaction with decreased anesthetic interventions. In this study, 166 women with viable pregnancies were included. After an epidural loading dose of 10mL with Ropivacaine 0.16% plus Sufentanil 10μg, parturient were randomly assigned to one of three regimens: A - Ropivacaine 0.15% plus Sufentanil 0.2μg/mL solution as continuous epidural infusion (5mL/h, beginning immediately after the initial bolus); B - Ropivacaine 0.1% plus Sufentanil 0.2μg/mL as programmed intermittent epidural bolus and C - Same solution as group A as programmed intermittent epidural bolus. PIEB regimens were programmed as 10mL/h starting 60min after the initial bolus. Rescue boluses of 5mL of the same solution were administered, with the infusion pump. We evaluated maternal satisfaction using a verbal numeric scale from 0 to 10. We also evaluated adverse, maternal and neonatal outcomes. We analyzed 130 pregnants (A=60; B=33; C=37). The median verbal numeric scale for maternal satisfaction was 8.8 in group A; 8.6 in group B and 8.6 in group C (p=0.83). We found a higher caesarean delivery rate in group A (56.7%; p=0.02). No differences in motor block, instrumental delivery rate and neonatal outcomes were observed. Maintenance of epidural analgesia with programmed intermittent epidural bolus is associated with a reduced incidence of caesarean delivery with equally high maternal satisfaction and no adverse outcomes. Copyright © 2015 Sociedade Brasileira de Anestesiologia. Published by Elsevier Editora Ltda. All rights reserved.

  1. Efficacy of topical chamomile on the incidence of phlebitis due to an amiodarone infusion in coronary care patients: a double-blind, randomized controlled trial.

    Science.gov (United States)

    Sharifi-Ardani, Maryam; Yekefallah, Leili; Asefzadeh, Saeed; Nassiri-Asl, Marjan

    2017-09-01

    Amiodarone is a useful antiarrhythmic drug. Phlebitis, caused by intravenous amiodarone, is common in patients in coronary care units (CCUs). The aim of this study was to evaluate the effect of topical chamomile on the incidence of phlebitis due to the administration of an amiodarone infusion into the peripheral vein. This was a randomized, double-blind clinical trial, conducted on 40 patients (n = 20 per group) in two groups-an intervention group (chamomile ointment) and a control group (lanoline, as a placebo), hospitalized in the CCUs and undergoing an amiodarone infusion into the peripheral vein over 24 h. Following the cannulation and commencement of the infusion, placebo or chamomile ointment was rubbed in, up to 10 cm superior to the catheter and repeated every eight hours for three days. The cannula site was then assessed based on the phlebitis checklist. The incidence and time of occurrence of phlebitis, relative risk, severity of phlebitis were the main outcome measures. Nineteen patients (19/20) in the control group had phlebitis on the first day of the study and one patient (20/20) on the second day. In the intervention group, phlebitis occurred in 13 cases (13/20) on the first day and another two (2/7) was found on the second day. The incidence of phlebitis was significantly different between two groups (P = 0.023). The cumulative incidence of phlebitis in the intervention group (15/20) is significantly later and lower than that in the control group (20/20) during two days (P = 0.008). Two patients in the intervention group did not develop phlebitis at all during the 3-day study. Also, the relative risk of phlebitis in the two groups was 0.68 (P = 0.008 5). A significant difference was not observed with regard to phlebitis severity in both groups. It seems that phlebitis occurred to a lesser extent and at a later time frame in the intervention group compared to control group. Topical chamomile may be effective in decreasing the incidence of phlebitis

  2. Beam Parameter Measurement and Control at the SNS Target

    CERN Document Server

    Plum, Michael; McManamy, Tom

    2005-01-01

    The spallation neutron production target at the SNS facility is designed for 1.4 MW beam power. Both beam position and profile must be carefully controlled within narrow margins to avoid damage to the target. The position must be within 2 mm of the target center, and 90% of the beam must be within the nominal 70 mm x 200 mm spot size, without exceeding 0.18 A/m2

  3. Effects of a novel method for enteral nutrition infusion involving a viscosity-regulating pectin solution: A multicenter randomized controlled trial.

    Science.gov (United States)

    Tabei, Isao; Tsuchida, Shigeru; Akashi, Tetsuro; Ookubo, Katsuichiro; Hosoda, Satoru; Furukawa, Yoshiyuki; Tanabe, Yoshiaki; Tamura, Yoshiko

    2018-02-01

    The initial complications associated with infusion of enteral nutrition (EN) for clinical and nutritional care are vomiting, aspiration pneumonia, and diarrhea. There are many recommendations to prevent these complications. A novel method involving a viscosity-regulating pectin solution has been demonstrated. In Japan, this method along with the other so-called "semi-solid EN" approaches has been widely used in practice. However, there has been no randomized clinical trial to prove the efficiency and safety of a viscosity-regulating pectin solution in EN management. Therefore, we planned and initiated a multicenter randomized controlled trial to determine the efficiency and safety. This study included 34 patients from 7 medical institutions who participated. Institutional review board (IRB) approval was obtained from all participating institutions. Patients who required EN management were enrolled and randomly assigned to the viscosity regulation of enteral feeding (VREF) group and control group. The VREF group (n = 15) was managed with the addition of a viscosity-regulating pectin solution. The control group (n = 12) was managed with conventional EN administration, usually in a gradual step-up method. Daily clinical symptoms of pneumonia, fever, vomiting, and diarrhea; defecation frequency; and stool form were observed in the 2 week trial period. The dose of EN and duration of infusion were also examined. A favorable trend for clinical symptoms was noticed in the VREF group. No significant differences were observed in episodes of pneumonia, fever, vomiting, and diarrhea between the 2 groups. An apparent reduction in infusion duration and hardening of stool form were noted in the VREF group. The novel method involving a viscosity-regulating pectin solution with EN administration can be clinically performed safely and efficiently, similar to the conventional method. Moreover, there were benefits, such as improvement in stool form, a short time for EN infusion

  4. Genetic improvement of tomato by targeted control of fruit softening

    KAUST Repository

    Uluisik, Selman

    2016-07-25

    Controlling the rate of softening to extend shelf life was a key target for researchers engineering genetically modified (GM) tomatoes in the 1990s, but only modest improvements were achieved. Hybrids grown nowadays contain \\'non-ripening mutations\\' that slow ripening and improve shelf life, but adversely affect flavor and color. We report substantial, targeted control of tomato softening, without affecting other aspects of ripening, by silencing a gene encoding a pectate lyase. © 2016 Nature America, Inc. All rights reserved.

  5. Is there an alternative to continuous opioid infusion for neonatal pain control? A preliminary report of parent/nurse-controlled analgesia in the neonatal intensive care unit.

    Science.gov (United States)

    Czarnecki, Michelle L; Hainsworth, Keri; Simpson, Pippa M; Arca, Marjorie J; Uhing, Michael R; Varadarajan, Jaya; Weisman, Steven J

    2014-04-01

    Continuous opioid infusion (COI) remains the mainstay of analgesic therapy in the neonatal intensive care unit (NICU). Parent/nurse-controlled analgesia (PNCA) has been accepted as safe and effective for pediatric patients, but few reports include use in neonates. This study sought to compare outcomes of PNCA and COI in postsurgical neonates and young infants. Twenty infants treated with morphine PNCA were retrospectively compared with 13 infants treated with fentanyl COI in a Midwestern pediatric hospital in the United States. Outcome measures included opioid consumption, pain scores, frequency of adverse events, and subsequent methadone use. The PNCA group (median 6.4 μg · kg(-1) · h(-1) morphine equivalents, range 0.0-31.4) received significantly less opioid (P < 0.001) than the COI group (median 40.0 μg · kg(-1) · h(-1) morphine equivalents; range 20.0-153.3), across postoperative days 0-3. Average daily pain scores (based on 0-10 scale) were low for both groups, but median scores differed nonetheless (0.8 PNCA vs 0.3 COI, P < 0.05). There was no significant difference in the frequency of adverse events or methadone use. Results suggest PNCA may be a feasible and effective alternative to COI for pain management in postsurgical infants in the NICU. Results also suggest PNCA may provide more individualized care for this vulnerable population and in doing so, may potentially reduce opioid consumption; however, more studies are needed. © 2014 John Wiley & Sons Ltd.

  6. Preoperative carbohydrate load and intraoperatively infused omega-3 polyunsaturated fatty acids positively impact nosocomial morbidity after coronary artery bypass grafting: a double-blind controlled randomized trial.

    Science.gov (United States)

    Feguri, Gibran Roder; de Lima, Paulo Ruiz Lúcio; de Cerqueira Borges, Danilo; Toledo, Laura Ramos; Batista, Larissa Nadaf; E Silva, Thaís Carvalho; Segri, Neuber José; de Aguilar-Nascimento, José Eduardo

    2017-04-20

    A strategy of limited preoperative fasting, with carbohydrate (CHO) loading and intraoperative infusion of omega-3 polyunsaturated fatty acids (ω-3 PUFA), has seldom been tried in cardiovascular surgery. Brief fasting, followed by CHO intake 2 h before anesthesia, may improve recovery from CABG procedures and lower perioperative vasoactive drug requirements. Infusion of ω-3 PUFA may reduce occurrences of postoperative atrial fibrillation (POAF) and shorten hospital stays. The aim of this study was to assess morbidity (especially POAF) in ICU patients after coronary artery bypass grafting (CABG)/cardiopulmonary bypass (CPB) in combination, if preoperative fasts are curtailed in favor of CHO loading, and ω-3 PUFA are infused intraoperatively. Fifty-seven patients undergoing CABG were randomly assigned to receive 12.5% maltodextrin (200 ml, 2 h before anesthesia), without infusing ω-3 PUFA (CHO, n = 14); water (200 ml, 2 h before anesthesia), without infusing ω-3 PUFA (controls, n = 14); 12.5% maltodextrin (200 ml, 2 h before anesthesia) plus intraoperative ω-3 PUFA (0.2 mcg/kg) (CHO + W3, n = 15); or water (200 ml, 2 h before anesthesia) plus intraoperative ω-3 PUFA (0.2 mcg/kg) (W3, n = 14). Perioperative clinical variables and mortality were analyzed, examining the incidence of POAF, as well as the need for inotropic vasoactive drugs during surgery and in ICU. Two deaths occurred (3.5%), but there were no instances of bronchoaspiration and mediastinitis. Neither ICU stays nor total postoperative stays differed by group (P > 0.05). Patients given preoperative CHO loads (CHO and CHO + W3 groups) experienced fewer instances of hospital infection (RR = 0.29, 95%CI 0.09-0.94; P = 0.023) and were less reliant on vasoactive amines during surgery (RR = 0.60, 95% CI 0.38-0.94; P = 0.020). Similarly, the number of patients requiring vasoactive drugs while recovering in ICU differed significantly by group (P = 0

  7. Method of quadrotor flight control in the target tracking problem

    Science.gov (United States)

    Kotov, K. Yu.; Nesterov, A. A.; Filippov, M. N.; Yan, A. P.

    2017-07-01

    A problem of control of trajectory motion of a quadrotor vehicle is considered. The choice of the form of required differential equations in the previously proposed method of tracking of a moving target is justified. The workability of the control system in the presence of measurement noise and external perturbations is confirmed by results of experiments with the AR.Drone quadrotor.

  8. Size-controlled synthesis of biodegradable nanocarriers for targeted ...

    Indian Academy of Sciences (India)

    1, February 2016, pp. 69–77. c Indian Academy of Sciences. Size-controlled synthesis of biodegradable nanocarriers for targeted and controlled cancer drug delivery using salting out cation. MADASAMY HARI BALAKRISHANAN and MARIAPPAN RAJAN∗. Department of Natural Products Chemistry, School of Chemistry, ...

  9. Infliximab-Related Infusion Reactions: Systematic Review

    Science.gov (United States)

    Ron, Yulia; Kivity, Shmuel; Ben-Horin, Shomron; Israeli, Eran; Fraser, Gerald M.; Dotan, Iris; Chowers, Yehuda; Confino-Cohen, Ronit; Weiss, Batia

    2015-01-01

    Objective: Administration of infliximab is associated with a well-recognised risk of infusion reactions. Lack of a mechanism-based rationale for their prevention, and absence of adequate and well-controlled studies, has led to the use of diverse empirical administration protocols. The aim of this study is to perform a systematic review of the evidence behind the strategies for preventing infusion reactions to infliximab, and for controlling the reactions once they occur. Methods: We conducted extensive search of electronic databases of MEDLINE [PubMed] for reports that communicate various aspects of infusion reactions to infliximab in IBD patients. Results: We examined full texts of 105 potentially eligible articles. No randomised controlled trials that pre-defined infusion reaction as a primary outcome were found. Three RCTs evaluated infusion reactions as a secondary outcome; another four RCTs included infusion reactions in the safety evaluation analysis; and 62 additional studies focused on various aspects of mechanism/s, risk, primary and secondary preventive measures, and management algorithms. Seven studies were added by a manual search of reference lists of the relevant articles. A total of 76 original studies were included in quantitative analysis of the existing strategies. Conclusions: There is still paucity of systematic and controlled data on the risk, prevention, and management of infusion reactions to infliximab. We present working algorithms based on systematic and extensive review of the available data. More randomised controlled trials are needed in order to investigate the efficacy of the proposed preventive and management algorithms. PMID:26092578

  10. Cryogenic control system of the large COMPASS polarized target

    CERN Document Server

    Gautheron, F; Baum, G; Berglund, P; Doshita, N; Görtz, S; Gustafsson, K K; Horikawa, N; Kisselev, Yu V; Koivuniemi, J H; Kondo, K; Meyer, Werner T; Reicherz, G

    2004-01-01

    The dilution refrigerator used to cool the large COMPASS polarized target is monitored through a PC running LabVIEW trademark 6.1 under Windows 2000 trademark . About 60 parameters of the target (temperatures, pressures, flow rates) are continuously plotted and checked. They are periodically recorded in an Oracle trademark database and in a data file. An alarm for every parameter can be individually activated and optionally connected to a GSM (Global System for Mobile Communication) delivery message system. A web server receives and publishes the online status of the target with online tables and graphics on a dedicated COMPASS polarized target information web site. A Siemens programmable logic controller (PLC) powered by an uninterruptable source keeps the cryogenic system safe and stable during the long beam periods by controlling valves and interlocks. This safety feature protects the dilution refrigerator against potential damages in case of power failure.

  11. Cryogenic control system of the large COMPASS polarized target

    Science.gov (United States)

    Gautheron, F.; Ball, J.; Baum, G.; Berglund, P.; Doshita, N.; Goertz, St.; Gustafsson, K.; Horikawa, N.; Kisselev, Y.; Koivuniemi, J.; Kondo, K.; Meyer, W.; Reicherz, G.

    2004-06-01

    The dilution refrigerator used to cool the large COMPASS polarized target is monitored through a PC running LabVIEW TM 6.1 under Windows 2000 TM. About 60 parameters of the target (temperatures, pressures, flow rates) are continuously plotted and checked. They are periodically recorded in an Oracle TM database and in a data file. An alarm for every parameter can be individually activated and optionally connected to a GSM (Global System for Mobile Communication) delivery message system. A web server receives and publishes the online status of the target with online tables and graphics on a dedicated COMPASS polarized target information web site. A Siemens programmable logic controller (PLC) powered by an uninterruptable source keeps the cryogenic system safe and stable during the long beam periods by controlling valves and interlocks. This safety feature protects the dilution refrigerator against potential damages in case of power failure.

  12. Study protocol for a double blind, randomised, placebo-controlled trial of continuous subpectoral local anaesthetic infusion for pain and shoulder function following mastectomy: SUB-pectoral Local anaesthetic Infusion following MastEctomy (SUBLIME) study.

    Science.gov (United States)

    Langford, R; Brown, I; Vickery, J; Mitchell, K; Pritchard, C; Creanor, S

    2014-09-30

    Over 16 000 mastectomies are performed in England and Wales annually. Acute postoperative pain and nausea are common. The most frequently occurring long-term complications are chronic pain (up to 50%) and reduced shoulder function (reported at 35%). Regional techniques that improve acute postoperative pain relief may reduce the incidence of these complications. This study assesses the effectiveness of a 24-hour continuous local anaesthetic in the subpectoral plane in improving postoperative pain and quality of life in patients undergoing mastectomy. This is a randomised, double blind, placebo-controlled, two-centre, parallel group trial in women undergoing mastectomy with or without axillary involvement. One hundred and sixty participants will be randomised in a 1:1 ratio to receive either 0.25% levobupivacaine or 0.9% saline by subpectoral infusion postoperatively for 24 h. All participants will be provided with an intravenous morphine patient-controlled analgesia (PCA) system. Participants will be followed-up for 24 h in hospital and at approximately 14 days and 6 months postoperatively. Joint primary outcome measures are total morphine consumption and total pain score (captured via patient-recorded visual analogue scale (VAS) 4 hourly) during the first 24 h postoperatively. Primary statistical analysis of total pain is based on the area under the curve of pain versus time graph. Secondary outcomes include PCA attempts in first 24 h; VAS pain scores and shoulder function by goniometry at 24 h, 14 days (approximately) and 6 months; Verbal Rating Scale pain scores in first 24 h; Brief Pain Inventory and Oxford Shoulder Score at 6 months; duration of hospital stay; incidence of postoperative nausea and vomiting; cost-effectiveness. The study is approved by the South West England Research Ethics Committee (12/SW/0149). will be published in a peer-reviewed journal and presented at local, national and international scientific meetings. ISRCTN

  13. Boosting target tracking using particle filter with flow control

    Science.gov (United States)

    Moshtagh, Nima; Chan, Moses W.

    2013-05-01

    Target detection and tracking with passive infrared (IR) sensors can be challenging due to significant degradation and corruption of target signature by atmospheric transmission and clutter effects. This paper summarizes our efforts in phenomenology modeling of boosting targets with IR sensors, and developing algorithms for tracking targets in the presence of background clutter. On the phenomenology modeling side, the clutter images are generated using a high fidelity end-to-end simulation testbed. It models atmospheric transmission, structured clutter and solar reflections to create realistic background images. The dynamics and intensity of a boosting target are modeled and injected onto the background scene. Pixel level images are then generated with respect to the sensor characteristics. On the tracking analysis side, a particle filter for tracking targets in a sequence of clutter images is developed. The particle filter is augmented with a mechanism to control particle flow. Specifically, velocity feedback is used to constrain and control the particles. The performance of the developed "adaptive" particle filter is verified with tracking of a boosting target in the presence of clutter and occlusion.

  14. Assessment of telemetry and fluidic control system used in the Medstream programmable infusion system: an in vivo and in vitro study.

    Science.gov (United States)

    Bork, Toralf; Crivelli, Rocco; Tardy, Yanik; Burger, Juergen

    2014-10-01

    The MedStream Programmable Infusion Pump, an intrathecal pump indicated for the treatment of chronic intractable pain and severe spasticity (CE-mark) or severe spasticity (US), has a highly accurate medication delivery (within 10% of the programmed flow rate) and is certified for use in 3-Tesla magnetic resonance imaging systems (conditional). Performance of the telemetric link between external control-unit and implanted pump was assessed in sheep (in vivo) up to 26 weeks, resulting in 1040 communication sessions. The telemetric communication envelope (communication distance and maximum antenna tilt angles) and communication duration were characterized in an in vitro test. Capacitance measurements of the piezoelectric actuator of the valve, valve flow rates, and leak rates were measured in an in vitro cyclic accelerated aging test to assess reliability of the valve over 6,200 k cycles. The pump was well tolerated in vivo; all communication sessions between control-unit and pump were successful (P = 6.889 × 10(-14)). Mean communication distance between pump and control-unit was 3.8 cm, with the maximum antenna tilt angles being 40° (θy) and 50° (θx) for all test cases; the maximum communication duration was 5.5 s. Capacitance measurements, flow rates, and leak rates were within ±10 % range up to 6,200 k cycles corresponding to approximately 10 times the valve cycles over the specified service life of the pump (8 years), except for one flow-rate value, which can be explained by the measurement setup. These results demonstrate the reliability of the telemetry link and piezoelectric valve system of the MedStream Programmable Infusion Pump.

  15. Direct effects of TNF-α on local fuel metabolism and cytokine levels in the placebo controlled bilaterally infused human leg

    DEFF Research Database (Denmark)

    Bach, Ermina; Nielsen, Bent Roni Ranghøj; Vendelbo, Mikkel

    2013-01-01

    Tumor necrosis factor-α (TNF-α) has widespread metabolic actions. Systemic TNF-α administration, however, generates a complex hormonal and metabolic response. Our study was designed to test whether regional, placebo-controlled TNF-α infusion directly affects insulin resistance and protein breakdown....... We studied eight healthy volunteers once with bilateral femoral vein and artery catheters during a 3-h basal period and a 3-h hyperinsulinemic-euglycemic clamp. One artery was perfused with saline and one with TNF-α. During the clamp, TNF-α perfusion increased glucose arteriovenous differences (0...... interest and may concurrently act to provide adequate tissue fuel supply and contribute to the occurrence of systemic hypoglycemia. This distinct metabolic feature places TNF-α among the rare insulin mimetics of human origin....

  16. The effect of adding a background infusion to patient-controlled epidural labor analgesia on labor, maternal, and neonatal outcomes: a systematic review and meta-analysis.

    Science.gov (United States)

    Heesen, Michael; Böhmer, Johannes; Klöhr, Sven; Hofmann, Thomas; Rossaint, Rolf; Straube, Sebastian

    2015-07-01

    Patient-controlled epidural analgesia (PCEA) has gained popularity, but it is still unclear whether adding a background infusion confers any benefit. A systematic literature search in PubMed, Embase, CINAHL, LILACS, CENTRAL, Clinicaltrials.gov, and ISI WOS was performed to identify randomized controlled double-blind trials that compare PCEA-only with PCEA combined with a continuous infusion (PCEA + CI) in parturients. The data were subjected to meta-analyses using the random-effects model. Our primary outcome was the incidence of instrumental vaginal delivery. Secondary outcomes were incidences of spontaneous vaginal and cesarean deliveries, duration of labor, analgesic outcomes, maternal outcomes (visual analog scale scores for pain, maternal satisfaction, nausea, pruritus, hypotension), and neonatal outcomes (Apgar score, umbilical artery pH). We identified 7 trials with a low risk of bias, reporting on 891 parturients, for inclusion in our systematic review. The risk of instrumental vaginal delivery was increased in the PCEA + CI group, risk ratio (RR) 1.66 (95% confidence interval 1.08-2.56, P = 0.02; I = 0%); the RR for cesarean delivery was 0.83 (95% confidence interval 0.61-1.13, I = 0%). The second stage of labor was prolonged (weighted mean difference 12.3 minutes, 95% confidence interval 5.1-19.5 minutes, P = 0.0008; I = 0%) in the PCEA + CI group. Fewer patients in the PCEA + CI group required physician-administered boluses (RR 0.35 [95% confidence interval 0.25-0.47, P neonatal outcomes (Apgar scores analgesia. Further high-quality studies involving a sufficient number of patients are required.

  17. Cooperative motion control for multi-target observation

    Energy Technology Data Exchange (ETDEWEB)

    Parker, L.E.

    1997-08-01

    An important issue that arises in the automation of many security, surveillance, and reconnaissance tasks is that of monitoring (or observing) the movements of targets navigating in a bounded area of interest. A key research issue in these problems is that of sensor placement--determining where sensors should be located to maintain the targets in view. In complex applications involving limited-range sensors, the use of multiple sensors dynamically moving over time is required. In this paper, the author investigates the use of a cooperative team of autonomous sensor-based robots for the observation of multiple moving targets. The focus is primarily on developing the distributed control strategies that allow the robot team to attempt to minimize the total time in which targets escape observation by some robot team member in the area of interest. This paper first formalizes the problem and discusses related work. The author then presents a distributed approximate approach to solving this problem that combines low-level multi-robot control with higher-level reasoning control based on the ALLIANCE formalism. The effectiveness of the approach is analyzed by comparing it to three other feasible algorithms for cooperative control, showing the superiority of the approach for a large class of problems.

  18. Postural control of elderly: moving to predictable and unpredictable targets.

    NARCIS (Netherlands)

    Jongman, Vera; Lamoth, Claudine J C; van Keeken, Helco; Caljouw, Simone R

    2012-01-01

    Impaired postural control with muscle weakness is an important predictor of falls within the elderly population.Particular daily activities that require weight shifting in order to be able to reach a specific target (a cup on a table) require continuous adjustments to keep the body's center of mass

  19. Cooperative motion control for multi-target observation

    International Nuclear Information System (INIS)

    Parker, L.E.

    1997-01-01

    An important issue that arises in the automation of many security, surveillance, and reconnaissance tasks is that of monitoring (or observing) the movements of targets navigating in a bounded area of interest. A key research issue in these problems is that of sensor placement--determining where sensors should be located to maintain the targets in view. In complex applications involving limited-range sensors, the use of multiple sensors dynamically moving over time is required. In this paper, the author investigates the use of a cooperative team of autonomous sensor-based robots for the observation of multiple moving targets. The focus is primarily on developing the distributed control strategies that allow the robot team to attempt to minimize the total time in which targets escape observation by some robot team member in the area of interest. This paper first formalizes the problem and discusses related work. The author then presents a distributed approximate approach to solving this problem that combines low-level multi-robot control with higher-level reasoning control based on the ALLIANCE formalism. The effectiveness of the approach is analyzed by comparing it to three other feasible algorithms for cooperative control, showing the superiority of the approach for a large class of problems

  20. The new control system of the SPS target sector

    CERN Document Server

    Carlier, E; Mecredy, N; O'Leary, J

    1999-01-01

    The SPS, the Super Proton Synchrotron at CERN, is an accelerator originally designed and commissioned in 1976 for protons. The control system of the SPS target stations, beam absorbers and other aperture limiting devices was developed in the seventies. It was mainly based on home made electronics and equipment dependent software. With time, this electronics has become obsolete, difficult to maintain in operation and not suitable for integration into a modern control system. In 1997, a project was set up to modernise the electronics and the related software. The new control system is largely based on standard industrial hardware and software components. SIEMENS Simatic S7-300 programmable logic controllers have been used as equipment controllers and connected through PROFIBUS to a Windows-NT front-end PC running the SIEMENS WinCC SCADA package which acts as local controller and remote access gateway. This fully industrial solution has been successfully integrated into the actual SPS accelerator control infrast...

  1. Continuous-infusion adriamycin

    International Nuclear Information System (INIS)

    Benjamin, R.S.; Chawla, S.P.; Ewer, M.S.; Hortobagyi, G.N.

    1986-01-01

    This chapter discusses the diminished cardiotoxicity as well as diminished nausea and vomiting with continuous infusions of adriamycin to patients undergoing radiation therapy, particularly with infusions of 48 hours or longer, and best with 96-hour infusions, the longest duration that has been studied systematically. In breast cancer, data show that more adriamycin is better, but only for a selected subgroup of patients: those with complete remission. The diminished cardiotoxicity makes the use of adriamycin more attractive in the adjuvant situation, where increased safety will decrease the chances of long-term complications and make retreatment easy for cured patients who develop second malignancies

  2. Efficacy and safety of an insulin infusion protocol in a surgical ICU.

    Science.gov (United States)

    Taylor, Beth E; Schallom, Marilyn E; Sona, Carrie S; Buchman, Timothy G; Boyle, Walter A; Mazuski, John E; Schuerer, Douglas E; Thomas, James M; Kaiser, Christy; Huey, Way Y; Ward, Myrna R; Zack, Jeanne E; Coopersmith, Craig M

    2006-01-01

    Hyperglycemia is associated with complications in the surgical intensive care unit. The purpose of this study was to determine the efficacy and safety of nurse-driven insulin infusion protocols in lowering blood glucose (BG) in critical illness. All patients in a 24-bed surgical intensive care unit who required i.v. insulin infusions during 3 noncontiguous 6-month periods from 2002 to 2004 were evaluated. In the preintervention phase, 71 patients received a physician-initiated insulin infusion without a developed protocol. They were compared with 95 patients who received a nurse-driven insulin infusion protocol with a target BG of 120 to 150 mg/dL and to 119 patients who received a more stringent protocol with a target BG of 80 to 110 mg/dL. There was a stepwise decrease in average daily BG levels, from 190 to 163 to 132 mg/dL (p < 0.001). The less stringent protocol decreased the time to achieve a BG level < 150 mg/dL from 14.1 to 7.4 hours compared with physician-driven management (p < 0.05) resulting in similar time on an insulin infusion (53 versus 48 hours). The more intensive protocol brought BG levels < 150 mg/dL in 7.2 hours and < 111 mg/dL in 13.6 hours, but increased the length of time a patient was on an insulin infusion to 77 hours. The incidence of severe hypoglycemia (BG < 40 mg/dL) was statistically similar between the groups, ranging between 1.1% and 3.4%. Implementation of a nurse-driven protocol led to more rapid and more effective BG control in critically ill surgical patients compared with physician management. Tighter BG control can be obtained without a significant increase in hypoglycemia, although this is associated with increased time on an insulin infusion.

  3. Insulin pump-associated adverse events are common, but not associated with glycemic control, socio-economic status, or pump/infusion set type.

    Science.gov (United States)

    Ross, P; Gray, A R; Milburn, J; Kumarasamy, I M; Wu, F; Farrand, S; Armishaw, J; Wiltshire, E; Rayns, J; Tomlinson, P; Wheeler, B J

    2016-12-01

    While there have been many outcome-focussed studies examining insulin pump therapy, only a few have looked at potential adverse events (AEs), with none examining the relationship between AEs and pump/infusion set type, ethnicity or socio-economic status. In addition, current data on the incidence and characteristics of pump-associated AEs are confined to one paediatric centre. We aimed to describe the incidence, characteristics and potential predictors of insulin pump-associated AEs in New Zealand adults and children with T1DM. We approached adults and families of children with T1DM on insulin pumps in four main New Zealand centres. Participants completed a questionnaire examining pump-related issues they had experienced in the preceding 12 months. Response rate was 64 % with 174 of 270 eligible people participating in the study. 84 % of subjects reported one or more AEs, with an overall AE incidence of 3.42 per person/year (95 % CI 3.14, 3.73). An event serious enough to require a hospital presentation occurred in 9.8 %, all but one reporting high ketones or diabetic ketoacidosis (DKA). Set/site problems were the AE most commonly reported (by 53 % of respondents), followed by cutaneous complications (43 %) and pump malfunction (38 %). Few predictors of AEs (of any type) were found; however, a negative binomial regression model found that a longer duration of pumping (p = 0.018) and age Insulin pump-associated AEs are very common. However, few variables are predictive of them with no relationships seen with glycaemic control, socio-economic status, pump manufacturer or infusion set type. Based on these findings, AEs should be anticipated in both adults and children, with anticipatory patient education and training recommended for their successful and safe use.

  4. A comparison of two different concentrations and infusion rates of ropivacaine in perineural infusion administered at the same total dose for analgesia after foot and ankle surgery: a randomized, double blinded, controlled study.

    Science.gov (United States)

    Bombardieri, Anna M; Maalouf, Daniel B; Kahn, Richard L; Ma, Yan; Bae, James J; Wukovits, Barbara; Lee, Andrew; Jules-Elysee, Kethy M; DE Gaudio, A Raffaele; Liguori, Gregory A

    2018-04-10

    Continuous popliteal nerve block is utilized for postoperative analgesia after foot and ankle surgery. Whether only the total dose of local anesthetic or the combination of concentration and volume determine the characteristics of a continuous popliteal nerve infusion remains currently unknown. We hypothesized a reduction of the incidence of insensate extremity in patients given ropivacaine 0.4% at 4 mL/h compared to patients given ropivacaine 0.2% at 8mL/h. Sixty-four patients scheduled for major foot and ankle surgery requiring a continuous popliteal catheter infusion for postoperative analgesia were studied. Thirty-three patients were randomized to receive a continuous popliteal nerve block with 0.2% (basal 8 mL/h) and thirty-one with 0.4% (basal 4 mL/h) ropivacaine, reaching the same total dose (16 mg/h). The primary outcome was the incidence of persistent sensory block in the distal sciatic nerve distributions in the postoperative period. Secondary outcomes were the incidence of motor block, NRS pain scores at rest in the postoperative period up to 48 hours after surgery, opioid use and related side effects, patients' satisfaction. The incidence of persistent sensory block was similar in patients given 0.2% and in patients receiving 0.4% ropivacaine. The incidence of motor block, postoperative pain scores at rest, use of oral opioids, side effects and patients' satisfaction with the quality of recovery were also similar in both groups. Our results suggest that local anesthetic total dose is the primary determinant of continuous popliteal perineural infusion effects.

  5. The effect of glucagon on infusion cholangiography

    International Nuclear Information System (INIS)

    Evans, A.F.; Whitehouse, G.H.

    1979-01-01

    An assessment has been made of the effects of glucagon on biliary tract opacification during intravenous cholangiography. Two series of infusion cholangiograms were obtained at two investigating centres designated A and B. In series A, 41 patients had ioglycamide infusions at a rate of 0.2833 g min -1 over 1 h. In series B, 31 patients had ioglycamide infusions at a rate of 0.3886 g min -1 over 30 min. Radiographs were taken in both series immediately at the end of the infusion, 10 min later and 30 min after the infusion. Two mg of intravenous glucagon was injected into alternate cases in both series A and B immediately after the first radiograph was taken at the completion of the ioglycamide infusion. Two observers in each series then assessed the radiographic opacification of the biliary system without prior knowledge of which patients had received the glucagon. Delineation of the biliary system was considered better in both series in those patients who received glucagon when compared with the controls. Gallbladder opacification was definitely increased in series A in those receiving glucagon, and a similar tendency was shown in series B. The amount of contrast in the upper intestine was increased in series A in the glucagon group, but not in series B. It is concluded that glucagon improves visualisation of the biliary tract, especially the gallbladder at infusion cholangiography. (author)

  6. Contemporary Targets for Control of Efficient Energy Use

    Directory of Open Access Journals (Sweden)

    Yu. S. Petrusha

    2012-01-01

    Full Text Available The paper describes main principles of the methodology for control of efficient energy use in power engineering and economy sectors as a whole. Targets for control of energy use at different levels have been considered in the paper. A special attention has been paid to technical, organizational and legal aspects of energy efficiency improvement. The paper contains an analysis of the history of the given issue, the present level of its development and near-term prospects under conditions of the Republic of Belarus.

  7. Targeting protein-protein interactions for parasite control.

    Directory of Open Access Journals (Sweden)

    Christina M Taylor

    2011-04-01

    Full Text Available Finding new drug targets for pathogenic infections would be of great utility for humanity, as there is a large need to develop new drugs to fight infections due to the developing resistance and side effects of current treatments. Current drug targets for pathogen infections involve only a single protein. However, proteins rarely act in isolation, and the majority of biological processes occur via interactions with other proteins, so protein-protein interactions (PPIs offer a realm of unexplored potential drug targets and are thought to be the next-generation of drug targets. Parasitic worms were chosen for this study because they have deleterious effects on human health, livestock, and plants, costing society billions of dollars annually and many sequenced genomes are available. In this study, we present a computational approach that utilizes whole genomes of 6 parasitic and 1 free-living worm species and 2 hosts. The species were placed in orthologous groups, then binned in species-specific orthologous groups. Proteins that are essential and conserved among species that span a phyla are of greatest value, as they provide foundations for developing broad-control strategies. Two PPI databases were used to find PPIs within the species specific bins. PPIs with unique helminth proteins and helminth proteins with unique features relative to the host, such as indels, were prioritized as drug targets. The PPIs were scored based on RNAi phenotype and homology to the PDB (Protein DataBank. EST data for the various life stages, GO annotation, and druggability were also taken into consideration. Several PPIs emerged from this study as potential drug targets. A few interactions were supported by co-localization of expression in M. incognita (plant parasite and B. malayi (H. sapiens parasite, which have extremely different modes of parasitism. As more genomes of pathogens are sequenced and PPI databases expanded, this methodology will become increasingly

  8. Effectiveness of continuous subcutaneous insulin infusion pump therapy during five years of treatment on metabolic control in children and adolescents with Type 1 diabetes mellitus.

    Science.gov (United States)

    Korkmaz, Özlem; Demir, Günay; Çetin, Hafize; Mecidov, İlkin; Atik Altınok, Yasemin; Özen, Samim; Darcan, Şükran; Gökşen, Damla

    2018-02-28

    To compare continuous subcutaneous insulin infusion therapy (CSII) with multiple daily insulin therapy (MDI) on metabolic control in children and adolescents with type 1 diabetes mellitus (T1DM) over the long term. 52 T1DM patients treated with CSII and monitored for at least 1 year prior to and at least five years following CSII were included. 38 age and sex-matched MDI controls with a 5-year follow up were recruited. Mean age of the subjects, duration of diabetes and CSII therapy were 17.0±4.8 years, 10.7±2.8 years and 7.7±1.5 years respectively. Mean HbA1c in the year prior to CSII, during the first year of treatment and after 5 years of CSII were 7.3±1% (56 mmol/mol), 7.0±0.7% (53 mmol/mol) and 7.8±1.3% (62 mmol/mol) respectively. Initial and 5-year mean HbA1C levels of controls were 7.9±1.08% and 8.6±1.8%. Mean HbA1c values were significantly lower in those receiving CSII therapy throughout follow-up. Basal and total insulin doses were significantly lower in the CSII group at all times. HbA1c was compared between subjects by age (0-5, 6-11 and 12-18 years) with no significant difference between them. Although CSII mean HbA1c values exceeded accepted good metabolic control limits after 5 years, CSII produces better HbA1c control at all times and in all age groups compared to MDI.

  9. Control de bacteriemia nosocomial pediátrica mediante un programa de cultivo de soluciones parenterales en uso Pediatric nosocomial bacteremia control program based on culturing in use parenteral infusions

    Directory of Open Access Journals (Sweden)

    Juan M. Muñoz

    1999-01-01

    Full Text Available OBJETIVO. Dado que Klebsiella, Enterobacter y Serratia se multiplican en soluciones parenterales y son responsables de una elevada proporción de bacteriemias en los hospitales de México, se propone una estrategia de control mediante la vigilancia microbiológica de las soluciones en uso. MATERIAL Y MÉTODOS. Hospital de enseñanza de segundo nivel con 193 camas. Atiende principalmente pacientes de escasos recursos. En 1992 se inició la vigilancia de la esterilidad de las soluciones parenterales en los servicios pediátricos mediante cuatro estrategias: durante la primera etapa se cultivó el total de soluciones en uso. Durante la segunda se cultivaron muestras aleatoriamente elegidas. Tercera y cuarta etapas con muestreo controlado y dirigido, respectivamente. RESULTADOS. Se han cultivado 1940 infusiones. Se ha observado una reducción de la tasa de contaminación (de 29.6% en 1992 a 12.9% en 1997, pOBJECTIVES. As Klebsiella, Enterobacter and Serratia are capable of growth in IV fluids and these bacteria are commonly implicated in nosocomial bacteremia, a control strategy through microbiological surveilance of in-use parenteral solutions is proposed. MATERIAL AND METHODS. A second level general teaching hospital, serving low-income patients. Through four consecutive strategies, a continous surveillance program of IV fluids sterility in pediatric wards was stablished in 1992. During the first stage all of the in -use solutions were cultured. During the second stage randomly selected samples were studied. Third stage was designed as a case-control study. The last stage included samples drawn in convenience. Positive cultures point out eventual infusion mishandling, as well as high-risk areas and patients. RESULTS. After culturing 1940 parenteral solutions, infusion contamination rates decreased from 29.6% in 1992 to 12.9% in 1997 (p< 0.001. The proportion of Gram-negative rods isolated from blood cultures went from 72.7% to 40.85% (p< 0

  10. Neural conflict-control mechanisms improve memory for target stimuli.

    Science.gov (United States)

    Krebs, Ruth M; Boehler, Carsten N; De Belder, Maya; Egner, Tobias

    2015-03-01

    According to conflict-monitoring models, conflict serves as an internal signal for reinforcing top-down attention to task-relevant information. While evidence based on measures of ongoing task performance supports this idea, implications for long-term consequences, that is, memory, have not been tested yet. Here, we evaluated the prediction that conflict-triggered attentional enhancement of target-stimulus processing should be associated with superior subsequent memory for those stimuli. By combining functional magnetic resonance imaging (fMRI) with a novel variant of a face-word Stroop task that employed trial-unique face stimuli as targets, we were able to assess subsequent (incidental) memory for target faces as a function of whether a given face had previously been accompanied by congruent, neutral, or incongruent (conflicting) distracters. In line with our predictions, incongruent distracters not only induced behavioral conflict, but also gave rise to enhanced memory for target faces. Moreover, conflict-triggered neural activity in prefrontal and parietal regions was predictive of subsequent retrieval success, and displayed conflict-enhanced functional coupling with medial-temporal lobe regions. These data provide support for the proposal that conflict evokes enhanced top-down attention to task-relevant stimuli, thereby promoting their encoding into long-term memory. Our findings thus delineate the neural mechanisms of a novel link between cognitive control and memory. © The Author 2013. Published by Oxford University Press. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

  11. Neural Conflict–Control Mechanisms Improve Memory for Target Stimuli

    Science.gov (United States)

    Krebs, Ruth M.; Boehler, Carsten N.; De Belder, Maya; Egner, Tobias

    2015-01-01

    According to conflict-monitoring models, conflict serves as an internal signal for reinforcing top-down attention to task-relevant information. While evidence based on measures of ongoing task performance supports this idea, implications for long-term consequences, that is, memory, have not been tested yet. Here, we evaluated the prediction that conflict-triggered attentional enhancement of target-stimulus processing should be associated with superior subsequent memory for those stimuli. By combining functional magnetic resonance imaging (fMRI) with a novel variant of a face-word Stroop task that employed trial-unique face stimuli as targets, we were able to assess subsequent (incidental) memory for target faces as a function of whether a given face had previously been accompanied by congruent, neutral, or incongruent (conflicting) distracters. In line with our predictions, incongruent distracters not only induced behavioral conflict, but also gave rise to enhanced memory for target faces. Moreover, conflict-triggered neural activity in prefrontal and parietal regions was predictive of subsequent retrieval success, and displayed conflict-enhanced functional coupling with medial-temporal lobe regions. These data provide support for the proposal that conflict evokes enhanced top-down attention to task-relevant stimuli, thereby promoting their encoding into long-term memory. Our findings thus delineate the neural mechanisms of a novel link between cognitive control and memory. PMID:24108799

  12. The Quadrotor Dynamic Modeling and Indoor Target Tracking Control Method

    Directory of Open Access Journals (Sweden)

    Dewei Zhang

    2014-01-01

    Full Text Available A reliable nonlinear dynamic model of the quadrotor is presented. The nonlinear dynamic model includes actuator dynamic and aerodynamic effect. Since the rotors run near a constant hovering speed, the dynamic model is simplified at hovering operating point. Based on the simplified nonlinear dynamic model, the PID controllers with feedback linearization and feedforward control are proposed using the backstepping method. These controllers are used to control both the attitude and position of the quadrotor. A fully custom quadrotor is developed to verify the correctness of the dynamic model and control algorithms. The attitude of the quadrotor is measured by inertia measurement unit (IMU. The position of the quadrotor in a GPS-denied environment, especially indoor environment, is estimated from the downward camera and ultrasonic sensor measurements. The validity and effectiveness of the proposed dynamic model and control algorithms are demonstrated by experimental results. It is shown that the vehicle achieves robust vision-based hovering and moving target tracking control.

  13. "FOLEY CATHETER CERVICAL RIPENING WITH EXTRAAMNIOTIC INFUSION OF SALINE OR CORTICOSTEROIDS: A DOUBLE-BLIND, RANDOMIZED CONTROLLED STUDY"

    Directory of Open Access Journals (Sweden)

    A.Sh. Zafarghandi

    2004-10-01

    Full Text Available Induction of labor is one of the most common procedures during pregnancy. Various methods for cervical ripening and labor induction have been described in the obstetrics literature; but the role of corticosteroids in the process of labor is not entirely understood. This study challenged the possible role of corticosteroids in induction of labor by extra-amniotic injection through an inflated intracervical Foley balloon catheter. This randomized trial was conducted on 44 women with a single pregnancy, intact membranes, and an unfavorable cervix. They were randomly assigned to receive either 20 mg of dexamethasone in saline solution (study group, n=22 or saline solution only (control group, n=22 administered extra-amniotically through an intracervical inflated Foley balloon catheter. Eighteen (81.8% patients in the study group and 20 (90.9% in the control group entered the active phase of labor and were delivered vaginally. The mean time intervals between induction of labor to the active phase and between induction of labor to delivery were significantly shorter in the study group compared with those of the control group (3.3±2.1 hours vs. 9±4.7 hours, P<0.01, 5.7±3.4 hours vs. 6.9±4.7 hours, P<0.01, respectively. There was no maternal or fetal complication in study or control group. The intracervical Foley balloon catheter with extra-amniotic corticosteroids was more efficient in reducing the induction-to-delivery interval for termination of midtrimester pregnancies than the same Foley catheter with saline solution only. Cervical ripening with extra-amniotic corticosteroids possesses the advantages of simplicity, low cost, and lack of systemic or serious side effects.

  14. Long-Term Effects of Continuous Subcutaneous Insulin Infusion on Glucose Control and Microvascular Complications in Patients With Type 1 Diabetes.

    Science.gov (United States)

    Marchand, Lucien; Kawasaki-Ogita, Yukiko; Place, Jérome; Fayolle, Corinne; Lauton, Dominique; Boulet, Françoise; Farret, Anne; Renard, Eric

    2017-09-01

    We investigated the long-term effects of continuous subcutaneous insulin infusion (CSII) on glucose control and microvascular complications in patients with type 1 diabetes (T1D). A total of 157 patients (59 M/98 W; age 39.1 ± 14.8 years) with T1D who switched from multiple daily injections to CSII and used CSII for at least one year were included. HbA1c levels and status of microvascular complications before and while under CSII were analyzed, retrospectively. The follow-up period was 4.0 ± 1.5 years. HbA1c significantly decreased from 8.4 ± 1.3 to 7.7 ± 1.3% (68 ± 14 to 61 ± 14 mmol/mol) after 1-year CSII and remained lower than pre-CSII levels during four years. Patients with pre-CSII HbA1c >8.0% (64 mmol/mol) showed significant improvement of HbA1c for four years, while those with pre-CSII HbA1c 15 years, and in three (4.3%) patients with diabetes duration 8% (64 mmol/mol) prior to CSII. Incidence and progression rates of retinopathy and albuminuria were low, particularly in patients with a diabetes duration 8% (64 mmol/mol).

  15. Changes in glycemic control and quality of life in pediatric type 1 diabetics with continuous subcutaneous insulin infusion of insulin aspart following multiple daily injection therapy.

    Science.gov (United States)

    Kawamura, Tomoyuki; Urakami, Tatsuhiko; Sugihara, Shigetaka; Kim, Hey Sook; Mochizuki, Mie; Amamiya, Shin

    2008-01-01

    The efficacy of continuous subcutaneous insulin infusion (CSII) of the rapid-acting insulin analogue, insulin aspart, was evaluated in 26 patients with childhood-onset type 1 diabetes aged between 6 and 18 yr who had been on basal-bolus therapy (multiple daily injection (MDI) of regular human insulin or rapid-acting insulin and intermediate/long-acting insulin). The glycemic control in the patients was evaluated based on changes in the clinical parameters and the patient quality of life (QOL) was evaluated by using the insulin therapy-related QOL questionnaire. Twenty two patients continued CSII during the 6-mo study period. The mean HbA1c was 7.8 ± 1.8% at baseline and it decreased to 7.4 ± 0.8% at 6 mo after the start of the CSII. Overall, no decrease of the QOL post-CSII initiation was noted. The possible superiority of CSII as compared to MDI was suggested for patients who "eat out" or "have to look for an appropriate place for insulin injection." Aside from an inadequate indwelling needle placement detected after the initiation of CSII in several patients, no adverse event associated with NovoRapid(®) was seen. In conclusion, CSII of rapid-acting insulin appears to be a useful therapy for patients with childhood-onset type 1 diabetes.

  16. Target Diagnostic Control System Implementation for the National Ignition Facility

    Energy Technology Data Exchange (ETDEWEB)

    Shelton, R T; Kamperschroer, J H; Lagin, L J; Nelson, J R; O' Brien, D W

    2010-05-12

    The extreme physics of targets shocked by NIF's 192-beam laser are observed by a diverse suite of diagnostics. Many diagnostics are being developed by collaborators at other sites, but ad hoc controls could lead to unreliable and costly operations. A Diagnostic Control System (DCS) framework for both hardware and software facilitates development and eases integration. Each complex diagnostic typically uses an ensemble of electronic instruments attached to sensors, digitizers, cameras, and other devices. In the DCS architecture each instrument is interfaced to a low-cost Windows XP processor and Java application. Each instrument is aggregated with others as needed in the supervisory system to form an integrated diagnostic. The Java framework provides data management, control services and operator GUI generation. DCS instruments are reusable by replication with reconfiguration for specific diagnostics in XML. Advantages include minimal application code, easy testing, and high reliability. Collaborators save costs by assembling diagnostics with existing DCS instruments. This talk discusses target diagnostic instrumentation used on NIF and presents the DCS architecture and framework.

  17. Target Diagnostic Control System Implementation for the National Ignition Facility

    International Nuclear Information System (INIS)

    Shelton, R.T.; Kamperschroer, J.H.; Lagin, L.J.; Nelson, J.R.; O'Brien, D.W.

    2010-01-01

    The extreme physics of targets shocked by NIF's 192-beam laser are observed by a diverse suite of diagnostics. Many diagnostics are being developed by collaborators at other sites, but ad hoc controls could lead to unreliable and costly operations. A Diagnostic Control System (DCS) framework for both hardware and software facilitates development and eases integration. Each complex diagnostic typically uses an ensemble of electronic instruments attached to sensors, digitizers, cameras, and other devices. In the DCS architecture each instrument is interfaced to a low-cost Windows XP processor and Java application. Each instrument is aggregated with others as needed in the supervisory system to form an integrated diagnostic. The Java framework provides data management, control services and operator GUI generation. DCS instruments are reusable by replication with reconfiguration for specific diagnostics in XML. Advantages include minimal application code, easy testing, and high reliability. Collaborators save costs by assembling diagnostics with existing DCS instruments. This talk discusses target diagnostic instrumentation used on NIF and presents the DCS architecture and framework.

  18. [Bacteriological control of blood preservation, production of infusion solutions and dry human plasma under conditions of aseptic work and possible sources of their contamination].

    Science.gov (United States)

    Bosković, S; Lucić, N; Aganović, N; Grbić, E

    1975-01-01

    In premises for blood conservation, production of dry human plasma and infusion solutions "notwithstanding the permanent measures for desinfection, new bacterial contamination occurs from time to time and whose source are the casings and material originating from non-sterile environment. Bacteriological control, which has primarily a preventive character, enables a due forecast for measures to be undertaken by the appropriate desinfection of the working surfaces and air, satisfactory conditions of aseptic work can be maintained. General hygiene should be paid attention to as well as mechanical cleansing of premises, avoidance of groups for lunch-time etc., since the treatment by desinfectors would not be sufficient for maintenance of aseptic working conditions. In order to prevent the transmission of bacterial contamination, premises for blood conservation should be strictly separated from other operations and also prevent the unnecessary movements of personnel through corridors. The results of the bacteriological control of the personnel show that greater attention should be paid to their health care since the workers there work in closed aseptic systems and thus avoid them as a bacteria transmittors in respect to danger of blood and dry human plasma contamination. It is also necessary to efficiently educate the personnel for work in aseptic conditions and also increase their elementary knowledge from bacteriology and hygiene. The bacterial skin-flora on the spot of donor's venepuncture also presents a certain danger for blood contamination. Therefore, it is necessary to establish the most optimal manner of skin desinfecate together with the most appropriate means having a fast bactericidal and fungicidal action. It would also be useful, on the basis of further test, to suggest certain standard for an allowed number of conditionally pathogenic and saprophytic microorganisms which would be used by the instutions performing the blood transfusion and production of

  19. Determination of 24-hour insulin infusion pattern by an artificial endocrine pancreas for intravenous insulin infusion with a miniature pump

    DEFF Research Database (Denmark)

    Kølendorf, K; Christiansen, J S; Bojsen, J

    1981-01-01

    UNLABELLED: Intravenous insulin infusion with a glucose controlled insulin infusion system (GCIIS) is known to restore glucose homeostasis. A simpler approach to improve blood glucose regulation is preprogrammed intravenous insulin infusion with portable pumps without sensor-mediated feedback. We...... report a study designed to evaluate whether the preprogrammed insulin infusion pattern to be used in the miniature insulin infusion pump (MIIP) could be optimized by concomitant employment of the GCIIS for blood glucose control. Six juvenile-onset insulin-dependent diabetics (mean age 31 yrs) were...... studied. Mean blood glucose (MBG) was 6.2 mmol/l +/- 0.5 (SD) during glucose controlled infusion and 5.3 +/- 0.6 during the combined MIIP + GCIIS-day. The insulin requirements calculated from the s.c. regimen (56 U +/- 10 SD) were identical to the GCIIS-measured (51 U +/- 14) and to the amounts delivered...

  20. The Effects of Intravenous Lidocaine Infusions on the Quality of Recovery and Chronic Pain After Robotic Thyroidectomy: A Randomized, Double-Blinded, Controlled Study.

    Science.gov (United States)

    Choi, Kwan Woong; Nam, Kee-Hyun; Lee, Jeong-Rim; Chung, Woong Youn; Kang, Sang-Wook; Joe, Young Eun; Lee, Jae Hoon

    2017-05-01

    The effect of the systemic lidocaine on postoperative recovery has not been definitively investigated despite its analgesic efficacy after surgery. The aim of this randomized, double-blinded, controlled study was to evaluate the effect of intravenously administered lidocaine on the quality of recovery and on acute and chronic postoperative pain after robot-assisted thyroidectomy. Ninety patients who were undergoing robotic thyroidectomy were randomly assigned to the lidocaine or the control groups. The patients received 2 mg/kg of lidocaine followed by continuous infusions of 3 mg/kg/h of lidocaine (Group L) or the same volume of 0.9% normal saline (Group C) intravenously during anesthesia. The acute pain profiles and the quality of recovery, which was assessed using the quality of recovery-40 questionnaire (QoR-40), were evaluated for 2 days postoperatively. Chronic postsurgical pain (CPSP) and sensory disturbances at the surgical sites were evaluated 3 months after surgery. The QoR-40 and pain scores that were assessed during the 2 days that followed surgery were largely comparable between the groups. However, CPSP was more prevalent in the Group C than in the Group L (16/43 vs. 6/41; p = 0.025). The tactile sensory score 3 months after the operation was significantly greater in the Group L than in the Group C (7 vs. 5; p = 0.001). Systemic lidocaine administration was associated with reductions in CPSP and sensory impairment after robot-assisted thyroidectomy although it was not able to reduce acute postsurgical pain or improve the quality of recovery. Trial registry number NCT01907997 ( http://clinicaltrials.gov ).

  1. Effect of perioperative insulin infusion on surgical morbidity and mortality

    DEFF Research Database (Denmark)

    Gandhi, Gunjan Y; Murad, M Hassan; Flynn, Errol David

    2008-01-01

    To conduct a systematic review and meta-analysis of randomized controlled trials (RCTs) to evaluate the effect of perioperative insulin infusion on outcomes important to patients.......To conduct a systematic review and meta-analysis of randomized controlled trials (RCTs) to evaluate the effect of perioperative insulin infusion on outcomes important to patients....

  2. Correlation of measured and calculated serum osmolality during mannitol or hypertonic saline infusion in patients after craniotomy: a study protocol and statistical analysis plan for a randomised controlled trial

    Science.gov (United States)

    Li, Qian; Xu, Ming; Zhou, Jian-Xin

    2014-01-01

    Introduction Brain oedema is a major complication after craniotomy. Hyperosmolar agents have been used as the medical treatment for this condition. Measurement and estimation of serum osmolality during hyperosmolar agent infusion is of clinical importance to evaluate clinical efficacy, adjust dosage and avoid side effects. However, several studies have shown that calculated serum osmolality may lead to a systematic bias compared with direct measurement. In the present study, mannitol or hypertonic saline (HS) will be used in patients after elective craniotomy. We aim to determine the accuracy of serum osmolality estimation during the application of hyperosmolar agent. Methods and analysis The study is a prospective, randomised, double-blinded, controlled, parallel-group design. Adult patients requiring the use of hyperosmolar agents for the prevention or treatment of postoperative brain oedema are enrolled and assigned randomly to one of the two treatment study groups, labelled as ‘M group’ and ‘HS group’. Patients in the M and HS groups receive intravenous infusion of 125 mL of either 20% mannitol or 3.1% sodium chloride solution, respectively. Data will be collected immediately before the infusion of study agents, 15, 30, 60, 120, 240 and 360 min after the start of infusion of experimental agents, which includes serum osmolality, concentration of serum sodium, potassium, urea and glucose. Serum osmolality will be measured by means of freezing point depression. Estimated serum osmolality will also be calculated by using four formulas published previously. Osmole gap is calculated as the difference between the measured and the estimated values. The primary endpoint is the correlation of measured and estimated serum osmolality during hyperosmolar agent infusion. Ethics and dissemination The study was approved by the International Review Board (IRB) of Beijing Tiantan Hospital, Capital Medical University. Study findings will be disseminated through peer

  3. Warmed intravenous infusion for controlling intraoperative hypothermia Infusión venosa calentada en el control de la hipotermia durante el período intraoperatorio Infusão venosa aquecida no controle da hipotermia no período intraoperatório

    Directory of Open Access Journals (Sweden)

    Ana Lúcia De Mattia

    2013-06-01

    Full Text Available OBJECTIVE: to verify the effectiveness of warmed intravenous infusion for hypothermia prevention in patients during the intraoperative period. METHOD: experimental, comparative, field, prospective and quantitative study undertaken at a federal public hospital. The sample was composed of 60 adults, included based on the criteria of axillary temperature between 36ºC and 37.1ºC and surgical abdominal access, divided into control and experimental groups, using the systematic probability sampling technique. RESULTS: 22 patients (73.4% from both groups left the operating room with hypothermia, that is, with temperatures below 36ºC (p=1.0000. The operating room temperature when patients arrived and patients' temperature when they arrived at the operating room were statistically significant to affect the occurrence of hypothermia. CONCLUSION: the planning and implementation of nursing interventions carried out by baccalaureate nurses are essential for preventing hypothermia and maintaining perioperative normothermia. OBJETIVO: verificar la eficacia de la intervención de infusión venosa calentada en la prevención de la hipotermia en pacientes en el período intraoperatorio. MÉTODO: estudio experimental, comparativo, de campo, prospectivo y cuantitativo, en un hospital público federal. La muestra abarcó a 60 adultos, que tuvieron como uno de los criterios de inclusión la temperatura axilar entre 36ºC y 37,1ºC y acceso quirúrgico abdominal, divididos en grupos control y experimental, compuestos utilizándose la técnica de muestreo probabilístico sistemático. RESULTADOS: en los 2 grupos, 22 pacientes (73,4% salieron del quirófano con hipotermia, o sea, temperatura inferior a 36ºC (p=1,0000. La temperatura del quirófano cuando de la entrada del paciente y la temperatura del paciente cuando de la entrada en el quirófano fueron estadísticamente significativas para influir en la ocurrencia de hipotermia. CONCLUSÍON: la planificación e

  4. Three-day versus five-day somatostatin infusion combination with endoscopic variceal ligation in the prevention of early rebleeding following acute variceal hemorrhage: A randomized controlled trial.

    Science.gov (United States)

    Chitapanarux, Taned; Ritdamrongthum, Phuripong; Leerapun, Apinya; Pisespongsa, Pises; Thongsawat, Satawat

    2015-12-01

    Combined pharmacological and endoscopic therapy is recommended for initial treatment of acute variceal bleeding (AVB). The optimal duration of therapy with a vasoactive agent is not well established. The aim of this study was to compare the efficacy and safety of 3-day and 5-day somatostatin treatment in the prevention of early rebleeding after endoscopic variceal ligation (EVL). In a double-blind, prospective trial, cirrhotic patients with AVB who underwent EVL were randomly assigned to receive a continuous infusion of somatostatin for either 3 days or 5 days. A total of 95 patients were enrolled; 50 patients in the 3-day group and 45 patients in the 5-day group after initial hemostasis by combination therapy with somatostatin and EVL. Both groups were comparable in terms of baseline data. Very early and early rebleeding within 5 days and 42 days occurred in one and three patient (2%, 6%) in the 3-day group and three and two patients (6.67%, 4.45%) in the 5-day group (P = 0.342, 0.735), respectively. Overall, eight patients died (three from variceal rebleeding and five from causes other than variceal bleed); four (8%) in the 3-day group and four (8.89%) in the 5-day group (P = 0.876). Multivariate analysis revealed that none of the factors was a predictor of rebleeding. No serious side-effects and complications were observed. A 3-day course of somatostatin is as effective as a 5-day course for the control of variceal bleeding and prevention of early rebleeding when used as combination therapy with EVL. © 2015 The Japan Society of Hepatology.

  5. Reducing by 50% the incidence of maternal hypotension during elective caesarean delivery under spinal anesthesia: Effect of prophylactic ondansetron and/or continuous infusion of phenylephrine - a double-blind, randomized, placebo controlled trial.

    Science.gov (United States)

    Ortiz-Gómez, Jose Ramon; Palacio-Abizanda, Francisco Javier; Morillas-Ramirez, Francisco; Fornet-Ruiz, Inocencia; Lorenzo-Jiménez, Ana; Bermejo-Albares, Maria Lourdes

    2017-01-01

    Prophylactic administrations of ondansetron or phenylephrine have been reported to provide a protective effect against hypotension in women undergoing cesarean delivery under spinal anesthesia (SA). The main hypothesis is that ondansetron improves the hemodynamic response, especially combined with phenylephrine infusion. This prospective, double-blind, randomized, placebo-controlled study included 265 healthy pregnant women scheduled for elective cesarean delivery under SA. Women were randomly allocated into four groups to receive either placebo (control), ondansetron (O) 8 mg intravenously before induction of SA, phenylephrine infusion (50 mcg/min) (P) or ondansetron plus phenylephrine (OP). Demographic, obstetric, intraoperative timing, and anesthetic variables were assessed at 16 time points. Anesthetic variables assessed included blood pressure, heart rate, oxygen saturation, nausea, vomiting, electrocardiographic changes, skin flushing, discomfort or pruritus, and vasopressor requirements. There were differences ( P = 0.0001) in the number of patients with hypotension (50.8% control, 44.6% O, 20.9% P, 25.0% OP), the percentage of time points ( P = 0.0001) with systolic hypotension per patient (17.4% control, 8.7% O, 2.1% P, 6.7% OP) and the number of patients requiring supplementary boluses of ephedrine ( P = 0.003), phenylephrine ( P = 0.017) or atropine ( P = 0.0001). A 50 μg/min phenylephrine infusion reduces by 50%, the incidence of maternal hypotension compared with placebo, but infusions of phenylephrine are still not routine in our environment. Prophylactic ondansetron 8 mg might be considered in this situation, because it does not reduce the incidence of maternal hypotension but diminishes its severity, reducing the number of hypotensive events per patient by 50%.

  6. Insulin glulisine compared to insulin aspart and to insulin lispro administered by continuous subcutaneous insulin infusion in patients with type 1 diabetes: a randomized controlled trial

    NARCIS (Netherlands)

    van Bon, Arianne C.; Bode, Bruce W.; Sert-Langeron, Caroline; DeVries, J. Hans; Charpentier, Guillaume

    2011-01-01

    In a previous pilot study comparing insulin glulisine (GLU) with insulin aspart (ASP) administered by continuous subcutaneous insulin infusion (CSII), GLU-treated patients did show a trend toward fewer catheter occlusions compared with ASP-treated patients. Here we performed a randomized open-label,

  7. Intravenous lidocaine infusion.

    Science.gov (United States)

    Soto, G; Naranjo González, M; Calero, F

    2018-02-26

    Systemic lidocaine used in continuous infusion during the peri-operative period has analgesic, anti-hyperalgesic, as well as anti-inflammatory properties. This makes it capable of reducing the use of opioids and inhalational anaesthetics, and the early return of bowel function, and patient hospital stay. The aim of this narrative review was to highlight the pharmacology and indications for clinical application, along with new and interesting research areas. The clinical applications of peri-operative lidocaine infusion have been reviewed in several recent systematic reviews and meta-analyses in patients undergoing open and laparoscopic abdominal procedures, ambulatory procedures, and other types of surgery. Peri-operative lidocaine infusion may be a useful analgesic adjunct in enhanced recovery protocols. Potential benefits of intravenous lidocaine in chronic post-surgical pain, post-operative cognitive dysfunction, and cancer recurrence are under investigation. Due to its immunomodulation properties over surgical stress, current evidence suggests that intravenous lidocaine could be used in the context of multimodal analgesia. Copyright © 2018 Sociedad Española de Anestesiología, Reanimación y Terapéutica del Dolor. Publicado por Elsevier España, S.L.U. All rights reserved.

  8. AAC as a Potential Target Gene to Control Verticillium dahliae

    Directory of Open Access Journals (Sweden)

    Xiaofeng Su

    2017-01-01

    Full Text Available Verticillium dahliae invades the roots of host plants and causes vascular wilt, which seriously diminishes the yield of cotton and other important crops. The protein AAC (ADP, ATP carrier is responsible for transferring ATP from the mitochondria into the cytoplasm. When V. dahliae protoplasts were transformed with short interfering RNAs (siRNAs targeting the VdAAC gene, fungal growth and sporulation were significantly inhibited. To further confirm a role for VdAAC in fungal development, we generated knockout mutants (ΔVdACC. Compared with wild-type V. dahliae (Vd wt, ΔVdAAC was impaired in germination and virulence; these impairments were rescued in the complementary strains (ΔVdAAC-C. Moreover, when an RNAi construct of VdAAC under the control of the 35S promoter was used to transform Nicotiana benthamiana, the expression of VdAAC was downregulated in the transgenic seedlings, and they had elevated resistance against V. dahliae. The results of this study suggest that VdAAC contributes to fungal development, virulence and is a promising candidate gene to control V. dahliae. In addition, RNAi is a highly efficient way to silence fungal genes and provides a novel strategy to improve disease resistance in plants.

  9. Novel acetylcholinesterase target site for malaria mosquito control.

    Directory of Open Access Journals (Sweden)

    Yuan-Ping Pang

    2006-12-01

    Full Text Available Current anticholinesterase pesticides were developed during World War II and are toxic to mammals because they target a catalytic serine residue of acetylcholinesterases (AChEs in insects and in mammals. A sequence analysis of AChEs from 73 species and a three-dimensional model of a malaria-carrying mosquito (Anopheles gambiae AChE (AgAChE reported here show that C286 and R339 of AgAChE are conserved at the opening of the active site of AChEs in 17 invertebrate and four insect species, respectively. Both residues are absent in the active site of AChEs of human, monkey, dog, cat, cattle, rabbit, rat, and mouse. The 17 invertebrates include house mosquito, Japanese encephalitis mosquito, African malaria mosquito, German cockroach, Florida lancelet, rice leaf beetle, African bollworm, beet armyworm, codling moth, diamondback moth, domestic silkworm, honey bee, oat or wheat aphid, the greenbug, melon or cotton aphid, green peach aphid, and English grain aphid. The four insects are house mosquito, Japanese encephalitis mosquito, African malaria mosquito, and German cockroach. The discovery of the two invertebrate-specific residues enables the development of effective and safer pesticides that target the residues present only in mosquito AChEs rather than the ubiquitous serine residue, thus potentially offering an effective control of mosquito-borne malaria. Anti-AgAChE pesticides can be designed to interact with R339 and subsequently covalently bond to C286. Such pesticides would be toxic to mosquitoes but not to mammals.

  10. Large scale RNAi screen in Tribolium reveals novel target genes for pest control and the proteasome as prime target.

    Science.gov (United States)

    Ulrich, Julia; Dao, Van Anh; Majumdar, Upalparna; Schmitt-Engel, Christian; Schwirz, Jonas; Schultheis, Dorothea; Ströhlein, Nadi; Troelenberg, Nicole; Grossmann, Daniela; Richter, Tobias; Dönitz, Jürgen; Gerischer, Lizzy; Leboulle, Gérard; Vilcinskas, Andreas; Stanke, Mario; Bucher, Gregor

    2015-09-03

    Insect pest control is challenged by insecticide resistance and negative impact on ecology and health. One promising pest specific alternative is the generation of transgenic plants, which express double stranded RNAs targeting essential genes of a pest species. Upon feeding, the dsRNA induces gene silencing in the pest resulting in its death. However, the identification of efficient RNAi target genes remains a major challenge as genomic tools and breeding capacity is limited in most pest insects impeding whole-animal-high-throughput-screening. We use the red flour beetle Tribolium castaneum as a screening platform in order to identify the most efficient RNAi target genes. From about 5,000 randomly screened genes of the iBeetle RNAi screen we identify 11 novel and highly efficient RNAi targets. Our data allowed us to determine GO term combinations that are predictive for efficient RNAi target genes with proteasomal genes being most predictive. Finally, we show that RNAi target genes do not appear to act synergistically and that protein sequence conservation does not correlate with the number of potential off target sites. Our results will aid the identification of RNAi target genes in many pest species by providing a manageable number of excellent candidate genes to be tested and the proteasome as prime target. Further, the identified GO term combinations will help to identify efficient target genes from organ specific transcriptomes. Our off target analysis is relevant for the sequence selection used in transgenic plants.

  11. Infusão contínua de lidocaína em diferentes taxas no controle de arritmias induzidas pela administração de adrenalina em cães anestesiados com isofluorano

    Directory of Open Access Journals (Sweden)

    R. Thiesen

    2012-02-01

    Full Text Available Avaliaram-se os efeitos da infusão de diferentes doses de lidocaína sobre o ritmo cardíaco, em cães anestesiados com isofluorano que receberam doses crescentes de adrenalina. Foram utilizados 10 cães, cada qual anestesiado quatro vezes, respeitando-se um intervalo de duas semanas. A indução anestésica foi realizada com propofol, 8mg/kg, e a manutenção com isofluorano a 1,5 CAM. Os animais foram distribuídos em quatro grupos, que receberam bolus de lidocaína, 1mg/kg, seguido pela infusão de lidocaína nas taxas de 50μg/kg/h (G50, 100μg/kg/h (G100 e 200μg/kg/h (G200. O grupo-controle (GC recebeu bolus e infusão de NaCl a 0,9%. As variáveis foram mensuradas 30 minutos após a indução, e em seguida, iniciadas as infusões. Após 10 minutos do princípio dos tratamentos, colheram-se novamente os dados e iniciou-se a infusão de adrenalina, 1μg/kg/min. Em intervalos de 10 minutos, realizou-se nova colheita de dados e acrescentou-se 1μg/kg/min na taxa de infusão de adrenalina, até atingir 5μg/kg/min. Comparativamente ao GC, ocorreu redução do aparecimento de batimentos de origem não sinusal e bloqueios atrioventriculares de segundo grau nos grupos tratados com lidocaína. Concluiu-se que a associação de lidocaína à anestesia com isofluorano diminuiu o aparecimento de irregularidades no ritmo cardíaco.

  12. Home infusion: overcoming the barriers to entry.

    Science.gov (United States)

    Franklin, David M

    2010-01-01

    The field of pharmacy service is evolving rapidly, as is the delivery of healthcare in general. From patients with infectious diseases dying because there was nothing available to fight the infections, to the involvement of an episodic-based model of care with patients traversing inpatient- and outpatient-based delivery systems, to the new frontier of chronic care and with supports such as the one by the Centers for Disease Control that hospital-acquired infections are killing about 100,000 Americans every year, the home infusion business has become a major alternative to in-hospital treatment. This article discusses the barriers to entry into the home infusion business and assists in the evaluation of a home infusion reimbursement organization.

  13. Delivery interaction between co-infused medications: an in vitro modeling study of microinfusion.

    Science.gov (United States)

    Tsao, Amy C; Lovich, Mark A; Parker, Michael J; Zheng, Hui; Peterfreund, Robert A

    2013-01-01

    To test the hypothesis that steady-state drug delivery by continuous infusion is predictably affected by a second drug infusion in the same lumen. Clinicians commonly administer two drugs by continuous infusion through one central venous catheter lumen (co-infusion). To limit fluid delivery, low flow rate carriers transport concentrated drug solutions; a method called microinfusion. How microinfusion delivery of one drug is affected by a second drug infusion has not been explored. Two water-soluble dyes, tartrazine and erioglaucine, infused at 3 ml · h(-1), modeled drug delivery through a four stopcock linear manifold and catheter lumen. A pump drove a carrier fluid (10 ml · h(-1)). After tartrazine reached steady-state delivery, erioglaucine entered downstream or upstream of the tartrazine infusion. Quantitative spectrophotometry measured dye delivery. Starting erioglaucine's infusion upstream of tartrazine's entry caused a transient tartrazine bolus (duration 10 min, peak drug delivery 20% higher than target levels). Starting erioglaucine's infusion downstream produced a similar amplitude, briefer, bolus. Stopping the erioglaucine infusion caused a transient reduction in tartrazine delivery. Measured delivery profiles were comparable to prediction models. We confirmed the hypothesis that delivery of one infused drug is transiently affected by starting or stopping a second drug infusion in the same line. The magnitude of the changes can be estimated quantitatively. The clinical impact depends on the drugs being co-infused and patient sensitivity, but could be clinically important; the findings have safety implications for infused medication delivery to critically ill or anesthetized children. We recommend minimizing infusion system dead volumes, connecting the most essential infusion(s) to the main fluid pathway as close as possible to the patient, and recognizing the potential for unintended alterations in delivery when multiple drugs co-infuse. © 2012

  14. Periarticular Liposomal Bupivacaine Injection Versus Intra-Articular Bupivacaine Infusion Catheter for Analgesia After Total Knee Arthroplasty: A Double-Blinded, Randomized Controlled Trial.

    Science.gov (United States)

    Smith, Eric B; Kazarian, Gregory S; Maltenfort, Mitchell G; Lonner, Jess H; Sharkey, Peter F; Good, Robert P

    2017-08-16

    Intra-articular bupivacaine hydrochloride (HCl) infusion catheters and periarticular injections of liposomal bupivacaine are often used as postoperative local anesthetics. The purpose of this study was to compare the efficacies of these local anesthetics following total knee arthroplasty. This study was a superiority trial with a randomized, controlled, double-blinded design. Patients were randomly assigned to either delivery of bupivacaine HCl by the ON-Q* Pain Relief System pump (n = 96) or by an injection of Exparel (liposomal bupivacaine) (n = 104). The primary outcome of this study was cumulative narcotic consumption on postoperative days 0 through 3. Narcotic consumption data were collected retrospectively from in-hospital records while patients were in the hospital. Following discharge, narcotic consumption data were gathered from patient surveys, as were secondary outcomes measures. We did not identify greater narcotic use in the ON-Q* group compared with the Exparel group (p = 0.641). The mean difference between the groups was 0.5 morphine equivalent (95% confidence interval [CI] = -1.7 to +2.8), with the ON-Q* group consuming an average 10.4 morphine equivalents (95% CI = 8.7 to 12.0) compared with 10.9 (95% CI = 9.3 to 12.5) in the Exparel group. There were no significant differences between groups with regard to any of the secondary measures of pain with the exception of pain while walking and pain with physical therapy (p = 0.019 and p = 0.010, respectively), both of which showed an approximately 1-point difference in favor of the ON-Q* group on a visual analog scale (VAS). There were also no differences in the postoperative side effects, including nausea, constipation, or vomiting, or in the rates of study-related complications, patient satisfaction, or length of hospital stay. Exparel did not have superior efficacy compared with the ON-Q* Pain Relief System as reflected by narcotic consumption, our primary outcome. There were small significant

  15. Improved Postprandial Glycemic Control with Faster-Acting Insulin Aspart in Patients with Type 1 Diabetes Using Continuous Subcutaneous Insulin Infusion.

    Science.gov (United States)

    Bode, Bruce W; Johnson, Joseph A; Hyveled, Liselotte; Tamer, Søren C; Demissie, Marek

    2017-01-01

    Faster aspart is insulin aspart (IAsp) in a new formulation, which in continuous subcutaneous insulin infusion (CSII) in subjects with type 1 diabetes has shown a faster onset and offset of glucose-lowering effect than IAsp. This double-blind, randomized, crossover active-controlled trial compared 2-h postprandial plasma glucose (PPG) response, following 2 weeks of CSII with faster aspart or IAsp. Primary endpoint: mean change in PPG 2 h after a standardized meal test (ΔPG av,0-2h ). Subjects (n = 43) had masked continuous glucose monitoring (CGM) throughout. Faster aspart provided a statistically significantly greater glucose-lowering effect following the meal versus IAsp: ΔPG av,0-2h : 3.03 mmol/L versus 4.02 mmol/L (54.68 mg/dL vs. 72.52 mg/dL); estimated treatment difference (ETD) [95% CI]: -0.99 mmol/L [-1.95; -0.03] (-17.84 mg/dL [-35.21; -0.46]; P = 0.044). One hour postmeal, PG levels were -1.64 mmol/L (-29.47 mg/dL) lower with faster aspart versus IAsp (P = 0.006). Interstitial glucose (IG) profiles supported these findings; the largest differences were observed at breakfast: 9.08 versus 9.56 mmol/L (163.57 vs. 172.19 mg/dL; ETD [95% CI]: -0.48 mmol/L [-0.97; 0.01]; -8.62 mg/dL [-17.49; 0.24]; P = 0.057). Duration of low IG levels (≤3.9 mmol/L [70 mg/dL] per 24 h) was statistically significantly shorter for faster aspart versus IAsp (2.03 h vs. 2.45 h; ETD [95% CI]: -0.42 [-0.72; -0.11]; P = 0.008). No unexpected safety findings were observed. CSII delivery of faster aspart had a greater glucose-lowering effect than IAsp after a meal test. CGM results recorded throughout all meals supported this finding, with less time spent with low IG levels.

  16. Standard concentration infusions in paediatric intensive care: the clinical approach.

    Science.gov (United States)

    Perkins, Joanne; Aguado-Lorenzo, Virginia; Arenas-Lopez, Sara

    2017-05-01

    The use of standard concentrations of intravenous infusions has been advocated by international organisations to increase intravenous medication safety in paediatric and neonatal critical care. However, there is no guidance on how to identify and implement these infusions leading to great interunit variability. To identify the most appropriate clinical concentrations required by our paediatric intensive care unit (PICU) population with regard to accuracy of delivery and overall fluid allowance. Firstly a matrix was used to balance the concentration, dose and infusion volume (weight range 1.5-50 kg). Results were further refined considering: patient fluid allowance based on fluid volume targets, infusion pump accuracy and challenging each infusion against clinical scenarios requiring administration of multiple drug infusions found in PICU. Consideration was given to the standard concentrations routinely used in adults, in order to assess whether alignment with paediatrics was possible for some of the concentrations proposed. Finally a risk assessment of the infusions was conducted using the NPSA 20 tool. Twenty-five drugs identified as the most commonly used intravenous infusions in the unit. For the majority of the medicines, three weight bands of standard concentrations were necessary to cover the children's weight ranges and kept within predefined fluid requirements and accuracy of delivery. This work shows a patient focused systematic approach for defining and evaluating standardised concentrations in intensive care children. © 2016 Royal Pharmaceutical Society.

  17. [A case report-advanced pancreas cancer with liver and lung metastases well controlled over one year by combination therapy with systemic chemotherapy, radiation and hepatic arterial infusion in an outpatient setting].

    Science.gov (United States)

    Hasuike, Yasunori; Tanigawa, Takahiko; Yamada, Masaharu; Minami, Yukiko; Ezumi, Koji; Kashiwazaki, Masaki; Fujimoto, Takayoshi

    2008-11-01

    We report a case of advanced pancreatic cancer with liver and lung metastases that was well controlled over one year by combination therapy with systemic chemotherapy, radiation and hepatic arterial infusion in an outpatient setting. The patient was a 74-year-old woman. Chief complaints were back pain and anorexia. She was diagnosed with pancreas cancer with liver and lung metastases at the time of first visit. We started systemic chemotherapy with gemcitabine 1 g/body and 5-FU 1 g/body alternately every other week on an outpatient basis. At 1.5 months (M) after initiation of chemotherapy, we started radiation therapy to the main tumor at a total dose of 40 Gy. After radiation, chemotherapy was resumed. As a result, the size of the main tumor decreased but metastatic liver tumors got larger. Then we changed to combination therapy with systemic chemotherapy (gemcitabine and 5-FU) and hepatic arterial infusion (5-FU weekly). Liver metastases almost disappeared after 7.5 M. Despite all these treatments, however, the number of metastatic lung tumors increased. The patient was hospitalized for 15 M and died after 17 M. We focused on and succeeded in the prolongation of lifetime and maintenance of QOL by combination therapy with systemic chemotherapy, radiation and hepatic arterial infusion therapy.

  18. Double oral esomeprazole after a 3-day intravenous esomeprazole infusion reduces recurrent peptic ulcer bleeding in high-risk patients: a randomised controlled study.

    Science.gov (United States)

    Cheng, Hsiu-Chi; Wu, Chung-Tai; Chang, Wei-Lun; Cheng, Wei-Chun; Chen, Wei-Ying; Sheu, Bor-Shyang

    2014-12-01

    Patients with high Rockall scores have increased risk of ulcer rebleeding after 3-day esomeprazole infusions. To investigate whether double oral esomeprazole given after a 3-day esomeprazole infusion decreases ulcer rebleeding for patients with high Rockall scores. We prospectively enrolled 293 patients with peptic ulcer bleeding who had achieved endoscopic haemostasis. After a 3-day esomeprazole infusion, patients with Rockall scores ≥6 were randomised into the oral double-dose group (n=93) or the oral standard-dose group (n=94) to receive 11 days of oral esomeprazole 40 mg twice daily or once daily, respectively. The patients with Rockall scores esomeprazole 40 mg once daily. Thereafter, all patients received oral esomeprazole 40 mg once daily for two more weeks until the end of the 28-day study period. The primary end point was peptic ulcer rebleeding. Among patients with Rockall scores ≥6, the oral double-dose group had a higher cumulative rebleeding-free proportion than the oral standard-dose group (p=0.02, log-rank test). The proportion of patients free from recurrent bleeding during the 4th-28th day in the oral double-dose group remained lower than that of the group with Rockall scores esomeprazole at 40 mg twice daily after esomeprazole infusion reduced recurrent peptic ulcer bleeding in high-risk patients with Rockall scores ≥6. NCT01591083. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  19. Intraoperative Low-Dose Ketamine Infusion Reduces Acute Postoperative Pain Following Total Knee Replacement Surgery: A Prospective, Randomized Double-Blind Placebo-Controlled Trial

    International Nuclear Information System (INIS)

    Pelin Cengiz, P.; Gokcinar, D.; Karabeyoglu, I.; Topcu, H.; Cicek, G. S.; Gogus, N.

    2014-01-01

    Objective: To evaluate the effect of intraoperative low-dose ketamine with general anesthesia on postoperative pain after total knee replacement surgery. Study Design: A randomized, double-blind comparative study. Place and Duration of Study: Ankara Numune Training and Research Hospital, Turkey, from January and June 2011. Methodology: Sixty adults undergoing total knee arthroplasty were enrolled in this study. The patients were randomly allocated into two groups of equal size to receive either racemic ketamine infusion (6.25 g/kg/minute) or the same volume of saline. A visual analogue scale (VAS) was used to measure each patient's level of pain at 1, 3, 6, 12, and 24 hours after surgery. Time to first analgesic request, postoperative morphine consumption and the incidence of side effects were also recorded. Results: Low-dose ketamine infusion prolonged the time to first analgesic request. It also reduced postoperative cumulative morphine consumption at 1, 3, 6, 12, and 24 hours postsurgery (p < 0.001). Postoperative VAS scores were also significantly lower in the ketamine group than placebo, at all observation times. Incidences of side effects were similar in both study groups. Conclusion: Intraoperative continuous low-dose ketamine infusion reduced pain and postoperative analgesic consumption without affecting the incidence of side effects. (author)

  20. Application of owner technical management in hydraulic machinery and electrical equipment investment target control

    International Nuclear Information System (INIS)

    Luo, H

    2012-01-01

    Using technical means in investment target control is an effective method to improve investment benefit of a construction project. Take the practice of construction and management in hydropower station as an example, the investment and management need of the owner is put forward through the investment target decision-making process of electromechanical equipment. Owner technical management in the specific application measures and effects of investment target control was discussed in the paper, and the revelation in investment target control application of owner technical management was also summarized. The paper is aimed to provide a useful reference for the investment target control work in the construction of electromechanical equipment.

  1. CAD Model and Visual Assisted Control System for NIF Target Area Positioners

    International Nuclear Information System (INIS)

    Tekle, E A; Wilson, E F; Paik, T S

    2007-01-01

    The National Ignition Facility (NIF) target chamber contains precision motion control systems that reach up to 6 meters into the target chamber for handling targets and diagnostics. Systems include the target positioner, an alignment sensor, and diagnostic manipulators (collectively called positioners). Target chamber shot experiments require a variety of positioner arrangements near the chamber center to be aligned to an accuracy of 10 micrometers. Positioners are some of the largest devices in NIF, and they require careful monitoring and control in 3 dimensions to prevent interferences. The Integrated Computer Control System provides efficient and flexible multi-positioner controls. This is accomplished through advanced video-control integration incorporating remote position sensing and realtime analysis of a CAD model of target chamber devices. The control system design, the method used to integrate existing mechanical CAD models, and the offline test laboratory used to verify proper operation of the control system are described

  2. A DNA nanocapsule with aptamer-controlled open-closure function for targeted delivery

    DEFF Research Database (Denmark)

    Bentin, Thomas

    2012-01-01

    A DNA capsule fitted with aptamer controlled target sensing has been "woven" using a 7308-base single-stranded DNA "thread" and 196 staple oligonucleotides. The capsule enables logic-gated molecular cargo delivery to targeted cell surfaces.......A DNA capsule fitted with aptamer controlled target sensing has been "woven" using a 7308-base single-stranded DNA "thread" and 196 staple oligonucleotides. The capsule enables logic-gated molecular cargo delivery to targeted cell surfaces....

  3. The effect of continuous low dose methylprednisolone infusion on inflammatory parameters in patients undergoing coronary artery bypass graft surgery: a randomized-controlled clinical trial.

    Directory of Open Access Journals (Sweden)

    Abbas Ghiasi

    2015-02-01

    Full Text Available This trial was performed to determine if a continuous low-dose infusion of methylprednisolone is as effective as its bolus of high-dose in reducing inflammatory response. The study was single-center, double-blinded randomized clinical trial and performed in a surgical intensive care unit of an academic hospital. In this study, 72 consecutive patients undergoing elective coronary artery bypass grafting (CABG were assigned to receive either a methylprednisolone loading dose (1mg/kg followed by continuous infusion (2mg/Kg/24 hours for 1 day (low-dose regime or a single dose of methylprednisolone (15 mg/kg before cardiopulmonary bypass (high dose regime. Serum concentrations of IL-6 and C- reactive protein (CRP were measured preoperatively and 6, 24 and 48 hours after surgery, and serum creatinine was measured before the operation and 24, 48 and 72 hours postoperatively. The measurements were then compared between the groups to evaluate the efficacy of each regimen. The basic characteristics and measurements were not different between the study groups. There was no significant difference in IL-6 and CRP elevation (P=0.52 and P=0.46, respectively. Early outcomes such as the length of stay in the intensive care unit, intubation time, changes in serum creatinine and blood glucose levels, inotropic support, insulin requirements, and rate of infection were also similar in both groups. A continuous low dose infusion of methylprednisolone was as effective as a single high dose methylprednisolone in reducing the inflammatory response after CABG with extracorporeal circulation with no significant difference in the postoperative measurements and outcomes.

  4. Infusion's greenfield subsidiary in Poland

    NARCIS (Netherlands)

    Williams, C.; van Eerde, W.; The, D.

    2012-01-01

    The president of Infusion Development Corporation was reviewing the progress of the new subsidiary the company had set up 15 months earlier in Krakow, Poland. The purpose of the subsidiary was to work with other Infusion offices around the world to provide innovative software development services to

  5. Impact and cost-effectiveness of snail control to achieve disease control targets for schistosomiasis.

    Science.gov (United States)

    Lo, Nathan C; Gurarie, David; Yoon, Nara; Coulibaly, Jean T; Bendavid, Eran; Andrews, Jason R; King, Charles H

    2018-01-23

    Schistosomiasis is a parasitic disease that affects over 240 million people globally. To improve population-level disease control, there is growing interest in adding chemical-based snail control interventions to interrupt the lifecycle of Schistosoma in its snail host to reduce parasite transmission. However, this approach is not widely implemented, and given environmental concerns, the optimal conditions for when snail control is appropriate are unclear. We assessed the potential impact and cost-effectiveness of various snail control strategies. We extended previously published dynamic, age-structured transmission and cost-effectiveness models to simulate mass drug administration (MDA) and focal snail control interventions against Schistosoma haematobium across a range of low-prevalence (5-20%) and high-prevalence (25-50%) rural Kenyan communities. We simulated strategies over a 10-year period of MDA targeting school children or entire communities, snail control, and combined strategies. We measured incremental cost-effectiveness in 2016 US dollars per disability-adjusted life year and defined a strategy as optimally cost-effective when maximizing health gains (averted disability-adjusted life years) with an incremental cost-effectiveness below a Kenya-specific economic threshold. In both low- and high-prevalence settings, community-wide MDA with additional snail control reduced total disability by an additional 40% compared with school-based MDA alone. The optimally cost-effective scenario included the addition of snail control to MDA in over 95% of simulations. These results support inclusion of snail control in global guidelines and national schistosomiasis control strategies for optimal disease control, especially in settings with high prevalence, "hot spots" of transmission, and noncompliance to MDA. Copyright © 2018 the Author(s). Published by PNAS.

  6. The incidence and management of infusion reactions to infliximab: a large center experience.

    Science.gov (United States)

    Cheifetz, Adam; Smedley, Michelle; Martin, Sara; Reiter, Monica; Leone, Grace; Mayer, Lloyd; Plevy, Scott

    2003-06-01

    To assess the incidence and management of infusion reactions to infliximab, a chimeric monoclonal antibody that targets human tumor necrosis factor-alpha, in patients with Crohn's disease treated at a large infusion center. A total of 165 consecutive patients who received 479 infliximab infusions in the Division of Clinical Immunology Infusion Center at Mount Sinai Medical Center from July, 1998 to January, 2001 were evaluated. Specific treatment protocols for initial and subsequent acute infusion reactions were followed and the outcomes documented. The overall incidence of infusion reactions to infliximab was 6.1% (29 of 479) of infusions, affecting 9.7% (16 of 165) of patients. Mild, moderate, or severe acute reactions occurred in 3.1% (15 of 479), 1.2% (six of 479), and 1.0% (five of 479) of infliximab infusions, respectively. Use of treatment protocols resulted in rapid resolution of all acute reactions to infliximab. With the prophylaxis protocol, all patients who experienced an initial mild or moderate acute reaction were able to receive additional infusions. Four patients experienced a total of five severe acute reactions. Three patients were retreated: two patients had no further problems, whereas one patient had a second severe acute reaction that rapidly resolved with treatment. Suggesting that acute infusion reactions are not type I hypersensitivity reactions, in 11 patients who experienced 14 acute infusion reactions, serum tryptase levels were normal. Delayed infusion reactions occurred in 0.6% (three of 479) of infusions. Infliximab infusions were accompanied by acute reactions in approximately 5% of infusions. These reactions did not seem to be true IgE-mediated type I hypersensitivity events. Using appropriate treatment protocols, these reactions were effectively treated and prevented upon retreatment in nearly all patients. Delayed reactions were rare, occurring in <1% of infusions.

  7. Precision Targeting: Reduced Pesticide Use Strategy for Pharaoh’s Ant (Hymenoptera: Formicidae) Control

    Science.gov (United States)

    1999-07-19

    AND SUBTITLE Precision Targeting: Reduced Pesticide Use Strategy for Pharaoh’s Ant (Hymenoptera: Formicidae ) Control 6. AUTHOR(S) David F. Williams...TARGETING: REDUCED PESTICIDE USE STRATEGY FOR PHARAOH’S ANT (HYMENOPTERA: FORMICIDAE ) CONTROL DAVID F. WILLIAMS, RICHARD J. BRENNER AND DAVID MILNE...space may benefit from this method of control. This Precision targeting - reduced pesticide use strategy for Pharaoh’s ant (Hymenoptera: Formicidae

  8. Early mechanism of action of arterially infused ethanol: an experimental study on the influence of infusion speed

    International Nuclear Information System (INIS)

    Han, Joon Koo

    1988-01-01

    Abdominal aortography and histopathologic examination after absolute ethanol infusion at fast (0.4cc/sec) and slow speed (0.04cc/sec) were performed on 16 rats (2 controls. 7 fast infusion group. 7 slow infusion group). Angiographic and histopathologic findings were correlated and the findings of slow and fast infusion groups were studied. The results are as follows: 1. Histopathologic findings of the fast infusion group revealed wide area of glomerular and tubular collapses, obliteration of the free space between the Bowmann's capsule and glomerulus, sloughing and loss of the endothelium, fresh thrombi attached to the wall, and cleavage of the muscle layer of the arteries. 2. Angiographic findings of the fast infusion group revealed luminal irregularity, early obstruction of the aorta and the renal arteries, and delayed circulation time. 3. Histopathologic findings of the slow infusion group revealed degenerated, coalesced red blood cell packed in the glomeruli, focal areas of severe glomerular and tubular damage on relatively normal background, endothelial and muscular damage of the arteries. 4. Angiographic findings of the slow infusion group revealed focal perfusion defect of the kidney, delayed circulation time, and mild luminal irregularity, but there was no obstruction of the major arteries. 5. In conclusion, author believes that endothelial damage and thrombus formation from the damaged vessel wall, as well as direct cytotoxicity and in situ emboli formation play a significant role in the embolic effect of absolute ethanol.

  9. Hitting Hotspots: Spatial Targeting of Malaria for Control and Elimination

    NARCIS (Netherlands)

    Bousema, T.; Griffin, J.T.; Sauerwein, R.W.; Smith, D.L.; Churcher, T.S.; Takken, W.; Ghani, A.; Drakeley, C.; Gosling, R.

    2012-01-01

    Current malaria elimination guidelines are based on the concept that malaria transmission becomes heterogeneous in the later phases of malaria elimination [1]. In the pre-elimination and elimination phases, interventions have to be targeted to entire villages or towns with higher malaria incidence

  10. Polymer carriers for targeted drug delivery and controlled drug release

    Czech Academy of Sciences Publication Activity Database

    Ulbrich, Karel; Pechar, Michal; Etrych, Tomáš; Jelínková, Markéta; Kovář, Marek; Říhová, Blanka

    2003-01-01

    Roč. 10, č. 1 (2003), s. 3-4 ISSN 1211-5894 R&D Projects: GA ČR GA305/02/1425; GA AV ČR IAA4050201 Institutional research plan: CEZ:AV0Z5020903; CEZ:AV0Z4050913 Keywords : HPMA copolymers * drug targeting * drug delivery Subject RIV: CD - Macromolecular Chemistry

  11. Malpighian Tubules as Novel Targets for Mosquito Control

    Directory of Open Access Journals (Sweden)

    Peter M. Piermarini

    2017-01-01

    Full Text Available The Malpighian tubules and hindgut are the renal excretory tissues of mosquitoes; they are essential to maintaining hemolymph water and solute homeostasis. Moreover, they make important contributions to detoxifying metabolic wastes and xenobiotics in the hemolymph. We have focused on elucidating the molecular mechanisms of Malpighian tubule function in adult female mosquitoes and developing chemical tools as prototypes for next-generation mosquitocides that would act via a novel mechanism of action (i.e., renal failure. To date, we have targeted inward rectifier potassium (Kir channels expressed in the Malpighian tubules of the yellow fever mosquito Aedes aegypti and malaria mosquito Anopheles gambiae. Inhibition of these channels with small molecules inhibits transepithelial K+ and fluid secretion in Malpighian tubules, leading to a disruption of hemolymph K+ and fluid homeostasis in adult female mosquitoes. In addition, we have used next-generation sequencing to characterize the transcriptome of Malpighian tubules in the Asian tiger mosquito Aedes albopictus, before and after blood meals, to reveal new molecular targets for potentially disrupting Malpighian tubule function. Within 24 h after a blood meal, the Malpighian tubules enhance the mRNA expression of genes encoding mechanisms involved with the detoxification of metabolic wastes produced during blood digestion (e.g., heme, NH3, reactive oxygen species. The development of chemical tools targeting these molecular mechanisms in Malpighian tubules may offer a promising avenue for the development of mosquitocides that are highly-selective against hematophagous females, which are the only life stage that transmits pathogens.

  12. Malpighian Tubules as Novel Targets for Mosquito Control.

    Science.gov (United States)

    Piermarini, Peter M; Esquivel, Carlos J; Denton, Jerod S

    2017-01-24

    The Malpighian tubules and hindgut are the renal excretory tissues of mosquitoes; they are essential to maintaining hemolymph water and solute homeostasis. Moreover, they make important contributions to detoxifying metabolic wastes and xenobiotics in the hemolymph. We have focused on elucidating the molecular mechanisms of Malpighian tubule function in adult female mosquitoes and developing chemical tools as prototypes for next-generation mosquitocides that would act via a novel mechanism of action (i.e., renal failure). To date, we have targeted inward rectifier potassium (Kir) channels expressed in the Malpighian tubules of the yellow fever mosquito Aedes aegypti and malaria mosquito Anopheles gambiae . Inhibition of these channels with small molecules inhibits transepithelial K⁺ and fluid secretion in Malpighian tubules, leading to a disruption of hemolymph K⁺ and fluid homeostasis in adult female mosquitoes. In addition, we have used next-generation sequencing to characterize the transcriptome of Malpighian tubules in the Asian tiger mosquito Aedes albopictus , before and after blood meals, to reveal new molecular targets for potentially disrupting Malpighian tubule function. Within 24 h after a blood meal, the Malpighian tubules enhance the mRNA expression of genes encoding mechanisms involved with the detoxification of metabolic wastes produced during blood digestion (e.g., heme, NH₃, reactive oxygen species). The development of chemical tools targeting these molecular mechanisms in Malpighian tubules may offer a promising avenue for the development of mosquitocides that are highly-selective against hematophagous females, which are the only life stage that transmits pathogens.

  13. Cell cycle controls: potential targets for chemical carcinogens?

    OpenAIRE

    Afshari, C A; Barrett, J C

    1993-01-01

    The progression of the cell cycle is controlled by the action of both positive and negative growth regulators. The key players in this activity include a family of cyclins and cyclin-dependent kinases, which are themselves regulated by other kinases and phosphatases. Maintenance of balanced cell cycle controls may be directly linked to genomic stability. Loss of the check-points involved in cell cycle control may result in unrepaired DNA damage during DNA synthesis or mitosis leading to genet...

  14. Size-controlled synthesis of biodegradable nanocarriers for targeted ...

    Indian Academy of Sciences (India)

    Abstract. Research for synthesis of size-controlled carriers is currently challenging one. In this research paper, a method for size-controlled synthesis of biodegradable nanocarriers is proposed and described. Salting out method is suitable for both hydrophilic and hydrophobic drugs for the encapsulation on carriers.

  15. Size-controlled synthesis of biodegradable nanocarriers for targeted ...

    Indian Academy of Sciences (India)

    2016-08-26

    Aug 26, 2016 ... Research for synthesis of size-controlled carriers is currently challenging one. In this research paper, a method for size-controlled synthesis of biodegradable nanocarriers is proposed and described. Salting out method is suitable for both hydrophilic and hydrophobic drugs for the encapsulation on carriers.

  16. An experimental study on the influence of infusion speed on the early mechanism of embolic effect of arterially infused absolute Ethanol in the rat

    International Nuclear Information System (INIS)

    Han, Joon Koo; Kim, Woo Ho; Lee, Byung Hee; Park, Kil Sun; Park, Jae Hyung; Kim, Chu Wan; Han, Man Chung

    1990-01-01

    In order to clarify the early mechanism of action of the tissue necrosis induced by intraarterially infused absolute ethanol, abdominal aortography and histopathologic examination after absolute ethanol infusion into aorta at fast (0.4ml/sec) and slow speed (0.04ml/sec) were performed on 22 rats (2 controls, 7 in fast infusion group, 7 in slow infusion group, 3 in fast and 3 in slow infusion groups during aorta compression, respectively). Histopathologic features under the light and scanning electron microscope were correlated with the angiographic findings within 30 minutes after ethanol infusion. The results are as follows : 1. In fast infusion group, histopathologic examination of the kidney showed severe glomerular and tubular damage. Extensive damage on endothelial and medial layer was noted in arteries, and fresh thrombi originated from the damaged arterial wall were seen. 2. Angiographic findings in the fast infusion group were luminal irregularity and early obstruction of large arteries. And circulation time was prolonged. 3. In slow infusion group, histopathologic examination of the kidney showed focal area of severe glomerular and tubular damage on relatively normal background. Endothelial and muscular damage was noted in arteries, but the degree of the damage was less severe than that of the fast infusion group. 4. Angiographic findings in the slow infusion group were focal perfusion defect of the kidney, delayed circulation time, and mild luminal irregularity, but obstruction of the major arteries was not seen

  17. Forum metrology 2009: control of optics, targets and optical analyzers

    International Nuclear Information System (INIS)

    Desenne, D.; Andre, R.

    2010-01-01

    The 1. 'Forum Metrologie' of the CEA/DAM has been held in the 'Institut Laser et Plasma' on the December 9, 2009, close to the 'Centre d'etudes Scientifiques et Techniques d'Aquitaine'. It has been set up by the 'Departement Lasers de Puissance'. The chosen thematic was the metrology around laser experiments, with a special focus on the metrology of the dedicated optics, targets and optical analysers. The talks have shown the progress and difficulties in each of these fields. (authors)

  18. New software of the control and data acquisition system for the Nuclotron internal target station

    International Nuclear Information System (INIS)

    Isupov, A.Yu.

    2012-01-01

    The control and data acquisition system for the Internal Target Station (ITS) of the Nuclotron (LHEP, JINR) is implemented. The new software is based on the ngdp framework under the Unix-like operating system FreeBSD to allow easy network distribution of the on-line data collected from ITS, as well as the internal target remote control

  19. Techniques to control and position laser targets. Final report

    International Nuclear Information System (INIS)

    Jones, T.B.

    1978-06-01

    The purpose of the work was to investigate the potential role of various electrohydrodynamic phenomena in the fabrication of small spherical particles and shells for laser target applications. A number of topics were considered. These included charged droplet levitation, specifically the combined effects of the Rayleigh limit and droplet elongation in the presence of electric fields. Two new levitation schemes for uncharged dielectric particles were studied. A dynamic dielectrophoretic levitation scheme was proposed and unsuccessful attempts were made to observe levitation with it. Another static dielectrophoretic levitation scheme was studied and used extensively. A theory was developed for this type of levitation, and a dielectric constant measurement scheme proposed. A charged droplet generator for the production of single droplets ( 4 /O 2 bubbles in Viscasil silicone fluid were conducted to learn about the possibility of using silane to form SiO 2 microballons from bubbles

  20. Curcumin: a Polyphenol with Molecular Targets for Cancer Control.

    Science.gov (United States)

    Qadir, Muhammad Imran; Naqvi, Syeda Tahira Qousain; Muhammad, Syed Aun

    2016-01-01

    Curcumin, is a polyphenol from Curcuma longa (turmeric plant), is a polyphenol that belongs to the ginger family which has long been used in Ayurveda medicines to treat various diseases such as asthma, anorexia, coughing, hepatic diseases, diabetes, heart diseases, wound healing and Alzheimer's. Various studies have shown that curcumin has anti-infectious, anti-inflammatory, anti-oxidant, hepatoprotective, thrombosuppressive, cardio protective, anti-arthritic, chemo preventive and anti-carcinogenic activities. It may suppress both initiation and progression stages of cancer. Anticancer activity of curcumin is due to negative regulation of inflammatory cytokines, transcription factors, protein kinases, reactive oxygen species (ROS) and oncogenes. This review focuses on the different targets of curcumin to treat cancer.

  1. CREATING AND AUDITING A NEW ELECTRONIC CONTINUOUS INFUSION PRESCRIPTION CHART FOR A PAEDIATRIC CRITICAL CARE UNIT.

    Science.gov (United States)

    Siu, Emily; Sadasivam, Kalaimaran; Christiansen, Nanna

    2016-09-01

    Prescription errors, including continuous infusion prescriptions are one major source of concern in the paediatric population. Evidence suggests that use of an electronic or web-based calculator could minimise these errors. In our paediatric critical care unit (PCCU) we have created an electronic continuous infusion prescription chart to target errors in this area and conducted an audit to assess its effect on error reduction. To create an electronic continuous infusion prescription chart and audit its effect on prescription errors. Similar electronic continuous infusion prescription charts were evaluated. A Choice of electronic formats were considered and excel was chosen for its simplicity and flexibility. The choice of medications to be included, dilution method, and dosage range was agreed between PCCU consultant, pharmacy and nursing staff. Formulas for calculating each medication infusion was created and validated for different age and weight ranges by at least 2 PCCU trained pharmacists, accounting for capping at certain age and weight bands as appropriate for the medication. These were programmed into the spreadsheet for automatic calculation using inputted age and weight for the selected medications. Continuous infusion prescriptions were audited 6 months before and after implementation in April 2015 of this electronic chart. Parameters audited include medication dose, infusion rate, concentration, route, legibility, and missing or incorrect patient details. A trial period of 4 weeks preceded implementation. The electronic continuous infusion prescription form was created and used on PCCU. Hand written prescriptions had higher error rate (30.7%) as compared to electronic charts (0.7%) with a p-value <0.002. No errors were found in electronic prescriptions in regards to dose, volume and rate calculation. The use of an electronic continuous infusion prescription chart has been successfully set up and used on PCCU. Its use has significantly reduced continuous

  2. Systematic targeted integration to study Albumin gene control elements.

    Directory of Open Access Journals (Sweden)

    Sanchari Bhattacharyya

    Full Text Available To study transcriptional regulation by distant enhancers, we devised a system of easily modified reporter plasmids for integration into single-copy targeting cassettes in clones of HuH7, a human hepatocellular carcinoma. The plasmid constructs tested transcriptional function of a 35-kb region that contained the rat albumin gene and its upstream flanking region. Expression of integrants was analyzed in two orientations, and compared to transient expression of non-integrated plasmids. Enhancers were studied in their natural positions relative to the promoter and localized by deletion. All constructs were also analyzed by transient transfection assays. In addition to the known albumin gene enhancer (E1 at -10 kb, we demonstrated two new enhancers, E2 at -13, and E4 at +1.2 kb. All three enhancers functioned in both transient assays and integrated constructs. However, chromosomal integration demonstrated several differences from transient expression. For example, analysis of E2 showed that enhancer function within the chromosome required a larger gene region than in transient assays. Another conserved region, E3 at -0.7 kb, functioned as an enhancer in transient assays but inhibited the function of E1 and E2 when chromosomally integrated. The enhancers did not show additive or synergistic behavior,an effect consistent with competition for the promoter or inhibitory interactions among enhancers. Growth arrest by serum starvation strongly stimulated the function of some integrated enhancers, consistent with the expected disruption of enhancer-promoter looping during the cell cycle.

  3. An open-label randomized controlled clinical trial for comparison of continuous phenylephrine versus norepinephrine infusion in prevention of spinal hypotension during cesarean delivery.

    Science.gov (United States)

    Vallejo, M C; Attaallah, A F; Elzamzamy, O M; Cifarelli, D T; Phelps, A L; Hobbs, G R; Shapiro, R E; Ranganathan, P

    2017-02-01

    During spinal anesthesia for cesarean delivery phenylephrine is the vasopressor of choice but can cause bradycardia. Norepinephrine has both β- and α-adrenergic activity suitable for maintaining blood pressure with less bradycardia. We hypothesized that norepinephrine would be superior to phenylephrine, requiring fewer rescue bolus interventions to maintain blood pressure. Eighty-five parturients having spinal anesthesia for elective cesarean delivery were randomized to Group P (phenylephrine 0.1μg/kg/min) or Group N (norepinephrine 0.05μg/kg/min) fixed-rate infusions. Rescue bolus interventions of phenylephrine 100μg for hypotension, or ephedrine 5mg for bradycardia with hypotension, were given as required to maintain systolic blood pressure. Maternal hemodynamic variables were measured non-invasively. There was no difference between groups in the proportion of patients who required rescue vasopressor boluses (Group P: 65.8% [n=25] vs. Group N: 48.8% [n=21], P=0.12). The proportion of patients who received ⩾1 bolus of phenylephrine was similar between groups (Group P: 52.6% [n=20] vs. Group N: 46.5% [n=20], P=0.58). However, more patients received ⩾1 bolus of ephedrine in the phenylephrine group (Group P: 23.7% [n=9] vs. Group N: 2.3% [n=1], Phypotension and can be considered as an alternative to phenylephrine. Copyright © 2016 Elsevier Ltd. All rights reserved.

  4. Rationale and design of Apo-I Event Reduction in Ischemic Syndromes I (AEGIS-I): A phase 2b, randomized, placebo-controlled, dose-ranging trial to investigate the safety and tolerability of CSL112, a reconstituted, infusible, human apoA-I, after acute myocardial infarction.

    Science.gov (United States)

    Gibson, C Michael; Korjian, Serge; Tricoci, Pierluigi; Daaboul, Yazan; Alexander, John H; Steg, Philippe G; Lincoff, A Michael; Kastelein, John J P; Mehran, Roxana; D'Andrea, Denise; Merkely, Bela; Zarebinski, Maciej; Ophius, Ton Oude; Harrington, Robert A

    2016-10-01

    Despite aggressive pharmacotherapy and stenting, there is a residual risk of major adverse cardiovascular events among patients with acute coronary syndrome. High-density lipoprotein (HDL) has been a major target for secondary acute coronary syndrome prevention; however, a better understanding of the physiologic function of HDL has demonstrated that a high cholesterol efflux capacity, rather than high HDL concentrations alone, may be critical to improving outcomes. CSL112, a reconstituted, infusible human apolipoprotein A-I, has been demonstrated to increase cholesterol efflux capacity and to have a protective effect in experimental models of atherosclerotic cardiovascular disease. The AEGIS-I trial (ClinicalTrials.govNCT02108262) is a phase 2b, multicenter, randomized, placebo-controlled, dose-ranging clinical trial to evaluate the hepatic and renal safety of multiple administrations of 2 doses of CSL112 among subjects with acute myocardial infarction (AMI). Approximately 1,200 subjects (400 per treatment group) with either normal renal function or mild renal impairment will be enrolled up to 7 days after an AMI and will be stratified by renal function and randomized in a 1:1:1 ratio to either 1 of 2 doses of CSL112 (either 2 g or 6 g) or placebo as a weekly 2-hour infusion over the course of 4 consecutive weeks. The coprimary safety endpoints will be the incidence of hepatic and renal toxicity, defined as either confirmed ALT >3 × ULN, total bilirubin >2 × ULN, serum creatinine ≥1.5×baseline value, or a new requirement for renal replacement therapy through the end of the active treatment period. The AEGIS-I trial will characterize the safety profile of CSL112, a reconstituted formulation of apolipoprotein A-I, and will assess if administration to patients with a recent AMI is associated with a clinically significant alteration in either liver or kidney function when compared with placebo. Copyright © 2016 Elsevier Inc. All rights reserved.

  5. Melatonin controls seasonal breeding by a network of hypothalamic targets

    DEFF Research Database (Denmark)

    Revel, Florent G; Masson-Pévet, Mireille; Pévet, Paul

    2009-01-01

    In seasonal species, the photoperiod (i.e. day length) tightly regulates reproduction to ensure that birth occurs at the most favourable time of year. In mammals, a distinct photoneuroendocrine circuit controls this process via the pineal hormone melatonin. This hormone is responsible for the sea......In seasonal species, the photoperiod (i.e. day length) tightly regulates reproduction to ensure that birth occurs at the most favourable time of year. In mammals, a distinct photoneuroendocrine circuit controls this process via the pineal hormone melatonin. This hormone is responsible...... for the seasonal timing of reproduction, but the anatomical substrates and the cellular mechanisms through which melatonin modulates seasonal functions remain imprecise. Recently, several genes have been identified as being regulated by the photoperiod in the brain of seasonal mammals. These genes are thought....../GPR54 system and to the RFamide-related peptides.Interestingly, these systems involve different hypothalamic nuclei, suggesting that several brain loci may be crucial for melatonin to regulate reproduction, and thus represent key starting points to identify the long-sought-after mode and site...

  6. [Adjustment of unstable diabetics with a simple insulin infusion program].

    Science.gov (United States)

    Morell, B; Blatter, G; Froesch, E R

    1978-11-18

    In view of the importance of knowing exactly how much insulin is required by diabetics who are difficult to control with subcutaneous insulin, an insulin infusion program has been tried in such patients. The apparatus, which was produced by Siemens as a prototype, works according to the following simple and flexible principle: During the day a basal rate of insulin is continuously infused. During the three main meals an additional rectangular insulin infusion is initiated by turning a knob. After an hour the apparatus switches automatically back to the basal ratio. We have used this machine in 13 patients who are fully mobile. 11 of them showed an almost ideal blood sugar profile after 4 days. After switching back to subcutaneous insulin 8 of these 11 patients did better than before but not as well as on the insulin infusion program.

  7. Research on regional intrusion prevention and control system based on target tracking

    Science.gov (United States)

    Liu, Yanfei; Wang, Jieling; Jiang, Ke; He, Yanhui; Wu, Zhilin

    2017-08-01

    In view of the fact that China’s border is very long and the border prevention and control measures are single, we designed a regional intrusion prevention and control system which based on target-tracking. The system consists of four parts: solar panel, radar, electro-optical equipment, unmanned aerial vehicle and intelligent tracking platform. The solar panel provides independent power for the entire system. The radar detects the target in real time and realizes the high precision positioning of suspicious targets, then through the linkage of electro-optical equipment, it can achieve full-time automatic precise tracking of targets. When the target appears within the range of detection, the drone will be launched to continue the tracking. The system is mainly to realize the full time, full coverage, whole process integration and active realtime control of the border area.

  8. Analysing the Integration of Engineering in Science Lessons with the Engineering-Infused Lesson Rubric

    Science.gov (United States)

    Peterman, Karen; Daugherty, Jenny L.; Custer, Rodney L.; Ross, Julia M.

    2017-01-01

    Science teachers are being called on to incorporate engineering practices into their classrooms. This study explores whether the Engineering-Infused Lesson Rubric, a new rubric designed to target best practices in engineering education, could be used to evaluate the extent to which engineering is infused into online science lessons. Eighty lessons…

  9. A comparison of two nuclear-medical techniques for effective renal plasma flow determination in rabbits: Radiation controlled infusion-pump and whole-body measurement according to Oberhausen

    International Nuclear Information System (INIS)

    Mayer-Wehrstein, R.

    1981-01-01

    Two nuclear techniques were investigated for determination of the effective renal plasma flow with J-131-Hippuran in rabbits: whole-body measurement according to Oberhausen and clearance determination with a radiation controlled feed back infusion pump. In the first method the clearance determination follows after a single injection of the testing substance in the decreasing phase of the blood level, in the second method a constant blood level of the testing substance is maintained. A technique was developed for the determination of the blood-tissue ratio by considering the values determined by the constant blood level. This way the exact clearance values were computet for the decreasing plasma level. Nineteen clearance determinations were performed in rabbits altogether. (orig.) [de

  10. Superselective arterial infusion and concomitant radiotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Homma, Akihiro; Suzuki, Fumiyuki; Inuyama, Yukio; Fukuda, Satoshi [Hokkaido Univ., Sapporo (Japan). School of Medicine

    2003-05-01

    Superselective arterial infusion for patients with advanced head and neck cancer has been increasingly applied in Japan. We analyzed our experiences and evaluated the efficacy and safety of this treatment. Through October 1999 to March 2002, 29 patients, ranging in age between 33 and 71 years (median 52 years), received superselective intra-arterial infusion therapy of cisplatin (100-120 mg/m{sup 2}/week) with simultaneous intravenous infusion of thiosulfate for neutralizing cisplatin toxicity, and conventional concomitant extrabeam radiotherapy (65 Gy/26 f/6.5 weeks). Four patients were diagnosed with stage III and 25 with stage IV. Thirteen patients were considered contraindicated for surgery, and the other 16 patients rejected radical surgery. Primary tumor sites included paranasal sinus (11 patients), hypopharynx (7), oropharynx (6), oral cavity (4), and parotid gland (1). During the median follow-up period of 20 months, there was no apparent recurrence in 14 (48.3%) of 29 patients. Eleven (37.9%) patients died of disease, and three (10.3%) were alive with disease. In twenty-one patients (72.4%) the primary lesions were well-controlled. Acute toxic effects were moderate, and severe toxic events occurred in four cases, namely, methicillin-resistant staphylococcus aureus (MRSA) pneumonia, sepsis, tetraplasia, and osteoradionecrosis. We confirmed the effectiveness and safety of superselective arterial infusion and concomitant radiotherapy. Furthermore, we must establish the optimal procedures and schedule, as well as the indications for this treatment. This treatment protocol may improve the prognosis of patients with unresectable disease and patients rejecting surgical treatment. Further study in this particular area is needed. (author)

  11. Superselective arterial infusion and concomitant radiotherapy

    International Nuclear Information System (INIS)

    Homma, Akihiro; Suzuki, Fumiyuki; Inuyama, Yukio; Fukuda, Satoshi

    2003-01-01

    Superselective arterial infusion for patients with advanced head and neck cancer has been increasingly applied in Japan. We analyzed our experiences and evaluated the efficacy and safety of this treatment. Through October 1999 to March 2002, 29 patients, ranging in age between 33 and 71 years (median 52 years), received superselective intra-arterial infusion therapy of cisplatin (100-120 mg/m 2 /week) with simultaneous intravenous infusion of thiosulfate for neutralizing cisplatin toxicity, and conventional concomitant extrabeam radiotherapy (65 Gy/26 f/6.5 weeks). Four patients were diagnosed with stage III and 25 with stage IV. Thirteen patients were considered contraindicated for surgery, and the other 16 patients rejected radical surgery. Primary tumor sites included paranasal sinus (11 patients), hypopharynx (7), oropharynx (6), oral cavity (4), and parotid gland (1). During the median follow-up period of 20 months, there was no apparent recurrence in 14 (48.3%) of 29 patients. Eleven (37.9%) patients died of disease, and three (10.3%) were alive with disease. In twenty-one patients (72.4%) the primary lesions were well-controlled. Acute toxic effects were moderate, and severe toxic events occurred in four cases, namely, methicillin-resistant staphylococcus aureus (MRSA) pneumonia, sepsis, tetraplasia, and osteoradionecrosis. We confirmed the effectiveness and safety of superselective arterial infusion and concomitant radiotherapy. Furthermore, we must establish the optimal procedures and schedule, as well as the indications for this treatment. This treatment protocol may improve the prognosis of patients with unresectable disease and patients rejecting surgical treatment. Further study in this particular area is needed. (author)

  12. Metformin selectively targets redox control of complex I energy transduction

    Directory of Open Access Journals (Sweden)

    Amy R. Cameron

    2018-04-01

    Full Text Available Many guanide-containing drugs are antihyperglycaemic but most exhibit toxicity, to the extent that only the biguanide metformin has enjoyed sustained clinical use. Here, we have isolated unique mitochondrial redox control properties of metformin that are likely to account for this difference. In primary hepatocytes and H4IIE hepatoma cells we found that antihyperglycaemic diguanides DG5-DG10 and the biguanide phenformin were up to 1000-fold more potent than metformin on cell signalling responses, gluconeogenic promoter expression and hepatocyte glucose production. Each drug inhibited cellular oxygen consumption similarly but there were marked differences in other respects. All diguanides and phenformin but not metformin inhibited NADH oxidation in submitochondrial particles, indicative of complex I inhibition, which also corresponded closely with dehydrogenase activity in living cells measured by WST-1. Consistent with these findings, in isolated mitochondria, DG8 but not metformin caused the NADH/NAD+ couple to become more reduced over time and mitochondrial deterioration ensued, suggesting direct inhibition of complex I and mitochondrial toxicity of DG8. In contrast, metformin exerted a selective oxidation of the mitochondrial NADH/NAD+ couple, without triggering mitochondrial deterioration. Together, our results suggest that metformin suppresses energy transduction by selectively inducing a state in complex I where redox and proton transfer domains are no longer efficiently coupled. Keywords: Diabetes, Metformin, Mitochondria, NADH, NAD+

  13. TARGETED STELLATE DECENTRALIZATION: IMPLICATIONS FOR SYMPATHETIC CONTROL OF VENTRICULAR ELECTROPHYSIOLOGY

    Science.gov (United States)

    Buckley, Una; Yamakawa, Kentaro; Takamiya, Tatsuo; Armour, J. Andrew; Shivkumar, Kalyanam; Ardell, Jeffrey L.

    2015-01-01

    Background Selective, bilateral cervicothoracic sympathectomy has proven to be effective for managing ventricular arrhythmias in the setting of structural heart disease. The procedure currently employed removes the caudal portions of both stellate ganglia, along with thoracic chain ganglia down to T4 ganglia. Objective To define the relative contributions of T1-T2 and the T3-T4 paravertebral ganglia in modulating ventricular electrical function. Methods In anesthetized vagotomised porcine subjects (n=8), the heart was exposed via sternotomy along with right and left paravertebral sympathetic ganglia to the T4 level. A 56-electrode epicardial sock was placed over both ventricles to assess epicardial activation recovery intervals (ARI) in response to individually stimulating right and left stellate vs T3 paravertebral ganglia. Responses to T3 stimuli were repeated following surgical removal of the caudal portions of stellate ganglia and T2 bilaterally. Results In intact preparations, stellate ganglion vs T3 stimuli (4Hz, 4ms duration) were titrated to produce equivalent decreases in global ventricular ARIs (right-side 85±6 vs 55±10 ms; left-side 24±3 vs 17±7 ms). Threshold of stimulus intensity applied to T3 ganglia to achieve threshold was 3 times that of T1 threshold. ARIs in unstimulated states were unaffected by bilateral stellate-T2 ganglion removal. Following acute decentralization, T3 stimulation failed to change ARIs. Conclusion Preganglionic sympathetic efferents arising from the T1-T4 spinal cord that project to the heart transit through stellate ganglia via the paravertebral chain. T1-T2 surgical excision is thus sufficient to functionally interrupt central control of peripheral sympathetic efferent activity. PMID:26282244

  14. A Study of Control Laws for Microsatellite Rendezvous with a Noncooperative Target

    National Research Council Canada - National Science Library

    Tschirhart, Troy

    2003-01-01

    This study investigated the feasibility of using a microsatellite to accomplish an orbital rendezvous with a noncooperative target, with a focus on the control laws necessary for achieving such a rendezvous...

  15. Guidance Law and Neural Control for Hypersonic Missile to Track Targets

    Directory of Open Access Journals (Sweden)

    Wenxing Fu

    2016-01-01

    Full Text Available Hypersonic technology plays an important role in prompt global strike. Because the flight dynamics of a hypersonic vehicle is nonlinear, uncertain, and highly coupled, the controller design is challenging, especially to design its guidance and control law during the attack of a maneuvering target. In this paper, the sliding mode control (SMC method is used to develop the guidance law from which the desired flight path angle is derived. With the desired information as control command, the adaptive neural control in discrete time is investigated ingeniously for the longitudinal dynamics of the hypersonic missile. The proposed guidance and control laws are validated by simulation of a hypersonic missile against a maneuvering target. It is demonstrated that the scheme has good robustness and high accuracy to attack a maneuvering target in the presence of external disturbance and missile model uncertainty.

  16. Experimental study of liquid-metal target designs of accelerating-controlled systems

    International Nuclear Information System (INIS)

    Iarmonov, Mikhail; Makhov, Kirill; Novozhilova, Olga; Meluzov, A.G.; Beznosov, A.V.

    2011-01-01

    Models of a liquid-metal target of an accelerator-controlled system have been experimentally studied at the Nizhny Novgorod State Technical University to develop an optimal design of the flow part of the target. The main explored variants of liquid-metal targets are: Design with a diaphragm (firm-and-impervious plug) mounted on the pipe tap of particle transport from the accelerator cavity to the working cavity of the liquid-metal target. Design without a diaphragm on the pipe tab of particle transport from the accelerator. The study was carried out in a high-temperature liquid-metal test bench under the conditions close to full-scale ones: the temperature of the eutectic lead-bismuth alloy was 260degC - 400degC, the coolant mass flow was 5-80 t/h, and the rarefaction in the gas cavity was 10 5 Pa, the coefficient of geometric similarity equal to 1. The experimental studies of hydrodynamic characteristics of flow parts in the designs of targets under full-scale conditions indicated high efficiency of a target in triggering, operating, and deactivating modes. Research and technology instructions for designs of the flow part of the liquid-metal target, the target design as a whole, and the target circuit of accelerator-controlled systems were formulated as a result of the studies. (author)

  17. Temperature-controlled irrigated tip radiofrequency catheter ablation

    DEFF Research Database (Denmark)

    Petersen, H H; Chen, X; Pietersen, Adrian

    1998-01-01

    INTRODUCTION: In patients with ventricular tachycardias due to structural heart disease, catheter ablation cures radiofrequency ablation. Irrigated tip radiofrequency ablation using power control and high infusion rates enlarges lesion......: We conclude that temperature-controlled radiofrequency ablation with irrigated tip catheters using low target temperature and low infusion rate enlarges lesion size without increasing the incidence of cratering and reduces coagulum formation of the tip....

  18. Infusion of radionuclides throughout pregnancy

    International Nuclear Information System (INIS)

    Mountford-Lister, P.G.; Lambert, B.E.; Milner, A.C.; Kang, X.Z.

    1992-01-01

    This work is part of a long-term study to examine the cancer incidence in the offspring of mice exposed to 239 Pu or 147 Pm throughout pregnancy. The need to model the human intake scenario and the possibility of a critical period during uterine development necessitates constant availability of radionuclides throughout pregnancy. Various methods (multiple daily injections, infusion by external cannula and infusion by indwelling osmotic pump) have been examined and osmotic infusion pumps chosen. These pumps result in a near-constant blood concentration for up to 21 days. Part of the study is the estimation of dose to the critical haemopoietic tissues of the pup from a knowledge of the radionuclide distribution and kinetics. At present the distribution has been followed from birth to 180 days. Activity in the suckling pups at 7 days old is around 1 percent of the infused activity, though most of this is accounted for by the contents of the stomach and gastrointestinal tract. The liver and femur account for around 0.025 percent and 0.012 percent respectively per pup. Activity increases in both liver and femur during lactation after which both concentration and activity fall with time. Long-term studies with the pups of dams exposed to a range of 239 Pu concentrations between 0-70 kBq/kg are underway. Correlation of average organ dose with tumour incidence will be determined at completion of the life-span study. (Author) 39 refs., 5 tabs., 6 figs

  19. Distributed Cooperative Search Control Method of Multiple UAVs for Moving Target

    Directory of Open Access Journals (Sweden)

    Chang-jian Ru

    2015-01-01

    Full Text Available To reduce the impact of uncertainties caused by unknown motion parameters on searching plan of moving targets and improve the efficiency of UAV’s searching, a novel distributed Multi-UAVs cooperative search control method for moving target is proposed in this paper. Based on detection results of onboard sensors, target probability map is updated using Bayesian theory. A Gaussian distribution of target transition probability density function is introduced to calculate prediction probability of moving target existence, and then target probability map can be further updated in real-time. A performance index function combining with target cost, environment cost, and cooperative cost is constructed, and the cooperative searching problem can be transformed into a central optimization problem. To improve computational efficiency, the distributed model predictive control method is presented, and thus the control command of each UAV can be obtained. The simulation results have verified that the proposed method can avoid the blindness of UAV searching better and improve overall efficiency of the team effectively.

  20. Spallation Neutron Source Accelerator Facility Target Safety and Non-safety Control Systems

    International Nuclear Information System (INIS)

    Battle, Ronald E.; DeVan, B.; Munro, John K. Jr.

    2006-01-01

    The Spallation Neutron Source (SNS) is a proton accelerator facility that generates neutrons for scientific researchers by spallation of neutrons from a mercury target. The SNS became operational on April 28, 2006, with first beam on target at approximately 200 W. The SNS accelerator, target, and conventional facilities controls are integrated by standardized hardware and software throughout the facility and were designed and fabricated to SNS conventions to ensure compatibility of systems with Experimental Physics Integrated Control System (EPICS). ControlLogix Programmable Logic Controllers (PLCs) interface to instruments and actuators, and EPICS performs the high-level integration of the PLCs such that all operator control can be accomplished from the Central Control room using EPICS graphical screens that pass process variables to and from the PLCs. Three active safety systems were designed to industry standards ISA S84.01 and IEEE 603 to meet the desired reliability for these safety systems. The safety systems protect facility workers and the environment from mercury vapor, mercury radiation, and proton beam radiation. The facility operators operated many of the systems prior to beam on target and developed the operating procedures. The safety and non-safety control systems were tested extensively prior to beam on target. This testing was crucial to identify wiring and software errors and failed components, the result of which was few problems during operation with beam on target. The SNS has continued beam on target since April to increase beam power, check out the scientific instruments, and continue testing the operation of facility subsystems

  1. A sub-target approach to the kinodynamic motion control of a wheeled mobile robot

    Science.gov (United States)

    Motonaka, Kimiko; Watanabe, Keigo; Maeyama, Shoichi

    2018-02-01

    A mobile robot with two independently driven wheels is popular, but it is difficult to stabilize it by a continuous controller with a constant gain, due to its nonholonomic property. It is guaranteed that a nonholonomic controlled object can always be converged to an arbitrary point using a switching control method or a quasi-continuous control method based on an invariant manifold in a chained form. From this, the authors already proposed a kinodynamic controller to converge the states of such a two-wheeled mobile robot to the arbitrary target position while avoiding obstacles, by combining the control based on the invariant manifold and the harmonic potential field (HPF). On the other hand, it was confirmed in the previous research that there is a case that the robot cannot avoid the obstacle because there is no enough space to converge the current state to the target state. In this paper, we propose a method that divides the final target position into some sub-target positions and moves the robot step by step, and it is confirmed by the simulation that the robot can converge to the target position while avoiding obstacles using the proposed method.

  2. Crops with target-site herbicide resistance for Orobanche and Striga control.

    Science.gov (United States)

    Gressel, Jonathan

    2009-05-01

    It is necessary to control root parasitic weeds before or as they attach to the crop. This can only be easily achieved chemically with herbicides that are systemic, or with herbicides that are active in soil. Long-term control can only be attained if the crops do not metabolise the herbicide, i.e. have target-site resistance. Such target-site resistances have allowed foliar applications of herbicides inhibiting enol-pyruvylshikimate phosphate synthase (EPSPS) (glyphosate), acetolactate synthase (ALS) (e.g. chlorsulfuron, imazapyr) and dihydropteroate synthase (asulam) for Orobanche control in experimental conditions with various crops. Large-scale use of imazapyr as a seed dressing of imidazolinone-resistant maize has been commercialised for Striga control. Crops with two target-site resistances will be more resilient to the evolution of resistance in the parasite, if well managed.

  3. DMPD: Protein kinase C epsilon: a new target to control inflammation andimmune-mediated disorders. [Dynamic Macrophage Pathway CSML Database

    Lifescience Database Archive (English)

    Full Text Available 14643884 Protein kinase C epsilon: a new target to control inflammation andimmune-m...g) (.html) (.csml) Show Protein kinase C epsilon: a new target to control inflammation andimmune-mediated di...sorders. PubmedID 14643884 Title Protein kinase C epsilon: a new target to control inflammation

  4. Target Diagnostic Instrument-Based Controls Framework for the National Ignition Facility

    International Nuclear Information System (INIS)

    Shelton, R; O'Brien, D; Nelson, J; Kamperschroer, J

    2007-01-01

    NIF target diagnostics are being developed to observe and measure the extreme physics of targets irradiated by the 192-beam laser. The response time of target materials can be on the order of 100ps--the time it takes light to travel 3 cm--temperatures more than 100 times hotter than the surface of the sun, and pressures that exceed 109 atmospheres. Optical and x-ray diagnostics were developed and fielded to observe and record the results of the first 4-beam experiments at NIF. Hard and soft x-ray spectra were measured, and time-integrated and gated x-ray images of hydrodynamics experiments were recorded. Optical diagnostics recorded backscatter from the target, and VISAR laser velocimetry measurements were taken of laser-shocked target surfaces. Additional diagnostics are being developed and commissioned to observe and diagnose ignition implosions, including various neutron and activation diagnostics. NIF's diagnostics are being developed at LLNL and with collaborators at other sites. To accommodate the growing number of target diagnostics, an Instrument-Based Controls hardware-software framework has been developed to facilitate development and ease integration into the NIF Integrated Computer Control System (ICCS). Individual WindowsXP PC controllers for each digitizer, power supply and camera (i.e., instruments) execute controls software unique to each instrument model. Each hardware-software controller manages a single instrument, in contrast to the complexity of combining all the controls software needed for a diagnostic into a single controller. Because of this simplification, controllers can be more easily tested on the actual hardware, evaluating all normal and off-normal conditions. Each target diagnostic is then supported by a number of instruments, each with its own hardware-software instrument-based controller. Advantages of the instrument-based control architecture and framework include reusability, testability, and improved reliability of the deployed

  5. Target Diagnostic Instrument-Based Controls Framework for the National Ignition Facility

    Energy Technology Data Exchange (ETDEWEB)

    Shelton, R; O' Brien, D; Nelson, J; Kamperschroer, J

    2007-05-07

    NIF target diagnostics are being developed to observe and measure the extreme physics of targets irradiated by the 192-beam laser. The response time of target materials can be on the order of 100ps--the time it takes light to travel 3 cm--temperatures more than 100 times hotter than the surface of the sun, and pressures that exceed 109 atmospheres. Optical and x-ray diagnostics were developed and fielded to observe and record the results of the first 4-beam experiments at NIF. Hard and soft x-ray spectra were measured, and time-integrated and gated x-ray images of hydrodynamics experiments were recorded. Optical diagnostics recorded backscatter from the target, and VISAR laser velocimetry measurements were taken of laser-shocked target surfaces. Additional diagnostics are being developed and commissioned to observe and diagnose ignition implosions, including various neutron and activation diagnostics. NIF's diagnostics are being developed at LLNL and with collaborators at other sites. To accommodate the growing number of target diagnostics, an Instrument-Based Controls hardware-software framework has been developed to facilitate development and ease integration into the NIF Integrated Computer Control System (ICCS). Individual WindowsXP PC controllers for each digitizer, power supply and camera (i.e., instruments) execute controls software unique to each instrument model. Each hardware-software controller manages a single instrument, in contrast to the complexity of combining all the controls software needed for a diagnostic into a single controller. Because of this simplification, controllers can be more easily tested on the actual hardware, evaluating all normal and off-normal conditions. Each target diagnostic is then supported by a number of instruments, each with its own hardware-software instrument-based controller. Advantages of the instrument-based control architecture and framework include reusability, testability, and improved reliability of the

  6. Continuous intraperitoneal insulin infusion in patients with 'brittle' diabetes

    DEFF Research Database (Denmark)

    DeVries, J H; Eskes, S A; Snoek, Frank J

    2002-01-01

    AIMS: To evaluate the effects of continuous intraperitoneal insulin infusion (CIPII) using implantable pumps on glycaemic control and duration of hospital stay in poorly controlled 'brittle' Dutch diabetes patients, and to assess their current quality of life. METHODS: Thirty-three patients were...

  7. [Controlling arachidonic acid metabolic network: from single- to multi-target inhibitors of key enzymes].

    Science.gov (United States)

    Liu, Ying; Chen, Zheng; Shang, Er-chang; Yang, Kun; Wei, Deng-guo; Zhou, Lu; Jiang, Xiao-lu; He, Chong; Lai, Lu-hua

    2009-03-01

    Inflammatory diseases are common medical conditions seen in disorders of human immune system. There is a great demand for anti-inflammatory drugs. There are major inflammatory mediators in arachidonic acid metabolic network. Several enzymes in this network have been used as key targets for the development of anti-inflammatory drugs. However, specific single-target inhibitors can not sufficiently control the network balance and may cause side effects at the same time. Most inflammation induced diseases come from the complicated coupling of inflammatory cascades involving multiple targets. In order to treat these complicated diseases, drugs that can intervene multi-targets at the same time attracted much attention. The goal of this review is mainly focused on the key enzymes in arachidonic acid metabolic network, such as phospholipase A2, cyclooxygenase, 5-lipoxygenase and eukotriene A4 hydrolase. Advance in single target and multi-targe inhibitors is summarized.

  8. Control of target-normal-sheath-accelerated protons from a guiding cone

    International Nuclear Information System (INIS)

    Zou, D. B.; Zhuo, H. B.; Yang, X. H.; Yu, T. P.; Shao, F. Q.; Pukhov, A.

    2015-01-01

    It is demonstrated through particle-in-cell simulations that target-normal-sheath-accelerated protons can be well controlled by using a guiding cone. Compared to a conventional planar target, both the collimation and number density of proton beams are substantially improved, giving a high-quality proton beam which maintained for a longer distance without degradation. The effect is attributed to the radial electric field resulting from the charge due to the hot target electrons propagating along the cone surface. This electric field can effectively suppress the spatial spread of the protons after the expansion of the hot electrons

  9. Role of limb and target vision in the online control of memory-guided reaches.

    Science.gov (United States)

    Heath, Matthew

    2005-07-01

    This investigation tested the proposal that a "highly accurate" and temporally unstable stored target representation is available to the motor system for the online control of memory-guided reaches. Participants reached to a target that was: (a) visible during the response, (b) extinguished at movement onset, and (c) occluded for 0, 500, 1,500 and 2,500 ms in advance of response cueing. Additionally, trials were performed with (i.e., limb visible) and without (i.e., limb occluded) vision of the reaching limb. Results showed that limb occluded trials undershot the target location in each target condition, and were characterized by a primarily offline mode of control. In contrast, limb visible trials showed a consistent level of endpoint accuracy for each target condition and elicited more online reaching corrections than limb occluded trials. It is therefore proposed that a reasonably accurate and temporally stable stored target representation can be combined with vision of the moving limb for the online control of memory-guided reaches.

  10. Analog experiment of transarterial catheter hyperthermic infusion in vitro

    International Nuclear Information System (INIS)

    Fan Shufeng Li Zheng; Gu Weizhong; Ru Fuming

    2006-01-01

    Objective: To investigate the factors related to the heating effect by transarterial catheter hyperthermic infusion with the evaluation of the feasibility in controlling the tumor temperature. Methods: Infusing 55-68 degree C liquid at the speed of 10-40 ml/min through 6F, 5F or 3F catheter with different length respectively under the similar clinical condition. The liquid temperature at the terminal exit of the catheter was measured with a digital thermometer. The factors related to the liquid temperature at the exit of the catheter were analyzed by multiple regression analysis. Results: The infusion temperature , rate and the catheter length were the main related factors to the liquid temperature at the exit of the catheter as the condition similar in clinical use. When 60-65 degree C liquid was infused at the rate of 20-40 ml/min through 5F catheter with length of 80 cm, the mean and 95% confident interval of the liquid temperature at the catheter exit were (47.55±0.44) degree C and 44.61-48.49 degree C respectively. Conclusions: The liquid temperature at the exit of infusion catheter can be regulated and controlled through adjusting the liquid perfusion temperature and speed. (authors)

  11. Decision factors for cooperative multiple warhead UAV target classification and attack with control applications

    Science.gov (United States)

    Decker, Douglas Dwayne

    Autonomous wide area search, classification and attack using Unmanned Combat Air Vehicles (UCAVs) is considered. The wide area search and attack scenario is modelled, capturing the important problem parameters of target density in the battle space, the density of false targets, the seeker and Autonomous Target Recognition (ATR) modules' performance parameters, as well as munition parameters such as search rate, time, and warhead lethality. The analysis in this research is an important stepping stone towards establishing benefits of cooperative search and engagement in a multi-vehicle scenario. This research uses probabilistic analysis to formulate and analytically solve for the probability of success in search and engagement as well as probabilities of other events of interest. Two methods are used to compute these probabilities. The first method utilizes a detailed examination of the sub-events required for the event of interest to occur. The second method utilizes a Markov chain approach. In each method, general expressions are first obtained that are applicable to any assumed a priori distributions of targets and false targets. These expressions are subsequently applied to a multiple warhead munition/UCAV operating in a single target/multiple false target scenario and then several multiple target/multiple false target scenarios. This research shows how the analytically derived results can be applied to all facets of the balanced system design and operation of Wide Area Search Munitions (WASM) including the evaluation of cooperation schemes and rules of engagement. This dissertation also formulates the problem as a control problem and examines the possibility of utilizing this formulation in the real-time estimation of the target and false target distribution parameters.

  12. Design of a control system for HIRFL-CSRe internal target facility in Lanzhou

    International Nuclear Information System (INIS)

    Wang Yanyu; Liu Wufeng; Shao Caojie; Lin Feiyu; Zhang Jianchuan; Xiao Wenjun

    2010-01-01

    It is described in this paper the design of the control system for HIRFL-CSRe internal target facility, in which there are many different kinds of units need to be monitored and controlled. The control system is composed of several subsystems which are designed to control the gas-jet temperature, chamber vacuum, valves and molecular pumps. A human-computer interaction interface is also realized to do the data acquisition, data processing and display. The whole system has been working stably and safely, it fully meets the requirements of physical experiments in the internal target facility. In January of 2010, the first physics experiment of the radioactive electron capture was finished successfully with the aids of this control system. (authors)

  13. Vacuum infusion manufacturing and experimental characterization of Kevlar/epoxy composites

    Science.gov (United States)

    Ricciardi, M. R.; Giordano, M.; Langella, A.; Nele, L.; Antonucci, V.

    2014-05-01

    Epoxy/Kevlar composites have been manufactured by conventional Vacuum Infusion process and the Pulse Infusion technique. Pulse Infusion allows to control the pressure of the vacuum bag on the dry fiber reinforcement by using a proper designed pressure distributor that induces a pulsed transverse action and promotes the through thickness resin flow. The realized composite panel have been mechanically characterized by performing tensile and short beam shear tests according with the ASTM D3039 and ASTM D2344/D 2344M standard respectively in order to investigate the effect of Pulse Infusion on the tensile strength and ILSS.

  14. Duration and distribution of experimental muscular hyperalgesia in humans following combined infusions of serotonin and bradykinin

    DEFF Research Database (Denmark)

    Babenko, Victor; Svensson, Peter; Graven-Nielsen, Thomas

    2000-01-01

    -infusions interval of 3 min. Infusions of isotonic saline (NaCl, 0.9%) were given as control. Pain intensity was continuously scored on a visual analogue scale (VAS), and subjects drew the distribution of the pain areas on an anatomical map. Pressure pain thresholds (PPTs) were assessed with an electronic algometer...... min after infusions. The VAS-peak after BKN was significantly higher (Ppain area after infusion of BKN....... In addition, PPTs were significantly decreased (Ppain and muscle hyperalgesia to mechanical stimuli. The combination of serotonin and bradykinin can produce muscle...

  15. Postoperative analgesia in TKA: ropivacaine continuous intraarticular infusion.

    Science.gov (United States)

    Gómez-Cardero, Primitivo; Rodríguez-Merchán, E Carlos

    2010-05-01

    Postoperative pain control is a challenge in patients undergoing TKA due to side effects and technical limitations of current analgesic approaches. Local anesthetic infiltration through continuous infusion pumps has been shown to reduce postoperative pain in previous studies. We assessed the effectiveness of intraarticular ropivacaine infusions in reducing pain and postoperative opioid use after TKA and determined whether such infusions accelerate functional recovery of the patient and reduce length of hospital stay. In a randomized, prospective, double-blind study, two groups were assigned: Group A (n = 25) underwent continuous intraarticular infusion with 300 mL ropivacaine 0.2% at a speed of 5 mL/hour through an elastomeric infusion pump and Group B (n = 25) had an elastomeric pump insertion with 300 mL saline solution at an infusion speed of 5 mL/hour. All patients had the same prosthesis model implanted. Parameters analyzed over the first 3 days, at discharge, and 1 month later included postoperative pain, joint function, opioid use, and length of hospital stay. All patients in Group A showed a decrease in pain intensity measured by a visual analog scale and opioid use in the first 3 days. Mean length of hospital stay was also reduced in Group A (5.72 days) compared to Group B (7.32 days). There were no device-related complications. Use of an infusion pump is effective in treating pain after TKA, reducing postoperative pain and opioid use. It also improves immediate functionality and patient comfort, reducing the mean length of hospital stay, without increasing the risk of complications. Level I, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.

  16. Agent-based multi-platform control, collaboration, and target hand-off

    Science.gov (United States)

    Coleman, Norm; Tirabassi, Ben; MacKenzie, Doug

    2007-04-01

    Deploying a world wide force that is strategically responsive and dominant at every point on the spectrum of conflict involves the cooperative system development and use of advanced technologies that yield revolutionary capabilities to support the war-fighters needs. This presentation describes an agent based control architecture and prototype implementation developed by ARDEC that enables command and control of multiple unmanned platforms and associated mission packages for collaborative target hand-off/engagement. Current prototypes provide the ability to remotely locate, track and predict the movement of enemy targets on the battlefield using a variety of sensor systems hosted on multiple, non-homogeneous SUAVs and UGVs.

  17. Advances in research of targeting delivery and controlled release of drug-loaded nanoparticles

    International Nuclear Information System (INIS)

    Tan Zhonghua

    2003-01-01

    Biochemistry drug, at present, is still the main tool that human struggle to defeat the diseases. So, developing safe and efficacious technique of drug targeting delivery and controlled release is key to enhance curative effect, decrease drug dosage, and lessen its side effect. Drug-loaded nanoparticles, which is formed by conjugate between nanotechnology and modern pharmaceutics, is a new fashioned pharmic delivery carrier. Because of advantages in pharmic targeting transport and controlled or slow release and improving bioavailability, it has been one of developing trend of modern pharmaceutical dosage forms

  18. Natural material-decorated mesoporous silica nanoparticle container for multifunctional membrane-controlled targeted drug delivery

    Directory of Open Access Journals (Sweden)

    Hu Y

    2017-11-01

    Full Text Available Yan Hu,1 Lei Ke,2 Hao Chen,1 Ma Zhuo,1 Xinzhou Yang,1 Dan Zhao,1 Suying Zeng,1 Xincai Xiao1 1Department of Pharmaceutics, School of Pharmaceutical Science, South-Central University for Nationalities, 2Department of Medicinal Chemistry, School of Pharmacy, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People’s Republic of China Abstract: To avoid the side effects caused by nonspecific targeting, premature release, weak selectivity, and poor therapeutic efficacy of current nanoparticle-based systems used for drug delivery, we fabricated natural material-decorated nanoparticles as a multifunctional, membrane-controlled targeted drug delivery system. The nanocomposite material coated with a membrane was biocompatible and integrated both specific tumor targeting and responsiveness to stimulation, which improved transmission efficacy and controlled drug release. Mesoporous silica nanoparticles (MSNs, which are known for their biocompatibility and high drug-loading capacity, were selected as a model drug container and carrier. The membrane was established by the polyelectrolyte composite method from chitosan (CS which was sensitive to the acidic tumor microenvironment, folic acid-modified CS which recognizes the folate receptor expressed on the tumor cell surface, and a CD44 receptor-targeted polysaccharide hyaluronic acid. We characterized the structure of the nanocomposite as well as the drug release behavior under the control of the pH-sensitive membrane switch and evaluated the antitumor efficacy of the system in vitro. Our results provide a basis for the design and fabrication of novel membrane-controlled nanoparticles with improved tumor-targeting therapy. Keywords: multifunctional, membrane-controlled, natural materials, mesoporous silica nanoparticles, targeted drug delivery

  19. Control of a six degree of freedom prosthetic arm after targeted muscle reinnervation surgery.

    Science.gov (United States)

    Miller, Laura A; Lipschutz, Robert D; Stubblefield, Kathy A; Lock, Blair A; Huang, He; Williams, T Walley; Weir, Richard F; Kuiken, Todd A

    2008-11-01

    To fit and evaluate the control of a complex prosthesis for a shoulder disarticulation-level amputee with targeted muscle reinnervation. One participant who had targeted muscle reinnervation surgery was fitted with an advanced prosthesis and his use of this device was compared with the device that he used in the home setting. The experiments were completed within a laboratory setting. The first recipient of targeted muscle reinnervation: a bilateral shoulder disarticulation-level amputee. Two years after surgery, the subject was fitted with a 6 degree of freedom (DOF) prosthesis (shoulder flexion, humeral rotation, elbow flexion, wrist rotation, wrist flexion, and hand control). Control of this device was compared with that of his commercially available 3-DOF system (elbow, wrist rotation, and powered hook terminal device). In order to assess performance, movement analysis and timed movement tasks were executed. The subject was able to independently operate all 6 arm functions with good control. He could simultaneously operate 2 DOF of several different joint combinations with relative ease. He operated up to 4 DOF simultaneously, but with poor control. Work space was markedly increased and some timed tasks were faster with the 6-DOF system. This proof-of-concept study shows that advances in control of shoulder disarticulation-level prostheses can improve the quality of movement. Additional control sources may spur the development of more advanced and complex componentry for these amputees.

  20. Controllability in cancer metabolic networks according to drug targets as driver nodes.

    Science.gov (United States)

    Asgari, Yazdan; Salehzadeh-Yazdi, Ali; Schreiber, Falk; Masoudi-Nejad, Ali

    2013-01-01

    Networks are employed to represent many nonlinear complex systems in the real world. The topological aspects and relationships between the structure and function of biological networks have been widely studied in the past few decades. However dynamic and control features of complex networks have not been widely researched, in comparison to topological network features. In this study, we explore the relationship between network controllability, topological parameters, and network medicine (metabolic drug targets). Considering the assumption that targets of approved anticancer metabolic drugs are driver nodes (which control cancer metabolic networks), we have applied topological analysis to genome-scale metabolic models of 15 normal and corresponding cancer cell types. The results show that besides primary network parameters, more complex network metrics such as motifs and clusters may also be appropriate for controlling the systems providing the controllability relationship between topological parameters and drug targets. Consequently, this study reveals the possibilities of following a set of driver nodes in network clusters instead of considering them individually according to their centralities. This outcome suggests considering distributed control systems instead of nodal control for cancer metabolic networks, leading to a new strategy in the field of network medicine.

  1. Cooperative control of UAVs for localization of intermittently emitting mobile targets.

    Science.gov (United States)

    Pack, Daniel J; Delima, Pedro; Toussaint, Gregory J; York, George

    2009-08-01

    Compared with a single platform, cooperative autonomous unmanned aerial vehicles (UAVs) offer efficiency and robustness in performing complex tasks. Focusing on ground mobile targets that intermittently emit radio frequency signals, this paper presents a decentralized control architecture for multiple UAVs, equipped only with rudimentary sensors, to search, detect, and locate targets over large areas. The proposed architecture has in its core a decision logic which governs the state of operation for each UAV based on sensor readings and communicated data. To support the findings, extensive simulation results are presented, focusing primarily on two success measures that the UAVs seek to minimize: overall time to search for a group of targets and the final target localization error achieved. The results of the simulations have provided support for hardware flight tests.

  2. Control of laser-accelerated proton beams by modifying the target density with ASE

    Energy Technology Data Exchange (ETDEWEB)

    Yogo, A.; Kiriyama, H.; Mori, M.; Esirkepov, T.Zh.; Ogura, K.; Sagisaka, A.; Orimo, S.; Nishiuchi, M.; Pirozhkov, A.S.; Nakai, Y.; Shimomura, T.; Tanoue, M.; Akutsu, A.; Okada, H.; Motomura, T.; Kondo, S.; Kanazawa, S.; Bulanov, S.V.; Bolton, P.R.; Daido, H. [Photo-Medical Research Center and Advanced Photon Research Center, JAEA, Kyoto (Japan); Nagatomo, H. [Osaka Univ., Institute of Laser Engineering (Japan)

    2009-11-15

    We demonstrate laser-ion acceleration from a near-critical density plasma, using amplified spontaneous emission (ASE) to convert a solid foil target into a lower-density target. In order to investigate the target density dependence of the laser-ion acceleration, two cases were investigated for which the ASE intensity differed by three orders of magnitude. In the low contrast case the beam centre for higher energy protons is shifted closer to the laser-propagation direction of 45 degrees, while the centre of lower-energy beam remains near the target normal direction. We show that a near-critical density plasma can be used to control proton beam direction based on its energy. (authors)

  3. Two phosphAte taRGets in End-stage renal disease Trial (TARGET): A Randomized Controlled Trial.

    Science.gov (United States)

    Wald, Ron; Rabbat, Christian G; Girard, Louis; Garg, Amit X; Tennankore, Karthik; Tyrwhitt, Jessica; Smyth, Andrew; Rathe-Skafel, Andrea; Gao, Peggy; Mazzetti, Andrea; Bosch, Jackie; Yan, Andrew T; Parfrey, Patrick; Manns, Braden J; Walsh, Michael

    2017-06-07

    Hyperphosphatemia is common among recipients of maintenance dialysis and is associated with a higher risk of mortality and cardiovascular events. A large randomized trial is needed to determine whether lowering phosphate concentrations with binders improves patient-important outcomes. To inform such an effort we conducted a pilot randomized controlled trial. We conducted a randomized controlled trial of prevalent hemodialysis recipients already receiving calcium carbonate as a phosphate binder at five Canadian centers between March 31, 2014 and October 2, 2014. Participants were randomly allocated to 26 weeks of an intensive phosphate goal of 2.33-4.66 mg/dl (0.75-1.50 mmol/L) or a liberalized target of 6.20-7.75 mg/dl (2.00-2.50 mmol/L) by titrating calcium carbonate using a dosing nomogram. The primary outcome was the difference in the change in serum phosphate from randomization to 26 weeks. Fifty-three participants were randomized to the intensive group and 51 to the liberalized group. The median (interquartile range) daily dose of elemental calcium at 26 weeks was 1800 (1275-3000) mg in the intensive group, and 0 (0-500) mg in the liberalized group. The mean (SD) serum phosphate at 26 weeks was 4.53 (1.12) mg/dl (1.46 [0.36] mmol/L) in the intensive group and 6.05 (1.40) mg/dl (1.95 [0.45] mmol/L) in the liberalized group. Phosphate concentration in the intensive group declined by 1.24 (95% confidence interval, 0.75 to 1.74) mg/dl (0.40 [95% confidence interval, 0.24 to 0.56] mmol/L) compared with the liberalized group. There were no statistically significant differences between the two groups in the risk of hypercalcemia, hypocalcemia, parathyroidectomy, or major vascular events. It is feasible to achieve and maintain a difference in serum phosphate concentrations in hemodialysis recipients by titrating calcium carbonate. A large trial is needed to determine if targeting a lower serum phosphate concentration improves patient-important outcomes. Copyright

  4. Optimal strategies for controlling riverine tsetse flies using targets: a modelling study.

    Directory of Open Access Journals (Sweden)

    Glyn A Vale

    2015-03-01

    Full Text Available Tsetse flies occur in much of sub-Saharan Africa where they transmit the trypanosomes that cause the diseases of sleeping sickness in humans and nagana in livestock. One of the most economical and effective methods of tsetse control is the use of insecticide-treated screens, called targets, that simulate hosts. Targets have been ~1 m2, but recently it was shown that those tsetse that occupy riverine situations, and which are the main vectors of sleeping sickness, respond well to targets only ~0.06 m2. The cheapness of these tiny targets suggests the need to reconsider what intensity and duration of target deployments comprise the most cost-effective strategy in various riverine habitats.A deterministic model, written in Excel spreadsheets and managed by Visual Basic for Applications, simulated the births, deaths and movement of tsetse confined to a strip of riverine vegetation composed of segments of habitat in which the tsetse population was either self-sustaining, or not sustainable unless supplemented by immigrants. Results suggested that in many situations the use of tiny targets at high density for just a few months per year would be the most cost-effective strategy for rapidly reducing tsetse densities by the ~90% expected to have a great impact on the incidence of sleeping sickness. Local elimination of tsetse becomes feasible when targets are deployed in isolated situations, or where the only invasion occurs from populations that are not self-sustaining.Seasonal use of tiny targets deserves field trials. The ability to recognise habitat that contains tsetse populations which are not self-sustaining could improve the planning of all methods of tsetse control, against any species, in riverine, savannah or forest situations. Criteria to assist such recognition are suggested.

  5. Targeting intensive versus conventional glycaemic control for type 1 diabetes mellitus

    DEFF Research Database (Denmark)

    Kähler, Pernille; Grevstad, Berit; Almdal, Thomas

    2014-01-01

    , EMBASE, Science Citation Index Expanded and LILACS to January 2013. STUDY SELECTION: Randomised clinical trials that prespecified different targets of glycaemic control in participants at any age with type 1 diabetes mellitus were included. DATA EXTRACTION: Two authors independently assessed studies...... macrovascular outcome and on nephropathy, and detrimental effects on severe hypoglycaemia. Notably, the data for retinopathy and ketoacidosis were inconsistent. There was a severe lack of reporting on patient relevant outcomes, and all trials had poor bias control....

  6. [Effect of ear point embedding on plasma and effect site concentrations of propofol-remifentanil in elderly patients after target-controlled induction].

    Science.gov (United States)

    Zheng, Xiaochun; Wan, Liling; Gao, Fei; Chen, Jianghu; Tu, Wenshao

    2017-08-12

    To observe the clinical effect of ear point embedding on plasma and effect site concentrations of propofol-remifentanil in elderly patients who underwent abdominal external hernia surgery at the time of consciousness and pain disappearing by target-controlled infusion (TCI) and bispectral index (BIS). Fifty patients who underwent elective abdominal hernia surgery were randomly assigned into an observation group and a control group, 25 cases in each one. In the observation group, 30 minutes before anesthesia induction, Fugugou (Extra), Gan (CO 12 ), Pizhixia (AT 4 ), and Shenmen (TF 4 ) were embedded by auricular needles until the end of surgery, 10 times of counter press each point. In the control group, the same amount of auricular tape was applied until the end of surgery at the same points without stimulation 30 minutes before anesthesia induction. Patients in the two groups were given total intravenous anesthesia, and BIS was monitored by BIS anesthesia depth monitor. Propofol was infused by TCI at a beginning concentration of 1.5μg/L and increased by 0.3μg/L every 30s until the patients lost their consciousness. After that, remifentanil was infused by TCI at a beginning concentration of 2.0μg/L and increased by 0.3μg/L every 30s until the patients had no body reaction to pain stimulation (orbital reflex). Indices were recorded, including mean arterial pressure (MAP), heart rate (HR) and the BIS values, at the time of T 0 (entering into the operation room), T 1 (losing consciousness) and T 2 (pain relief), the plasma and effect site concentrations of propofol at T 1 , the plasma and effect site concentrations of remifentanil at T 2 . After surgery we recorded the total amounts of propofol and remifentanil, surgery time and anesthesia time. At T 1 and T 2 , MAP and HR of the observation group were higher than those of the control group ( P effect site concentrations of propofol in the observation group were significantly lower than those in the control group

  7. Studies of irradiation sterilization for single infusion device

    International Nuclear Information System (INIS)

    Chen Ruyan; Wang Keqin; Lu Zongmeng; Xiao Fenyuan; Xie Meizhi

    1988-05-01

    In practice of irradiation sterilization for single infusion device, object bacteria were selected and then their radiosensitivity were tested on the basis of practical production and irradiation environment. In view of the cylinder source and the static irradiation form, the dose rate of irradiation field and the dose distribution and uniformity in product box were measured in order to control sterilization quality. Through the measurements of material properties for irradiated infusion device and the test of causing rabbit fever as well as the survey of clinical practice, it was verified that the irradiation apparatus, the irradiation process and the product material etc. can satisfy the demands of sterilixzation and praction

  8. Progress towards malaria control targets in relation to national malaria programme funding

    NARCIS (Netherlands)

    E.L. Korenromp (Eline); M. Hosseini (Mehran); R.D. Newman (Robert D); R.E. Cibulskis (Richard E)

    2013-01-01

    textabstractBackground: Malaria control has been dramatically scaled up the past decade, mainly thanks to increasing international donor financing since 2003. This study assessed progress up to 2010 towards global malaria impact targets, in relation to Global Fund, other donor and domestic malaria

  9. Aiming at a far target under different viewing conditions: Visual control in basketball jump shooting

    NARCIS (Netherlands)

    Oudejans, R.R.D.; van de Langenberg, R.W.; Hutter, R.I.

    2002-01-01

    Most research on visual search in aiming at far targets assumes preprogrammed motor control implying that relevant visual information is detected prior to the final shooting or throwing movements. Eye movement data indirectly support this claim for stationary tasks. Using the basketball jump shot as

  10. Targeting Fear of Spiders with Control-, Acceptance-, and Information-Based Approaches

    Science.gov (United States)

    Wagener, Alexandra L.; Zettle, Robert D.

    2011-01-01

    The relative impact of control-, acceptance-, and information-based approaches in targeting a midlevel fear of spiders among college students was evaluated. Participants listened to a brief protocol presenting one of the three approaches before completing the Perceived-Threat Behavioral Approach Test (PT-BAT; Cochrane, Barnes-Holmes, &…

  11. Frizzled3 controls axonal polarity and intermediate target entry during striatal pathway development

    NARCIS (Netherlands)

    Morello, Francesca; Prasad, Asheeta A.; Rehberg, Kati; Baptista Vieira de Sá, Renata; Antón-Bolaños, Noelia; Leyva-Diaz, Eduardo; Adolfs, Youri; Tissir, Fadel; López-Bendito, Guillermina; Pasterkamp, R. Jeroen

    2015-01-01

    The striatum is a large brain nucleus with an important role in the control of movement and emotions.Mediumspiny neurons (MSNs) are striatal output neurons forming prominent descending axon tracts that target different brain nuclei. However, how MSN axon tracts in the forebrain develop remains

  12. Control of the beam-internal target interaction at the nuclotron by means of light radiation

    Energy Technology Data Exchange (ETDEWEB)

    Artiomov, A.S. [Laboratory of High Energies, Joint Institute for Nuclear Research, Dubna 141980 (Russian Federation)]. E-mail: artiomov@moonhe.jinr.ru; Anisimov, Yu.S. [Laboratory of High Energies, Joint Institute for Nuclear Research, Dubna 141980 (Russian Federation); Afanasiev, S.V. [Laboratory of High Energies, Joint Institute for Nuclear Research, Dubna 141980 (Russian Federation); Bazilev, S.N. [Laboratory of High Energies, Joint Institute for Nuclear Research, Dubna 141980 (Russian Federation); Zolin, L.S. [Laboratory of High Energies, Joint Institute for Nuclear Research, Dubna 141980 (Russian Federation); Issinsky, I.B. [Laboratory of High Energies, Joint Institute for Nuclear Research, Dubna 141980 (Russian Federation); Kliman, J. [Laboratory of High Energies, Joint Institute for Nuclear Research, Dubna 141980 (Russian Federation); Institute of Physics, Slovak Academy of Sciences, Bratislava (Slovakia); Malakhov, A.I. [Laboratory of High Energies, Joint Institute for Nuclear Research, Dubna 141980 (Russian Federation); Matousek, V. [Institute of Physics, Slovak Academy of Sciences, Bratislava (Slovakia); Morhac, M. [Laboratory of High Energies, Joint Institute for Nuclear Research, Dubna 141980 (Russian Federation); Institute of Physics, Slovak Academy of Sciences, Bratislava (Slovakia); Nikitin, V.A. [Laboratory of High Energies, Joint Institute for Nuclear Research, Dubna 141980 (Russian Federation); Nikiforov, A.S. [Laboratory of High Energies, Joint Institute for Nuclear Research, Dubna 141980 (Russian Federation); Nomokonov, P.V. [Laboratory of High Energies, Joint Institute for Nuclear Research, Dubna 141980 (Russian Federation); Pilyar, A.V. [Laboratory of High Energies, Joint Institute for Nuclear Research, Dubna 141980 (Russian Federation); Turzo, I. [Institute of Physics, Slovak Academy of Sciences, Bratislava (Slovakia)

    2005-02-11

    The light radiation from various internal targets at the nuclotron can be utilized for the operative control and time optimization of the interaction intensity of the beam. The examples presented in the paper illustrate information about the space characteristics of the circulating beam during one cycle of the accelerator run at the stages of injection, acceleration and during the physical experiments, respectively.

  13. Preventing mussel adhesion using lubricant-infused materials

    Science.gov (United States)

    Amini, Shahrouz; Kolle, Stefan; Petrone, Luigi; Ahanotu, Onyemaechi; Sunny, Steffi; Sutanto, Clarinda N.; Hoon, Shawn; Cohen, Lucas; Weaver, James C.; Aizenberg, Joanna; Vogel, Nicolas; Miserez, Ali

    2017-08-01

    Mussels are opportunistic macrofouling organisms that can attach to most immersed solid surfaces, leading to serious economic and ecological consequences for the maritime and aquaculture industries. We demonstrate that lubricant-infused coatings exhibit very low preferential mussel attachment and ultralow adhesive strengths under both controlled laboratory conditions and in marine field studies. Detailed investigations across multiple length scales—from the molecular-scale characterization of deposited adhesive proteins to nanoscale contact mechanics to macroscale live observations—suggest that lubricant infusion considerably reduces fouling by deceiving the mechanosensing ability of mussels, deterring secretion of adhesive threads, and decreasing the molecular work of adhesion. Our study demonstrates that lubricant infusion represents an effective strategy to mitigate marine biofouling and provides insights into the physical mechanisms underlying adhesion prevention.

  14. Radioprotection of the digestive tract by intravenous infusion of vasopressin

    Energy Technology Data Exchange (ETDEWEB)

    Juillard, G.J.F.; Peter, H.H.; Weisenburger, T.H.; Tesler, A.S.; Langdon, E.A.; Barenfus, M.; Lagasse, L.D.; Watring, W.E.; Smith, M.L.

    1975-09-01

    The effect of venous infusions of vasopressin during fractionated abdominal radiation exposures was evaluated in four pairs of dogs. In each pair, the control dog was given venous infusion of saline during irradiation. The results were analyzed from clinical observation, autopsy findings, and pathological examination. It appears that venous infusion of vasopressin has a definite and reproducible effect of radioprotection on the gastrointestinal tract, the dose modifying factor (DMF) being 1.5. Radiation therapy of the gynecologic malignancies would be one major application since the radiosensitivity of the intestinal tract is often a limiting factor in delivering high doses to the tumor, and further investigations are being done to study the effects of vasopressin on the radiosensitivity of malignant tumors.

  15. Target of physiological gait: Realization of speed adaptive control for a prosthetic knee during swing flexion.

    Science.gov (United States)

    Cao, Wujing; Yu, Hongliu; Zhao, Weiliang; Li, Jin; Wei, Xiaodong

    2017-10-13

    Prosthetic knee is the most important component of lower limb prosthesis. Speed adaptive for prosthetic knee during swing flexion is the key method to realize physiological gait. This study aims to discuss the target of physiological gait, propose a speed adaptive control method during swing flexion and research the damping adjustment law of intelligent hydraulic prosthetic knee. According to the physiological gait trials of healthy people, the control target during swing flexion is defined. A new prosthetic knee with fuzzy logical control during swing flexion is designed to realize the damping adjustment automatically. The function simulation and evaluation system of intelligent knee prosthesis is provided. Speed adaptive control test of the intelligent prosthetic knee in different velocities are researched. The maximum swing flexion of the knee angle is set between sixty degree and seventy degree as the target of physiological gait. Preliminary experimental results demonstrate that the prosthetic knee with fuzzy logical control is able to realize physiological gait under different speeds. The faster the walking, the bigger the valve closure percentage of the hydraulic prosthetic knee. The proposed fuzzy logical control strategy and intelligent hydraulic prosthetic knee are effective for the amputee to achieve physiological gait.

  16. Development and Implementation of New Control Law for Vision Based Target Tracking System Onboard Small Unmanned Aerial Vehicles

    National Research Council Canada - National Science Library

    Chong, Tay B

    2006-01-01

    ...) system onboard a small unmanned aerial vehicle (SUAV). The new control law allows for coordinated SUAV guidance and vision-based target tracking of stationary and moving targets in the presence of atmospheric disturbances and measurements noise...

  17. The effects of incisional bupivacaine infusions on postoperative ...

    African Journals Online (AJOL)

    Background: The aim of this study was to determine opioid requirements and pain intensity scores in patients after a total abdominal hysterectomy (TAH) administered with a bupivacaine infusion for a 30-hour period, and then to compare the data with that of a control group. Method: This was a prospective, parallel, ...

  18. The effects of lactose infusion on the pathological manifestations of ...

    African Journals Online (AJOL)

    Except for 4 control calves, 8 calves were experimentally infected using 11 x 106 T. vivax Trypanosomes, intravenously, as a source of neuraminidase. At the peak of parasitaemia, lactose was intravenously infused at the rate of 0.5g kg-1 body weight into 4 of the infected calves, to inhibit the binding of desialylated ...

  19. The satiety effects of intragastric macronutrient infusions in fatty and lean Zucker rats.

    Science.gov (United States)

    Maggio, C A; Greenwood, M R; Vasselli, J R

    1983-09-01

    To evaluate satiety in the hyperphagic, genetically obese Zucker "fatty" (fafa) rat, food-deprived fatty and lean (FaFa) control rats were given equicaloric intragastric infusions consisting largely of fat, carbohydrate, or protein. Relative to distilled water infusion, these infusions resulted in immediate reductions of food intake in both fatty and lean rats allowed to feed 20 min post-infusion. Cumulative food intakes remained reduced throughout the 2 hr period of observation. Thus, despite its hyperphagia, the fatty rat is responsive to the satiating effect of infused nutrients. However, the relative satiating effectiveness of the macronutrient infusions differed for the two genotypes. In lean rats, the different macronutrient infusions resulted in equivalent reductions of feeding. In contrast, in fatty rats, fat was the least satiating and protein was the most satiating macronutrient. Moreover, compared to lean rats, fatty rats displayed less initial suppression of feeding after fat infusion and greater overall suppression after protein infusion. These effects are consistent with the long-term feeding behavior of the fatty rat for the different macronutrients and may be related to pre- and postabsorptive metabolic alterations that have been documented in this animal.

  20. Clinical evaluation of preoperative arterial infusion chemotherapy and surgical operation for colorectal carcinoma

    International Nuclear Information System (INIS)

    Yuan Jianhua; Zhao Zhongsheng; Deng Gaoli; Hu Tingyang; Yu Wenqiang; Chen Fanghong; Luo Zuyan; Ru Guoqing; Dong Quanjin; Tu Shiliang

    2003-01-01

    Objective: To investigate the clinical values of preoperative arterial infusion chemotherapy and surgical operation for colorectal carcinoma. Methods: 66 patients with colorectal carcinoma were subjected to percutaneous femoral artery catheterization by Seldinger's technique with infusion of anti-cancer drugs. The resection was performed 5-30 days after the arterial infusion (mean 12 days). In 50 surgical specimens of the 66 cases, histological findings were evaluated including the density and distribution of the apoptosis cells under the observation by DNA nick end labelling technique. Of which 22 specimens before arterial infusion chemotherapy (got from biopsy of preoperation) and 25 normal mucosa (got from normal surgical specimens) were used as controls. Results: The total histological response rate was 100% with grade I in 20 cases, grade II in 21 cases, grade III in 9 cases. The densities of the apoptosis cells were 31.47 ± 5.58 before arterial infusion chemotherapy, 76.69 ± 17.12 after arterial infusion chemotherapy and 8.01 ± 3.39 in normal mucosa. The density of the apoptosis cells after arterial infusion chemotherapy was significantly higher than that before arterial infusion chemotherapy (P 2 =4.696, P>0.30). There were no significant differences in the apoptosis of adenocarcinoma during different pathological stages (F=0.001376, P>0.05). Conclusions: Peroperative transcatheter arterial infusion chemotherapy resulting in apoptosis of adenocarcinoma, can raise the radical operation rate, and prolong survival rate for colorectal carcinoma patients

  1. Nutritional education and carbohydrate counting in children with type 1 diabetes treated with continuous subcutaneous insulin infusion: the effects on dietary habits, body composition and glycometabolic control.

    Science.gov (United States)

    Marigliano, Marco; Morandi, Anita; Maschio, Maddalena; Sabbion, Alberto; Contreas, Giovanna; Tomasselli, Francesca; Tommasi, Mara; Maffeis, Claudio

    2013-12-01

    Carbohydrate counting (CHC) in combination with nutritional education has been used to optimize the insulin dose in patients with type 1 diabetes (T1D). The aim of this study was to test the impact of CHC and nutritional education on changes in dietary habits, body composition and body fat distribution in children with T1D treated with insulin pumps (CSII). Twenty-five children with T1D and CSII were recruited and valuated at baseline and after 18 months of follow-up. They were trained in CHC and following standard nutrition education program (based on American Diabetes Association and International Society of Pediatric and Adolescent Diabetes guidelines); clinical, biochemical and nutritional variables were measured. In the total population, body composition, body fat distribution and biochemical variables did not change, at follow-up; HbA1c was significantly reduced (8.50 ± 0.77 vs 7.92 ± 0.74 %; p education, does not affect dietary habits, body composition and body fat distribution in children with T1D treated with CSII. Moreover, the sub-group of subjects showing a significant improvement in glycometabolic control reported an increase in CHO intake and a reduction in fat and protein intake.

  2. A two isocenter IMRT technique with a controlled junction dose for long volume targets

    International Nuclear Information System (INIS)

    Zeng, G G; Heaton, R K; Catton, C N; Chung, P W; O'Sullivan, B; Lau, M; Parent, A; Jaffray, D A

    2007-01-01

    Most IMRT techniques have been designed to treat targets smaller than the field size of conventional linac accelerators. In order to overcome the field size restrictions in applying IMRT, we developed a two isocenter IMRT technique to treat long volume targets. The technique exploits an extended dose gradient throughout a junction region of 4-6 cm to minimize the impact of field match errors on a junction dose and manipulates the inverse planning and IMRT segments to fill in the dose gradient and achieve dose uniformity. Techniques for abutting both conventional fields with IMRT ('Static + IMRT') and IMRT fields ('IMRT + IMRT') using two separate isocenters have been developed. Five long volume sarcoma cases have been planned in Pinnacle (Philips, Madison, USA) using Elekta Synergy and Varian 2100EX linacs; two of the cases were clinically treated with this technique. Advantages were demonstrated with well-controlled junction target uniformity and tolerance to setup uncertainties. The junction target dose heterogeneity was controlled at a level of ±5%; for 3 mm setup errors at the field edges, the junction target dose changed less than 5% and the dose sparing to organs at risk (OARs) was maintained. Film measurements confirmed the treatment planning results

  3. Multitype Network-Guided Target Controllability in Phenotypically Characterized Osteosarcoma: Role of Tumor Microenvironment

    Directory of Open Access Journals (Sweden)

    Ankush Sharma

    2017-07-01

    Full Text Available This study highlights the relevance of network-guided controllability analysis as a precision oncology tool. Target controllability through networks is potentially relevant to cancer research for the identification of therapeutic targets. With reference to a recent study on multiple phenotypes from 22 osteosarcoma (OS cell lines characterized both in vitro and in vivo, we found that a variety of critical proteins in OS regulation circuits were in part phenotype specific and in part shared. To generalize our inference approach and match cancer phenotypic heterogeneity, we employed multitype networks and identified targets in correspondence with protein sub-complexes. Therefore, we established the relevance for diagnostic and therapeutic purposes of inspecting interactive targets, namely those enriched by significant connectivity patterns in protein sub-complexes. Emerging targets appeared with reference to the OS microenvironment, and relatively to small leucine-rich proteoglycan members and D-type cyclins, among other collagen, laminin, and keratin proteins. These described were evidences shared across all phenotypes; instead, specific evidences were provided by critical proteins including IGFBP7 and PDGFRA in the invasive phenotype, and FGFR3 and THBS1 in the colony forming phenotype.

  4. Advances in Targeted Pesticides with Environmentally Responsive Controlled Release by Nanotechnology.

    Science.gov (United States)

    Huang, Bingna; Chen, Feifei; Shen, Yue; Qian, Kun; Wang, Yan; Sun, Changjiao; Zhao, Xiang; Cui, Bo; Gao, Fei; Zeng, Zhanghua; Cui, Haixin

    2018-02-11

    Pesticides are the basis for defending against major biological disasters and important for ensuring national food security. Biocompatible, biodegradable, intelligent, and responsive materials are currently an emerging area of interest in the field of efficient, safe, and green pesticide formulation. Using nanotechnology to design and prepare targeted pesticides with environmentally responsive controlled release via compound and chemical modifications has also shown great potential in creating novel formulations. In this review, special attention has been paid to intelligent pesticides with precise controlled release modes that can respond to micro-ecological environment changes such as light-sensitivity, thermo-sensitivity, humidity sensitivity, soil pH, and enzyme activity. Moreover, establishing intelligent and controlled pesticide release technologies using nanomaterials are reported. These technologies could increase pesticide-loading, improve the dispersibility and stability of active ingredients, and promote target ability.

  5. Advances in Targeted Pesticides with Environmentally Responsive Controlled Release by Nanotechnology

    Directory of Open Access Journals (Sweden)

    Bingna Huang

    2018-02-01

    Full Text Available Pesticides are the basis for defending against major biological disasters and important for ensuring national food security. Biocompatible, biodegradable, intelligent, and responsive materials are currently an emerging area of interest in the field of efficient, safe, and green pesticide formulation. Using nanotechnology to design and prepare targeted pesticides with environmentally responsive controlled release via compound and chemical modifications has also shown great potential in creating novel formulations. In this review, special attention has been paid to intelligent pesticides with precise controlled release modes that can respond to micro-ecological environment changes such as light-sensitivity, thermo-sensitivity, humidity sensitivity, soil pH, and enzyme activity. Moreover, establishing intelligent and controlled pesticide release technologies using nanomaterials are reported. These technologies could increase pesticide-loading, improve the dispersibility and stability of active ingredients, and promote target ability.

  6. Residues and contaminants in tea and tea infusions: a review.

    Science.gov (United States)

    Abd El-Aty, A M; Choi, Jeong-Heui; Rahman, Md Musfiqur; Kim, Sung-Woo; Tosun, Alev; Shim, Jae-Han

    2014-01-01

    Consumers are very aware of contaminants that could pose potential health hazards. Most people drink tea as an infusion (adding hot water); however, in some countries, including India, China and Egypt, tea is drunk as a decoction (tea and water are boiled together). An infusion usually brings the soluble ingredients into solution, whereas a decoction brings all soluble and non-soluble constituents together. Therefore, a cup of tea may contain various kinds of contaminants. This review focuses on green and black tea because they are most commonly consumed. The target was to examine the transfer rate of contaminants - pesticides, environmental pollutants, mycotoxins, microorganisms, toxic heavy metals, radioactive isotopes (radionuclides) and plant growth regulators - from tea to infusion/brewing, factors contributing to the transfer potential and contaminants degradation, and residues in or on the spent leaves. It is concluded that most contaminants leaching into tea infusion are not detected or are detected at a level lower than the regulatory limits. However, the traditional practice of over-boiling tea leaves should be discouraged as there may be a chance for more transfer of contaminants from the tea to the brew.

  7. Safety and Efficacy of the Intravenous Infusion of Umbilical Cord Mesenchymal Stem Cells in Patients With Heart Failure: A Phase 1/2 Randomized Controlled Trial (RIMECARD Trial [Randomized Clinical Trial of Intravenous Infusion Umbilical Cord Mesenchymal Stem Cells on Cardiopathy]).

    Science.gov (United States)

    Bartolucci, Jorge; Verdugo, Fernando J; González, Paz L; Larrea, Ricardo E; Abarzua, Ema; Goset, Carlos; Rojo, Pamela; Palma, Ivan; Lamich, Ruben; Pedreros, Pablo A; Valdivia, Gloria; Lopez, Valentina M; Nazzal, Carolina; Alcayaga-Miranda, Francisca; Cuenca, Jimena; Brobeck, Matthew J; Patel, Amit N; Figueroa, Fernando E; Khoury, Maroun

    2017-10-27

    Umbilical cord-derived mesenchymal stem cells (UC-MSC) are easily accessible and expanded in vitro, possess distinct properties, and improve myocardial remodeling and function in experimental models of cardiovascular disease. Although bone marrow-derived mesenchymal stem cells have been previously assessed for their therapeutic potential in individuals with heart failure and reduced ejection fraction, no clinical trial has evaluated intravenous infusion of UC-MSCs in these patients. Evaluate the safety and efficacy of the intravenous infusion of UC-MSC in patients with chronic stable heart failure and reduced ejection fraction. Patients with heart failure and reduced ejection fraction under optimal medical treatment were randomized to intravenous infusion of allogenic UC-MSCs (Cellistem, Cells for Cells S.A., Santiago, Chile; 1×10 6 cells/kg) or placebo (n=15 per group). UC-MSCs in vitro, compared with bone marrow-derived mesenchymal stem cells, displayed a 55-fold increase in the expression of hepatocyte growth factor, known to be involved in myogenesis, cell migration, and immunoregulation. UC-MSC-treated patients presented no adverse events related to the cell infusion, and none of the patients tested at 0, 15, and 90 days presented alloantibodies to the UC-MSCs (n=7). Only the UC-MSC-treated group exhibited significant improvements in left ventricular ejection fraction at 3, 6, and 12 months of follow-up assessed both through transthoracic echocardiography ( P =0.0167 versus baseline) and cardiac MRI ( P =0.025 versus baseline). Echocardiographic left ventricular ejection fraction change from baseline to month 12 differed significantly between groups (+7.07±6.22% versus +1.85±5.60%; P =0.028). In addition, at all follow-up time points, UC-MSC-treated patients displayed improvements of New York Heart Association functional class ( P =0.0167 versus baseline) and Minnesota Living with Heart Failure Questionnaire ( P <0.05 versus baseline). At study completion

  8. Natriuretic peptide infusion reduces myocardial injury during acute ischemia/reperfusion

    DEFF Research Database (Denmark)

    Kousholt, Birgitte S.; Larsen, Jens Kjærgaard Rolighed; Bisgaard, Line Stattau

    2012-01-01

    Aim: The aim of this study was to determine whether a natriuretic peptide infusion during reperfusion can reduce cardiomyocyte ischemia–reperfusion damage. Materials and methods: The effect of B-type natriuretic peptide (BNP) activity was assessed in vitro and in vivo: the cellular effect...... in apoptotic changes in the BNP-stimulated cells. Pigs tolerated the BNP and CD-NP (a CNP analogue) infusion well, with a decrease in systemic blood pressure (~15 mmHg) and increased diuresis compared with the controls. Left ventricular pressure decreased in the pigs that received BNP infusion compared...... with controls (P=0.02). A similar trend was observed in the pigs that received CD-NP infusion, although this was not significant (P=0.3). BNP and CD-NP infusion in pigs reduced total cardiac troponin T release by 46 and 40%, respectively (P=0.0015 and 0.0019), and were associated with improved RNA integrity...

  9. Natriuretic peptide infusion reduces myocardial injury during acute ischemia/reperfusion

    DEFF Research Database (Denmark)

    Kousholt, Birgitte S.; Larsen, Jens Kjærgaard Rolighed; Bisgaard, Line Stattau

    2012-01-01

    Aim: The aim of this study was to determine whether a natriuretic peptide infusion during reperfusion can reduce cardiomyocyte ischemia–reperfusion damage. Materials and methods: The effect of B-type natriuretic peptide (BNP) activity was assessed in vitro and in vivo: the cellular effect...... in apoptotic changes in the BNP-stimulated cells. Pigs tolerated the BNP and CD-NP (a CNP analogue) infusion well, with a decrease in systemic blood pressure (∼15 mmHg) and increased diuresis compared with the controls. Left ventricular pressure decreased in the pigs that received BNP infusion compared...... with controls (P=0.02). A similar trend was observed in the pigs that received CD-NP infusion, although this was not significant (P=0.3). BNP and CD-NP infusion in pigs reduced total cardiac troponin T release by 46 and 40%, respectively (P=0.0015 and 0.0019), and were associated with improved RNA integrity...

  10. Dynamic target high pressure control of a VRF system for heating energy savings

    International Nuclear Information System (INIS)

    Yun, Geun Young; Lee, Je Hyeon; Kim, Inhan

    2017-01-01

    Highlights: • We developed the dynamic target high pressure control of a VRF system. • We created the VRF control model using the EnergyPlus runtime language. • Multicalorimeter experimental results indicate that the energy efficiency improved by 21%. • EnergyPlus simulations demonstrate that the annual heating energy consumption was lowered by 22%. - Abstract: Variable refrigerant flow (VRF) systems are widely used because of their ability to provide individualized comfort control with energy-saving potential. This study develops load responsive high pressure control of a VRF system with the aim of reducing the heating energy consumption of a VRF system under part load conditions. The developed control consists of two parts: one part that determines the level of heating load, and the other that assigns a target high pressure based on the level of heating load. In this way, the compressor speed can be accurately matched to heating load, which improves the energy performance of the VRF system. A series of multicalorimeter experiments revealed that the heating capacity of the VRF system varied by 45% by modulating the target high pressure and that its efficiency was enhanced by 21% by changing the high pressure from 30 kgf/cm 2 to 25 kgf/cm 2 . To evaluate the annual heating energy performance of the VRF system with the developed control, a custom computer code was developed to implement the developed control using a programming language called EnergyPlus Runtime Language. Simulation outcomes showed that the annual heating energy consumption of a medium-size office building was reduced by 22% when the developed control was applied.

  11. Impact of syringe size on the performance of infusion pumps at low flow rates.

    Science.gov (United States)

    Schmidt, Nadia; Saez, Claudia; Seri, Istvan; Maturana, Andrés

    2010-03-01

    To evaluate the impact of syringe size on start-up delay and the time to reach 50% and 90% of target flow rates, using two commercially available syringe infusion pumps at infusion rates of < or =1 mL/hr. Two syringes (Terumo) of different size (10-mL and 50-mL), using two syringe infusion pumps (Pump A, Terumo Terufusion Infusion Pump TE-331; and Pump B, Braun Perfusor Compact S) were studied. Effective fluid delivery was measured at 0.4 mL/hr, 0.8 mL/hr, and 1.0 mL/hr for the initial 60 mins, using the gravimetric method. Instant flow was calculated as volume difference for every 1-min interval per minute. Start-up delay was defined as time in minutes of 0 flow from the start of infusion. Syringe placement, bubble removal, infusion line priming, and positioning were standardized for all measurements, using new syringes and infusion lines. Each experiment was repeated six times. Statistical analysis was performed, using a nonparametric test (Mann-Whitney U test). None. None. None. Using the 50-mL syringe, the start-up delay was consistently higher and the time to reach 50% and 90% of target flow were significantly longer, independent of which syringe infusion pump was used. At every flow rate studied, the pumps did not reach the target flow rate before 60 mins with the 50-mL syringe. With the 10-mL syringe, target flow rate was achieved before 20 mins for both pumps. Our findings demonstrate a clinically relevant impact of syringe size on syringe infusion pump performance at low flow rates. The time to reach 50% and 90% of target flow are significantly longer, using the 50-mL syringe compared with the 10-mL syringe, and the time to reach 50% of target flow is independent of the longer start-up delay. Based on our findings, we speculate that smaller syringe sizes and higher infusion rates are preferable for continuous drug infusions, particularly when prompt establishment of the drug effect is critical.

  12. Fundamental movement skills in preschoolers: a randomized controlled trial targeting object control proficiency.

    Science.gov (United States)

    Donath, L; Faude, O; Hagmann, S; Roth, R; Zahner, L

    2015-11-01

    Adequately developed fundamental movement skills, particularly object control dimensions, are considered essential to learn more complex movement patterns and to increase the likelihood to successfully participate in organized and non-organized sports during later years. Thus, the present randomized controlled trial aimed at improving object control dimensions at an early state in a kindergarten setting. Catching, throwing, kicking, rolling and stationary dribbling were assessed via gross motor development 2 (TGMD-2) testing in 41 normally developed preschoolers. On a cluster-randomized basis [strata: age, sex and body mass index (BMI)], three kindergartens were randomly assigned to an intervention group (n = 22, INT, age: 4.6 ± 1.0 years; BMI: 16.2 ± 1.1 kg/m(2) ) and three to a control group (n = 19, CON: age: 4.5 ± 1.2 years; BMI: 16.8 ± 1.2 kg/m(2) ). Twelve structured training sessions were given within 6 weeks (12 sessions). The total training volume was 330 min. Moderate time × group interaction were observed for the total sum score (Δ+22%, P = 0.05) and dribbling (Δ+41%, P = 0.002). Adjusting for baseline differences analyses of covariance did not affect these results. Interestingly, likely to most likely practically worthwhile effects were detected for the total sum score, catching and dribbling. Object control dimensions such as dribbling and catching that apparently rely on rhythmical movement patterns and anticipatory eye-hand coordination seem to benefit from short-term object control training. These skills are considered important for successful team-sport participation and appropriate sportive motor development. © 2015 John Wiley & Sons Ltd.

  13. Ion Channel Trafficking: Control of Ion Channel Density as a Target for Arrhythmias?

    Directory of Open Access Journals (Sweden)

    Elise Balse

    2017-10-01

    Full Text Available The shape of the cardiac action potential (AP is determined by the contributions of numerous ion channels. Any dysfunction in the proper function or expression of these ion channels can result in a change in effective refractory period (ERP and lead to arrhythmia. The processes underlying the correct targeting of ion channels to the plasma membrane are complex, and have not been fully characterized in cardiac myocytes. Emerging evidence highlights ion channel trafficking as a potential causative factor in certain acquired and inherited arrhythmias, and therapies which target trafficking as opposed to pore block are starting to receive attention. In this review we present the current evidence for the mechanisms which underlie precise control of cardiac ion channel trafficking and targeting.

  14. Engineering tolerance using biomaterials to target and control antigen presenting cells.

    Science.gov (United States)

    Tostanoski, Lisa H; Gosselin, Emily A; Jewell, Christopher M

    2016-05-01

    Autoimmune diseases occur when cells of the adaptive immune system incorrectly recognize and attack "self" tissues. Importantly, the proliferation and differentiation of these cells is triggered and controlled by interactions with antigen presenting cells (APCs), such as dendritic cells. Thus, modulating the signals transduced by APCs (e.g., cytokines, costimulatory surface proteins) has emerged as a promising strategy to promote tolerance for diseases such as multiple sclerosis, type 1 diabetes, and lupus. However, many approaches have been hindered by non-specific activity of immunosuppressive or immunoregulatory cues, following systemic administration of soluble factors via traditional injections routes (e.g., subcutaneous, intravenous). Biomaterials offer a unique opportunity to control the delivery of tolerogenic signals in vivo via properties such as controlled particle size, tunable release kinetics, and co-delivery of multiple classes of cargo. In this review, we highlight recent reports that exploit these properties of biomaterials to target APCs and promote tolerance via three strategies, i) passive or active targeting of particulate carriers to APCs, ii) biomaterial-mediated control over antigen localization and processing, and iii) targeted delivery of encapsulated or adsorbed immunomodulatory signals. These reports represent exciting advances toward the goal of more effective therapies for autoimmune diseases, without the broad suppressive effects associated with current clinically-approved therapies.

  15. Regional cerebral effects of ketone body infusion with 3-hydroxybutyrate in humans: Reduced glucose uptake, unchanged oxygen consumption and increased blood flow by positron emission tomography. A randomized, controlled trial.

    Science.gov (United States)

    Svart, Mads; Gormsen, Lars C; Hansen, Jakob; Zeidler, Dora; Gejl, Michael; Vang, Kim; Aanerud, Joel; Moeller, Niels

    2018-01-01

    Ketone bodies are neuroprotective in neurological disorders such as epilepsy. We randomly studied nine healthy human subjects twice-with and without continuous infusion of 3-hydroxybutyrate-to define potential underlying mechanisms, assessed regionally (parietal, occipital, temporal, cortical grey, and frontal) by PET scan. During 3-hydroxybutyrate infusions concentrations increased to 5.5±0.4 mmol/l and cerebral glucose utilisation decreased 14%, oxygen consumption remained unchanged, and cerebral blood flow increased 30%. We conclude that acute 3-hydroxybutyrate infusion reduces cerebral glucose uptake and increases cerebral blood flow in all measured brain regions, without detectable effects on cerebral oxygen uptake though oxygen extraction decreased. Increased oxygen supply concomitant with unchanged oxygen utilisation may contribute to the neuroprotective effects of ketone bodies.

  16. Targeting Erosion Control: Adoption of Erosion Control Practices. A Report from a National Research Project.

    Science.gov (United States)

    West, Peter; And Others

    Research analyzed adoption of erosion control practices by farm operators in two counties in each of four states: Alabama, Missouri, Tennessee, and Washington. Analysis was based on farm survey data and technical and financial assistance information from county Soil Conservation Service (SCS) and Agricultural Stabilization and Conservation Service…

  17. The insect ecdysone receptor is a good potential target for RNAi-based pest control.

    Science.gov (United States)

    Yu, Rong; Xu, Xinping; Liang, Yongkang; Tian, Honggang; Pan, Zhanqing; Jin, Shouheng; Wang, Na; Zhang, Wenqing

    2014-01-01

    RNA interference (RNAi) has great potential for use in insect pest control. However, some significant challenges must be overcome before RNAi-based pest control can become a reality. One challenge is the proper selection of a good target gene for RNAi. Here, we report that the insect ecdysone receptor (EcR) is a good potential target for RNAi-based pest control in the brown planthopper Nilaparvata lugens, a serious insect pest of rice plants. We demonstrated that the use of a 360 bp fragment (NlEcR-c) that is common between NlEcR-A and NlEcR-B for feeding RNAi experiments significantly decreased the relative mRNA expression levels of NlEcR compared with those in the dsGFP control. Feeding RNAi also resulted in a significant reduction in the number of offspring per pair of N. lugens. Consequently, a transgenic rice line expressing NlEcR dsRNA was constructed by Agrobacterium- mediated transformation. The results of qRT-PCR showed that the total copy number of the target gene in all transgenic rice lines was 2. Northern blot analysis showed that the small RNA of the hairpin dsNlEcR-c was successfully expressed in the transgenic rice lines. After newly hatched nymphs of N. lugens fed on the transgenic rice lines, effective RNAi was observed. The NlEcR expression levels in all lines examined were decreased significantly compared with the control. In all lines, the survival rate of the nymphs was nearly 90%, and the average number of offspring per pair in the treated groups was significantly less than that observed in the control, with a decrease of 44.18-66.27%. These findings support an RNAi-based pest control strategy and are also important for the management of rice insect pests.

  18. Ketamine Infusions for Treatment Refractory Headache.

    Science.gov (United States)

    Pomeroy, Jared L; Marmura, Michael J; Nahas, Stephanie J; Viscusi, Eugene R

    2017-02-01

    Management of chronic migraine (CM) or new daily persistent headache (NDPH) in those who require aggressive outpatient and inpatient treatment is challenging. Ketamine has been suggested as a new treatment for this intractable population. This is a retrospective review of 77 patients who underwent administration of intravenous, subanesthetic ketamine for CM or NDPH. All patients had previously failed aggressive outpatient and inpatient treatments. Records were reviewed for patients treated between January 2006 and December 2014. The mean headache pain rating using a 0-10 pain scale was an average of 7.1 at admission and 3.8 on discharge (P ketamine well. A number of adverse events were observed, but very few were serious. Subanesthetic ketamine infusions may be beneficial in individuals with CM or NDPH who have failed other aggressive treatments. Controlled trials may confirm this, and further studies may be useful in elucidating more robust benefit in a less refractory patient population. © 2016 American Headache Society.

  19. The effect of targeting scheme on tidal volume delivery during volume control mechanical ventilation.

    Science.gov (United States)

    Volsko, Teresa A; Hoffman, Justin; Conger, Alecia; Chatburn, Robert L

    2012-08-01

    Technological advances have increased ventilator mode complexity and risk of operator error. To compare differences in volume control (VC) ventilation with set-point and dual targeting. Two hypotheses were tested: tidal volume (V(T)) delivery is different with VC using set-point versus dual targeting during active versus passive breathing; VC with dual targeting delivers V(T) similar to pressure support ventilation (PS) with active breathing. The Ingmar Medical ASL 5000 lung model simulated pulmonary mechanics of an adult patient with ARDS during active and passive ventilation. Resistance was standardized at 10 cm H(2)O/L/s and compliance at 32 mL/cm H(2)O. Active breathing was simulated by setting the frequency (f) = 26 breaths/min, and adjusting the muscle pressure (P(mus)) to produce a V(T) of 384 mL. VC was initiated with the Puritan Bennett 840 (set-point targeting) and the Servo-i (dual targeting) at V(T) = 430 mL, mandatory f = 15 breaths/min, and PEEP = 10 cm H(2)O. During PS, cycle threshold was set to 30% and peak inspiratory pressure adjusted to produce a V(T) similar to that delivered during VC. Expiratory V(T) was collected on 10 consecutive breaths during active and passive breathing with VC and PS. Mean V(T) differences (active vs passive model) were compared using analysis of variance. Statistical significance was established at P targeting schemes: VC set-point = 37.3 ± 3.5 mL, VC-dual = 77.1 ± 3.3 mL, and PS = 406.1 ± 1.5 mL (P targeting during VC allows increased V(T), compared to set-point, but not as much as PS.

  20. Photo-controlled aptamers delivery by dual surface gold-magnetic nanoparticles for targeted cancer therapy.

    Science.gov (United States)

    Zhao, Jian; Tu, Keyao; Liu, Yanlei; Qin, Yulei; Wang, Xiwei; Qi, Lifeng; Shi, Donglu

    2017-11-01

    Dual surfaced dumbbell-like gold magnetic nanoparticles (Au-Fe 3 O 4 ) were synthesized for targeted aptamers delivery. Their unique biological properties were characterized as a smart photo-controlled drug carrier. DNA aptamers targeting vascular endothelial growth factor (VEGF) were assembled onto the surface of Au-Fe 3 O 4 by electrostatic absorption. The binding capacity of the nanoparticles with VEGF aptamers was confirmed by gel electrophoresis. The targeted recognization of ovarian cancer cells by the aptamers-functionalized Au-Fe 3 O 4 nanoparticles (Apt-Au-Fe 3 O 4 NPs) was observed by confocal microscopy. Apt-Au-Fe 3 O 4 was found to bind with SKOV-3 ovarian cancer cells specifically, leading to marked intracellular release of aptamers upon plasmon-resonant light (605nm) radiation, and to enhance the in vitro inhibition against tumor cell proliferation. The results show high potential of Apt-Au-Fe 3 O 4 as a targeted cancer hyperthermia carrier by remote control with high spatial/temporal resolution. Copyright © 2017. Published by Elsevier B.V.

  1. Climate warming increases biological control agent impact on a non-target species.

    Science.gov (United States)

    Lu, Xinmin; Siemann, Evan; He, Minyan; Wei, Hui; Shao, Xu; Ding, Jianqing

    2015-01-01

    Climate change may shift interactions of invasive plants, herbivorous insects and native plants, potentially affecting biological control efficacy and non-target effects on native species. Here, we show how climate warming affects impacts of a multivoltine introduced biocontrol beetle on the non-target native plant Alternanthera sessilis in China. In field surveys across a latitudinal gradient covering their full distributions, we found beetle damage on A. sessilis increased with rising temperature and plant life history changed from perennial to annual. Experiments showed that elevated temperature changed plant life history and increased insect overwintering, damage and impacts on seedling recruitment. These results suggest that warming can shift phenologies, increase non-target effect magnitude and increase non-target effect occurrence by beetle range expansion to additional areas where A. sessilis occurs. This study highlights the importance of understanding how climate change affects species interactions for future biological control of invasive species and conservation of native species. © 2014 The Authors. Ecology Letters published by John Wiley & Sons Ltd and CNRS.

  2. Simulation and Automation of Microwave Frequency Control in Dynamic Nuclear Polarization for Solid Polarized Targets

    Science.gov (United States)

    Perera, Gonaduwage; Johnson, Ian; Keller, Dustin

    2017-09-01

    Dynamic Nuclear Polarization (DNP) is used in most of the solid polarized target scattering experiments. Those target materials must be irradiated using microwaves at a frequency determined by the difference in the nuclear Larmor and electron paramagnetic resonance (EPR) frequencies. But the resonance frequency changes with time as a result of radiation damage. Hence the microwave frequency should be adjusted accordingly. Manually adjusting the frequency can be difficult, and improper adjustments negatively impact the polarization. In order to overcome these difficulties, two controllers were developed which automate the process of seeking and maintaining the optimal frequency: one being a standalone controller for a traditional DC motor and the other a LabVIEW VI for a stepper motor configuration. Further a Monte-Carlo simulation was developed which can accurately model the polarization over time as a function of microwave frequency. In this talk, analysis of the simulated data and recent improvements to the automated system will be presented. DOE.

  3. Controlling range expansion in habitat networks by adaptively targeting source populations.

    Science.gov (United States)

    Hock, Karlo; Wolff, Nicholas H; Beeden, Roger; Hoey, Jessica; Condie, Scott A; Anthony, Kenneth R N; Possingham, Hugh P; Mumby, Peter J

    2016-08-01

    Controlling the spread of invasive species, pests, and pathogens is often logistically limited to interventions that target specific locations at specific periods. However, in complex, highly connected systems, such as marine environments connected by ocean currents, populations spread dynamically in both space and time via transient connectivity links. This results in nondeterministic future distributions of species in which local populations emerge dynamically and concurrently over a large area. The challenge, therefore, is to choose intervention locations that will maximize the effectiveness of the control efforts. We propose a novel method to manage dynamic species invasions and outbreaks that identifies the intervention locations most likely to curtail population expansion by selectively targeting local populations most likely to expand their future range. Critically, at any point during the development of the invasion or outbreak, the method identifies the local intervention that maximizes the long-term benefit across the ecosystem by restricting species' potential to spread. In so doing, the method adaptively selects the intervention targets under dynamically changing circumstances. To illustrate the effectiveness of the method we applied it to controlling the spread of crown-of-thorns starfish (Acanthaster sp.) outbreaks across Australia's Great Barrier Reef. Application of our method resulted in an 18-fold relative improvement in management outcomes compared with a random targeting of reefs in putative starfish control scenarios. Although we focused on applying the method to reducing the spread of an unwanted species, it can also be used to facilitate the spread of desirable species through connectivity networks. For example, the method could be used to select those fragments of habitat most likely to rebuild a population if they were sufficiently well protected. © 2016 Society for Conservation Biology.

  4. Perioperative very low-dose ketamine infusion actually increases the incidence of postoperative remifentanil-induced shivering-double-blind randomized trial.

    Science.gov (United States)

    Suzuki, Manzo; Osumi, Makoto; Shimada, Hiromi; Bito, Hiroyasu

    2013-12-01

    Low-dose ketamine infusion (blood concentration around 100 ng/mL) during surgery reduces the incidence of postoperative shivering after remifentanil-based anesthesia. We hypothesized that perioperative infusion of very low-dose ketamine (blood concentration around 40 ng/mL) during remifentanil-based anesthesia may also prevent the development of remifentanil-induced shivering during the 2-hour period after the end of anesthesia. Fifty female patients scheduled to undergo laparoscopic cystectomy or oophorectomy were assigned to one of two groups: (1) ketamine group, in which the patients received ketamine infusion (0.1 mg/kg/hour) from induction of anesthesia to emergence from anesthesia; and (2) control group, in which the patients received saline infusion from induction up till emergence from anesthesia. Anesthesia was induced and maintained by target-controlled infusion of propofol (estimated blood concentration: 2-4 μg/mL) and infusion of remifentanil, at 0.2-0.3 μg/kg/minute. Patients were observed for shivering from the end of anesthesia to 120 minutes after anesthesia. The time point at which the patient began to shiver was recorded and assigned to one of four time periods: at emergence, from emergence to 30 minutes after anesthesia, from 30 minutes to 60 minutes after anesthesia, and >60 minutes after anesthesia. During the 120-minute observation period, the number of patients who shivered was higher in the ketamine group than the in control group (18 vs. 8, ketamine group vs. control group, p = 0.01). The time period during which patients began to shiver was different between the two groups (1 patient, 4 patients, and 13 patients vs. 3 patients, 2 patients, and 3 patients at emergence, from emergence to 30 minutes, and from 30 minutes to 60 minutes after anesthesia, respectively; ketamine group vs. control group, p = 0.007). Intraoperative infusion of very low-dose ketamine during remifentanil-based anesthesia may increase the incidence of postoperative

  5. Stoichiometry control of complex oxides by sequential pulsed-laser deposition from binary-oxide targets

    Energy Technology Data Exchange (ETDEWEB)

    Herklotz, A. [ORNL, Materials Science and Technology Division, Bethel Valley Road, Oak Ridge, Tennessee 37831-6056 (United States); Martin Luther University Halle-Wittenberg, Institute for Physics, Von-Danckelmann-Platz 3, 06120 Halle (Germany); Dörr, K. [Martin Luther University Halle-Wittenberg, Institute for Physics, Von-Danckelmann-Platz 3, 06120 Halle (Germany); Ward, T. Z.; Eres, G. [ORNL, Materials Science and Technology Division, Bethel Valley Road, Oak Ridge, Tennessee 37831-6056 (United States); Christen, H. M.; Biegalski, M. D. [ORNL, Center for Nanophase Materials Sciences, Bethel Valley Road, Oak Ridge, Tennessee 37831-6496 (United States)

    2015-03-30

    To have precise atomic layer control over interfaces, we examine the growth of complex oxides through the sequential deposition from binary targets by pulsed laser deposition. In situ reflection high-energy electron diffraction (RHEED) is used to control the growth and achieve films with excellent structural quality. The growth from binary oxide targets is fundamentally different from single target growth modes and shows more similarities to shuttered growth by molecular beam epitaxy. The RHEED intensity oscillations of non-stoichiometric growth are consistent with a model of island growth and accumulation of excess material on the surface that can be utilized to determine the correct stoichiometry for growth. Correct monolayer doses can be determined through an envelope frequency in the RHEED intensity oscillations. In order to demonstrate the ability of this growth technique to create complex heterostructures, the artificial n = 2 and 3 Sr{sub n+1}Ti{sub n}O{sub 3n+1} Ruddlesden-Popper phases are grown with good long-range order. This method enables the precise unit-cell level control over the structure of perovskite-type oxides, and thus the growth of complex materials with improved structural quality and electronic functionality.

  6. Controlling antimicrobial resistance through targeted, vaccine-induced replacement of strains.

    Directory of Open Access Journals (Sweden)

    Yonas I Tekle

    Full Text Available Vaccination has proven effective in controlling many infectious diseases. However, differential effectiveness with regard to pathogen genotype is a frequent reason for failures in vaccine development. Often, insufficient immune response is induced to prevent infection by the diversity of existing serotypes present in pathogenic populations of bacteria. These vaccines that target a too narrow spectrum of serotypes do not offer sufficient prevention of infections, and can also lead to undesirable strain replacements. Here, we examine a novel idea to specifically exploit the narrow spectrum coverage of some vaccines to combat specific, emerging multi- and pan-resistant strains of pathogens. Application of a narrow-spectrum vaccine could serve to prevent infections by some strains that are hard to treat, rather than offer the vaccinated individual protection against infections by the pathogenic species as such. We suggest that vaccines targeted to resistant serotypes have the potential to become important public health tools, and would represent a new approach toward reducing the burden of particular multi-resistant strains occurring in hospitals. Vaccines targeting drug-resistant serotypes would also be the first clinical intervention with the potential to drive the evolution of pathogenic populations toward drug-sensitivity. We illustrate the feasibility of this approach by modeling a hypothetical vaccine that targets a subset of methicillin-resistant Staphylococcus aureus (MRSA genotypes, in combination with drug treatment targeted at drug-sensitive genotypes. We find that a combined intervention strategy can limit nosocomial outbreaks, even when vaccine efficacy is imperfect. The broader utility of vaccine-based resistance control strategies should be further explored taking into account population structure, and the resistance and transmission patterns of the pathogen considered.

  7. Auditory target processing in methadone substituted opiate addicts: The effect of nicotine in controls

    Directory of Open Access Journals (Sweden)

    Zerbin Dieter

    2007-11-01

    Full Text Available Abstract Background The P300 component of the auditory evoked potential is an indicator of attention dependent target processing. Only a few studies have assessed cognitive function in substituted opiate addicts by means of evoked potential recordings. In addition, P300 data suggest that chronic nicotine use reduces P300 amplitudes. While nicotine and opiate effects combine in addicted subjects, here we investigated the P300 component of the auditory event related potential in methadone substituted opiate addicts with and without concomitant non-opioid drug use in comparison to a group of control subjects with and without nicotine consumption. Methods We assessed 47 opiate addicted out-patients under current methadone substitution and 65 control subjects matched for age and gender in an 2-stimulus auditory oddball paradigm. Patients were grouped for those with and without additional non-opioid drug use and controls were grouped for current nicotine use. P300 amplitude and latency data were analyzed at electrodes Fz, Cz and Pz. Results Patients and controls did not differ with regard to P300 amplitudes and latencies when whole groups were compared. Subgroup analyses revealed significantly reduced P300 amplitudes in controls with nicotine use when compared to those without. P300 amplitudes of methadone substituted opiate addicts were in between the two control groups and did not differ with regard to additional non-opioid use. Controls with nicotine had lower P300 amplitudes when compared to patients with concomitant non-opioid drugs. No P300 latency effects were found. Conclusion Attention dependent target processing as indexed by the P300 component amplitudes and latencies is not reduced in methadone substituted opiate addicts when compared to controls. The effect of nicotine on P300 amplitudes in healthy subjects exceeds the effects of long term opioid addiction under methadone substitution.

  8. Cell morphogenesis proteins are translationally controlled through UTRs by the Ndr/LATS target Ssd1.

    Directory of Open Access Journals (Sweden)

    Antony G Wanless

    Full Text Available Eukaryotic cells control their growth and morphogenesis to maintain integrity and viability. Free-living cells are further challenged by their direct interaction with the environment and in many cases maintain a resilient cell wall to stay alive under widely varying conditions. For these organisms, stringent and highly localized control of the cell wall's remodeling and expansion is crucial for cell growth and reproduction. In the budding yeast Saccharomyces cerevisiae the RNA binding protein Ssd1 helps control cell wall remodeling by repressing translation of proteins involved in wall expansion. Ssd1 is itself negatively regulated by the highly conserved Ndr/LATS protein kinase Cbk1. We sought to identify mRNA regions that confer Ssd1-mediated translational control. After validating a GFP reporter system as a readout of Ssd1 activity we found that 3' untranslated regions of the known Ssd1 targets CTS1, SIM1 and UTH1 are sufficient for Cbk1-regulated translational control. The 5' untranslated region of UTH1 also facilitated Ssd1-mediated translational control in a heterologous context. The CTS1 and SIM1 3' untranslated regions confer Ssd1 binding, and the SIM1 3' untranslated region improves Ssd1 immunoprecipitation of the endogenous SIM1 transcript. However, SIM1's 3' untranslated region is not essential for Ssd1-regulated control of the message's translation. We propose that Ssd1 regulates translation of its target message primarily through UTRs and the SIM1 message through multiple potential points of interaction, permitting fine translational control in various contexts.

  9. LPS infusion suppresses serum FGF21 levels in healthy adult volunteers

    DEFF Research Database (Denmark)

    Lauritzen, Esben Stistrup; Rittig, Nikolaj; Bach, Ermina

    2017-01-01

    circulating levels of FGF21 after lipopolysaccharide (LPS) infusion. DESIGN: Two randomized, single blinded, placebo-controlled crossover trials were used. SETTING: The studies were performed at a university hospital clinical research center. PATIENTS AND INTERVENTIONS: Study 1 (LPS bolus): Eight young......, healthy, lean males were investigated two times: 1) after isotonic saline injection, and 2) after LPS injection (bolus of 1 ng/kg). Each study day lasted 4 hours. Study 2 (continuous LPS infusion): Eight, healthy males were investigated two times: 1) during continuously isotonic saline infusion, and 2......) during continuously LPS infusion (0.06 ng/kg/h). Each study day lasted 4 hours. Circulating FGF21 levels were quantified every second hour by an immunoassay. RESULTS: A LPS bolus resulted in a late suppression (t = 240 minutes) of serum FGF21 (P=0.035). Continuous LPS infusion revealed no significant...

  10. Doubling the single-dose infusion rate of tocilizumab in rheumatoid arthritis is safe and efficacious

    DEFF Research Database (Denmark)

    Lindegaard, H M; Johansen, P; Gröndal, G

    2016-01-01

    OBJECTIVES: To investigate the impact of enhanced infusion rate of tocilizumab on the occurrence of infusion reactions, overall safety, and efficacy in rheumatoid arthritis (RA). METHOD: We conducted a 24-week multicentre, open-label, randomized parallel group study comparing adverse event (AE......) and effect profiles following tocilizumab IV 8 mg/kg every 4 weeks over 31 min vs. standard 60-min infusions in patients with RA and an inadequate clinical response to disease-modifying anti-rheumatic drugs (DMARDs) and/or tumour necrosis factor (TNF)-α inhibitors. RESULTS: A total of 47 patients were...... enrolled in the study and randomized to fast infusions (n = 25) and controls (n = 22). Incidences of infusion reactions were similar between the two groups, neither of them leading to withdrawal. Likewise, the incidence of additional AEs did not differ between the treatment arms. Two serious adverse events...

  11. Noninvasive pulsed focused ultrasound allows spatiotemporal control of targeted homing for multiple stem cell types in murine skeletal muscle and the magnitude of cell homing can be increased through repeated applications.

    Science.gov (United States)

    Burks, Scott R; Ziadloo, Ali; Kim, Saejeong J; Nguyen, Ben A; Frank, Joseph A

    2013-11-01

    Stem cells are promising therapeutics for cardiovascular diseases, and i.v. injection is the most desirable route of administration clinically. Subsequent homing of exogenous stem cells to pathological loci is frequently required for therapeutic efficacy and is mediated by chemoattractants (cell adhesion molecules, cytokines, and growth factors). Homing processes are inefficient and depend on short-lived pathological inflammation that limits the window of opportunity for cell injections. Noninvasive pulsed focused ultrasound (pFUS), which emphasizes mechanical ultrasound-tissue interactions, can be precisely targeted in the body and is a promising approach to target and maximize stem cell delivery by stimulating chemoattractant expression in pFUS-treated tissue prior to cell infusions. We demonstrate that pFUS is nondestructive to murine skeletal muscle tissue (no necrosis, hemorrhage, or muscle stem cell activation) and initiates a largely M2-type macrophage response. We also demonstrate that local upregulation of chemoattractants in pFUS-treated skeletal muscle leads to enhance homing, permeability, and retention of human mesenchymal stem cells (MSC) and human endothelial precursor cells (EPC). Furthermore, the magnitude of MSC or EPC homing was increased when pFUS treatments and cell infusions were repeated daily. This study demonstrates that pFUS defines transient "molecular zip codes" of elevated chemoattractants in targeted muscle tissue, which effectively provides spatiotemporal control and tunability of the homing process for multiple stem cell types. pFUS is a clinically translatable modality that may ultimately improve homing efficiency and flexibility of cell therapies for cardiovascular diseases. © AlphaMed Press.

  12. General-purpose infusion pumps.

    Science.gov (United States)

    1998-01-01

    General-purpose infusion pumps deliver liquid medications to patients through intravenous or epidural routes at specified flows. They are most often used in hospitals and alternative care settings (e.g., physician' offices, patients' homes) when liquid medications need to be administered with greater accuracy or at higher flows than can be provided through a manually adjusted gravity administration set. In this Update of our February 1997 Evaluation of infusion pumps (Health Devices 26[2]), we tested 3 additional pumps from 3 suppliers. We also rated and ranked them in comparison with the 16 units from the February 1997 study that are still being produced. With a few exceptions, we tested the new pumps against the same criteria and using the same test methods as those in the previous Evaluation. However, for this Update, the focus of our findings has broadened: although we continue to place strong emphasis on the pumps' protection against gravity free-flow, we also give significant weight to their overall safety, performance, and human factors design. As a result, our ratings and rankings scheme has changed, affecting the rankings of some of the previously evaluated units. Of the 19 currently available units that have been evaluated to date, we rated 13 units Acceptable, with 5 of those units ranked above the other 8. A further 5 units were rated Conditionally Acceptable; we consider them Acceptable if they are used with the available free-flow protection. And 1 unit had performance problems that caused us to rate it Unacceptable (this unit has been recalled by its supplier; see the inset on page 162). As always, we caution readers not to base selection and purchasing decisions on our conclusions alone, but on a thorough understanding of the issues behind those conclusions, which can be gained by reading this Evaluation in its entirety and carefully reviewing the February 1997 issue.

  13. Responses to Starch Infusion on Milk Synthesis in Low Yield Lactating Dairy Cows

    Directory of Open Access Journals (Sweden)

    Yang Zou

    2015-09-01

    Full Text Available The effect of starch infusion on production, metabolic parameters and relative mRNA abundance was investigated in low yield lactating cows from 86 days in milk. Six Holstein cows fitted with permanent ruminal cannulas were arranged into one of two complete 3×3 Latin squares and infused with a starch solution containing 800 grams starch for 16 days. The three treatments were: i ruminal and abomasal infusion with water (Control; ii ruminal infusion with cornstarch solution and abomasal infusion with water (Rumen; iii ruminal infusion with water and abomasal infusion with cornstarch solution (Abomasum. There were no significant differences (p>0.05 among the three treatments with low yield lactating cows in feed and energy intake, milk yield and composition, plasma metabolism, or even on gene expression. However, cows receiving starch through rumen performed better than directly through the abomasum during the glucose tolerance test procedure with a higher area under the curve (AUC; p = 0.08 and shorter half-time (t1/2; p = 0.11 of plasma insulin, therefore, it increased glucose disposal, which stated a lipid anabolism other than mobilization after energy supplementation. In conclusion, extra starch infusion at concentration of 800 g/d did not enhance energy supplies to the mammary gland and improve the lactating performance in low yield lactating cows.

  14. Venous plasma levels of endothelin-1 are not altered immediately after nitroglycerin infusion in healthy subjects

    DEFF Research Database (Denmark)

    Thomsen, L L; Iversen, Helle Klingenberg; Emmeluth, C

    1995-01-01

    Endothelin-1 and nitric oxide play an important regulatory role in the control of vascular smooth muscle tone. Nitroglycerin (NTG), a nitric oxide donating drug, may inhibit endothelin production. In this double-blind placebo-controlled crossover study, plasma levels of endothelin-1 were measured...... levels were induced by NTG infusion (2.4 pg.ml-1 before NTG vs. 2.7 pg.ml-1 after NTG) and placebo infusion also did not affect plasma endothelin-1. It is concluded that venous plasma levels of endothelin-1 are not altered immediately after NTG infusion....

  15. Evaluation of spatially targeted strategies to control non-domiciliated Triatoma dimidiata vector of Chagas disease.

    Directory of Open Access Journals (Sweden)

    Corentin Barbu

    2011-05-01

    Full Text Available BACKGROUND: Chagas disease is a major neglected tropical disease with deep socio-economical effects throughout Central and South America. Vector control programs have consistently reduced domestic populations of triatomine vectors, but non-domiciliated vectors still have to be controlled efficiently. Designing control strategies targeting these vectors is challenging, as it requires a quantitative description of the spatio-temporal dynamics of village infestation, which can only be gained from combinations of extensive field studies and spatial population dynamic modelling. METHODOLOGY/PRINCIPAL FINDINGS: A spatially explicit population dynamic model was combined with a two-year field study of T. dimidiata infestation dynamics in the village of Teya, Mexico. The parameterized model fitted and predicted accurately both intra-annual variation and the spatial gradient in vector abundance. Five different control strategies were then applied in concentric rings to mimic spatial design targeting the periphery of the village, where vectors were most abundant. Indoor insecticide spraying and insect screens reduced vector abundance by up to 80% (when applied to the whole village, and half of this effect was obtained when control was applied only to the 33% of households closest to the village periphery. Peri-domicile cleaning was able to eliminate up to 60% of the vectors, but at the periphery of the village it has a low effect, as it is ineffective against sylvatic insects. The use of lethal traps and the management of house attractiveness provided similar levels of control. However this required either house attractiveness to be null, or ≥ 5 lethal traps, at least as attractive as houses, to be installed in each household. CONCLUSION/SIGNIFICANCE: Insecticide and insect screens used in houses at the periphery of the village can contribute to reduce house infestation in more central untreated zones. However, this beneficial effect remains insufficient

  16. The Infusion Approach to Teacher Development.

    Science.gov (United States)

    Kowalski, Ellen M.

    1995-01-01

    The underlying premise of infusion is that information about individuals with disabilities must be more systematically integrated throughout an entire curriculum. This article describes the infusion approach to teacher development, explaining three central premises, providing sample program applications for each premise, and discussing brain…

  17. Adaptive Hands-On Control for Reaching and Targeting Tasks in Surgery

    Directory of Open Access Journals (Sweden)

    Elisa Beretta

    2015-05-01

    Full Text Available Cooperatively controlled robotic assistants can be used in surgery for the repetitive execution of targeting/reaching tasks, which require smooth motions and accurate placement of a tool inside a working area. A variable damping controller, based on a priori knowledge of the location of the surgical site, is proposed to enhance the physical human-robot interaction experience. The performance of this and of typical constant damping controllers is comparatively assessed using a redundant light-weight robot. Results show that it combines the positive features of both null (acceleration capabilities > 0.8m/s2 and optimal (mean pointing error < 1.5mm constant damping controllers, coupled with smooth and intuitive convergence to the target (direction changes reduced by 30%, which ensures that assisted tool trajectories feel natural to the user. An application scenario is proposed for brain cortex stimulation procedures, where the surgeon's intentions of motion are explicitly defined intra-operatively through an image-guided navigational system.

  18. [Diuretic activity of the infusion of flowers from Lavandula officinalis].

    Science.gov (United States)

    Elhajili, M; Baddouri, K; Elkabbaj, S; Meiouat, F; Settaf, A

    2001-01-01

    The diuretic activity of an infusion of Lavandula officinalis was studied in the Wistar rat. Thus, the kinetics of hydroelectrolytic elimination in response to the oral administration of an infusion of pharmaceutical lavender flowers were measured in the rats. Experiments were completed under similar conditions using a synthetic pharmacological diuretic, Diamox. The aqueous extract of this aromatic plant accelerated the elimination of the water overload. At the peak of the diuretic response, urinary osmolarity was significantly less than that of controls (111+/-14 vs. 195+/-11 mosmol x kg(-1)). Sodium excretion was moderate following administration of the infusion when compared to the synthetic diuretic. The stability of the aldosterone concentrations in the plasma and the absence of correlation with plasma sodium concentrations, coupled with the observed clearance of the free water (0.055+/-0.007 vs. 0.045+/-0.012 mL x min(-1)) show that the increase in diuresis and the moderate increase in sodium excretion are of tubular origin. The result of the phytochemical analysis of hexane extracts in the infusion and in urine indicated that four or five chemical factors may be involved in the diuretic effect of lavender.

  19. Effects of Psidium guajava Leaf Infusion on Streptococci viridans

    Directory of Open Access Journals (Sweden)

    Hing Yi Chen

    2016-09-01

    Full Text Available Background: Dental caries is recognized as the most important oral burden. It is caused by the formation of lactate acid formed through reaction of bacteria and carbohydrates. Streptococci viridans has been proven as the primary etiologic agents for dental caries. Low accessibility in oral care services leads the Indonesian community to use plants in order to prevent dental caries. One of those plants is Psidium guajava (pink guava. The leaves were suggested to have antimicrobial effects on some gram-positive bacteria. When the organism is resistant to specific substance tested on media, a circular/inhibition zone around a disc containing antimicrobial substance was formed. The purpose of this study was to identify the presence of inhibition zones by infusion of Psidium guajava leaf on Streptococci viridians in vitro. Methods: This laboratory experiment was carried out in September to October 2014 at the Microbiology Laboratory, Faculty of Medicine, Universitas Padjadjaran. Infusions of Psidium guajava leaf were made into four different concentrations (10%, 25%, 50% and 100%, respectively and the identification of inhibition zones on Streptococci viridans obtained from the laboratory was tested using modified disk diffusion test. Distilled water acted as negative control. The results were then interpreted after 24 hours of incubation. Every procedure was repeated three times. Results: All four concentrations of Psidium guajava leaf infusions have formed inhibition zones on the media, with the highest concentration (100% producing largest average diameter. Conclusions: The infusion of Psidium guajava leaf produces inhibition zones on Streptococci virdans in vitro.

  20. Cardiovascular effects of intravenous ghrelin infusion in healthy young men

    DEFF Research Database (Denmark)

    Vestergaard, Esben Thyssen; Andersen, Niels Holmark; Hansen, Troels Krarup

    2007-01-01

    Ghrelin infusion improves cardiac function in patients suffering from cardiac failure, and bolus administration of ghrelin increases cardiac output in healthy subjects. The cardiovascular effects of more continuous intravenous ghrelin exposure remain to be studied. We therefore studied the cardio......Ghrelin infusion improves cardiac function in patients suffering from cardiac failure, and bolus administration of ghrelin increases cardiac output in healthy subjects. The cardiovascular effects of more continuous intravenous ghrelin exposure remain to be studied. We therefore studied...... the cardiovascular effects of a constant infusion of human ghrelin at a rate of 5 pmol/kg per minute for 180 min. Fifteen healthy, young (aged 23.2 ± 0.5 yr), normal-weight (23.0 ± 0.4 kg/m2) men volunteered in a randomized double-blind, placebo-controlled crossover study. With the subjects remaining fasting, peak...... myocardial systolic velocity S′, tissue tracking TT, left ventricular ejection fraction EF, and endothelium-dependent flow-mediated vasodilatation were measured. Ghrelin infusion increased S′ 9% (P = 0.002) and TT 10% (P

  1. Liquid-Infused Smooth Surface for Improved Condensation Heat Transfer.

    Science.gov (United States)

    Tsuchiya, Hirotaka; Tenjimbayashi, Mizuki; Moriya, Takeo; Yoshikawa, Ryohei; Sasaki, Kaichi; Togasawa, Ryo; Yamazaki, Taku; Manabe, Kengo; Shiratori, Seimei

    2017-09-12

    Control of vapor condensation properties is a promising approach to manage a crucial part of energy infrastructure conditions. Heat transfer by vapor condensation on superhydrophobic coatings has garnered attention, because dropwise condensation on superhydrophobic surfaces with rough structures leads to favorable heat-transfer performance. However, pinned condensed water droplets within the rough structure and a high thermodynamic energy barrier for nucleation of superhydrophobic surfaces limit their heat-transfer increase. Recently, slippery liquid-infused surfaces (SLIPS) have been investigated, because of their high water sliding ability and surface smoothness originating from the liquid layer. However, even on SLIPS, condensed water droplets are eventually pinned to degrade their heat-transfer properties after extended use, because the rough base layer is exposed as infused liquid is lost. Herein, we report a liquid-infused smooth surface named "SPLASH" (surface with π electron interaction liquid adsorption, smoothness, and hydrophobicity) to overcome the problems derived from the rough structures in previous approaches to obtain stable, high heat-transfer performance. The SPLASH displayed a maximum condensation heat-transfer coefficient that was 175% higher than that of an uncoated substrate. The SPLASH also showed higher heat-transfer performance and more stable dropwise condensation than superhydrophobic surfaces and SLIPS from the viewpoints of condensed water droplet mobility and the thermodynamic energy barrier for nucleation. The effects of liquid-infused surface roughness and liquid viscosity on condensation heat transfer were investigated to compare heat-transfer performance. This research will aid industrial applications using vapor condensation.

  2. Efficacy and safety of a subacromial continuous ropivacaine infusion for post-operative pain management following arthroscopic rotator cuff surgery: A protocol for a randomised double-blind placebo-controlled trial

    Directory of Open Access Journals (Sweden)

    Bell Simon N

    2008-04-01

    Full Text Available Abstract Background Major shoulder surgery often results in severe post-operative pain and a variety of interventions have been developed in an attempt to address this. The continuous slow infusion of a local anaesthetic directly into the operative site has recently gained popularity but it is expensive and as yet there is little conclusive evidence that it provides additional benefits over other methods of post-operative pain management. Methods/Design This will be a randomised, placebo-controlled trial involving 158 participants. Following diagnostic arthroscopy, all participants will undergo arthroscopic subacromial decompression with or without rotator cuff repair, all operations performed by a single surgeon. Participants, the surgeon, nurses caring for the patients and outcome assessors will be blinded to treatment allocation. All participants will receive a pre-incision bolus injection of 20 mls of ropivacaine 1% into the shoulder and an intra-operative intravenous bolus of parecoxib 40 mg. Using concealed allocation participants will be randomly assigned to active treatment (local anaesthetic ropivacaine 0.75% or placebo (normal saline administered continuously into the subacromial space by an elastomeric pump at 5 mls per hour post-operatively. Patient controlled opioid analgesia and oral analgesics will be available for breakthrough pain. Outcome assessment will be at 15, 30 and 60 minutes, 2, 4, 8, 12, 18 and 24 hours, and 2 or 4 months for decompression or decompression plus repair respectively. The primary end point will be average pain at rest over the first 12-hour post-operative period on a verbal analogue pain score. Secondary end points will be average pain at rest over the second 12-hour post-operative period, maximal pain at rest over the first and second 12-hour periods, amount of rescue medication used, length of inpatient stay and incidence of post-operative adhesive capsulitis. Discussion The results of this trial will

  3. Intravenous drugs infusion safety through smart pumps

    Directory of Open Access Journals (Sweden)

    C. Gómez-Baraza

    2014-07-01

    Full Text Available Objective: To analyze the role of smart infusion pumps in reducing errors related with the administration of intravenous medications. Method: Retrospective, observational study analyzing the implementation of a system with smart intravenous infusion pumps (Hospira MedNetTM and the role of the safety system for the detection of errors during the administration of drugs, sera, and blood. We included infusions administered at the day-care hospitals of hematology, oncology, rheumatology, and oncopediatrics. We analyzed adherence to the safety system, the number of programming errors detected, the commonly implicated drugs in these errors, and improvement actions. Results: During the study period, 120 smart pumps were implemented and data on 70,028 infusions were gathered. The rate of adherence to the safety program was 62.30% in hematology (6,887 infusions, 60,30% in oncology (28,127 infusions, 46,50% in rheumatology (1,950 infusions and 1.8% in oncopediatrics (139 infusions. 3,481 out of the established limits programming alerts were generated by the pumps: 2,716 of relative limit and 765 of absolute limit. En 807 infusions (2.17%, errors that could have had consequences for the patients could be prevented. These findings allowed implementing a series of strategies aimed at minimizing these errors in the future. Conclusions: The Hospira MedNetTM system detects deviations from the established protocols of intravenous infusion, preventing in this way potential adverse events for the patients. It also allows establishing correction measures and implementing the improvement strategies.

  4. Nanoparticle-Enabled Transdermal Drug Delivery Systems for Enhanced Dose Control and Tissue Targeting

    Directory of Open Access Journals (Sweden)

    Brian C. Palmer

    2016-12-01

    Full Text Available Transdermal drug delivery systems have been around for decades, and current technologies (e.g., patches, ointments, and creams enhance the skin permeation of low molecular weight, lipophilic drugs that are efficacious at low doses. The objective of current transdermal drug delivery research is to discover ways to enhance skin penetration of larger, hydrophilic drugs and macromolecules for disease treatment and vaccination. Nanocarriers made of lipids, metals, or polymers have been successfully used to increase penetration of drugs or vaccines, control drug release, and target drugs to specific areas of skin in vivo. While more research is needed to identify the safety of nanocarriers, this technology has the potential to expand the use of transdermal routes of administration to a wide array of therapeutics. Here, we review the current state of nanoparticle skin delivery systems with special emphasis on targeting skin diseases.

  5. Diffusion and clearance of superparamagnetic iron oxide nanoparticles infused into the rat striatum studied by MRI and histochemical techniques

    Energy Technology Data Exchange (ETDEWEB)

    Wang, F H; Yoshitake, T; Kehr, J [Department of Physiology and Pharmacology, Karolinska Institutet, 171 77 Stockholm (Sweden); Kim, D K [Department of Materials Science, Royal Institute of Technology, 100 44 Stockholm (Sweden); Johansson, S M; Muhammed, M [Department of Neuroscience, Karolinska Institutet, 171 77 Stockholm (Sweden); Bjelke, B, E-mail: Jan.Kehr@ki.se [Department of Clinical Neuroscience, Karolinska Institutet, 171 77 Stockholm (Sweden)

    2011-01-07

    The purpose of the present study was to investigate, by MRI and histochemical techniques, the diffusion and clearance abilities of superparamagnetic iron oxide nanoparticles (SPION) coated with dextran (Dextran-SPION) and gold (Au-SPION) following their local infusions into the rat brain. In separate groups of anesthetized rats, the Dextran-SPION and Au-SPION were infused at concentrations of 0.01, 0.1, 1 and 5 {mu}g Fe/0.5 {mu}l and at the flow rate of 0.5 {mu}l min{sup -1} into the left and right striata, respectively. Repetitive T2-weighted spin-echo MRI scans were performed at time intervals of 1, 6, 12, 24, 48, 72 h, and one, two and eight weeks after inoculation. Following infusion of Dextran-SPION (0.1 {mu}g and 1 {mu}g Fe), the maximal distribution volume was observed at about 12-24 h after inoculation and two weeks later the Fe signals were undetectable for the lower dose. On the other hand, Au-SPION remained tightly localized in the closest vicinity of the infusion site as revealed by unchanged MRI signal intensities and strong histochemical staining of Fe{sup 2+} and Fe{sup 3+} ions in the corresponding brain slices. Immunohistochemical staining of astrocytic and microglial reactions revealed that there were no marked differences in GFAP, VIM or OX-42 labeling observed between the nanoparticle types, however the astrocytic reaction was more pronounced in rats receiving nanoparticles compared to the control (aCSF-infused) rats. In conclusion, the present data demonstrate that the viral-sized Dextran-SPION were able to diffuse freely through the interstitial space of the brain being progressively cleared out from the infusion site within two weeks. Thus, Dextran-SPION could be beneficially used in MRI-guided diagnostic applications such as in experimental oncology or as labels and carriers for targeted drug delivery, whereas Au-SPION could be used for labeling and tracking the transplanted stem cells in experimental MRI.

  6. Formation and control of stoichiometric hafnium nitride thin films by direct sputtering of hafnium nitride target

    CERN Document Server

    Gotoh, Y; Ishikawa, J; Liao, M Y

    2003-01-01

    Hafnium nitride thin films were prepared by radio-frequency sputter deposition with a hafnium nitride target. Deposition was performed with various rf powers, argon pressures, and substrate temperatures, in order to investigate the influences of these parameters on the film properties, particularly the nitrogen composition. It was found that stoichiometric hafnium nitride films were formed at an argon gas pressure of less than 2 Pa, irrespective of the other deposition parameters within the range investigated. Maintaining the nitrogen composition almost stoichiometric, orientation, stress, and electrical resistivity of the films could be controlled with deposition parameters. (author)

  7. Screening and brief intervention targeting risky drinkers in Danish general practice - a pragmatic controlled trial

    DEFF Research Database (Denmark)

    Beich, A.; Gannik, D.; Saelan, H.

    2007-01-01

    AIMS: Recommendations for routine alcohol screening and brief counselling intervention in primary health care rest on results from intervention efficacy studies. By conducting a pragmatic controlled trial (PCT), we aimed at evaluating the effectiveness of the WHO recommendations for screening......-14 months. Outcome measures focused on patients' acceptance of screening and intervention and their self-reported alcohol consumption. RESULTS: Patient acceptance of screening and intervention -10.3% (N = 794) of the target population (N = 7, 691) explicitly refused screening. All intervention group...

  8. Persistent effects of a pedagogical device targeted at prevention of severe hypoglycaemia: a randomized, controlled study.

    Science.gov (United States)

    Nordfeldt, Sam; Johansson, Calle; Carlsson, Eric; Hammersjö, Jan-Ake

    2005-10-01

    To study the long-term use of self-study material in type 1 diabetes patient education targeted at the prevention of severe hypoglycaemia. Randomized 1:1:1 control study in three local hospitals. We studied 332 type 1 diabetes patients from the geographic population, aged 2.6-18.9 y at entry. The intervention group received a videotape and brochure in which interviewed patients, parents and medical experts reviewed in detail practical skills for self-control and treatment, with the aim of preventing severe hypoglycaemia. There were two control groups: one received a videotape and brochure with general diabetes information and the other only traditional treatment. Primary endpoints were severe hypoglycaemia needing assistance by another person and HbA1c. Dissemination, reading/viewing level, patients' attitudes and extra contact with caregivers were also investigated. At 24 mo, 249 subjects provided data. The yearly incidence of severe hypoglycaemia decreased at 24 mo from 42% to 25% (difference 17%, 95% CI 3-31, p = 0.0241) in the intervention group, but not in controls. HbA1c remained unchanged. Video use during months 13-24 was higher in the intervention group than in controls (p = 0.0477), ranging from 1-15 (median 2) times, among 37% of patients (months 1-12, 100%). Higher future use was anticipated for intervention material (p = 0.0003). Extra caregiver contact was related to severe hypoglycaemia (p = 0.0009). The cost of the material was quality video programmes and brochures may reach high dissemination levels and, when targeted, contribute to the prevention of severe hypoglycaemia over a longer period of time, being a cost-effective complement to traditional care.

  9. Safety, local tolerability and pharmacokinetics of ceftaroline fosamil administered in a reduced infusion volume.

    Science.gov (United States)

    Edeki, Timi; Kujacic, Mirjana; Broadhurst, Helen; Li, Jianguo; Sunzel, Maria

    2014-12-01

    The standard dose of ceftaroline fosamil for patients with normal renal function is 600 mg diluted in 250 ml by 60 min intravenous infusion every 12 h. This two part phase I trial (NCT01577589) assessed safety and local tolerability of multiple ceftaroline fosamil 50 ml and 250 ml infusions, and pharmacokinetics following single administrations of each infusion volume. Part A was a placebo-controlled, double-blind, multiple dose crossover study. Twenty-four healthy subjects were randomized to simultaneous, bilateral ceftaroline fosamil 600 mg and placebo infusions in each arm (50 ml then 250 ml or vice versa) every 12 h for 72 h, with a ≥ 4.5 day washout. Local tolerability was evaluated by the Visual Infusion Phlebitis scale, with scores ≥2 considered infusion site reactions (ISRs). Part B was an open label crossover study. Ten subjects were randomized to single 50 ml and 250 ml ceftaroline fosamil 600 mg infusions on days 1 and 3 (washout on day 2). Blood samples for pharmacokinetic analysis were taken over 24 h. In part A, four subjects (16.7%) experienced ISRs, all of which were associated with placebo infusions. No ISRs were reported for either ceftaroline fosamil 50 ml or 250 ml. Plasma pharmacokinetics (ceftaroline fosamil, active ceftaroline and an inactive metabolite) were similar following single 50 ml and 250 ml infusions in part B. No new safety concerns were identified for ceftaroline fosamil 600 mg 50 ml compared with 250 ml. These findings suggest infusion volumes down to 50 ml may be used in patients with fluid intake restrictions. © 2014 The British Pharmacological Society.

  10. Systemic and regional hemodynamic effects of enalaprilat infusion in experimental normotensive sepsis

    Directory of Open Access Journals (Sweden)

    L. Rahal

    Full Text Available Angiotensin-converting enzyme inhibitors have been shown to improve splanchnic perfusion in distinct shock states. We hypothesized that enalaprilat potentiates the benefits of early fluid resuscitation in severe experimental sepsis, particularly in the splanchnic region. Anesthetized and mechanically ventilated mongrel dogs received an intravenous infusion of live Escherichia coli over a period of 30 min. Thereafter, two interventions were performed: fluid infusion (normal saline, 32 mL/kg over 30 min and enalaprilat infusion (0.02 mg kg-1 min-1 for 60 min in randomized groups. The following groups were studied: controls (fluid infusion, N = 4, E1 (enalaprilat infusion followed by fluid infusion, N = 5 and E2 (fluid infusion followed by enalaprilat infusion, N = 5. All animals were observed for a 120 min after bacterial infusion. Mean arterial pressure, cardiac output (CO, portal vein blood flow (PVBF, systemic and regional oxygen-derived variables, and lactate levels were measured. Rapid and progressive reductions in CO and PVBF were induced by the infusion of live bacteria, while minor changes were observed in mean arterial pressure. Systemic and regional territories showed a significant increase in oxygen extraction and lactate levels. Widening venous-arterial and portal-arterial pCO2 gradients were also detected. Fluid replacement promoted transient benefits in CO and PVBF. Enalaprilat after fluid resuscitation did not affect systemic or regional hemodynamic variables. We conclude that in this model of normotensive sepsis inhibition of angiotensin-converting enzyme did not interfere with the course of systemic or regional hemodynamic and oxygen-derived variables.

  11. Pharmacokinetics and toxicology of continuously infused nitroimidazoles

    International Nuclear Information System (INIS)

    Eifel, P.J.; Brown, J.M.

    1984-01-01

    The pharmacokinetics and toxicology of misonidazole (MISO) and SR-2508 given by continuous intraperitoneal infusion were studied in female C 3 H mice. The survival (time to death) of animals receiving continuous infusions of SR-2508 and MISO was compared and related to plasma concentration, rate of infusion and total amount of drug delivered. Brain and plasma concentrations were determined by HPLC. For SR-2508, plasma concentration was directly proportional to the infusion rate. However, as the infusion rate of MISO was doubled, the plasma concentration of MISO increased approximately 6-fold, reflecting a substantial increase in the apparent half-life. The brain/plasma concentration ratio in animals infused for up to 6 days with SR-2508 remained constant, at approximately 0.09. At plasma concentrations of 0.08-1.5 mM, animals receiving SR-2508 survived approximately 3 times as long as animals exposed to a comparable plasma concentration of MISO. Even at the lowest infusion rates employed in this study, the survival of mice receiving SR-2508 was much shorter than would have been predicted if the toxicity of these two drugs were solely related to the integral brain exposure. The low brain/plasma concentration ratio of SR-2508 was maintained throughout long continuous exposures

  12. Assistance algorithm of nursing for amiodarone intravenous infusion

    Directory of Open Access Journals (Sweden)

    Francimar Tinoco de Oliveira

    2014-12-01

    Full Text Available This study aimed at identifying scientific publication on phlebitis caused by amiodarone and proposes a nursing care algorithm for interventions in intravenous amiodarone administration grounded in the Infusion Nursing Society and the Center for Disease Control and Prevention. It is a descriptive study mediated by integrative review in MedLine, LILACS, IBECS, BDENF, Cochrane Library and Scielo bases, published from 2006 to 2013. The sample consisted of nine articles. The evidence pointed the incidence of phlebitis due to the infusion of amiodarone and the need to control this event. The algorithm proposed shows the materials to be used and the procedure of drug administration in order to minimize injury. Besides subsidizing the development of future studies, this algorithm also promotes the incorporation of the best recommendation for the interventionist clinical practice.

  13. A targetable HB-EGF-CITED4 axis controls oncogenesis in lung cancer.

    Science.gov (United States)

    Hsieh, C-H; Chou, Y-T; Kuo, M-H; Tsai, H-P; Chang, J-L; Wu, C-W

    2017-05-25

    Aberrant epidermal growth factor (EGF) receptor (EGFR) signaling contributes to neoplastic initiation and progression in lung. Mutated EGFR has become as an important therapeutic target in lung cancer, whereas targeted treatment is not available for wild-type EGFR or its ligands. In this study, we found that heparin-binding (HB)-EGF, a member of the EGF family, was highly expressed in a subset of lung cancer, proliferation of which was dependent on HB-EGF signaling. Silencing of HB-EGF with RNA interference inhibited cell cycle progression in lung cancer cells. We observed that, upon HB-EGF induction, CITED4 was induced through a signal transducer and activator of transcription 3 (STAT3)-dependent pathway, regulating cell proliferation. CITED4 interacted with MYC and potentiated MYC-mediated transactivation of the CCND1 promoter, leading to cell cycle progression. Correlation analysis revealed that HB-EGF and CITED4 were significantly positively associated in primary lung tumors, and expression of HB-EGF predicted a poor survival outcome in patients. In vitro and in vivo experiments revealed that pharmacological inhibition of HB-EGF with CRM197 significantly attenuated tumor cell growth. Thus, CITED4 functions as a molecular switch in HB-EGF-induced growth control, and HB-EGF provides a novel therapeutic target for lung cancer intervention.

  14. β-Cyclodextrin grafted polypyrrole magnetic nanocomposites toward the targeted delivery and controlled release of doxorubicin

    Science.gov (United States)

    Hong, Shasha; Li, Zengbo; Li, Chenzhong; Dong, Chuan; Shuang, Shaomin

    2018-01-01

    The Fe3O4@PPy-HA-β-CD nanocomposites as the novel nanocarrier were prepared by grafting ethylenediamine derivative of​ β-​CD to the surface of polypyrrole-coated magnetic nanoparticles (Fe3O4@PPy) via using hyaluronan (HA) as the intermediate linker. HA was also the efficient target ligand for CD44. The as-prepared drug carrier was characterized by TEM, TGA, XRD, and VSM and used for the delivery of doxorubicin hydrochloride (DOX) with the high loading content of 447 mg/g. The multilayer Freundlich isotherm model was found to be a good fit for the loading of the drug carrier for DOX. Significant NIR-triggered release of DOX was observed in a weak acidic pH. And the release data in vitro was well described using the Retiger-Pepper kinetic model. Furthermore, MTT assay and confocal microscopy against Hep-G2 cells clearly illustrated that the drug carrier had no associated cytotoxicity and could easily enter the cells. The release and accumulation of DOX were observed in the cell nuclei. Thus, the DOX-loaded drug carrier killed the cancer cells efficaciously and minimized adverse side effects due to its target effect. These results suggested the as-prepared drug carrier would be of great potential for the controlled release and targeted delivery of DOX.

  15. Reduction of "6"8Ga-PSMA renal uptake with mannitol infusion. Preliminary results

    International Nuclear Information System (INIS)

    Matteucci, Federica; Caroli, Paola; Celli, Monica; Fantini, Lorenzo; Paganelli, Giovanni; Mezzenga, Emilio; Sarnelli, Anna; Di Iorio, Valentina; Moretti, Andrea; Galassi, Riccardo; De Giorgi, Ugo

    2017-01-01

    Urea-based prostate-specific membrane antigen (PSMA) ligands labelled with "6"8Ga or "1"7"7Lu are new tracers with great potential for theranostic approaches in prostate cancer. However, clinical studies have shown that the kidneys are one of the off-target organs along with the salivary and lacrimal glands. In the kidneys, PSMA is physiologically expressed in the apical epithelium of the proximal tubules, and mannitol acts as an osmotic diuretic in these tubules. We investigated the potential of mannitol to reduce renal uptake of "6"8Ga-PSMA. Kidney uptake (SUVmax) was calculated in nine patients undergoing "6"8Ga-PSMA PET/CT at baseline (b-PET/CT) and after intravenous infusion of 500 ml of 10% mannitol (m-PET/CT). Two different infusion schemes for mannitol were used: (1) 500 ml mannitol was infused over 40 min after "6"8Ga-PSMA administration (A-infusion) and (2) 250 ml mannitol was infused over 15 min before and again after "6"8Ga-PSMA administration (B-infusion). In patients receiving the A-infusion, mean SUV_m_a_x increased by 11.9% and 7.4% in the right and left kidney, respectively. In patients receiving the B-infusion, mean SUV_m_a_x decreased by 24.3% and 22.4% in the right and left kidney, respectively. Our preliminary findings indicate that mannitol may play a role in reducing off-target "6"8Ga-PSMA renal uptake. Administration of the osmotic diuretic should be rapid and start before "6"8Ga-PSMA injection. These results warrant dosimetric studies in patients treated with "1"7"7Lu-PSMA to find the best scheme for mannitol administration. (orig.)

  16. Reduction of {sup 68}Ga-PSMA renal uptake with mannitol infusion. Preliminary results

    Energy Technology Data Exchange (ETDEWEB)

    Matteucci, Federica; Caroli, Paola; Celli, Monica; Fantini, Lorenzo; Paganelli, Giovanni [Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Nuclear Medicine Unit, Meldola (Italy); Mezzenga, Emilio; Sarnelli, Anna [Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Medical Physics Unit, Meldola (Italy); Di Iorio, Valentina [Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Oncology Pharmacy, Meldola (Italy); Moretti, Andrea; Galassi, Riccardo [AUSL Romagna, Nuclear Medicine Unit, Forli (Italy); De Giorgi, Ugo [Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Department of Medical Oncology, Meldola (Italy)

    2017-12-15

    Urea-based prostate-specific membrane antigen (PSMA) ligands labelled with {sup 68}Ga or {sup 177}Lu are new tracers with great potential for theranostic approaches in prostate cancer. However, clinical studies have shown that the kidneys are one of the off-target organs along with the salivary and lacrimal glands. In the kidneys, PSMA is physiologically expressed in the apical epithelium of the proximal tubules, and mannitol acts as an osmotic diuretic in these tubules. We investigated the potential of mannitol to reduce renal uptake of {sup 68}Ga-PSMA. Kidney uptake (SUVmax) was calculated in nine patients undergoing {sup 68}Ga-PSMA PET/CT at baseline (b-PET/CT) and after intravenous infusion of 500 ml of 10% mannitol (m-PET/CT). Two different infusion schemes for mannitol were used: (1) 500 ml mannitol was infused over 40 min after {sup 68}Ga-PSMA administration (A-infusion) and (2) 250 ml mannitol was infused over 15 min before and again after {sup 68}Ga-PSMA administration (B-infusion). In patients receiving the A-infusion, mean SUV{sub max} increased by 11.9% and 7.4% in the right and left kidney, respectively. In patients receiving the B-infusion, mean SUV{sub max} decreased by 24.3% and 22.4% in the right and left kidney, respectively. Our preliminary findings indicate that mannitol may play a role in reducing off-target {sup 68}Ga-PSMA renal uptake. Administration of the osmotic diuretic should be rapid and start before {sup 68}Ga-PSMA injection. These results warrant dosimetric studies in patients treated with {sup 177}Lu-PSMA to find the best scheme for mannitol administration. (orig.)

  17. I.v. contrast administration with dual source 128-MDCT: a randomized controlled study comparing 18-gauge nonfenestrated and 20-gauge fenestrated catheters for catheter placement success, infusion rate, image quality, and complications.

    Science.gov (United States)

    Johnson, Pamela T; Christensen, Gale M; Fishman, Elliot K

    2014-06-01

    The purpose of this study was to compare the performance of a 20-gauge fenestrated catheter with an 18-gauge nonfenestrated catheter for i.v. contrast infusion during MDCT. Two hundred five adult outpatients imaged on a dual-source 128-MDCT scanner with arterial phase body CT (flow rates, 5.0-7.5 mL/s) were randomized to either an 18-gauge nonfenestrated or 20-gauge fenestrated catheter. After randomization, any 18-gauge nonfenestrated subjects whose veins were deemed insufficient for that catheter gauge were assigned to a third cohort for placement of a 20-gauge fenestrated catheter. Catheter placement success, infusion rate, contrast volume, maximum pressure, complications, and aortic enhancement levels were recorded. Catheters were placed on the first attempt in 97% (100/103) for 18-gauge nonfenestrated and 94% (96/102) for 20-gauge fenestrated placements and in two or fewer attempts in 99% of both groups. Mean infusion rates (5.74 mL/s for 18-gauge nonfenestrated and 5.58 mL/s for 20-gauge fenestrated placements) and aortic enhancement levels were not significantly different. Maximum pressure was higher with 20-gauge fenestrated catheters (mean ± SD, 230.5 ± 27.6 pounds per square inch [psi]) than 18-gauge nonfenestrated catheters (mean ± SD 215.6 ± 32.8 psi) (p = 0.002). One subject with an 18-gauge nonfenestrated catheter had a high-pressure alarm. In the third cohort, a 20-gauge fenestrated catheter was successfully placed in two or fewer attempts in 85% (28/33), with one minor extravasation attributed to vein insufficiency. A 20-gauge fenestrated catheter performs similarly to an 18-gauge nonfenestrated catheter with respect to i.v. contrast infusion rates and aortic enhancement levels and can be placed in most subjects whose veins are deemed insufficient for an 18-gauge catheter.

  18. Thrombolytic treatment for acute ischemic cerebral stroke: intraarterial urokinase infusion vs. intravenous heparin and urokinase infusion

    International Nuclear Information System (INIS)

    Ko, Gi Young; Suh, Dae Chul; Lee, Jae Hong; Kim, Jun Hyoung; Choi, Choong Gon; Lee, Ho Kyu; Lee, Myoung Chong

    1996-01-01

    To evaluate the efficacy and limitation of intra-arterial urokinase (IAUK) infusion for treatment of acute cerebral stroke. Twenty-seven acute cerebral stroke patients treated with IAUK infusion within six hours of stroke onset were reviewed. All patients showed normal initial brain findings on CT. In 21 patients, urokinase(5-15 x 10 5 IU) was administered through a microcatheter placed into or proximal to occluded segment. Mechanical disruption of thrombus by guidewire was performed in 17 patients. Angiographic and clinical responses and complications after IAUK infusion, were evaluated and the results were compared with those of intravenous heparin(N=19) and urokinase infusion(N=19). Complete or partial angiographic recanalization of occluded segment was found in 18 patients (67%), and neurologic improvement was followed in 14 patients(52%). The degree of improvement on the stroke scale score after IAUK infusion was statistically more significant(p<0.05) than that shown after intravenous heparin and urokinase infusion. Complications after IAUK infusion were large(15%) and small amount intracerebral hemorrhage(15%), contrast leakage into brain parenchyma(11%), and gastrointestinal bleeding(4%). Between the IAVK and the intravenous urokinase infusion group, differences in extent and types of complications were statistically insignificant, but were significantly higher in those two groups than in the intravenous heparin infusion group. IAUK infusion may be effective for the treatment of acute cerebral stroke

  19. TARGET CONTROLLING METHOD OF THE PRICING PROCESS IN THE TOURISM ENTERPRISES

    Directory of Open Access Journals (Sweden)

    N. Sagalakova

    2016-02-01

    Full Text Available Key stages of the pricing process in the tourism enterprises are investigated: subprocess of establishing of nominal value of the new tourism product price and subprocess of adjustment of the established price depending on a situation in the tourism market. For establishing of nominal value of the price it is offered by use of optimizing model, which maximizes the usefulness function of structural parts of the tourism product price. For adjustment of the tourism product price under change of external conditions procedure of installation of the target with use of the process behavior charts of the pricing process is applied. The new methodology of the pricing process controlling in the tourism enterprises, which based on complex application of methods of the statistical processes control and a method of dynamic programming, is presented in article and fully considers one of key features of the tourism sphere - seasonal fluctuations of the tourism product price.

  20. Control of target gene specificity during metamorphosis by the steroid response gene E93

    Science.gov (United States)

    Mou, Xiaochun; Duncan, Dianne M.; Baehrecke, Eric H.; Duncan, Ian

    2012-01-01

    Hormonal control of sexual maturation is a common feature in animal development. A particularly dramatic example is the metamorphosis of insects, in which pulses of the steroid hormone ecdysone drive the wholesale transformation of the larva into an adult. The mechanisms responsible for this transformation are not well understood. Work in Drosophila indicates that the larval and adult forms are patterned by the same underlying sets of developmental regulators, but it is not understood how the same regulators pattern two distinct forms. Recent studies indicate that this ability is facilitated by a global change in the responsiveness of target genes during metamorphosis. Here we show that this shift is controlled in part by the ecdysone-induced transcription factor E93. Although long considered a dedicated regulator of larval cell death, we find that E93 is expressed widely in adult cells at the pupal stage and is required for many patterning processes at this time. To understand the role of E93 in adult patterning, we focused on a simple E93-dependent process, the induction of the Dll gene within bract cells of the pupal leg by EGF receptor signaling. In this system, we show that E93 functions to cause Dll to become responsive to EGF receptor signaling. We demonstrate that E93 is both necessary and sufficient for directing this switch. E93 likely controls the responsiveness of many other target genes because it is required broadly for patterning during metamorphosis. The wide conservation of E93 orthologs suggests that similar mechanisms control life-cycle transitions in other organisms, including vertebrates. PMID:22308414

  1. Control of target gene specificity during metamorphosis by the steroid response gene E93.

    Science.gov (United States)

    Mou, Xiaochun; Duncan, Dianne M; Baehrecke, Eric H; Duncan, Ian

    2012-02-21

    Hormonal control of sexual maturation is a common feature in animal development. A particularly dramatic example is the metamorphosis of insects, in which pulses of the steroid hormone ecdysone drive the wholesale transformation of the larva into an adult. The mechanisms responsible for this transformation are not well understood. Work in Drosophila indicates that the larval and adult forms are patterned by the same underlying sets of developmental regulators, but it is not understood how the same regulators pattern two distinct forms. Recent studies indicate that this ability is facilitated by a global change in the responsiveness of target genes during metamorphosis. Here we show that this shift is controlled in part by the ecdysone-induced transcription factor E93. Although long considered a dedicated regulator of larval cell death, we find that E93 is expressed widely in adult cells at the pupal stage and is required for many patterning processes at this time. To understand the role of E93 in adult patterning, we focused on a simple E93-dependent process, the induction of the Dll gene within bract cells of the pupal leg by EGF receptor signaling. In this system, we show that E93 functions to cause Dll to become responsive to EGF receptor signaling. We demonstrate that E93 is both necessary and sufficient for directing this switch. E93 likely controls the responsiveness of many other target genes because it is required broadly for patterning during metamorphosis. The wide conservation of E93 orthologs suggests that similar mechanisms control life-cycle transitions in other organisms, including vertebrates.

  2. Attractiveness of botanical infusions to ovipositing Culex quinquefasciatus, Cx. nigripalpus, and Cx. erraticus in San Antonio, Texas.

    Science.gov (United States)

    McPhatter, Lee P; Debboun, Mustapha

    2009-12-01

    Field experiments were conducted on the Fort Sam Houston Military Reservation, San Antonio, TX, in fall 2008 to observe the attractiveness of selected botanical infusions to ovipositing female mosquitoes. The following infusions were tested in Centers for Disease Control and Prevention gravid traps: Bermuda grass (Cynodon dactylon), oak leaf (Quercus virginiana), acacia leaf (Acacia schaffneri), rabbit chow (alfalfa pellets), and algae (Spirogyra sp.). Four (Bermuda, acacia, oak, and algae) of the 5 infusions were effective in collecting Culex quinquefasciatus, Cx. nigripalpus, and Cx. erraticus. Of the 4 infusions, Bermuda collected the greatest number of the mosquitoes sampled. Female Aedes albopictus mosquitoes were collected in moderate numbers during this study.

  3. Target-dependent control of synaptic inhibition by endocannabinoids in the thalamus

    Science.gov (United States)

    Sun, Yan-Gang; Wu, Chia-Shan; Lu, Hui-Chen; Beierlein, Michael

    2011-01-01

    Inhibitory neurons in the thalamic reticular nucleus (TRN) play a critical role in controlling information transfer between thalamus and neocortex. GABAergic synapses formed by TRN neurons contact both thalamic relay cells as well as neurons within TRN. These two types of synapses are thought to have distinct roles for the generation of thalamic network activity but their selective regulation is poorly understood. In many areas throughout the brain, retrograde signaling mediated by endocannabinoids acts to dynamically regulate synaptic strength over both short and long time scales. However, retrograde signaling has never been demonstrated in the thalamus. Here, we show that depolarization-induced suppression of inhibition (DSI) is prominent at inhibitory synapses interconnecting TRN neurons. DSI is completely abolished in the presence of a cannabinoid receptor 1 (CB1R) antagonist and in mice lacking CB1Rs. DSI is prevented by DAG lipase inhibitors and prolonged by blocking the 2-arachidonoylglycerol (2-AG) degradation enzyme monoacylglycerol lipase (MGL), indicating that it is mediated by the release of 2-AG from TRN neurons. By contrast, DSI is not observed at TRN synapses targeting thalamic relay neurons. A combination of pharmacological and immunohistochemical data indicate that the differences in endocannabinoid signaling at the two synapses are mediated by a synapse-specific targeting of CB1Rs, as well as differences in endocannabinoid release between the two target neurons. Taken together, our results show that endocannabinoids control transmitter release at specific thalamic synapses, and could dynamically regulate sensory information processing and thalamus-mediated synchronous oscillations. PMID:21697372

  4. Target-nontarget similarity decreases search efficiency and increases stimulus-driven control in visual search.

    Science.gov (United States)

    Barras, Caroline; Kerzel, Dirk

    2017-10-01

    Some points of criticism against the idea that attentional selection is controlled by bottom-up processing were dispelled by the attentional window account. The attentional window account claims that saliency computations during visual search are only performed for stimuli inside the attentional window. Therefore, a small attentional window may avoid attentional capture by salient distractors because it is likely that the salient distractor is located outside the window. In contrast, a large attentional window increases the chances of attentional capture by a salient distractor. Large and small attentional windows have been associated with efficient (parallel) and inefficient (serial) search, respectively. We compared the effect of a salient color singleton on visual search for a shape singleton during efficient and inefficient search. To vary search efficiency, the nontarget shapes were either similar or dissimilar with respect to the shape singleton. We found that interference from the color singleton was larger with inefficient than efficient search, which contradicts the attentional window account. While inconsistent with the attentional window account, our results are predicted by computational models of visual search. Because of target-nontarget similarity, the target was less salient with inefficient than efficient search. Consequently, the relative saliency of the color distractor was higher with inefficient than with efficient search. Accordingly, stronger attentional capture resulted. Overall, the present results show that bottom-up control by stimulus saliency is stronger when search is difficult, which is inconsistent with the attentional window account.

  5. A real-time brain-machine interface combining motor target and trajectory intent using an optimal feedback control design.

    Science.gov (United States)

    Shanechi, Maryam M; Williams, Ziv M; Wornell, Gregory W; Hu, Rollin C; Powers, Marissa; Brown, Emery N

    2013-01-01

    Real-time brain-machine interfaces (BMI) have focused on either estimating the continuous movement trajectory or target intent. However, natural movement often incorporates both. Additionally, BMIs can be modeled as a feedback control system in which the subject modulates the neural activity to move the prosthetic device towards a desired target while receiving real-time sensory feedback of the state of the movement. We develop a novel real-time BMI using an optimal feedback control design that jointly estimates the movement target and trajectory of monkeys in two stages. First, the target is decoded from neural spiking activity before movement initiation. Second, the trajectory is decoded by combining the decoded target with the peri-movement spiking activity using an optimal feedback control design. This design exploits a recursive Bayesian decoder that uses an optimal feedback control model of the sensorimotor system to take into account the intended target location and the sensory feedback in its trajectory estimation from spiking activity. The real-time BMI processes the spiking activity directly using point process modeling. We implement the BMI in experiments consisting of an instructed-delay center-out task in which monkeys are presented with a target location on the screen during a delay period and then have to move a cursor to it without touching the incorrect targets. We show that the two-stage BMI performs more accurately than either stage alone. Correct target prediction can compensate for inaccurate trajectory estimation and vice versa. The optimal feedback control design also results in trajectories that are smoother and have lower estimation error. The two-stage decoder also performs better than linear regression approaches in offline cross-validation analyses. Our results demonstrate the advantage of a BMI design that jointly estimates the target and trajectory of movement and more closely mimics the sensorimotor control system.

  6. A real-time brain-machine interface combining motor target and trajectory intent using an optimal feedback control design.

    Directory of Open Access Journals (Sweden)

    Maryam M Shanechi

    Full Text Available Real-time brain-machine interfaces (BMI have focused on either estimating the continuous movement trajectory or target intent. However, natural movement often incorporates both. Additionally, BMIs can be modeled as a feedback control system in which the subject modulates the neural activity to move the prosthetic device towards a desired target while receiving real-time sensory feedback of the state of the movement. We develop a novel real-time BMI using an optimal feedback control design that jointly estimates the movement target and trajectory of monkeys in two stages. First, the target is decoded from neural spiking activity before movement initiation. Second, the trajectory is decoded by combining the decoded target with the peri-movement spiking activity using an optimal feedback control design. This design exploits a recursive Bayesian decoder that uses an optimal feedback control model of the sensorimotor system to take into account the intended target location and the sensory feedback in its trajectory estimation from spiking activity. The real-time BMI processes the spiking activity directly using point process modeling. We implement the BMI in experiments consisting of an instructed-delay center-out task in which monkeys are presented with a target location on the screen during a delay period and then have to move a cursor to it without touching the incorrect targets. We show that the two-stage BMI performs more accurately than either stage alone. Correct target prediction can compensate for inaccurate trajectory estimation and vice versa. The optimal feedback control design also results in trajectories that are smoother and have lower estimation error. The two-stage decoder also performs better than linear regression approaches in offline cross-validation analyses. Our results demonstrate the advantage of a BMI design that jointly estimates the target and trajectory of movement and more closely mimics the sensorimotor control system.

  7. SCF(SAP) controls organ size by targeting PPD proteins for degradation in Arabidopsis thaliana.

    Science.gov (United States)

    Wang, Zhibiao; Li, Na; Jiang, Shan; Gonzalez, Nathalie; Huang, Xiahe; Wang, Yingchun; Inzé, Dirk; Li, Yunhai

    2016-04-06

    Control of organ size by cell proliferation and growth is a fundamental process, but the mechanisms that determine the final size of organs are largely elusive in plants. We have previously revealed that the ubiquitin receptor DA1 regulates organ size by repressing cell proliferation in Arabidopsis. Here we report that a mutant allele of STERILE APETALA (SAP) suppresses the da1-1 mutant phenotype. We show that SAP is an F-box protein that forms part of a SKP1/Cullin/F-box E3 ubiquitin ligase complex and controls organ size by promoting the proliferation of meristemoid cells. Genetic analyses suggest that SAP may act in the same pathway with PEAPOD1 and PEAPOD2, which are negative regulators of meristemoid proliferation, to control organ size, but does so independently of DA1. Further results reveal that SAP physically associates with PEAPOD1 and PEAPOD2, and targets them for degradation. These findings define a molecular mechanism by which SAP and PEAPOD control organ size.

  8. Carbon Nanotube Infused Launch Vehicle Structures

    Data.gov (United States)

    National Aeronautics and Space Administration — For the past 5 years Orbital ATK has been investing in, prototyping, and testing carbon nanotube infused composite structures to evaluate their impact on launch...

  9. A randomized trial of automated intermittent ropivacaine administration vs. continuous infusion in an interscalene catheter

    DEFF Research Database (Denmark)

    Oxlund, J; Clausen, A H; Venø, S

    2018-01-01

    BACKGROUND: Ultrasound-guided interscalene nerve block with ropivacaine as local anesthetic agent given as boluses or continuous infusion is the preferred pain management after major shoulder surgery. The use of automated intermittent boluses has been shown to be superior to continuous infusion....... Patients were allocated to either automated intermittent boluses with 16 mg ropivacaine every 2 h combined with patient-controlled administration or to a conventional regimen of continuous infusion of 8 mg/h (4 ml/h) of ropivacaine combined with patient controlled administration (2 ml, lockout time 30 min......). Pain (Visual Analog Scale, VAS) was assessed every 8 h postoperatively. RESULTS: Fifty-seven patients completed the study, 29 in the continuous infusion group and 28 in the automated intermittent bolus group. Shoulder arthroplasty was performed in 49 (86%) of the cases. There were no significant...

  10. Targeted subsidy for malaria control with treated nets using a discount voucher system in Tanzania.

    Science.gov (United States)

    Mushi, Adiel K; Schellenberg, Joanna R M Armstrong; Mponda, Haji; Lengeler, Christian

    2003-06-01

    During the last decade insecticide-treated nets have become a key strategy for malaria control. Social marketing is an appealing tool for getting such nets to poor rural African communities who are most afflicted by malaria. This approach usually involves subsidized prices to make nets and insecticide more affordable and help establish a commercial market. We evaluated a voucher system for targeted subsidy of treated nets in young children and pregnant women in two rural districts of southern Tanzania. Qualitative work involved focus group discussions with community leaders, male and female parents of children under 5 years. In-depth interviews were held with maternal and child health clinic staff and retail agents. Quantitative data were collected through interviewing more than 750 mothers of children under 5 years during a cluster sample survey of child health. The voucher return rate was extremely high at 97% (7720/8000). However, 2 years after the start of the scheme awareness among target groups was only 43% (45/104), and only 12% of women (12/103; 95% CI 4-48%) had used a voucher towards the cost of a net. We found some evidence of increased voucher use among least poor households, compared with the poorest households. On the basis of these results we renewed our information, education and communication (IEC) campaign about vouchers. Discount vouchers are a feasible system for targeted subsidies, although a substantial amount of time and effort may be needed to achieve high awareness and uptake - by which we mean the proportion of eligible women who used the vouchers - among those targeted. Within a poor society, vouchers may not necessarily increase health equity unless they cover a high proportion of the total cost: since some cash is needed when using a voucher as part-payment, poorer women among the target group are likely to have lower uptake than richer women. The vouchers have two important additional functions: strengthening the role of public health

  11. Muscle inactivity and activity patterns after sedentary time--targeted randomized controlled trial.

    Science.gov (United States)

    Pesola, Arto J; Laukkanen, Arto; Haakana, Piia; Havu, Marko; Sääkslahti, Arja; Sipilä, Sarianna; Finni, Taija

    2014-11-01

    Interventions targeting sedentary time are needed. We used detailed EMG recordings to study the short-term effectiveness of simple sedentary time-targeted tailored counseling on the total physical activity spectrum. This cluster randomized controlled trial was conducted between 2011 and 2013 (InPact, ISRCTN28668090), and short-term effectiveness of counseling is reported in the present study. A total of 133 office workers volunteered to participate, from which muscle activity data were analyzed from 48 (intervention, n = 24; control, n = 24). After a lecture, face-to-face tailored counseling was used to set contractually binding goals regarding breaking up sitting periods and increasing family based physical activity. Primary outcome measures were assessed 11.8 ± 1.1 h before and a maximum of 2 wk after counseling including quadriceps and hamstring muscle inactivity time, sum of the five longest muscle inactivity periods, and light muscle activity time during work, commute, and leisure time. Compared with those in the controls, counseling decreased the intervention group's muscle inactivity time by 32.6 ± 71.8 min from 69.1% ± 8.5% to 64.6% ± 10.9% (whole day, P work, P activity time increased by 20.6 ± 52.6 min, from 22.2% ± 7.9% to 25.0% ± 9.7% (whole day, P work, P work time, average EMG amplitude (percentage of EMG during maximal voluntary isometric contraction (MVC) (%EMG MVC)) increased from 1.6% ± 0.9% to 1.8% ± 1.0% (P activity. During work time, average EMG amplitude increased by 13%, reaching an average of 1.8% of EMG MVC. If maintained, this observed short-term effect may have health-benefiting consequences.

  12. Modeling and optimization of tissue 10B concentration and dosimetry for arbitrary BPA-F infusion schedules in humans

    International Nuclear Information System (INIS)

    Kiger, W.S. III; Newton, T.H.; Palmer, M.R.

    2000-01-01

    Separate compartmental models have been derived for the concentration of 10 B resulting from BPA-F infusion in the central vascular space (i.e., blood or, more appropriately, plasma) and in glioblastoma multiforme and normal brain. By coupling the model for the temporal variation of 10 B concentration in the central vascular space with that for tissue, the dynamic behavior of the 10 B concentration and the resulting dosimetry in the relevant tissues and blood may be predicted for arbitrary infusion schedules. This coupled model may be used as a tool for identifying the optimal time for BNCT irradiation and optimal BPA-F infusion schedule (i.e., temporal targeting) in humans without the need for expensive and time-consuming pharmacokinetic studies for every infusion schedule considered. This model was used to analyze the concentration profiles resulting from a wide range of infusion schedules and their implications for dosimetry. (author)

  13. Infusion Antihypoxants in Children with Critical Conditions

    Directory of Open Access Journals (Sweden)

    Yu. S. Aleksandrovich

    2014-01-01

    Full Text Available Hypoxia and mitochondrial damage are a key component of the pathogenesis and tanatogenesis of a critical condition, suggesting the need for its prevention and maximally rapid elimination. Objective: to analyze the efficacy and safety of infusion antihypoxants used in critically ill children from the results of researches. Materials and methods. Available investigations dealing with infusion therapy in children and papers on the use of infusion antihypoxants in adults in 2005 to 2013 were sought in the medical databases PubMed and Cochrane Library with their free availability and analyzed. Results. The analysis included 70 trials. The pathophysiology and pathobiochemistry of hypoxia in critically ill children are given; the current principles of its correction by infusion therapy are considered in detail. Particular emphasis is placed on trials evaluating the efficacy and safety of succinic acid solutions in children. Main indications for and contraindications to their use are demonstrated. Conclusion. The use of Krebs cycle substrate-based infusion antihypoxants (malate, succinate is an effective and promising procedure for the intensive therapy and correction of hypoxia in both adults and children with critical conditions. Considering the fact that papers on the use of infusion antihypoxants in children are scanty, there is a need for further investigations. 

  14. The study of target delineation and target movement of whole breast assisted by active breathing control in intensity modulated radiotherapy after breast conservative surgery

    International Nuclear Information System (INIS)

    Li Jianbing; Yu Jinming; Ma Zhifang; Lu Jie; Sun Tao; Guo Shoufang; Wang Jingguo

    2009-01-01

    Objective: To explore the influence of different delineators and different delineating time on target determination of the whole breast and to explore intrafraction and interfraction target displacements of the breast on moderate deep inspiration breathing hold (mDIBH) assisted by active breathing control (ABC) alter breast conservative surgery. Methods: Twenty patients received primary CT-simulation assisted by ABC to get five sets of CT image on the three breathing condition which included one set from free breath (FB), two sets from mDIBH and two sets from deep expiration breathing control (DEBH). After radiotherapy with ten to fifteen fractions, the repeat CT-simulation was carried out to get the same five sets of CT image as the primary CT- simulation. The whole breast target were delineated at different time by the same delineator and delineated respectively by five delineators on the first set of CT images got with mDIBH from the primary CT-simulation, and to compare the influence of delineator and delineating time on the whole breast target. The total silver clips in the cavity were marked respectively on the two sets of CT images got with mDIBH from the primary CT-simulation, and to compare the intrafraction displacement of geometric body structured by the total of silver clips. The two ribs near the isocentric plane of the breast target were delineated respectively on two sets of the mDIBH CT image from the primary CT-simulation and on one set of the mDIBH CT image from the repeat CT-simulation, and comparing the movement of the point of interest (POI) of the ribs delineated to get the value of intrafraction and interfraction thoracic expansion. Results: There was not statistically significant between the four volumes of whole breast targets delineated by the same delineator at different time, but with statistics significant between the volumes of whole breast target delineated by the different delineators ( F=19.681, P=0.000). There was not statistically

  15. Adaptive estimation for control of uncertain nonlinear systems with applications to target tracking

    Science.gov (United States)

    Madyastha, Venkatesh Kattigari

    2005-08-01

    Design of nonlinear observers has received considerable attention since the early development of methods for linear state estimation. The most popular approach is the extended Kalman filter (EKF), that goes through significant degradation in the presence of nonlinearities, particularly if unmodeled dynamics are coupled to the process and the measurement. For uncertain nonlinear systems, adaptive observers have been introduced to estimate the unknown state variables where no priori information about the unknown parameters is available. While establishing global results, these approaches are applicable only to systems transformable to output feedback form. Over the recent years, neural network (NN) based identification and estimation schemes have been proposed that relax the assumptions on the system at the price of sacrificing on the global nature of the results. However, most of the NN based adaptive observer approaches in the literature require knowledge of the full dimension of the system, therefore may not be suitable for systems with unmodeled dynamics. We first propose a novel approach to nonlinear state estimation from the perspective of augmenting a linear time invariant observer with an adaptive element. The class of nonlinear systems treated here are finite but of otherwise unknown dimension. The objective is to improve the performance of the linear observer when applied to a nonlinear system. The approach relies on the ability of the NNs to approximate the unknown dynamics from finite time histories of available measurements. Next we investigate nonlinear state estimation from the perspective of adaptively augmenting an existing time varying observer, such as an EKF. EKFs find their applications mostly in target tracking problems. The proposed approaches are robust to unmodeled dynamics, including unmodeled disturbances. Lastly, we consider the problem of adaptive estimation in the presence of feedback control for a class of uncertain nonlinear systems

  16. Effect of burst swimming and adrenaline infusion on O2 consumption and CO2 excretion in rainbow trout, Salmo gairdneri

    DEFF Research Database (Denmark)

    Steffensen, J F; Tufts, B L; Randall, D J

    1987-01-01

    control values. 2. Infusion of adrenaline into resting fish had no significant effect on oxygen consumption or carbon dioxide excretion and therefore there was no significant change in the respiratory exchange ratio. 3. This infusion of adrenaline caused a significant elevation in the red blood cell p...

  17. Effect of burst swimming and adrenaline infusion on O2 consumption and CO2 excretion in rainbow trout, Salmo gairdneri

    DEFF Research Database (Denmark)

    Steffensen, J F; Tufts, B L; Randall, D J

    1987-01-01

    control values. 2. Infusion of adrenaline into resting fish had no significant effect on oxygen consumption or carbon dioxide excretion and therefore there was no significant change in the respiratory exchange ratio. 3. This infusion of adrenaline caused a significant elevation in the red blood cell pH...

  18. Cardiovascular collapse during amiodarone infusion in a hemodynamically compromised child with refractory supraventricular tachycardia

    Directory of Open Access Journals (Sweden)

    Sunil Saharan

    2015-01-01

    Full Text Available We describe a 7-week-old female infant who presented with refractory supraventricular tachycardia (SVT. During amiodarone infusion, she developed hypotension and cardiac arrest requiring extracorporeal membrane oxygenation (ECMO support. After successful control of SVT using procainamide infusion, she was weaned from ECMO and discharged home on oral flecainide. We conclude that infants with acidosis, ventricular dysfunction, and prolonged refractory SVT may poorly tolerate intravenous amiodarone.

  19. Evaluation of pharmacokinetic model designs for subcutaneous infusion of insulin aspart

    DEFF Research Database (Denmark)

    Mansell, Erin J.; Schmidt, Signe; Docherty, Paul D.

    2017-01-01

    Effective mathematical modelling of continuous subcutaneous infusion pharmacokinetics should aid understanding and control in insulin therapy. Thorough analysis of candidate model performance is important for selecting the appropriate models. Eight candidate models for insulin pharmacokinetics...... included a range of modelled behaviours, parameters and complexity. The models were compared using clinical data from subjects with type 1 diabetes with continuous subcutaneous insulin infusion. Performance of the models was compared through several analyses: R2 for goodness of fit; the Akaike Information...

  20. Evaluation of sodium nitroprusside for controlled hypotension in children during surgery

    Directory of Open Access Journals (Sweden)

    David R Drover

    2015-07-01

    Full Text Available Purpose. (1 To define the onset and offset of the blood-pressure-lowering effects of sodium nitroprusside (SNP for use in developing instructions for dose titration in children undergoing a surgical or medical procedure, and (2 to assess the safety of SNP administration in pediatric patients requiring controlled reduction of blood pressure.Methods. We conducted a randomized, double-blind, parallel-group, dose-ranging, effect-controlled, multicenter study of intravenous (IV infusions of SNP in pediatric patients <17 years, who required controlled hypotension for at least 2 hours while undergoing a surgical or medical procedure. A blinded SNP dose of 0.3, 1, 2, or 3 µg/kg/min was infused for 30 min, followed by open-label administration for at least 90 min. Both infusions were titrated to effect.Results. The final intent-to-treat group comprised 203 patients. Significant reductions in mean arterial pressure (MAP from baseline were observed for all four doses at 20 and 25 minutes after the start of infusion (p≤0.009 and p≤0.010 for each time, respectively. Overall, 98.5% of the patients achieved the target MAP; 72.9% first achieved the target MAP during the blinded infusion. The mean infusion rate at target MAP was 1.07 µg/kg/min.Conclusion. We determined that 0.3 µg/kg/m is a reasonable starting dose for SNP in pediatric patients requiring controlled hypotension. The infusion rate can then be increased to achieve the desired reduction in blood pressure. On the basis of our results, we found an average infusion rate of 1 µg/kg/min might be appropriate. Of note, no cyanide toxicity was reported, and no measureable cyanide levels were detected in any blood samples obtained during the study.http://clinicaltrials.gov/show/NCT00135668

  1. Design of planning target volume margin using an active breathing control and Varian image-guided radiotherapy (IGRT) system in unresectable liver tumor

    International Nuclear Information System (INIS)

    Yue Jinbo; Yu Jinming; Liu Jing; Liu Tonghai; Yin Yong; Shi Xuetao; Song Jinlong

    2007-01-01

    Objective: To define the planning target volume(PTV) margin with an active breathing control (ABC) and the Varian image-guided radiotherapy (IGRT) system. Methods: Thirteen patients with liver cancer were treated with radiotherapy from May 2006 to September 2006. Prior to radiotherapy, all patients had undergone transarterial chemoembolization (TACE) by infusing a mixture of iodized oil contrast medium and chemotherapeutic agents, kV fluoroscopy was used to measure the potential motion of lipiodol spot positions during ABC breath-holds. ABC was used for planning CT scan and radiation delivery, with the breath held at the same phase of the respiratory cycle (near end-exhalation). Cone beam CT (CBCT) was taken using Varian IGRT system, which was then compared online with planning CT using a 3 D-3 D matching tool. Analysis relied on lipiodol spots on planning CT and CBCT manually. The treatment table was moved to produce acceptable setup before treatment delivery. Repeated CBCT image and another analysis were obtained after irradiation. Results: No motion of the intrahepatic tumor was observed on fluoroscopy during ABC breath-holds. The estimated required PTV margins, calculated according to the Stroom formula, were 4.4 mm, 5.3 mm and 7.8 mm in the x, y and z axis directions before radiotherapy. The corresponding parameters were 2.5m, 2.6 mm and 3.9 mm after radiotherapy. Conclusions: We have adopted a PTV margin of 5 mm, 6 mm and 8 mm in the x, y and z axis directions with ABC, and 3,3 and 4 mm with ABC and on-line kilovoltage CBCT. (authors)

  2. Contextual control over selective attention: evidence from a two-target method.

    Science.gov (United States)

    MacLellan, Ellen; Shore, David I; Milliken, Bruce

    2015-07-01

    Selective attention is generally studied with conflict tasks, using response time as the dependent measure. Here, we study the impact of selective attention to a first target, T1, presented simultaneously with a distractor, on the accuracy of subsequent encoding of a second target item, T2. This procedure produces an "attentional blink" (AB) effect much like that reported in other studies, and allowed us to study the influence of context on cognitive control with a novel method. In particular, we examined whether preparation to attend selectively to T1 had an impact on the selective encoding of T1 that would translate to report of T2. Preparation to attend selectively was manipulated by varying whether difficult selective attention T1 trials were presented in the context of other difficult selective attention T1 trials. The results revealed strong context effects of this nature, with smaller AB effects when difficult selective attention T1 trials were embedded in a context with many, rather than few, other difficult selective attention T1 trials. Further, the results suggest that both the trial-to-trial local context and the block-wide global context modulate performance in this task.

  3. HAND2 Target Gene Regulatory Networks Control Atrioventricular Canal and Cardiac Valve Development.

    Science.gov (United States)

    Laurent, Frédéric; Girdziusaite, Ausra; Gamart, Julie; Barozzi, Iros; Osterwalder, Marco; Akiyama, Jennifer A; Lincoln, Joy; Lopez-Rios, Javier; Visel, Axel; Zuniga, Aimée; Zeller, Rolf

    2017-05-23

    The HAND2 transcriptional regulator controls cardiac development, and we uncover additional essential functions in the endothelial to mesenchymal transition (EMT) underlying cardiac cushion development in the atrioventricular canal (AVC). In Hand2-deficient mouse embryos, the EMT underlying AVC cardiac cushion formation is disrupted, and we combined ChIP-seq of embryonic hearts with transcriptome analysis of wild-type and mutants AVCs to identify the functionally relevant HAND2 target genes. The HAND2 target gene regulatory network (GRN) includes most genes with known functions in EMT processes and AVC cardiac cushion formation. One of these is Snai1, an EMT master regulator whose expression is lost from Hand2-deficient AVCs. Re-expression of Snai1 in mutant AVC explants partially restores this EMT and mesenchymal cell migration. Furthermore, the HAND2-interacting enhancers in the Snai1 genomic landscape are active in embryonic hearts and other Snai1-expressing tissues. These results show that HAND2 directly regulates the molecular cascades initiating AVC cardiac valve development. Copyright © 2017 The Author(s). Published by Elsevier Inc. All rights reserved.

  4. Evolutionary control: Targeted change of allele frequencies in natural populations using externally directed evolution.

    Science.gov (United States)

    Shafiey, Hassan; Gossmann, Toni I; Waxman, David

    2017-04-21

    Random processes in biology, in particular random genetic drift, often make it difficult to predict the fate of a particular mutation in a population. Using principles of theoretical population genetics, we present a form of biological control that ensures a focal allele's frequency, at a given locus, achieves a prescribed probability distribution at a given time. This control is in the form of an additional evolutionary force that acts on a population. We provide the mathematical framework that determines the additional force. Our analysis indicates that generally the additional force depends on the frequency of the focal allele, and it may also depend on the time. We argue that translating this additional force into an externally controlled process, which has the possibility of being implemented in a number of different ways corresponding to selection, migration, mutation, or a combination of these, may provide a flexible instrument for targeted change of traits of interest in natural populations. This framework may be applied, or used as an informed form of guidance, in a variety of different biological scenarios including: yield and pesticide optimisation in crop production, biofermentation, the local regulation of human-associated natural populations, such as parasitic animals, or bacterial communities in hospitals. Copyright © 2017 Elsevier Ltd. All rights reserved.

  5. In silico models for predicting vector control chemicals targeting Aedes aegypti

    Science.gov (United States)

    Devillers, J.; Lagneau, C.; Lattes, A.; Garrigues, J.C.; Clémenté, M.M.; Yébakima, A.

    2014-01-01

    Human arboviral diseases have emerged or re-emerged in numerous countries worldwide due to a number of factors including the lack of progress in vaccine development, lack of drugs, insecticide resistance in mosquitoes, climate changes, societal behaviours, and economical constraints. Thus, Aedes aegypti is the main vector of the yellow fever and dengue fever flaviviruses and is also responsible for several recent outbreaks of the chikungunya alphavirus. As for the other mosquito species, the A. aegypti control relies heavily on the use of insecticides. However, because of increasing resistance to the different families of insecticides, reduction of Aedes populations is becoming increasingly difficult. Despite the unquestionable utility of insecticides in fighting mosquito populations, there are very few new insecticides developed and commercialized for vector control. This is because the high cost of the discovery of an insecticide is not counterbalanced by the ‘low profitability’ of the vector control market. Fortunately, the use of quantitative structure–activity relationship (QSAR) modelling allows the reduction of time and cost in the discovery of new chemical structures potentially active against mosquitoes. In this context, the goal of the present study was to review all the existing QSAR models on A. aegypti. The homology and pharmacophore models were also reviewed. Specific attention was paid to show the variety of targets investigated in Aedes in relation to the physiology and ecology of the mosquito as well as the diversity of the chemical structures which have been proposed, encompassing man-made and natural substances. PMID:25275884

  6. PCSK 9, a new therapeutic target for the control of hypercholesterolemia

    Directory of Open Access Journals (Sweden)

    Roberto Antonio Fuentealba Leyton

    2016-12-01

    Full Text Available Hypercholesterolemia is produced not only by a sedentary lifestyle and nutritional disorders but also due to genetic factors that result in elevated serum lipids, mainly low-density lipoproteins associated cholesterol (LDL-C, contributing as a risk factor for the development of cardiovascular diseases. A therapeutic diet and statins are the first line strategies aimed to reduce the levels of LDL-C in hypercholesterolemic patients. Nevertheless, statins are not devoid of side effects, or a lack of efficiency in some patients. The proprotein convertase subtilisin/kexin type 9 (PCSK9, a serine protease has been described recently to play an important role in the metabolism of LDL-C, favoring the degradation of its membrane receptor (LDLR in the hepatocyte. This makes PCSK9 an excellent therapeutic target for the control of LDL-C in hypercholesterolemic patients, reducing their cardiovascular risks. The best-characterized approach so far to control the activity PCSK9 has been the use of monoclonal antibodies. There have been several clinical trials that tested the use of anti-PCSK antibodies showing high effectivity in the control of serum LDL-C and minimal side effects. This review describes part of those studies and their results with the use of this new pharmaceutical that is still in development but shows tremendous potential

  7. EFEKTIVITAS BERBAGAI KONSENTRASI FORMULASI CAIR Bacillus thuringiensis H-14 GALUR LOKAL DALAM MEDIA INFUS KEDELAI TERHADAP JENTIKAnopheles maculatus DI KECAMATAN KOKAP KABUPATEN KULON PROGO DIY

    Directory of Open Access Journals (Sweden)

    Blondine Ch.P Blondine Ch.P

    2012-10-01

    Full Text Available Bacillus thuringiensis H-14 (local strain is a pathogenic bacteria which specijiclly target to mosquito larvae. It is safe for human, mammals and does not cause any environmental pollution. The aims of this study were to measure 1. the efficacy of liquid formula of B.thuringiensis H-14 local strain at several concentration in soybean infusion medium against An. maculatus, 2. the determine optimum concentration of the liquid formula of Bacillus thuringiensis H-14 local strain in soybean infusion medium against An. maculatus larvae in Kokap District Kulon Progo Regency DIY. This research was based on the quasi experiment with the Pre test-Post test Control Group Design. We tested 3 liquid formula of B. thuringiensis H-14 local strain with concentration of 1 x LC90 5 x LC90 and 10 x LC90 in 9 ponds each formula and one control sample. Other 9 ponds were selected as a control group of An. maculatus with 0.20 to 1.20 m2 width. The effectiveness ofthe liquid formula of B.thuringiensis H-14 local strain in soybean infusion medium concentration of 0.059 ml/l (1 x LC90, 0.295 ml/l (5 x LC90 and 0.59 ml/l (10 x LC90 against An. maculatus larvae which reached 70% were survived for 6.75 days, 8.35 days and 12.58 days. There was a significant difference between the effectiveness of the liquid formula of B. thuringiensis H-14 local strain in soybean infusion medium concentration of 0.059 ml/l (1 x LC90 and 0.295 ml/l (5 x LC90 and 0.59 ml/l (10 x LC90 at p<0.05. The liquid formula of B.thuringiensis H-14 local strain in soybean infusion medium could be used as the vector control agent. Keywords: Effectiveness , B. thuringiensis H-14, Soybean infusion

  8. The effect of ethanol infusion on the size of the ablated lesion in radiofrequency thermal ablation: A pilot study

    International Nuclear Information System (INIS)

    Kim, Young Sun; Rhim, Hyun Chul; Koh, Byung Hee; Cho, On Koo; Seo, Heung Suk; Kim, Yong Soo; Joo, Kyoung Bin

    2001-01-01

    To assess the effect of ethanol infusion on the size of ablated lesion during radiofrequency (RF) thermal ablation. We performed an ex vivo experimental study using a total of 15 pig livers. Three groups were designed: 1)normal control (n=10), 2) saline infusion (n=10) 3) ethanol infusion (n=10). Two radiofrequency ablations were done using a 50 watt RF generator and a 15 guage expandable elections with four prongs in each liver. During ablation for 8 minutes, continuous infusion of fluid at a rate of 0.5 ml/min through the side arm of electrode was performed. We checked the frequency of the 'impeded-out' phenomenon due to abrupt increase of impedance during ablation. Size of ablated lesion was measured according to length, width, height, and subsequently volume after the ablations. The sizes of the ablated lesions were compared between the three groups. 'Impeded-out' phenomenon during ablation was noted 4 times in control group, although that never happened in saline or ethanol infusion groups. There were significant differences in the volumes of ablated lesions between control group (10.62 ± 1.45 cm 3 ) and saline infusion group (15.33 ± 2.47 cm 3 ), and saline infusion group and ethanol infusion group (18.78 ± 3.58 cm 3 ) (p<0.05). Fluid infusion during radiofrequency thermal ablation decrease a chance of charming and increase the volume of the ablated lesion. Ethanol infusion during ablation may induce larger volume of ablated lesion than saline infusion.

  9. Construction of Target Controllable Image Segmentation Model Based on Homotopy Perturbation Technology

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    Shu-Li Mei

    2013-01-01

    Full Text Available Based on the basic idea of the homotopy perturbation method which was proposed by Jihuan He, a target controllable image segmentation model and the corresponding multiscale wavelet numerical method are constructed. Using the novel model, we can get the only right object from the multiobject images, which is helpful to avoid the oversegmentation and insufficient segmentation. The solution of the variational model is the nonlinear PDEs deduced by the variational approach. So, the bottleneck of the variational model on image segmentation is the lower efficiency of the algorithm. Combining the multiscale wavelet interpolation operator and HPM, a semianalytical numerical method can be obtained, which can improve the computational efficiency and accuracy greatly. The numerical results on some images segmentation show that the novel model and the numerical method are effective and practical.

  10. Prospects for immunocontraception in feral horse population control: exploring novel targets for an equine fertility vaccine.

    Science.gov (United States)

    Swegen, Aleona; Aitken, R John

    2016-06-01

    Feral horses populate vast land areas and often induce significant ecological and economic damage throughout the landscape. Non-lethal population control methods are considered favourable in light of animal welfare, social and ethical considerations; however, no single effective, safe and species-specific contraceptive agent is currently available for use in free-ranging wild and feral horses. This review explores aspects of equine reproductive physiology that may provide avenues for the development of specific and long-lasting immunocontraceptive vaccines and some of the novel strategies that may be employed to facilitate appropriate antigen discovery in future research. Potential antigen targets pertaining to spermatozoa, the ovary and oocyte, as well as the early conceptus and its associated factors, are reviewed in the context of their suitability for immunocontraceptive vaccine development.

  11. Depressed left ventricular performance. Response to volume infusion in patients with sepsis and septic shock

    International Nuclear Information System (INIS)

    Ognibene, F.P.; Parker, M.M.; Natanson, C.; Shelhamer, J.H.; Parrillo, J.E.

    1988-01-01

    Volume infusion, to increase preload and to enhance ventricular performance, is accepted as initial management of septic shock. Recent evidence has demonstrated depressed myocardial function in human septic shock. We analyzed left ventricular performance during volume infusion using serial data from simultaneously obtained pulmonary artery catheter hemodynamic measurements and radionuclide cineangiography. Critically ill control subjects (n = 14), patients with sepsis but without shock (n = 21), and patients with septic shock (n = 21) had prevolume infusion hemodynamic measurements determined and received statistically similar volumes of fluid resulting in similar increases in pulmonary capillary wedge pressure. There was a strong trend (p = 0.004) toward less of a change in left ventricular stroke work index (LVSWI) after volume infusion in patients with sepsis and septic shock compared with control subjects. The LVSWI response after volume infusion was significantly less in patients with septic shock when compared with critically ill control subjects (p less than 0.05). These data demonstrate significantly altered ventricular performance, as measured by LVSWI, in response to volume infusion in patients with septic shock

  12. Targeted physiotherapy for patellofemoral joint osteoarthritis: A protocol for a randomised, single-blind controlled trial

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    Schache Anthony G

    2008-09-01

    Full Text Available Abstract Background The patellofemoral joint (PFJ is one compartment of the knee that is frequently affected by osteoarthritis (OA and is a potent source of OA symptoms. However, there is a dearth of evidence for compartment-specific treatments for PFJ OA. Therefore, this project aims to evaluate whether a physiotherapy treatment, targeted to the PFJ, results in greater improvements in pain and physical function than a physiotherapy education intervention in people with symptomatic and radiographic PFJ OA. Methods 90 people with PFJ OA (PFJ-specific history, signs and symptoms and radiographic evidence of PFJ OA will be recruited from the community and randomly allocated into one of two treatments. A randomised controlled trial adhering to CONSORT guidelines will evaluate the efficacy of physiotherapy (8 individual sessions over 12 weeks, as well as a home exercise program 4 times/week compared to a physiotherapist-delivered OA education control treatment (8 individual sessions over 12 weeks. Physiotherapy treatment will consist of (i quadriceps muscle retraining; (ii quadriceps and hip muscle strengthening; (iii patellar taping; (iv manual PFJ and soft tissue mobilisation; and (v OA education. Resistance and dosage of exercises will be tailored to the participant's functional level and clinical state. Primary outcomes will be evaluated by a blinded examiner at baseline, 12 weeks and 9 months using validated and reliable pain, physical function and perceived global effect scales. All analyses will be conducted on an intention-to-treat basis using linear mixed regression models, including respective baseline scores as a covariate, subjects as a random effect, treatment condition as a fixed factor and the covariate by treatment interaction. Conclusion This RCT is targeting PFJ OA, an important sub-group of knee OA patients, with a specifically designed conservative intervention. The project's outcome will influence PFJ OA rehabilitation, with the

  13. Targeted physiotherapy for patellofemoral joint osteoarthritis: A protocol for a randomised, single-blind controlled trial

    Science.gov (United States)

    Crossley, Kay M; Vicenzino, Bill; Pandy, Marcus G; Schache, Anthony G; Hinman, Rana S

    2008-01-01

    Background The patellofemoral joint (PFJ) is one compartment of the knee that is frequently affected by osteoarthritis (OA) and is a potent source of OA symptoms. However, there is a dearth of evidence for compartment-specific treatments for PFJ OA. Therefore, this project aims to evaluate whether a physiotherapy treatment, targeted to the PFJ, results in greater improvements in pain and physical function than a physiotherapy education intervention in people with symptomatic and radiographic PFJ OA. Methods 90 people with PFJ OA (PFJ-specific history, signs and symptoms and radiographic evidence of PFJ OA) will be recruited from the community and randomly allocated into one of two treatments. A randomised controlled trial adhering to CONSORT guidelines will evaluate the efficacy of physiotherapy (8 individual sessions over 12 weeks, as well as a home exercise program 4 times/week) compared to a physiotherapist-delivered OA education control treatment (8 individual sessions over 12 weeks). Physiotherapy treatment will consist of (i) quadriceps muscle retraining; (ii) quadriceps and hip muscle strengthening; (iii) patellar taping; (iv) manual PFJ and soft tissue mobilisation; and (v) OA education. Resistance and dosage of exercises will be tailored to the participant's functional level and clinical state. Primary outcomes will be evaluated by a blinded examiner at baseline, 12 weeks and 9 months using validated and reliable pain, physical function and perceived global effect scales. All analyses will be conducted on an intention-to-treat basis using linear mixed regression models, including respective baseline scores as a covariate, subjects as a random effect, treatment condition as a fixed factor and the covariate by treatment interaction. Conclusion This RCT is targeting PFJ OA, an important sub-group of knee OA patients, with a specifically designed conservative intervention. The project's outcome will influence PFJ OA rehabilitation, with the potential to reduce

  14. Target product profile choices for intra-domiciliary malaria vector control pesticide products: repel or kill?

    Directory of Open Access Journals (Sweden)

    Moore Sarah J

    2011-07-01

    Full Text Available Abstract Background The most common pesticide products for controlling malaria-transmitting mosquitoes combine two distinct modes of action: 1 conventional insecticidal activity which kills mosquitoes exposed to the pesticide and 2 deterrence of mosquitoes away from protected humans. While deterrence enhances personal or household protection of long-lasting insecticidal nets and indoor residual sprays, it may also attenuate or even reverse communal protection if it diverts mosquitoes to non-users rather than killing them outright. Methods A process-explicit model of malaria transmission is described which captures the sequential interaction between deterrent and toxic actions of vector control pesticides and accounts for the distinctive impacts of toxic activities which kill mosquitoes before or after they have fed upon the occupant of a covered house or sleeping space. Results Increasing deterrency increases personal protection but consistently reduces communal protection because deterrent sub-lethal exposure inevitably reduces the proportion subsequently exposed to higher lethal doses. If the high coverage targets of the World Health Organization are achieved, purely toxic products with no deterrence are predicted to generally provide superior protection to non-users and even users, especially where vectors feed exclusively on humans and a substantial amount of transmission occurs outdoors. Remarkably, this is even the case if that product confers no personal protection and only kills mosquitoes after they have fed. Conclusions Products with purely mosquito-toxic profiles may, therefore, be preferable for programmes with universal coverage targets, rather than those with equivalent toxicity but which also have higher deterrence. However, if purely mosquito-toxic products confer little personal protection because they do not deter mosquitoes and only kill them after they have fed, then they will require aggressive "catch up" campaigns, with

  15. A remote drip infusion monitoring system employing Bluetooth.

    Science.gov (United States)

    Amano, Hikaru; Ogawa, Hidekuni; Maki, Hiromichi; Tsukamoto, Sosuke; Yonezawa, Yoshiharu; Caldwell, W Morton

    2012-01-01

    We have developed a remote drip infusion monitoring system for use in hospitals. The system consists of several infusion monitoring devices and a central monitor. The infusion monitoring device employing a Bluetooth module can detect the drip infusion rate and an empty infusion solution bag, and then these data are sent to the central monitor placed at the nurses' station via the Bluetooth. The central monitor receives the data from several infusion monitoring devices and then displays graphically them. Therefore, the developed system can monitor intensively the drip infusion situation of the several patients at the nurses' station.

  16. Subcutaneous insulin infusion: change in basal infusion rate has no immediate effect on insulin absorption rate

    International Nuclear Information System (INIS)

    Hildebrandt, P.; Birch, K.; Jensen, B.M.; Kuehl, C.

    1986-01-01

    Eight insulin-dependent diabetic patients were simultaneously given subcutaneous infusions (1.12 IU/h each) of 125 I-labeled Actrapid insulin in each side of the abdominal wall. After 24 h of infusion, the size of the infused insulin depots was measured by external counting for 5 h. The basal infusion rate was then doubled in one side and halved in the other for the next 4 h. Finally, 1.12 IU/h of insulin was given in both sides of the abdominal wall for an additional 3 h. The changes in the size of the depots were measured, and the absorption rates for each hour were calculated. During the first 5 h of infusion, the depot size was almost constant (approximately 5 IU) with an absorption rate that equaled the infusion rate. Doubling the infusion rate led to a significant increase in depot size, but the absorption rate remained unchanged for the first 3 h, and only thereafter was a significant increase seen. When the infusion rate was reduced to the initial 1.12 IU/h, the absorption rate remained elevated during the next 3 h. Correspondingly, when the infusion rate was decreased, the depot size also decreased, but the absorption rate remained unchanged for the first 3 h. The results show that a change in the basal insulin infusion rate does not lead to any immediate change in the insulin absorption rate. This should be considered when planning an insulin-infusion program that includes alteration(s) in the basal-rate setting

  17. Conservative versus Liberal Oxygenation Targets for Mechanically Ventilated Patients. A Pilot Multicenter Randomized Controlled Trial.

    Science.gov (United States)

    Panwar, Rakshit; Hardie, Miranda; Bellomo, Rinaldo; Barrot, Loïc; Eastwood, Glenn M; Young, Paul J; Capellier, Gilles; Harrigan, Peter W J; Bailey, Michael

    2016-01-01

    There are no randomized controlled trials comparing different oxygenation targets for intensive care unit (ICU) patients. To determine whether a conservative oxygenation strategy is a feasible alternative to a liberal oxygenation strategy among ICU patients requiring invasive mechanical ventilation (IMV). At four multidisciplinary ICUs, 103 adult patients deemed likely to require IMV for greater than or equal to 24 hours were randomly allocated to either a conservative oxygenation strategy with target oxygen saturation as measured by pulse oximetry (SpO2) of 88-92% (n = 52) or a liberal oxygenation strategy with target SpO2 of greater than or equal to 96% (n = 51). The mean area under the curve and 95% confidence interval (CI) for SpO2 (93.4% [92.9-93.9%] vs. 97% [96.5-97.5%]), SaO2 (93.5% [93.1-94%] vs. 96.8% [96.3-97.3%]), PaO2 (70 [68-73] mm Hg vs. 92 [89-96] mm Hg), and FiO2 (0.26 [0.25-0.28] vs. 0.36 [0.34-0.39) in the conservative versus liberal oxygenation arm were significantly different (P liberal arm was 1% versus 0.3% (P = 0.03), and percentage time spent with SpO2 greater than 98% in conservative versus liberal arm was 4% versus 22% (P < 0.001). The adjusted hazard ratio for 90-day mortality in the conservative arm was 0.77 (95% CI, 0.40-1.50; P = 0.44) overall and 0.49 (95% CI, 0.20-1.17; P = 0.10) in the prespecified subgroup of patients with a baseline PaO2/FiO2 less than 300. Our study supports the feasibility of a conservative oxygenation strategy in patients receiving IMV. Larger randomized controlled trials of this intervention appear justified. Clinical trial registered with Australian New Zealand Clinical Trials Registry (ACTRN 12613000505707).

  18. A randomized, double-blind, placebo-controlled trial to evaluate the efficacy, safety, tolerability, and pharmacokinetic/pharmacodynamic effects of a targeted exposure of intravenous repinotan in patients with acute ischemic stroke: modified Randomized Exposure Controlled Trial (mRECT).

    Science.gov (United States)

    Teal, Philip; Davis, Stephen; Hacke, Werner; Kaste, Markku; Lyden, Patrick D; Fierus, Monika

    2009-11-01

    Repinotan hydrochloride is a serotonin (5-HT)(1A) receptor full agonist with evidence of neuroprotection in animal models of permanent and transient focal ischemia. The purpose of this Phase IIb study was to investigate the efficacy, safety, and tolerability of a targeted exposure to repinotan in patients with acute ischemic stroke. This was a double-blind, placebo-controlled, parallel-group, multicenter study of 681 patients stratified according to whether or not tissue plasminogen activator was administered and then randomly assigned to treatment with repinotan or placebo. A continuous 72-hour intravenous infusion of repinotan or placebo was to be started within 4.5 hours from the onset of ischemic symptoms. A Point-of-Care test was used to adjust the infusion rate if appropriate. The goal of Modified Randomized Exposure Controlled Trial (mRECT) was to show whether repinotan is statistically superior to placebo (alpha or=85) at 3 months, using a Cochran-Mantel-Haenszel test. For the intention-to-treat population at 3 months, the response rate on the Barthel Index was 37.1% (127 of 342) for patients on repinotan and 42.4% (143 of 337) for patients taking the placebo (Cochran-Mantel-Haenszel probability value=0.149). No apparent safety concerns were identified. mRECT demonstrated the feasibility of conducting a rigorous trial using a short therapeutic window demanding clinical and radiographic criteria to optimize patient selection and a Point-of-Care test to achieve a targeted exposure to repinotan. The study failed to demonstrate a clinical benefit of repinotan. The development of repinotan in acute ischemic stroke was discontinued.

  19. Remodeling and Control of Homologous Recombination by DNA Helicases and Translocases that Target Recombinases and Synapsis

    Science.gov (United States)

    Northall, Sarah J.; Ivančić-Baće, Ivana; Soultanas, Panos; Bolt, Edward L.

    2016-01-01

    Recombinase enzymes catalyse invasion of single-stranded DNA (ssDNA) into homologous duplex DNA forming “Displacement loops” (D-loops), a process called synapsis. This triggers homologous recombination (HR), which can follow several possible paths to underpin DNA repair and restart of blocked and collapsed DNA replication forks. Therefore, synapsis can be a checkpoint for controlling whether or not, how far, and by which pathway, HR proceeds to overcome an obstacle or break in a replication fork. Synapsis can be antagonized by limiting access of a recombinase to ssDNA and by dissociation of D-loops or heteroduplex formed by synapsis. Antagonists include DNA helicases and translocases that are identifiable in eukaryotes, bacteria and archaea, and which target synaptic and pre-synaptic DNA structures thereby controlling HR at early stages. Here we survey these events with emphasis on enabling DNA replication to be resumed from sites of blockage or collapse. We also note how knowledge of anti-recombination activities could be useful to improve efficiency of CRISPR-based genome editing. PMID:27548227

  20. Use of the target diagnostic control system in the National Ignition Facility

    International Nuclear Information System (INIS)

    Shelton, R.; Lagin, L.; Nelson, J.

    2011-01-01

    The extreme physics of targets shocked by NIF's 192-beam laser are observed by a diverse suite of diagnostics including optical backscatter, time-integrated, time resolved and gated X-ray sensors, laser velocity interferometry, and neutron time of flight. Diagnostics to diagnose fusion ignition implosion and neutron emissions have been developed. A Diagnostic Control System (DCS) for both hardware and software facilitates development and eases integration. Each complex diagnostic typically uses an ensemble of electronic instruments attached to sensors, digitizers, cameras, and other devices. In the DCS architecture each instrument is interfaced to a low-cost Window XP processor and Java application. Instruments are aggregated as needed in the supervisory system to form an integrated diagnostic. The Java framework provides data management, control services and operator GUI generation. During the past several years, over thirty-six diagnostics have been deployed using this architecture in support of the National Ignition Campaign (NIC). The DCS architecture facilitates the expected additions and upgrades to diagnostics as more experiments are performed. This paper presents the DCS architecture, framework and our experiences in using it during the NIC to operate, upgrade and maintain a large set of diagnostic instruments.

  1. Electrotransfer parameters as a tool for controlled and targeted gene expression in skin

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    Spela Kos

    2016-01-01

    Full Text Available Skin is an attractive target for gene electrotransfer. It consists of different cell types that can be transfected, leading to various responses to gene electrotransfer. We demonstrate that these responses could be controlled by selecting the appropriate electrotransfer parameters. Specifically, the application of low or high electric pulses, applied by multi-electrode array, provided the possibility to control the depth of the transfection in the skin, the duration and the level of gene expression, as well as the local or systemic distribution of the transgene. The influence of electric pulse type was first studied using a plasmid encoding a reporter gene (DsRed. Then, plasmids encoding therapeutic genes (IL-12, shRNA against endoglin, shRNA against melanoma cell adhesion molecule were used, and their effects on wound healing and cutaneous B16F10 melanoma tumors were investigated. The high-voltage pulses resulted in gene expression that was restricted to superficial skin layers and induced a local response. In contrast, the low-voltage electric pulses promoted transfection into the deeper skin layers, resulting in prolonged gene expression and higher transgene production, possibly with systemic distribution. Therefore, in the translation into the clinics, it will be of the utmost importance to adjust the electrotransfer parameters for different therapeutic approaches and specific mode of action of the therapeutic gene.

  2. Can Targeted Intervention Mitigate Early Emotional and Behavioral Problems?: Generating Robust Evidence within Randomized Controlled Trials.

    Directory of Open Access Journals (Sweden)

    Orla Doyle

    Full Text Available This study examined the impact of a targeted Irish early intervention program on children's emotional and behavioral development using multiple methods to test the robustness of the results. Data on 164 Preparing for Life participants who were randomly assigned into an intervention group, involving home visits from pregnancy onwards, or a control group, was used to test the impact of the intervention on Child Behavior Checklist scores at 24-months. Using inverse probability weighting to account for differential attrition, permutation testing to address small sample size, and quantile regression to characterize the distributional impact of the intervention, we found that the few treatment effects were largely concentrated among boys most at risk of developing emotional and behavioral problems. The average treatment effect identified a 13% reduction in the likelihood of falling into the borderline clinical threshold for Total Problems. The interaction and subgroup analysis found that this main effect was driven by boys. The distributional analysis identified a 10-point reduction in the Externalizing Problems score for boys at the 90th percentile. No effects were observed for girls or for the continuous measures of Total, Internalizing, and Externalizing problems. These findings suggest that the impact of this prenatally commencing home visiting program may be limited to boys experiencing the most difficulties. Further adoption of the statistical methods applied here may help to improve the internal validity of randomized controlled trials and contribute to the field of evaluation science more generally.ISRCTN Registry ISRCTN04631728.

  3. Exploring polyamine metabolism of Alternaria alternata to target new substances to control the fungal infection.

    Science.gov (United States)

    Estiarte, N; Crespo-Sempere, A; Marín, S; Sanchis, V; Ramos, A J

    2017-08-01

    Polyamines are essential for all living organisms as they are involved in several vital cell functions. The biosynthetic pathway of polyamines and its regulation is well established and, in this sense, the ornithine descarboxylase (ODC) enzyme acts as one of the controlling factors of the entire pathway. In this work we assessed the inhibition of the ODC with D, l-α-difluoromethylornithine (DFMO) on Alternaria alternata and we observed that fungal growth and mycotoxin production were reduced. This inhibition was not completely restored by the addition of exogenous putrescine. Actually, increasing concentrations of putrescine on the growth media negatively affected mycotoxin production, which was corroborated by the downregulation of pksJ and altR, both genes involved in mycotoxin biosynthesis. We also studied the polyamine metabolism of A. alternata with the goal of finding new targets that compromise its growth and its mycotoxin production capacity. In this sense, we tested two different polyamine analogs, AMXT-2455 and AMXT-3016, and we observed that they partially controlled A. alternata's viability in vitro and in vivo using tomato plants. Finding strategies to design new fungicide substances is becoming a matter of interest as resistance problems are emerging. Copyright © 2017. Published by Elsevier Ltd.

  4. Use of the target diagnostic control system in the National Ignition Facility

    Energy Technology Data Exchange (ETDEWEB)

    Shelton, R; Lagin, L; Nelson, J

    2011-07-25

    The extreme physics of targets shocked by NIF's 192-beam laser are observed by a diverse suite of diagnostics including optical backscatter, time-integrated, time resolved and gated X-ray sensors, laser velocity interferometry, and neutron time of flight. Diagnostics to diagnose fusion ignition implosion and neutron emissions have been developed. A Diagnostic Control System (DCS) for both hardware and software facilitates development and eases integration. Each complex diagnostic typically uses an ensemble of electronic instruments attached to sensors, digitizers, cameras, and other devices. In the DCS architecture each instrument is interfaced to a low-cost Window XP processor and Java application. Instruments are aggregated as needed in the supervisory system to form an integrated diagnostic. The Java framework provides data management, control services and operator GUI generation. During the past several years, over thirty-six diagnostics have been deployed using this architecture in support of the National Ignition Campaign (NIC). The DCS architecture facilitates the expected additions and upgrades to diagnostics as more experiments are performed. This paper presents the DCS architecture, framework and our experiences in using it during the NIC to operate, upgrade and maintain a large set of diagnostic instruments.

  5. MK3 controls Polycomb target gene expression via negative feedback on ERK

    Directory of Open Access Journals (Sweden)

    Prickaerts Peggy

    2012-08-01

    Full Text Available Abstract Background Gene-environment interactions are mediated by epigenetic mechanisms. Polycomb Group proteins constitute part of an epigenetic cellular transcriptional memory system that is subject to dynamic modulation during differentiation. Molecular insight in processes that control dynamic chromatin association and dissociation of Polycomb repressive complexes during and beyond development is limited. We recently showed that MK3 interacts with Polycomb repressive complex 1 (PRC1. The functional relevance of this interaction, however, remained poorly understood. MK3 is activated downstream of mitogen- and stress-activated protein kinases (M/SAPKs, all of which fulfill crucial roles during development. We here use activation of the immediate-early response gene ATF3, a bona fide PRC1 target gene, as a model to study how MK3 and its effector kinases MAPK/ERK and SAPK/P38 are involved in regulation of PRC1-dependent ATF3 transcription. Results Our current data show that mitogenic signaling through ERK, P38 and MK3 regulates ATF3 expression by PRC1/chromatin dissociation and epigenetic modulation. Mitogenic stimulation results in transient P38-dependent H3S28 phosphorylation and ERK-driven PRC1/chromatin dissociation at PRC1 targets. H3S28 phosphorylation by itself appears not sufficient to induce PRC1/chromatin dissociation, nor ATF3 transcription, as inhibition of MEK/ERK signaling blocks BMI1/chromatin dissociation and ATF3 expression, despite induced H3S28 phosphorylation. In addition, we establish that concomitant loss of local H3K27me3 promoter marking is not required for ATF3 activation. We identify pERK as a novel signaling-induced binding partner of PRC1, and provide evidence that MK3 controls ATF3 expression in cultured cells via negative regulatory feedback on M/SAPKs. Dramatically increased ectopic wing vein formation in the absence of Drosophila MK in a Drosophila ERK gain-of-function wing vein patterning model, supports the

  6. Effects of infusing milk precursors into the artery on rumen fermentation in lactating cows

    Directory of Open Access Journals (Sweden)

    Xianjue Wang

    2016-06-01

    Full Text Available This experiment was conducted to investigate the effects of infusing milk precursors into the external pudic artery on rumen fermentation in lactating dairy cows. Eight multiparous Holstein cows were randomly assigned to Group A (experimental group and Group B (control group with 4 cows each. A 2 × 4 complex factor crossover design was used. Cows in Group A were fed corn straw as the only roughage, and cows in Group B were fed mixed roughage. The experiment was divided into two periods. In the first period, cows in Group A, received treatments: 1 a basal infusate as a control (CSC; 2 a milk fat precursor infusion including C16:0, C18:0, C18:1c9, C18:2c6, C18:3n3, acetic acid (CSF; 3 a milk protein precursor infusion including 16 amino acids (CSA; 4 the mixed infusion of milk fat and protein precursors (CSFA. And meanwhile, cows in Group B were infused the basal infusate as a control group. In the second period, the cows in both Groups A and B were crossed over, which cows in Group A were named as Group B and the cows originally in Group B were in Group A. The experimental results showed that cows in experimental group had higher ruminal pH compared with the control, and ruminal pH in CSC, CSF, CSA were significantly higher than those in their respective control group (P < 0.05. The concentration of ammonia nitrogen (NH3–N was significantly higher in CSA and CSFA compared with Group B (P < 0.05. We also observed that the infusion of mixed amino acids significantly increased the bacterial protein (BCP content in rumen (P < 0.05 and influenced the rumen acetic acid concentration as well as the acetic to propionic ratio (P < 0.05. Milk fat precursors infusion significantly affected butyric acid concentration (P < 0.05. In addition, the content of lipopolysaccharide (LPS in CSA was significantly higher than that in the control group (P < 0.05. It is concluded that the milk precursors infused into external pudic artery caused feedback

  7. Effects of leucine, isoleucine, or threonine infusion on leucine metabolism in humans

    International Nuclear Information System (INIS)

    Schwenk, W.F.; Haymond, M.W.

    1987-01-01

    Leucine and/or its α-keto acid, α-ketoisocaproate (KIC), have been reported to spare protein in humans. To determine whether specific amino acid infusions affect whole-body protein metabolism as estimated by changes in leucine flux and oxidation, five groups of normal subjects were infused with saline, leucine, isoleucine, or threonine. Independent estimates of leucine metabolism were obtained using simultaneous infusions of [ 3 H]-leucine and α-[ 14 C]ketoisocaproate. Nearly identical results were obtained using either tracer compared with the saline controls. Compared with the saline controls, leucine infusion (1) had no effect on estimated rates of appearance of endogenous leucine, (2) stimulated leucine oxidation, (3) decreased plasma concentrations of other amino acids, and (4) stimulated nonoxidized leucine disappearance in a dose-dependent fashion. In contrast, isoleucine and threonine infusions had no effect on leucine metabolism. Assuming the validity of the isotope model employed, these data suggest that the purported anabolic effect of leucine infusion on whole-body protein metabolism is mediated via stimulation of protein synthesis rather than decreased proteolysis

  8. Sympathetic responses during saline infusion into the veins of an occluded limb.

    Science.gov (United States)

    Cui, Jian; McQuillan, Patrick; Moradkhan, Raman; Pagana, Charles; Sinoway, Lawrence I

    2009-07-15

    Animal studies have shown that the increased intravenous pressure stimulates the group III and IV muscle afferent fibres, and in turn induce cardiovascular responses. However, this pathway of autonomic regulation has not been examined in humans. The aim of this study was to examine the hypothesis that infusion of saline into the venous circulation of an arterially occluded vascular bed evokes sympathetic activation in healthy individuals. Blood pressure, heart rate, and muscle sympathetic nerve activity (MSNA) responses were assessed in 19 young healthy subjects during local infusion of 40 ml saline into a forearm vein in the circulatory arrested condition. From baseline (11.8 +/- 1.2 bursts min(-1)), MSNA increased significantly during the saline infusion (22.5 +/- 2.6 bursts min(-1), P Blood pressure also increased significantly during the saline infusion. Three control trials were performed during separate visits. The results from the control trial show that the observed MSNA and blood pressure responses were not due to muscle ischaemia. The present data show that saline infusion into the venous circulation of an arterially occluded vascular bed induces sympathetic activation and an increase in blood pressure. We speculate that the infusion under such conditions stimulates the afferent endings near the vessels, and evokes the sympathetic activation.

  9. Light-controlled endosomal escape of the novel CD133-targeting immunotoxin AC133-saporin by photochemical internalization - A minimally invasive cancer stem cell-targeting strategy.

    Science.gov (United States)

    Bostad, Monica; Olsen, Cathrine Elisabeth; Peng, Qian; Berg, Kristian; Høgset, Anders; Selbo, Pål Kristian

    2015-05-28

    The cancer stem cell (CSC) marker CD133 is an attractive target to improve antitumor therapy. We have used photochemical internalization (PCI) for the endosomal escape of the novel CD133-targeting immunotoxin AC133-saporin (PCIAC133-saporin). PCI employs an endocytic vesicle-localizing photosensitizer, which generates reactive oxygen species upon light-activation causing a rupture of the vesicle membranes and endosomal escape of entrapped drugs. Here we show that AC133-saporin co-localizes with the PCI-photosensitizer TPCS2a, which upon light exposure induces cytosolic release of AC133-saporin. PCI of picomolar levels of AC133-saporin in colorectal adenocarcinoma WiDr cells blocked cell proliferation and induced 100% inhibition of cell viability and colony forming ability at the highest light doses, whereas no cytotoxicity was obtained in the absence of light. Efficient PCI-based CD133-targeting was in addition demonstrated in the stem-cell-like, triple negative breast cancer cell line MDA-MB-231 and in the aggressive malignant melanoma cell line FEMX-1, whereas no enhanced targeting was obtained in the CD133-negative breast cancer cell line MCF-7. PCIAC133-saporin induced mainly necrosis and a minimal apoptotic response based on assessing cleavage of caspase-3 and PARP, and the TUNEL assay. PCIAC133-saporin resulted in S phase arrest and reduced LC3-II conversion compared to control treatments. Notably, co-treatment with Bafilomycin A1 and PCIAC133-saporin blocked LC3-II conversion, indicating a termination of the autophagic flux in WiDr cells. For the first time, we demonstrate laser-controlled targeting of CD133 in vivo. After only one systemic injection of AC133-saporin and TPCS2a, a strong anti-tumor response was observed after PCIAC133-saporin. The present PCI-based endosomal escape technology represents a minimally invasive strategy for spatio-temporal, light-controlled targeting of CD133+ cells in localized primary tumors or metastasis. Copyright © 2015

  10. Liquid infused porous surfaces for mineral fouling mitigation.

    Science.gov (United States)

    Charpentier, Thibaut V J; Neville, Anne; Baudin, Sophie; Smith, Margaret J; Euvrard, Myriam; Bell, Ashley; Wang, Chun; Barker, Richard

    2015-04-15

    Prevention of mineral fouling, known as scale, is a long-standing problem in a wide variety of industrial applications, such as oil production, water treatment, and many others. The build-up of inorganic scale such as calcium carbonate on surfaces and facilities is undesirable as it can result in safety risks and associated flow assurance issues. To date the overwhelming amount of research has mainly focused on chemical inhibition of scale bulk precipitation and little attention has been paid to deposition onto surfaces. The development of novel more environmentally-friendly strategies to control mineral fouling will most probably necessitate a multifunctional approach including surface engineering. In this study, we demonstrate that liquid infused porous surfaces provide an appealing strategy for surface modification to reduce mineral scale deposition. Microporous polypyrrole (PPy) coatings were fabricated onto stainless steel substrates by electrodeposition in potentiostatic mode. Subsequent infusion of low surface energy lubricants (fluorinated oil Fluorinert FC-70 and ionic liquid 1-Butyl-3-methylimidazolium bis(trifluoromethylsulfonyl)imide (BMIm)) into the porous coatings results in liquid-repellent slippery surfaces. To assess their ability to reduce surface scaling the coatings were subjected to a calcium carbonate scaling environment and the scale on the surface was quantified using Inductively Coupled Plasma Atomic Emission Spectroscopy (ICP-AES). PPy surfaces infused with BMIm (and Fluorinert to a lesser extent) exhibit remarkable antifouling properties with the calcium carbonate deposition reduced by 18 times in comparison to untreated stainless steel. These scaling tests suggest a correlation between the stability of the liquid infused surfaces in artificial brines and fouling reduction efficiency. The current work shows the great potential of such novel coatings for the management of mineral scale fouling. Copyright © 2014 Elsevier Inc. All rights

  11. Identification of Arx targets unveils new candidates for controlling cortical interneuron migration and differentiation

    Directory of Open Access Journals (Sweden)

    Gaelle M Friocourt

    2011-12-01

    Full Text Available Mutations in the homeobox transcription factor ARX have been found to be responsible for a wide spectrum of disorders extending from phenotypes with severe neuronal migration defects, such as lissencephaly, to mild forms of intellectual disabilities without apparent brain abnormalities, but with associated features of dystonia and epilepsy. Arx expression is mainly restricted to populations of GABA-containing neurons. Studies of the effects of ARX loss of function, either in humans or mutant mice, revealed varying defects, suggesting multiple roles of this gene in brain patterning, neuronal proliferation and migration, cell maturation and differentiation, as well as axonal outgrowth and connectivity. However, to date, little is known about how Arx functions as a transcription factor or which genes it binds and regulates. Recently, we combined chromatin immunoprecipitation and mRNA expression with microarray analysis and identified approximately 1000 gene promoters bound by Arx in transfected neuroblastoma N2a cells and mouse embryonic brain. To narrow the analysis of Arx targets to those most likely to control cortical interneuron migration and/or differentiation, we compare here our data to previously published studies searching for genes enriched or down-regulated in cortical interneurons between E13.5 and E15.5. We thus identified 14 Arx-target genes enriched (Cxcr7, Meis1, Ppap2a, Slc12a5, Ets2, Phlda1, Zif268, Igf1, Lmo3, Sema6, Lgi1, Alk, Tgfb3, Napb and 5 genes specifically down-regulated (Hmgn3, Lmo1, Ebf3, Rasgef1b and Slit2 in cortical migrating neurons. In this review, we present these genes and discuss how their possible regulation by Arx may lead to the dysfunction of GABAergic neurons, resulting in mental retardation and epilepsy.

  12. Targeted Sequencing of Lung Function Loci in Chronic Obstructive Pulmonary Disease Cases and Controls.

    Science.gov (United States)

    Artigas, María Soler; Wain, Louise V; Shrine, Nick; McKeever, Tricia M; Sayers, Ian; Hall, Ian P; Tobin, Martin D

    2017-01-01

    Chronic obstructive pulmonary disease (COPD) is the third leading cause of death worldwide; smoking is the main risk factor for COPD, but genetic factors are also relevant contributors. Genome-wide association studies (GWAS) of the lung function measures used in the diagnosis of COPD have identified a number of loci, however association signals are often broad and collectively these loci only explain a small proportion of the heritability. In order to examine the association with COPD risk of genetic variants down to low allele frequencies, to aid fine-mapping of association signals and to explain more of the missing heritability, we undertook a targeted sequencing study in 300 COPD cases and 300 smoking controls for 26 loci previously reported to be associated with lung function. We used a pooled sequencing approach, with 12 pools of 25 individuals each, enabling high depth (30x) coverage per sample to be achieved. This pooled design maximised sample size and therefore power, but led to challenges during variant-calling since sequencing error rates and minor allele frequencies for rare variants can be very similar. For this reason we employed a rigorous quality control pipeline for variant detection which included the use of 3 independent calling algorithms. In order to avoid false positive associations we also developed tests to detect variants with potential batch effects and removed them before undertaking association testing. We tested for the effects of single variants and the combined effect of rare variants within a locus. We followed up the top signals with data available (only 67% of collapsing methods signals) in 4,249 COPD cases and 11,916 smoking controls from UK Biobank. We provide suggestive evidence for the combined effect of rare variants on COPD risk in TNXB and in sliding windows within MECOM and upstream of HHIP. These findings can lead to an improved understanding of the molecular pathways involved in the development of COPD.

  13. Targeted Sequencing of Lung Function Loci in Chronic Obstructive Pulmonary Disease Cases and Controls.

    Directory of Open Access Journals (Sweden)

    María Soler Artigas

    Full Text Available Chronic obstructive pulmonary disease (COPD is the third leading cause of death worldwide; smoking is the main risk factor for COPD, but genetic factors are also relevant contributors. Genome-wide association studies (GWAS of the lung function measures used in the diagnosis of COPD have identified a number of loci, however association signals are often broad and collectively these loci only explain a small proportion of the heritability. In order to examine the association with COPD risk of genetic variants down to low allele frequencies, to aid fine-mapping of association signals and to explain more of the missing heritability, we undertook a targeted sequencing study in 300 COPD cases and 300 smoking controls for 26 loci previously reported to be associated with lung function. We used a pooled sequencing approach, with 12 pools of 25 individuals each, enabling high depth (30x coverage per sample to be achieved. This pooled design maximised sample size and therefore power, but led to challenges during variant-calling since sequencing error rates and minor allele frequencies for rare variants can be very similar. For this reason we employed a rigorous quality control pipeline for variant detection which included the use of 3 independent calling algorithms. In order to avoid false positive associations we also developed tests to detect variants with potential batch effects and removed them before undertaking association testing. We tested for the effects of single variants and the combined effect of rare variants within a locus. We followed up the top signals with data available (only 67% of collapsing methods signals in 4,249 COPD cases and 11,916 smoking controls from UK Biobank. We provide suggestive evidence for the combined effect of rare variants on COPD risk in TNXB and in sliding windows within MECOM and upstream of HHIP. These findings can lead to an improved understanding of the molecular pathways involved in the development of COPD.

  14. Electrostatic levitation, control and transport in high rate, low cost production of inertial confinement fusion targets

    International Nuclear Information System (INIS)

    Hendricks, C.D.; Johnson, W.L.

    1979-01-01

    Inertial confinement fusion requires production of power plant grade targets at high rates and process yield. A review of present project specifications and techniques to produce targets is discussed with special emphasis on automating the processes and combining them with an electrostatic transport and suspension system through the power plant target factory

  15. Anticoagulant rodenticide toxicity to non-target wildlife under controlled exposure conditions

    Science.gov (United States)

    Rattner, Barnett A.; Mastrota, F. Nicholas; van den Brink, Nico; Elliott, J.; Shore, R.; Rattner, B.

    2018-01-01

    Much of our understanding of anticoagulant rodenticide toxicity to non-target wildlife has been derived from molecular through whole animal research and registration studies in domesticated birds and mammals, and to a lesser degree from trials with captive wildlife. Using these data, an adverse outcome pathway identifying molecular initiating and anchoring events (inhibition of vitamin K epoxide reductase, failure to activate clotting factors), and established and plausible linkages (coagulopathy, hemorrhage, anemia, reduced fitness) associated with toxicity, is presented. Controlled exposure studies have demonstrated that second-generation anticoagulant rodenticides (e.g., brodifacoum) are more toxic than first- and intermediate-generation compounds (e.g., warfarin, diphacinone), however the difference in potency is diminished when first- and intermediate-generation compounds are administered on multiple days. Differences in species sensitivity are inconsistent among compounds. Numerous studies have compared mortality rate of predators fed prey or tissue containing anticoagulant rodenticides. In secondary exposure studies in birds, brodifacoum appears to pose the greatest risk, with bromadiolone, difenacoum, flocoumafen and difethialone being less hazardous than brodifacoum, and warfarin, coumatetralyl, coumafuryl, chlorophacinone and diphacinone being even less hazardous. In contrast, substantial mortality was noted in secondary exposure studies in mammals ingesting prey or tissue diets containing either second- or intermediate-generation compounds. Sublethal responses (e.g., prolonged clotting time, reduced hematocrit and anemia) have been used to study the sequelae of anticoagulant intoxication, and to some degree in the establishment of toxicity thresholds or toxicity reference values. Surprisingly few studies have undertaken histopathological evaluations to identify cellular lesions and hemorrhage associated with anticoagulant rodenticide exposure in non-target

  16. Regenerative Medicine: A Vehicle to Infuse Laboratory-Bench Modules into an Exercise Physiology Curriculum

    Science.gov (United States)

    Brown, Jason M.; Guy, Breonte S.; Henderson, Dawn X.; Ebert, C. Edward; Harp, Jill; Markert, Chad D.

    2018-01-01

    Regenerative medicine is a novel discipline that both excites undergraduates and may be used as a vehicle to expose students to scientific concepts and opportunities. The goal of this article is to describe the implementation of a National Science Foundation-funded Targeted Infusion Project in which underrepresented minority undergraduates are…

  17. Control of electron beam by using high-Z gas target in the laser-plasma acceleration

    International Nuclear Information System (INIS)

    Mori, Michiaki

    2012-01-01

    We investigate the pointing stability and the divergence of a quasi-monoenergetic electron beam generated in a self-injected laser-plasma acceleration regime using high-Z gas-jet target. Gas-jet targets have been irradiated with focused 40 fs laser pulses at the 4-TW peak power. A pointing stability and a beam divergence of electron beam were improved using argon target. These values were about three times smaller than at the optimum condition using helium. This stabilization method is available for another gas material such as nitrogen. At nitrogen gas-jet target, the pointing stability is more improved to two times smaller than that in argon gas-jet target and the peak energy is increased to >30 MeV. These results prove that this method not only stabilizes the e-beam but also allows controlling the electron energy. (author)

  18. An indirect adaptive neural control of a visual-based quadrotor robot for pursuing a moving target.

    Science.gov (United States)

    Shirzadeh, Masoud; Amirkhani, Abdollah; Jalali, Aliakbar; Mosavi, Mohammad R

    2015-11-01

    This paper aims to use a visual-based control mechanism to control a quadrotor type aerial robot which is in pursuit of a moving target. The nonlinear nature of a quadrotor, on the one hand, and the difficulty of obtaining an exact model for it, on the other hand, constitute two serious challenges in designing a controller for this UAV. A potential solution for such problems is the use of intelligent control methods such as those that rely on artificial neural networks and other similar approaches. In addition to the two mentioned problems, another problem that emerges due to the moving nature of a target is the uncertainty that exists in the target image. By employing an artificial neural network with a Radial Basis Function (RBF) an indirect adaptive neural controller has been designed for a quadrotor robot in search of a moving target. The results of the simulation for different paths show that the quadrotor has efficiently tracked the moving target. Copyright © 2015 ISA. Published by Elsevier Ltd. All rights reserved.

  19. Design of Infusion Schemes for Neuroreceptor Imaging

    DEFF Research Database (Denmark)

    Feng, Ling; Svarer, Claus; Madsen, Karine

    2016-01-01

    for bolus infusion (BI) or programmed infusion (PI) experiments. Steady-state quantitative measurements can be made with one short scan and venous blood samples. The GABAA receptor ligand [(11)C]Flumazenil (FMZ) was chosen for this purpose, as it lacks a suitable reference region. Methods. Five bolus [(11)C...... state was attained within 40 min, which was 8 min earlier than the optimal BI (B/I ratio = 55 min). Conclusions. The system can design both BI and PI schemes to attain steady state rapidly. For example, subjects can be [(11)C]FMZ-PET scanned after 40 min of tracer infusion for 40 min with venous...

  20. Forearm metabolism during infusion of adrenaline

    DEFF Research Database (Denmark)

    Simonsen, L; Stefl, B; Bülow, J

    2000-01-01

    Human skeletal muscle metabolism is often investigated by measurements of substrate fluxes across the forearm. To evaluate whether the two forearms give the same metabolic information, nine healthy subjects were studied in the fasted state and during infusion of adrenaline. Both arms were...... catheterized in a cubital vein in the retrograde direction. A femoral artery was catheterized for blood sampling, and a femoral vein for infusion of adrenaline. Forearm blood flow was measured by venous occlusion strain-gauge plethysmography. Forearm subcutaneous adipose tissue blood flow was measured...... by the local 133Xe washout method. Metabolic fluxes were calculated as the product of forearm blood flow and a-v differences of metabolite concentrations. After baseline measurements, adrenaline was infused at a rate of 0.3 nmol kg-1 min-1. No difference in the metabolic information obtained in the fasting...

  1. Intensive intravenous infusion of insulin in diabetic cats.

    Science.gov (United States)

    Hafner, M; Dietiker-Moretti, S; Kaufmann, K; Mueller, C; Lutz, T A; Reusch, C E; Zini, E

    2014-01-01

    Remission occurs in 10-50% of cats with diabetes mellitus (DM). It is assumed that intensive treatment improves β-cell function and increases remission rates. Initial intravenous infusion of insulin that achieves tight glycemic control decreases subsequent insulin requirements and increases remission rate in diabetic cats. Thirty cats with newly diagnosed DM. Prospective study. Cats were randomly assigned to one of 2 groups. Cats in group 1 (n = 15) received intravenous infusion of insulin with the goal of maintaining blood glucose concentrations at 90-180 mg/dL, for 6 days. Cats in group 2 (n = 15) received subcutaneous injections of insulin glargine (cats ≤4 kg: 0.5-1.0 IU, q12h; >4 kg 1.5-2.0 IU, q12h), for 6 days. Thereafter, all cats were treated with subcutaneous injections of insulin glargine and followed up for 6 months. Cats were considered in remission when euglycemia occurred for ≥4 weeks without the administration of insulin. Nonparametric tests were used for statistical analysis. In groups 1 and 2, remission was achieved in 10/15 and in 7/14 cats (P = .46), and good metabolic control was achieved in 3/5 and in 1/7 cats (P = .22), respectively. Overall, good metabolic control or remission occurred in 13/15 cats of group 1 and in 8/14 cats of group 2. In group 1, the median insulin dosage given during the 6-month follow-up was significantly lower than in group 2 (group 1: 0.32 IU/kg/day, group 2: 0.51 IU/kg/day; P = .013). Initial intravenous infusion of insulin for tight glycemic control in cats with DM decreases insulin requirements during the subsequent 6 months. Copyright © 2014 by the American College of Veterinary Internal Medicine.

  2. Screen-Time Weight-loss Intervention Targeting Children at Home (SWITCH): a randomized controlled trial.

    Science.gov (United States)

    Maddison, Ralph; Marsh, Samantha; Foley, Louise; Epstein, Leonard H; Olds, Timothy; Dewes, Ofa; Heke, Ihirangi; Carter, Karen; Jiang, Yannan; Mhurchu, Cliona Ni

    2014-09-10

    Screen-based activities, such as watching television (TV), playing video games, and using computers, are common sedentary behaviors among young people and have been linked with increased energy intake and overweight. Previous home-based sedentary behaviour interventions have been limited by focusing primarily on the child, small sample sizes, and short follow-up periods. The SWITCH (Screen-Time Weight-loss Intervention Targeting Children at Home) study aimed to determine the effect of a home-based, family-delivered intervention to reduce screen-based sedentary behaviour on body composition, sedentary behaviour, physical activity, and diet over 24 weeks in overweight and obese children. A two-arm, parallel, randomized controlled trial was conducted. Children and their primary caregiver living in Auckland, New Zealand were recruited via schools, community centres, and word of mouth. The intervention, delivered over 20 weeks, consisted of a face-to-face meeting with the parent/caregiver and the child to deliver intervention content, which focused on training and educating them to use a wide range of strategies designed to reduce their child's screen time. Families were given Time Machine TV monitoring devices to assist with allocating screen time, activity packages to promote alternative activities, online support via a website, and monthly newsletters. Control participants were given the intervention material on completion of follow-up. The primary outcome was change in children's BMI z-score from baseline to 24 weeks. Children (n = 251) aged 9-12 years and their primary caregiver were randomized to receive the SWITCH intervention (n = 127) or no intervention (controls; n = 124). There was no significant difference in change of zBMI between the intervention and control groups, although a favorable trend was observed (-0.016; 95% CI: -0.084, 0.051; p = 0.64). There were also no significant differences on secondary outcomes, except for a trend towards

  3. Cryogenic hydrogen fuel for controlled inertial confinement fusion (formation of reactor-scale cryogenic targets)

    Science.gov (United States)

    Aleksandrova, I. V.; Koresheva, E. R.; Krokhin, O. N.; Osipov, I. E.

    2016-12-01

    In inertial fusion energy research, considerable attention has recently been focused on low-cost fabrication of a large number of targets by developing a specialized layering module of repeatable operation. The targets must be free-standing, or unmounted. Therefore, the development of a target factory for inertial confinement fusion (ICF) is based on methods that can ensure a cost-effective target production with high repeatability. Minimization of the amount of tritium (i.e., minimization of time and space at all production stages) is a necessary condition as well. Additionally, the cryogenic hydrogen fuel inside the targets must have a structure (ultrafine layers—the grain size should be scaled back to the nanometer range) that supports the fuel layer survivability under target injection and transport through the reactor chamber. To meet the above requirements, significant progress has been made at the Lebedev Physical Institute (LPI) in the technology developed on the basis of rapid fuel layering inside moving free-standing targets (FST), also referred to as the FST layering method. Owing to the research carried out at LPI, unique experience has been gained in the development of the FST-layering module for target fabrication with an ultrafine fuel layer, including a reactor- scale target design. This experience can be used for the development of the next-generation FST-layering module for construction of a prototype of a target factory for power laser facilities and inertial fusion power plants.

  4. Applying Ancestry and Sex Computation as a Quality Control Tool in Targeted Next-Generation Sequencing.

    Science.gov (United States)

    Mathias, Patrick C; Turner, Emily H; Scroggins, Sheena M; Salipante, Stephen J; Hoffman, Noah G; Pritchard, Colin C; Shirts, Brian H

    2016-03-01

    To apply techniques for ancestry and sex computation from next-generation sequencing (NGS) data as an approach to confirm sample identity and detect sample processing errors. We combined a principal component analysis method with k-nearest neighbors classification to compute the ancestry of patients undergoing NGS testing. By combining this calculation with X chromosome copy number data, we determined the sex and ancestry of patients for comparison with self-report. We also modeled the sensitivity of this technique in detecting sample processing errors. We applied this technique to 859 patient samples with reliable self-report data. Our k-nearest neighbors ancestry screen had an accuracy of 98.7% for patients reporting a single ancestry. Visual inspection of principal component plots was consistent with self-report in 99.6% of single-ancestry and mixed-ancestry patients. Our model demonstrates that approximately two-thirds of potential sample swaps could be detected in our patient population using this technique. Patient ancestry can be estimated from NGS data incidentally sequenced in targeted panels, enabling an inexpensive quality control method when coupled with patient self-report. © American Society for Clinical Pathology, 2016. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  5. Geographic profiling as a novel spatial tool for targeting infectious disease control

    Directory of Open Access Journals (Sweden)

    Fuller Douglas O

    2011-05-01

    Full Text Available Abstract Background Geographic profiling is a statistical tool originally developed in criminology to prioritise large lists of suspects in cases of serial crime. Here, we use two data sets - one historical and one modern - to show how it can be used to locate the sources of infectious disease. Results First, we re-analyse data from a classic epidemiological study, the 1854 London cholera outbreak. Using 321 disease sites as input, we evaluate the locations of 13 neighbourhood water pumps. The Broad Street pump - the outbreak's source- ranks first, situated in the top 0.2% of the geoprofile. We extend our study with an analysis of reported malaria cases in Cairo, Egypt, using 139 disease case locations to rank 59 mosquitogenic local water sources, seven of which tested positive for the vector Anopheles sergentii. Geographic profiling ranks six of these seven sites in positions 1-6, all in the top 2% of the geoprofile. In both analyses the method outperformed other measures of spatial central tendency. Conclusions We suggest that geographic profiling could form a useful component of integrated control strategies relating to a wide variety of infectious diseases, since evidence-based targeting of interventions is more efficient, environmentally friendly and cost-effective than untargeted intervention.

  6. Target of rapamycin (TOR) signaling controls epithelial morphogenesis in the vertebrate intestine.

    Science.gov (United States)

    Makky, Khadijah; Tekiela, Jackie; Mayer, Alan N

    2007-03-15

    The target of rapamycin (TOR) signaling pathway regulates cell growth and proliferation, however the extent to which TOR signaling mediates particular organogenesis programs remains to be determined. Here we report an examination of TOR signaling during zebrafish development, using a combination of small molecule treatment and morpholino-mediated gene knockdown. First, we amplified and sequenced the full-length cDNA for the zebrafish TOR ortholog (ztor). By in situ hybridization, we found that ztor is expressed ubiquitously in the early embryo, but displays a dynamic pattern in the gut between 48 and 72 h post-fertilization (hpf). Treatment of zebrafish embryos with rapamycin induced only a mild general developmental delay up to 72 hpf, but digestive tract development became arrested at the primitive gut tube stage. Rapamycin inhibited intestinal epithelial growth, morphogenesis and differentiation. Using morpholino-mediated gene knockdown of TOR pathway components, we show that this effect is mediated specifically by the rapamycin-sensitive TOR complex 1 (TORC1). Thus, in addition to regulating cell growth and proliferation, TOR signaling controls the developmental program guiding epithelial morphogenesis in the vertebrate intestine.

  7. Mycobacterium tuberculosis Controls Phagosomal Acidification by Targeting CISH-Mediated Signaling.

    Science.gov (United States)

    Queval, Christophe J; Song, Ok-Ryul; Carralot, Jean-Philippe; Saliou, Jean-Michel; Bongiovanni, Antonino; Deloison, Gaspard; Deboosère, Nathalie; Jouny, Samuel; Iantomasi, Raffaella; Delorme, Vincent; Debrie, Anne-Sophie; Park, Sei-Jin; Gouveia, Joana Costa; Tomavo, Stanislas; Brosch, Roland; Yoshimura, Akihiko; Yeramian, Edouard; Brodin, Priscille

    2017-09-26

    Pathogens have evolved a range of mechanisms to counteract host defenses, notably to survive harsh acidic conditions in phagosomes. In the case of Mycobacterium tuberculosis, it has been shown that regulation of phagosome acidification could be achieved by interfering with the retention of the V-ATPase complexes at the vacuole. Here, we present evidence that M. tuberculosis resorts to yet another strategy to control phagosomal acidification, interfering with host suppressor of cytokine signaling (SOCS) protein functions. More precisely, we show that infection of macrophages with M. tuberculosis leads to granulocyte-macrophage colony-stimulating factor (GM-CSF) secretion, inducing STAT5-mediated expression of cytokine-inducible SH2-containing protein (CISH), which selectively targets the V-ATPase catalytic subunit A for ubiquitination and degradation by the proteasome. Consistently, we show that inhibition of CISH expression leads to reduced replication of M. tuberculosis in macrophages. Our findings further broaden the molecular understanding of mechanisms deployed by bacteria to survive. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

  8. Mycobacterium tuberculosis Controls Phagosomal Acidification by Targeting CISH-Mediated Signaling

    Directory of Open Access Journals (Sweden)

    Christophe J. Queval

    2017-09-01

    Full Text Available Pathogens have evolved a range of mechanisms to counteract host defenses, notably to survive harsh acidic conditions in phagosomes. In the case of Mycobacterium tuberculosis, it has been shown that regulation of phagosome acidification could be achieved by interfering with the retention of the V-ATPase complexes at the vacuole. Here, we present evidence that M. tuberculosis resorts to yet another strategy to control phagosomal acidification, interfering with host suppressor of cytokine signaling (SOCS protein functions. More precisely, we show that infection of macrophages with M. tuberculosis leads to granulocyte-macrophage colony-stimulating factor (GM-CSF secretion, inducing STAT5-mediated expression of cytokine-inducible SH2-containing protein (CISH, which selectively targets the V-ATPase catalytic subunit A for ubiquitination and degradation by the proteasome. Consistently, we show that inhibition of CISH expression leads to reduced replication of M. tuberculosis in macrophages. Our findings further broaden the molecular understanding of mechanisms deployed by bacteria to survive.

  9. Experimental intraperitoneal infusion of OK-432 in rats: Evaluation of peritoneal complications and pathology

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Dong Wook [Department of Radiology, Busan Paik Hospital, Inje University College of Medicine, Busan (Korea, Republic of); Kim, Hak Jin, E-mail: hakjink@pusan.ac.k [Department of Radiology, Pusan National University Hospital, Pusan National University College of Medicine, Medical Research Institute, Busan (Korea, Republic of); Lee, Jun Woo [Department of Radiology, Pusan National University Hospital, Pusan National University College of Medicine, Medical Research Institute, Busan (Korea, Republic of)

    2010-06-15

    Purpose: OK-432 is known to be a potent sclerosant of cystic lesions. The purpose of this study was to evaluate both its safety and pathologic effects after the infusion of OK-432 into the peritoneal cavity of rats. Materials and methods: Twenty male rats were used in this study. Twelve rats were infused intraperitoneally with 0.2 Klinishe Einheit of OK-432 melted in 2 mL of normal saline (group 1: the treated group); four rats each were infused intraperitoneally with 0.5 mL of 99% ethanol (group 2) and normal saline (group 3), and served as the control groups. An abdominal ultrasonographic examination was performed both before and after the infusions in all rats. Three rats in group 1 and one rat in each of groups 2 and 3 were sacrificed each week following the infusion. Gross and microscopic evaluations of the peritoneum and abdominal cavity were performed on each rat. Results: In group 1, the abdomen was clear on gross inspection and the peritoneum was unremarkable on microscopic examination. In group 2, mild-to-moderate peritoneal adhesions were revealed grossly, and inflammation and fibrosis of the peritoneum were demonstrated microscopically. In group 3, no specific abnormalities were noted on gross or microscopic examinations. Conclusion: Leakage or abnormal infusion of OK-432 solution into the peritoneal cavity during sclerotherapy of intra-abdominal or retroperitoneal cystic lesions does not result in any significant complications.

  10. Experimental intraperitoneal infusion of OK-432 in rats: Evaluation of peritoneal complications and pathology

    International Nuclear Information System (INIS)

    Kim, Dong Wook; Kim, Hak Jin; Lee, Jun Woo

    2010-01-01

    Purpose: OK-432 is known to be a potent sclerosant of cystic lesions. The purpose of this study was to evaluate both its safety and pathologic effects after the infusion of OK-432 into the peritoneal cavity of rats. Materials and methods: Twenty male rats were used in this study. Twelve rats were infused intraperitoneally with 0.2 Klinishe Einheit of OK-432 melted in 2 mL of normal saline (group 1: the treated group); four rats each were infused intraperitoneally with 0.5 mL of 99% ethanol (group 2) and normal saline (group 3), and served as the control groups. An abdominal ultrasonographic examination was performed both before and after the infusions in all rats. Three rats in group 1 and one rat in each of groups 2 and 3 were sacrificed each week following the infusion. Gross and microscopic evaluations of the peritoneum and abdominal cavity were performed on each rat. Results: In group 1, the abdomen was clear on gross inspection and the peritoneum was unremarkable on microscopic examination. In group 2, mild-to-moderate peritoneal adhesions were revealed grossly, and inflammation and fibrosis of the peritoneum were demonstrated microscopically. In group 3, no specific abnormalities were noted on gross or microscopic examinations. Conclusion: Leakage or abnormal infusion of OK-432 solution into the peritoneal cavity during sclerotherapy of intra-abdominal or retroperitoneal cystic lesions does not result in any significant complications.

  11. Should we use closed or open infusion containers for prevention of bloodstream infections?

    Directory of Open Access Journals (Sweden)

    Martinez-Soto Jose

    2010-02-01

    Full Text Available Abstract Background Hospitalized patients in critical care settings are at risk for bloodstream infections (BSI. Most BSIs originate from a central line (CL, and they increase length of stay, cost, and mortality. Open infusion containers may increase the risk of contamination and administration-related (CLAB because they allow the entry of air into the system, thereby also providing an opportunity for microbial entry. Closed infusion containers were designed to overcome this flaw. However, open infusion containers are still widely used throughout the world. The objective of the study was to determine the effect of switching from open (glass, burettes, and semi-rigid infusion containers to closed, fully collapsible, plastic infusion containers (Viaflex® on the rate and time to onset of central line-associated bloodstream infections CLABs. Methods An open label, prospective cohort, active healthcare-associated infection surveillance, sequential study was conducted in four ICUs in Mexico. Centers for Disease Control National Nosocomial Infections Surveillance Systems definitions were used to define device-associated infections. Results A total of 1,096 adult patients who had a central line in place for >24 hours were enrolled. The CLAB rate was significantly higher during the open versus the closed container period (16.1 versus 3.2 CLAB/1000 central line days; RR = 0.20, 95% CI = 0.11-0.36, P Conclusions Closed infusion containers significantly reduced CLAB rate, the probability of acquiring CLAB, and mortality.

  12. Optimization of induction of mild therapeutic hypothermia with cold saline infusion: A laboratory experiment

    Directory of Open Access Journals (Sweden)

    Jure Fluher

    2015-11-01

    Full Text Available Cold fluid infusions can be used to induce mild therapeutic hypothermia after cardiac arrest. Fluid temperature higher than 4°C can increase the volume of fluid needed, prolong the induction phase of hypothermia and thus contribute to complications. We performed a laboratory experiment with two objectives. The first objective was to analyze the effect of wrapping fluid bags in ice packs on the increase of fluid temperature with time in bags exposed to ambient conditions. The second objective was to quantify the effect of insulating venous tubing and adjusting flow rate on fluid temperature increase from bag to the level of an intravenous cannula during a simulated infusion. The temperature of fluid in bags wrapped in ice packs was significantly lower compared to controls at all time points during the 120 minutes observation. The temperature increase from the bag to the level of intravenous cannula was significantly lower for insulated tubing at all infusion rates (median temperature differences between bag and intravenous cannula were: 8.9, 4.8, 4.0, and 3.1°C, for non-insulated and 5.9, 3.05, 1.1, and 0.3°C, for insulated tubing, at infusion rates 10, 30, 60, and 100 mL/minute, respectively. The results from this study could potentially be used to decrease the volume of fluid infused when inducing mild hypothermia with an infusion of cold fluids.

  13. Safety of Striatal Infusion of siRNA in a Transgenic Huntington's Disease Mouse Model.

    Science.gov (United States)

    Johnson, Emily; Chase, Kathryn; McGowan, Sarah; Mondo, Erica; Pfister, Edith; Mick, Eric; Friedline, Randall H; Kim, Jason K; Sapp, Ellen; DiFiglia, Marian; Aronin, Neil

    2015-01-01

    The immune system In Huntington's disease (HD) is activated and may overreact to some therapies. RNA interference using siRNA lowers mutant huntingtin (mHTT) protein but could increase immune responses. To examine the innate immune response following siRNA infusion into the striatum of wild-type (WT) and HD transgenic (YAC128) mice. siRNAs (2'-O-methyl phosphorothioated) were infused unilaterally into striatum of four month-old WT and YAC128 mice for 28 days. Microglia number and morphology (resting (normal), activated, dystrophic), cytokine levels, and DARPP32-positive neurons were measured in striatum immediately or 14 days post-infusion. Controls included contralateral untreated striatum, and PBS and sham treated striata. The striata of untreated YAC128 mice had significantly fewer resting microglia and more dystrophic microglia than WT mice, but no difference from WT in the proportion of activated microglia or total number of microglia. siRNA infusion increased the total number of microglia in YAC128 mice compared to PBS treated and untreated striata and increased the proportion of activated microglia in WT and YAC128 mice compared to untreated striata and sham treated groups. Cytokine levels were low and siRNA infusion resulted in only modest changes in those levels. siRNA infusion did not change the number of DARPP32-positive neurons. Findings suggest that siRNA infusion may be a safe method for lowering mHTT levels in the striatum in young animals, since treatment does not produce a robust cytokine response or cause neurotoxicity. The potential long-term effects of a sustained increase in total and activated microglia after siRNA infusion in HD mice need to be explored.

  14. Gradual withdrawal of remifentanil infusion may prevent opioid-induced hyperalgesia.

    Science.gov (United States)

    Comelon, M; Raeder, J; Stubhaug, A; Nielsen, C S; Draegni, T; Lenz, H

    2016-04-01

    The aim of this study was to examine if gradual withdrawal of remifentanil infusion prevented opioid-induced hyperalgesia (OIH) as opposed to abrupt withdrawal. OIH duration was also evaluated. Nineteen volunteers were enrolled in this randomized, double-blinded, placebo-controlled, crossover study. All went through three sessions: abrupt or gradual withdrawal of remifentanil infusion and placebo. Remifentanil was administered at 2.5 ng ml(-1) for 30 min before abrupt withdrawal or gradual withdrawal by 0.6 ng ml(-1) every five min. Pain was assessed at baseline, during infusion, 45-50 min and 105-110 min after end of infusions using the heat pain test (HPT) and the cold pressor test (CPT). The HPT 45 min after infusion indicated OIH development in the abrupt withdrawal session with higher pain scores compared with the gradual withdrawal and placebo sessions (both Pwithdrawal compared with placebo (P=0.93). In the CPT 50 min after end of infusion there was OIH in both remifentanil sessions compared with placebo (gradual P=0.01, abrupt Pwithdrawal of remifentanil infusion in the HPT. After abrupt withdrawal OIH was present in the HPT. In the CPT there was OIH after both gradual and abrupt withdrawal of infusion. The duration of OIH was less than 105 min for both pain modalities. NCT 01702389. EudraCT number 2011-002734-39. © The Author 2016. Published by Oxford University Press on behalf of the British Journal of Anaesthesia. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  15. Costs of Providing Infusion Therapy for Rheumatoid Arthritis in a Hospital-based Infusion Center Setting.

    Science.gov (United States)

    Schmier, Jordana; Ogden, Kristine; Nickman, Nancy; Halpern, Michael T; Cifaldi, Mary; Ganguli, Arijit; Bao, Yanjun; Garg, Vishvas

    2017-08-01

    Many hospital-based infusion centers treat patients with rheumatoid arthritis (RA) with intravenous biologic agents, yet may have a limited understanding of the overall costs of infusion in this setting. The purposes of this study were to conduct a microcosting analysis from a hospital perspective and to develop a model using an activity-based costing approach for estimating costs associated with the provision of hospital-based infusion services (preparation, administration, and follow-up) in the United States for maintenance treatment of moderate to severe RA. A spreadsheet-based model was developed. Inputs included hourly wages, time spent providing care, supply/overhead costs, laboratory testing, infusion center size, and practice pattern information. Base-case values were derived from data from surveys, published studies, standard cost sources, and expert opinion. Costs are presented in year-2017 US dollars. The base case modeled a hospital infusion center serving patients with RA treated with abatacept, tocilizumab, infliximab, or rituximab. Estimated overall costs of infusions per patient per year were $36,663 (rituximab), $36,821 (tocilizumab), $44,973 (infliximab), and $46,532 (abatacept). Of all therapies, the biologic agents represented the greatest share of overall costs, ranging from 87% to $91% of overall costs per year. Excluding infusion drug costs, labor accounted for 53% to 57% of infusion costs. Biologic agents represented the highest single cost associated with RA infusion care; however, personnel, supplies, and overhead costs also contributed substantially to overall costs (8%-16%). This model may provide a helpful and adaptable framework for use by hospitals in informing decision making about services offered and their associated financial implications. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

  16. Strict versus liberal target range for perioperative glucose in patients undergoing coronary artery bypass grafting: a prospective randomized controlled trial.

    Science.gov (United States)

    Desai, Shalin P; Henry, Linda L; Holmes, Sari D; Hunt, Sharon L; Martin, Chidima T; Hebsur, Shrinivas; Ad, Niv

    2012-02-01

    The purpose of this study was to test the hypothesis that a liberal blood glucose strategy (121-180 mg/dL) is not inferior to a strict blood glucose strategy (90-120 mg/dL) for outcomes in patients after first-time isolated coronary artery bypass grafting and is superior for glucose control and target blood glucose management. A total of 189 patients undergoing coronary artery bypass grafting were investigated in this prospective randomized study to compare 2 glucose control strategies on patient perioperative outcomes. Three methods of analyses (intention to treat, completer, and per protocol) were conducted. Observed power was robust (>80%) for significant results. The groups were similar on preoperative hemoglobin A(1c) and number of diabetic patients. The liberal group was found to be noninferior to the strict group for perioperative complications and superior on glucose control and target range management. The liberal group had significantly fewer patients with hypoglycemic events (liberal range after coronary artery bypass grafting led to similar outcomes compared with a strict target range and was superior in glucose control and target range management. On the basis of the results of this study, a target blood glucose range of 121 to 180 mg/dL is recommended for patients after coronary artery bypass grafting as advocated by the Society of Thoracic Surgeons. Copyright © 2012 The American Association for Thoracic Surgery. Published by Mosby, Inc. All rights reserved.

  17. Anopheline larval habitats seasonality and species distribution: a prerequisite for effective targeted larval habitats control programmes.

    Directory of Open Access Journals (Sweden)

    Eliningaya J Kweka

    Full Text Available Larval control is of paramount importance in the reduction of malaria vector abundance and subsequent disease transmission reduction. Understanding larval habitat succession and its ecology in different land use managements and cropping systems can give an insight for effective larval source management practices. This study investigated larval habitat succession and ecological parameters which influence larval abundance in malaria epidemic prone areas of western Kenya.A total of 51 aquatic habitats positive for anopheline larvae were surveyed and visited once a week for a period of 85 weeks in succession. Habitats were selected and identified. Mosquito larval species, physico-chemical parameters, habitat size, grass cover, crop cycle and distance to nearest house were recorded. Polymerase chain reaction revealed that An. gambiae s.l was the most dominant vector species comprised of An.gambiae s.s (77.60% and An.arabiensis (18.34%, the remaining 4.06% had no amplification by polymerase chain reaction. Physico-chemical parameters and habitat size significantly influenced abundance of An. gambiae s.s (P = 0.024 and An. arabiensis (P = 0.002 larvae. Further, larval species abundance was influenced by crop cycle (P≤0.001, grass cover (P≤0.001, while distance to nearest houses significantly influenced the abundance of mosquito species larvae (r = 0.920;P≤0.001. The number of predator species influenced mosquito larval abundance in different habitat types. Crop weeding significantly influenced with the abundance of An.gambiae s.l (P≤0.001 when preceded with fertilizer application. Significantly higher anopheline larval abundance was recorded in habitats in pasture compared to farmland (P = 0.002. When habitat stability and habitat types were considered, hoof print were the most productive followed by disused goldmines.These findings suggest that implementation of effective larval control programme should be targeted with larval

  18. Cyclooxygenase-2 suppresses the anabolic response to PTH infusion in mice.

    Science.gov (United States)

    Choudhary, Shilpa; Canalis, Ernesto; Estus, Thomas; Adams, Douglas; Pilbeam, Carol

    2015-01-01

    We previously reported that the ability of continuously elevated PTH to stimulate osteoblastic differentiation in bone marrow stromal cell cultures was abrogated by an osteoclastic factor secreted in response to cyclooxygenase-2 (Cox2)-produced prostaglandin E2. We now examine the impact of Cox2 (Ptgs2) knockout (KO) on the anabolic response to continuously elevated PTH in vivo. PTH (40 μg/kg/d) or vehicle was infused for 12 or 21 days in 3-mo-old male wild type (WT) and KO mice in the outbred CD-1 background. Changes in bone phenotype were assessed by bone mineral density (BMD), μCT and histomorphometry. PTH infusion for both 12 and 21 days increased femoral BMD in Cox2 KO mice and decreased BMD in WT mice. Femoral and vertebral trabecular bone volume fractions were increased in KO mice, but not in WT mice, by PTH infusion. In the femoral diaphysis, PTH infusion increased cortical area in Cox2 KO, but not WT, femurs. PTH infusion markedly increased trabecular bone formation rate in the femur, serum markers of bone formation, and expression of bone formation-related genes, growth factors, and Wnt target genes in KO mice relative to WT mice, and decreased gene expression of Wnt antagonists only in KO mice. In contrast to the differential effects of PTH on anabolic factors in WT and KO mice, PTH infusion increased serum markers of resorption, expression of resorption-related genes, and the percent bone surface covered by osteoclasts similarly in both WT and KO mice. We conclude that Cox2 inhibits the anabolic, but not the catabolic, effects of continuous PTH. These data suggest that the bone loss with continuously infused PTH in mice is due largely to suppression of bone formation and that this suppression is mediated by Cox2.

  19. Evaluation for intravenous, arterial and local infusion of a hypoxic cell radiosensitizer RK28 on rabbit VX2 tumor system

    International Nuclear Information System (INIS)

    Kuramitsu, Tatsuya

    1993-01-01

    We evaluated the radiosensitizing effect of intraarterial, intravenous and local infusion of a hypoxic cell radiosensitizer RK28 on rabbit VX2 tumor system. Six rabbits were treated in each infusion group. VX2 tumor was implanted in the left hind leg. Tumor grown up to 3 cm in diameter was treated with 15 Gy of X-ray irradiation just after infusion of radiosensitizer RK28 (80 mg/kg.b.w.). Intratumoral and serum mean concentration of RK28 and its metabolites were measured. Tumor regression curve and survival time were analyzed. The following results were obtained. Mean concentration of RK28 was about 2.5 times greater in local infusion and 1.5 times in intraarterial infusion than in intravenous infusion. Significant regression of tumor was obtained in intraarterial infusion (p<0.01). There was no significant difference in survival time. These data suggest that the usefulness of intraarterial infusion of RK28 for local control using intraoperative radiation therapy and brachytherapy. (author)

  20. Intravascular streaming and variable delivery to brain following carotid artery infusions in the Sprague-Dawley rat

    International Nuclear Information System (INIS)

    Saris, S.C.; Wright, D.C.; Oldfield, E.H.; Blasberg, R.G.

    1988-01-01

    Intracarotid artery infusions in animals are commonly performed in studies of the blood-brain barrier and in chemotherapy trials. Implicit in the analysis of these experiments is that the infusate will be distributed to the territory of the internal carotid artery in a manner that is proportional to blood flow. Fifteen Sprague-Dawley rats were studied to determine if poor infusate mixing with blood due to intravascular streaming occurred during intracarotid artery drug infusions and if it could be eliminated with fast retrograde infusion. In three experimental groups, a radiolabeled flow tracer-- 14 C-iodoantipyrine (IAP)--was infused retrograde through the external carotid artery into the common carotid artery at slow, medium, and fast rates (0.45, 1.5, and 5.0 ml/min). In a control group, IAP was injected intravenously (i.v.). Local isotope concentrations in the brain were determined by quantitative autoradiography, and the variability of isotope delivery was assessed in the frontoparietal cortex, temporal cortex, and caudate putamen of all animals. Streaming phenomena were manifest in all selected anatomic areas after the slow and medium rates of intraarterial infusion. After fast intracarotid infusion or i.v. injection, there was uniform distribution of isotope in the same brain regions

  1. Targeting Deregulated Epigenetic Control in Cancer: Cancer Epigenomics as a Platform for Risk Assessment, Early Detection, Targeted Therapy and Potential for Relapse

    Science.gov (United States)

    Zaidi, Sayyed K.; van Wijnen, Andre J.; Lian, Jane B.; Stein, Janet L.; Stein, Gary S.

    2013-01-01

    Summary Cancer is a multifaceted disease that involves acquisition of genetic mutations, deletions, and amplifications as well as deregulation of epigenetic mechanisms that fine-tune gene regulation. Key epigenetic mechanisms that include histone modifications, DNA methylation, and non-coding RNA-mediated gene silencing are often deregulated in a variety of cancers. Subnuclear localization of key proteins in the interphase nucleus and bookmarking of genes by lineage commitment factors in mitosis – a new dimension to epigenetic control of fundamental biological processes – is also modified in cancer. In this review, we discuss the various aspects of epigenetic control that are operative in a variety of cancers and their potential for risk assessment, early detection, targeted therapy and personalized medicine. PMID:23589100

  2. Switching From Intermittent to Continuous Infusion of Vancomycin in Critically Ill Patients : Toward a More Robust Exposure

    NARCIS (Netherlands)

    van Maarseveen, Erik M; Gipmans, Suzan; Vasbinder, Erwin; Petjak, Manfred; van Zanten, Arthur R H

    BACKGROUND: To increase target attainment rates, switching the mode of administration from intermittent (InI) to continuous infusion (CoI) has been proposed. In this study, target attainment rates and interpatient variation in exposure were compared between vancomycin InI- and CoI-treated critically

  3. Routine saline infusion sonohysterography prior to assisted ...

    African Journals Online (AJOL)

    53.85%), 8 (30.77%) and 4 (15.38%) respectively. The average duration of the procedure was 6 minutes with a range of 4-9 minutes. Saline infusion sonohysterography is a reliable, cost effective and safe diagnostic tool in the evaluation of the ...

  4. Forearm metabolism during infusion of adrenaline

    DEFF Research Database (Denmark)

    Simonsen, L; Stefl, B; Bülow, J

    2000-01-01

    Human skeletal muscle metabolism is often investigated by measurements of substrate fluxes across the forearm. To evaluate whether the two forearms give the same metabolic information, nine healthy subjects were studied in the fasted state and during infusion of adrenaline. Both arms were cathete...

  5. Comparison of infusion pumps calibration methods

    Science.gov (United States)

    Batista, Elsa; Godinho, Isabel; do Céu Ferreira, Maria; Furtado, Andreia; Lucas, Peter; Silva, Claudia

    2017-12-01

    Nowadays, several types of infusion pump are commonly used for drug delivery, such as syringe pumps and peristaltic pumps. These instruments present different measuring features and capacities according to their use and therapeutic application. In order to ensure the metrological traceability of these flow and volume measuring equipment, it is necessary to use suitable calibration methods and standards. Two different calibration methods can be used to determine the flow error of infusion pumps. One is the gravimetric method, considered as a primary method, commonly used by National Metrology Institutes. The other calibration method, a secondary method, relies on an infusion device analyser (IDA) and is typically used by hospital maintenance offices. The suitability of the IDA calibration method was assessed by testing several infusion instruments at different flow rates using the gravimetric method. In addition, a measurement comparison between Portuguese Accredited Laboratories and hospital maintenance offices was performed under the coordination of the Portuguese Institute for Quality, the National Metrology Institute. The obtained results were directly related to the used calibration method and are presented in this paper. This work has been developed in the framework of the EURAMET projects EMRP MeDD and EMPIR 15SIP03.

  6. Effect of intravenous dexmedetomidine infusion on some ...

    African Journals Online (AJOL)

    Background: This study was designed to evaluate the effect of intravenous dexmedetomidine infusion in patients undergoing major abdominal surgery on stress response markers as plasma interleukin-6, cortisol and blood glucose level. It also assessed its effect on recovery profile and postoperative pain. Methods: Thirty ...

  7. Adverse events with continuous doxapram infusion against late postoperative hypoxaemia

    DEFF Research Database (Denmark)

    Rosenberg, J; Kristensen, P A; Pedersen, M H

    1996-01-01

    OBJECTIVE: A randomized double-blind controlled trial of doxapram versus placebo against late postoperative hypoxaemia was planned to include 40 patients (2 x 20). RESULTS: After inclusion of 18 patients a serious adverse event was encountered with development of a brain stem infarction in a 90-y...... promising, further studies on the effect of continuous nocturnal postoperative doxapram infusion on levels of arterial oxygen saturation should be postponed until more knowledge about the pharmacokinetics of doxapram in this particular clinical situation has been gathered....

  8. 25m2 target-aligned heliostat with closed-loop control

    CSIR Research Space (South Africa)

    Roos, TH

    2007-09-01

    Full Text Available system making use of a solar tracker has been developed and tested on a 1.252m target-aligned miniheliostat. A tracking accuracy of 3.3 milliradians was obtained. A good focal spot has been obtained with the 252m target-aligned research heliostat....

  9. Identification of highly effective target genes for RNAi-mediated control of emerald ash borer, Agrilus planipennis.

    Science.gov (United States)

    Rodrigues, Thais B; Duan, Jian J; Palli, Subba R; Rieske, Lynne K

    2018-03-22

    Recent study has shown that RNA interference (RNAi) is efficient in emerald ash borer (EAB), Agrilus planipennis, and that ingestion of double-stranded RNA (dsRNA) targeting specific genes causes gene silencing and mortality in neonates. Here, we report on the identification of highly effective target genes for RNAi-mediated control of EAB. We screened 13 candidate genes in neonate larvae and selected the most effective target genes for further investigation, including their effect on EAB adults and on a non-target organism, Tribolium castaneum. The two most efficient target genes selected, hsp (heat shock 70-kDa protein cognate 3) and shi (shibire), caused up to 90% mortality of larvae and adults. In EAB eggs, larvae, and adults, the hsp is expressed at higher levels when compared to that of shi. Ingestion of dsHSP and dsSHI caused mortality in both neonate larvae and adults. Administration of a mixture of both dsRNAs worked better than either dsRNA by itself. In contrast, injection of EAB.dsHSP and EAB.dsSHI did not cause mortality in T. castaneum. Thus, the two genes identified cause high mortality in the EAB with no apparent phenotype effects in a non-target organism, the red flour beetle, and could be used in RNAi-mediated control of this invasive pest.

  10. Controlled synthesis of target strings in a class of splicing systems.

    Science.gov (United States)

    Chen, Peter C Y

    2005-08-01

    This article presents an approach for synthesizing target strings in a class of computational models of DNA recombination. The computational models are formalized as splicing systems in the context of formal languages. Given a splicing system (of a restricted type) and a target string to be synthesized, we construct (i) a rule-embedded splicing automaton that recognizes languages containing strings embedded with symbols representing splicing rules, and (ii) an automaton that implicitly recognizes the target string. By manipulating these two automata, we extract all rule sequences that lead to the production of the target string (if that string belongs to the splicing language). An algorithm for synthesizing a certain type of target strings based on such rule sequences is presented.

  11. Life-threatening hyperkalemia following zoledronic acid infusion for Paget's disease: a case report

    Directory of Open Access Journals (Sweden)

    Naysmith Morag

    2011-08-01

    Full Text Available Abstract Introduction Zoledronic acid is a highly effective treatment in Paget's disease for persistent bone pain and prevention of further progression of the disease. The commonest electrolyte abnormality is hypocalcemia. To the best of our knowledge this is the first case of hyperkalemia secondary to zoledronic acid to be published in the world literature. The commonest arrhythmia related to zoledronic acid is atrial fibrillation. Case presentation We describe the case of an 80-year-old Caucasian man, with a history of ischemic heart disease, who had an in-hospital cardiac arrest related to hyperkalemia. Increasing potassium levels were noted following his first zoledronic acid infusion for symptomatic control of bone pain secondary to Paget's disease. Our patient suffered a cardiac arrest 10 days following the zoledronic acid infusion. Our patient's biochemistry and electrocardiogram output were monitored until his death 26 days after his cardiac arrest. Our patient developed paroxysmal atrial fibrillation in the post-resuscitation period and there was persistent hyperkalemia that required prolonged treatment with calcium resonium. All other possible causes of hyperkalemia were excluded. Conclusion In our patient's case persistent hyperkalemia and life-threatening arrhythmias were associated with use of zoledronic acid. These side effects have not been reported before and the causative mechanism is far from clear as there are no obvious systemic effects of zoledronic acid. The combination of zoledronic acid with predisposing factors such as structural heart disease might account for the clinical picture we witnessed. As a result, electrolyte monitoring should be adopted early in zoledronic acid use. Further studies are required to elucidate the underlying mechanism of hyperkalemia and identify the target group of patients where zoledronic acid can be safely administered. Great caution is advised in patients with underlying heart conditions.

  12. Controlled and targeted release of antigens by intelligent shell for improving applicability of oral vaccines.

    Science.gov (United States)

    Zhang, Lei; Zeng, Zhanzhuang; Hu, Chaohua; Bellis, Susan L; Yang, Wendi; Su, Yintao; Zhang, Xinyan; Wu, Yunkun

    2016-01-01

    Conventional oral vaccines with simple architecture face barriers with regard to stimulating effective immunity. Here we describe oral vaccines with an intelligent phase-transitional shielding layer, poly[(methyl methacrylate)-co-(methyl acrylate)-co-(methacrylic acid)]-poly(D,L-lactide-co-glycolide) (PMMMA-PLGA), which can protect antigens in the gastro-intestinal tract and achieve targeted vaccination in the large intestine. With the surface immunogenic protein (SIP) from group B Streptococcus (GBS) entrapped as the antigen, oral administration with PMMMA-PLGA (PTRBL)/Trx-SIP nanoparticles stimulated robust immunity in tilapia, an animal with a relatively simple immune system. The vaccine succeeded in protecting against Streptococcus agalactiae, a pathogen of worldwide importance that threatens human health and is transmitted in water with infected fish. After oral vaccination with PTRBL/Trx-SIP, tilapia produced enhanced levels of SIP specific antibodies and displayed durability of immune protection. 100% of the vaccinated tilapia were protected from GBS infection, whereas the control groups without vaccines or vaccinated with Trx-SIP only exhibited respective infection rates of 100% or >60% within the initial 5 months after primary vaccination. Experiments in vivo demonstrated that the recombinant antigen Trx-SIP labeled with FITC was localized in colon, spleen and kidney, which are critical sites for mounting an immune response. Our results revealed that, rather than the size of the nanoparticles, it is more likely that the negative charge repulsion produced by ionization of the carboxyl groups in PMMMA shielded the nanoparticles from uptake by small intestinal epithelial cells. This system resolves challenges arising from gastrointestinal damage to antigens, and more importantly, offers a new approach applicable for oral vaccination. Copyright © 2015 Elsevier Ltd. All rights reserved.

  13. The membrane as a target for controlling hypervirulent Clostridium difficile infections

    Science.gov (United States)

    Wu, Xiaoqian; Cherian, Philip T.; Lee, Richard E.; Hurdle, Julian G.

    2013-01-01

    Objectives The stationary phase of Clostridium difficile, which is primarily responsible for diarrhoeal symptoms, is refractory to antibiotic killing. We investigated whether disrupting the functions of the clostridial membrane is an approach to control C. difficile infections by promptly removing growing and non-growing cells. Methods The bactericidal activities of various membrane-active agents were determined against C. difficile logarithmic-phase and stationary-phase cultures and compared with known antibiotics. Their effects on the synthesis of ATP, toxins A/B and sporulation were also determined. The effect of rodent caecal contents on anti-difficile activities was examined using two reutericyclin lead compounds, clofazimine, daptomycin and other comparator antibiotics. Results Most membrane-active agents and partially daptomycin showed concentration-dependent killing of both logarithmic-phase and stationary-phase cultures. The exposure of cells to compounds at their MBC resulted in a rapid loss of viability with concomitant reductions in cellular ATP, toxins A/B and spore numbers. With the exception of nisin, these effects were not due to membrane pore formation. Interestingly, the activity of the proton ionophore nigericin significantly increased as the growth of C. difficile decreased, suggesting the importance of the proton gradient to the survival of non-growing cells. The activities of the lipophilic antimicrobials reutericyclins and clofazimine were reduced by caecal contents. Conclusions These findings indicate that C. difficile is uniquely susceptible to killing by molecules affecting its membrane function and bioenergetics, indicating that the clostridial membrane is a novel antimicrobial target for agents to alleviate the burden of C. difficile infections. PMID:23264511

  14. Integration of bio-inspired, control-based visual and olfactory data for the detection of an elusive target

    Science.gov (United States)

    Duong, Tuan A.; Duong, Nghi; Le, Duong

    2017-01-01

    In this paper, we present an integration technique using a bio-inspired, control-based visual and olfactory receptor system to search for elusive targets in practical environments where the targets cannot be seen obviously by either sensory data. Bio-inspired Visual System is based on a modeling of extended visual pathway which consists of saccadic eye movements and visual pathway (vertebrate retina, lateral geniculate nucleus and visual cortex) to enable powerful target detections of noisy, partial, incomplete visual data. Olfactory receptor algorithm, namely spatial invariant independent component analysis, that was developed based on data of old factory receptor-electronic nose (enose) of Caltech, is adopted to enable the odorant target detection in an unknown environment. The integration of two systems is a vital approach and sets up a cornerstone for effective and low-cost of miniaturized UAVs or fly robots for future DOD and NASA missions, as well as for security systems in Internet of Things environments.

  15. Chemoradiotherapy using retrograde superselective intra-arterial infusion for advanced oral cancer

    International Nuclear Information System (INIS)

    Mitsudo, Kenji; Iwai, Toshinori; Mitsunaga, Sachiyo

    2011-01-01

    Concurrent chemoradiotherapy using retrograde superselective intra-arterial infusion demonstrates good local control and overall survival rates due to the advantage of simultaneous infusion of anticancer agent with the synergistic effects of chemotherapy and radiotherapy. This study evaluated the therapeutic results, overall survival and local control rates in patients with advanced oral cancer treated with definitive concurrent chemoradiotherapy using retrograde superselective intra-arterial infusion. A total of 688 patients with carcinoma of the head and neck were referred to our institution between January 2001 and December 2006. Among them, 175 patients with carcinoma of the oral cavity underwent definitive concurrent chemoradiotherapy using retrograde superselective intra-arterial infusion. Treatment consisted of superselective intra-arterial infusions (docetaxel, total 60 mg/m 2 , cisplatin, total 125-150 mg/m 2 ) and daily concurrent radiotherapy (total 50-60 Gy) for 5-6 weeks. Four weeks after the completion of all treatments, patients underwent biopsy of the primary lesion and radiological examinations. Complete response (CR) of the primary site was achieved in 160 (91.4%) of the 175 patients. Residual disease at the primary site was seen in 15 patients (8.6%), and 14 patients (8.0%) showed local recurrence during follow-up. Five-year survival and local control rates were 71.6% and 82.2%, respectively. (author)

  16. Ubiquitous Sensor Networks: Efisiensi Sistem Kontrol Cairan Infus Pasien Rawat Inap

    Directory of Open Access Journals (Sweden)

    BUDI RAHMADYA

    2017-07-01

    Full Text Available ABSTRAKPenelitian ini membahas tentang sistem kontrol cairan infus pada pasien dengan memanfaatkan teknologi sensor networks dan mikrokontroler arduino uno.  Sensor yang digunakan adalah sensor Ultrasonik HC-SR04 yang difungsikan untuk mendeteksi sisa cairan infus. Data yang terbaca oleh sensor dikirimkan menggunakan jaringan nirkabel/wireless dari Transmitter (Tx di ruang pasien ke Receiver (Rx di ruang perawat dengan menggunakan modul wireless Xbee S2. Efisiensi dari sistem kontrol yang dibuat yaitu ketika sensor mendeteksi cairan infus mendekati batas habis cairan yang telah ditentukan maka motor yang berada pada selang infus akan berfungsi untuk menutup aliran cairan infus pada selang. Dari simulasi yang dilakukan, didapatkan hasil presentasi error ketinggian cairan infus sebesar 1.96% dan presentasi error volume cairan sebesar 2.16%. Performa dari modul wireless Xbee S2 juga di ujicoba dengan mengirimkan data dari Xbee end device ke Xbee coordinator dalam penelitian ini. Kata kunci: Infus, Sensor Networks, Sensor Ultrasonik HC-SR04, Xbee S2 dan Mikrokontroler Arduino Uno.ABSTRACTThis research discusses about intravenous fluids Control System on Patients, utilizing sensor network technology and Arduino Uno microcontroller. We used  HC-SR04 Ultrasonic sensors to detect the review time intravenous fluids. The sensors data is readable by transmitted using wireless network/wireless from Transmitter (Tx in Patients Into Space Receiver (Rx at nurse room with using XBee wireless device S2. The efficiency of the control system were made, namely when the sensor detects the approaching limits of intravenous fluids discharged liquid that has been determined then the motor that was on the infus line will serve to close the infusion fluid flow in the line. In our simulations we found, the findings obtained Presentation intravenous fluids altitude error is 1.96% and presentations volume Liquid error is 2.16%. The performance of network devices XBee S2

  17. Bronchial arterial infusion versus bronchial combined pulmonary arterial infusion for pulmonary metastatic tumors

    International Nuclear Information System (INIS)

    Dong Sheng; Dong Weihua; Jia Ningyang; Zhang Dianbo; Xiao Xiangsheng

    2008-01-01

    Objective: To evaluate the pulmonary metastatic tumor response to different ways of transcatheter arterial infusion. Methods: Thirty-five patients with pulmonary metastatic tumors were randomized divided into two groups: 15 patients with 49 lesions treated with bronchial arterial infusion (BAI) and 20 patients with 65 lesions treated with bronchial arterial infusion (BM)combined with pulmonary arterial infusion (PAI). The therapeutic response was assessed by the WHO evaluation criteria. Results: The total effective rate(CR + PR) of BAI was 65.3% (32/49), PAI + BAI was 61.5%(40/65) showing no statistical difference. The median survival time of BAI was 9 mo, BAI + PAI was 11.5 mo, demonstrating no statistical significance. Conclusions: BAI should be the primary treatment for pulmonary metastatic tumor. (authors)

  18. Fabrication and Mechanical Characterization of Hydrogel Infused Network Silk Scaffolds

    Directory of Open Access Journals (Sweden)

    Lakshminath Kundanati

    2016-09-01

    Full Text Available Development and characterization of porous scaffolds for tissue engineering and regenerative medicine is of great importance. In recent times, silk scaffolds were developed and successfully tested in tissue engineering and drug release applications. We developed a novel composite scaffold by mechanical infusion of silk hydrogel matrix into a highly porous network silk scaffold. The mechanical behaviour of these scaffolds was thoroughly examined for their possible use in load bearing applications. Firstly, unconfined compression experiments show that the denser composite scaffolds displayed significant enhancement in the elastic modulus as compared to either of the components. This effect was examined and further explained with the help of foam mechanics principles. Secondly, results from confined compression experiments that resemble loading of cartilage in confinement, showed nonlinear material responses for all scaffolds. Finally, the confined creep experiments were performed to calculate the hydraulic permeability of the scaffolds using soil mechanics principles. Our results show that composite scaffolds with some modifications can be a potential candidate for use of cartilage like applications. We hope such approaches help in developing novel scaffolds for tissue engineering by providing an understanding of the mechanics and can further be used to develop graded scaffolds by targeted infusion in specific regions.

  19. Fabrication and Mechanical Characterization of Hydrogel Infused Network Silk Scaffolds.

    Science.gov (United States)

    Kundanati, Lakshminath; Singh, Saket K; Mandal, Biman B; Murthy, Tejas G; Gundiah, Namrata; Pugno, Nicola M

    2016-09-26

    Development and characterization of porous scaffolds for tissue engineering and regenerative medicine is of great importance. In recent times, silk scaffolds were developed and successfully tested in tissue engineering and drug release applications. We developed a novel composite scaffold by mechanical infusion of silk hydrogel matrix into a highly porous network silk scaffold. The mechanical behaviour of these scaffolds was thoroughly examined for their possible use in load bearing applications. Firstly, unconfined compression experiments show that the denser composite scaffolds displayed significant enhancement in the elastic modulus as compared to either of the components. This effect was examined and further explained with the help of foam mechanics principles. Secondly, results from confined compression experiments that resemble loading of cartilage in confinement, showed nonlinear material responses for all scaffolds. Finally, the confined creep experiments were performed to calculate the hydraulic permeability of the scaffolds using soil mechanics principles. Our results show that composite scaffolds with some modifications can be a potential candidate for use of cartilage like applications. We hope such approaches help in developing novel scaffolds for tissue engineering by providing an understanding of the mechanics and can further be used to develop graded scaffolds by targeted infusion in specific regions.

  20. Odour-baited targets to control New World screwworm: A preliminary field study in Mexico

    International Nuclear Information System (INIS)

    Torr, S.J.; Hall, M.J.R.

    1992-01-01

    Biconical, F3 and Wind Oriented (WOT) traps and black cloth targets, baited with swormlure-4, were assessed as catching and killing devices for the New World screwworm fly, Cochliomyia hominivorax, in Mexico. The WOT was significantly better than the other trap designs, with a mean catch 2.7 and 86.4 times better than those of the Biconical and F3, respectively. It was demonstrated that the release of swormlure-4 could be reduced from the standard 10 ml/day to 2 ml/day without a reduction in the numbers of screwworm caught in a WOT. Use of electric nets demonstrated that a visual target was not necessary for the precise location of a swormlure-4 source by screwworm. Target colour was important with respect to the landing response of screwworms on targets: in a two-choice situation, flies landed much more frequently on black than on blue or yellow, and more on these two colours than they did on white. Screwworm tend not to circle a target before landing on it: about 75% of the flies caught on a combination of electrified black target plus electric flanking net were caught on the target. 6 tabs

  1. Infusion reactions during infliximab treatment are not associated with IgE anti-infliximab antibodies

    NARCIS (Netherlands)

    van Schie, Karin A.; Ooijevaar-de Heer, Pleuni; Kruithof, Simone; Plasencia, Chamaida; Jurado, Teresa; Pascual Salcedo, Dora; Brandse, Johannan F.; D'Haens, Geert Ram; Wolbink, Gerrit Jan; Rispens, Theo

    2017-01-01

    Controversy exists on the role of IgE antidrug antibodies (IgE-ADA) in infusion reactions (IR) on infliximab treatment, partly due to the lack of a positive control used for assay validation. We sought to (1) develop a robust assay to measure IgE-ADA, including a positive control, (2) determine the

  2. Effects of dexmedetomidine infusion during spinal anesthesia on ...

    African Journals Online (AJOL)

    Effects of dexmedetomidine infusion during spinal anesthesia on hemodynamics and sedation. ... Libyan Journal of Medicine ... evaluated the effects of intravenous dexmedetomidine during spinal anesthesia on hemodynamics, respiratory rate, oxygen saturation, sedpain, and compared them with those of saline infusion.

  3. Cost-benefit analysis for biological control programs that target insects pests of eucalypts in urban landscapes of California

    Science.gov (United States)

    T.D. Paine; J.G. Millar; L.M. Hanks; J. Gould; Q. Wang; K. Daane; D.L. Dahlsten; E.G. McPherson

    2015-01-01

    As well as being planted for wind breaks, landscape trees, and fuel wood, eucalypts are also widely used as urban street trees in California. They now are besieged by exotic insect herbivores of four different feeding guilds. The objective of the current analysis was to determine the return on investment from biological control programs that have targeted these pests....

  4. A Preliminary Controlled Comparison of Programs Designed to Reduce Risk of Eating Disorders Targeting Perfectionism and Media Literacy

    Science.gov (United States)

    Wilksch, Simon M.; Durbridge, Mitchell R.; Wade, Tracey D.

    2008-01-01

    The study aims to find out whether programs targeting perfectionism and media literacy are more effective than control classes in reducing eating disorder risk factors. Finding reveals that perfectionism programs are well suited to individuals of mid- to late adolescent age and shows the importune of making prevention programs developmentally…

  5. Transcriptome Analysis and Screening for Potential Target Genes for RNAi-Mediated Pest Control of the Beet Armyworm, Spodoptera exigua.

    Science.gov (United States)

    Li, Hang; Jiang, Weihua; Zhang, Zan; Xing, Yanru; Li, Fei

    2013-01-01

    The beet armyworm, Spodoptera exigua (Hübner), is a serious pest worldwide that causes significant losses in crops. Unfortunately, genetic resources for the beet armyworm is extremely scarce. To improve these resources we sequenced the transcriptome of S. exigua representing all stages including eggs, 1(st) to 5(th) instar larvae, pupae, male and female adults using the Illumina Solexa platform. We assembled the transcriptome with Trinity that yielded 31,414 contigs. Of these contigs, 18,592 were annotated as protein coding genes by Blast searches against the NCBI nr database. It has been shown that knockdown of important insect genes by dsRNAs or siRNAs is a feasible mechanism to control insect pests. The first key step towards developing an efficient RNAi-mediated pest control technique is to find suitable target genes. To screen for effective target genes in the beet armyworm, we selected nine candidate genes. The sequences of these genes were amplified using the RACE strategy. Then, siRNAs were designed and chemically synthesized. We injected 2 µl siRNA (2 µg/µl) into the 4(th) instar larvae to knock down the respective target genes. The mRNA abundance of target genes decreased to different levels (∼20-94.3%) after injection of siRNAs. Knockdown of eight genes including chitinase7, PGCP, chitinase1, ATPase, tubulin1, arf2, tubulin2 and arf1 caused a significantly high level of mortality compared to the negative control (Ppest control.

  6. Association between augmented renal clearance and clinical outcomes in patients receiving β-lactam antibiotic therapy by continuous or intermittent infusion: a nested cohort study of the BLING-II randomised, placebo-controlled, clinical trial.

    Science.gov (United States)

    Udy, Andrew A; Dulhunty, Joel M; Roberts, Jason A; Davis, Joshua S; Webb, Steven A R; Bellomo, Rinaldo; Gomersall, Charles; Shirwadkar, Charudatt; Eastwood, Glenn M; Myburgh, John; Paterson, David L; Starr, Therese; Paul, Sanjoy K; Lipman, Jeffrey

    2017-05-01

    Augmented renal clearance (ARC) is known to influence β-lactam antibiotic pharmacokinetics. This substudy of the BLING-II trial aimed to explore the association between ARC and patient outcomes in a large randomised clinical trial. BLING-II enrolled 432 participants with severe sepsis randomised to receive β-lactam therapy by continuous or intermittent infusion. An 8-h creatinine clearance (CL Cr ) measured on Day 1 was used to identify ARC, defined as CL Cr  ≥ 130 mL/min. Patients receiving any form of renal replacement therapy were excluded. Primary outcome was alive ICU-free days at Day 28. Secondary outcomes included 90-day mortality and clinical cure at 14 days following antibiotic cessation. A total of 254 patients were included, among which 45 (17.7%) manifested ARC [median (IQR) CL Cr 165 (144-198) mL/min]. ARC patients were younger (P antibiotics in severe sepsis, ARC was not associated with any differences in outcomes, regardless of dosing strategy. Copyright © 2017 Elsevier B.V. and International Society of Chemotherapy. All rights reserved.

  7. 75 FR 21641 - Infusion Pumps; Public Meeting; Request for Comments

    Science.gov (United States)

    2010-04-26

    ...] Infusion Pumps; Public Meeting; Request for Comments AGENCY: Food and Drug Administration, HHS. ACTION... announcing a public meeting regarding external infusion pumps. The purpose of the meeting is to inform the public about current problems associated with external infusion pump use, to help the agency identify...

  8. Continuous infusion of chemotherapy: focus on 5-fluorouracil and fluorodeoxyuridine

    NARCIS (Netherlands)

    Poorter, R. L.; Bakker, P. J.; Veenhof, C. H.

    1998-01-01

    Continuous infusion of chemotherapy is one of the developments to try to improve the treatment of metastatic cancer. There is a sound theoretical rationale to deliver cytotoxic drugs as a continuous infusion. Furthermore, the development of reliable venous access devices and portable infusion pumps

  9. Effects of Fetal and Neonatal Murine Peripheral Blood Mononuclear Cells Infusion on MicroRNA-145 Expression in Renal Vascular Smooth Muscle Cells in MRL/lpr Mice.

    Science.gov (United States)

    Wen, C; Liu, X Y; Wan, W Q; Yi, Z W

    2015-10-01

    For patients with refractory systemic lupus erythematosus, current medications are insufficient to control their condition, and new treatments are necessary. We aimed to evaluate the therapeutic effect of fetal and neonatal murine peripheral blood (FNPB) mononuclear cells and their impact on microRNA-145 (miR-145) in renal vascular smooth muscle cells (VSMCs) of MRL/lpr lupus-prone mice. MRL/lpr mice aged 20 weeks were randomized to 3 groups of 15 (control group, radiation group, infusion group). The renal tissues were subjected to pathological examination. In situ hybridization assay was applied to measure miR-145 expression in renal vessels of MRL/lpr mice. The infusion group had significantly better results for pathological renal tissue lesions than either the control or radiation group. In MRL/lpr mice, there was positive expression of miR-145 in renal VSMCs, although the expression of miR-145 was not discernible in renal vascular intima and adventitia. The miR-145 expression in renal VSMCs in the infusion group was significantly higher than in the control or radiation group, and higher in the radiation group than in the control group; however, the difference was not statistically significant. The increased expression of miR-145 in renal VSMCs might be one of the mechanisms supporting FNPB as a therapy for lupus nephritis; it also suggests that the miR-145 in renal vessels might be a new target for treatment of lupus nephritis. Copyright © 2015 Elsevier Inc. All rights reserved.

  10. An audit of hospital based outpatient infusions and a pilot program of community-based monoclonal antibody infusions.

    LENUS (Irish Health Repository)

    Doran, J-P

    2012-02-01

    INTRODUCTION: Infliximab, a chimeric monoclonal antibody to tumour necrosis factor alpha, is administered as an intravenous infusion requiring a costly hospital day case or inpatient admission. METHODS: An audit of all current therapies given by intravenous infusions in an outpatient setting in St Vincent\\'s University Hospital (SVUH) was undertaken. Furthermore, in conjunction with TCP homecare, we established in a general practise health clinic, the first Irish community infusion centre for the administration of infliximab in August 2006. RESULTS: All outpatient departments indicated that they would favour a centralized hospital infusion unit. There were no adverse events and the mean global satisfaction improved in the community infliximab infusion pilot programme of seven patients. CONCLUSION: This study suggests efficiencies in providing centralized infusion facilities, while the community based infusion of infliximab is feasible and safe in this small cohort and identifies the community infusion unit as a viable and cost efficient alternative for administration of infliximab.

  11. PACAP-38 infusion causes sustained vasodilation of the middle meningeal artery in the rat

    DEFF Research Database (Denmark)

    Bhatt, Deepak K; Gupta, Saurabh; Olesen, Jes

    2014-01-01

    BACKGROUND: In healthy human volunteers and in migraineurs, pituitary adenylate cyclase-activating polypeptide-38 (PACAP-38) infusion caused sustained vasodilation of the middle meningeal artery (MMA) and an immediate as well as a delayed headache. All the study subjects experienced facial flushing....... Mast cells (MCs) might have a role in the long-lasting effect of PACAP-38 infusion. We hypothesized that in mast cell-depleted (MCD) rats the vascular responses to PACAP-38 would be lesser than in control rats because of a lack of vasodilatory products released during MC degranulation. METHODS: MCs...... were depleted by chronic treatment with compound 48/80. The effect of 20 minutes' intravenous (i.v.) infusion of calcitonin gene-related peptide (CGRP), PACAP-38, PACAP(6-38) (PAC-1 receptor antagonist) and PACAP-27 on the diameter of the MMA and on mean arterial blood pressure (MABP) in control...

  12. Recombinant human tripeptidyl peptidase-1 infusion to the monkey CNS: Safety, pharmacokinetics, and distribution

    Energy Technology Data Exchange (ETDEWEB)

    Vuillemenot, Brian R., E-mail: bvuillemenot@bmrn.com [BioMarin Pharmaceutical Inc., Novato, CA (United States); Kennedy, Derek [BioMarin Pharmaceutical Inc., Novato, CA (United States); Reed, Randall P.; Boyd, Robert B. [Northern Biomedical Research, Inc., Muskegon, MI (United States); Butt, Mark T. [Tox Path Specialists, LLC, Hagerstown, MD (United States); Musson, Donald G.; Keve, Steve; Cahayag, Rhea; Tsuruda, Laurie S.; O' Neill, Charles A. [BioMarin Pharmaceutical Inc., Novato, CA (United States)

    2014-05-15

    CLN2 disease is caused by deficiency in tripeptidyl peptidase-1 (TPP1), leading to neurodegeneration and death. The safety, pharmacokinetics (PK), and CNS distribution of recombinant human TPP1 (rhTPP1) were characterized following a single intracerebroventricular (ICV) or intrathecal-lumbar (IT-L) infusion to cynomolgus monkeys. Animals received 0, 5, 14, or 20 mg rhTPP1, ICV, or 14 mg IT-L, in artificial cerebrospinal fluid (aCSF) vehicle. Plasma and CSF were collected for PK analysis. Necropsies occurred at 3, 7, and 14 days post-infusion. CNS tissues were sampled for rhTPP1 distribution. TPP1 infusion was well tolerated and without effect on clinical observations or ECG. A mild increase in CSF white blood cells (WBCs) was detected transiently after ICV infusion. Isolated histological changes related to catheter placement and infusion were observed in ICV treated animals, including vehicle controls. The CSF and plasma exposure profiles were equivalent between animals that received an ICV or IT-L infusion. TPP1 levels peaked at the end of infusion, at which point the enzyme was present in plasma at 0.3% to 0.5% of CSF levels. TPP1 was detected in brain tissues with half-lives of 3–14 days. CNS distribution between ICV and IT-L administration was similar, although ICV resulted in distribution to deep brain structures including the thalamus, midbrain, and striatum. Direct CNS infusion of rhTPP1 was well tolerated with no drug related safety findings. The favorable nonclinical profile of ICV rhTPP1 supports the treatment of CLN2 by direct administration to the CNS. - Highlights: • TPP1 enzyme replacement therapy to the CNS is in development for CLN2 disease. • Toxicology, pharmacokinetics, and CNS distribution were assessed in monkeys. • TPP1 infusion directly to the brain did not result in any safety concerns. • A positive pharmacokinetic and distribution profile resulted from TPP1 infusion. • This study demonstrates the feasibility of ICV administered

  13. Recombinant human tripeptidyl peptidase-1 infusion to the monkey CNS: Safety, pharmacokinetics, and distribution

    International Nuclear Information System (INIS)

    Vuillemenot, Brian R.; Kennedy, Derek; Reed, Randall P.; Boyd, Robert B.; Butt, Mark T.; Musson, Donald G.; Keve, Steve; Cahayag, Rhea; Tsuruda, Laurie S.; O'Neill, Charles A.

    2014-01-01

    CLN2 disease is caused by deficiency in tripeptidyl peptidase-1 (TPP1), leading to neurodegeneration and death. The safety, pharmacokinetics (PK), and CNS distribution of recombinant human TPP1 (rhTPP1) were characterized following a single intracerebroventricular (ICV) or intrathecal-lumbar (IT-L) infusion to cynomolgus monkeys. Animals received 0, 5, 14, or 20 mg rhTPP1, ICV, or 14 mg IT-L, in artificial cerebrospinal fluid (aCSF) vehicle. Plasma and CSF were collected for PK analysis. Necropsies occurred at 3, 7, and 14 days post-infusion. CNS tissues were sampled for rhTPP1 distribution. TPP1 infusion was well tolerated and without effect on clinical observations or ECG. A mild increase in CSF white blood cells (WBCs) was detected transiently after ICV infusion. Isolated histological changes related to catheter placement and infusion were observed in ICV treated animals, including vehicle controls. The CSF and plasma exposure profiles were equivalent between animals that received an ICV or IT-L infusion. TPP1 levels peaked at the end of infusion, at which point the enzyme was present in plasma at 0.3% to 0.5% of CSF levels. TPP1 was detected in brain tissues with half-lives of 3–14 days. CNS distribution between ICV and IT-L administration was similar, although ICV resulted in distribution to deep brain structures including the thalamus, midbrain, and striatum. Direct CNS infusion of rhTPP1 was well tolerated with no drug related safety findings. The favorable nonclinical profile of ICV rhTPP1 supports the treatment of CLN2 by direct administration to the CNS. - Highlights: • TPP1 enzyme replacement therapy to the CNS is in development for CLN2 disease. • Toxicology, pharmacokinetics, and CNS distribution were assessed in monkeys. • TPP1 infusion directly to the brain did not result in any safety concerns. • A positive pharmacokinetic and distribution profile resulted from TPP1 infusion. • This study demonstrates the feasibility of ICV administered

  14. [Security of hospital infusion practices: From an a priori risk analysis to an improvement action plan].

    Science.gov (United States)

    Pignard, J; Cosserant, S; Traore, O; Souweine, B; Sautou, V

    2016-03-01

    Infusion in care units, and all the more in intensive care units, is a complex process which can be the source of many risks for the patient. Under cover of an institutional approach for the improvement of the quality and safety of patient healthcare, a risk mapping infusion practices was performed. The analysis was focused on intravenous infusion situations in adults, the a priori risk assessment methodology was applied and a multidisciplinary work group established. Forty-three risks were identified for the infusion process (prescription, preparation and administration). The risks' assessment and the existing means of control showed that 48% of them would have a highly critical patient security impact. Recommendations were developed for 20 risks considered to be most critical, to limit their occurrence and severity, and improve their control level. An institutional action plan was developed and validated in the Drug and Sterile Medical Devices Commission. This mapping allowed the realization of an exhaustive inventory of potential risks associated with the infusion. At the end of this work, multidisciplinary groups were set up to work on different themes and regular quarterly meetings were established to follow the progress of various projects. Risk mapping will be performed in pediatric and oncology unit where the risks associated with the handling of toxic products is omnipresent. Copyright © 2015 Académie Nationale de Pharmacie. Published by Elsevier Masson SAS. All rights reserved.

  15. Midcourse Guidance Law Based on High Target Acquisition Probability Considering Angular Constraint and Line-of-Sight Angle Rate Control

    Directory of Open Access Journals (Sweden)

    Xiao Liu

    2016-01-01

    Full Text Available Random disturbance factors would lead to the variation of target acquisition point during the long distance flight. To acquire a high target acquisition probability and improve the impact precision, missiles should be guided to an appropriate target acquisition position with certain attitude angles and line-of-sight (LOS angle rate. This paper has presented a new midcourse guidance law considering the influences of random disturbances, detection distance restraint, and target acquisition probability with Monte Carlo simulation. Detailed analyses of the impact points on the ground and the random distribution of the target acquisition position in the 3D space are given to get the appropriate attitude angles and the end position for the midcourse guidance. Then, a new formulation biased proportional navigation (BPN guidance law with angular constraint and LOS angle rate control has been derived to ensure the tracking ability when attacking the maneuvering target. Numerical simulations demonstrates that, compared with the proportional navigation guidance (PNG law and the near-optimal spatial midcourse guidance (NSMG law, BPN guidance law demonstrates satisfactory performances and can meet both the midcourse terminal angular constraint and the LOS angle rate requirement.

  16. Spatial Targeting for Bovine Tuberculosis Control: Can the Locations of Infected Cattle Be Used to Find Infected Badgers?

    Directory of Open Access Journals (Sweden)

    Catherine M Smith

    Full Text Available Bovine tuberculosis is a disease of historical importance to human health in the UK that remains a major animal health and economic issue. Control of the disease in cattle is complicated by the presence of a reservoir species, the Eurasian badger. In spite of uncertainty in the degree to which cattle disease results from transmission from badgers, and opposition from environmental groups, culling of badgers has been licenced in two large areas in England. Methods to limit culls to smaller areas that target badgers infected with TB whilst minimising the number of uninfected badgers culled is therefore of considerable interest. Here, we use historical data from a large-scale field trial of badger culling to assess two alternative hypothetical methods of targeting TB-infected badgers based on the distribution of cattle TB incidents: (i a simple circular 'ring cull'; and (ii geographic profiling, a novel technique for spatial targeting of infectious disease control that predicts the locations of sources of infection based on the distribution of linked cases. Our results showed that both methods required coverage of very large areas to ensure a substantial proportion of infected badgers were removed, and would result in many uninfected badgers being culled. Geographic profiling, which accounts for clustering of infections in badger and cattle populations, produced a small but non-significant increase in the proportion of setts with TB-infected compared to uninfected badgers included in a cull. It also provided no overall improvement at targeting setts with infected badgers compared to the ring cull. Cattle TB incidents in this study were therefore insufficiently clustered around TB-infected badger setts to design an efficient spatially targeted cull; and this analysis provided no evidence to support a move towards spatially targeted badger culling policies for bovine TB control.

  17. Anaphylactoid reactions after infusion of radiographic contrast media

    Energy Technology Data Exchange (ETDEWEB)

    Ring, J.; Rothenberger, K.H.

    1984-05-18

    Pathophysiology and Prophylaxis: Anaphylactoid reactions after infusion of radiographic contrast media (RCM) do not occur infrequently (5-20%). The pathophysiology of these reactions is not totally clear. In the majority of the reactions, immunological mechanisms do not seem to play a role; rather pseudo-allergic mechanisms are involved, namely the direct liberation of vasoactive mediator substances (e.g. histamine) or activation of the complement, coagulation or kallikrein-kinin system. For the prophylaxis of RCM-induced reactions, different drugs have been recommended such as antihistamines, gluco-corticosteroids, adrenergic agents, epsilonaminocaproic acid, psychopharmaca or hypnotic suggestion. In a controlled randomized study with 800 patients undergoing intravenous urography, the efficacy of 3 different pretreatment schedules (H1-antagonists, combined H1 + H2-antagonists, prednisolone) was compared to a placebo control. It was found that the application of combined H1- and H2-antagonists 5 minutes prior to RCM infusion significantly reduced the frequency of objective anaphylactoid reactions. Neither H1-antagonists alone nor prednisolone (250 mg) showed an effect in this study.

  18. Intracerebral Infusion of Antisense Oligonucleotides Into Prion-infected Mice

    Directory of Open Access Journals (Sweden)

    Karah Nazor Friberg

    2012-01-01

    Full Text Available Mice deficient for the cellular prion protein (PrPC do not develop prion disease; accordingly, gene-based strategies to diminish PrPC expression are of interest. We synthesized a series of chemically modified antisense oligonucleotides (ASOs targeted against mouse Prnp messenger RNA (mRNA and identified those that were most effective in decreasing PrPC expression. Those ASOs were also evaluated in scrapie-infected cultured cells (ScN2a for their efficacy in diminishing the levels of the disease-causing prion protein (PrPSc. When the optimal ASO was infused intracerebrally into FVB mice over a 14-day period beginning 1 day after infection with the Rocky Mountain Laboratory (RML strain of mouse prions, a prolongation of the incubation period of almost 2 months was observed. Whether ASOs can be used to develop an effective therapy for patients dying of Creutzfeldt–Jakob disease remains to be established.

  19. Is pomegranate peels infusion effective for disinfection of toothbrushes?

    Directory of Open Access Journals (Sweden)

    Priscila Lima de Luna FREIRE

    Full Text Available Abstract Introduction Methods of decontamination or sanitization of toothbrushes have been questioned. Objective This study assessed the effectiveness of pomegranate peels infusion as a disinfectant of toothbrushes against Streptococcus mutans. Material and method A sample of 16 schoolchildren aged between 7 and 9 years performed brushing 5 days/week, with a careful brushing once a day. After each day of brushing, the toothbrushes were washed and sprayed with one disinfectant solution. This procedure was repeated for 4 weeks using one of the different solutions per week: distilled water (G1; negative control, pomegranate (Punica granatum Linn peels infusion (G2, 1% sodium hypochlorite (G3 and 0.12% chlorhexidine digluconate (G4. After the fifth day, toothbrushes were collected for laboratory analysis. Toothbrushes heads were subjected to agitation in saline dilution of 10–1, 10–2,10–3, and 25 μL of each dilution were seeded in mitis salivarius agar culture medium for S. mutans colony-forming unit (CFU counting. One calibrated examiner (Kappa = 0.91 performed the CFU (mL–1 × 104 counts. Kruskal-Wallis and Dunn Multiple Comparison tests were used at a significance level of 5%. Result G1 presented the highest number of CFU (3.9 ± 8.4, followed by G2 (3.2 ± 4.0. No S. mutans growth was observed in G3 and G4. There was no statistically significant difference between G1 and G2 and between G3 and G4 (p>0.05. Conclusion Pomegranate infusion was completely ineffective for the disinfection of toothbrushes against S. mutans when compared with 1% sodium hypochlorite and 0.12% chlorhexidine digluconate solutions.

  20. Carotid artery mixing with diastole-phased pulsed drug infusion

    International Nuclear Information System (INIS)

    Saris, S.C.; Shook, D.R.; Blasberg, R.G.; Dedrick, R.L.; Doppman, J.L.; Bankiewicz, K.S.; Blacklock, J.B.; Oldfield, E.H.

    1987-01-01

    Focal injury to the brain or retina is a frequent complication of drug delivery to the internal carotid artery (ICA) and may be due to poor mixing of the drug with blood at the infusion site. Rhesus monkeys were studied to determine whether phased drug delivery during diastole from a modified pulsatile angiographic injector would improve drug mixing in vivo. A radiolabeled flow tracer, carbon-14-iodoantipyrine ( 14 C-IAP), was injected into the ICA of three monkeys in 80-msec pulses, each ending at least 50 msec before the end of local diastole. Local isotope concentration in the brain was determined by quantitative autoradiography. The ratio of highest to lowest concentration was 1.86 +/- 0.26 (mean +/- standard deviation) in the frontoparietal cortex, 1.65 +/- 0.42 in the frontoparietal white matter, 1.89 +/- 0.28 in the temporal cortex, and 1.39 +/- 0.17 in the basal ganglia. These results were similar to recordings in three control animals that received intravenous 14 C-IAP to demonstrate complete drug mixing (1.37 +/- 0.12, 1.41 +/- 0.11, 1.70 +/- 0.08, 1.22 +/- 0.24, respectively), and contrasted to findings in five animals which received continuous intracarotid infusions to demonstrate standard ICA drug delivery (4.54 +/- 2.07, 2.94 +/- 1.45, 5.43 +/- 3.57, 3.60 +/- 2.90, respectively). Pulsed intra-arterial infusion during diastole provides a technically simple method for improving intravascular drug mixing, and results in drug delivery to tissue capillaries that is proportional to blood flow

  1. Anaphylaxis after intravenous infusion of dexketoprofen trometamol

    Directory of Open Access Journals (Sweden)

    Sertac Guler

    2016-09-01

    Full Text Available Dexketoprofen trometamol (DT, a nonsteroidal anti-inflammatory drug, is a highly water-soluble salt and active enantiomer of rac-ketoprofen. Its parenteral form is commonly used for acute pain management in emergency departments of our country. Side effects such as diarrhea, indigestion, nausea, stomach pain, and vomiting may be seen after the use of DT. Anaphylactic shock (AS secondary to infusion of DT is very rare and, to our knowledge, it is the first case report describing this side effect. This case report was presented to emphasize that AS may be seen after the use of DT. Keywords: Anaphylactic shock, Dexketoprofen trometamol, Intravenous infusion (MeSH database

  2. Software Engineering Technology Infusion Within NASA

    Science.gov (United States)

    Zelkowitz, Marvin V.

    1996-01-01

    Abstract technology transfer is of crucial concern to both government and industry today. In this paper, several software engineering technologies used within NASA are studied, and the mechanisms, schedules, and efforts at transferring these technologies are investigated. The goals of this study are: 1) to understand the difference between technology transfer (the adoption of a new method by large segments of an industry) as an industry-wide phenomenon and the adoption of a new technology by an individual organization (called technology infusion); and 2) to see if software engineering technology transfer differs from other engineering disciplines. While there is great interest today in developing technology transfer models for industry, it is the technology infusion process that actually causes changes in the current state of the practice.

  3. Programming controlled adhesion of E. coli to target surfaces, cells, and tumors with synthetic adhesins.

    Science.gov (United States)

    Piñero-Lambea, Carlos; Bodelón, Gustavo; Fernández-Periáñez, Rodrigo; Cuesta, Angel M; Álvarez-Vallina, Luis; Fernández, Luis Ángel

    2015-04-17

    In this work we report synthetic adhesins (SAs) enabling the rational design of the adhesion properties of E. coli. SAs have a modular structure comprising a stable β-domain for outer membrane anchoring and surface-exposed immunoglobulin domains with high affinity and specificity that can be selected from large repertoires. SAs are constitutively and stably expressed in an E. coli strain lacking a conserved set of natural adhesins, directing a robust, fast, and specific adhesion of bacteria to target antigenic surfaces and cells. We demonstrate the functionality of SAs in vivo, showing that, compared to wild type E. coli, lower doses of engineered E. coli are sufficient to colonize solid tumors expressing an antigen recognized by the SA. In addition, lower levels of engineered bacteria were found in non-target tissues. Therefore, SAs provide stable and specific adhesion capabilities to E. coli against target surfaces of interest for diverse applications using live bacteria.

  4. Scavenged body heat powered infusion pump

    International Nuclear Information System (INIS)

    Bell, Alexander; Ehringer, William D; McNamara, Shamus

    2013-01-01

    An infusion pump powered by body heat is investigated in this paper, with the goal of addressing the needs of dermal wound healing. The infusion pump incorporates a Knudsen gas pump, a type of thermally driven pump, to pneumatic push the pharmaceutical agent from a reservoir. Two designs are considered: an integrated pump and reservoir, and a design with cascaded pump and reservoir. Thermal models are developed for both pumps, and the simulations agree well with the experimental results. The integrated pump and reservoir design uses hydrophobic materials to prevent a flow from occurring unless the infusion pump is placed on a human body. Flow rates in the µL min −1 range for the integrated pump and reservoir, and approximately 70 µL min −1 for the cascaded pump were obtained. The dynamic behavior of the cascaded pump is described based on the thermal models. Multiple copies of the cascaded pump are easily made in series or parallel, to increase either the pressure or the flow rate. The flow rate of multiple pumps in series does not change, and the pressure of multiple pumps in parallel does not change. (paper)

  5. Engineered CAR T Cells Targeting the Cancer-Associated Tn-Glycoform of the Membrane Mucin MUC1 Control Adenocarcinoma

    DEFF Research Database (Denmark)

    Posey, Avery D; Schwab, Robert D; Boesteanu, Alina C

    2016-01-01

    Genetically modified T cells expressing chimeric antigen receptors (CARs) demonstrate robust responses against lineage restricted, non-essential targets in hematologic cancers. However, in solid tumors, the full potential of CAR T cell therapy is limited by the availability of cell surface antigens......-associated Tn glycoform of MUC1, a neoantigen expressed in a variety of cancers. Anti-Tn-MUC1 CAR T cells demonstrated target-specific cytotoxicity and successfully controlled tumor growth in xenograft models of T cell leukemia and pancreatic cancer. These findings demonstrate the therapeutic efficacy of CAR T...... cells directed against Tn-MUC1 and present aberrantly glycosylated antigens as a novel class of targets for tumor therapy with engineered T cells....

  6. Guidance and Control of Position and Attitude for Rendezvous and Dock/Berthing with a Noncooperative/Target Spacecraft

    Directory of Open Access Journals (Sweden)

    Gilberto Arantes

    2014-01-01

    Full Text Available Noncooperative target spacecrafts are those assets in orbit that cannot convey any information about their states (position, attitude, and velocities or facilitate rendezvous and docking/berthing (RVD/B process. Designing a guidance, navigation, and control (GNC module for the chaser in a RVD/B mission with noncooperative target should be inevitably solved for on-orbit servicing technologies. The proximity operations and the guidance for achieving rendezvous problems are addressed in this paper. The out-of-plane maneuvers of proximity operations are explored with distinct subphases, including a chaser far approach in the target’s orbit to the first hold point and a closer approach to the final berthing location. Accordingly, guidance solutions are chosen for each subphase from the standard Hill based Closhessy-Willtshire (CW solution, elliptical fly-around, and Glideslope algorithms. The control is based on a linear quadratic regulator approach (LQR. At the final berthing location, attitude tracker based on a proportional derivative (PD form is tested to synchronize the chaser and target attitudes. The paper analyzes the performance of both controllers in terms of the tracking ability and the robustness. Finally, it prescribes any restrictions that may be imposed on the guidance during any subphase which can help to improve the controllers tracking ability.

  7. DEVELOPMENT OF DOMESTIC INFUSION DRUGS BASED ON PARACETAMOL

    Directory of Open Access Journals (Sweden)

    Almakaeva L.G.

    2016-06-01

    aqueous solution decreases in acidic and alkaline environments where paratse - tamol gradually destroyed to acetic acid or p - aminophenol To prevent oxidation of the drug administered antioxidant - sodium metabisulfite in concentrations generally 1.0 g / l. In order to prevent the negative - tive impact of oxygen on paracetamol solution 10 mg / mL drug preparation was conducted under nitrogen gas protection . It is established that the use of nitrogen gas protection affects the quality of the drug. Prepared sample preparation without nitrogen gas protection did not meet project MKYA in terms of " 4 - aminophenol " and " color ", besides a slight tendency pH change and reducing quantitative content of active ingredient. Therefore, the production of the drug " Paracetamol , infusion solution 10 mg / ml. in bottles of 100 ml " necessary solution prepared bubbling nitrogen for 20 minutes. It is established that the use of nitrogen gas protection affects the quality of the drug. the manufacture of the drug " Paracetamol , infusion solution 10 mg / ml. in bottles of 100 ml " necessary solution prepared bubbling nitrogen for 20 minutes. Calculated theoretical osmolarity of the drug- 299,47 мОsм / l. Solution osmolarity close to osmolarity of blood, which is an important criterion when used in injection therapy. Conclusions. Theoretically grounded and experimentally confirmed rational composition drug infusion composition based on paracetamol. Selected auxiliaries and processing methods in the preparation of the solution , prevents oxidation of the main active ingredient , and also provide the optimum level of osmolarity solution. Results of this development are used during compile of registration dossier of preparation, analytical and technological normative documents on his production and control of quality of intermediate products and prepared products.

  8. Influence of controlled and uncontrolled interventions on Twitter in different target groups

    NARCIS (Netherlands)

    Maanen, P.P. van; Aarts, O.; Boertjes, E.; Wijn, R.

    2013-01-01

    In this paper the influence of interventions on Twitter users is studied. We define influence in a) number of participants, b) size of the audience, c) amount of activity, and d) reach. Influence is studied for four different target groups: a) politicians, b) journalists, c) employees and d) the

  9. Effect of Insulin Infusion on Liver Protein Synthesis during Hemodialysis

    DEFF Research Database (Denmark)

    Reinhard, Mark; Frystyk, Jan; Jespersen, Bente

    2011-01-01

    Background Hemodialysis (HD) is a catabolic procedure that may contribute to the high frequency of protein-energy wasting among patients receiving maintenance HD. The present study investigated the additional effect of glucose and glucose-insulin infusion on liver protein synthesis during HD...... compared with a meal alone. Methods In a randomized cross-over study with three arms, 11 non-diabetic HD patients were assigned to receive a conventional HD session with either: • no treatment (NT) • IV infusion of glucose (G) • IV infusion of glucose-insulin (GI) During infusions blood glucose levels were...... maintained at 8.0-10.0 mmol/L by additional glucose infusion. Glucose and glucose-insulin infusions were commenced 2 h prior to HD and continued throughout the HD session. Fasting blood samples were collected at baseline before infusion and followed by the only meal allowed during the study. Results Blood...

  10. INR targets and site-level anticoagulation control: results from the Veterans AffaiRs Study to Improve Anticoagulation (VARIA).

    Science.gov (United States)

    Rose, A J; Berlowitz, D R; Miller, D R; Hylek, E M; Ozonoff, A; Zhao, S; Reisman, J I; Ash, A S

    2012-04-01

    Not all clinicians target the same International Normalized Ratio (INR) for patients with a guideline-recommended target range of 2-3. A patient's mean INR value suggests the INR that was actually targeted. We hypothesized that sites would vary by mean INR, and that sites of care with mean values nearest to 2.5 would achieve better anticoagulation control, as measured by per cent time in therapeutic range (TTR). To examine variations among sites in mean INR and the relationship with anticoagulation control in an integrated system of care. We studied 103,897 patients receiving oral anticoagulation with an expected INR target between 2 and 3 at 100 Veterans Health Administration (VA) sites from 1 October 2006 to 30 September 2008. Key site-level variables were: proportion near 2.5 (that is, percentage of patients with mean INR between 2.3 and 2.7) and mean risk-adjusted TTR. Site mean INR ranged from 2.22 to 2.89; proportion near 2.5, from 30 to 64%. Sites' proportions of patients near 2.5, below 2.3 and above 2.7 were consistent from year to year. A 10 percentage point increase in the proportion near 2.5 predicted a 3.8 percentage point increase in risk-adjusted TTR (P < 0.001). Proportion of patients with mean INR near 2.5 is a site-level 'signature' of care and an implicit measure of targeted INR. This proportion varies by site and is strongly associated with site-level TTR. Our study suggests that sites wishing to improve TTR, and thereby improve patient outcomes, should avoid the explicit or implicit pursuit of non-standard INR targets. © 2012 International Society on Thrombosis and Haemostasis.

  11. Ileal microbiota of growing pigs fed different dietary calcium phosphate levels and phytase content and subjected to ileal pectin infusion.

    Science.gov (United States)

    Metzler-Zebeli, B U; Vahjen, W; Baumgärtel, T; Rodehutscord, M; Mosenthin, R

    2010-01-01

    Two experiments with growing pigs were conducted to determine the effects of dietary P and Ca levels, phytase supplementation, and ileal pectin infusion on changes in bacterial populations in the ileum and on ileal and fecal fermentation patterns. Growing pigs (BW 30.1 +/- 1.3 kg) were fitted with simple T-cannulas at the distal ileum and were fed a low-P corn-soybean meal control diet (3 g of P/kg), or the control diet supplemented with either 15 g of monocalcium phosphate (MCP)/kg (Exp. 1) or 1,000 phytase units of phytase/kg (Exp. 2). Daily infusion treatments consisted of either 60 g of pectin dissolved in 1.8 L of demineralized water or 1.8 L of demineralized water as a control infusion, infused via the ileal cannula. In each experiment, 8 barrows were assigned to 4 dietary treatments according to a double incomplete 4 x 2 Latin square design. The dietary treatments in Exp. 1 were the control diet with water infusion, the control diet with pectin infusion, the MCP diet with water infusion, or the MCP diet with pectin infusion. In Exp. 2, the pigs received the same control treatments as in Exp. 1 and the phytase diet in combination with water or pectin infusion. Gene copy numbers of total bacteria, Lactobacillus spp., Lactobacillus reuteri, Lactobacillus amylovorus/Lactobacillus sobrius, Lactobacillus mucosae, Enterococcus spp., Enterococcus faecium, Enterococcus faecalis, bifidobacteria, the Clostridium coccoides cluster, the Clostridium leptum cluster, the Bacteroides-Prevotella-Porphyrmonas group, and Enterobacteriaceae were determined by quantitative PCR in DNA extracts of ileal digesta. In Exp. 1, addition of MCP reduced ileal gene copy numbers of Enterococcus spp. (P = 0.048), E. faecium (P = 0.015), and the C. leptum cluster (P = 0.028), whereas pectin infusion enhanced (P = 0.008) ileal d-lactate concentration. In Exp. 2, supplemental phytase led to greater ileal gene copy numbers of the C. coccoides (P = 0.041) and C. leptum (P = 0.048) clusters and

  12. Efeito da bomba de infusão de soluções sobre o grau de hemólise em concentrados de hemácias Effect of the infusion pumps of solutions on the degree of hemolysis

    Directory of Open Access Journals (Sweden)

    Eunice B. Carvalho

    2007-06-01

    Full Text Available A lise das hemácias, de causa imune ou não imune, pode provocar a elevação da hemoglobina plasmática induzindo efeitos deletérios principalmente nos rins e no sistema cardiovascular. Este trabalho objetiva evidenciar o possível efeito hemolítico induzido pelo trauma mecânico provocado pela passagem das hemácias em diferentes modelos de bombas de infusão de soluções, em concentrados de hemácias com até dez dias de armazenamento, preparados com Sag-Manitol. Foram utilizados três modelos de bombas (Nutrimat, Infusomat Compact e Volumed, com quatro aparelhos de cada modelo, testados em três velocidades de infusão (120 mL/h, 240 mL/h e 360 mL/h. Os parâmetros utilizados para evidenciar o grau de hemólise foram o percentual de hemólise e os níveis de hemoglobina e potássio livres no plasma. As amostras foram coletadas antes da passagem do concentrado de hemácias pelas bombas, na metade do tempo de infusão e no final da infusão, nas diferentes velocidades. Não ocorreu variação significativa entre os valores dos parâmetros analisados nas amostras controle e naquelas coletadas nas diferentes velocidades, marcas de bombas, mecanismos de infusão entre as bombas da mesma marca e entre os diferentes tempos de infusão. A principal variação encontrada foi relacionada com o potássio livre, devido à variação inerente aos próprios concentrados, o que foi evidenciado ao se compararem os valores obtidos nas amostras controle e nas amostras colhidas nos tempos médio e final em cada bomba. De acordo com os resultados obtidos, não houve alteração estatisticamente significativa do percentual de hemólise após a passagem pelas bombas de infusão nos modelos analisados.The lyses of red blood cells, both for immune or non-immune reasons, can cause an elevation in plasmatic hemoglobin, inducing harmful effects mainly in the kidneys and cardiovascular system. This work aims at identifying the possible hemolytic effect, related to

  13. Prostaglandin synthesis can be inhibited locally by infusion of NSAIDS through microdialysis catheters in human skeletal muscle

    DEFF Research Database (Denmark)

    Mikkelsen, Ulla Ramer; Helmark, Ida Carøe; Kjaer, Michael

    2008-01-01

    of nonsteroidal anti-inflammatory drugs (NSAIDs). However, to study the local role of prostaglandins, the formation of prostaglandins within the tissue must be controlled. Microdialysis enables determination of local concentrations of water-soluble substances within the tissue. In the present study......, the microdialysis method was used to infuse NSAIDs locally into human skeletal muscles producing a local block of prostaglandin formation. In addition, the graded blockade at various distances from the infusion site within the muscle during rest, exercise and recovery was determined. Microdialysis was performed...... in thigh muscles (vastus lateralis muscle) in six healthy men. One of the microdialysis catheters was used to block prostaglandin synthesis by infusion of the NSAID indomethacin. Additional catheters were placed 1 and 4 cm away from the infusion and in the contralateral leg (working control). Following 2 h...

  14. Infusion MR arteriography during hepatic arterial infusion chemotherapy. Evaluation of clinical usefulness

    International Nuclear Information System (INIS)

    Uchino, Minako; Takizawa, Kenji

    2003-01-01

    We developed a new method of infusion MR arteriography (IMRA) via an implantable port system using an infusion pump for the evaluation of drug distribution during hepatic arterial infusion chemotherapy. The purposes of this study were to optimize the method and evaluate its clinical usefulness. We used 3D-T1 turbo field echo (TFE) as the most suitable sequence for IMRA according to the results of a phantom model experiment. We examined 33 cases of liver cancer that had been treated by arterial infusion chemotherapy via the port system. The following investigations were performed: degree of tumor enhancement, intra- and extra- hepatic perfusion abnormality, and related toxicity. The evaluation of images was performed separately by two radiologists. IMRA provided good images of contrast enhancement, to reveal the perfusion patterns. The treatment response rate in the tumor group with well enhancement was higher than that of the group with poor enhancement (p<0.0001). Extrahepatic perfusion was well visualized and was correlated with toxicity (p<0.0001). IMRA is a useful method to evaluate drug perfusion for the optimization of arterial infusion chemotherapy. (author)

  15. Antioxidant and Angiotensin-Converting Enzyme Inhibitory Activity of Eucalyptus camaldulensis and Litsea glaucescens Infusions Fermented with Kombucha Consortium

    Directory of Open Access Journals (Sweden)

    Claudia I. Gamboa-Gómez

    2016-01-01

    Full Text Available Physicochemical properties, consumer acceptance, antioxidant and angiotensin-converting enzyme (ACE inhibitory activities of infusions and fermented beverages of Eucalyptus camaldulensis and Litsea glaucescens were compared. Among physicochemical parameters, only the pH of fermented beverages decreased compared with the unfermented infusions. No relevant changes were reported in consumer preference between infusions and fermented beverages. Phenolic profi le measured by UPLC MS/MS analysis demonstrated significant concentration changes of these compounds in plant infusions and fermented beverages. Fermentation induced a decrease in the concentration required to stabilize 50 % of DPPH radical (i.e. lower IC50. Additionally, it enhanced the antioxidant activity measured by the nitric oxide scavenging assay (14 % of E. camaldulensis and 49 % of L. glaucescens; whereas relevant improvements in the fermented beverage were not observed in the lipid oxidation assay compared with unfermented infusions. The same behaviour was observed in the inhibitory activity of ACE; however, both infusions and fermented beverages had lower IC50 than positive control (captopril. The present study demonstrated that fermentation has an influence on the concentration of phenolics and their potential bioactivity. E. camaldulensis and L. glaucescens can be considered as natural sources of biocompounds with antihypertensive potential used either as infusions or fermented beverages.

  16. Assessing pest control using changes in instantaneous rate of population increase: treated targets and stable fly populations case study.

    Science.gov (United States)

    Beresford, D V; Sutcliffe, J F

    2010-06-01

    The instantaneous rate of population increase was used to assess the ability of attractive targets coated with permethrin to control stable fly populations on 3 dairy farms in south central Ontario, Canada. Two attractive targets were deployed over 10 wk in 2001 at each of 6 dairy farms. Three farms were outfitted with 2 untreated targets and 3 were outfitted with 2 targets treated with permethrin [Ectiban-impregnated Coroplast (Ectiban: Schering-Plough Canada Inc., Pointe-Claire, Québec, Canada; Coroplast: Great Pacific Enterprises Inc., Granby, Québec, Canada)]. Population growth rate was measured in terms of degree-days above a 10 degrees C developmental threshold (r(DD10)). The r(DD10) at the 3 treated dairy farms were significantly lower than r(DD10) at the 3 neighboring untreated dairy farms (mean r(DD10): treated=0.0088, untreated=0.013), but not in the previous year when targets were not installed (mean r(DD10): treated=0.012, untreated=0.015). This supports a long-term approach to management that lowers population growth rates in those regions where stable fly numbers increase exponentially from spring until winter, by shortening the period of economic impact of this pest. 2010 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.

  17. Dropouts and Compliance in Exercise Interventions Targeting Bone Mineral Density in Adults: A Meta-Analysis of Randomized Controlled Trials

    Directory of Open Access Journals (Sweden)

    George A. Kelley

    2013-01-01

    Full Text Available Background. Dropouts and compliance to exercise interventions targeting bone mineral density (BMD in adults are not well established. The purpose of this study was to address that gap. Methods. Meta-analysis of randomized controlled exercise intervention trials in adults ≥18 years of age. The primary outcomes were dropouts in the exercise and control groups as well as compliance to the exercise interventions. A random-effects model was used to pool results. Moderator analyses were conducted using mixed-effects ANOVA-like models and metaregression. Statistical significance was set at . Results. Thirty-six studies representing 3,297 participants (1,855 exercise, 1,442 control were included. Dropout rates in the exercise and control groups averaged 20.9% (95% CI 16.7%–25.9% and 15.9% (11.8%–21.1% while compliance to exercise was 76.3% (71.7%–80.3%. For both exercise and control groups, greater dropout rates were associated with studies conducted in the USA versus other countries, females versus males, premenopausal versus postmenopausal women, younger versus older participants, longer studies (controls only, and high- versus moderate-intensity training (exercisers only. Greater compliance to exercise was associated with being female, home- or facility-based exercise versus both, and shorter studies. Conclusion. These findings provide important information for researchers and practitioners with respect to exercise programs targeting BMD in adults.

  18. Migration of plasticizers from PVC medical devices: Development of an infusion model.

    Science.gov (United States)

    Bernard, L; Cueff, R; Chagnon, Mc; Abdoulouhab, F; Décaudin, B; Breysse, C; Kauffmann, S; Cosserant, B; Souweine, B; Sautou, V

    2015-10-15

    Alternatives to DEHP plasticizers are used in various PVC medical devices (MD) for infusion. As they are able to migrate from these MDs into infused solutions, they may come into contact with patient. Different and specific clinical parameters influence their migration in at-risk situations such as infusion. In contrast to the regulations for Food Contact Materials (MCDA), there is currently no acceptable migration limits for the use of these plasticizers in clinical situations. In order to assess their migration, and thus control the risks linked to these MDs, we developed a migration model for the plasticizers in MDs. To this end, we applied a cross-disciplinary methodological process similar to that used in the food-processing industry, taking into account the MDs' conditions of use in clinical practice. The simulation model is simple and includes the following conditions: MD should be tested with a dynamic method that respects our established clinical assumption (2 L of infused solutions via 13 dm(2) of plasticized PVC), at a temperature of 25 °C and during 24 h of contact, using a 50/50 (v/v) ethanol/water simulant. This model could be proposed as a tool for the safety evaluation of the patients' exposure risk to plasticizers from PVC medical devices for infusions. Copyright © 2015 Elsevier B.V. All rights reserved.

  19. LPS infusion suppresses serum FGF21 levels in healthy adult volunteers.

    Science.gov (United States)

    Lauritzen, Esben S; Rittig, Nikolaj; Bach, Ermina; Møller, Niels; Bjerre, Mette

    2017-01-01

    During the inflammatory acute phase response, plasma glucose and serum triglycerides are increased in humans. Fibroblast growth factor (FGF) 21 has plasma glucose and lipid-reducing actions, but its role in the acute inflammatory response in human is unknown. To investigate circulating levels of FGF21 after lipopolysaccharide (LPS) infusion. Two randomized, single-blinded, placebo-controlled crossover trials were used. The studies were performed at a university hospital clinical research center. Study 1 (LPS bolus): Eight young, healthy, lean males were investigated two times: (1) after isotonic saline injection and (2) after LPS injection (bolus of 1 ng/kg). Each study day lasted 4 h. Study 2 (continuous LPS infusion): Eight, healthy males were investigated two times: (1) during continuously isotonic saline infusion and (2) during continuous LPS infusion (0.06 ng/kg/h). Each study day lasted 4 h. Circulating FGF21 levels were quantified every second hour by an immunoassay. A LPS bolus resulted in a late suppression (t = 240 min) of serum FGF21 (P = 0.035). Continuous LPS infusion revealed no significant effects on FGF21 levels (P = 0.82). Our studies show that a bolus of LPS results in decreased FGF21 levels 4 h from exposure. © 2017 The authors.

  20. Apoptosis and histological response of preoperative intraarterial chemotherapy infusion for colorectal carcinoma

    International Nuclear Information System (INIS)

    Yuan Jianhua; Hu Tingyang; Yu Wenqiang; Chen Fanghong; Luo Zuyan; Mao Yinmin; Zhao Zhongsheng; Ru Guoqing; Deng Gaoli; Dong Quanjin; Tu Shiliang

    2003-01-01

    Objective: To investigate apoptosis and histological response of preoperative intraarterial chemotherapy infusion for colorectal carcinoma. Methods: Fifty patients with colorectal carcinoma were treated by intraarterial infusion of anti-cancer drugs. Surgical resection of the tumor was performed 5-30 days after the intraarterial infusion (mean 12 days). The histological response was evaluated. The density and distribution of the apoptosis cells were observed by DNA nick end labelling technique. 22 biopsy specimens before the intraarterial chemotherapy and 25 normal mucosa (obtained from surgery specimen) were used as controls. Results: The total histological response rate was 100% with grade I in 20 cases, grade II in 21 cases, and grade III in 9 cases. The density of the apoptosis cells was 31.47±5.58 before and 76.69±17.12 after the intraarterial chemotherapy infusion, and 8.01±3.39 in normal mucosa, respectively. The density of the apoptosis cells after the intraarterial chemotherapy was significantly higher than that before the intraarterial chemotherapy (t=13.701, P 2 =4.696, P>0.30). The apoptosis of adenocarcinoma was significantly different with different histological response (F=7.73, P 0.05) and for adenocarcinoma with different pathological stages (F=0.001376, P>0.05). Conclusion: As an effective and safe procedure, preoperative transcatheter intraarterial chemotherapy infusion achieves a significant histological response and apoptosis in colorectal adenocarcinoma

  1. Inositol lipid metabolism in vasopressin stimulated hepatocytes from rats infused with tumor necrosis factor

    International Nuclear Information System (INIS)

    Spitzer, J.A.; Rodriguez de Turco, E.B.

    1989-01-01

    We studied the effect of i.v. infusion of human recombinant tumor necrosis factor alpha (rHuTNF alpha, Cetus, 15 micrograms/100 g bw over 3 h) on vasopressin (VP)-stimulated 32 P-inositol lipid turnover and the release of 3 H-inositol phosphates in isolated rat hepatocytes. The early VP-induced decrease (within 30 s) in 32 P-phosphatidylinositol 4-phosphate and 32 P-phosphatidylinositol 4,5-bisphosphate labeling was significantly reduced (-40%) and at the same time the uptake of 32 P into phosphatidic acid was 50% lower than in saline-infused (matched control) rats. Within 5 min of VP-stimulation, lower 32 P phosphatidylinositol (-40%) and higher 32 P-phosphatidic acid (+30%) labeling were observed in rHuTNF alpha-infused rats.