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  1. Complex Regional Pain Syndrome

    Science.gov (United States)

    Complex regional pain syndrome (CRPS) is a chronic pain condition. It causes intense pain, usually in the arms, hands, legs, or feet. It may happen ... move the affected body part The cause of CRPS is unknown. There is no specific diagnostic test. ...

  2. An atypical case of postsurgical complex regional pain syndrome in a patient having nonhealing varicose venous ulcer treated by lumbar sympathectomy

    Directory of Open Access Journals (Sweden)

    Kailash Kothari

    2017-01-01

    Full Text Available Complex regional pain syndrome (CRPS of the lower limb is a relatively uncommon entity as compared to CRPS of the upper extremity. Literature search has revealed only 2 retrospective case series and a single case report of lower extremity CRPS type I from 1975 to 2014 on Pubmed, isolated cases of CRPS type I of lower extremity have also been reported following knee surgeries and arthroscopies. This report presents a case of lower limb CRPS type I, following surgery for varicose vein ulcer. Pain was not relieved with medications. Diagnostic lumbar sympathectomy was done and patient had tremendous relief of pain following that, proving sympathetic mediated pain of the involved limb.

  3. Brain in complex regional pain syndrome

    OpenAIRE

    Hotta, Jaakko

    2017-01-01

    Complex regional pain syndrome (CRPS) causes disabling and severe limb pain that is difficult to treat. The pain typically increases during motor actions, but is present also at rest. The pathophysiology of CRPS is incompletely understood. Some of the symptoms suggest involvement of the central nervous system, and accordingly, patients have been shown to display alterations in, for instance, the primary sensorimotor cortex (SM1) and indications of neuroinflammation. More thorough pathophysiol...

  4. Quantifying China's regional economic complexity

    Science.gov (United States)

    Gao, Jian; Zhou, Tao

    2018-02-01

    China has experienced an outstanding economic expansion during the past decades, however, literature on non-monetary metrics that reveal the status of China's regional economic development are still lacking. In this paper, we fill this gap by quantifying the economic complexity of China's provinces through analyzing 25 years' firm data. First, we estimate the regional economic complexity index (ECI), and show that the overall time evolution of provinces' ECI is relatively stable and slow. Then, after linking ECI to the economic development and the income inequality, we find that the explanatory power of ECI is positive for the former but negative for the latter. Next, we compare different measures of economic diversity and explore their relationships with monetary macroeconomic indicators. Results show that the ECI index and the non-linear iteration based Fitness index are comparative, and they both have stronger explanatory power than other benchmark measures. Further multivariate regressions suggest the robustness of our results after controlling other socioeconomic factors. Our work moves forward a step towards better understanding China's regional economic development and non-monetary macroeconomic indicators.

  5. Triangular fibrocartilage complex injury treated with prolotherapy

    Directory of Open Access Journals (Sweden)

    Serdar Kesikburun

    2016-06-01

    Full Text Available Triangular fibrocartilage complex has a crucial role in stability and functionality of the wrist. Traumatic or degenerative injury of the triangular fibrocartilage complex is a common cause of ulnar side wrist pain. Arthroscopic treatment has been offered in chronic triangular fibrocartilage complex injury. A 19-year old male patient presented with pain at ulnar side of the wrist. He was diagnosed as having triangular fibrocartilage complex injury after assessment with MR imaging. The patients who did not benefit from drugs underwent prolotherapy three times. After treatment, he had pain relief and reported that he could use his wrist better. In this case, triangular fibrocartilage complex injury improved with prolotherapy and arthroscopic treatment was not required. Further clinical trials are needed to show better the role of prolotherapy in the treatment of triangular fibrocartilage complex injury. [Cukurova Med J 2016; 41(2.000: 403-405

  6. Rethinking the Psychogenic Model of Complex Regional Pain Syndrome: Somatoform Disorders and Complex Regional Pain Syndrome

    Science.gov (United States)

    Hill, Renee J.; Chopra, Pradeep; Richardi, Toni

    2012-01-01

    Abstract Explaining the etiology of Complex Regional Pain Syndrome (CRPS) from the psychogenic model is exceedingly unsophisticated, because neurocognitive deficits, neuroanatomical abnormalities, and distortions in cognitive mapping are features of CRPS pathology. More importantly, many people who have developed CRPS have no history of mental illness. The psychogenic model offers comfort to physicians and mental health practitioners (MHPs) who have difficulty understanding pain maintained by newly uncovered neuro inflammatory processes. With increased education about CRPS through a biopsychosocial perspective, both physicians and MHPs can better diagnose, treat, and manage CRPS symptomatology. PMID:24223338

  7. Complex Regional Pain Syndrome and Treatment Approaches

    Directory of Open Access Journals (Sweden)

    Neslihan Gokcen

    2013-08-01

    Full Text Available Complex Regional Pain Syndrome is a symptom complex including severe pain which is disproportioned by the initiating event. Formerly, it was known as reflex sympathetic dystropy, Sudeck’s atrophy and algoneurodystrophy. There are two types of complex regional pain syndrome (CPRS. CRPS type 1 (Reflex sympathetic dystropy occurs after a minor trauma of the extremities, CRPS type 2 (Causalgia occurs following peripheral nevre injury. Diagnosis is made according to the history, symptoms and physical findings of the patients. Patient education, physical therapy and medical treatment are the most common treatment approaches of complex regional pain syndrome. The aim of this review is to revise the treatment options ofcomplex regional pain syndrome, as well as to overview the new treatment approaches and options for the refractory complex regional pain syndrome cases. [Archives Medical Review Journal 2013; 22(4.000: 514-531

  8. Complex Regional Pain Syndrome: An inflammatory disease

    NARCIS (Netherlands)

    M. Dirckx (Maaike)

    2015-01-01

    markdownabstractThe pathophysiology of Complex Regional Pain Syndrome (CRPS) is complex and still not completely understood. In addition to a convincing role of inflammation, there are a number of arguments why an involvement of the immune system has been suggested in the pathophysiology of CRPS.

  9. Spontaneous onset of Complex Regional Pain Syndrome

    NARCIS (Netherlands)

    de Rooij, A.M.; Perez, R.S.G.M.; Huygen, F.J.; van Eijs, F.; van Kleef, M.; Bauer, M.C.R.; van Hilten, J.J.; Marinus, J.

    2010-01-01

    Complex Regional Pain Syndrome (CRPS) usually develops after a noxious event, but spontaneous onsets have been described in 3-11% of the cases. The existence of spontaneous-onset CRPS is highly debated and the aim of the present study was therefore to compare the phenotypic characteristics of CRPS

  10. COMPLEX REGIONAL PAIN SYNDROME: AN UPDATE

    Directory of Open Access Journals (Sweden)

    Patta

    2015-10-01

    Full Text Available Complex Regional Pain Syndrome or CRPS is a chronic disabling heterogenous pain disorder due to trauma, resulting in sensory changes, motor function impairment, psychological changes. Diagnosis is based on clinical features and investigations. The patho - physiology is not clearly known. There is no single drug therapy, only combinations work. Treatment is multidisplinary involving medical, psychological and rehabi li tation. Newer modes of spinal cord stimulations, neuraxial mode of analgesics and newe r drugs are promising

  11. Region Tourist and Recreation Complex Development

    Directory of Open Access Journals (Sweden)

    Elizaveta Oyusovna Tappaskhanova

    2015-06-01

    Full Text Available The subject matter of the research is the tourist and recreation complex of Kabardino-Balkar Republic. The purpose of the work is to provide solutions to problems of the republic tourist and recreation complex development. The results obtained from the study showed that in spite of the fact that in the region’s development certain positive steps are taken, according to the indicators of the tourism and recreation development, the region has not reach the level of the 1990th yet, the possibilities of this major sector of the republic economy remain not demanded. It is highlighted, that the most important factor in the tourist and recreation complex development is its infrastructure condition. It is recommended to use the model of the infrastructure management aimed at providing its effective functioning and development due to formation of interaction system at every power level through a network of the centers of the tourist and recreation complex development. In the article, the need for the use of the innovative approaches for the republic tourist and recreation complex development in the particular development of the new tourist directions are also found. For the purpose to improve the professional training of personnel for the tourism and recreation sphere, the need for a transition to multilevel training of personnel is proved. The main directions of the republic image development on the basis of designing and implementing of the regional program of its image development as the tourist territory and creation of the tourist information center are defined. Realization of all these problems allows to develop a highly effective and competitive tourist and recreation complex in Kabardino-Balkaria.

  12. New Concepts in Complex Regional Pain Syndrome

    Science.gov (United States)

    Tajerian, Maral; Clark, J David

    2015-01-01

    SYNOPSIS Despite the severe pain and disability associated with Complex Regional Pain Syndrome (CRPS), our lack of understanding of the pathophysiological mechanisms supporting this enigmatic condition prevents the rational design of new therapies, a situation that is frustrating both to the physician and the patient. The following review will highlight some of the mechanisms thought to be involved in the pathophysiology of CRPS in preclinical models and CRPS patients, with the ultimate goal that understanding these mechanisms will lead to the design of efficacious, mechanism-based treatments available to the clinic. PMID:26611388

  13. [Complex regional pain syndrome (CRPS) : An update].

    Science.gov (United States)

    Dimova, V; Birklein, F

    2018-04-17

    The acute phase of complex regional pain syndrome (CRPS) is pathophysiologically characterized by an activation of the immune system and its associated inflammatory response. During the course of CRPS, central nervous symptoms like mechanical hyperalgesia, loss of sensation, and body perception disorders develop. Psychological factors such as pain-related anxiety and traumatic events might have a negative effect on the treatment outcome. While the visible inflammatory symptoms improve, the pain often persists. A stage adapted, targeted treatment could improve the prognosis. Effective multidisciplinary treatment includes the following: pharmacotherapy with steroids, bisphosphonates, or dimethylsulfoxide cream (acute phase), and antineuropathic analgesics (all phases); physiotherapy and behavioral therapy for pain-related anxiety and avoidance of movement; and interventional treatment like spinal cord or dorsal root ganglion stimulation if noninvasive options failed.

  14. Inflammation in complex regional pain syndrome

    Science.gov (United States)

    Parkitny, Luke; McAuley, James H.; Di Pietro, Flavia; Stanton, Tasha R.; O’Connell, Neil E.; Marinus, Johan; van Hilten, Jacobus J.

    2013-01-01

    Objectives: We conducted a systematic review of the literature with meta-analysis to determine whether complex regional pain syndrome (CRPS) is associated with a specific inflammatory profile and whether this is dependent on the duration of the condition. Methods: Comprehensive searches of the literature using MEDLINE, Embase, Scopus, Web of Science, and reference lists from published reviews identified articles that measured inflammatory factors in CRPS. Two independent investigators screened titles and abstracts, and performed data extraction and risk of bias assessments. Studies were subgrouped by medium (blood, blister fluid, and CSF) and duration (acute and chronic CRPS). Where possible, meta-analyses of inflammatory factor concentrations were performed and pooled effect sizes were calculated using random-effects models. Results: Twenty-two studies were included in the systematic review and 15 in the meta-analysis. In acute CRPS, the concentrations of interleukin (IL)-8 and soluble tumor necrosis factor receptors I (sTNF-RI) and II (sTNF-RII) were significantly increased in blood. In chronic CRPS, significant increases were found in 1) TNFα, bradykinin, sIL-1RI, IL-1Ra, IL-2, sIL-2Ra, IL-4, IL-7, interferon-γ, monocyte chemoattractant protein-1 (MCP-1), and sRAGE (soluble receptor for advanced glycation end products) in blood; 2) IL-1Ra, MCP-1, MIP-1β, and IL-6 in blister fluid; and 3) IL-1β and IL-6 in CSF. Chronic CRPS was also associated with significantly decreased 1) substance P, sE-selectin, sL-selectin, sP-selectin, and sGP130 in blood; and 2) soluble intercellular adhesion molecule-1 (sICAM-1) in CSF. Most studies failed to meet 3 or more of our quality criteria. Conclusion: CRPS is associated with the presence of a proinflammatory state in the blood, blister fluid, and CSF. Different inflammatory profiles were found for acute and chronic cases. PMID:23267031

  15. What is Complex Regional Pain Syndrome?

    Science.gov (United States)

    ... muscle diseases, a clotted vein, or small fiber polyneuropathies, because these require different treatment. The distinguishing feature ... CRPS treated? The following therapies are often used: Rehabilitation and physical therapy . An exercise program to keep the painful limb or body ...

  16. Schur Stability Regions for Complex Quadratic Polynomials

    Science.gov (United States)

    Cheng, Sui Sun; Huang, Shao Yuan

    2010-01-01

    Given a quadratic polynomial with complex coefficients, necessary and sufficient conditions are found in terms of the coefficients such that all its roots have absolute values less than 1. (Contains 3 figures.)

  17. Complex regional pain syndrome type I following pacemaker implantation

    Directory of Open Access Journals (Sweden)

    Sangita Kamath

    2015-12-01

    Full Text Available A 70-year-old woman presented with burning pain and swelling over dorsum of right hand and small joints of the fingers, associated with redness, feeling of warmth, and stiffness of the fingers, with inability to bend the fingers since 2 months. The symptoms were progressively increasing in intensity for the past 1 month. There was no history of fever or trauma to the hand. Two months before her symptoms started, she had permanent pacemaker implanted for complete heart block with syncope. She was hypertensive and was on regular medication. Her X-ray of right hand showed decreased bone density (demineralisation, suggestive of osteopenia. A diagnosis of reflex sympathetic dystrophy syndrome or complex regional pain syndrome type I induced by pacemaker insertion was made. She was treated with amitriptyline and steroids, after which her symptoms improved dramatically.

  18. Orofacial complex regional pain syndrome: pathophysiologic mechanisms and functional MRI.

    Science.gov (United States)

    Lee, Yeon-Hee; Lee, Kyung Mi; Kim, Hyug-Gi; Kang, Soo-Kyung; Auh, Q-Schick; Hong, Jyung-Pyo; Chun, Yang-Hyun

    2017-08-01

    Complex regional pain syndrome (CRPS) is one of the most challenging chronic pain conditions and is characterized by burning pain, allodynia, hyperalgesia, autonomic changes, trophic changes, edema, and functional loss involving mainly the extremities. Until recently, very few reports have been published concerning CRPS involving the orofacial area. We report on a 50-year-old female patient who presented with unbearable pain in all of her teeth and hypersensitivity of the facial skin. She also reported intractable pain in both extremities accompanied by temperature changes and orofacial pain that increased when the other pains were aggravated. In the case of CRPS with trigeminal neuropathic pain, protocols for proper diagnosis and prompt treatment have yet to be established in academia or in the clinical field. We performed functional magnetic resonance imaging for a thorough analysis of the cortical representation of the affected orofacial area immediately before and immediately after isolated light stimulus of the affected hand and foot and concluded that CRPS can be correlated with trigeminal neuropathy in the orofacial area. Furthermore, the patient was treated with carbamazepine administration and stellate ganglion block, which can result in a rapid improvement of pain in the trigeminal region. Copyright © 2017 Elsevier Inc. All rights reserved.

  19. Environmental management on the basis of Complex Regional Indicators Concept: case of the Murmansk region

    Science.gov (United States)

    Kozlov, A.; Gutman, S.; Zaychenko, I.; Rytova, E.; Nijinskaya, P.

    2015-09-01

    The article presents an approach to sustainable environmental development of the Murmansk region of the Russian Federation based on the complex regional indicators as a transformation of a balance scorecard method. The peculiarities of Murmansk region connected with sustainable environmental development are described. The complex regional indicators approach allows to elaborate the general concept of complex regional development taking into consideration economic and non-economic factors with the focus on environmental aspects, accumulated environmental damage in particular. General strategic chart of sustainable environmental development of the Murmansk region worked out on the basis of complex regional indicators concept is composed. The key target indicators of sustainable ecological development of the Murmansk region are presented for the following strategic chart components: regional finance; society and market; industry and entrepreneurship; training, development and innovations. These charts are to be integrated with international environmental monitoring systems.

  20. Coronary bifurcation lesions treated with simple or complex stenting

    DEFF Research Database (Denmark)

    Behan, Miles W; Holm, Niels R; de Belder, Adam J

    2016-01-01

    AIMS: Randomized trials of coronary bifurcation stenting have shown better outcomes from a simple (provisional) strategy rather than a complex (planned two-stent) strategy in terms of short-term efficacy and safety. Here, we report the 5-year all-cause mortality based on pooled patient-level data...

  1. Complex regional pain syndromes (CRPS type 1 validating case histories

    Directory of Open Access Journals (Sweden)

    P. Berger

    2003-01-01

    Full Text Available The treatment of patients with complex regional pain syndrome (CRPS type 1 is challenging and unpredictable as the condition presents with vascular and neuropathic symptoms after nil or even minor injury to a peripheral nerve. The condition is one of a pain and motor dysfunction. The pathophysiology is not well understood and the relief of symptoms may change from being sympathetically mediated to sympathetically independent during  the course of the disease. At any stage physiotherapy has been advocated as the corner stone and most important aspect of treatment in the rehabilitation of these individuals but unfortunately it has been difficult to execute when pain is exacerbated due to allodynia (unbearable to touch or move and hyperalgesia. Best results have been obtained if the patients are recognised and treated in the early or acute phase and it has been found that through careful assessment and analysis these patients can be recognised by previous events that have occurred in their initial case history. The treatment in the acute stage with physiotherapy modalities such as electrical stimulation and acupuncture will produce an early cessation of the symptoms and prevention of the disease developing into the fully blown CRPS type 1 with irreversible and possibly atrophic consequences. Case histories have been presented that illustrate these important aspects and demonstrate  the value of early and the appropriate physiotherapy that may be more successful than other pharmacological and physical interventions in this disease.

  2. Complex regional pain syndrome–up-to-date

    Science.gov (United States)

    Birklein, Frank; Dimova, Violeta

    2017-01-01

    Abstract Complex regional pain syndrome (CRPS) was described for the first time in the 19th century by Silas Weir Mitchell. After the exclusion of other causes, CRPS is characterised by a typical clinical constellation of pain, sensory, autonomic, motor, or trophic symptoms which can no longer be explained by the initial trauma. These symptoms spread distally and are not limited to innervation territories. If CRPS is not improved in the acute phase and becomes chronic, the visible symptoms change throughout because of the changing pathophysiology; the pain, however, remains. The diagnosis is primarily clinical, although in complex cases further technical examination mainly for exclusion of alternative diagnoses is warranted. In the initial phase, the pathophysiology is dominated by a posttraumatic inflammatory reaction by the activation of the innate and adaptive immune system. In particular, without adequate treatment, central nociceptive sensitization, reorganisation, and implicit learning processes develop, whereas the inflammation moderates. The main symptoms then include movement disorders, alternating skin temperature, sensory loss, hyperalgesia, and body perception disturbances. Psychological factors such as posttraumatic stress or pain-related fear may impact the course and the treatability of CRPS. The treatment should be ideally adjusted to the pathophysiology. Pharmacological treatment maybe particularly effective in acute stages and includes steroids, bisphosphonates, and dimethylsulfoxide cream. Common anti-neuropathic pain drugs can be recommended empirically. Intravenous long-term ketamine administration has shown efficacy in randomised controlled trials, but its repeated application is demanding and has side effects. Important components of the treatment include physio- and occupational therapy including behavioural therapy (eg, graded exposure in vivo and graded motor imaging). If psychosocial comorbidities exist, patients should be appropriately

  3. Complex regional pain syndrome–up-to-date

    Directory of Open Access Journals (Sweden)

    Frank Birklein

    2017-12-01

    Full Text Available Abstract. Complex regional pain syndrome (CRPS was described for the first time in the 19th century by Silas Weir Mitchell. After the exclusion of other causes, CRPS is characterised by a typical clinical constellation of pain, sensory, autonomic, motor, or trophic symptoms which can no longer be explained by the initial trauma. These symptoms spread distally and are not limited to innervation territories. If CRPS is not improved in the acute phase and becomes chronic, the visible symptoms change throughout because of the changing pathophysiology; the pain, however, remains. The diagnosis is primarily clinical, although in complex cases further technical examination mainly for exclusion of alternative diagnoses is warranted. In the initial phase, the pathophysiology is dominated by a posttraumatic inflammatory reaction by the activation of the innate and adaptive immune system. In particular, without adequate treatment, central nociceptive sensitization, reorganisation, and implicit learning processes develop, whereas the inflammation moderates. The main symptoms then include movement disorders, alternating skin temperature, sensory loss, hyperalgesia, and body perception disturbances. Psychological factors such as posttraumatic stress or pain-related fear may impact the course and the treatability of CRPS. The treatment should be ideally adjusted to the pathophysiology. Pharmacological treatment maybe particularly effective in acute stages and includes steroids, bisphosphonates, and dimethylsulfoxide cream. Common anti-neuropathic pain drugs can be recommended empirically. Intravenous long-term ketamine administration has shown efficacy in randomised controlled trials, but its repeated application is demanding and has side effects. Important components of the treatment include physio- and occupational therapy including behavioural therapy (eg, graded exposure in vivo and graded motor imaging. If psychosocial comorbidities exist, patients should

  4. Optimizing velocities and transports for complex coastal regions and archipelagos

    OpenAIRE

    Haley, Patrick; Agarwal, Arpit; Lermusiaux, Pierre

    2015-01-01

    We derive and apply a methodology for the initialization of velocity and transport fields in complex multiply-connected regions with multiscale dynamics. The result is initial fields that are consistent with observations, complex geometry and dynamics, and that can simulate the evolution of ocean processes without large spurious initial transients. A class of constrained weighted least squares optimizations is defined to best fit first-guess velocities while satisfying the complex bathymetry,...

  5. Estimation of Economic Efficiency of Regional Touristic Complex

    Directory of Open Access Journals (Sweden)

    Kurchenkov Vladimir Viktorovich

    2015-09-01

    Full Text Available The article describes the features of the development of the regional touristic complex in modern conditions and determines the direction of realizing the potential of the regional market of tourist services. The authors reveal the multiplicative interrelation for analyzing the interaction of the primary and secondary sectors of the regional market of tourist services. The key indicators of efficiency are outlined, the extent of their relevance for assessing the potential of international tourism in the region is revealed. The authors calculate the relative indicators reflecting the dynamics of incomes from inbound, outbound and domestic tourism in relation to the total income from tourism activities in the region during the reporting period, usually for one calendar year. On the basis of these parameters, the classification of the regions of the Southern Federal District in terms of tourist attraction is carried out. The authors determine the reasons of the low tourist attractiveness of the Volgograd region in comparison with other regions of the Southern Federal District. It is substantiated that the potential of expanding tourism activity is not fully realized today in the Volgograd region. The technique of analysis and evaluation of the effectiveness of regional touristic complex on the basis of cluster approach is suggested. For analyzing the effectiveness of regional tourism cluster the authors propose to use indicators that reflect the overall performance of the regional tourism cluster, characterizing the impact of cluster development of the area, or the regional market, as well as evaluating the performance of each of the companies cooperating in the framework of the cluster. The article contains recommendations to the regional authorities on improving the efficiency of regional touristic complex in the short- and long-term prospects.

  6. Harvey Cushing Treated the First Known Patient With Carney Complex.

    Science.gov (United States)

    Tsay, Cynthia J; Stratakis, Constantine A; Faucz, Fabio Rueda; London, Edra; Stathopoulou, Chaido; Allgauer, Michael; Quezado, Martha; Dagradi, Terry; Spencer, Dennis D; Lodish, Maya

    2017-10-01

    Carney complex (CNC) is a syndrome characterized by hyperplasia of endocrine organs and may present with clinical features of Cushing syndrome and acromegaly due to functional adrenal and pituitary gland tumors. CNC has been linked to mutations in the regulatory subunit of protein kinase A type I-alpha ( PRKAR1A ) gene. Tissue samples were taken from the hypothalamus or thalamus or tumors of patients with pituitary adenomas seen and operated on by neurosurgeon Harvey Cushing between 1913 and 1932. Following DNA extraction, sequencing for genes of interest was attempted, including PRKAR1A , AIP , USP8 , GNAS1 , and GPR101 , to explore the possibility that these mutations associated with acromegaly, CNC, and Cushing syndrome have been conserved over time. We report a patient described by Dr. Cushing in 1914 with a clinical presentation and postmortem findings suggestive of CNC. Genetic sequencing of the hypothalamus and pituitary adenoma revealed a germline heterozygous p.Arg74His mutation in the PRKAR1A gene, a codon previously described as mutated in CNC, but with a novel amino acid change. This patient is, to our knowledge, the first molecularly confirmed individual with CNC. This case demonstrates the power of modern genetics in studying archived tissues and the importance of recording detailed clinical notes in the diagnosis of disease.

  7. On synchronized regions of discrete-time complex dynamical networks

    International Nuclear Information System (INIS)

    Duan Zhisheng; Chen Guanrong

    2011-01-01

    In this paper, the local synchronization of discrete-time complex networks is studied. First, it is shown that for any natural number n, there exists a discrete-time network which has at least left floor n/2 right floor +1 disconnected synchronized regions for local synchronization, which implies the possibility of intermittent synchronization behaviors. Different from the continuous-time networks, the existence of an unbounded synchronized region is impossible for discrete-time networks. The convexity of the synchronized regions is also characterized based on the stability of a class of matrix pencils, which is useful for enlarging the stability region so as to improve the network synchronizability.

  8. COMPLEX REGIONAL PAIN SYNDROME – CLINIC, DIAGNOSTICS, TREATMENT

    Directory of Open Access Journals (Sweden)

    N. A. Shostak

    2014-07-01

    Full Text Available The problem of pain today remains one of the fundamental issues of medical care. It is known that the pain is the leading cause of treatmentto the doctor. Among pain syndromes, a special place belongs to the complex regional pain syndromes. They are distinguished by the multidisciplinary problem, the presence of explicit nature of the pain, difficulty of diagnosis and nature of the treatment. The article presentsmodern data on the diagnosis and treatment of the complex regional pain syndromes.

  9. COMPLEX REGIONAL PAIN SYNDROME – CLINIC, DIAGNOSTICS, TREATMENT

    Directory of Open Access Journals (Sweden)

    N. A. Shostak

    2013-01-01

    Full Text Available The problem of pain today remains one of the fundamental issues of medical care. It is known that the pain is the leading cause of treatmentto the doctor. Among pain syndromes, a special place belongs to the complex regional pain syndromes. They are distinguished by the multidisciplinary problem, the presence of explicit nature of the pain, difficulty of diagnosis and nature of the treatment. The article presentsmodern data on the diagnosis and treatment of the complex regional pain syndromes.

  10. Regional CBF in chronic stable TBI treated with hyperbaric oxygen.

    Science.gov (United States)

    Barrett, K F; Masel, B; Patterson, J; Scheibel, R S; Corson, K P; Mader, J T

    2004-01-01

    To investigate whether Hyperbaric Oxygen Therapy (HBO2) could improve neurologic deficits and regional cerebral blood flow (rCBF) in chronic traumatic brain injuries (TBI), the authors employed a nonrandomized control pilot trial. Five subjects, at least three years post head injury, received HBO2. Five head injured controls (HIC) were matched for age, sex, and type of injury. Five healthy subjects served as normal controls. Sixty-eight normal volunteers comprised a reference data bank against which to compare SPECT brain scans. HBO2 subjects received 120 HBO2 in blocks of 80 and 40 treatments with an interval five-month break. Normal controls underwent a single SPECT brain scan, HBO2, and repeat SPECT battery. TBI subjects were evaluated by neurologic, neuropsychometric, exercise testing, and pre and post study MRIs, or CT scans if MRI was contraindicated. Statistical Parametric Mapping was applied to SPECT scans for rCBF analysis. There were no significant objective changes in neurologic, neuropsychometric, exercise testing, MRIs, or rCBF. In this small pilot study, HBO2 did not effect clinical or regional cerebral blood flow improvement in TBI subjects.

  11. Increased water resistance of paper treated with amylose-fatty ammonium salt inclusion complexes

    Science.gov (United States)

    Amylose inclusion complexes were prepared from high amylose corn starch and the HCl salts of hexadecylamine and octadecylamine. Solutions of the complexes were applied to paper at concentrations of 2-4%. After the treated papers were dried, sodium hydroxide solution was applied to convert the adsorb...

  12. Complex Regional Pain Syndrome in Children: Asking the Right Questions

    Directory of Open Access Journals (Sweden)

    Kenneth R Goldschneider

    2012-01-01

    Full Text Available BACKGROUND: Complex regional pain syndrome (CRPS is a painful disorder without a known unifying mechanism. There are little data on which to base evaluation and treatment decisions, and what data are available come from studies involving adults; however, even that literature is relatively sparse. Developing robust research for CRPS in children is essential for the progress toward optimal treatment.

  13. Genetic and epidemiological aspect of Complex Regional Pain Syndrome

    NARCIS (Netherlands)

    Rooij, Annetje Monique de

    2010-01-01

    Complex Regional Pain Syndrome (CRPS) is a painful disorder affecting one or more extremities. CRPS is characterized by various combinations of sensory, autonomic and motor disturbances. Genetic factors are suggested to play a role in CRPS, but this has not been extensively studied. Therefore the

  14. Neuroimmune Alterations in the Complex Regional Pain Syndrome

    NARCIS (Netherlands)

    F.J.P.M. Huygen (Frank)

    2004-01-01

    textabstractComplex Regional Pain Syndrome (CRPS) is a disease which occurs as a complication after surgery or trauma, although spontaneous development is described. CRPS is characterized by continuing pain, sensory and vasomotor, sudomotor, motor and trophic disturbances. Many of these symptoms are

  15. Reflex sympathetic dystrophy/complex regional pain syndrome, type 1

    African Journals Online (AJOL)

    Enrique

    with MRI every 3 months and the bone marrow oedema disappeared after 6 months. Introduction ... SA JOURNAL OF RADIOLOGY • August 2004. Reflex sympathetic dystrophy/complex regional pain syndrome, type 1 ... may be either trauma of external origin or iatrogenic, post surgery. In some patients particularly children ...

  16. [Complex regional pain syndrome type 1: negating the myth

    NARCIS (Netherlands)

    Frolke, J.P.M.; Dongen, R.T.M. van; Meent, H. van de

    2015-01-01

    Complex regional pain syndrome type 1 (CRPS-1) was identified in the Netherlands more than 30 years ago, but since then the arguments supporting this diagnosis have become weaker. Incidence has decreased, it is often not possible to make a definite diagnosis, the pathophysiology remains unclear and

  17. Evidence based guidelines for complex regional pain syndrome type 1

    NARCIS (Netherlands)

    Perez, R.S.G.M.; Zollinger, P.E.; Dijkstra, P.U.; Thomassen-Hilgersom, I.L.; Zuurmond, W.W.A.; Rosenbrand, C.J.G.M.; Geerzen, J.H.B.

    2010-01-01

    Background: Treatment of complex regional pain syndrome type I (CRPS-I) is subject to discussion. The purpose of this study was to develop multidisciplinary guidelines for treatment of CRPS-I.Method: A multidisciplinary task force graded literature evaluating treatment effects for CRPS-I according

  18. Evidence based guidelines for complex regional pain syndrome type 1

    NARCIS (Netherlands)

    Perez, Roberto S.; Zollinger, Paul E.; Dijkstra, Pieter U.; Thomassen-Hilgersom, Ilona L.; Zuurmond, Wouter W.; Rosenbrand, Kitty C. J.; Geertzen, Jan H.

    2010-01-01

    Background: Treatment of complex regional pain syndrome type I (CRPS-I) is subject to discussion. The purpose of this study was to develop multidisciplinary guidelines for treatment of CRPS-I. Method: A multidisciplinary task force graded literature evaluating treatment effects for CRPS-I according

  19. Contribution of Large Region Joint Associations to Complex Traits Genetics

    Science.gov (United States)

    Paré, Guillaume; Asma, Senay; Deng, Wei Q.

    2015-01-01

    A polygenic model of inheritance, whereby hundreds or thousands of weakly associated variants contribute to a trait’s heritability, has been proposed to underlie the genetic architecture of complex traits. However, relatively few genetic variants have been positively identified so far and they collectively explain only a small fraction of the predicted heritability. We hypothesized that joint association of multiple weakly associated variants over large chromosomal regions contributes to complex traits variance. Confirmation of such regional associations can help identify new loci and lead to a better understanding of known ones. To test this hypothesis, we first characterized the ability of commonly used genetic association models to identify large region joint associations. Through theoretical derivation and simulation, we showed that multivariate linear models where multiple SNPs are included as independent predictors have the most favorable association profile. Based on these results, we tested for large region association with height in 3,740 European participants from the Health and Retirement Study (HRS) study. Adjusting for SNPs with known association with height, we demonstrated clustering of weak associations (p = 2x10-4) in regions extending up to 433.0 Kb from known height loci. The contribution of regional associations to phenotypic variance was estimated at 0.172 (95% CI 0.063-0.279; p < 0.001), which compared favorably to 0.129 explained by known height variants. Conversely, we showed that suggestively associated regions are enriched for known height loci. To extend our findings to other traits, we also tested BMI, HDLc and CRP for large region associations, with consistent results for CRP. Our results demonstrate the presence of large region joint associations and suggest these can be used to pinpoint weakly associated SNPs. PMID:25856144

  20. Optimizing velocities and transports for complex coastal regions and archipelagos

    Science.gov (United States)

    Haley, Patrick J.; Agarwal, Arpit; Lermusiaux, Pierre F. J.

    2015-05-01

    We derive and apply a methodology for the initialization of velocity and transport fields in complex multiply-connected regions with multiscale dynamics. The result is initial fields that are consistent with observations, complex geometry and dynamics, and that can simulate the evolution of ocean processes without large spurious initial transients. A class of constrained weighted least squares optimizations is defined to best fit first-guess velocities while satisfying the complex bathymetry, coastline and divergence strong constraints. A weak constraint towards the minimum inter-island transports that are in accord with the first-guess velocities provides important velocity corrections in complex archipelagos. In the optimization weights, the minimum distance and vertical area between pairs of coasts are computed using a Fast Marching Method. Additional information on velocity and transports are included as strong or weak constraints. We apply our methodology around the Hawaiian islands of Kauai/Niihau, in the Taiwan/Kuroshio region and in the Philippines Archipelago. Comparisons with other common initialization strategies, among hindcasts from these initial conditions (ICs), and with independent in situ observations show that our optimization corrects transports, satisfies boundary conditions and redirects currents. Differences between the hindcasts from these different ICs are found to grow for at least 2-3 weeks. When compared to independent in situ observations, simulations from our optimized ICs are shown to have the smallest errors.

  1. Priority Directions of The Regional Food Complex Effectiveness Increase

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    Dmitry Andreyevich Karkh

    2015-06-01

    Full Text Available In the article, the modern trends of management integration as a solution of food and sectoral problems are considered. On the basis of national and foreign experience of development of integration, the classification of integration in economic systems is developed. On the basis of the given classification, the concept of integration is conducted. In the article, much attention is given to the food problem solution, which depends more on the agro-industrial complex based on metaintegration. The leading place of a food complex in the system of agro-industrial complex is caused by a role of food and food raw materials in life of the population of the country. The ratio of the sectors participating in the food production and consumer goods makes the sectoral structure of agro-industrial complex. In the conditions of the resource limitation necessary for the production and food delivery to the domestic market, the role of trade will increase not only in agro-industrial complex, but in all national economy. Also, in this article, the phenomenon of clusters is studied. The attention to clusters as to innovation systems reflects a rising tide of interest of economic science to the questions of economics functioning in regional level and understanding of a role of specific local resources in stimulation of innovative opportunities and competitiveness of small and medium business. Creating a cluster, participants develop the spatial and organizational integrated structure, in interaction of legal entities the status is saved and cooperation provides competitive advantages with other business entities. The role of the state in integration of cluster formations in the Russian Federation is more significant, than in any other country. The state represented by regional authorities actively participates in decision-making process by the business located in its catchment area not only through membership in governing bodies of large joint stock companies.

  2. Metformin-treated patients with type 2 diabetes have normal mitochondrial complex I respiration

    DEFF Research Database (Denmark)

    Larsen, Steen; Rabøl, R; Hansen, C N

    2012-01-01

    The glucose-lowering drug metformin has been shown to inhibit complex I of the mitochondrial electron transport chain in skeletal muscle. To investigate this effect in vivo we studied skeletal muscle mitochondrial respiratory capacity and content from patients with type 2 diabetes treated...

  3. Security Inequalities in North America: Reassessing Regional Security Complex Theory

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    Richard Kilroy

    2017-12-01

    Full Text Available This article re-evaluates earlier work done by the authors on Regional Security Complex Theory (RSCT in North America, using sectoral analysis initially developed by Buzan and Waever, but also adding the variables of institutions, identity, and interests. These variables are assessed qualitatively in the contemporary context on how they currently impress upon the process of securitization within sectoral relations between Canada, Mexico, and the United States. The article reviews the movement from bilateral security relations between these states to the development of a trilateral response to regional security challenges post- 9/11. It further addresses the present period and what appears to be a security process derailed by recent political changes and security inequalities, heightened by the election of Donald Trump in 2016. The article argues that while these three states initially evinced a convergence of regional security interests after 9/11, which did create new institutional responses, under the current conditions, divergence in political interests and security inequalities have reduced the explanatory power of RSCT in North America. Relations between states in North American are becoming less characterized by the role of institutions and interests and more by identity politics in the region.

  4. Complex Regional Pain Syndrome (CRPS/RSD and Neuropathic Pain: Role of Intravenous Bisphosphonates as Analgesics

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    Jennifer Yanow

    2008-01-01

    Full Text Available Neuropathic pain is a sequela of dysfunction, injuries, or diseases of the peripheral and/or central nervous system pain pathways, which has historically been extremely difficult to treat. Complex regional pain syndrome (CRPS types 1 and 2 are neuropathic pain conditions that have a long history in the medical literature but whose pathophysiology remains elusive and whose available treatment options remain few. While an exact animal model for CRPS doesn't yet exist, there are several animal models of neuropathic pain that develop behaviors of hypersensitivity, one of the hallmark signs of neuropathic pain in humans.

  5. Treatment of Complex Regional Pain Syndrome (CRPS) using low dose naltrexone (LDN).

    Science.gov (United States)

    Chopra, Pradeep; Cooper, Mark S

    2013-06-01

    Complex Regional Pain Syndrome (CRPS) is a neuropathic pain syndrome, which involves glial activation and central sensitization in the central nervous system. Here, we describe positive outcomes of two CRPS patients, after they were treated with low-dose naltrexone (a glial attenuator), in combination with other CRPS therapies. Prominent CRPS symptoms remitted in these two patients, including dystonic spasms and fixed dystonia (respectively), following treatment with low-dose naltrexone (LDN). LDN, which is known to antagonize the Toll-like Receptor 4 pathway and attenuate activated microglia, was utilized in these patients after conventional CRPS pharmacotherapy failed to suppress their recalcitrant CRPS symptoms.

  6. Immunological aspects of the complex regional pain syndrome (CRPS).

    Science.gov (United States)

    Krämer, Heidrun H

    2012-01-01

    Limb trauma can lead to the development of a complex regional pain syndrome (CRPS). CRPS is a descriptive term of a variety of different symptoms. According to the current IASP-approved criteria, human CRPS can be diagnosed if a combination of signs is present: continuing pain and hyperalgesia, disproportionate to the initial trauma, skin temperature and colour asymmetry, sweating asymmetry, edema, decreased range of motion, and trophic changes. The diagnosis and treatment of human CRPS can be demanding and the pathophysiology underlying the disease is still under investigation. Immunological aspects are considered to play an important role in the development of CRPS. The impact of elevated pro-inflammatory cytokines systemically as well as locally, increased neurogenic inflammation and auto-antibodies in the pathophysiological development of CRPS are discussed in this review.

  7. The Responsive Amygdala: Treatment-induced Alterations in Functional Connectivity in Pediatric Complex Regional Pain Syndrome

    Science.gov (United States)

    Simons, LE; Pielech, M; Erpelding, N; Linnman, C; Moulton, E; Sava, S; Lebel, A; Serrano, P; Sethna, N; Berde, C; Becerra, L; Borsook, D

    2014-01-01

    The amygdala is a key brain region with efferent and afferent neural connections that involve complex behaviors such as pain, reward, fear and anxiety. This study evaluated resting state functional connectivity of the amygdala with cortical and subcortical regions in a group of chronic pain patients (pediatric complex regional pain syndrome) with age-gender matched controls before and after intensive physical-biobehavioral pain treatment. Our main findings include (1) enhanced functional connectivity from the amygdala to multiple cortical, subcortical, and cerebellar regions in patients compared to controls, with differences predominantly in the left amygdala in the pre-treated condition (disease state); (2) dampened hyperconnectivity from the left amygdala to the motor cortex, parietal lobe, and cingulate cortex after intensive pain rehabilitation treatment within patients with nominal differences observed among healthy controls from Time 1 to Time 2 (treatment effects); (3) functional connectivity to several regions key to fear circuitry (prefrontal cortex, bilateral middle temporal lobe, bilateral cingulate, hippocampus) correlated with higher pain-related fear scores and (4) decreases in pain-related fear associated with decreased connectivity between the amygdala and the motor and somatosensory cortex, cingulate, and frontal areas. Our data suggest that there are rapid changes in amygdala connectivity following an aggressive treatment program in children with chronic pain and intrinsic amygdala functional connectivity activity serving as a potential indicator of treatment response. PMID:24861582

  8. Evidence based guidelines for complex regional pain syndrome type 1

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    Thomassen-Hilgersom Ilona L

    2010-03-01

    Full Text Available Abstract Background Treatment of complex regional pain syndrome type I (CRPS-I is subject to discussion. The purpose of this study was to develop multidisciplinary guidelines for treatment of CRPS-I. Method A multidisciplinary task force graded literature evaluating treatment effects for CRPS-I according to their strength of evidence, published between 1980 to June 2005. Treatment recommendations based on the literature findings were formulated and formally approved by all Dutch professional associations involved in CRPS-I treatment. Results For pain treatment, the WHO analgesic ladder is advised with the exception of strong opioids. For neuropathic pain, anticonvulsants and tricyclic antidepressants may be considered. For inflammatory symptoms, free-radical scavengers (dimethylsulphoxide or acetylcysteine are advised. To promote peripheral blood flow, vasodilatory medication may be considered. Percutaneous sympathetic blockades may be used to increase blood flow in case vasodilatory medication has insufficient effect. To decrease functional limitations, standardised physiotherapy and occupational therapy are advised. To prevent the occurrence of CRPS-I after wrist fractures, vitamin C is recommended. Adequate perioperative analgesia, limitation of operating time, limited use of tourniquet, and use of regional anaesthetic techniques are recommended for secondary prevention of CRPS-I. Conclusions Based on the literature identified and the extent of evidence found for therapeutic interventions for CRPS-I, we conclude that further research is needed into each of the therapeutic modalities discussed in the guidelines.

  9. Multifractal analysis of forest fires in complex regions

    Science.gov (United States)

    Vega Orozco, C. D.; Kanevski, M.; Golay, J.; Tonini, M.; Conedera, M.

    2012-04-01

    Forest fires can be studied as point processes where the ignition points represent the set of locations of the observed events in a defined study region. Their spatial and temporal patterns can be characterized by their fractal properties; which quantify the global aspect of the geometry of the support data. However, a monofractal dimension can not completely describe the pattern structure and related scaling properties. Enhancements in fractal theory had developed the multifractal concept which describes the measures from which interlinked fractal sets can be retrieved and characterized by their fractal dimension and singularity strength [1, 2]. The spatial variability of forest fires is conditioned by an intermixture of human, topographic, meteorological and vegetation factors. This heterogeneity makes fire patterns complex scale-invariant processes difficult to be depicted by a single scale. Therefore, this study proposes an exploratory data analysis through a multifractal formalism to characterize and quantify the multiscaling behaviour of the spatial distribution pattern of this phenomenon in a complex region like the Swiss Alps. The studied dataset is represented by 2,401 georeferenced forest fire ignition points in canton Ticino, Switzerland, in a 40-years period from 1969 to 2008. Three multifractal analyses are performed: one assesses the multiscaling behaviour of fire occurrence probability of the support data (raw data) and four random patterns simulated within three different support domains; second analysis studies the multifractal behavior of patterns from anthropogenic and natural ignited fires (arson-, accident- and lightning-caused fires); and third analysis aims at detecting scale-dependency of the size of burned area. To calculate the generalized dimensions, Dq, a generalization of the box counting methods is carried out based on the generalization of Rényi information of the qth order moment of the probability distribution. For q > 0, Dq

  10. Continuous Thoracic Sympathetic Ganglion Block in Complex Regional Pain Syndrome Patients with Spinal Cord Stimulation Implantation

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    EungDon Kim

    2016-01-01

    Full Text Available The sympathetic block is widely used for treating neuropathic pain such as complex regional pain syndrome (CRPS. However, single sympathetic block often provides only short-term effect. Moreover, frequent procedures for sympathetic block may increase the risk of complications. The use of epidural route may be limited by concern of infection in case of previous implantation of the spinal cord stimulation (SCS. In contrast, a continuous sympathetic block can be administered without such concerns. The continuous thoracic sympathetic block (TSGB has been used to treat the ischemic disease and other neuropathic conditions such as postherpetic neuralgia. We administered continuous thoracic sympathetic block using catheter in CRPS patients who underwent SCS implantations and achieved desirable outcomes. We believe a continuous sympathetic block is a considerable option before performing neurolysis or radiofrequency rhizotomy and even after SCS implantation.

  11. An empirical application of regional security complex theory on eastern partnership region

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    Ludmila STUPARU

    2015-12-01

    Full Text Available Eastern Partnership (EaP is a very dynamic region. If a year ago the EaP was seen as an authentic and vibrant „laboratory” of democracy building, overcoming the remains of the totalitarian state and putting the basis of a free and pluralist society, nowadays the Eastern Partnership is seen as an „out-dated” approach of the EU. However, Eastern Partnership is visible on European political arena and the big powers (USA, Russia and the EU pay attention more and more to the evolution of EaP countries. Moreover, it seems to be a confrontation between Russia and Western powers regarding the political and geopolitical orientation of EaP countries. Kremlin tries actively to stop the efforts of the EaP to close to the EU and on the other side, the EU as well as the USA encourage EaP countries to implement reforms in order to build their democracy. This paper aims to analyse the Eastern Partnership in terms of security complex, trying to argue that Eastern Partnership countries at this phase don’t form a Regional Security Complex and the EU and USA should rethink its approach towards this region.

  12. Genome-wide expression profiling of complex regional pain syndrome.

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    Eun-Heui Jin

    Full Text Available Complex regional pain syndrome (CRPS is a chronic, progressive, and devastating pain syndrome characterized by spontaneous pain, hyperalgesia, allodynia, altered skin temperature, and motor dysfunction. Although previous gene expression profiling studies have been conducted in animal pain models, there genome-wide expression profiling in the whole blood of CRPS patients has not been reported yet. Here, we successfully identified certain pain-related genes through genome-wide expression profiling in the blood from CRPS patients. We found that 80 genes were differentially expressed between 4 CRPS patients (2 CRPS I and 2 CRPS II and 5 controls (cut-off value: 1.5-fold change and p<0.05. Most of those genes were associated with signal transduction, developmental processes, cell structure and motility, and immunity and defense. The expression levels of major histocompatibility complex class I A subtype (HLA-A29.1, matrix metalloproteinase 9 (MMP9, alanine aminopeptidase N (ANPEP, l-histidine decarboxylase (HDC, granulocyte colony-stimulating factor 3 receptor (G-CSF3R, and signal transducer and activator of transcription 3 (STAT3 genes selected from the microarray were confirmed in 24 CRPS patients and 18 controls by quantitative reverse transcription-polymerase chain reaction (qRT-PCR. We focused on the MMP9 gene that, by qRT-PCR, showed a statistically significant difference in expression in CRPS patients compared to controls with the highest relative fold change (4.0±1.23 times and p = 1.4×10(-4. The up-regulation of MMP9 gene in the blood may be related to the pain progression in CRPS patients. Our findings, which offer a valuable contribution to the understanding of the differential gene expression in CRPS may help in the understanding of the pathophysiology of CRPS pain progression.

  13. Complex regional pain syndrome 1 – the Swiss cohort study

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    Perez Roberto SGM

    2008-06-01

    Full Text Available Abstract Background Little is known about the course of Complex Regional Pain Syndrome 1 and potential factors influencing the course of this disorder over time. The goal of this study is a to set up a database with patients suffering from suspected CRPS 1 in an initial stadium, b to perform investigations on epidemiology, diagnosis, prognosis, and socioeconomics within the database and c to develop a prognostic risk assessment tool for patients with CRPS 1 taking into account symptomatology and specific therapies. Methods/design Prospective cohort study. Patients suffering from a painful swelling of the hand or foot which appeared within 8 weeks after a trauma or a surgery and which cannot be explained by conditions that would otherwise account for the degree of pain and dysfunction will be included. In accordance with the recommendations of International Classification of Functioning, Disability and Health (ICF model, standardised and validated questionnaires will be used. Patients will be monitored over a period of 2 years at 6 scheduled visits (0 and 6 weeks, 3, 6, 12, and 24 months. Each visit involves a physical examination, registration of therapeutic interventions, and completion of the various study questionnaires. Outcomes involve changes in health status, quality of life and costs/utility. Discussion This paper describes the rationale and design of patients with CRPS 1. Ideally, potential risk factors may be identified at an early stage in order to initiate an early and adequate treatment in patients with increased risk for delayed recovery. Trial registration Not applicable

  14. Activation of cutaneous immune responses in complex regional pain syndrome

    Science.gov (United States)

    Birklein, Frank; Drummond, Peter D.; Li, Wenwu; Schlereth, Tanja; Albrecht, Nahid; Finch, Philip M.; Dawson, Linda F.; Clark, J. David; Kingery, Wade S.

    2014-01-01

    The pathogenesis of complex regional pain syndrome (CRPS) is unresolved, but TNF-α and IL-6 are elevated in experimental skin blister fluid from CRPS affected limbs, as is tryptase, a marker for mast cells. In the rat fracture model of CRPS exaggerated sensory and sympathetic neural signaling stimulate keratinocyte and mast cell proliferation, causing the local production of high levels of inflammatory cytokines leading to pain behavior. The current investigation used CRPS patient skin biopsies to determine whether keratinocyte and mast cell proliferation occur in CRPS skin and to identify the cellular source of the up-regulated TNF-α, IL-6, and tryptase observed in CRPS experimental skin blister fluid. Skin biopsies were collected from the affected skin and the contralateral mirror site in 55 CRPS patients and the biopsy sections were immunostained for keratinocyte, cell proliferation, mast cell markers, TNF-α, and IL-6. In early CRPS keratinocytes were activated in the affected skin, resulting in proliferation, epidermal thickening, and up-regulated TNF-α and IL-6 expression. In chronic CRPS there was reduced keratinocyte proliferation with epidermal thinning in the affected skin. Acute CRPS patients also had increased mast cell accumulation in the affected skin, but there was no increase in mast cell numbers in chronic CRPS. PMID:24462502

  15. Genome-Wide Expression Profiling of Complex Regional Pain Syndrome

    Science.gov (United States)

    Jin, Eun-Heui; Zhang, Enji; Ko, Youngkwon; Sim, Woo Seog; Moon, Dong Eon; Yoon, Keon Jung; Hong, Jang Hee; Lee, Won Hyung

    2013-01-01

    Complex regional pain syndrome (CRPS) is a chronic, progressive, and devastating pain syndrome characterized by spontaneous pain, hyperalgesia, allodynia, altered skin temperature, and motor dysfunction. Although previous gene expression profiling studies have been conducted in animal pain models, there genome-wide expression profiling in the whole blood of CRPS patients has not been reported yet. Here, we successfully identified certain pain-related genes through genome-wide expression profiling in the blood from CRPS patients. We found that 80 genes were differentially expressed between 4 CRPS patients (2 CRPS I and 2 CRPS II) and 5 controls (cut-off value: 1.5-fold change and pCRPS patients and 18 controls by quantitative reverse transcription-polymerase chain reaction (qRT-PCR). We focused on the MMP9 gene that, by qRT-PCR, showed a statistically significant difference in expression in CRPS patients compared to controls with the highest relative fold change (4.0±1.23 times and p = 1.4×10−4). The up-regulation of MMP9 gene in the blood may be related to the pain progression in CRPS patients. Our findings, which offer a valuable contribution to the understanding of the differential gene expression in CRPS may help in the understanding of the pathophysiology of CRPS pain progression. PMID:24244504

  16. Reflex sympathetic dystrophy/complex regional pain syndrome, type 1

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    S.H. Botha

    2004-06-01

    Full Text Available Complex regional pain syndrome (CPRS, type 1 is a pain disorder that develops unpredictably and can follow a minor injury. A 12-year-old boy presented with severe pain in the feet and could not walk or stand weight bearing. Normal X-rays showed osteopenic changes and radiolucent lines, which appeared to be stress fractures. Three-phase bone scintigraphy showed no uptake in the left lower leg on the blood pool phase or on the immediate or delayed images. This indicated typical CPRS type 1 in children. The uptake in the right foot was increased and the stress fracture and other illness could not be differentiated. Computed tomography was done to exclude stress fractures. Only osteopenic changes in both calcaneus bones were found and there was no evidence of cortical stress fractures. Magnetic resonance images revealed oedema in the calcaneus and talus bones of both feet. The patient received epidural narcotic infusion with sympathetic blockage for 1 week combined with extensive physiotherapy. The blood pool phase of the bone scan became normal within 2 weeks, and increased uptake in both feet was noticed. The patient was followed up with MRI every 3 months and the bone marrow oedema disappeared after 6 months.

  17. Complex Regional Pain Syndrome after Transradial Cardiac Catheterization

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    Chih-Jou Lai

    2006-04-01

    Full Text Available Complex regional pain syndrome (CRPS is a disease with unclear pathophysiology. The condition is characterized by pain, soft tissue change, vasomotor change, and even psychosocial disturbance. It may affect the upper more than the lower extremities, and the distal more than the proximal. The trigger factors include carpal tunnel release, Dupuytren's repair, tendon release procedures, knee surgery, crush injury, ankle arthrodesis, amputation, and hip arthroplasty. Rarely, it has been associated with stroke, mastectomy, pregnancy, and osteogenesis imperfecta. Herein, we present a rare case of a patient who was diagnosed with CRPS after transradial cardiac catheterization. CRPS was first diagnosed due to hand swelling, allodynia, paresthesia, and the limited range of motion of interphalangeal, metacarpophalangeal, and wrist joints, with the preceding factor of transradial cardiac catheterization, and was then confirmed by a three-phase bone scan. After intensive physical therapy with hydrotherapy, manual soft tissue release, and occupational therapy for the hand function, there was much improvement in range of motion and hand function. There was no allodynia or painful sensation in the follow-up. After training, the functional status of this patient was adequate for daily activity.

  18. Estrogens and the risk of complex regional pain syndrome (CRPS).

    Science.gov (United States)

    de Mos, M; Huygen, F J P M; Stricker, B H Ch; Dieleman, J P; Sturkenboom, M C J M

    2009-01-01

    Since complex regional pain syndrome (CRPS) shows a clear female predominance, we investigated the association between the cumulative as well as current exposure to estrogens, and CRPS. A population-based case-control study was conducted in the Integrated Primary Care Information (IPCI) project in the Netherlands. Cases were identified from electronic records (1996-2005) and included if they were confirmed during a visit (using International Association for the Study of Pain Criteria), or had been diagnosed by a specialist. Controls were matched to cases on gender, age, calendar time, and injury. Measures of cumulative endogenous estrogen exposure were obtained by questionnaire and included age of menarche and menopause, menstrual life, and cumulative months of pregnancy and breast-feeding. Current estrogen exposure at CRPS onset was retrieved from the electronic medical records and determined by current pregnancy or by the use of oral contraceptive (OC) drugs or hormonal replacement therapy (HRT). Hundred and forty-three female cases (1493 controls) were included in analyses on drug use and pregnancies, while cumulative endogenous estrogen exposure was studied in 53 cases (58 controls) for whom questionnaire data were available. There was no association between CRPS and either cumulative endogenous estrogen exposure, OC, or HRT use. CRPS onset was increased during the first 6 months after pregnancy (OR: 5.6, 95%CI: 1.0-32.4), although based on small numbers. We did not find an association between CRPS onset and cumulative endogenous estrogen exposure or current OC or HRT use, but more powered studies are needed to exclude potential minor associations.

  19. Sensitization of the Nociceptive System in Complex Regional Pain Syndrome

    Science.gov (United States)

    Diedrichs, Carolina; Baron, Ralf; Gierthmühlen, Janne

    2016-01-01

    Background Complex regional pain syndrome type I (CRPS-I) is characterized by sensory, motor and autonomic abnormalities without electrophysiological evidence of a nerve lesion. Objective Aims were to investigate how sensory, autonomic and motor function change in the course of the disease. Methods 19 CRPS-I patients (17 with acute, 2 with chronic CRPS, mean duration of disease 5.7±8.3, range 1–33 months) were examined with questionnaires (LANSS, NPS, MPI, Quick DASH, multiple choice list of descriptors for sensory, motor, autonomic symptoms), motor and autonomic tests as well as quantitative sensory testing according to the German Research Network on Neuropathic Pain at two visits (baseline and 36±10.6, range 16–53 months later). Results CRPS-I patients had an improvement of sudomotor and vasomotor function, but still a great impairment of sensory and motor function upon follow-up. Although pain and mechanical detection improved upon follow-up, thermal and mechanical pain sensitivity increased, including the contralateral side. Increase in mechanical pain sensitivity and loss of mechanical detection were associated with presence of ongoing pain. Conclusions The results demonstrate that patients with CRPS-I show a sensitization of the nociceptive system in the course of the disease, for which ongoing pain seems to be the most important trigger. They further suggest that measured loss of function in CRPS-I is due to pain-induced hypoesthesia rather than a minimal nerve lesion. In conclusion, this article gives evidence for a pronociceptive pain modulation profile developing in the course of CRPS and thus helps to assess underlying mechanisms of CRPS that contribute to the maintenance of patients’ pain and disability. PMID:27149519

  20. Sensitization of the Nociceptive System in Complex Regional Pain Syndrome.

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    Maren Reimer

    Full Text Available Complex regional pain syndrome type I (CRPS-I is characterized by sensory, motor and autonomic abnormalities without electrophysiological evidence of a nerve lesion.Aims were to investigate how sensory, autonomic and motor function change in the course of the disease.19 CRPS-I patients (17 with acute, 2 with chronic CRPS, mean duration of disease 5.7±8.3, range 1-33 months were examined with questionnaires (LANSS, NPS, MPI, Quick DASH, multiple choice list of descriptors for sensory, motor, autonomic symptoms, motor and autonomic tests as well as quantitative sensory testing according to the German Research Network on Neuropathic Pain at two visits (baseline and 36±10.6, range 16-53 months later.CRPS-I patients had an improvement of sudomotor and vasomotor function, but still a great impairment of sensory and motor function upon follow-up. Although pain and mechanical detection improved upon follow-up, thermal and mechanical pain sensitivity increased, including the contralateral side. Increase in mechanical pain sensitivity and loss of mechanical detection were associated with presence of ongoing pain.The results demonstrate that patients with CRPS-I show a sensitization of the nociceptive system in the course of the disease, for which ongoing pain seems to be the most important trigger. They further suggest that measured loss of function in CRPS-I is due to pain-induced hypoesthesia rather than a minimal nerve lesion. In conclusion, this article gives evidence for a pronociceptive pain modulation profile developing in the course of CRPS and thus helps to assess underlying mechanisms of CRPS that contribute to the maintenance of patients' pain and disability.

  1. MicroRNA modulation in complex regional pain syndrome

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    Orlova Irina A

    2011-11-01

    Full Text Available Abstract Background Aberrant expression of small noncoding RNAs called microRNAs (miRNAs is a common feature of several human diseases. The objective of the study was to identify miRNA modulation in patients with complex regional pain syndrome (CRPS a chronic pain condition resulting from dysfunction in the central and/or peripheral nervous systems. Due to a multitude of inciting pathologies, symptoms and treatment conditions, the CRPS patient population is very heterogeneous. Our goal was to identify differentially expressed miRNAs in blood and explore their utility in patient stratification. Methods We profiled miRNAs in whole blood from 41 patients with CRPS and 20 controls using TaqMan low density array cards. Since neurogenic inflammation is known to play a significant role in CRPS we measured inflammatory markers including chemokines, cytokines, and their soluble receptors in blood from the same individuals. Correlation analyses were performed for miRNAs, inflammatory markers and other parameters including disease symptoms, medication, and comorbid conditions. Results Three different groups emerged from miRNA profiling. One group was comprised of 60% of CRPS patients and contained no control subjects. miRNA profiles from the remaining patients were interspersed among control samples in the other two groups. We identified differential expression of 18 miRNAs in CRPS patients. Analysis of inflammatory markers showed that vascular endothelial growth factor (VEGF, interleukin1 receptor antagonist (IL1Ra and monocyte chemotactic protein-1 (MCP1 were significantly elevated in CRPS patients. VEGF and IL1Ra showed significant correlation with the patients reported pain levels. Analysis of the patients who were clustered according to their miRNA profile revealed correlations that were not significant in the total patient population. Correlation analysis of miRNAs detected in blood with additional parameters identified miRNAs associated with

  2. Demographic Features in Patients with Complex Regional Pain Syndrome

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    Berat Meryem Alkan

    2011-12-01

    Full Text Available Summary Özet Orijinal Araştırma / Original Investigation 77 Aim: Complex regional pain syndrome (CRPS is characterized by pain, vasomotor and sudomotor changes and trophic disturbances. It may develop as a result of trauma, especially extremity fractures and surgery. Although the pathogenesis of CRPS is not exactly clear explained, it has been suggested that central and periferal mechanisms play role and neurogenic inflamatuar and microvasculer functional impairmensts are accompanying to the process. Not all but some of the patients with past trauma or with other possible etiological factors develop CRPS. This suggests the presence of an individual predisposition. In this article, we searched post fractüred CRPS-I patients demographic characteristics, current systemic diseases and symptoms that accompany a CRPS in our records. Materials and Methods: In this retrospective study conducted in Ankara Atatürk Education and Research Hospital, medical records of 356 patients admitted to physical medicine and rehabilitation outpatient clinics with fractures between January 2011 and June 2011 were evaluated and 34 patients diagnosed as CRPS-1 were included in the study. Results: 34 of 356 patients (9.56% with fractures were diagnosed as CRPS-1 in our outpatient clinics. Mean age of the patients was 46.05 years and 10 patients were females (29.4% and 24 patients (70.6% were males. Fractures were in upper extremities in 18 patients (52.9% and in lower extremities in 16 (47.1% patients. Neuropsychiatric disorders and other systemic diseases that may have a role in etiology of CRPS were found in lower rates in medical records of our patients. Conclusion: CRPS does not develop in every patients after travma who has etiologic risk factors, so it reminds that there exists a tendency to CRPS. We have observed that CRPS-1 risk was increased in male patients and in upper extremity fractures. We did not observe any other impertant factor which increases

  3. Bee Venom Pharmacopuncture: An Effective Treatment for Complex Regional Pain Syndrome

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    Jong-Min Kim

    2014-12-01

    Full Text Available Objectives: Treating complex regional pain syndrome (CRPS is difficult because it still does not have a recommended therapy. A 29-year-old man was diagnosed with CRPS after surgery on his 4th and 5th left toes 7 years ago. Though he had undergone diverse pain treatment, the symptoms persisted, so he visited Dunsan Korean Medicine Hospital of Daejeon University. This case report presents results on the effect of bee venom pharmacopuncture in treating patient with CRPS. Methods: Bee venom pharmacopuncture (BVP, 0.15 to 0.4 mL dosage, was administered at GB43. The treatment was applied each week for a total 14 times. The symptoms were evaluated using a numeric rating scale (NRS and the dosage of pain medicine. Results: On the first visit, he was taking an anticonvulsant, a trycyclic antidepressant, and an analgesic. On the NRS the worst pain in the toes received a score of 8. He also complained of severe pain and hypersensitivity when the 4th and the 5th toes were touched just slightly. Other complaint included dyspepsia, rash, and depression. After treatment, on the NRS, the score for toe pain was 0, and he no longer needed to take pain medication. During the 4-months follow-up period, he has remained without pain; neither have additional symptoms appeared nor adverse events occurred. Conclusion: BVP may have potential benefits for treating patients with CRPS.

  4. Clinical investigation: Regional nodal failure patterns in breast cancer patients treated with mastectomy without radiotherapy

    International Nuclear Information System (INIS)

    Strom, Eric A.; Woodward, Wendy A.; Katz, Angela; Buchholz, Thomas A.; Perkins, George H.; Jhingran, Anuja; Theriault, Richard; Singletary, Eva; Sahin, Aysegul; McNeese, Marsha D.

    2005-01-01

    Purpose: The purpose of this study was to describe regional nodal failure patterns in patients who had undergone mastectomy with axillary dissection to define subgroups of patients who might benefit from supplemental regional nodal radiation to the axilla or supraclavicular fossa/axillary apex. Methods and Materials: The cohort consisted of 1031 patients treated with mastectomy (including a level I-II axillary dissection) and doxorubicin-based systemic therapy without radiation on five clinical trials at M.D. Anderson Cancer Center. Patient records, including pathology reports, were retrospectively reviewed. All regional recurrences (with or without distant metastasis) were recorded. Median follow-up was 116 months (range, 6-262 months). Results: Twenty-one patients recurred within the low-mid axilla (10-year actuarial rate 3%). Of these, 16 were isolated regional failures (no chest wall failure). The risk of failure in the low-mid axilla was not significantly higher for patients with increasing numbers of involved nodes, increasing percentage of involved nodes, larger nodal size or gross extranodal extension. Only 3 of 100 patients with 20% involved axillary nodes, and the presence of gross extranodal extension (10-year actuarial rates 15%, 14%, and 19%, respectively, p 20% involved axillary nodes, or gross extranodal extension are at increased risk of failure in the supraclavicular fossa/axillary apex and should receive radiation to undissected regions in addition to the chest wall

  5. Complex approach to power supply system in the Tomsk region

    International Nuclear Information System (INIS)

    Meshcheryakov, V.N.; Bojko, V.I.; Koshelev, F.P.; Kolpakov, G.N.; Shamanin, I.V.

    2001-01-01

    The problem of power supply of the Tomsk region is under consideration. Power sources are compared with regard to economical and ecological effectiveness. It is shown that nuclear power industry is promising for the Tomsk region due to a unique nuclear park in a town of Seversk with developed scientific, industrial, skilled personnel and construction bases. It is noted that the construction of the NPP based on two WWER-640, WWER-1000 reactors of new generation permits solving the problem of power supply of the Tomsk region [ru

  6. Type III odontoid fractures: A subgroup analysis of complex, high-energy fractures treated with external immobilization

    Directory of Open Access Journals (Sweden)

    Thomas E Niemeier

    2018-01-01

    Conclusions: Complex Type III odontoid fractures are distinctly different from low-energy injuries. In the current study, 21% of patients were unsuccessfully treated nonoperatively with external immobilization and required surgery. For complex Type III fractures, we recommend initial conservative treatment, while maintaining close monitoring throughout patient recovery and fracture union.

  7. Conflict and complexity countering terrorism, insurgency, ethnic and regional violence

    CERN Document Server

    Bar-Yam, Yaneer; Minai, Ali

    2015-01-01

    Complexity science affords a number of novel tools for examining terrorism, particularly network analysis and NK-Boolean fitness landscapes as well as other tools drawn from non-linear dynamical systems modeling. This book follows the methodologies of complex adaptive systems research in their application to addressing the problems of terrorism, specifically terrorist networks, their structure and various methods of mapping and interdicting them as well as exploring the complex landscape of network-centric and irregular warfare. A variety of new models and approaches are presented here, including Dynamic Network Analysis, DIME/PMESII models, percolation models and emergent models of insurgency. In addition, the analysis is informed by practical experience, with analytical and policy guidance from authors who have served within the U.S. Department of Defense, the British Ministry of Defence as well as those who have served in a civilian capacity as advisors on terrorism and counter-terrorism.

  8. Altered relationships between rCBF in different brain regions of never-treated schizophrenics

    International Nuclear Information System (INIS)

    Sabri, O.; Schreckenberger, M.; Cremerius, U.; Dickmann, C.; Schulz, G.; Zimny, M.; Buell, U.; Erkwoh, R.; Owega, A.; Sass, H.

    1997-01-01

    Aim of this study was to investigate the relations between regional cerebral blood flow (rCBF) of different brain regions in acute schizophrenia and following neuroleptic treatment. Methods: Twenty-two never-treated, acute schizophrenic patients were examined with HMPAO brain SPECT and assessed psychopathologically, and reexamined following neuroleptic treatment (over 96.8 days) and psychopathological remission. rCBF was determined by region/cerebellar count quotients obtained from 98 irregular regions of interest (ROIs), summed up to 11 ROIs on each hemisphere. In acute schizophrenics, interregional rCBF correlations of each ROI to every other ROI were compared to the interregional correlations following neuroleptic treatment and to those of controls. Results: All significant correlations of rCBF ratios of different brain regions were exclusively positive in controls and patients. In controls, all ROIs of one hemisphere except the mesial temporal ROI correlated significantly to its contralateral ROI. Each hemisphere showed significant frontal-temporal correlations, as well as cortical-subcortical and some cortico-limbic. In contrast, in acute schizophrenics nearly every ROI correlated significantly with every other ROI, without a grouping or relation of the rCBF of certain ROIs as in controls. After neuroleptic treatment and clinical improvement, this diffuse pattern of correlations remained. Conclusions: These results indicate differences in the neuronal interplay between regions in schizophrenic and healthy subjects. In nevertreated schizophrenics, diffuse interregional rCBF correlations can be seen as a sign of change and dysfunction of the systems regulating specificity and diversity of the neuronal functions. Neuroleptic therapy and psychopathologic remission showed no normalizing effect on interregional correlations. (orig.) [de

  9. THE COMPLEX NORTH TRANSITION REGION OF CENTAURUS A: RADIO STRUCTURE

    Energy Technology Data Exchange (ETDEWEB)

    Neff, Susan G. [NASA' s Goddard Space Flight Center, Laboratory for Observational Cosmology, Mail Code 665, Greenbelt, MD 20771 (United States); Eilek, Jean A. [Physics Department, New Mexico Tech, Socorro, NM 87801 (United States); Owen, Frazer N., E-mail: susan.g.neff@nasa.gov [National Radio Astronomy Observatory, P.O. Box O,  Socorro, NM 87801 (United States)

    2015-04-01

    We present deep radio images of the inner ∼50 kpc of Centaurus A, taken with the Karl G. Jansky Very Large Array at 90 cm. We focus on the Transition Regions between the inner galaxy—including the active nucleus, inner radio lobes, and star-forming disk—and the outer radio lobes. We detect previously unknown extended emission around the Inner Lobes, including radio emission from the star-forming disk. We find that the radio-loud part of the North Transition Region (NTR), known as the North Middle Lobe, is significantly overpressured relative to the surrounding interstellar medium. We see no evidence for a collimated flow from the active galactic nucleus through this region. Our images show that the structure identified by Morganti et al. as a possible large-scale jet appears to be part of a narrow ridge of emission within the broader, diffuse, radio-loud region. This knotty radio ridge is coincident with other striking phenomena: compact X-ray knots, ionized gas filaments, and streams of young stars. Several short-lived phenomena in the NTR, as well as the frequent re-energization required by the Outer Lobes, suggest that energy must be flowing through both Transition Regions at the present epoch. We suggest that the energy flow is in the form of a galactic wind.

  10. The Emerging Architecture of a Regional Security Complex in the ...

    African Journals Online (AJOL)

    2015-03-03

    Mar 3, 2015 ... Council for the Development of Social Science Research in Africa, 2017 .... of International Security Studies by appropriating Regional Security .... collaborative network is also embedded across Saharan and Sahelian Africa, ... (previously located in the city of Baga in Nigeria's Borno State), fell into the.

  11. Children and adolescents treated for post-traumatic stress disorder at the Free State Psychiatric Complex

    Directory of Open Access Journals (Sweden)

    F J W Calitz

    2014-04-01

    Full Text Available Background. Children and adolescents can develop post-traumatic stress disorder (PTSD after exposure to a range of traumatic events, including domestic, political or community violence, violent crime, physical and sexual abuse, hijacking, witnessing a violent crime and motor vehicle accidents. This is particularly critical given the substantial challenge that PTSD poses to the healthy physical, cognitive and emotional development of children and adolescents. Methods. The clinical records of 1 229 children (age 2 - 11 years and adolescents (age 12 - 18 years treated at the Child Mental Health Unit of the Free State Psychiatric Complex (FSPC were screened for the diagnosis of PTSD and analysed for the purpose of this study. Results. Forty-nine (4.0% of the children and adolescents treated at the unit were diagnosed with PTSD, of whom most were female (63.3%. Approximately 22% of the participants had comorbid major depressive disorder. The main traumatic event in both groups was witnessing the death of a close relative (32.7%, followed by sexual assault (25%, rape (25% and physical attack (10.2%. Associated stressors identified included problems at school (55.1%, isolation (39%, fear or anxiety (37%, problematic family relationships (29%, emotional (27% and physical (23% abuse, and lack of social support (23%. Most of the participants (59.2% received psychotherapy. Conclusions. Children and adolescents referred to the FSPC are also exposed to traumatic events which lead to the development of PTSD. The Free State is a sprawling province with remote areas where specialist services and facilities are limited. It is therefore recommended that preventive programmes, training opportunities and consultation services are implemented to identify and treat children and adolescents with PTSD. Schools with limited access to psychological services and large classrooms, impeding the diagnosis and treatment of PTSD specifically, face similar challenges

  12. Microwave Saturation of Complex EPR Spectra and Free Radicals of Burnt Skin Treated with Apitherapeutic Agent

    Directory of Open Access Journals (Sweden)

    Pawel Olczyk

    2013-01-01

    Full Text Available The effect of microwave power on the complex electron paramagnetic resonance spectra of the burn matrix after the therapy with propolis was examined. The spectra were measured with microwaves in the range of 2.2–79 mW. Three groups of free radicals were found in the damaged skin samples. Their spectral lines evolve differently with the microwave power. In order to detect these free radical groups, the lineshape of the spectra was numerically analysed. The spectra were a superposition of three component lines. The best fit was obtained for the deconvolution of the experimental spectra into one Gauss and two Lorentz lines. The microwave power changes also the lineshape of the spectra of thermally injured skin treated with the conventional agent—silver sulphadiazine. The spectral changes were different for propolis and for silver sulphadiazine. The number of individual groups of free radicals in the wound bed after implementation of these two substances is not equal. It may be explained by a higher activity of propolis than of silver sulphadiazine as therapeutic agents.

  13. REGIONAL FEATURES OF SPATIAL DEVELOPMENT OF THE INDUSTRIAL COMPLEX OF REGION IN CONDITIONS OF INSTABILITY

    Directory of Open Access Journals (Sweden)

    J.G. Lavrikova

    2009-09-01

    Full Text Available In clause the methodical approach to typology of spatial development of economy of the regions, considering position of region in national geoeconomic space, orientation to the global markets and character of interactions (network or integrated managing subjects in region is considered. Regional features of spatial development of regions of the Ural federal district are allocated. Directions of perfection of a level of the organization of spatial development of economy of regions in conditions of instability from positions of theories of unbalanced growth are offered.

  14. Critical Hydrologic and Atmospheric Measurements in Complex Alpine Regions

    Science.gov (United States)

    Parlange, M. B.; Bou-Zeid, E.; Barrenetxea, G.; Krichane, M.; Ingelrest, F.; Couach, O.; Luyet, V.; Vetterli, M.; Lehning, M.; Duffy, C.; Tobin, C.; Selker, J.; Kumar, M.

    2007-12-01

    The Alps are often referred to as the « Water Towers of Europe » and as such play an essential role in European water resources. The impact of climatic change is expected to be particularly pronounced in the Alps and the lack of detailed hydrologic field observations is problematic for predictions of hydrologic and hazard assessment. Advances in information technology and communications provide important possibilities to improve the situation with relatively few measurements. We will present sensorscope technology (arrays of wireless weather stations including soil moisture, pressure, and temperature) that has now been deployed at the Le Genepi and Grand St. Bernard pass. In addition, a Distributed Temperature Sensor array on the stream beds has been deployed and stream discharge monitored. The high spatial resolution data collected in these previously "ungaged" regions are used in conjunction with new generation hydrologic models. The framework as to what is possible today with sensor arrays and modeling in extreme mountain environments is discussed.

  15. Experience from the ECORS program in regions of complex geology

    Science.gov (United States)

    Damotte, B.

    1993-04-01

    The French ECORS program was launched in 1983 by a cooperation agreement between universities and petroleum companies. Crustal surveys have tried to find explanations for the formation of geological features, such as rifts, mountains ranges or subsidence in sedimentary basins. Several seismic surveys were carried out, some across areas with complex geological structures. The seismic techniques and equipment used were those developed by petroleum geophysicists, adapted to the depth aimed at (30-50 km) and to various physical constraints encountered in the field. In France, ECORS has recorded 850 km of deep seismic lines onshore across plains and mountains, on various kinds of geological formations. Different variations of the seismic method (reflection, refraction, long-offset seismic) were used, often simultaneously. Multiple coverage profiling constitutes the essential part of this data acquisition. Vibrators and dynamite shots were employed with a spread generally 15 km long, but sometimes 100 km long. Some typical seismic examples show that obtaining crustal reflections essentialy depends on two factors: (1) the type and structure of shallow formations, and (2) the sources used. Thus, when seismic energy is strongly absorbed across the first kilometers in shallow formations, or when these formations are highly structured, standard multiple-coverage profiling is not able to provide results beyond a few seconds. In this case, it is recommended to simultaneously carry out long-offset seismic in low multiple coverage. Other more methodological examples show: how the impact on the crust of a surface fault may be evaluated according to the seismic method implemented ( VIBROSEIS 96-fold coverage or single dynamite shot); that vibrators make it possible to implement wide-angle seismic surveying with an offset 80 km long; how to implement the seismic reflection method on complex formations in high mountains. All data were processed using industrial seismic software

  16. Neuropeptides, neurogenic inflammation and complex regional pain syndrome (CRPS).

    Science.gov (United States)

    Birklein, Frank; Schmelz, Martin

    2008-06-06

    This review explains symptoms and nature of neuropeptide signaling and its importance for clinical symptoms of CRPS. Neurogenic inflammation regularly accompanies excitation of primary afferent nociceptors. It has two major components-plasma extravasation and vasodilatation. The most important mediators are the calcitonin gene-related peptide (CGRP) and substance P (SP). After peripheral trauma immune reaction (e.g. cytokines) and the attempts of the tissue to regenerate (e.g. growth factors) sensitize nociceptors and amplify neurogenic inflammation. This cascade of events has been demonstrated in rat models of CRPS. Clinical findings in these animals strongly resemble clinical findings in CRPS, and can be prevented by anti-cytokine and anti-neuropeptide treatment. In CRPS patients, there is meanwhile also plenty of evidence that neurogenic inflammation contributes to clinical presentation. Increased cytokine production was demonstrated, as well as facilitated neurogenic inflammation. Very recently even "non-inflammatory" signs of CRPS (hyperhidrosis, cold skin) have been linked to neuropeptide signaling. Surprisingly, there was even moderately increased neurogenic inflammation in unaffected body regions. This favors the possibility that CRPS patients share genetic similarities. The future search for genetic commonalities will help us to further unravel the "mystery" CRPS.

  17. Hydrogen-boron complexes in heavily boron-doped silicon treated with high concentration of hydrogen atoms

    International Nuclear Information System (INIS)

    Fukata, N.; Fukuda, S.; Sato, S.; Ishioka, K.; Kitajima, M.; Hishita, S.; Murakami, K.

    2006-01-01

    The formation of hydrogen (H)-related complexes was investigated in boron (B)-doped Si treated with high concentration of H. The isotope shifts of H-related Raman peaks by replacement of H to deuterium and 1 B to 11 B clearly showed the formation of the B-H complexes in which H directly bonds to B in Si. The results of the resistivity measurements suggested that the B acceptors are passivated via the formation of the B-H complexes, as well as the well-known passivation center in B-doped Si, namely, H-B passivation center

  18. Hierarchical Model for the Similarity Measurement of a Complex Holed-Region Entity Scene

    Directory of Open Access Journals (Sweden)

    Zhanlong Chen

    2017-11-01

    Full Text Available Complex multi-holed-region entity scenes (i.e., sets of random region with holes are common in spatial database systems, spatial query languages, and the Geographic Information System (GIS. A multi-holed-region (region with an arbitrary number of holes is an abstraction of the real world that primarily represents geographic objects that have more than one interior boundary, such as areas that contain several lakes or lakes that contain islands. When the similarity of the two complex holed-region entity scenes is measured, the number of regions in the scenes and the number of holes in the regions are usually different between the two scenes, which complicates the matching relationships of holed-regions and holes. The aim of this research is to develop several holed-region similarity metrics and propose a hierarchical model to measure comprehensively the similarity between two complex holed-region entity scenes. The procedure first divides a complex entity scene into three layers: a complex scene, a micro-spatial-scene, and a simple entity (hole. The relationships between the adjacent layers are considered to be sets of relationships, and each level of similarity measurements is nested with the adjacent one. Next, entity matching is performed from top to bottom, while the similarity results are calculated from local to global. In addition, we utilize position graphs to describe the distribution of the holed-regions and subsequently describe the directions between the holes using a feature matrix. A case study that uses the Great Lakes in North America in 1986 and 2015 as experimental data illustrates the entire similarity measurement process between two complex holed-region entity scenes. The experimental results show that the hierarchical model accounts for the relationships of the different layers in the entire complex holed-region entity scene. The model can effectively calculate the similarity of complex holed-region entity scenes, even if the

  19. A Novel Compound Analgesic Cream (Ketamine, Pentoxifylline, Clonidine, DMSO) for Complex Regional Pain Syndrome Patients.

    Science.gov (United States)

    Russo, Marc A; Santarelli, Danielle M

    2016-01-01

    Evidence suggests that complex regional pain syndrome (CRPS) is a manifestation of microvascular dysfunction. Topical combinations of α2-adrenergic receptor agonists or nitric oxide donors with phosphodiesterase or phosphatidic acid inhibitors formulated to treat microvascular dysfunction have been shown to reduce allodynia in a rat model of CRPS-I. Driven by these findings, we assessed the outcomes of CRPS patients treated with a compound analgesic cream (CAC) consisting of ketamine 10%, pentoxifylline 6%, clonidine 0.2%, and dimethyl sulfoxide 6% to 10%. An audit was conducted on 13 CRPS patients who trialed the CAC. A detailed report was compiled for each patient which comprised baseline characteristics, including CRPS description, previous treatments, and pain scores (numerical pain rating scale; 0 to 10). Recorded outcomes consisted of pain scores, descriptive outcomes, and concurrent medications/treatments, for which basic analysis was performed to determine the effectiveness of the CAC. Case reports are presented for 3 patients with varying outcomes. Nine patients (69%) reported pain/symptom reduction (4.4 ± 2.1 vs. 6.3 ± 1.9) with use of the CAC. Six patients reported sustained benefits after 2 months of CAC use, and 2 patients reported complete resolution of pain/symptoms: one had early CRPS-I and the other received a partial CRPS diagnosis. An otherwise medication refractory and intolerant patient found partial benefit with the CAC. These results demonstrate promise for this topical combination as a useful treatment in multimodal therapy for patients with CRPS, with the potential to resolve pain/symptoms in early CRPS patients. © 2015 World Institute of Pain.

  20. Complex Regional Pain Syndrome following an Episode of Herpes Zoster: A Case Report.

    Science.gov (United States)

    Marrero, Christopher E; Mclean, Neuyen; Varnado, Keyana

    2017-01-01

    Complex regional pain syndrome (CRPS) is characterized by searing pain, hyperalgesia, edema, allodynia, and skin changes. CRPS may be difficult to diagnose and to treat given poorly understood mechanisms as well as its presentation of symptoms that may mimic common conditions such as joint stiffness in this condition as well as rheumatoid arthritis. A 71-year-old female presented to our clinic post shingles of the right upper extremity. We diagnosed her with CRPS based on the Budapest diagnostic criteria and the clinical findings of pain and decreased the range of motion along with edema, hypersensitivity, discoloration and allodynia of the right thumb and index finger. She was treated with vitamin C as well as gabapentin and physical therapy. The patient was unable to go consistently to physical therapy due to insurance limitations, and we found no clinical benefit of vitamin C in reducing her symptoms. She was lost to follow-up during her treatment but re-emerged at 21 months. At that time she reported, she was largely unchanged in regards to her right-hand symptoms but did believe the gabapentin was helpful and still continued to take 300 mg daily. This case report highlights the usefulness of the Budapest diagnostic criteria to make the diagnosis of CRPS when associated with shingles, which can cause long-term pain and mimic some findings. Prompt diagnosis is important, as recovery typically extends beyond 6 months; our patient still reported continued symptoms at 21 months post initial presentation. Our primary treatment plan was physical therapy, which she discontinued due to insurance limitations. We recommend that patients, physicians, and third-party payers work together to extend access to physical therapy. More investigation is warranted regarding symptomatic treatment, as we found limited clinical benefit of gabapentin and vitamin C.

  1. Methods for deconvoluting and interpreting complex gamma- and x-ray spectral regions

    International Nuclear Information System (INIS)

    Gunnink, R.

    1983-06-01

    Germanium and silicon detectors are now widely used for the detection and measurement of x and gamma radiation. However, some analysis situations and spectral regions have heretofore been too complex to deconvolute and interpret by techniques in general use. One example is the L x-ray spectrum of an element taken with a Ge or Si detector. This paper describes some new tools and methods that were developed to analyze complex spectral regions; they are illustrated with examples

  2. Public-private delivery of insecticide-treated nets: a voucher scheme in Volta Region, Ghana

    Directory of Open Access Journals (Sweden)

    Taylor Ian

    2007-02-01

    Full Text Available Abstract Background Coverage of vulnerable groups with insecticide-treated nets (ITNs in Ghana, as in the majority of countries of sub-Saharan Africa is currently low. A voucher scheme was introduced in Volta Region as a possible sustainable delivery system for increasing this coverage through scale-up to other regions. Successful scale-up of public health interventions depends upon optimal delivery processes but operational research for delivery processes in large-scale implementation has been inadequate. Methods A simple tool was developed to monitor numbers of vouchers given to each health facility, numbers issued to pregnant women by the health staff, and numbers redeemed by the distributors back to the management agent. Three rounds of interviews were undertaken with health facility staff, retailers and pregnant women who had attended antenatal clinic (ANC. Results During the one year pilot 25,926 vouchers were issued to eligible women from clinics, which equates to 50.7% of the 51,658 ANC registrants during this time period. Of the vouchers issued 66.7% were redeemed by distributors back to the management agent. Initially, non-issuing of vouchers to pregnant women was mainly due to eligibility criteria imposed by the midwives; later in the year it was due to decisions of the pregnant women, and supply constraints. These in turn were heavily influenced by factors external to the programme: current household ownership of nets, competing ITN delivery strategies, and competition for the limited number of ITNs available in the country from major urban areas of other regions. Conclusion Both issuing and redemption of vouchers should be monitored as factors assumed to influence voucher redemption had an influence on issuing, and vice versa. More evidence is needed on how specific contextual factors influence the success of voucher schemes and other models of delivery of ITNs. Such an evidence base will facilitate optimal strategic decision making

  3. Complex researches on substantiation of construction and seismic stability of large dams in seismic region

    International Nuclear Information System (INIS)

    Negmatullaev, S.Kh.; Yasunov, P.A.

    2001-01-01

    This article is devoted to complex researches on substantiation of construction and seismic stability of large dams (Nurec hydroelectric power station) in seismic region. Geological, seismological, model, and engineering investigations are discussed in this work. At construction of Nurec hydroelectric power station the rich experience is accumulated. This experience can be used in analogous seismically active regions at construction similar hydroelectric power stations.

  4. Complex Regional Pain Syndrome (CRPS Type II After Carpal Tunnel Release Surgery: Case Report

    Directory of Open Access Journals (Sweden)

    Hakan Tunç

    2010-08-01

    Full Text Available Summary Complex regional pain syndrome is a chronic syndrome characterised with dystrophic changes and neurovascular disordes of bone and skin of extremities. The most common etiological factors are trauma, ischemic heart disease, cerebral lesions, servical region disorders, infections, and surgical treatments. Carpal tunnel syndrome is the most common compressive neuropaty of the upper extremity. There are various surgical and conservative alternatives in the treatment of carpal tunnel syndrome. Complex regional pain syndrome has been reported as a complication of surgical carpal tunnel release in 2-5% of patients. In this case report clinical characteristics and rehabilitation outcomes of a patient with complex regional pain syndrome after carpal tunnel release surgery is presented. (Osteoporoz Dünyasından 2010;16:41-3

  5. Good Functional Recovery of Complex Elbow Dislocations Treated With Hinged External Fixation: A Multicenter Prospective Study

    NARCIS (Netherlands)

    Iordens, Gijs I. T.; den Hartog, Dennis; van Lieshout, Esther M. M.; Tuinebreijer, Wim E.; de Haan, Jeroen; Patka, Peter; Verhofstad, Michael H. J.; Schep, Niels W. L.; Bronkhorst, M. W. G. A.; de Vries, M. R.; Goslings, J. C.; Rhemrev, S. J.; Roukema, G. R.; van der Meulen, H. G. W. M.; Verleisdonk, E. J. M. M.; Vroemen, J. P. A. M.; Wittich, Ph

    2015-01-01

    After a complex dislocation, some elbows remain unstable after closed reduction or fracture treatment. Function after treatment with a hinged external fixator theoretically allows collateral ligaments to heal without surgical reconstruction. However, there is a lack of prospective studies that

  6. Good Functional Recovery of Complex Elbow Dislocations Treated With Hinged External Fixation: A Multicenter Prospective Study

    NARCIS (Netherlands)

    G.I.T. Iordens (Gijs); D. den Hartog (Dennis); E.M.M. van Lieshout (Esther); W.E. Tuinebreijer (Wim); J. de Haan (Jeroen); P. Patka (Peter); M.H.J. Verhofstad (Michiel); N.W.L. Schep (Niels)

    2015-01-01

    textabstractBackground: After a complex dislocation, some elbows remain unstable after closed reduction or fracture treatment. Function after treatment with a hinged external fixator theoretically allows collateral ligaments to heal without surgical reconstruction. However, there is a lack of

  7. Reducing Sand Fly Numbers in Leishmania Endemic Regions in Kenya with Insecticide Treated Camouflage Screening

    Science.gov (United States)

    Current US military operations in deserts face persistent threats from sand flies that transmit human Leishmania. Methods to reduce the risk of human infection from leishmaniasis by reducing the number of sand fly vectors were investigated in Kenya. Bifenthrin treated and un-treated camouflage netti...

  8. Incidence of Complex Regional Pain Syndrome I Following Foot and Ankle Fractures Using the Budapest Criteria.

    Science.gov (United States)

    Bullen, Michael; Lang, Coran; Tran, Phong

    2016-12-01

    OBJECTIVE : Fractures are a well-recognized inciting event in the development of complex regional pain syndrome. This study aimed to prospectively determine the incidence of complex regional pain syndrome following foot and ankle fractures. METHODS : A prospective study was conducted of patients presenting to two metropolitan hospitals with plain radiograph diagnosis of fractures to the foot or ankle. Patients were initially screened by phone 3 months after injury using the validated International Association for the Study of Pain Budapest criteria. Patients who fulfilled the screening criteria were then physically examined by a pain specialist to assess clinical signs as part of the Budapest criteria. RESULTS : A total of 306 consecutive eligible patients were included. One hundred and ten patients reported at least one symptom of complex regional pain syndrome; however, only three fulfilled the minimum requirements to necessitate clinical review. Of these three, only one patient fulfilled the combination of symptom and sign criteria for a positive diagnosis according to the validated Budapest criteria. The incidence of complex regional pain syndrome following foot and ankle fracture in this study was 0.3%. CONCLUSION : Although many patients may experience vasomotor, sensory, and sudomotor disturbance following a fracture to the foot and ankle, the observed incidence of complex regional pain syndrome using a prospectively collected validated criteria is significantly lower than previously published. © 2016 American Academy of Pain Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  9. Region-specific expression of mitochondrial complex I genes during murine brain development.

    Directory of Open Access Journals (Sweden)

    Stefanie Wirtz

    Full Text Available Mutations in the nuclear encoded subunits of mitochondrial complex I (NADH:ubiquinone oxidoreductase may cause circumscribed cerebral lesions ranging from degeneration of the striatal and brainstem gray matter (Leigh syndrome to leukodystrophy. We hypothesized that such pattern of regional pathology might be due to local differences in the dependence on complex I function. Using in situ hybridization we investigated the relative expression of 33 nuclear encoded complex I subunits in different brain regions of the mouse at E11.5, E17.5, P1, P11, P28 and adult (12 weeks. With respect to timing and relative intensity of complex I gene expression we found a highly variant pattern in different regions during development. High average expression levels were detected in periods of intense neurogenesis. In cerebellar Purkinje and in hippocampal CA1/CA3 pyramidal neurons we found a second even higher peak during the period of synaptogenesis and maturation. The extraordinary dependence of these structures on complex I gene expression during synaptogenesis is in accord with our recent findings that gamma oscillations--known to be associated with higher cognitive functions of the mammalian brain--strongly depend on the complex I activity. However, with the exception of the mesencephalon, we detected only average complex I expression levels in the striatum and basal ganglia, which does not explain the exquisite vulnerability of these structures in mitochondrial disorders.

  10. Characterization of patients with ostomy treated at a public municipal and regional reference center

    Directory of Open Access Journals (Sweden)

    Luis Fernando Melotti

    2013-04-01

    Full Text Available Objective: to characterize patients with ostomy treated at a municipal and regional refer- ence center in the state of Rio Grande do Sul. Methods: this is a retrospective and descriptive study, based on the records of patients with ileostomy or colostomy recorded in this service between 2000 and 2010. Results: a total of 273 patients were studied, of which 145 were females. The mean age was 64.5 years. Patients with incomplete elementary education (43.6% and retirees/pensioners (44.7% were the most prevalent. The main cause for the stoma was neoplastic disease, with 45.8% of colorectal cancer and 5.5% of cancers at other sites. Other causes were: diverticular disease (7%, bowel obstruction (7%, functional bowel disorders (4.8%, abdominal trauma (2.9%, non-traumatic bowel perforation (2.6%, inflammatory bowel diseases (1.8% and intestinal polyposis (0.7%. Regarding the type of ostomy, 85.7% were performed by colostomy and 15.8% by ileostomy. Conclusions: the study population consisted mainly of patients older than 60 and females. The main intervention performed was permanent colostomy and the most important cause for the procedure performance was colorectal cancer. Resumo: Objetivo: caracterizar as pessoas com estomia atendidas em um serviço de referência mu- nicipal e regional do Rio Grande do Sul. Métodos: estudo retrospectivo e documental, com consulta aos registros dos usuários com ileostomia ou colostomia cadastrados no referido serviço entre 2000 e 2010. Resultados: foram avaliadas 273 pessoas, sendo 145 mulheres e 128 homens. A média de idade foi de 64,5 anos. Prevaleceram usuários com ensino fundamental incompleto (43,6% e da classe de aposentados/pensionistas (44,7%. A principal causa motivadora da estomia foi a neoplásica, sendo 45,8% de neoplasia de intestino e 5,5% de neoplasias em outros sí- tios. Outras causas encontradas foram: doença diverticular (7%, obstrução intestinal (7%, transtornos funcionais do intestino (4

  11. GBA manager: an online tool for querying low-complexity regions in proteins.

    Science.gov (United States)

    Bandyopadhyay, Nirmalya; Kahveci, Tamer

    2010-01-01

    Abstract We developed GBA Manager, an online software that facilitates the Graph-Based Algorithm (GBA) we proposed in our earlier work. GBA identifies the low-complexity regions (LCR) of protein sequences. GBA exploits a similarity matrix, such as BLOSUM62, to compute the complexity of the subsequences of the input protein sequence. It uses a graph-based algorithm to accurately compute the regions that have low complexities. GBA Manager is a user friendly web-service that enables online querying of protein sequences using GBA. In addition to querying capabilities of the existing GBA algorithm, GBA Manager computes the p-values of the LCR identified. The p-value gives an estimate of the possibility that the region appears by chance. GBA Manager presents the output in three different understandable formats. GBA Manager is freely accessible at http://bioinformatics.cise.ufl.edu/GBA/GBA.htm .

  12. Binding of α2-macroglobulin-thrombin complexes and methylamine-treated α2-macroglobulin to human blood monocytes

    International Nuclear Information System (INIS)

    Straight, D.L.; Jakoi, L.; McKee, P.A.; Snyderman, R.

    1988-01-01

    The binding of α 2 -macroglobulin (α 2 M) to human peripheral blood monocytes was investigated. Monocytes, the precursors of tissue macrophages, were isolated from fresh blood by centrifugal elutriation or density gradient centrifugation. Binding studies were performed using 125 I-labeled α 2 M. Cells and bound ligand were separated from free ligand by rapid vacuum filtration. Nonlinear least-squares analysis of data obtained in direct binding studies at 0 0 C showed that monocytes bound the α 2 M-thrombin complex with a K/sub d/ 3.0 +- .09 nM and the monocyte had 1545 +- 153 sitescell. Thrombin alone did not compete for the site. Binding was divalent cation dependent. Direct binding studies also demonstrated that monocytes bound methylamine-treated α 2 M in a manner similar to α 2 M-thrombin. Competitive binding studies showed that α 2 M-thrombin and methylamine-treated α 2 M bound to the same sites on the monocyte. In contrast, native α 2 M did not compete with α 2 M-thrombin for the site. Studies done at 37 0 C suggested that after binding, the monocyte internalized and degraded α 2 M-thrombin and excreted the degradation products. Receptor turnover and degradation of α 2 M-thrombin complexes were blocked in monocytes treated with chloroquine, an inhibitor of lysosomal function. The results indicate that human monocytes have a divalent cation dependent, high-affinity binding site for α 2 M-thrombin and methylamine-treated α 2 M which may function to clear α 2 M-proteinase complexes from the circulation

  13. Comparison of Public Perception in Desert and Rainy Regions of Chile Regarding the Reuse of Treated Sewage Water

    Directory of Open Access Journals (Sweden)

    Daniela Segura

    2018-03-01

    Full Text Available The objective of this study was to compare the public perception in desert and rainy regions of Chile regarding the reuse of treated sewage water. The methodology of this study consisted of applying a survey to the communities of San Pedro de Atacama (desert region and Hualqui (rainy region to identify attitudes about the reuse of sewage water. The survey was applied directly to men and women, 18 to 90 years old, who were living in the studied communities. The results indicate that inhabitants of San Pedro de Atacama (desert region were aware of the state of their water resources, with 86% being aware that there are water shortages during some part of the year. In contrast, only 55% of residents in Hualqui (rainy region were aware of water shortages. With respect of the reuse of treated sewage water, 47% of respondents in San Pedro de Atacama understood the concept, as compared to 27% in Hualqui. There was more acceptance of using treated sewage water for non-potable purposes than as drinking water.

  14. The plausible reason why the length of 5' untranslated region is unrelated to organismal complexity

    Directory of Open Access Journals (Sweden)

    Chen Feng-Chi

    2011-08-01

    Full Text Available Abstract Background Organismal complexity is suggested to increase with the complexity of transcriptional and translational regulations. Supporting this notion is a recent study that demonstrated a higher level of tissue-specific gene expression in human than in mouse. However, whether this correlation can be extended beyond mammals remains unclear. In addition, 5' untranslated regions (5'UTRs, which have undergone stochastic elongation during evolution and potentially included an increased number of regulatory elements, may have played an important role in the emergence of organismal complexity. Although the lack of correlation between 5'UTR length and organismal complexity has been proposed, the underlying mechanisms remain unexplored. Results In this study, we select the number of cell types as the measurement of organismal complexity and examine the correlation between (1 organismal complexity and transcriptional regulatory complexity; and (2 organismal complexity and 5'UTR length by comparing the 5'UTRs and multiple-tissue expression profiles of human (Homo sapiens, mouse (Mus musculus, and fruit fly (Drosophila melanogaster. The transcriptional regulatory complexity is measured by using the tissue specificity of gene expression and the ratio of non-constitutively expressed to constitutively expressed genes. We demonstrate that, whereas correlation (1 holds well in the three-way comparison, correlation (2 is not true. Results from a larger dataset that includes more than 15 species, ranging from yeast to human, also reject correlation (2. The reason for the failure of correlation (2 may be ascribed to: Firstly, longer 5'UTRs do not contribute to increased tissue specificity of gene expression. Secondly, the increased numbers of common translational regulatory elements in longer 5'UTRs do not lead to increased organismal complexity. Conclusions Our study has extended the evidence base for the correlation between organismal complexity and

  15. Children and adolescents with complex regional pain syndrome: More psychologically distressed than other children in pain?

    Science.gov (United States)

    Logan, Deirdre E; Williams, Sara E; Carullo, Veronica P; Claar, Robyn Lewis; Bruehl, Stephen; Berde, Charles B

    2013-01-01

    BACKGROUND Historically, in both adult and pediatric populations, a lack of knowledge regarding complex regional pain syndrome (CRPS) and absence of clear diagnostic criteria have contributed to the view that this is a primarily psychiatric condition. OBJECTIVE: To test the hypothesis that children with CRPS are more functionally disabled, have more pain and are more psychologically distressed than children with other pain conditions. METHODS: A total of 101 children evaluated in a tertiary care pediatric pain clinic who met the International Association for the Study of Pain consensus diagnostic criteria for CRPS participated in the present retrospective study. Comparison groups included 103 children with abdominal pain, 291 with headache and 119 with back pain. Children and parents completed self-report questionnaires assessing disability, somatization, pain coping, depression, anxiety and school attendance. RESULTS: Children with CRPS reported higher pain intensity and more recent onset of pain at the initial tertiary pain clinic evaluation compared with children with other chronic pain conditions. They reported greater functional disability and more somatic symptoms than children with headaches or back pain. Scores on measures of depression and anxiety were within normal limits and similar to those of children in other pain diagnostic groups. CONCLUSIONS: As a group, clinic-referred children with CRPS may be more functionally impaired and experience more somatic symptoms compared with children with other pain conditions. However, overall psychological functioning as assessed by self-report appears to be similar to that of children with other chronic pain diagnoses. Comprehensive assessment using a biopsychosocial framework is essential to understanding and appropriately treating children with symptoms of CRPS. PMID:23662291

  16. Complex active regions as the main source of extreme and large solar proton events

    Science.gov (United States)

    Ishkov, V. N.

    2013-12-01

    A study of solar proton sources indicated that solar flare events responsible for ≥2000 pfu proton fluxes mostly occur in complex active regions (CARs), i.e., in transition structures between active regions and activity complexes. Different classes of similar structures and their relation to solar proton events (SPEs) and evolution, depending on the origination conditions, are considered. Arguments in favor of the fact that sunspot groups with extreme dimensions are CARs are presented. An analysis of the flare activity in a CAR resulted in the detection of "physical" boundaries, which separate magnetic structures of the same polarity and are responsible for the independent development of each structure.

  17. Current state and development trends of the agroindustrial complex and rural territories of Perm Region

    Directory of Open Access Journals (Sweden)

    Gennadiy Vladimirovich Klimenkov

    2011-12-01

    Full Text Available Analysis of regional agricultural sector status and rural areas of Perm in 1990-2011 years indicates a systemic crisis of agriculture in Perm region, which is largely determined by the fact that Perm region has no strategy or strategic plan and program for sustainable agricultural sector and rural areas of Perm region development, there is no scheme of territorial development and master plans of territorial development with the development of agro-industrial complex of Perm region. In these circumstances, there is a steady downward trend in production, weakening and bankruptcy of enterprises, social impoverishment of rural areas, appearance of many of irreversible processes (sale and neglect of agricultural land, demographic problems associated with low living standards, population migration, policy optimization in the areas of education and health, union of territories, policy of depopulation of territories etc.. This paper presents main recommendations for improving the situation in agriculture of Perm region.

  18. Heterogeneous convergence of regional house prices and the complexity in China

    Directory of Open Access Journals (Sweden)

    Rui Lin

    2015-12-01

    Full Text Available The purpose of this research is to analyze the convergence of regional house prices and its complexity in China. In this purpose it used nonlinear time varying factor model. The obtained results have provided evidences for the existence of some degree of segmentation in China’s housing market. By further dynamic analysis of the convergence, we have found that important housing policies from Chinese central government can significantly alter the housing market but with a time lag of 4 to 5 months, and that quite different behaviors exist between the new house market and the second-hand house market in China, which provides the evidence for the complexity of housing market in China. Multiple factors together are the driving forces for the regional house price convergence. And the driving forces differ among three clubs. The basic conclusion provided from the realized research is that the conventional definitions of economic regions may not be appropriate to analyze house price segregation in China. Heterogeneous convergence exists in China’s regional house prices, indicating the complexity of regional house prices in China. And housing policies should be implemented with different focus among the regions. The way of the central government is to make housing policies aiming at different sub-markets of the new house market and the second-hand house market.

  19. Stability and activity of anaerobic sludge from UASB reactors treating sewage in subtropical regions

    NARCIS (Netherlands)

    Seghezzo, L.; Cuevas, C.M.; Trupiano, A.P.; Guerra, R.G.; Gonzalez, S.M.; Zeeman, G.; Lettinga, G.

    2006-01-01

    The production of small amounts of well-stabilized biological sludge is one of the main advantages of upflow anaerobic sludge bed (UASB) reactors over aerobic wastewater treatment systems. In this work, sludge produced in three pilot-scale UASB reactors used to treat sewage under subtropical

  20. Insecticide Treated Camouflage Sceening Reduces Sand Fly Numbers in Leishmania-Endemic Regions in Kenya

    Science.gov (United States)

    Current U.S. military operations in deserts face persistent threats from sand flies that transmit human Leishmania. In this study we investigated the efficacy of artificial barriers treated with residual insecticide to potentially reduce the risk of human infection from leishmaniasis by reducing the...

  1. Formation of competitive potential of the machine-building complex of the region

    Directory of Open Access Journals (Sweden)

    Oleg Ivanovich Botkin

    2014-03-01

    Full Text Available The article describes the features of competitive potential of regional machine-building complex in a globalized world economy. The purpose of the research is the development of theoretically reasonable economic basis of the machine-building complex considering  the  features of business in the conditions of the WTO. In the work, the hypothesis of a special role of the external economic factors locates in development of the enterprises of regional industrial complexes. The study of the theoretical provisions defining the development of the region revealed the factors determining influence of the international trade agreements on spatial localization of the industry. The main attention is paid to an analytical assessment of the current state and the trends, which have developed in the period of post-crisis economic recovery. Analysis of the main indicators of attractiveness has revealed the weak position of local industrial enterprises in the WTO. The directions of strengthening of the competitive capacity of the local industrial enterprises are defined. The obtained results allow us to increase the sustainability of the industry by means of effective management mechanism improvements and to create favorable operating conditions of a machine-building complex of the region

  2. Complex regional pain syndrome related movement disorders : studies on pathophysiology and therapy.

    NARCIS (Netherlands)

    Munts, Alexander Gerard

    2011-01-01

    Complex regional pain syndrome (CRPS) may occur after trauma, usually to one limb, and is characterised by pain and disturbed blood flow, temperature regulation and motor control. Knowledge on CRPS and its movement disorders is scarce. Dysfunction in small nerve fiber processing was found in CRPS

  3. Mitochondrial dysfunction in muscle tissue of complex regional pain syndrome type I patients

    NARCIS (Netherlands)

    Tan, E.C.T.H.; Janssen, A.J.W.M.; Roestenberg, P.M.H.; Heuvel, L.P.W.J. van den; Goris, R.J.A.; Rodenburg, R.J.T.

    2011-01-01

    Reactive oxygen species (ROS) are known to be involved in the pathophysiology of complex regional pain syndrome type I (CRPS I). Since the mitochondrial respiratory chain is a major source of ROS, we hypothesized that mitochondria play a role in the pathophysiology of CRPS I. The hypothesis was

  4. Mannitol as salvage treatment for Complex Regional Pain Syndrome Type I.

    NARCIS (Netherlands)

    Tan, E.C.T.H.; Tacken, M.C.; Groenewoud, J.M.M.; Goor, H. van; Frolke, J.P.M.

    2010-01-01

    INTRODUCTION: Complex Regional Pain Syndrome Type I (CRPS I) is a continuation of symptoms and signs due to a pathological exaggerated reaction in an extremity of the human body after an injury or operation. Although the clinical picture of CRPS I in the majority of patients is well known, the

  5. Evidence for local inflammation in complex regional pain syndrome type 1

    Directory of Open Access Journals (Sweden)

    Frank J. P. M. Huygen

    2002-01-01

    Full Text Available Background: The pathophysiology of complex regional pain syndrome type 1 (CRPS 1 is still a matter of debate. Peripheral afferent, efferent and central mechanisms are supposed. Based on clinical signs and symptoms (e.g. oedema, local temperature changes and chronic pain local inflammation is suspected.

  6. Dystonia in complex regional pain syndrome : clinical, pathophysiological and therapeutic aspects

    NARCIS (Netherlands)

    Rijn, Monica Adriana van

    2010-01-01

    The clinical characteristics of Complex Regional Pain Syndrome (CRPS) are defined by pain and various combinations of sensory disturbances, autonomic features, and sudomotor and trophic changes. Furthermore, patients with CRPS may suffer from movement disorders, of which dystonia is the most

  7. Muscle Hyperalgesia Correlates With Motor Function in Complex Regional Pain Syndrome Type 1

    NARCIS (Netherlands)

    van Rooijen, Diana E.; Marinus, Johan; Schouten, Alfred Christiaan; Noldus, Lucas P.J.J.; van Hilten, Jacobus J.

    2013-01-01

    At present it is unclear if disturbed sensory processing plays a role in the development of the commonly observed motor impairments in patients with complex regional pain syndrome (CRPS). This study aims to investigate the relation between sensory and motor functioning in CRPS patients with and

  8. Genetic HLA Associations in Complex Regional Pain Syndrome With and Without Dystonia

    NARCIS (Netherlands)

    van Rooijen, D.E.; Roelen, D.L.; Verduijn, W.; Haasnoot, G.W.; Huygen, F.J.P.M.; Perez, R.S.G.M.; Claas, F.H.J.; Marinus, J.; van Hilten, J.J.; van den Maagdenberg, A.M.J.M.

    2012-01-01

    We previously showed evidence for a genetic association of the human leukocyte antigen (HLA) system and complex regional pain syndrome (CRPS) with dystonia. Involvement of the HLA system suggests that CRPS has a genetic component with perturbed regulation of inflammation and neuroplasticity as

  9. Informed Decision-Making Regarding Amputation for Complex Regional Pain Syndrome Type I

    NARCIS (Netherlands)

    Bodde, Marlies I.; Dijkstra, Pieter U.; Schrier, Michiel; van den Dungen, Johannes; den Dunnen, Wilfred E.; Geertzen, Joannes

    2014-01-01

    Background: Literature on complex regional pain syndrome type I (CRPS-I) discussing the decision to amputate or not, the level of amputation, or the timing of the amputation is scarce: We evaluated informed decision-making regarding amputation for CRPS-I. Methods: We describe our findings in a

  10. ECOLOGICAL SAFETY OF MINING REGIONS THROUGH CREATION OF POWER‐HEATING COMPLEXES (in Russian

    Directory of Open Access Journals (Sweden)

    I. A. YEFREMOV

    2014-04-01

    Full Text Available There was presented a method of use of alterative source of energy, namely coal mine methane, the use of which as a fuel for power and heatiing generation is a main direction in coal mines. By this means some ecological problems of the region are solved. Highly efficient power and heating technologies are implemented and energy complexes are established.

  11. Ecosystem services provided by a complex coastal region: challenges of classification and mapping

    Science.gov (United States)

    Sousa, Lisa P.; Sousa, Ana I.; Alves, Fátima L.; Lillebø, Ana I.

    2016-03-01

    A variety of ecosystem services classification systems and mapping approaches are available in the scientific and technical literature, which needs to be selected and adapted when applied to complex territories (e.g. in the interface between water and land, estuary and sea). This paper provides a framework for addressing ecosystem services in complex coastal regions. The roadmap comprises the definition of the exact geographic boundaries of the study area; the use of CICES (Common International Classification of Ecosystem Services) for ecosystem services identification and classification; and the definition of qualitative indicators that will serve as basis to map the ecosystem services. Due to its complexity, the Ria de Aveiro coastal region was selected as case study, presenting an opportunity to explore the application of such approaches at a regional scale. The main challenges of implementing the proposed roadmap, together with its advantages are discussed in this research. The results highlight the importance of considering both the connectivity of natural systems and the complexity of the governance framework; the flexibility and robustness, but also the challenges when applying CICES at regional scale; and the challenges regarding ecosystem services mapping.

  12. Cerebral activation during motor imagery in complex regional pain syndrome type 1 with dystonia

    NARCIS (Netherlands)

    Gieteling, Esther W.; van Rijn, Monique A.; de Jong, Bauke M.; Hoogduin, Johannes M.; Renken, Remco; van Hilten, Jacobus J.; Leenders, Klaus L.

    The pathogenesis of dystonia in Complex Regional Pain Syndrome type 1 (CRPS-1) is unclear. In primary dystonia, functional magnetic resonance imaging (fMRI) has revealed changes in cerebral networks during execution of movement. The aim of this study was to determine cerebral network function in

  13. Regional and Historical Minerageny of the Gemstone Complexes in Russia (Quantitative Aspects

    Directory of Open Access Journals (Sweden)

    Polyanin V.S.

    2015-06-01

    Full Text Available The paper presents an approximate quantitative estimation of the mineragenic potentials of gems in the paleogeodynamic systems, complexes, and geological formations of Russia, which are characterized by different age and regional distribution. General trends of the changes in the scale and intensity of formation processes of the same gem deposits over geologic time were identified.

  14. Complex regional pain syndrome 1 : a study on pain and motor impairments

    NARCIS (Netherlands)

    G.M. Ribbers (Gerard)

    2001-01-01

    textabstractThis thesis, is compiled of publications on reflex sympathetic dystrophy (RSD) or Complex Regional Pain Syndrome type 1 (CRPS 1), as it was renamed by the committee on taxonomy of the International Association for the Study of Pain (IASP). It is a puzzling syndrome both from a clinical

  15. Modelling of the flow of stable air over a complex region

    CSIR Research Space (South Africa)

    Scholtz, MT

    1976-01-01

    Full Text Available The flow of stable air over a general region of complex topography and non-uniform surface temperature has been investigated. In order to gain further understanding of the motion of surface air, it was necessary to study the vertical structure...

  16. Stressful life events and psychological dysfunction in complex regional pain syndrome type I

    NARCIS (Netherlands)

    Geertzen, JHB; de Bruijn-Kofman, AT; de Bruijn, HP; van de Wiel, HBM; Dijkstra, PU

    Objective: To determine to what extent stressful life events and psychological dysfunction play a role in the pathogenesis of Complex Regional Pain Syndrome type I (CRPS). Design: A comparative study between a CRPS group and a control group. Stressful life events and psychological dysfunction

  17. Ecosystem services provided by a complex coastal region: challenges of classification and mapping.

    Science.gov (United States)

    Sousa, Lisa P; Sousa, Ana I; Alves, Fátima L; Lillebø, Ana I

    2016-03-11

    A variety of ecosystem services classification systems and mapping approaches are available in the scientific and technical literature, which needs to be selected and adapted when applied to complex territories (e.g. in the interface between water and land, estuary and sea). This paper provides a framework for addressing ecosystem services in complex coastal regions. The roadmap comprises the definition of the exact geographic boundaries of the study area; the use of CICES (Common International Classification of Ecosystem Services) for ecosystem services identification and classification; and the definition of qualitative indicators that will serve as basis to map the ecosystem services. Due to its complexity, the Ria de Aveiro coastal region was selected as case study, presenting an opportunity to explore the application of such approaches at a regional scale. The main challenges of implementing the proposed roadmap, together with its advantages are discussed in this research. The results highlight the importance of considering both the connectivity of natural systems and the complexity of the governance framework; the flexibility and robustness, but also the challenges when applying CICES at regional scale; and the challenges regarding ecosystem services mapping.

  18. Resilience in patients with amputation because of Complex Regional Pain Syndrome type I

    NARCIS (Netherlands)

    Bodde, Marlies I.; Schrier, Ernst; Krans, Hilde K.; Geertzen, J.H.B.; Dijkstra, Pieter U.

    2014-01-01

    Purpose: Although controversial, an amputation for longstanding and therapy-resistant Complex Regional Pain Syndrome Type I (CRPS-I) may improve quality of life and pain intensity. Resilience, the way people deal with adversity in a positive way may be related to these positive outcomes. This study

  19. Optokinetic stimulation increases limb pain and forehead hyperalgesia in complex regional pain syndrome

    DEFF Research Database (Denmark)

    Knudsen, Lone F.; Drummond, Peter D.

    2015-01-01

    BACKGROUND: Ambiguous visual stimuli increase limb pain in patients with complex regional pain syndrome (CRPS), possibly due to afferent sensory feedback conflicts. Conflicting sensory stimuli can also generate unpleasant sensations in healthy people such as during motion sickness. We wanted to i...

  20. Evaluation of low level laser and interferential current in the therapy of complex regional pain syndrome by infrared thermographic camera

    Directory of Open Access Journals (Sweden)

    Kocić Mirjana

    2010-01-01

    Full Text Available Background/Aim. Complex regional pain syndrome type I (CRPS I is characterized by continuous regional pain, disproportional according to duration and intensity and to the sort of trauma or other lesion it was caused by. The aim of the study was to evaluate and compare, by using thermovison, the effects of low level laser therapy and therapy with interferential current in treatment of CRPS I. Methods. The prospective randomized controlled clinical study included 45 patients with unilateral CRPS I, after a fracture of the distal end of the radius, of the tibia and/or the fibula, treated in the Clinical Centre in Nis from 2004 to 2007. The group A consisted of 20 patients treated by low level laser therapy and kinesy-therapy, while the patients in the group B (n = 25 were treated by interferential current and kinesy-therapy. The regions of interest were filmed by a thermovision camera on both sides, before and after the 20 therapeutic procedures had been applied. Afterwards, the quantitative analysis and the comparing of thermograms taken before and after the applied therapy were performed. Results. There was statistically significant decrease of the mean maximum temperature difference between the injured and the contralateral extremity after the therapy in comparison to the status before the therapy, with the patients of the group A (p < 0.001 as well as those of the group B (p < 0.001. The decrease was statistically significantly higher in the group A than in the group B (p < 0.05. Conclusions. By the use of the infrared thermovision we showed that in the treatment of CRPS I both physical medicine methods were effective, but the effectiveness of laser therapy was statistically significantly higher compared to that of the interferential current therapy.

  1. Complex immunological monitoring of breast cancer patients treated postoperatively by electron beam irradiation

    International Nuclear Information System (INIS)

    Horvath, M.; Horvath, A.; Fekete, B.; Toth, J.

    1986-01-01

    To monitor the electron beam therapy some immunological parameters of breast cancer patients previously undergone surgery were tested before, during and after irradiation. Immune complex levels measured by complement consumption technique were not altered by irradiation. Killer cell activity tested in so-called antibody dependent cellular cytotoxicity (ADCC) capacity assay showed a marked decrease in some cases. Based on the phagocytic capacity of the granulocytes the patients could be divided into two groups: one with declining activity and another with rising activity: The majority of the patients (22/45) were humoral leukocyte adherence inhibition (H-LAI) negative before and during irradiation. Those showed positive H-LAI indices before electron therapy had unchanged (7/45) or decreasing (9/45) tendencies during the observation period. Further study is needed to establish the clinical relevance of these in vitro assays used by us. (orig.) [de

  2. Mobility and leachability of zinc in two soils treated with six organic zinc complexes.

    Science.gov (United States)

    Alvarez, J M; Novillo, J; Obrador, A; López-Valdivia, L M

    2001-08-01

    A study of soil columns was conducted to evaluate Zn movement potential in two reconstructed soil profiles. Zn-phenolate, Zn-EDDHA, Zn-EDTA, Zn-lignosulfonate, Zn-polyflavonoid, and Zn-heptagluconate were applied in the upper zone of the column. The different physicochemical properties of the two soils and the micronutrient source may influence Zn leaching, the distribution of Zn among soil fractions, and the Zn available to the plant in the depth of the layers. In Aquic Haploxeralf soil, the application of six fertilizers produced little migration and very small leaching of Zn in the soil profiles. In Calcic Haploxeralf soil, Zn-EDTA migrated and was distributed throughout the soil columns. This Zn chelate produces a loss of Zn by leaching, which was 36% of the added Zn. In the latter soil, Zn leached very little with the other five fertilizer treatments. The same as for these organic Zn complexes, the retention of added Zn indicated the potential of metal accumulation in the A(p) horizons of the two soil profiles. A large portion of applied Zn was available to plants [diethylenetriaminepentaacetic acid (DTPA) and Mehlich-3 extractable Zn] in the depths reached by the different commercial formulations. The relationship between the two methods was highly significant (Mehlich-3-Zn = 1.25 + 1.13 DTPA-Zn, R(2) = 99.19%). When Zn was added as Zn-EDTA, the amounts of the most labile fractions (water-soluble plus exchangeable and organically complexed Zn) increased throughout the entire profile column in comparison with the control columns, although in the B(t) horizon of the Aquic Haploxeralf soil they increased only slightly.

  3. Determination of haplotypes at structurally complex regions using emulsion haplotype fusion PCR.

    Science.gov (United States)

    Tyson, Jess; Armour, John A L

    2012-12-11

    Genotyping and massively-parallel sequencing projects result in a vast amount of diploid data that is only rarely resolved into its constituent haplotypes. It is nevertheless this phased information that is transmitted from one generation to the next and is most directly associated with biological function and the genetic causes of biological effects. Despite progress made in genome-wide sequencing and phasing algorithms and methods, problems assembling (and reconstructing linear haplotypes in) regions of repetitive DNA and structural variation remain. These dynamic and structurally complex regions are often poorly understood from a sequence point of view. Regions such as these that are highly similar in their sequence tend to be collapsed onto the genome assembly. This is turn means downstream determination of the true sequence haplotype in these regions poses a particular challenge. For structurally complex regions, a more focussed approach to assembling haplotypes may be required. In order to investigate reconstruction of spatial information at structurally complex regions, we have used an emulsion haplotype fusion PCR approach to reproducibly link sequences of up to 1kb in length to allow phasing of multiple variants from neighbouring loci, using allele-specific PCR and sequencing to detect the phase. By using emulsion systems linking flanking regions to amplicons within the CNV, this led to the reconstruction of a 59kb haplotype across the DEFA1A3 CNV in HapMap individuals. This study has demonstrated a novel use for emulsion haplotype fusion PCR in addressing the issue of reconstructing structural haplotypes at multiallelic copy variable regions, using the DEFA1A3 locus as an example.

  4. Determination of haplotypes at structurally complex regions using emulsion haplotype fusion PCR

    Directory of Open Access Journals (Sweden)

    Tyson Jess

    2012-12-01

    Full Text Available Abstract Background Genotyping and massively-parallel sequencing projects result in a vast amount of diploid data that is only rarely resolved into its constituent haplotypes. It is nevertheless this phased information that is transmitted from one generation to the next and is most directly associated with biological function and the genetic causes of biological effects. Despite progress made in genome-wide sequencing and phasing algorithms and methods, problems assembling (and reconstructing linear haplotypes in regions of repetitive DNA and structural variation remain. These dynamic and structurally complex regions are often poorly understood from a sequence point of view. Regions such as these that are highly similar in their sequence tend to be collapsed onto the genome assembly. This is turn means downstream determination of the true sequence haplotype in these regions poses a particular challenge. For structurally complex regions, a more focussed approach to assembling haplotypes may be required. Results In order to investigate reconstruction of spatial information at structurally complex regions, we have used an emulsion haplotype fusion PCR approach to reproducibly link sequences of up to 1kb in length to allow phasing of multiple variants from neighbouring loci, using allele-specific PCR and sequencing to detect the phase. By using emulsion systems linking flanking regions to amplicons within the CNV, this led to the reconstruction of a 59kb haplotype across the DEFA1A3 CNV in HapMap individuals. Conclusion This study has demonstrated a novel use for emulsion haplotype fusion PCR in addressing the issue of reconstructing structural haplotypes at multiallelic copy variable regions, using the DEFA1A3 locus as an example.

  5. Primary intestinal lymphangiectasia treated with rapamycin in a child with tuberous sclerosis complex (TSC).

    Science.gov (United States)

    Pollack, Sarah F; Geffrey, Alexandra L; Thiele, Elizabeth A; Shah, Uzma

    2015-09-01

    Primary intestinal lymphangiectasia (PIL) is a rare protein-losing enteropathy characterized by a congenital malformation of the lymphatic vessels of the small intestine causing insufficient drainage and leakage of lymph fluid. Tuberous sclerosis complex (TSC) is an autosomal dominant genetic disorder characterized by benign hamartomas in multiple organ systems. While the lymphatic system has been implicated in TSC through lymphangioleiomyomatosis (LAM) and lymphedema, this paper reports the first case of PIL in TSC, a female patient with a TSC2 mutation. She developed persistent and significant abdominal distension with chronic diarrhea during her first year of life. Due to lack of treatment options and the involvement of the mTOR pathway in TSC, a trial of an mTOR inhibitor, rapamycin, was initiated. This treatment was highly effective, with improvement in clinical symptoms of PIL as well as abnormal laboratory values including VEGF-C, which was elevated to over seven times the normal upper limit before treatment. This case suggests that PIL is a rare manifestation of TSC, warranting the use of mTOR inhibitors in future studies. © 2015 Wiley Periodicals, Inc.

  6. Independent variable complexity for regional regression of the flow duration curve in ungauged basins

    Science.gov (United States)

    Fouad, Geoffrey; Skupin, André; Hope, Allen

    2016-04-01

    The flow duration curve (FDC) is one of the most widely used tools to quantify streamflow. Its percentile flows are often required for water resource applications, but these values must be predicted for ungauged basins with insufficient or no streamflow data. Regional regression is a commonly used approach for predicting percentile flows that involves identifying hydrologic regions and calibrating regression models to each region. The independent variables used to describe the physiographic and climatic setting of the basins are a critical component of regional regression, yet few studies have investigated their effect on resulting predictions. In this study, the complexity of the independent variables needed for regional regression is investigated. Different levels of variable complexity are applied for a regional regression consisting of 918 basins in the US. Both the hydrologic regions and regression models are determined according to the different sets of variables, and the accuracy of resulting predictions is assessed. The different sets of variables include (1) a simple set of three variables strongly tied to the FDC (mean annual precipitation, potential evapotranspiration, and baseflow index), (2) a traditional set of variables describing the average physiographic and climatic conditions of the basins, and (3) a more complex set of variables extending the traditional variables to include statistics describing the distribution of physiographic data and temporal components of climatic data. The latter set of variables is not typically used in regional regression, and is evaluated for its potential to predict percentile flows. The simplest set of only three variables performed similarly to the other more complex sets of variables. Traditional variables used to describe climate, topography, and soil offered little more to the predictions, and the experimental set of variables describing the distribution of basin data in more detail did not improve predictions

  7. Young stellar population and star formation history ofW4 HII region/Cluster Complex

    Science.gov (United States)

    Panwar, Neelam

    2018-04-01

    The HII region/cluster complex has been a subject of numerous investigations to study the feedback effect of massive stars on their surroundings. Massive stars not only alter the morphology of the parental molecular clouds, but also influence star formation, circumstellar disks and the mass function of low-mass stars in their vicinity. However, most of the studies of low-mass stellar content of the HII regions are limited only to the nearby regions. We study the star formation in the W4 HII region using deep optical observations obtained with the archival data from Canada - France - Hawaii Telescope, Two-Micron All Sky Survey, Spitzer, Herschel and Chandra. We investigate the spatial distribution of young stellar objects in the region, their association with the remnant molecular clouds, and search for the clustering to establish the sites of recent star formation. Our analysis suggests that the influence of massive stars on circumstellar disks is significant only to thei! r immediate neighborhood. The spatial correlation of the young stars with the distribution of gas and dust of the complex indicate that the clusters would have formed in a large filamentary cloud. The observing facilities at the 3.6-m Devasthal Optical Telescope (DOT), providing high-resolution spectral and imaging capabilities, will fulfill the major objectives in the study of HII regions.

  8. Use of telehealth to treat and manage chronic viral hepatitis in regional Queensland.

    Science.gov (United States)

    Keogh, Kandice; Clark, Paul; Valery, Patricia C; McPhail, Steven M; Bradshaw, Candise; Day, Melany; Smith, Anthony C

    2016-12-01

    For regional and rural Queenslanders, chronic viral hepatitis treatment is a major unmet health need, with restricted access to specialists outside of tertiary, largely metropolitan hospitals. To increase treatment of chronic viral hepatitis in regional Queensland, a team-based telehealth model was expanded. This expansion embedded an initial nursing consultation prior to specialist telehealth consultation. We conducted a retrospective audit of the introduction and expansion of hepatology telehealth services. Activity from July 2014-June 2015 (pre-expansion) was compared with July 2015- June 2016 (post-expansion). Interviews were conducted with key staff to determine factors contributing to success of the service and identify ongoing challenges to the service model. A greater than four-fold increase in clinical consultation was observed (131 telehealth consultations pre-expansion vs 572 post-expansion; p Queensland. It may serve as a model to further expand telehealth management of chronic disease for regional Queenslanders. © The Author(s) 2016.

  9. A cross-sectional retrospective analysis of the regionalization of complex surgery.

    Science.gov (United States)

    Studnicki, James; Craver, Christopher; Blanchette, Christopher M; Fisher, John W; Shahbazi, Sara

    2014-08-16

    longest lengths of stay were found in higher volume hospitals. Complex surgery in Florida is effectively regionalized so that small volume hospitals operating within the range of complex procedures appropriate to their capabilities provide no increased risk of post surgical mortality.

  10. Drug interactions in HIV patients treated in a high complexity hospital of Antofagasta city

    Directory of Open Access Journals (Sweden)

    Patricio R. Araya

    2017-11-01

    Full Text Available Context: From the beginning of the global HIV epidemic there has been a great concern about drug interactions (DI considering that up to 27% of all patients may be affected by at least one type of DI, this risk increases by receiving concomitant treatments. This DI leads to negative consequences such as adverse drug reactions (ADR, lack of treatment adherence and new hospital admissions. Aims: To determine the prevalence of DI of antiretroviral drugs and their clinical consequences in UNACESS-VIH-SIDA patients of Hospital Regional de Antofagasta. Methods: The study included a total of 100 HIV patients. To identify DI, Micromedex database was used. All data were gathered in a pharmaceutical datasheet, the theoretical DI were identified and real DI were detected by using hematologic tests and the patient’s clinical evolution. After the detection of any real DI, a pharmaceutical intervention took place. Results: A total of 106 DI were detected; 86% of DI found were related to drug’s pharmacokinetic properties, which were mostly metabolism related interactions (96.9%; the most commonly found associations were atazanavir with ritonavir, efavirenz with atorvastatin and efavirenz with gemfibrozil. The main clinical consequences associated with DI were ADR (49%. Conclusions: High prevalence of metabolism-related interactions was found and the antiretroviral drugs mostly associated with DI were found to be atazanavir, ritonavir y efavirenz. A high prevalence of ADR was found; however, they were mild or moderate.

  11. Combined therapies to treat complex diseases: The role of the gut microbiota in multiple sclerosis.

    Science.gov (United States)

    Calvo-Barreiro, Laura; Eixarch, Herena; Montalban, Xavier; Espejo, Carmen

    2018-02-01

    The commensal microbiota has emerged as an environmental risk factor for multiple sclerosis (MS). Studies in experimental autoimmune encephalomyelitis (EAE) models have shown that the commensal microbiota is an essential player in triggering autoimmune demyelination. Likewise, the commensal microbiota modulates the host immune system, alters the integrity and function of biological barriers and has a direct effect on several types of central nervous system (CNS)-resident cells. Moreover, a characteristic gut dysbiosis has been recognized as a consistent feature during the clinical course of MS, and the MS-related microbiota is gradually being elucidated. This review highlights animal studies in which commensal microbiota modulation was tested in EAE, as well as the mechanisms of action and influence of the commensal microbiota not only in the local milieu but also in the innate and adaptive immune system and the CNS. Regarding human research, this review focuses on studies that show how the commensal microbiota might act as a pathogenic environmental risk factor by directing immune responses towards characteristic pathogenic profiles of MS. We speculate how specific microbiome signatures could be obtained and used as potential pathogenic events and biomarkers for the clinical course of MS. Finally, we review recently published and ongoing clinical trials in MS patients regarding the immunomodulatory properties exerted by some microorganisms. Because MS is a complex disease with a large variety of associated environmental risk factors, we suggest that current treatments combined with strategies that modulate the commensal microbiota would constitute a broader immunotherapeutic approach and improve the clinical outcome for MS patients. Copyright © 2017 Elsevier B.V. All rights reserved.

  12. Potential Risk Factors for the Onset of Complex Regional Pain Syndrome Type 1: A Systematic Literature Review

    Directory of Open Access Journals (Sweden)

    Tracey Pons

    2015-01-01

    Full Text Available Anaesthetists in the acute and chronic pain teams are often involved in treating Complex Regional Pain Syndromes. Current literature about the risk factors for the onset of Complex Regional Pain Syndrome Type 1 (CRPS 1 remains sparse. This syndrome has a low prevalence, a highly variable presentation, and no gold standard for diagnosis. In the research setting, the pathogenesis of the syndrome continues to be elusive. There is a growing body of literature that addresses efficacy of a wide range of interventions as well as the likely mechanisms that contribute to the onset of CRPS 1. The objective for this systematic search of the literature focuses on determining the potential risk factors for the onset of CRPS 1. Eligible articles were analysed, dated 1996 to April 2014, and potential risk factors for the onset of CRPS 1 were identified from 10 prospective and 6 retrospective studies. Potential risk factors for the onset of CRPS 1 were found to include being female, particularly postmenopausal female, ankle dislocation or intra-articular fracture, immobilisation, and a report of higher than usual levels of pain in the early phases of trauma. It is not possible to draw definite conclusions as this evidence is heterogeneous and of mixed quality, relevance, and weighting strength against bias and has not been confirmed across multiple trials or in homogenous studies.

  13. Treatment of complex regional pain syndrome type 1 in a pediatric patient using the lidocaine patch 5%: a case report

    Directory of Open Access Journals (Sweden)

    Steven G Frost, MD

    2003-09-01

    Full Text Available Background: Successful treatment of complex regional pain syndrome type 1 (CRPS-1 requires a coordinated, multidisciplinary approach. Physical rehabilitation is an important component of long-term treatment. Unfortunately, patients with significant allodynia or hyperalgesia characteristic of CRPS-1 often have difficulty progressing through a physical therapy (PT regimen. In most adults with CRPS-1, the treatment of choice is PO opioids. Objective: This article presents a case report of the use of the lidocaine patch 5%, a targeted peripheral analgesic, in a pediatric patient and its effects on reducing pain, improving the patient's overall attitude, and facilitating compliance with ongoing PT. Results: A 10-year-old girl developed CRPS-1 after arthroscopic surgery for a sprained ankle. Attempts at PT were unsuccessful due to inadequate pain relief from various treatment modalities. Therapy with the lidocaine patch 5% was initiated and resulted in significant pain relief, improvements in the patient's attitude, and progress with PT. Conclusion: This case report of a child with CRPS-1 showed that therapy with lidocaine patch 5% may be efficacious in treating children with pain resulting from CRPS-1, thereby increasing the success of PT. Keywords: complex regional pain syndrome, lidocaine patch 5%, targeted peripheral analgesic, pediatrics

  14. Intravenous magnesium for chronic complex regional pain syndrome type 1 (CRPS-1).

    Science.gov (United States)

    Fischer, Sigrid G L; Collins, Susan; Boogaard, Sabine; Loer, Stephan A; Zuurmond, Wouter W A; Perez, Roberto S G M

    2013-09-01

    To assess the effects of intravenous administration of magnesium on complex regional pain syndrome type 1 (CRPS-1), a randomized double-blind placebo-controlled trial was performed. Fifty-six patients with CRPS-1 (International Association for the Study of Pain Orlando criteria) received MgSO(4) 70 mg/kg or placebo (NaCl 0.9%) in 4 hours over 5 consecutive days. Pain (BOX-11 and McGill), the level of impairment (Impairment level Sum Score [ISS]), functional limitations (Radboud Skills Questionnaire, Walking Skills Questionnaire/questionnaire rising and sitting down), participation (Impact on Participation and Autonomy [IPA]), and quality of life (Short Form-36, EuroQol, IPA) were evaluated at baseline and at 1, 3, 6, and 12 weeks. No significant differences were found between MgSO(4) and placebo on the BOX-11 and ISS at different time points during the trial on intention-to-treat and per-protocol analysis. A significant improvement on the BOX-11 was found after the first week of the trial in both groups (mean 0.7; standard deviation 1.1). For the MgSO(4) group, a clinically relevant and statistically significant improvement on the ISS at 1 week (median 5, interquartile range [IQR] -1 to 8) and a significant improvement on the McGill up to 6 weeks (median 2 words, IQR 0-4.5) were found compared with baseline, which were not found in the placebo group. Significant improvement in perceived job participation was found for the MgSO(4) group at 12 weeks (median improvement 1.44-1.17; P = 0.01). ISS improved significantly more in patients with a low Hospital Anxiety and Depression Scale (HADS) score (≤10) in the MgSO(4) group (mean 4.4 vs mean -3.1; P = 0.02). Administration of the physiological competitive N-methyl-D-aspartate receptor antagonist magnesium in chronic CRPS provides insufficient benefit over placebo. Future research should focus on patients with acute CRPS and early signs and symptoms of central sensitization. Wiley Periodicals, Inc.

  15. Simulating Complex, Cold-region Process Interactions Using a Multi-scale, Variable-complexity Hydrological Model

    Science.gov (United States)

    Marsh, C.; Pomeroy, J. W.; Wheater, H. S.

    2017-12-01

    Accurate management of water resources is necessary for social, economic, and environmental sustainability worldwide. In locations with seasonal snowcovers, the accurate prediction of these water resources is further complicated due to frozen soils, solid-phase precipitation, blowing snow transport, and snowcover-vegetation-atmosphere interactions. Complex process interactions and feedbacks are a key feature of hydrological systems and may result in emergent phenomena, i.e., the arising of novel and unexpected properties within a complex system. One example is the feedback associated with blowing snow redistribution, which can lead to drifts that cause locally-increased soil moisture, thus increasing plant growth that in turn subsequently impacts snow redistribution, creating larger drifts. Attempting to simulate these emergent behaviours is a significant challenge, however, and there is concern that process conceptualizations within current models are too incomplete to represent the needed interactions. An improved understanding of the role of emergence in hydrological systems often requires high resolution distributed numerical hydrological models that incorporate the relevant process dynamics. The Canadian Hydrological Model (CHM) provides a novel tool for examining cold region hydrological systems. Key features include efficient terrain representation, allowing simulations at various spatial scales, reduced computational overhead, and a modular process representation allowing for an alternative-hypothesis framework. Using both physics-based and conceptual process representations sourced from long term process studies and the current cold regions literature allows for comparison of process representations and importantly, their ability to produce emergent behaviours. Examining the system in a holistic, process-based manner can hopefully derive important insights and aid in development of improved process representations.

  16. Gastrointestinal toxicity and its relation to dose distributions in the anorectal region of prostate cancer patients treated with radiotherapy

    International Nuclear Information System (INIS)

    Heemsbergen, Wilma D.; Hoogeman, Mischa S.; Hart, Guus A.M.; Lebesque, Joos V.; Koper, Peter C.M.

    2005-01-01

    Purpose: To study the correlations between the dose distributions in the anorectal region and late GI symptoms in patients treated for localized prostate carcinoma. Methods and materials: Data from a randomized study were analyzed. In this trial, patients were treated with either rectangular or conformal fields with a dose of 66 Gy. Data concerning GI symptoms were collected from questionnaires of 197 patients. The distributions of the anorectal region were projected on maps, and the dose parameters were calculated. The incidences of complaints were studied as a function of the dose-area parameters and clinical parameters, using a proportional hazard regression model. Finally, we tested a series of dose parameters originating from different parts of the anorectal region. Results: Analyzing the total region, only a statistically significant dose-area effect relation for bleeding was found (p < 0.01). Defining subareas, we found effect relations for bleeding, soiling, fecal incontinence, and mucus loss. For bleeding and mucus loss, the strongest correlation was found for the dose received by the upper 70-80% of the anorectal region (p < 0.01). For soiling and fecal incontinence, we found the strongest association with the dose to the lower 40-50% (p < 0.05). Conclusion: We found evidence that complaints originate from specific regions of the irradiated lower GI tract. Bleeding and mucus loss are probably related to irradiation of the upper part of the rectum. Soiling and fecal incontinence are more likely related to the dose to the anal canal and the lower part of the rectum

  17. Systems Pharmacology Dissecting Holistic Medicine for Treatment of Complex Diseases: An Example Using Cardiocerebrovascular Diseases Treated by TCM.

    Science.gov (United States)

    Wang, Yonghua; Zheng, Chunli; Huang, Chao; Li, Yan; Chen, Xuetong; Wu, Ziyin; Wang, Zhenzhong; Xiao, Wei; Zhang, Boli

    2015-01-01

    Holistic medicine is an interdisciplinary field of study that integrates all types of biological information (protein, small molecules, tissues, organs, external environmental signals, etc.) to lead to predictive and actionable models for health care and disease treatment. Despite the global and integrative character of this discipline, a comprehensive picture of holistic medicine for the treatment of complex diseases is still lacking. In this study, we develop a novel systems pharmacology approach to dissect holistic medicine in treating cardiocerebrovascular diseases (CCDs) by TCM (traditional Chinese medicine). Firstly, by applying the TCM active ingredients screened out by a systems-ADME process, we explored and experimentalized the signed drug-target interactions for revealing the pharmacological actions of drugs at a molecule level. Then, at a/an tissue/organ level, the drug therapeutic mechanisms were further investigated by a target-organ location method. Finally, a translational integrating pathway approach was applied to extract the diseases-therapeutic modules for understanding the complex disease and its therapy at systems level. For the first time, the feature of the drug-target-pathway-organ-cooperations for treatment of multiple organ diseases in holistic medicine was revealed, facilitating the development of novel treatment paradigm for complex diseases in the future.

  18. Bilateral complex regional pain syndrome following spinal cord injury and bilateral calcaneus fracture

    Directory of Open Access Journals (Sweden)

    Ahmet Boyacı

    2013-09-01

    Full Text Available Complex regional pain syndrome (CRPS is a disease affectingone or more extremities, characterized by spontaneouspain, allodynia, hyperpathia and hyperalgesia.CRPS is separated into Type 1 and Type 2. CRPS whichdevelops after a nociceptive event is labeled as Type 1and when it develops following peripheral nerve damage,Type 2. Although the pathogenesis is not fully understood,peripheral and central sensitivity are held responsible.Bilateral lower extremity involvement is extremely rare.However, it should be borne in mind that it can develop intraumatic injuries which occur in more than one area anddiagnosis and commencement of a rehabilitation programshould be made in the early period. The case is presentedhere of bilateral Type 1 CRPS developing after incompletespinal cord injury and bilateral calcaneus fracture. JClin Exp Invest 2013; 4 (3: 360-363Key words: complex regional pain syndrome, calcaneusfracture, spinal cord injury

  19. ON MAGNETIC ACTIVITY BAND OVERLAP, INTERACTION, AND THE FORMATION OF COMPLEX SOLAR ACTIVE REGIONS

    Energy Technology Data Exchange (ETDEWEB)

    McIntosh, Scott W. [High Altitude Observatory, National Center for Atmospheric Research, P.O. Box 3000, Boulder, CO 80307 (United States); Leamon, Robert J., E-mail: mscott@hao.ucar.edu [Department of Physics, Montana State University, Bozeman, MT 59717 (United States)

    2014-11-20

    Recent work has revealed a phenomenological picture of the how the ∼11 yr sunspot cycle of the Sun arises. The production and destruction of sunspots is a consequence of the latitudinal-temporal overlap and interaction of the toroidal magnetic flux systems that belong to the 22 yr magnetic activity cycle and are rooted deep in the Sun's convective interior. We present a conceptually simple extension of this work, presenting a hypothesis on how complex active regions can form as a direct consequence of the intra- and extra-hemispheric interaction taking place in the solar interior. Furthermore, during specific portions of the sunspot cycle, we anticipate that those complex active regions may be particularly susceptible to profoundly catastrophic breakdown, producing flares and coronal mass ejections of the most severe magnitude.

  20. Risk Factors for Post-treatment Complex Regional Pain Syndrome (CRPS)

    DEFF Research Database (Denmark)

    Petersen, Pelle B; Mikkelsen, Kim Lyngby; Lauritzen, Jes B

    2018-01-01

    OBJECTIVES: Complex regional pain syndrome is a challenging condition that includes a broad spectrum of sensory, autonomic, and motor features predominantly in extremities recovering from a trauma. Few large-scale studies have addressed occurrence of and factors associated with complex regional......, gender, initial diagnosis, treatment, and amount of compensation were extracted. Multivariate logistic regressions were performed to identify variables associated with approval of the claim. For carpal tunnel syndrome (CTS) patients, we registered whether symptoms were bilateral or unilateral...... normal neurophysiology. CONCLUSIONS: Female gender, surgical treatment, and treatment to the upper limb were risk factors. Elective surgery accounted for a large number of post-treatment CRPS patients. In CTS patients developing CRPS, normal neurophysiological examination findings were common...

  1. The comparative osteology of the petrotympanic complex (ear region of extant baleen whales (Cetacea: Mysticeti.

    Directory of Open Access Journals (Sweden)

    Eric G Ekdale

    Full Text Available Anatomical comparisons of the ear region of baleen whales (Mysticeti are provided through detailed osteological descriptions and high-resolution photographs of the petrotympanic complex (tympanic bulla and petrosal bone of all extant species of mysticete cetaceans. Salient morphological features are illustrated and identified, including overall shape of the bulla, size of the conical process of the bulla, morphology of the promontorium, and the size and shape of the anterior process of the petrosal. We place our comparative osteological observations into a phylogenetic context in order to initiate an exploration into petrotympanic evolution within Mysticeti.The morphology of the petrotympanic complex is diagnostic for individual species of baleen whale (e.g., sigmoid and conical processes positioned at midline of bulla in Balaenoptera musculus; confluence of fenestra cochleae and perilymphatic foramen in Eschrichtius robustus, and several mysticete clades are united by derived characteristics. Balaenids and neobalaenids share derived features of the bulla, such as a rhomboid shape and a reduced anterior lobe (swelling in ventral aspect, and eschrichtiids share derived morphologies of the petrosal with balaenopterids, including loss of a medial promontory groove and dorsomedial elongation of the promontorium. Monophyly of Balaenoidea (Balaenidae and Neobalaenidae and Balaenopteroidea (Balaenopteridae and Eschrichtiidae was recovered in phylogenetic analyses utilizing data exclusively from the petrotympanic complex.This study fills a major gap in our knowledge of the complex structures of the mysticete petrotympanic complex, which is an important anatomical region for the interpretation of the evolutionary history of mammals. In addition, we introduce a novel body of phylogenetically informative characters from the ear region of mysticetes. Our detailed anatomical descriptions, illustrations, and comparisons provide valuable data for current and

  2. The sodium pentothal hypnosis interview with follow-up treatment for complex regional pain syndrome.

    Science.gov (United States)

    Simon, E P; Dahl, L F

    1999-08-01

    A patient who was unresponsive to multiple conservative medical treatments for complex regional pain syndrome was assessed using a novel approach--the sodium pentothal hypnosis interview. The interview suggested that his pain was centrally generated. The patient's pain symptoms resolved with hypnotherapeutic treatment. Indications for this procedure and implications for assessment and treatment are discussed. This case raises more questions than it answers, and leaves the reader to struggle with current difficulties in diagnostic decision-making.

  3. Regional labour market analysis and policy evaluation: Job insecurity, flexibility and complexity. Evidence from Switzerland

    OpenAIRE

    Baruffini, Moreno; Maggi, Rico

    2014-01-01

    The thesis focuses on labour market flexibility, security and complexity. The research is divided into three chapters: two of the chapters specifically relate to perceived security, flexibility and job satisfaction, using data from the longitudinal Swiss Household Panel (SHP), while the last investigates labour market programs and their impact on a regional labour market. The first essay analyses perceptions of economic insecurity in Switzerland, during the business cycle between 2008 an...

  4. Child Abuse and Dissociation in Patients with Complex Regional Pain Syndrome

    Directory of Open Access Journals (Sweden)

    Michael Williams

    1999-01-01

    Full Text Available >OBJECTIVE: In the absence of a proven medical explanation for the chronic pain syndrome Complex Regional Pain Syndrome type I (CRPS I, this study explored a hypothetical link between childhood physical and sexual abuse, and the subsequent development of CRPS I. The hypothesis predicts the existence of a subpopulation of CRPS I patients with a high frequency of dissociative experiences corresponding to a history of childhood trauma.

  5. Geographic/conceptual delimitation of the «Southern Mediterranean». A Regional Security Complex?

    Directory of Open Access Journals (Sweden)

    Alberto Priego Moreno

    2016-07-01

    Full Text Available This article seeks to analyse how the Mediterranean Area has evolved after the changes occurred with the so-called Arab Springs. The main idea is to focus on the Southern Mediterranean as a dynamic space that expands itself as a result of its internal transformations and subsequent external changes caused by the Arab Spring. We will use the IR theory of the Regional Security Complex as it is considered as the most adaptable to this changing reality.

  6. Measurement of regional calcium accretion in patients treated for Paget's disease and in paraplegics

    International Nuclear Information System (INIS)

    Bergmann, P.; Schoutens, A.; Paternot, J.; Heilporn, E.

    1975-01-01

    The measurement of regional bone accretion of calcium has proved its worth in the study of two localised bone disorders, Paget's disease and the bone complications of medullar lesions. Intraveinous injection of 47 Ca is followed during 6 days of external measurements with the human whole-body counter and daily determinations of the serum specific activity. Assuming that the decay slope of the extra-osseous activity is parallel to that which follows the serum activity between two and six days, the activity fixed on the skeleton is calculated by zones. The experiment covers 15 normal subjects, 10 patients with Paget's disease, 10 paraplegics and 28 case of miscellaneous ailments [fr

  7. Association between adjuvant regional radiotherapy and cognitive function in breast cancer patients treated with conservation therapy

    International Nuclear Information System (INIS)

    Shibayama, Osamu; Yoshiuchi, Kazuhiro; Inagaki, Masatoshi; Matsuoka, Yutaka; Yoshikawa, Eisho; Sugawara, Yuriko; Akechi, Tatsuo; Wada, Noriaki; Imoto, Shigeru; Murakami, Koji; Ogawa, Asao; Akabayashi, Akira; Uchitomi, Yosuke

    2014-01-01

    Although protracted cognitive impairment has been reported to occur after radiotherapy even when such therapy is not directed to brain areas, the mechanism remains unclear. This study investigated whether breast cancer patients exposed to local radiotherapy showed lower cognitive function mediated by higher plasma interleukin (IL)-6 levels than those unexposed. We performed the Wechsler Memory Scale-Revised (WMS-R) and measured plasma IL-6 levels for 105 breast cancer surgical patients within 1 year after the initial therapy. The group differences in each of the indices of WMS-R were investigated between cancer patients exposed to adjuvant regional radiotherapy (n = 51) and those unexposed (n = 54) using analysis of covariance. We further investigated a mediation effect by plasma IL-6 levels on the relationship between radiotherapy and the indices of WMS-R using the bootstrapping method. The radiotherapy group showed significantly lower Immediate Verbal Memory Index and Delayed Recall Index (P = 0.001, P = 0.008, respectively). Radiotherapy exerted an indirect effect on the lower Delayed Recall Index of WMS-R through elevation of plasma IL-6 levels (bootstrap 95% confidence interval = −2.6626 to −0.0402). This study showed that breast cancer patients exposed to adjuvant regional radiotherapy in conservation therapy might have cognitive impairment even several months after their treatment. The relationship between the therapy and the cognitive impairment could be partially mediated by elevation of plasma IL-6 levels

  8. PROPERTIES OF THE COMPACT H II REGION COMPLEX G-0.02-0.07

    International Nuclear Information System (INIS)

    Mills, E.; Morris, M. R.; Lang, C. C.; Dong, H.; Wang, Q. D.; Cotera, A.; Stolovy, S. R.

    2011-01-01

    We present new extinction maps and high-resolution Paschen-alpha images of G-0.02-0.07, a complex of compact H II regions located adjacent to the M-0.02-0.07 giant molecular cloud, 6 pc in projection from the center of the Galaxy. These H II regions, which lie in projection just outside the boundary of the Sgr A East supernova remnant, represent one of the most recent episodes of star formation in the central parsecs of the Galaxy. The 1.87 μm extinctions of regions A, B, and C are almost identical, approximately 3.7 mag. Region D, in contrast, has a peak extinction of A 1.87 = 5.9 mag. Adopting an extinction law specific to the Galactic center, we find that these extinctions correspond to visual extinctions of A V = 45 and A V = 71. The similar and uniform extinctions of regions A, B, and C are consistent with that expected for foreground extinction in the direction of the Galactic center, suggesting that they lie at the front side of the M-0.02-0.07 molecular cloud. Region D is more compact, has a higher extinction, and is thus suspected to be younger and embedded in a dense core in a compressed ridge on the western edge of this cloud.

  9. Central Nervous System Birth Defects in Surgically Treated Infants in Sarajevo Region of Bosnia and Herzegovina

    Directory of Open Access Journals (Sweden)

    Selma Aličelebić

    2007-11-01

    Full Text Available Congenital anomalies of the central nervous system (CNS are common. The prevalence of these anomalies shows considerable geographical variation and female predominance. The aim of this work was to obtain the frequency of different CNS congenital anomalies types and their sex distribution among cases hospitalized in a Department of Neurosurgery, University of Sarajevo Clinics Center, Bosnia and Herzegovina, during the period January 2001 to December 2004. Retrospective study was carried out on the basis of the clinical records. Standard methods of descriptive statistics were performed for the data analysis. A total of 103 cases were surgically treated in the period from 2001 through 2004. Out of that number 56 (54,4% were female patients, while 47 (46,6% were male patients. Seven different CNS birth defect types were found in this investigation. These were: spina bifida (42 cases or 40,78%, congenital hydrocephalus (35 cases or 33,98%, arachnoid cyst (15 cases or 14,56%, Dandy-Walker syndrome (5 cases or 4,85%, dermoid cyst (4 cases or 3,88%, one of Arnold-Chiari syndrome (0,98% and one of encefalocele (0,98%. According to this investigation, CNS congenital birth defects were slightly higher in females (54,4%. The most frequent types were spina bifida (40,78% both in females (22,33% and in males (18,45%, hydrocephalus (33,98% and arachnoid cyst (14,56%. The anomalies of the other organ systems, associated with CNS anomalies obtained in this investigation, were pes equinovarus, cheiloshisis, cardiomegalia and palatoshisis. They were found in six cases (5,82%, equal in both sexes.

  10. Towards a regional ontology of management education in Africa: A complexity leadership theory perspective

    Directory of Open Access Journals (Sweden)

    Nixon M. Ochara

    2017-02-01

    Full Text Available Orientation: The title of this critique, ‘Towards a regional ontology of management education in Africa: A complexity leadership theory perspective’, sought to capture a paradox in the prescriptive nature and universalistic leaning of current leadership theories; yet local realities may call for being cognisant of (possible extant regional ontologies. Motivation for the study: The argumentation and analysis developed in this article were based on a synthesis of ideas from literature to evolve a preliminary regional ontology for reorienting business and management education relevant for Africa. Research design, approach and method: The critique was structured on insights from complexity leadership theory. The outcome was a proposition for an Afrocentric regional ontology for strengthening business and management education anchored on four themes: ethical and moral engagement, entrepreneurial leadership, Ubuntu and local National Systems of Innovation (NSI. These emerging ideas were considered to be tentative and should be considered as a foundation to inform further inquiry into how business and management education in Africa can be better interpreted and legitimised in the behavioural sciences. Practical/managerial implications: From an Afrocentric perspective, conceptualising and maintaining the logic of leadership was considered to be desirable and imperative in evolving a regional ontology of leadership that takes into account local realities. Of course, we recognised that these defining rationalities are not unique to Africa, but that said; a regional perspective that is unique cannot continue to be ignored but should find their place in discourses about leadership in the 21st century. Contribution/value-add: The synthesis and narrative presented in this paper concisely summarises and provides traction on how to advance business and management education in Africa.

  11. Class II malocclusion with complex problems treated with a novel combination of lingual orthodontic appliances and lingual arches.

    Science.gov (United States)

    Yanagita, Takeshi; Nakamura, Masahiro; Kawanabe, Noriaki; Yamashiro, Takashi

    2014-07-01

    This case report describes a novel method of combining lingual appliances and lingual arches to control horizontal problems. The patient, who was 25 years of age at her first visit to our hospital with a chief complaint of crooked anterior teeth, was diagnosed with skeletal Class II and Angle Class II malocclusion with anterior deep bite, lateral open bite, premolar crossbite, and severe crowding in both arches. She was treated with premolar extractions and temporary anchorage devices. Conventionally, it is ideal to use labial brackets simultaneously with appliances, such as a lingual arch, a quad-helix, or a rapid expansion appliance, in patients with complex problems requiring horizontal, anteroposterior, and vertical control; however, this patient strongly requested orthodontic treatment with lingual appliances. A limitation of lingual appliances is that they cannot be used with other conventional appliances. In this report, we present the successful orthodontic treatment of a complex problem using modified lingual appliances that enabled combined use of a conventional lingual arch. Copyright © 2014 American Association of Orthodontists. Published by Mosby, Inc. All rights reserved.

  12. Urinary System Birth Defects in Surgically Treated Infants in Sarajevo Region of Bosnia and Herzegovina

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    Selma Aličelebić

    2008-05-01

    Full Text Available Congenital anomalies of the urinary system are relatively common anomalies. In Bosnia and Herzegovina there is no existent unique evidence of congenital anomalies and registries. The aim of this study was to obtain the frequency of different urinary tract anomalies types and their sex distribution among cases hospitalized in the Department of Pediatric Surgery of the University of Sarajevo Clinics Centre, Bosnia and Herzegovina, during the period from January 2002 to December 2006. Retrospective study was carried out on the basis of clinical records. Standard methods of descriptive statistics were performed for the data analysis. Among 289 patients that were surgically treated 62,37% of the patients were male patients, while 37,63% were female patients. Twenty nine different urinary system anomalies types were found in this study. These were: vesicoureteral reflux (99 cases or 30,75%, hypospadias (62 cases or 19,26%, pelviureteric junction obstruction (42 cases or 13,04%, megaureter (35 cases or 10,87%, duplex pelvis and ureter (16 cases or 4,97%, bladder diverticulum (8 cases or 2,48%, ureterocoele (7 cases or 2,17%, stenosis of the external urethral opening (6 cases or 1,86%, ectopic kidney, duplex kidney and pelvis (each 5 cases or 1,55%, polycystic kidneys and urethral stricture (each 4 cases or 1,24%, multicystic kidney (3 cases or 0,93%, kidney agenesis, ureter agenesis, urethral diverticulum, ectopic ureter, horseshoe kidney and fetal kidney (each 2 cases or 0,62%, renal aplasia, urethral atresia, renal cyst, urachal cyst, epispadias, bladder exstrophy, renal hypoplasia, renal malrotation and Prune-Belly syndrome (each 1 case or 0,31%. According to this study, urinary tract anomalies were more common in male than in female patients (62,37%, Generally, the most frequent anomaly type was vesicoureteral reflux in total number of 99 cases, and in females (66 cases, but hypospadias was the most common anomaly in males (62 cases. The anomalies

  13. Characteristics of postharvest quality in regional fruits treate with ionizing radiation

    Energy Technology Data Exchange (ETDEWEB)

    Silva, Josenilda M.; Villar, Heldio P. [Centro Regional de Ciencias Nucleares (CRCN/CNEN-NE), Recife, PE (Brazil)], e-mail: jmnilda@cnen.gov.br; Correia, Lidia C.S.A.; Maciel, Maria Ines S. [Universidade Federal Rural de Pernambuco (UFRPE), Recife, PE (Brazil)], e-mail: aidil_alencar@yahoo.com.br, e-mail: marines@ufrpe.br

    2009-07-01

    In order to investigate the effects of irradiation on the main characteristics of quality postharvest of three cultivated species of the Northeast Region of Brazil, experiments with cashew (Anacardium occidentale L. var. Nanum), sapodilla (Manilkara sapodilla (L) Van Royen) and mangaba (Hancornia speciosa Gomes) have been performed. Cashew peduncles stored for fourteen days under 6.5 deg C had presented best results in the sensorial analyses for external appearance, flavour and aroma when irradiated with 1 kGy. sapodillas irradiated with doses of 300, 600 and 900 Gy have not displayed harmed sensorial qualities when stored under 20 deg C during twelve days. Doses up to 800 Gy had not harmed the external and internal appearance of mangabas after being stored for a fortnight under 13 deg C. Chemical characteristics of TSS, TTA, pH and solid/acidity ratio have not been affected significantly by the different doses applied to the three studied species. Amount of ascorbic acid was lower in the irradiated fruits, with significant differences for the species Anacardium occidentale L. var. Nanum and Hancornia speciosa Gomes. (author)

  14. Characteristics of postharvest quality in regional fruits treate with ionizing radiation

    International Nuclear Information System (INIS)

    Silva, Josenilda M.; Villar, Heldio P.; Correia, Lidia C.S.A.; Maciel, Maria Ines S.

    2009-01-01

    In order to investigate the effects of irradiation on the main characteristics of quality postharvest of three cultivated species of the Northeast Region of Brazil, experiments with cashew (Anacardium occidentale L. var. Nanum), sapodilla (Manilkara sapodilla (L) Van Royen) and mangaba (Hancornia speciosa Gomes) have been performed. Cashew peduncles stored for fourteen days under 6.5 deg C had presented best results in the sensorial analyses for external appearance, flavour and aroma when irradiated with 1 kGy. sapodillas irradiated with doses of 300, 600 and 900 Gy have not displayed harmed sensorial qualities when stored under 20 deg C during twelve days. Doses up to 800 Gy had not harmed the external and internal appearance of mangabas after being stored for a fortnight under 13 deg C. Chemical characteristics of TSS, TTA, pH and solid/acidity ratio have not been affected significantly by the different doses applied to the three studied species. Amount of ascorbic acid was lower in the irradiated fruits, with significant differences for the species Anacardium occidentale L. var. Nanum and Hancornia speciosa Gomes. (author)

  15. Water reduction by constructed wetlands treating waste landfill leachate in a tropical region.

    Science.gov (United States)

    Ogata, Yuka; Ishigaki, Tomonori; Ebie, Yoshitaka; Sutthasil, Noppharit; Chiemchaisri, Chart; Yamada, Masato

    2015-10-01

    One of the key challenges in landfill leachate management is the prevention of environmental pollution by the overflow of untreated leachate. To evaluate the feasibility of constructed wetlands (CWs) for the treatment of waste landfill leachate in tropical regions, water reduction and pollutant removal by a CW subjected to different flow patterns (i.e., horizontal subsurface flow (HSSF) and free water surface (FWS)) were examined in both rainy and dry seasons in Thailand. A pilot-scale CW planted with cattail was installed at a landfill site in Thailand. With HSSF, the CW substantially removed pollutants from the landfill leachate without the need to harvest plants, whereas with FWS, it only slightly removed pollutants. Under both flow patterns, the CW significantly reduced the leachate volume to a greater extent than surface evaporation, which is regarded as an effect of the storage pond. Additionally, water reduction occurred regardless of season and precipitation, within the range 0-9 mm d(-1). In the case of low feeding frequency, water reduction by the CW with HSSF was lower than that with FWS. However, high feeding frequency improved water reduction by the CW with HSSF and resulted in a similar reduction to that observed with FWS, which exhibited maximum evapotranspiration. In terms of water reduction, with both HSSF in conjunction with high frequency feeding and FWS, the CW provided a high degree of evapotranspiration. However, pollutant removal efficiencies with HSSF were higher than for FWS. The present study suggested that CWs with HSSF and high frequency feeding could be useful for the prevention of uncontrollable dispersion of polluted leachate in the tropical climate zone. Copyright © 2015 Elsevier Ltd. All rights reserved.

  16. Complex emergencies in the Eastern Mediterranean Region: Impact on tuberculosis control.

    Science.gov (United States)

    Seita, Akihiro

    2016-12-01

    The Eastern Mediterranean Region (EMR) has witnessed the largest refugee crisis in history. Overall, 70% of the global refugee populations are from Palestine, Syria, Afghanistan, or Somalia. We reviewed the possible impact of such crisis on the tuberculosis situation in EMR. We used the available data and information from the World Health Organization and other international and national institutions. Overall, 15 out of 22 countries in the EMR are either engulfed in complex emergencies (10 countries) or suffering from their neighbors' complex emergencies (7 countries), whereas two countries suffer from both. Eighty-five percent of the total population (636 million) in the region lives in these 15 countries. For tuberculosis, these 15 countries account for a significant burden in EMR: 94% of the estimated total incidence of 740,000 cases a year and 95% of the estimated total mortality of 91,000 a year. These countries have yet to show the significant negative impact on tuberculosis epidemiology as such changes take considerable time to manifest. Still, there are reports on health systems impact: access to health facilities, destruction of health facilities, health staff casualties, and shortage of medicines. Complex emergencies pose a significant negative impact on tuberculosis in the EMR. This issue should be raised in the global health and political arena. This is a time bomb for tuberculosis. Copyright © 2016.

  17. Brazilian Policy and the Creation of a Regional Security Complex in the South Atlantic: Pax Brasiliana?

    Directory of Open Access Journals (Sweden)

    Beatriz Rodrigues Bessa Mattos

    Full Text Available Abstract Over the past five years, the South Atlantic region has become a central element of Brazilian security policy, with Brazil actively supporting the notion of a trans-oceanic security consciousness involving African littoral states. It has invested in diplomatic initiatives such as the Zone of Peace and Cooperation of the South Atlantic (ZPCSA, or ZOPACAS, and extensive military co-operation with West African states such as São Tomé e Príncipe, Namibia and Cape Verde. Its internal security and defence policy documents have repeatedly been updated to reflect this dimension, and now provide the foundation for advancing these initiatives. This policy thrust is directed at securing Brazil’s offshore oil assets, and limiting the influence of what it has termed ‘extra-regional powers’ such as the P-5. This article highlights these initiatives and reviews the prospects for this policy by examining the plausibility of the South Atlantic region as a regional security complex in the sense coined by Buzan and Wæver. The analysis is based on the role of geographical and linguistic proximity in international relations, and the impact of multilateral bodies on building support for a regional approach to security governance.

  18. Pinning-controlled synchronization of complex networks with bounded or unbounded synchronized regions

    International Nuclear Information System (INIS)

    Yan-Li, Zou; Guan-Rong, Chen

    2009-01-01

    This paper studies pinning-controlled synchronization of complex networks with bounded or unbounded synchronized regions. To study a state-feedback pinning-controlled network with N nodes, it first converts the controlled network to an extended network of N+1 nodes without controls. It is shown that the controlled synchronizability of the given network is determined by the real part of the smallest nonzero eigenvalue of the coupling matrix of its extended network when the synchronized region is unbounded; but it is determined by the ratio of the real parts of the largest and the smallest nonzero eigenvalues of the coupling matrix when the synchronized region is bounded. Both theoretical analysis and numerical simulation show that the portion of controlled nodes has no critical values when the synchronized region is unbounded, but it has a critical value when the synchronized region is bounded. In the former case, therefore, it is possible to control the network to achieve synchronization by pinning only one node. In the latter case, the network can achieve controlled synchronization only when the portion of controlled nodes is larger than the critical value. (general)

  19. A population-based study of sport and recreation-related head injuries treated in a Canadian health region.

    Science.gov (United States)

    Harris, Andrew W; Jones, C Allyson; Rowe, Brian H; Voaklander, Donald C

    2012-07-01

    To report the rates of SR-related HIs presenting to EDs in a Canadian population-based sample. Descriptive epidemiology study. Using administrative data, sport and recreation-related emergency department presentations for persons 0-35 years of age, from April 1997 through March 2008, were obtained from the Edmonton Zone (formerly the Capital Health Region), Alberta Health Services through the Ambulatory Care Classification System. Of the 3,230,890 visits to the emergency departments of the five hospitals in Edmonton, 63,219 sport and recreation-related injury records and 4935 sport and recreation-head injury records were identified. Head injuries were most frequently treated for the activities of hockey (20.7%), cycling (12.0%), and skiing/snowboarding/sledding. Males accounted for 71.9% (n=3546) and patients less than 18 years of age sustained 3446 (69.8%) sport and recreation-head injuries. Sport and recreation-related head injuries most frequently treated in emergency departments involve common activities such as hockey, cycling, skiing/snowboarding/sledding, and soccer. Males and those less than 18 years of age sustain the majority of sport and recreation-related head injuries treated in emergency departments. These findings underscore the importance of sport-specific policies and safety promotion for the prevention of head injuries, in sports and recreational activities. Copyright © 2011 Sports Medicine Australia. All rights reserved.

  20. Locally-regionally advanced tonsillar squamous cell carcinoma treated with concurrent chemoradiotherapy

    International Nuclear Information System (INIS)

    Krstevska, Valentina; Stojkovski, Igor

    2013-01-01

    Purpose: To perform a retrospective review of stage III-IV squamous cell carcinoma of the tonsil managed by definitive concurrent chemoradiotherapy (CCRT) in order to analyze the patients’ outcome and to evaluate the acute and late toxic effects of this treatment modality. Material and methods: Between January 2005 and December 2010, 36 patients with locally and/or regionally advanced tonsillar cancer underwent three dimensional conformal radiotherapy (3DCRT) with concurrent platinum-based chemotherapy. The dose prescription of the planning target volume for gross tumor and low-risk subclinical disease was 70 Gy and 50 Gy, respectively. Conventional fractionation with a daily dose of 2.0 Gy, 5 times per week was used. Concurrent chemotherapy consisted of cisplatin 30 mg/m2 given on a weekly basis. Acute and late radiotherapy-related toxicities were recorded using European Organization for Research and Treatment of Cancer/Radiation Therapy Oncology Group (EORTC/RTOG) grading system. The 3-year locoregional relapse-free survival (LRRFS), disease-free survival (DFS), and overall survival (OS) rates were calculated using the Kaplan-Meier method. Results: The median follow-up of all patients was 20.5 months (range, 5 to 90 months). The median followup of living patients was 59 months (range, 30 to 90 months). Complete response rates of the primary tumor and of the nodal disease were 72.2% and 64.0%, respectively. A complete composite response was present in 25 patients (69.4%). Treatment failure occurred in 15 out of 25 patients who achieved complete composite response following CCRT. The 3-year LRRFS, DFS, and OS rate was 38.8%, 27.8%, and 27.3%, respectively. Grade 3 mucositis occurred in 58.3% of patients. Xerostomia grade 2 was revealed in 72.2% of patients. Conclusion: Taking into account the low 3-year survival rates observed in our study and the high percentage of grade 2 xerostomia, it can be concluded that in the future, instead of 3DCRT with concurrent

  1. Are Pain-Related Fears Mediators for Reducing Disability and Pain in Patients with Complex Regional Pain Syndrome Type 1? An Explorative Analysis on Pain Exposure Physical Therapy

    Science.gov (United States)

    Barnhoorn, Karlijn J.; Staal, J. Bart; van Dongen, Robert T. M.; Frölke, Jan Paul M.; Klomp, Frank P.; van de Meent, Henk; Samwel, Han; Nijhuis-van der Sanden, Maria W. G.

    2015-01-01

    Objective To investigate whether pain-related fears are mediators for reducing disability and pain in patients with Complex Regional Pain Syndrome type 1 when treating with Pain Exposure Physical Therapy. Design An explorative secondary analysis of a randomised controlled trial. Participants Fifty-six patients with Complex Regional Pain Syndrome type 1. Interventions The experimental group received Pain Exposure Physical Therapy in a maximum of five treatment sessions; the control group received conventional treatment following the Dutch multidisciplinary guideline. Outcome measures Levels of disability, pain, and pain-related fears (fear-avoidance beliefs, pain catastrophizing, and kinesiophobia) were measured at baseline and after 3, 6, and 9 months follow-up. Results The experimental group had a significantly larger decrease in disability of 7.77 points (95% CI 1.09 to 14.45) and in pain of 1.83 points (95% CI 0.44 to 3.23) over nine months than the control group. The potential mediators pain-related fears decreased significantly in both groups, but there were no significant differences between groups, which indicated that there was no mediation. Conclusion The reduction of pain-related fears was comparable in both groups. We found no indication that pain-related fears mediate the larger reduction of disability and pain in patients with Complex Regional Pain Syndrome type 1 treated with Pain Exposure Physical Therapy compared to conventional treatment. Trial registration International Clinical Trials Registry NCT00817128 PMID:25919011

  2. Use of sequential diagnostic pain blocks in a patient of posttraumatic complex regional pain syndrome-not otherwise specified complicated by myofascial trigger points and thoracolumbar pain syndrome

    Directory of Open Access Journals (Sweden)

    Kailash Kothari

    2017-01-01

    Full Text Available We are presenting a case of posttraumatic lower limb Complex regional pain syndrome – Not otherwise specified (CRPS – NOS. As it was not treated in acute phase, the pain became chronic and got complicated by myofascial and thoracolumbar pain syndrome. This case posed us a diagnostic challenge. We used sequential diagnostic pain blocks to identify the pain generators and successfully treat the patient. We used diagnostic blocks step by step to identify and treat pain generators – T12,L1 and L2 Facet joints, Lumbar sympathetic block for CRPS NOS and Trigger point injection with dry needling for myofascial pain syndrome. This case highlights the facet that additional pain generators unrelated to original pain may complicate the presentation. Identifying these pain generators requires out of box thinking and high index of suspicion.

  3. Segmental Duplication, Microinversion, and Gene Loss Associated with a Complex Inversion Breakpoint Region in Drosophila

    Science.gov (United States)

    Calvete, Oriol; González, Josefa; Betrán, Esther; Ruiz, Alfredo

    2012-01-01

    Chromosomal inversions are usually portrayed as simple two-breakpoint rearrangements changing gene order but not gene number or structure. However, increasing evidence suggests that inversion breakpoints may often have a complex structure and entail gene duplications with potential functional consequences. Here, we used a combination of different techniques to investigate the breakpoint structure and the functional consequences of a complex rearrangement fixed in Drosophila buzzatii and comprising two tandemly arranged inversions sharing the middle breakpoint: 2m and 2n. By comparing the sequence in the breakpoint regions between D. buzzatii (inverted chromosome) and D. mojavensis (noninverted chromosome), we corroborate the breakpoint reuse at the molecular level and infer that inversion 2m was associated with a duplication of a ∼13 kb segment and likely generated by staggered breaks plus repair by nonhomologous end joining. The duplicated segment contained the gene CG4673, involved in nuclear transport, and its two nested genes CG5071 and CG5079. Interestingly, we found that other than the inversion and the associated duplication, both breakpoints suffered additional rearrangements, that is, the proximal breakpoint experienced a microinversion event associated at both ends with a 121-bp long duplication that contains a promoter. As a consequence of all these different rearrangements, CG5079 has been lost from the genome, CG5071 is now a single copy nonnested gene, and CG4673 has a transcript ∼9 kb shorter and seems to have acquired a more complex gene regulation. Our results illustrate the complex effects of chromosomal rearrangements and highlight the need of complementing genomic approaches with detailed sequence-level and functional analyses of breakpoint regions if we are to fully understand genome structure, function, and evolutionary dynamics. PMID:22328714

  4. Complex regional pain syndrome type 1 mimicking Raynaud’s phenomenon

    Directory of Open Access Journals (Sweden)

    Serpil Tuna

    2014-09-01

    Full Text Available Complex regional pain syndrome type 1 (CRPS-1 is a chronic pain syndrome characterized by severe pain, swelling, autonomic dysfunction and dystrophic changes in affected extremity. RSDS is a rare disease in children and usually occurs after trauma, however, without trauma may also occur. We were detected CRPS-1 activated by cold and stress and characterized by recurrent attacks in the bilateral upper extremities in 14 year-old girl, which is similar to Raynaud’s phenomenon. We present this case with the literature because of its rarity and atypical course.

  5. Inflammatory arthritis mimicking Complex Regional Pain Syndrome (CRPS) in a child: A case report.

    Science.gov (United States)

    Egilmez, Zeliha; Turgut, Selin Turan; Icagasioglu, Afitap; Bicakci, Irem

    2016-01-01

    Joint complaints in childhood are seen frequently and differential diagnosis can be difficult. Juvenile idiopathic arthritis (JIA) is the most common rheumatological disease of childhood. It involves peripheral joint arthritis, chronic synovitis, and extra-articular manifestations. Accurate diagnosis can take a long time and sometimes multiple diagnoses are used while following the patient until a final diagnosis can be reached. Arthritis may be triggered by trauma and confused with other diseases like complex regional pain syndrome (CRPS), in which trauma plays a role in the etiology. In the present case, ankle pain in an 8-year-old girl was misdiagnosed as CRPS.

  6. Clinical features and pathophysiology of Complex Regional Pain Syndrome – current state of the art

    Science.gov (United States)

    Marinus, Johan; Moseley, G. Lorimer; Birklein, Frank; Baron, Ralf; Maihöfner, Christian; Kingery, Wade S.; van Hilten, Jacobus J.

    2017-01-01

    That a minor injury can trigger a complex regional pain syndrome (CRPS) - multiple system dysfunction, severe and often chronic pain and disability - has fascinated scientists and perplexed clinicians for decades. However, substantial advances across several medical disciplines have recently increased our understanding of CRPS. Compelling evidence implicates biological pathways that underlie aberrant inflammation, vasomotor dysfunction, and maladaptive neuroplasticity in the clinical features of CRPS. Collectively, the evidence points to CRPS being a multifactorial disorder that is associated with an aberrant host response to tissue injury. Varying susceptibility to perturbed regulation of any of the underlying biological pathways probably accounts for the clinical heterogeneity of CRPS. PMID:21683929

  7. Radiofrequency ablation of stellate ganglion in a patient with complex regional pain syndrome

    Directory of Open Access Journals (Sweden)

    Chinmoy Roy

    2014-01-01

    Full Text Available Complex regional pain syndrome (CRPS is characterized by a combination of sensory, motor, vasomotor, pseudomotor dysfunctions and trophic signs. We describe the use of radiofrequency (RF ablation of Stellate ganglion (SG under fluoroscopy, for long-term suppression of sympathetic nervous system, in a patient having CRPS-not otherwise specified. Although the effects of thermal RF neurolysis may be partial or temporary, they may promote better conditions toward rehabilitation. The beneficial effect obtained by the RF neurolysis of SG in this particular patient strongly advocates the use of this mode of therapy in patients with CRPS.

  8. Post-traumatic complex regional pain syndrome: clinical features and epidemiology

    Science.gov (United States)

    Ratti, Chiara; Nordio, Andrea; Resmini, Giuseppina; Murena, Luigi

    2015-01-01

    Summary Complex Regional Pain Syndrome (CRPS) is a chronic pain condition that occurs after a tissue injury (fractures, sprain, surgery) of the upper or lower extremities. A clear pathophysiological mechanism has not been established yet and different patterns are considered to play a role in the genesis of the disease. The diagnosis is made by different diagnosis criteria and a gold standard has not been established yet. Incidence of CRPS is unclear and large prospective studies on the incidence and prevalence of CRPS are scarce. The aim of this review is to give an overview on the prevalent data regarding this chronic syndrome. PMID:27134626

  9. Bilateral Complex Regional Pain Syndrome after Fracture of Bilateral Tibia and Fibula

    Directory of Open Access Journals (Sweden)

    Senem Şaş

    2017-04-01

    Full Text Available Complex regional syndrome type 1 (CRPS-1 is a painful clinical condition. It occurs after a painful event and characterized by allodynia, hyperalgesia, edema, abnormalities in skin blood flow and abnormal sudomotor activity. When CRPS-1 is associated with nerve injury, it is defined as CRPS-2. Central and peripheral theory are responsible in etiopathogenesis of CRPS-1. Generally it occurs in the injured limb. But, it may ocur in the opposite extremities. In this article, we present a case developing bilateral CRPS-1 after bilateral tibia and fibula fracture by reviewing current literatüre.

  10. Pulsed Radiofrequency Treatment of Complex Regional Pain Syndrome: A Case Series

    Directory of Open Access Journals (Sweden)

    Vlad Djuric

    2014-01-01

    Full Text Available BACKGROUND: Various forms of sympathetic chain neurolysis (sympathectomy have, at one time or another, held promise as effective treatment options for complex regional pain syndrome (CRPS. Complications, such as worsening pain and the development of new pain syndromes, have prevented sympathectomy from emerging as a standard intervention. In an effort to avoid poor outcomes associated with neurolysis, pulsed radiofrequency (PRF has been proposed as a potential treatment alternative for a number of chronic neuropathic pain states, including some forms of CRPS.

  11. Imaging of Posttraumatic Arthritis, Avascular Necrosis, Septic Arthritis, Complex Regional Pain Syndrome, and Cancer Mimicking Arthritis.

    Science.gov (United States)

    Rupasov, Andrey; Cain, Usa; Montoya, Simone; Blickman, Johan G

    2017-09-01

    This article focuses on the imaging of 5 discrete entities with a common end result of disability: posttraumatic arthritis, a common form of secondary osteoarthritis that results from a prior insult to the joint; avascular necrosis, a disease of impaired osseous blood flow, leading to cellular death and subsequent osseous collapse; septic arthritis, an infectious process leading to destructive changes within the joint; complex regional pain syndrome, a chronic limb-confined painful condition arising after injury; and cases of cancer mimicking arthritis, in which the initial findings seem to represent arthritis, despite a more insidious cause. Copyright © 2017 Elsevier Inc. All rights reserved.

  12. Synaptonemal complex aberrations in the pseudoautosomal region of X, Y chromosomes in irradiated hamsters

    Energy Technology Data Exchange (ETDEWEB)

    Allen, J.W.; Collins, B.W. [Environmental Protection Agency, Research Triangle Park, NC (United States); Poorman-Allen, P. [Wellcome Research Lab., Research Triangle Park, N.C. (United States); Sontag, M.R. [Duke Univ., Durham, NC (United States). Medical Center

    1994-05-01

    The effects of X-radiation, bleomycin and amsacrine (m-AMSA) on the meiotic chromosomes of male Armenian hamsters were determined by electron microscopic analysis of synaptonemal complex (SC) damage. Pachytene stage cells were analyzed 5 or 6 days following their treatment at putative preleptotene-leptotene stages of meiosis. Of the multiple types of SC aberrations observed to be significantly increased over control levels, lateral element breakage and synaptic anomalies were most prevalent. The focus of these studies was on the sex chromosomes which, in the Armenian hamster, reveal an unusally well-defined pseudoautosomal region. In the XY pair, radiation and chemical treatments caused certain forms of structural and synaptic anomalies which appeared to be preferentially localized to telomeric and/or crossover regions. The nature of these specific aberrations, involving breakage, bridge formation and asynapsis, is not well understood; however, their distributions are suggestive of possible relationships with sites and processes of crossing over. (author).

  13. Lung deformations and radiation-induced regional lung collapse in patients treated with stereotactic body radiation therapy

    Energy Technology Data Exchange (ETDEWEB)

    Diot, Quentin, E-mail: quentin.diot@ucdenver.edu; Kavanagh, Brian; Vinogradskiy, Yevgeniy; Gaspar, Laurie; Miften, Moyed [Department of Radiation Oncology, University of Colorado School of Medicine, Aurora, Colorado 80045 (United States); Garg, Kavita [Department of Radiology, University of Colorado School of Medicine, Aurora, Colorado 80045 (United States)

    2015-11-15

    Purpose: To differentiate radiation-induced fibrosis from regional lung collapse outside of the high dose region in patients treated with stereotactic body radiation therapy (SBRT) for lung tumors. Methods: Lung deformation maps were computed from pre-treatment and post-treatment computed tomography (CT) scans using a point-to-point translation method. Fifty anatomical landmarks inside the lung (vessel or airway branches) were matched on planning and follow-up scans for the computation process. Two methods using the deformation maps were developed to differentiate regional lung collapse from fibrosis: vector field and Jacobian methods. A total of 40 planning and follow-ups CT scans were analyzed for 20 lung SBRT patients. Results: Regional lung collapse was detected in 15 patients (75%) using the vector field method, in ten patients (50%) using the Jacobian method, and in 12 patients (60%) by radiologists. In terms of sensitivity and specificity the Jacobian method performed better. Only weak correlations were observed between the dose to the proximal airways and the occurrence of regional lung collapse. Conclusions: The authors presented and evaluated two novel methods using anatomical lung deformations to investigate lung collapse and fibrosis caused by SBRT treatment. Differentiation of these distinct physiological mechanisms beyond what is usually labeled “fibrosis” is necessary for accurate modeling of lung SBRT-induced injuries. With the help of better models, it becomes possible to expand the therapeutic benefits of SBRT to a larger population of lung patients with large or centrally located tumors that were previously considered ineligible.

  14. Block-induced Complex Structures Building the Flare-productive Solar Active Region 12673

    Energy Technology Data Exchange (ETDEWEB)

    Yang, Shuhong; Zhang, Jun [CAS Key Laboratory of Solar Activity, National Astronomical Observatories, Chinese Academy of Sciences, Beijing 100012 (China); Zhu, Xiaoshuai [Max-Planck Institute for Solar System Research, D-37077 Göttingen (Germany); Song, Qiao, E-mail: shuhongyang@nao.cas.cn [Key Laboratory of Space Weather, National Center for Space Weather, China Meteorological Administration, Beijing 100081 (China)

    2017-11-10

    Solar active region (AR) 12673 produced 4 X-class, 27 M-class, and numerous lower-class flares during its passage across the visible solar disk in 2017 September. Our study is to answer the questions why this AR was so flare-productive and how the X9.3 flare, the largest one of the past decade, took place. We find that there was a sunspot in the initial several days, and then two bipolar regions emerged nearby it successively. Due to the standing of the pre-existing sunspot, the movement of the bipoles was blocked, while the pre-existing sunspot maintained its quasi-circular shaped umbra only with the disappearance of a part of penumbra. Thus, the bipolar patches were significantly distorted, and the opposite polarities formed two semi-circular shaped structures. After that, two sequences of new bipolar regions emerged within the narrow semi-circular zone, and the bipolar patches separated along the curved channel. The new bipoles sheared and interacted with the previous ones, forming a complex topological system, during which numerous flares occurred. At the highly sheared region, a great deal of free energy was accumulated. On September 6, one negative patch near the polarity inversion line began to rapidly rotate and shear with the surrounding positive fields, and consequently the X9.3 flare erupted. Our results reveal that the block-induced complex structures built the flare-productive AR and the X9.3 flare was triggered by an erupting filament due to the kink instability. To better illustrate this process, a block-induced eruption model is proposed for the first time.

  15. Impaired insula functional connectivity associated with persistent pain perception in patients with complex regional pain syndrome

    Science.gov (United States)

    Jang, Joon Hwan; Lee, Do-Hyeong; Lee, Kyung-Jun; Lee, Won Joon; Moon, Jee Youn; Kim, Yong Chul

    2017-01-01

    Given that the insula plays a contributory role in the perception of chronic pain, we examined the resting-state functional connectivity between the insular cortex and other brain regions to investigate neural underpinnings of persisting perception of background pain in patients with complex regional pain syndrome (CRPS). A total of 25 patients with CRPS and 25 matched healthy controls underwent functional magnetic resonance imaging at rest. With the anterior and posterior insular cortices as seed regions, we compared the strength of the resting-state functional connectivity between the two groups. Functional connectivity between the anterior and posterior insular cortices and the postcentral and inferior frontal gyri, cingulate cortices was reduced in patients with CRPS compared with controls. Additionally, greater reductions in functional connectivity between the anterior insula and right postcentral gyrus were associated with more severe sensory pain in patients with CRPS (short-form McGill Pain Questionnaire sensory subscores, r = -.517, P = .023). The present results imply a possible role of the insula in aberrant processing of pain information in patients with CRPS. The findings suggest that a functional derangement of the connection between one of the somatosensory cortical functions of perception and one of the insular functions of awareness can play a significant role in the persistent experience of regional pain that is not confined to a specific nerve territory. PMID:28692702

  16. Genes involved in complex adaptive processes tend to have highly conserved upstream regions in mammalian genomes

    Directory of Open Access Journals (Sweden)

    Kohane Isaac

    2005-11-01

    Full Text Available Abstract Background Recent advances in genome sequencing suggest a remarkable conservation in gene content of mammalian organisms. The similarity in gene repertoire present in different organisms has increased interest in studying regulatory mechanisms of gene expression aimed at elucidating the differences in phenotypes. In particular, a proximal promoter region contains a large number of regulatory elements that control the expression of its downstream gene. Although many studies have focused on identification of these elements, a broader picture on the complexity of transcriptional regulation of different biological processes has not been addressed in mammals. The regulatory complexity may strongly correlate with gene function, as different evolutionary forces must act on the regulatory systems under different biological conditions. We investigate this hypothesis by comparing the conservation of promoters upstream of genes classified in different functional categories. Results By conducting a rank correlation analysis between functional annotation and upstream sequence alignment scores obtained by human-mouse and human-dog comparison, we found a significantly greater conservation of the upstream sequence of genes involved in development, cell communication, neural functions and signaling processes than those involved in more basic processes shared with unicellular organisms such as metabolism and ribosomal function. This observation persists after controlling for G+C content. Considering conservation as a functional signature, we hypothesize a higher density of cis-regulatory elements upstream of genes participating in complex and adaptive processes. Conclusion We identified a class of functions that are associated with either high or low promoter conservation in mammals. We detected a significant tendency that points to complex and adaptive processes were associated with higher promoter conservation, despite the fact that they have emerged

  17. Household possession, use and non-use of treated or untreated mosquito nets in two ecologically diverse regions of Nigeria – Niger Delta and Sahel Savannah

    Directory of Open Access Journals (Sweden)

    Otsemobor Peju

    2009-02-01

    Full Text Available Abstract Background Current use of treated mosquito nets for the prevention of malaria falls short of what is expected in sub-Saharan Africa (SSA, though research within the continent has indicated that the use of these commodities can reduce malaria morbidity by 50% and malaria mortality by 20%. Governments in sub-Sahara Africa are investing substantially in scaling-up treated mosquito net coverage for impact. However, certain significant factors still prevent the use of the treated mosquito nets, even among those who possess them. This survey examines household ownership as well as use and non-use of treated mosquito nets in Sahel Savannah and Niger Delta regions of Nigeria. Methodology This survey employed cross-sectional survey to collect data from households on coverage and use of mosquito nets, whether treated or not. Fever episodes in previous two weeks among children under the age of five were also recorded. The study took place in August 1 – 14 2007, just five months after the March distribution of treated mosquito nets, coinciding with the second raining period of the year and a time of high malaria transmission during the wet season. EPI INFO version 2003 was used in data analysis. Results The survey covered 439 households with 2,521 persons including 739 under-fives, 585 women in reproductive age and 78 pregnant women in Niger Delta Region and Sahel Savannah Region. Of the 439 HHs, 232 had any mosquito nets. Significantly higher proportion of households in the Niger Delta Region had any treated or untreated mosquito nets than those in the Sahel Savannah Region. In the Niger Delta Region, the proportion of under-fives that had slept under treated nets the night before the survey exceeded those that slept under treated nets in the Sahel Savannah Region. Children under the age of five years in the Niger Delta Region were four times more likely to sleep under treated nets than those in the Sahel Savannah Region. Conclusion This study

  18. Fear of pain in children and adolescents with neuropathic pain and complex regional pain syndrome.

    Science.gov (United States)

    Simons, Laura E

    2016-02-01

    A significant proportion of children and adolescents with chronic pain endorse elevated pain-related fear. Pain-related fear is associated with high levels of disability, depressive symptoms, and school impairment. Because of faulty nerve signaling, individuals with neuropathic pain and complex regional pain syndrome may be more prone to develop pain-related fear as they avoid use of and neglect the affected body area(s), resulting in exacerbated symptoms, muscle atrophy, maintenance of pain signaling, and ongoing pain-related disability. Not surprisingly, effective treatments for elevated pain-related fears involve exposure to previously avoided activities to downregulate incorrect pain signaling. In the context of intensive interdisciplinary pain treatment of youth with neuropathic pain, decreasing pain-related fear is associated with improved physical and psychological functioning, whereas high initial pain-related fear is a risk factor for less treatment responsiveness. An innovative approach to targeting pain-related fear and evidence of a neural response to treatment involving decoupling of the amygdala with key fear circuits in youth with complex regional pain syndrome suggest breakthroughs in our ability to ameliorate these issues.

  19. Evaluation of Optimized WRF Precipitation Forecast over a Complex Topography Region during Flood Season

    Directory of Open Access Journals (Sweden)

    Yuan Li

    2016-11-01

    Full Text Available In recent years, the Weather Research and Forecast (WRF model has been utilized to generate quantitative precipitation forecasts with higher spatial and temporal resolutions. However, factors including horizontal resolution, domain size, and the physical parameterization scheme have a strong impact on the dynamic downscaling ability of the WRF model. In this study, the influence of these factors has been analyzed in precipitation forecasting for the Xijiang Basin, southern China—a region with complex topography. The results indicate that higher horizontal resolutions always result in higher Critical Success Indexes (CSI, but higher biases as well. Meanwhile, the precipitation forecast skills are also influenced by the combination of microphysics parameterization scheme and cumulus convective parameterization scheme. On the basis of these results, an optimized configuration of the WRF model is built in which the horizontal resolution is 10 km, the microphysics parameterization is the Lin scheme, and the cumulus convective parameterization is the Betts–Miller–Janjic scheme. This configuration is then evaluated by simulating the daily weather during the 2013–2014 flood season. The high Critical Success Index scores and low biases at various thresholds and lead times confirm the high accuracy of the optimized WRF model configuration for Xijiang Basin. However, the performance of the WRF model varies from different sub-basins due to the complexity of the mesoscale convective system (MCS over this region.

  20. Path Complexity in Virtual Water Maze Navigation: Differential Associations with Age, Sex, and Regional Brain Volume.

    Science.gov (United States)

    Daugherty, Ana M; Yuan, Peng; Dahle, Cheryl L; Bender, Andrew R; Yang, Yiqin; Raz, Naftali

    2015-09-01

    Studies of human navigation in virtual maze environments have consistently linked advanced age with greater distance traveled between the start and the goal and longer duration of the search. Observations of search path geometry suggest that routes taken by older adults may be unnecessarily complex and that excessive path complexity may be an indicator of cognitive difficulties experienced by older navigators. In a sample of healthy adults, we quantify search path complexity in a virtual Morris water maze with a novel method based on fractal dimensionality. In a two-level hierarchical linear model, we estimated improvement in navigation performance across trials by a decline in route length, shortening of search time, and reduction in fractal dimensionality of the path. While replicating commonly reported age and sex differences in time and distance indices, a reduction in fractal dimension of the path accounted for improvement across trials, independent of age or sex. The volumes of brain regions associated with the establishment of cognitive maps (parahippocampal gyrus and hippocampus) were related to path dimensionality, but not to the total distance and time. Thus, fractal dimensionality of a navigational path may present a useful complementary method of quantifying performance in navigation. © The Author 2014. Published by Oxford University Press. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

  1. Acute esophagitis for patients with local-regional advanced non small cell lung cancer treated with concurrent chemoradiotherapy

    DEFF Research Database (Denmark)

    Pan, Yi; Brink, Carsten; Knap, Marianne

    2016-01-01

    PURPOSE: Esophagitis is common in patients treated with definitive radiotherapy for local-regional advanced non small cell lung cancer (NSCLC). The purpose of this study was to estimate the dose-effect relationship using clinical and dosimetric parameters in patients receiving intensity modulated...... significantly associated with esophagitis. The two models using the relative esophagus volume irradiated above 40Gy (V40, OR=2.18/10% volume) or the length of esophagus irradiated above 40Gy (L40, OR=4.03/5cm) were optimal. The upper part of esophagus was more sensitive and females experienced more toxicity...... than men. CONCLUSION: V40 and L40 were most effective dosimetric predictors of grade ⩾2 esophagitis. The upper part of esophagus was more sensitive....

  2. Relation between the treated region of the patient with ca. of the uterine cervix and her body-type in whole pelvis irradiation with conformation technique

    International Nuclear Information System (INIS)

    Morita, Kozo; Kakehi, Masae

    1975-01-01

    In whole pelvis irradiation using the conformation technique for the patient with carcinoma of the uterine cervix, standardization of the shape of the treated region was tried on the basis of measuring the pelvis in X-ray films. This was done on the X-rays of 200 patients with carcinoma of the uterine cervix. The body-type of the patient the most remarkably influenced the shape of the treated region. Ten clinical types of cam-group (treated region) were determined, in order to perform conformation radiotherapy for carcinoma of the uterine cervix. Although the shape of the treated region could also be changed by the invasion of the lesion, the position of the portio and the general condition of the patients, these 10 standard types of cam-group can be applied practically to almost all of the patients. (Evans, J.)

  3. Complex pegmatite - apelitic of Cabecinha - strategies appreciation of geological heritage and economic development of the region

    Science.gov (United States)

    Nobre, José; Cabral, Tiago; Cabral, João; Gomes, Ana

    2014-05-01

    The Complex pegmatite - apelitic of Cabecinha corresponds to an isolated ridge that reaches 933 meters, located in the middle zone of transition between the Hesperian massif and the Cova da Beira being located in the NE central part of Portugal, more specifically in the Mountainous region of the province of Beira Alta, council of Sabugal. This complex lies embedded in porphyritic granites with terms of switching to a medium-grained granite rich in sodium feldspars in which they are muscovite granite intrusions. The lodes have pegmatites with NE-SW orientation, presenting phases of predominantly quartz crystallization with multiple parageneses. The inclusions observed are veins filonianian secondary. Some veins have structural discontinuity due to further their training tectonics. The apelitico material is basic in nature engaging in descontinuiddes of pegmatite material, showing no preferred orientation. The petrological characteristics of the area in question provide the appearance of motivating exotic landforms of scientific interest. These landforms, over time, have motivated the popular level the emergence of various myths, thus contributing to the enrichment of the local cultural heritage. This study proceeded to the geological and geomorphological mapping an area of about 6945,350 m2 with a maximum length of 182 m. The huge patent mineralogical, petrological and geomorphological level geodiversity, allied to the structural complexity and associated cultural heritage, allow geoconservation strategies and recovery, using new multimedia technologies including use of QR codes and 3D. All this geological framework and environment becomes an asset for the scientific, educational and economic development of the region. On the other hand, it has the vital Importance in the context of the strategy of forming a geological park, in the point of view of tourism, research and interpretation.

  4. Lack of genetic association of neutral endopeptidase (NEP) with complex regional pain syndrome (CRPS).

    Science.gov (United States)

    Huehne, Kathrin; Schaal, Ute; Leis, Stefan; Uebe, Steffen; Gosso, M Florencia; van den Maagdenberg, Arn M J M; Maihöfner, Christian; Birklein, Frank; Rautenstrauss, Bernd; Winterpacht, Andreas

    2010-03-12

    Complex regional pain syndrome (CRPS) is a condition that is characterized by severe pain and exaggerated neurogenic inflammation, which may develop after injury or surgery. Neurogenic inflammation is mediated by neuropeptides, such as calcitonin gene-related peptide (CGRP) and substance P (SP) that are released from nociceptors. Genetic factors may play a role in CRPS as was suggested by the occurrence of familial cases and several genetic association studies investigating mainly the human leukocyte antigen (HLA) system. Here we investigated the role of neutral endopeptidase (NEP), a key enzyme in neuropeptide catabolism. NEP dysfunction resulting in reduced inactivation of neuropeptides may be a possible pathomechanism in CRPS. To this end, we tested a GT-repeat polymorphism in the NEP promoter region as well as 18 tag-SNPs in six linkage disequilibrium (LD) blocks in the NEP gene region in 320 CRPS patients and 376 controls. No significant genetic association was observed. Thus, we conclude that the NEP gene does not seem to be a major risk factor for CRPS. Copyright 2010 Elsevier Ireland Ltd. All rights reserved.

  5. Dynamical downscaling of ERA-40 in complex terrain using the WRF regional climate model

    Energy Technology Data Exchange (ETDEWEB)

    Heikkilae, U. [Bjerknes Centre for Climate Research, Uni Bjerknes Centre, Bergen (Norway); Sandvik, A. [Bjerknes Centre for Climate Research, Institute for Marine Research (IMR), Bergen (Norway); Sorteberg, A. [University of Bergen, Geophysical Institute, Bergen (Norway)

    2011-10-15

    Results from a first-time employment of the WRF regional climate model to climatological simulations in Europe are presented. The ERA-40 reanalysis (resolution 1 ) has been downscaled to a horizontal resolution of 30 and 10 km for the period of 1961-1990. This model setup includes the whole North Atlantic in the 30 km domain and spectral nudging is used to keep the large scales consistent with the driving ERA-40 reanalysis. The model results are compared against an extensive observational network of surface variables in complex terrain in Norway. The comparison shows that the WRF model is able to add significant detail to the representation of precipitation and 2-m temperature of the ERA-40 reanalysis. Especially the geographical distribution, wet day frequency and extreme values of precipitation are highly improved due to the better representation of the orography. Refining the resolution from 30 to 10 km further increases the skill of the model, especially in case of precipitation. Our results indicate that the use of 10-km resolution is advantageous for producing regional future climate projections. Use of a large domain and spectral nudging seems to be useful in reproducing the extreme precipitation events due to the better resolved synoptic scale features over the North Atlantic, and also helps to reduce the large regional temperature biases over Norway. This study presents a high-resolution, high-quality climatological data set useful for reference climate impact studies. (orig.)

  6. Central Asia as a Regional Security Complex from the Perspectives of Realism, Liberalism and Constructivism

    Directory of Open Access Journals (Sweden)

    Caroline Putri Pratama

    2013-05-01

    Full Text Available Tulisan ini bertujuan menganalisis kawasan Asia Tengah, dilihat dari perspektif Realisme, Liberalisme dan Konstruktivisme, melalui teori Regional Security Complex oleh Barry Buzan dan Ole Waever. Teori ini hendak menunjukkan keamanan regional berdasarkan interdependensi antar unit dalam kawasan dilihat dari struktur power dan proses sekuritisasi di dalamnya, demikian pola hubungan keamanan dalam kawasan Asia Tengah berusaha dijelaskan dengan elemen-elemen dari ketiga paradigma yang terdapat dalam teori tersebut. Hasil analisis tulisan ini menunjukkan bahwa Asia Tengah dipandang sebagai bentuk insecurity interdependence by external forces dari perspektif Realis, security interdependence by interest dari perspektif Liberalis dan securitization interdependence by understanding of threat/security dari perspektif Konstruktivis. Kompleks keamanan Asia Tengah termasuk dalam tipe kompleks keamanan Great Power, terlihat dari peran besar kekuatan-kekuatan eksternal terutama Rusia dan Cina dalam kawasan tersebut; baik dalam pembentukan pola pertemanan dengan kerjasama, pola permusuhan dengan persaingan dan ketakutan, juga proses sekuritisasi isu separatisme, ekstremisme dan terorisme sebagai ancaman terhadap keamanan regional.Tulisan ini diambil dari tugas karya akhir penulis yang diajukan untuk medapatkan gelar Sarjana Sosial dari Departemen Ilmu Hubungan Internasional, Universitas Indonesia.

  7. Are you better? A multi-centre study of patient-defined recovery from Complex Regional Pain Syndrome

    DEFF Research Database (Denmark)

    Llewellyn, A; McCabe, CS; Hibberd, Y

    2018-01-01

    Background: Complex Regional Pain Syndrome (CRPS) symptoms can significantly differ between patients, fluctuate over time, disappear or persist. This leads to problems in defining recovery and in evaluating the efficacy of therapeutic interventions. Objectives: To define recovery from the patient...

  8. Cambrian nepheline syenite complex at Jabal Sawda, Midyan region, Kingdom of Saudi Arabia

    Science.gov (United States)

    Liddicoat, W.K.; Ramsay, C.R.; Hedge, C.E.

    1986-01-01

    The only nepheline syenite complex presently known in the Arabian Shield is at Jabal Sawda, about 30 km S of Haql in the extreme NW of Saudi Arabia. It is a post-tectonic, composite intrusion with a crudely concentric structure. A core of leuco-nepheline syenite, a partial ring of mela-nepheline syenite, and an almost complete outer ring of alkali-feldspar syenite are the main rock units. Several mega-inclusions of porphyritic nepheline syenite, nepheline monzosyenite, malignite and ijolite are present in the leuco-nepheline syenite. The chemical composition is notable for very high values of Al2O3, Na2O, Ba, La, Nb, Sr and Zr. U{single bond}Pb isotope dating indicates an emplacement age of 553 ?? 4 Ma, one of an increasing number of reliable Cambrian isotope dates in the northern Red Sea region. ?? 1986.

  9. Association of Neglect-Like Symptoms with Anxiety, Somatization, and Depersonalization in Complex Regional Pain Syndrome.

    Science.gov (United States)

    Michal, Matthias; Adler, Julia; Reiner, Iris; Wermke, Andreas; Ackermann, Tatiana; Schlereth, Tanja; Birklein, Frank

    2017-04-01

    Many patients with complex regional pain syndrome (CRPS) report some foreignness of the affected limb, which is referred to as "neglect-like symptoms" (NLS). Despite similarities of the NLS reports to symptoms of body image disturbances in mental disorders, no study has been conducted to examine such associations. We investigated 50 patients with CRPS and 45 pain control patients (N = 27, chronic limb pain; N = 18, migraine headache). NLS, anxiety, depression, depersonalization, and somatization were assessed using validated questionnaires. Seventy-two percent of the CRPS patients reported at least one NLS vs 29.6% and 33.3% in the two patient control groups. In limb pain controls, NLS correlated with pain intensity. In CRPS patients, NLS correlated with anxiety (rho = 0.658, P  psychological studies. © 2016 American Academy of Pain Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

  10. Complex regional pain syndrome with associated chest wall dystonia: a case report

    Directory of Open Access Journals (Sweden)

    Schwartzman Robert J

    2011-09-01

    Full Text Available Abstract Patients with complex regional pain syndrome (CRPS often suffer from an array of associated movement disorders, including dystonia of an affected limb. We present a case of a patient with long standing CRPS after a brachial plexus injury, who after displaying several features of the movement disorder previously, developed painful dystonia of chest wall musculature. Detailed neurologic examination found palpable sustained contractions of the pectoral and intercostal muscles in addition to surface allodynia. Needle electromyography of the intercostal and paraspinal muscles supported the diagnosis of dystonia. In addition, pulmonary function testing showed both restrictive and obstructive features in the absence of a clear cardiopulmonary etiology. Treatment was initiated with intrathecal baclofen and the patient had symptomatic relief and improvement of dystonia. This case illustrates a novel form of the movement disorder associated with CRPS with response to intrathecal baclofen treatment.

  11. Motor imagery and its effect on complex regional pain syndrome: an integrative review

    Directory of Open Access Journals (Sweden)

    Nélio Silva de Souza

    2015-12-01

    Full Text Available The motor imagery (MI has been proposed as a treatment in the complex regional pain syndrome type 1 (CRPS-1, since it seems to promote a brain reorganization effect on sensory- motor areas of pain perception. The aim of this paper is to investigate, through an integrative critical review, the influence of MI on the CRPS-1, correlating their evidence to clinical practice. Research in PEDro, Medline, Bireme and Google Scholar databases was conducted. Nine randomized controlled trials (level 2, 1 non-controlled clinical study (level 3, 1 case study (level 4, 1 systematic review (level 1, 2 review articles and 1 comment (level 5 were found. We can conclude that MI has shown effect in reducing pain and functionality that remains after 6 months of treatment. However, the difference between the MI strategies for CRPS-1 is unknown as well as the intensity of mental stress influences the painful response or effect of MI or other peripheral neuropathies.

  12. Molecular signature of complex regional pain syndrome (CRPS) and its analysis.

    Science.gov (United States)

    König, Simone; Schlereth, Tanja; Birklein, Frank

    2017-10-01

    Complex Regional Pain Syndrome (CRPS) is a rare, but often disabling pain disease. Biomarkers are lacking, but several inflammatory substances have been associated with the pathophysiology. This review outlines the current knowledge with respect to target biomolecules and the analytical tools available to measure them. Areas covered: Targets include cytokines, neuropeptides and resolvins; analysis strategies are thus needed for different classes of substances such as proteins, peptides, lipids and small molecules. Traditional methods like immunoassays are of importance next to state-of-the art high-resolution mass spectrometry techniques and 'omics' approaches. Expert commentary: Future biomarker studies need larger cohorts, which improve subgrouping of patients due to their presumed pathophysiology, and highly standardized workflows from sampling to analysis.

  13. Complex organic molecules toward low-mass and high-mass star forming regions

    Science.gov (United States)

    Favre, C.; Ceccarelli, C.; Lefloch, B.; Bergin, E.; Carvajal, M.; Brouillet, N.; Despois, D.; Jørgensen, J.; Kleiner, I.

    2016-12-01

    One of the most important questions in molecular astrophysics is how, when, and where complex organic molecules, COMs (≥ 6 atoms) are formed. In the Interstellar-Earth connection context, could this have a bearing on the origin of life on Earth? Formation mechanisms of COMs, which include potentially prebiotic molecules, are still debated and may include grain-mantle and/or gas-phase chemistry. Understanding the mechanisms that lead to the interstellar molecular complexification, along with the involved physicochemical processes, is mandatory to answer the above questions. In that context, active researches are ongoing in theory, laboratory experiment, chemical modeling and observations. Thanks to recent progress in radioastronomy instrumentation for both single-dish and millimeter array (e.g. Herschel, NOEMA, ALMA), new results have been obtained. I will review some notable results on the detection of COMs, including prebiotic molecules, towards star forming regions.

  14. Cambrian nepheline syenite complex at Jabal Sawda, Midyan region, Kingdom of Saudi Arabia

    Science.gov (United States)

    Liddicoat, W. K.; Ramsay, C. R.; Hedge, C. E.

    The only nepheline syenite complex presently known in the Arabian Shield is at Jabal Sawda, about 30 km S of Haql in the extreme NW of Saudi Arabia. It is a post-tectonic, composite intrusion with a crudely concentric structure. A core of leuco-nepheline syenite, a partial ring of mela-nepheline syenite, and an almost complete outer ring of alkali-feldspar syenite are the main rock units. Several mega-inclusions of porphyritic nepheline syenite, nepheline monzosyenite, malignite and ijolite are present in the leuco-nepheline syenite. The chemical composition is notable for very high values of Al 2O 3, Na 2O, Ba, La, Nb, Sr and Zr. U sbnd Pb isotope dating indicates an emplacement age of 553 ± 4 Ma, one of an increasing number of reliable Cambrian isotope dates in the northern Red Sea region.

  15. Antiallodynic Effects of Bee Venom in an Animal Model of Complex Regional Pain Syndrome Type 1 (CRPS-I).

    Science.gov (United States)

    Lee, Sung Hyun; Lee, Jae Min; Kim, Yun Hong; Choi, Jung Hyun; Jeon, Seung Hwan; Kim, Dong Kyu; Jeong, Hyeon Do; Lee, You Jung; Park, Hue Jung

    2017-09-15

    Neuropathic pain in a chronic post-ischaemic pain (CPIP) model mimics the symptoms of complex regional pain syndrome type I (CRPS I). The administration of bee venom (BV) has been utilized in Eastern medicine to treat chronic inflammatory diseases accompanying pain. However, the analgesic effect of BV in a CPIP model remains unknown. The application of a tight-fitting O-ring around the left ankle for a period of 3 h generated CPIP in C57/Bl6 male adult mice. BV (1 mg/kg ; 1, 2, and 3 times) was administered into the SC layer of the hind paw, and the antiallodynic effects were investigated using the von Frey test and by measuring the expression of neurokinin type 1 (NK-1) receptors in dorsal root ganglia (DRG). The administration of BV dose-dependently reduced the pain withdrawal threshold to mechanical stimuli compared with the pre-administration value and with that of the control group. After the development of the CPIP model, the expression of NK-1 receptors in DRG increased and then decreased following the administration of BV. SC administration of BV results in the attenuation of allodynia in a mouse model of CPIP. The antiallodynic effect was objectively proven through a reduction in the increased expression of NK-1 receptors in DRG.

  16. Venipuncture-Induced Complex Regional Pain Syndrome: A Case Report and Review of the Literature

    Directory of Open Access Journals (Sweden)

    Foad Elahi

    2014-01-01

    Full Text Available Venipuncture, the most frequently performed invasive medical procedure, is usually benign. Generally it produces only transitory mild discomfort. Venipuncture-induced neuropathic pain is hard to recognize at an early stage. Medical literature reviews show that there is not adequate medical knowledge about this important subject. The inciting incident in complex regional pain syndrome (CRPS can often seem far too trivial to result in a condition with such severe pathophysiologic effects. The practicing physician has little information available to enable early recognition of the condition, initiation of multidisciplinary treatment modalities, and proper referral to pain specialists. We encountered a unique case of venipuncture-induced complex regional pain syndrome (CRPS. The patient is a 52-year-old school teacher with no significant past medical history, who presented initially to the Center of Pain Medicine with left upper extremity pain. The pain started while phlebotomy was performed in the patient’s left antecubital area for routine blood check. The patient’s pain did not improve with multiple medications, physical therapy, or several nerve blocks. The patient demonstrated all the signs and symptoms of chronic neuropathic pain of CRPS in the upper extremity with minimal response to the continuous pain management. We decided to proceed with cervical spinal cord nerve stimulation along with continuing other modalities. The patient responded to this combination. During the follow-up, we noticed that the patient’s pain course was complicated by extension of the CRPS to her lower extremity. We will describe the course of treatment for the patient in this paper. In this paper we will discuss the electrical neuromodulation as an important modality in addition to the multidisciplinary pain management for a patient with venipuncture-induced chronic neuropathic pain.

  17. An immunohistochemical study of the triangular fibrocartilage complex of the wrist: regional variations in cartilage phenotype

    Science.gov (United States)

    Milz, S; Sicking, B; Sprecher, C M; Putz, R; Benjamin, M

    2007-01-01

    The triangular fibrocartilage complex (TFCC) transmits load from the wrist to the ulna and stabilizes the distal radioulnar joint. Damage to it is a major cause of wrist pain. Although its basic structure is well established, little is known of its molecular composition. We have analysed the immunohistochemical labelling pattern of the extracellular matrix of the articular disc and the meniscal homologue of the TFCC in nine elderly individuals (age range 69–96 years), using a panel of monoclonal antibodies directed against collagens, glycosaminoglycans, proteoglycans and cartilage oligomeric matrix protein (COMP). Although many of the molecules (types I, III and VI collagen, chondroitin 4 sulphate, dermatan sulphate and keratan sulphate, the oversulphated epitope of chondroitin 6 sulphate, versican and COMP) were found in all parts of the TFCC, aggrecan, link protein and type II collagen were restricted to the articular disc and to entheses. They were thus not a feature of the meniscal homologue. The shift in tissue phenotype within the TFCC, from a fibrocartilaginous articular disc to a more fibrous meniscal homologue, correlates with biomechanical data suggesting that the radial region is stiff and subject to considerable stress concentration. The presence of aggrecan, link protein and type II collagen in the articular disc could explain why the TFCC is destroyed in rheumatoid arthritis, given that it has been suggested that autoimmunity to these antigens results in the destruction of articular cartilage. The differential distribution of aggrecan within the TFCC is likely to be reflected by regional differences in water content and mobility on the radial and ulnar side. This needs to be taken into account in the design of improved MRI protocols for visualizing this ulnocarpal complex of the wrist. PMID:17532798

  18. Granulitic orthogneisses geochemistry of Caraiba complex, in Riachao do Jacuipe region - Bahia state, Brazil

    International Nuclear Information System (INIS)

    Teixeira, L.R.; Mello, R.C.

    1990-01-01

    This paper describes the granulitic orthogneisses of the Riachao do Jacuipe unit (Caraiba Complex) petrographicaly classified as tonalitic (predominating), trondhjemitic, granodioritic and quartz dioritic hyperstene gneisses. The chemical composition of the orthogneisses is dominantly tonalitic/granodioritic, that is typical of a calc-alkaline parentage depleted in K and enriched in Al sub(2) O sub(3). Their geochemical characteristics are very similar to those of the grey gneisses of other regions of the world, usually named TTG (tonalite-trondhhemite-granodiorite). In the sequence of orthogneiss coexist rocks both normal and depleted in LILE. The patterns of distribution of highly fractioned REE (La/YbN ratio up to 102) with Eu anomaly small or absent points against a direct mantle origin. On the other hand the only Rb-Sr age determination in the se rocks gives an age of 2,35 Ga with an initial ratio (Ro) of 0,702. This initial ratio suggests that the rocks did not originated from reworking of a much older continental crust. The available data suggest that the granulitized orthogneisses of the Caraiba Complex were formed by partial melt of basaltic material (amphibalitized oceanic crust). (author)

  19. Stratigraphic units overlying the Zambales Ophiolite Complex (ZOC) in Luzon, (Philippines): Tectonostratigraphic significance and regional implications

    Science.gov (United States)

    Queaño, Karlo L.; Dimalanta, Carla B.; Yumul, Graciano P.; Marquez, Edanjarlo J.; Faustino-Eslava, Decibel V.; Suzuki, Shigeyuki; Ishida, Keisuke

    2017-07-01

    The Zambales Ophiolite Complex (ZOC) on the island of Luzon, Philippines is one of the most well-studied crust-mantle sequences in the region. Several massifs comprise the ZOC, one of which is the Coto Block overlain by clastic sedimentary units previously dated as Eocene. Geochronologic studies from diabase, granodiorites and other late-stage magmatic products similarly yielded the same age. Succeeding tectonic models have therefore all been grounded on the assumption that the entire ZOC is Eocene. Recent investigations, however, revealed the presence of chert blocks within the Early to Middle Miocene clastic formation overlying the Acoje Block in the northern part of the ophiolite complex. Radiolarians extracted from the cherts yielded a stratigraphic range that suggests a Late Jurassic to Early Cretaceous age. The recognition of a much older age than previously reported of the ZOC warrants a re-examination of its actual distribution and genesis. Correlating with other similarly-aged ophiolites, we suggest defining a western Mesozoic ophiolite belt, largely extending from the west-central portion of the archipelago to the northeastern tip of Luzon island. Tentatively, we attribute the Mesozoic ophiolitic and associated rocks in western Luzon to an arc-continent collision involving the Philippine Mobile Belt and the Palawan Microcontinental Block. In addition, differences in the clastic compositions of the Cenozoic sedimentary formations provide material not only for deciphering the ZOC's unroofing history but also for constraining the timing of province linkage. The intermittent appearance of lithic fragments and detrital minerals from the ophiolite in the units of the Middle Miocene Candelaria Limestone and the Late Miocene to Early Pliocene Sta. Cruz Formation indicates significant but geographically variable contributions from the ophiolite complex. In the northern Zambales Range, the Sta. Cruz Formation caps the Coto Block and the Acoje Block of the ZOC

  20. Consumption trends for specific drugs used to treat dementia in the region of Madrid (Spain) from 2002 to 2012.

    Science.gov (United States)

    de Hoyos-Alonso, M C; Tapias-Merino, E; Meseguer Barros, C M; Sánchez-Martínez, M; Otero, A

    2015-09-01

    Analysing drug consumption in large population groups lets us observe consumption trends and compare them between different settings. to analyse the time trends for consumption and costs of specific drugs used to treat dementia in the region of Madrid (Spain) and compare trends by sex and age cohort. Descriptive study of cholinesterase inhibitors (N06DA) and memantine (N06DX01) dispensed in Madrid between 2002 and 2012 and covered by the Spain's national health system. Consumption was calculated by analysing changes in DDD (defined daily doses) to find total and yearly increases. The cost was estimated based on DDD price. To compare consumption rates by age and sex, we calculated DDD per 100 inhabitants/day. Between 2002 and 2012, consumption of drugs used to treat dementia increased sixfold. During this period, cholinesterase inhibitors accounted for 76.70% of the drugs consumed and memantine, 23.30%. The estimated cost rose by a by a factor of 5.7 over 11 years (or by a factor of 4 taking into account the use of generic drugs). In 2012, 2.42% of the patients aged 65 or over consumed cholinesterase inhibitors (women 2.82%, men 1.83%) and 0.90% consumed memantine (women 1.10%, men 0.61%). Consumption increased in age cohorts up to 86 to 90 (5.84% for cholinesterase inhibitors and 2.33% for memantine) and declined thereafter. Consumption of cholinesterase inhibitors and memantine gradually increased, but consumption in 2012 did not reach levels equivalent to dementia prevalence figures. Pharmaceutical expenditure restraint measures may temporarily slow the cost increase temporarily but if the same trend of consumption persists, costs will rise. Copyright © 2013 Sociedad Española de Neurología. Published by Elsevier España, S.L.U. All rights reserved.

  1. The semiquantitative three-phase bone scintigraphy on hemiplegic patients with earlier complex regional pain syndrome

    International Nuclear Information System (INIS)

    Li Fang; Liu Xingdang; Lu Zhihui; Liu Congjin

    2010-01-01

    Objective: To investigate the difference between the early phases and delay phase of three-phase bone scintigraphy on hemiplegic patients with earlier complex regional pain syndrome (CRPS). Methods: Twenty-nine stroke patients with hemiplegia complicating CRPS received three-phase bone scintigraphy after intravenous injection of 99 Tc m -methylene diphosphonate (MDP). The region of interest (ROI) technique was used to obtain the radioactive counts of involved joints and contralateral sites on wrists, metacarpophalangeal, proximal interphalangeal and distal interphalangeal joints. The total counts of these four sites in each patient were then obtained and the total uptake ratios of involved joints/contralateral joints for each phase were calculated to compare the difference among the three phases. Wilcoxon test and ANOVA were used in data analyses. Results: The involved joints of hemiplegic side displayed higher tracer uptake. There were significant differences of the radioactive counts between involved joints and uninvolved ones in the perfusion, pool and delay phase (Wilcoxon test, Z: -4.73 to -2.10, P<0.05). There was no significant difference of total uptake ratios of involved joints/contralateral joints among the three phases (ANOVA, F = 0. 807, P < 0.05). Conclusions: Due to higher bone seeking agent accumulation on three-phase bone scintigraphy, both early phases and delay phase imaging showed similar value in stroke patients with hemiplegia complicating earlier CRPS. (authors)

  2. A comparison of spatial interpolation methods for soil temperature over a complex topographical region

    Science.gov (United States)

    Wu, Wei; Tang, Xiao-Ping; Ma, Xue-Qing; Liu, Hong-Bin

    2016-08-01

    Soil temperature variability data provide valuable information on understanding land-surface ecosystem processes and climate change. This study developed and analyzed a spatial dataset of monthly mean soil temperature at a depth of 10 cm over a complex topographical region in southwestern China. The records were measured at 83 stations during the period of 1961-2000. Nine approaches were compared for interpolating soil temperature. The accuracy indicators were root mean square error (RMSE), modelling efficiency (ME), and coefficient of residual mass (CRM). The results indicated that thin plate spline with latitude, longitude, and elevation gave the best performance with RMSE varying between 0.425 and 0.592 °C, ME between 0.895 and 0.947, and CRM between -0.007 and 0.001. A spatial database was developed based on the best model. The dataset showed that larger seasonal changes of soil temperature were from autumn to winter over the region. The northern and eastern areas with hilly and low-middle mountains experienced larger seasonal changes.

  3. A neutral lipophilic technetium-99m complex for regional cerebral blood flow imaging

    International Nuclear Information System (INIS)

    Narra, R.K.; Nunn, A.D.; Kuczynski, B.L.; DiRocco, R.J.; Feld, T.; Silva, D.A.; Eckelman, W.C.

    1990-01-01

    Technetium-99m-DMG-2MP (Chloro[bis[2,3-butanedionedioxime(1-)-0][2,3- butanedionedioximato (2-)-N,N',N double-prime,N'double-prime,N double-prime double-prime,N'double-prime double-prime] (2-methylpropyl borato (2-))technetium]), also known as SQ 32097 is a member of a family of neutral lipophilic compounds generally known as boronic acid adducts of technetium dioxime complexes (BATOs). After i.v. administration, the concentration of [ 99m Tc]DMG-2MP in various regions of the brain appears to be proportional to blood flow. In rats, 1.1% ID was in the brain at 5 min postinjection when the blood contained less than 3% ID. Over 24 hr excretion was 59% in the feces and 23% in the urine. The activity in monkey brain at 5 min was 2.8% ID and it cleared with a t1/2 of 86 min. Autoradiographs of monkey brain sections showed excellent regional detail with a gray/white ratio of 3.6 at 10 min. The distribution of [ 99m Tc]DMG-2MP in the monkey brain corresponds to the known cytoarchitectural pattern of cerebral glucose metabolism. The properties of [ 99m Tc]DMG-2MP make it a potentially useful agent for cerebral perfusion imaging in man

  4. Institutional Analysis of Knowledge Generation Resource Potential at the Enterprises of Regional Military-Industrial Complex

    Directory of Open Access Journals (Sweden)

    Evgeny Vasilyevich Popov

    2016-09-01

    Full Text Available The article is devoted to the processes of knowledge generation at the enterprises of military-industrial complex, which are the leaders of the regional innovative activity. The target of the research is to develop the methodology based on the use of resource application potential for increasing the efficiency of knowledge generation at the instrument-making enterprises of military-industrial complex. The system analysis of the knowledge generation processes is conducted at one of them. It allows to draw a conclusion that such enterprises have a lack of the institutes of knowledge generation processes. The authors are offered a technique of the development of the knowledge generation system at the military-industrial enterprises based on the accounting of assets and opportunities of the enterprise in the realization of intellectual activity. The developed technique is based on the determination of the horizontal resource potential of knowledge generation and allows to determine the potential of resource application at each stage of product life cycle. The comparison of the actual and theoretical values of horizontal resource potential allows to correct the distribution of a share of each of resources within a stage, and therefore, to optimize the realization of tasks at a specific stage. The offered tools were implemented in 2015 at one of the regional military-Industrial enterprises. The methodological tools of the research include the methods of expert assessment, mathematical statistics and the institutional analysis. On the basis of the offered technique and received empirical results, the institutional spiral of knowledge generation during the filling of state order at the military-industrial enterprise is developed. Its implementation will promote the decrease in the level of uncertainty during the whole life cycle of innovative activity product. The developed institutional spiral of knowledge generation at instrument-making military

  5. Complex and region-specific changes in astroglial markers in the aging brain.

    Science.gov (United States)

    Rodríguez, José J; Yeh, Chia-Yu; Terzieva, Slavica; Olabarria, Markel; Kulijewicz-Nawrot, Magdalena; Verkhratsky, Alexei

    2014-01-01

    Morphological aging of astrocytes was investigated in entorhinal cortex (EC), dentate gyrus (DG), and cornu ammonis 1 (CA1) regions of hippocampus of male SV129/C57BL6 mice of different age groups (3, 9, 18, and 24 months). Astroglial profiles were visualized by immunohistochemistry by using glial fibrillary acidic protein (GFAP), glutamine synthetase (GS), and s100β staining; these profiles were imaged using confocal or light microscopy for subsequent morphometric analysis. GFAP-positive profiles in the DG and the CA1 of the hippocampus showed progressive age-dependent hypertrophy, as indicated by an increase in surface, volume, and somata volume at 24 months of age compared with 3-month-old mice. In contrast with the hippocampal regions, aging induced a decrease in GFAP-positive astroglial profiles in the EC: the surface, volume, and cell body volume of astroglial cells at 24 months of age were decreased significantly compared with the 3-month group. The GS-positive astrocytes displayed smaller cellular surface areas at 24 months compared with 3-month-old animals in both areas of hippocampus, whereas GS-positive profiles remained unchanged in the EC of old mice. The morphometry of s100β-immunoreactive profiles revealed substantial increase in the EC, more moderate increase in the DG, and no changes in the CA1 area. Based on the morphological analysis of 3 astroglial markers, we conclude that astrocytes undergo a complex age-dependent remodeling in a brain region-specific manner. Copyright © 2014. Published by Elsevier Inc.

  6. Comparison of different wind data interpolation methods for a region with complex terrain in Central Asia

    Science.gov (United States)

    Reinhardt, Katja; Samimi, Cyrus

    2018-01-01

    While climatological data of high spatial resolution are largely available in most developed countries, the network of climatological stations in many other regions of the world still constitutes large gaps. Especially for those regions, interpolation methods are important tools to fill these gaps and to improve the data base indispensible for climatological research. Over the last years, new hybrid methods of machine learning and geostatistics have been developed which provide innovative prospects in spatial predictive modelling. This study will focus on evaluating the performance of 12 different interpolation methods for the wind components \\overrightarrow{u} and \\overrightarrow{v} in a mountainous region of Central Asia. Thereby, a special focus will be on applying new hybrid methods on spatial interpolation of wind data. This study is the first evaluating and comparing the performance of several of these hybrid methods. The overall aim of this study is to determine whether an optimal interpolation method exists, which can equally be applied for all pressure levels, or whether different interpolation methods have to be used for the different pressure levels. Deterministic (inverse distance weighting) and geostatistical interpolation methods (ordinary kriging) were explored, which take into account only the initial values of \\overrightarrow{u} and \\overrightarrow{v} . In addition, more complex methods (generalized additive model, support vector machine and neural networks as single methods and as hybrid methods as well as regression-kriging) that consider additional variables were applied. The analysis of the error indices revealed that regression-kriging provided the most accurate interpolation results for both wind components and all pressure heights. At 200 and 500 hPa, regression-kriging is followed by the different kinds of neural networks and support vector machines and for 850 hPa it is followed by the different types of support vector machine and

  7. Metamorphic and tectonic evolution of the Greater Himalayan Crystalline Complex in Nyalam region, south Tibet

    Science.gov (United States)

    Wang, Jia-Min; Zhang, Jin-Jiang; Rubatto, Daniela

    2016-04-01

    Recent studies evoke dispute whether the Himalayan metamorphic core - Greater Himalayan Crystalline Complex (GHC) - was exhumed as a lateral crustal flow or a critical taper wedge during the India-Asia collision. This contribution investigated the evolution of the GHC in the Nyalam region, south Tibet, with comprehensive studies on structural kinematics, metamorphic petrology and geochronology. The GHC in the Nyalam region can be divided into the lower and upper GHC. Phase equilibria modelling and conventional thermobarometric results show that peak temperature conditions are lower in the lower GHC (~660-700°C) and higher in the upper GHC (~740-780°C), whereas corresponding pressure conditions at peak-T decrease from ~9-13 kbar to ~4 kbar northward. Monazite, zircon and rutile U-Pb dating results reveal two distinct blocks within the GHC of the Nyalam region. The upper GHC underwent higher degree of partial melting (15-25%, via muscovite dehydration melting) that initiated at ~32 Ma, peaked at ~29 Ma to 25 Ma, possibly ended at ~20 Ma. The lower GHC underwent lower degree of melting (0-10%) that lasted from 19 to 16 Ma, which was produced mainly via H2O-saturated melting. At different times, both the upper and lower blocks underwent initial slow cooling (35 ± 8 and 10 ± 5°C/Myr, respectively) and subsequent rapid cooling (120 ± 40°C/Myr). The established timescale of metamorphism suggests that high-temperature metamorphism within the GHC lasted a long duration (~15 Myr), whereas duration of partial melting lasted for ~3 Myr in the lower GHC and lasted for 7-12 Myr in the upper GHC. The documented diachronous metamorphism and discontinuity of peak P-T conditions implies the presence of the Nyalam Thrust in the study area. This thrust is probably connected to the other thrusts in Nepal and Sikkim Himalaya, which extends over ~800 km and is named the "High Himalayan Thrust". Timing of activity along this thrust is at ~25-16 Ma, which is coeval with active

  8. Radiofrequency therapy in back pain and complex regional pain syndrome (CRPS

    Directory of Open Access Journals (Sweden)

    Norina Bergamin

    2011-01-01

    Full Text Available Percutaneous radiofrequency procedures are frequently used in the management of chronic pain. Continuous radiofrequency (CRF has been established as a safe and effective treatment for pain originating from facet and sacroiliac joints by way of co-agulation of their nerve supply. Different methods have been proposed to account for the complex nerve supply of the sacroiliac joint. Due to its neurodestructive property, CRF was limited to the treatment of neuropathic pain. When applied to the dorsal root ganglion (DRG for spinal pain or to the sympathetic ganglia in treatment of CRPS, heat related side effects have been reported. With the development of pulsed radiofrequency (PRF, a less destructive alternative to CRF became available, that is more suitable to treat neuropathic pain. PRF was adopted in the treatment of several pain conditions with different success. The results with PRF adjacent to the DRG are promising, whereas for facet and sacroiliac joint pain PRF could not yet be proven equally effective as CRF. As for PRF in CRPS there is almost no evidence available. The potential of PRF seems to lie in those areas where CRF is of limited value. Con-versely, it is questionable if PRF will ever be equally effective in indications, where CRF is already well established. Despite its active use in clinical practice, PRF is not validated yet nor is its mode of action. The literature in both cases is accumulating but further studies are urgently needed.

  9. Effects of recombinant human granulocyte colony-stimulating factor on leucopenia in zidovudine-treated patients with AIDS and AIDS related complex, a phase I/II study

    NARCIS (Netherlands)

    van der Wouw, P. A.; van Leeuwen, R.; van Oers, R. H.; Lange, J. M.; Danner, S. A.

    1991-01-01

    Twelve male patients, eight with the acquired immunodeficiency syndrome (AIDS) and four with AIDS related complex (ARC), who had zidovudine associated neutropenia (less than 1 x 10(9) neutrophils/l) were treated with recombinant human granulocyte colony-stimulating factor (G-CSF) in a phase I/II

  10. Comparative studies on mitochondrial electron transport chain complexes of Sitophilus zeamais treated with allyl isothiocyanate and calcium phosphide.

    Science.gov (United States)

    Zhang, Chao; Wu, Hua; Zhao, Yuan; Ma, Zhiqing; Zhang, Xing

    2016-01-01

    With Sitophilus zeamais as the target organism, the present study for the first time attempted to elucidate the comparative effects between allyl isothiocyanate (AITC) and calcium phosphide (Ca3P2), exposure on mitochondrial electron transport chain (ETC.) complex I & IV and their downstream effects on enzymes relevant to reactive oxygen species (ROS). In vivo, both AITC and Ca3P2 inhibited complex I and IV with similar downstream effects. In contrast with Ca3P2, the inhibition of complex I caused by AITC was dependent on time and dose. In vitro, AITC inhibited complex IV more significantly than complex I. These results indicate that mitochondrial complex IV is the primary target of AITC, and that complex I is another potential target. Copyright © 2015 Elsevier B.V. All rights reserved.

  11. Glucocorticoid Receptor Hetero-Complex Gene STIP1 Is Associated with Improved Lung Function in Asthmatics Treated with Inhaled Corticosteroids

    Science.gov (United States)

    Hawkins, Gregory A.; Lazarus, Ross; Smith, Richard S.; Tantisira, Kelan G.; Meyers, Deborah A.; Peters, Stephen P.; Weiss, Scott T.; Bleecker, Eugene R.

    2015-01-01

    Background Corticosteroids exert their anti-inflammatory action by binding and activating the intracellular the glucocorticoid receptor (GR) hetero-complex. Objective Evaluate the genes HSPCB, HSPCA, STIP1, HSPA8, DNAJB1, PTGES3, FKBP5, and FKBP4 on corticosteroid response. Methods Caucasian asthmatics (382) randomized to once daily flunisolide or conventional inhaled corticosteroid therapy were genotyped. Outcome measures were baseline FEV1, % predicted FEV1, and % change in FEV1 after corticosteroid treatment. Multivariable analyses adjusted for age, gender, and height, were performed fitting the most appropriate genetic model based on quantitative mean derived from ANOVA models to determine if there was an independent effect of polymorphisms on change in FEV1 independent of baseline level. Results Positive recessive model correlations for STIP1 SNPs were observed for baseline FEV1 [rs4980524, p=0.009; rs6591838, p=0.0045; rs2236647, p=0.002; and rs2236648; p=0.013], baseline % predicted FEV1 [rs4980524, p=0.002; rs6591838, p=0.017; rs2236647, p=0.003; and rs2236648; p=0.008] ; % change in FEV1 at 4 weeks [rs4980524, p=0.044; rs6591838, p=0.016; rs2236647; p=0.01] and 8 weeks therapy [rs4980524, p=0.044; rs6591838, p=0.016; rs2236647; p=0.01]. Haplotypic associations were observed for baseline FEV1 and % change in FEV1 at 4 weeks therapy [p=0.05 and p=0.01, respectively]. Significant trends towards association were observed for baseline % predicted FEV1 and % change in FEV1 at 8 weeks therapy. Positive correlations between haplotypes and % change in FEV1 were also observed. Conclusions STIP1 genetic variations may play a role in regulating corticosteroid response in asthmatics with reduced lung function. Replication in a second asthma population is required to confirm these observations. Clinical Implications Identifying genes that regulate corticosteroid responses could allow a priori determination of individual responses to corticosteroid therapy, leading to

  12. Objective sensory evaluation of the spread of complex regional pain syndrome.

    Science.gov (United States)

    Edinger, Lara; Schwartzman, Robert J; Ahmad, Ayesha; Erwin, Kirsten; Alexander, Guillermo M

    2013-01-01

    The spread of complex regional pain syndrome (CRPS) has been well documented. Many severe refractory long-standing patients have total body pain (TBP) that evolved from a single extremity injury. The purpose of this study was to document by objective sensory threshold testing the extent of body area involvement in 20 long-standing patients with CRPS who have TBP. A comparison of sensory threshold testing parameters between 20 long-standing refractory patients with CRPS who have TBP versus 10 healthy participants. Twenty patients with CRPS who stated that they suffered from total body pain were chosen from the Drexel University College of Medicine CRPS database. They were compared to 10 healthy participants that were age and gender matched to the patients with CRPS. The sensory parameters tested were: skin temperature; static and mechanical allodynia; thermal allodynia; mechanical hyperalgesia; after sensations following all sensory tests. The sites chosen for testing in the patients with CRPS were the most painful area in each of 8 body regions that comprised the total body area. Five patients with CRPS had signs of CRPS over 100% of their body (20%). One patient had pain over 87% and another had pain over 90% of their body area. The average percentage of body involvement was 62% (range 37% - 100%). All patients with CRPS had at least one sensory parameter abnormality in all body regions. All patients with CRPS had lower pain thresholds for static allodynia in all body areas, while 50% demonstrated a lower threshold for dynamic allodynia in all body regions compared to the healthy participants. Cold allodynia had a higher median pain rating on the Likert pain scale in all body areas versus healthy participants except for the chest, abdomen, and back. Eighty-five percent of the patients with CRPS had a significantly lower pain threshold for mechanical hyperalgesia in all body areas compared to the healthy participants. After sensations occurred after all sensory

  13. Utilization of manual therapy to the lumbar spine in conjunction with traditional conservative care for individuals with bilateral lower extremity complex regional pain syndrome: A case series.

    Science.gov (United States)

    Walston, Zachary; Hernandez, Luis; Yake, Dale

    2018-06-06

    Conservative therapies for complex regional pain syndrome (CRPS) have traditionally focused on exercise and desensitization techniques targeted at the involved extremity. The primary purpose of this case series is to report on the potential benefit of utilizing manual therapy to the lumbar spine in conjunction with traditional conservative care when treating patients with lower extremity CRPS. Two patients with the diagnosis of lower extremity CRPS were treated with manual therapy to the lumbar spine in conjunction with education, exercise, desensitization, and soft tissue techniques for the extremity. Patient 1 received 13 sessions over 6 weeks resulting in a 34-point improvement in oswestry disability index (ODI) and 35-point improvement in lower extremity functional scale (LEFS). Patient 2 received 21 sessions over 12 weeks resulting in a 28-point improvement in ODI and a 41-point improvement in LEFS. Both patients exhibited reductions in pain and clinically meaningful improvements in function. Manual therapies when applied to the lumbar spine in these patients as part of a comprehensive treatment plan resulted in improved spinal mobility, decreased pain, and reduction is distal referred symptoms. Although one cannot infer a cause and effect relationship from a case series, this report identifies meaningful clinical outcomes potentially associated with manual physical therapy to the lumbar spine for two patients with complex regional pain syndrome type 1.

  14. Dissection of a Complex Disease Susceptibility Region Using a Bayesian Stochastic Search Approach to Fine Mapping.

    Directory of Open Access Journals (Sweden)

    Chris Wallace

    2015-06-01

    Full Text Available Identification of candidate causal variants in regions associated with risk of common diseases is complicated by linkage disequilibrium (LD and multiple association signals. Nonetheless, accurate maps of these variants are needed, both to fully exploit detailed cell specific chromatin annotation data to highlight disease causal mechanisms and cells, and for design of the functional studies that will ultimately be required to confirm causal mechanisms. We adapted a Bayesian evolutionary stochastic search algorithm to the fine mapping problem, and demonstrated its improved performance over conventional stepwise and regularised regression through simulation studies. We then applied it to fine map the established multiple sclerosis (MS and type 1 diabetes (T1D associations in the IL-2RA (CD25 gene region. For T1D, both stepwise and stochastic search approaches identified four T1D association signals, with the major effect tagged by the single nucleotide polymorphism, rs12722496. In contrast, for MS, the stochastic search found two distinct competing models: a single candidate causal variant, tagged by rs2104286 and reported previously using stepwise analysis; and a more complex model with two association signals, one of which was tagged by the major T1D associated rs12722496 and the other by rs56382813. There is low to moderate LD between rs2104286 and both rs12722496 and rs56382813 (r2 ≃ 0:3 and our two SNP model could not be recovered through a forward stepwise search after conditioning on rs2104286. Both signals in the two variant model for MS affect CD25 expression on distinct subpopulations of CD4+ T cells, which are key cells in the autoimmune process. The results support a shared causal variant for T1D and MS. Our study illustrates the benefit of using a purposely designed model search strategy for fine mapping and the advantage of combining disease and protein expression data.

  15. Complex Regional Pain Syndrome Type I Affects Brain Structure in Prefrontal and Motor Cortex

    Science.gov (United States)

    Pleger, Burkhard; Draganski, Bogdan; Schwenkreis, Peter; Lenz, Melanie; Nicolas, Volkmar; Maier, Christoph; Tegenthoff, Martin

    2014-01-01

    The complex regional pain syndrome (CRPS) is a rare but debilitating pain disorder that mostly occurs after injuries to the upper limb. A number of studies indicated altered brain function in CRPS, whereas possible influences on brain structure remain poorly investigated. We acquired structural magnetic resonance imaging data from CRPS type I patients and applied voxel-by-voxel statistics to compare white and gray matter brain segments of CRPS patients with matched controls. Patients and controls were statistically compared in two different ways: First, we applied a 2-sample ttest to compare whole brain white and gray matter structure between patients and controls. Second, we aimed to assess structural alterations specifically of the primary somatosensory (S1) and motor cortex (M1) contralateral to the CRPS affected side. To this end, MRI scans of patients with left-sided CRPS (and matched controls) were horizontally flipped before preprocessing and region-of-interest-based group comparison. The unpaired ttest of the “non-flipped” data revealed that CRPS patients presented increased gray matter density in the dorsomedial prefrontal cortex. The same test applied to the “flipped” data showed further increases in gray matter density, not in the S1, but in the M1 contralateral to the CRPS-affected limb which were inversely related to decreased white matter density of the internal capsule within the ipsilateral brain hemisphere. The gray-white matter interaction between motor cortex and internal capsule suggests compensatory mechanisms within the central motor system possibly due to motor dysfunction. Altered gray matter structure in dorsomedial prefrontal cortex may occur in response to emotional processes such as pain-related suffering or elevated analgesic top-down control. PMID:24416397

  16. Complex regional pain syndrome type I affects brain structure in prefrontal and motor cortex.

    Directory of Open Access Journals (Sweden)

    Burkhard Pleger

    Full Text Available The complex regional pain syndrome (CRPS is a rare but debilitating pain disorder that mostly occurs after injuries to the upper limb. A number of studies indicated altered brain function in CRPS, whereas possible influences on brain structure remain poorly investigated. We acquired structural magnetic resonance imaging data from CRPS type I patients and applied voxel-by-voxel statistics to compare white and gray matter brain segments of CRPS patients with matched controls. Patients and controls were statistically compared in two different ways: First, we applied a 2-sample ttest to compare whole brain white and gray matter structure between patients and controls. Second, we aimed to assess structural alterations specifically of the primary somatosensory (S1 and motor cortex (M1 contralateral to the CRPS affected side. To this end, MRI scans of patients with left-sided CRPS (and matched controls were horizontally flipped before preprocessing and region-of-interest-based group comparison. The unpaired ttest of the "non-flipped" data revealed that CRPS patients presented increased gray matter density in the dorsomedial prefrontal cortex. The same test applied to the "flipped" data showed further increases in gray matter density, not in the S1, but in the M1 contralateral to the CRPS-affected limb which were inversely related to decreased white matter density of the internal capsule within the ipsilateral brain hemisphere. The gray-white matter interaction between motor cortex and internal capsule suggests compensatory mechanisms within the central motor system possibly due to motor dysfunction. Altered gray matter structure in dorsomedial prefrontal cortex may occur in response to emotional processes such as pain-related suffering or elevated analgesic top-down control.

  17. Analysis of gene expression profile microarray data in complex regional pain syndrome.

    Science.gov (United States)

    Tan, Wulin; Song, Yiyan; Mo, Chengqiang; Jiang, Shuangjian; Wang, Zhongxing

    2017-09-01

    The aim of the present study was to predict key genes and proteins associated with complex regional pain syndrome (CRPS) using bioinformatics analysis. The gene expression profiling microarray data, GSE47603, which included peripheral blood samples from 4 patients with CRPS and 5 healthy controls, was obtained from the Gene Expression Omnibus (GEO) database. The differentially expressed genes (DEGs) in CRPS patients compared with healthy controls were identified using the GEO2R online tool. Functional enrichment analysis was then performed using The Database for Annotation Visualization and Integrated Discovery online tool. Protein‑protein interaction (PPI) network analysis was subsequently performed using Search Tool for the Retrieval of Interaction Genes database and analyzed with Cytoscape software. A total of 257 DEGs were identified, including 243 upregulated genes and 14 downregulated ones. Genes in the human leukocyte antigen (HLA) family were most significantly differentially expressed. Enrichment analysis demonstrated that signaling pathways, including immune response, cell motion, adhesion and angiogenesis were associated with CRPS. PPI network analysis revealed that key genes, including early region 1A binding protein p300 (EP300), CREB‑binding protein (CREBBP), signal transducer and activator of transcription (STAT)3, STAT5A and integrin α M were associated with CRPS. The results suggest that the immune response may therefore serve an important role in CRPS development. In addition, genes in the HLA family, such as HLA‑DQB1 and HLA‑DRB1, may present potential biomarkers for the diagnosis of CRPS. Furthermore, EP300, its paralog CREBBP, and the STAT family genes, STAT3 and STAT5 may be important in the development of CRPS.

  18. Solar resource assessment in complex orography: a comparison of available datasets for the Trentino region

    Science.gov (United States)

    Laiti, Lavinia; Giovannini, Lorenzo; Zardi, Dino

    2015-04-01

    The accurate assessment of the solar radiation available at the Earth's surface is essential for a wide range of energy-related applications, such as the design of solar power plants, water heating systems and energy-efficient buildings, as well as in the fields of climatology, hydrology, ecology and agriculture. The characterization of solar radiation is particularly challenging in complex-orography areas, where topographic shadowing and altitude effects, together with local weather phenomena, greatly increase the spatial and temporal variability of such variable. At present, approaches ranging from surface measurements interpolation to orographic down-scaling of satellite data, to numerical model simulations are adopted for mapping solar radiation. In this contribution a high-resolution (200 m) solar atlas for the Trentino region (Italy) is presented, which was recently developed on the basis of hourly observations of global radiation collected from the local radiometric stations during the period 2004-2012. Monthly and annual climatological irradiation maps were obtained by the combined use of a GIS-based clear-sky model (r.sun module of GRASS GIS) and geostatistical interpolation techniques (kriging). Moreover, satellite radiation data derived by the MeteoSwiss HelioMont algorithm (2 km resolution) were used for missing-data reconstruction and for the final mapping, thus integrating ground-based and remote-sensing information. The results are compared with existing solar resource datasets, such as the PVGIS dataset, produced by the Joint Research Center Institute for Energy and Transport, and the HelioMont dataset, in order to evaluate the accuracy of the different datasets available for the region of interest.

  19. Brain alpha-ketoglutarate dehydrogenase complex: kinetic properties, regional distribution, and effects of inhibitors.

    Science.gov (United States)

    Lai, J C; Cooper, A J

    1986-11-01

    The substrate and cofactor requirements and some kinetic properties of the alpha-ketoglutarate dehydrogenase complex (KGDHC; EC 1.2.4.2, EC 2.3.1.61, and EC 1.6.4.3) in purified rat brain mitochondria were studied. Brain mitochondrial KGDHC showed absolute requirement for alpha-ketoglutarate, CoA and NAD, and only partial requirement for added thiamine pyrophosphate, but no requirement for Mg2+ under the assay conditions employed in this study. The pH optimum was between 7.2 and 7.4, but, at pH values below 7.0 or above 7.8, KGDHC activity decreased markedly. KGDHC activity in various brain regions followed the rank order: cerebral cortex greater than cerebellum greater than or equal to midbrain greater than striatum = hippocampus greater than hypothalamus greater than pons and medulla greater than olfactory bulb. Significant inhibition of brain mitochondrial KGDHC was noted at pathological concentrations of ammonia (0.2-2 mM). However, the purified bovine heart KGDHC and KGDHC activity in isolated rat heart mitochondria were much less sensitive to inhibition. At 5 mM both beta-methylene-D,L-aspartate and D,L-vinylglycine (inhibitors of cerebral glucose oxidation) inhibited the purified heart but not the brain mitochondrial enzyme complex. At approximately 10 microM, calcium slightly stimulated (by 10-15%) the brain mitochondrial KGDHC. At concentrations above 100 microM, calcium (IC50 = 1 mM) inhibited both brain mitochondrial and purified heart KGDHC. The present results suggest that some of the kinetic properties of the rat brain mitochondrial KGDHC differ from those of the purified bovine heart and rat heart mitochondrial enzyme complexes. They also suggest that the inhibition of KGDHC by ammonia and the consequent effect on the citric acid cycle fluxes may be of pathophysiological and/or pathogenetic importance in hyperammonemia and in diseases (e.g., hepatic encephalopathy, inborn errors of urea metabolism, Reye's syndrome) where hyperammonemia is a

  20. Regional molecular and cellular differences in the female rabbit Achilles tendon complex: potential implications for understanding responses to loading.

    Science.gov (United States)

    Huisman, Elise S; Andersson, Gustav; Scott, Alexander; Reno, Carol R; Hart, David A; Thornton, Gail M

    2014-05-01

    The aim of this study was: (i) to analyze the morphology and expression of extracellular matrix genes in six different regions of the Achilles tendon complex of intact normal rabbits; and (ii) to assess the effect of ovariohysterectomy (OVH) on the regional expression of these genes. Female New Zealand White rabbits were separated into two groups: (i) intact normal rabbits (n = 4); and (ii) OVH rabbits (n = 8). For each rabbit, the Achilles tendon complex was dissected into six regions: distal gastrocnemius (DG); distal flexor digitorum superficialis; proximal lateral gastrocnemius (PLG); proximal medial gastrocnemius; proximal flexor digitorum superficialis; and paratenon. For each of the regions, hematoxylin and eosin staining was performed for histological evaluation of intact normal rabbit tissues and mRNA levels for proteoglycans, collagens and genes associated with collagen regulation were assessed by real-time reverse transcription-quantitative polymerase chain reaction for both the intact normal and OVH rabbit tissues. The distal regions displayed a more fibrocartilaginous phenotype. For intact normal rabbits, aggrecan mRNA expression was higher in the distal regions of the Achilles tendon complex compared with the proximal regions. Collagen Type I and matrix metalloproteinase-2 expression levels were increased in the PLG compared to the DG in the intact normal rabbit tissues. The tendons from OVH rabbits had lower gene expressions for the proteoglycans aggrecan, biglycan, decorin and versican compared with the intact normal rabbits, although the regional differences of increased aggrecan expression in distal regions compared with proximal regions persisted. The tensile and compressive forces experienced in the examined regions may be related to the regional differences found in gene expression. The lower mRNA expression of the genes examined in the OVH group confirms a potential effect of systemic estrogen on tendon. © 2014 Anatomical Society.

  1. Willingness to pay for insecticide-treated nets in Berehet District, Amhara Region, Northern Ethiopia: implication of social marketing.

    Science.gov (United States)

    Aleme, Adisu; Girma, Eshetu; Fentahun, Netsanet

    2014-01-01

    Understanding the feasibility of achieving widespread coverage with Insecticide-Treated Nets has to be preceded by learning how people value the Insecticide-Treated Nets and estimating the potential demand and willingness to pay so that sustainability of the intervention can be assured. The objective of this study was to determine willingness to pay for Insecticide-Treated Nets among households in Berehet District, Northern Ethiopia. A community-based cross-sectional study was conducted using both quantitative and qualitative methods in five randomly selected Kebeles from January-February 2012. Open ended contingent valuation technique with follow-up method was used. Qualitative data were collected through focus group discussions and observation methods. Binary logistic regression was used to determine the association between dependent and independent variables. The average number of individuals per Insecticide-Treated Nets was 3.83. Nearly 68.5% persons had willingness to buy Insecticide-Treated Nets if they have access to these Nets. The median maximum price a person is willingness to pay for blue rectangular Insecticide-Treated Net was 20 ETB. People had willingness to pay 30 ETB for blue and white conical insecticide-treated nets. Working on knowledge of malaria (OR=0.68, CI (0.47, 0.98; ppay Insecticide-Treated Nets. Respondents who prefer Kebele/place/ to buy Insecticide-Treated Net for rectangular shape had a significant association with a willingness to pay for Insecticide-Treated Nets (OR=1.92, CI= 1.07-3.92). Promotions, products, price and place had significant association with willingness to pay for Insecticide-Treated Nets. Designing a social marketing strategy helps ensure sustainable supply of Insecticide-Treated Nets and proper use of Insecticide-Treated Nets.

  2. INVESTMENT ACTIVITY OF AGRIBUSINESS IN THE AGROINDUSTRIAL COMPLEX REGION, AS ONE OF THE ELEMENTS OF THE FINANCIAL SECURITY OF THE AGRO-INDUSTRIAL COMPLEX OF THE STATE

    Directory of Open Access Journals (Sweden)

    Olga Nikolaevna Uglitskikh

    2015-09-01

    Full Text Available The developed economic-political situation around of Russia, specifies an indispensability of support of agricultural commodity producers as from their financial well-being, investment activity the financial security of agrarian and industrial complex of the state depends. Limitation of own financial resources at agrarians does not allow them to realize independently conceived projects. Studying of questions of formation and functioning of investment activity in agriculture of Stavropol Territory and an assessment of investment projects offered to reali-zation, have allowed to analyse investment activity of agrarian and industrial complex of region up to the introduction of Russia into WTO and in conditions of its membership. By results of the lead assessment the administrative areas of region showing the greatest investment activity, threats of a financial security of agrarian and industrial complex of region not putting by the activity have been revealed. It is drawn a conclusion on influence West-American sanctions on financial without-danger agra-rian and industrial complex of the state and the responsibility сельхозтоваропроизводителей about delivery of agricultural production in necessary volume and import substitution.

  3. Personality assessment of patients with complex regional pain syndrome type I.

    Science.gov (United States)

    Monti, D A; Herring, C L; Schwartzman, R J; Marchese, M

    1998-12-01

    There is controversy regarding the importance of psychological/psychiatric factors in the development of the Complex Regional Pain Syndrome (CRPS). Our objective was to determine whether CRPS type I patients were psychiatrically different from other chronic pain patients, with particular attention to personality pathology. A standardized clinical assessment of all major psychiatric categories, including personality disorders, was performed on 25 CRPS type I patients and a control group of 25 patients with chronic low back pain from disc-related radiculopathy. Both sections of the Structured Clinical Interview for the Diagnostic and Statistical Manual (3rd ed., rev.) and the visual analog scale. Both groups were similar in terms of pain intensity and duration. Statistical analysis showed both groups to have a significant amount of major psychiatric comorbidity, in particular major depressive disorder, and a high incidence of personality disorders. Therefore, intense chronic pain was associated with significant psychiatric comorbidity in both groups and in similar proportions. The high incidence of personality pathology in both groups may represent an exaggeration of maladaptive personality traits and coping styles as a result of a chronic, intense, state of pain.

  4. Proteomic identification of altered cerebral proteins in the complex regional pain syndrome animal model.

    Science.gov (United States)

    Nahm, Francis Sahngun; Park, Zee-Yong; Nahm, Sang-Soep; Kim, Yong Chul; Lee, Pyung Bok

    2014-01-01

    Complex regional pain syndrome (CRPS) is a rare but debilitating pain disorder. Although the exact pathophysiology of CRPS is not fully understood, central and peripheral mechanisms might be involved in the development of this disorder. To reveal the central mechanism of CRPS, we conducted a proteomic analysis of rat cerebrum using the chronic postischemia pain (CPIP) model, a novel experimental model of CRPS. After generating the CPIP animal model, we performed a proteomic analysis of the rat cerebrum using a multidimensional protein identification technology, and screened the proteins differentially expressed between the CPIP and control groups. Results. A total of 155 proteins were differentially expressed between the CPIP and control groups: 125 increased and 30 decreased; expressions of proteins related to cell signaling, synaptic plasticity, regulation of cell proliferation, and cytoskeletal formation were increased in the CPIP group. However, proenkephalin A, cereblon, and neuroserpin were decreased in CPIP group. Altered expression of cerebral proteins in the CPIP model indicates cerebral involvement in the pathogenesis of CRPS. Further study is required to elucidate the roles of these proteins in the development and maintenance of CRPS.

  5. Proteomic Identification of Altered Cerebral Proteins in the Complex Regional Pain Syndrome Animal Model

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    Francis Sahngun Nahm

    2014-01-01

    Full Text Available Background. Complex regional pain syndrome (CRPS is a rare but debilitating pain disorder. Although the exact pathophysiology of CRPS is not fully understood, central and peripheral mechanisms might be involved in the development of this disorder. To reveal the central mechanism of CRPS, we conducted a proteomic analysis of rat cerebrum using the chronic postischemia pain (CPIP model, a novel experimental model of CRPS. Materials and Methods. After generating the CPIP animal model, we performed a proteomic analysis of the rat cerebrum using a multidimensional protein identification technology, and screened the proteins differentially expressed between the CPIP and control groups. Results. A total of 155 proteins were differentially expressed between the CPIP and control groups: 125 increased and 30 decreased; expressions of proteins related to cell signaling, synaptic plasticity, regulation of cell proliferation, and cytoskeletal formation were increased in the CPIP group. However, proenkephalin A, cereblon, and neuroserpin were decreased in CPIP group. Conclusion. Altered expression of cerebral proteins in the CPIP model indicates cerebral involvement in the pathogenesis of CRPS. Further study is required to elucidate the roles of these proteins in the development and maintenance of CRPS.

  6. Abnormal thalamocortical activity in patients with Complex Regional Pain Syndrome (CRPS) type I.

    Science.gov (United States)

    Walton, K D; Dubois, M; Llinás, R R

    2010-07-01

    Complex Regional Pain Syndrome (CRPS) is a neuropathic disease that presents a continuing challenge in terms of pathophysiology, diagnosis, and treatment. Recent studies of neuropathic pain, in both animals and patients, have established a direct relationship between abnormal thalamic rhythmicity related to Thalamo-cortical Dysrhythmia (TCD) and the occurrence of central pain. Here, this relationship has been examined using magneto-encephalographic (MEG) imaging in CRPS Type I, characterized by the absence of nerve lesions. The study addresses spontaneous MEG activity from 13 awake, adult patients (2 men, 11 women; age 15-62), with CRPS Type I of one extremity (duration range: 3months to 10years) and from 13 control subjects. All CRPS I patients demonstrated peaks in power spectrum in the delta (CRPS Type I patients presented abnormal brain activity typical of TCD, which has both diagnostic value indicating a central origin for this ailment and a potential treatment interest involving pharmacological and electrical stimulation therapies. Copyright 2010 International Association for the Study of Pain. Published by Elsevier B.V. All rights reserved.

  7. Interaction of hyperalgesia and sensory loss in complex regional pain syndrome type I (CRPS I.

    Directory of Open Access Journals (Sweden)

    Volker Huge

    Full Text Available BACKGROUND: Sensory abnormalities are a key feature of Complex Regional Pain Syndrome (CRPS. In order to characterise these changes in patients suffering from acute or chronic CRPS I, we used Quantitative Sensory Testing (QST in comparison to an age and gender matched control group. METHODS: 61 patients presenting with CRPS I of the upper extremity and 56 healthy subjects were prospectively assessed using QST. The patients' warm and cold detection thresholds (WDT; CDT, the heat and cold pain thresholds (HPT; CPT and the occurrence of paradoxical heat sensation (PHS were observed. RESULTS: In acute CRPS I, patients showed warm and cold hyperalgesia, indicated by significant changes in HPT and CPT. WDT and CDT were significantly increased as well, indicating warm and cold hypoaesthesia. In chronic CRPS, thermal hyperalgesia declined, but CDT as well as WDT further deteriorated. Solely patients with acute CRPS displayed PHS. To a minor degree, all QST changes were also present on the contralateral limb. CONCLUSIONS: We propose three pathomechanisms of CRPS I, which follow a distinct time course: Thermal hyperalgesia, observed in acute CRPS, indicates an ongoing aseptic peripheral inflammation. Thermal hypoaesthesia, as detected in acute and chronic CRPS, signals a degeneration of A-delta and C-fibres, which further deteriorates in chronic CRPS. PHS in acute CRPS I indicates that both inflammation and degeneration are present, whilst in chronic CRPS I, the pathomechanism of degeneration dominates, signalled by the absence of PHS. The contralateral changes observed strongly suggest the involvement of the central nervous system.

  8. Intrinsic brain networks normalize with treatment in pediatric complex regional pain syndrome

    Science.gov (United States)

    Becerra, Lino; Sava, Simona; Simons, Laura E.; Drosos, Athena M.; Sethna, Navil; Berde, Charles; Lebel, Alyssa A.; Borsook, David

    2014-01-01

    Pediatric complex regional pain syndrome (P-CRPS) offers a unique model of chronic neuropathic pain as it either resolves spontaneously or through therapeutic interventions in most patients. Here we evaluated brain changes in well-characterized children and adolescents with P-CRPS by measuring resting state networks before and following a brief (median = 3 weeks) but intensive physical and psychological treatment program, and compared them to matched healthy controls. Differences in intrinsic brain networks were observed in P-CRPS compared to controls before treatment (disease state) with the most prominent differences in the fronto-parietal, salience, default mode, central executive, and sensorimotor networks. Following treatment, behavioral measures demonstrated a reduction of symptoms and improvement of physical state (pain levels and motor functioning). Correlation of network connectivities with spontaneous pain measures pre- and post-treatment indicated concomitant reductions in connectivity in salience, central executive, default mode and sensorimotor networks (treatment effects). These results suggest a rapid alteration in global brain networks with treatment and provide a venue to assess brain changes in CRPS pre- and post-treatment, and to evaluate therapeutic effects. PMID:25379449

  9. Sex differences in complex regional pain syndrome type I (CRPS-I) in mice.

    Science.gov (United States)

    Tang, Chaoliang; Li, Juan; Tai, Wai Lydia; Yao, Weifeng; Zhao, Bo; Hong, Junmou; Shi, Si; Wang, Song; Xia, Zhongyuan

    2017-01-01

    Sex differences have been increasingly highlighted in complex regional pain syndrome (CRPS) in clinical practice. In CRPS type I (CRPS-I), although inflammation and oxidative stress have been implicated in its pathogenesis, whether pain behavior and the underlying mechanism are sex-specific is unclear. In the present study, we sought to explore whether sex differences have an impact on inflammation, oxidative stress, and pain sensitivity in CRPS-I. Chronic post-ischemia pain (CPIP) was established in both male and female mice as an animal model of CRPS-I. Edema and mechanical allodynia of bilateral hind paws were assessed after reperfusion. Blood samples were analyzed for serum levels of oxidative stress markers and inflammatory cytokines. Both male and female mice developed edema. Male mice developed CPIP at day 3 after reperfusion; female mice developed CPIP at day 2 after reperfusion. Female mice displayed significantly earlier and higher mechanical allodynia in the ischemic hind paw, which was associated with higher serum levels of IL-2, TNF-α, isoprostanes, 8 OhdG, and malondialdehyde at day 2 after reperfusion. Moreover, female mice showed significantly lower SOD and IL-4 compared to male mice at day 2 after reperfusion. Our results indicate that sex differences in inflammatory and oxidative stress states may play a central role in the sex-specific nociceptive hypersensitivity in CRPS-I, and offer a new insight into pharmacology treatments to improve pain management with CRPS.

  10. Local cytokine changes in complex regional pain syndrome type I (CRPS I) resolve after 6 months.

    Science.gov (United States)

    Lenz, Melanie; Uçeyler, Nurcan; Frettlöh, Jule; Höffken, Oliver; Krumova, Elena K; Lissek, Silke; Reinersmann, Annika; Sommer, Claudia; Stude, Philipp; Waaga-Gasser, Ana M; Tegenthoff, Martin; Maier, Christoph

    2013-10-01

    There is evidence that inflammatory processes are involved in at least the early phase of complex regional pain syndrome (CRPS). We compared a panel of pro- and antiinflammatory cytokines in skin blister fluids and serum from patients with CRPS and patients with upper-limb pain of other origin (non-CRPS) in the early stage (CRPS patients compared to non-CRPS patients. Neither group showed side differences. After 6 months under analgesic treatment, protein levels of all measured cytokines in CRPS patients, except for IL-6, significantly changed bilaterally to the level of non-CRPS patients. These changes were not related to treatment outcome. In serum, only IL-8, TNF-α, eotaxin, MCP-1, and MIP-1β were detectable without intergroup differences. Blister fluid of CRPS patients showed a bilateral proinflammatory cytokine profile. This profile seems to be relevant only at the early stage of CRPS. Almost all measured cytokine levels were comparable to those of non-CRPS patients after 6 months of analgesic treatment and were not related to treatment outcome. Copyright © 2013 International Association for the Study of Pain. Published by Elsevier B.V. All rights reserved.

  11. Intrinsic brain networks normalize with treatment in pediatric complex regional pain syndrome

    Directory of Open Access Journals (Sweden)

    Lino Becerra

    2014-01-01

    Full Text Available Pediatric complex regional pain syndrome (P-CRPS offers a unique model of chronic neuropathic pain as it either resolves spontaneously or through therapeutic interventions in most patients. Here we evaluated brain changes in well-characterized children and adolescents with P-CRPS by measuring resting state networks before and following a brief (median = 3 weeks but intensive physical and psychological treatment program, and compared them to matched healthy controls. Differences in intrinsic brain networks were observed in P-CRPS compared to controls before treatment (disease state with the most prominent differences in the fronto-parietal, salience, default mode, central executive, and sensorimotor networks. Following treatment, behavioral measures demonstrated a reduction of symptoms and improvement of physical state (pain levels and motor functioning. Correlation of network connectivities with spontaneous pain measures pre- and post-treatment indicated concomitant reductions in connectivity in salience, central executive, default mode and sensorimotor networks (treatment effects. These results suggest a rapid alteration in global brain networks with treatment and provide a venue to assess brain changes in CRPS pre- and post-treatment, and to evaluate therapeutic effects.

  12. Interaction of hyperalgesia and sensory loss in complex regional pain syndrome type I (CRPS I).

    Science.gov (United States)

    Huge, Volker; Lauchart, Meike; Förderreuther, Stefanie; Kaufhold, Wibke; Valet, Michael; Azad, Shahnaz Christina; Beyer, Antje; Magerl, Walter

    2008-07-23

    Sensory abnormalities are a key feature of Complex Regional Pain Syndrome (CRPS). In order to characterise these changes in patients suffering from acute or chronic CRPS I, we used Quantitative Sensory Testing (QST) in comparison to an age and gender matched control group. 61 patients presenting with CRPS I of the upper extremity and 56 healthy subjects were prospectively assessed using QST. The patients' warm and cold detection thresholds (WDT; CDT), the heat and cold pain thresholds (HPT; CPT) and the occurrence of paradoxical heat sensation (PHS) were observed. In acute CRPS I, patients showed warm and cold hyperalgesia, indicated by significant changes in HPT and CPT. WDT and CDT were significantly increased as well, indicating warm and cold hypoaesthesia. In chronic CRPS, thermal hyperalgesia declined, but CDT as well as WDT further deteriorated. Solely patients with acute CRPS displayed PHS. To a minor degree, all QST changes were also present on the contralateral limb. We propose three pathomechanisms of CRPS I, which follow a distinct time course: Thermal hyperalgesia, observed in acute CRPS, indicates an ongoing aseptic peripheral inflammation. Thermal hypoaesthesia, as detected in acute and chronic CRPS, signals a degeneration of A-delta and C-fibres, which further deteriorates in chronic CRPS. PHS in acute CRPS I indicates that both inflammation and degeneration are present, whilst in chronic CRPS I, the pathomechanism of degeneration dominates, signalled by the absence of PHS. The contralateral changes observed strongly suggest the involvement of the central nervous system.

  13. A case of complex regional pain syndrome with agnosia for object orientation.

    Science.gov (United States)

    Robinson, Gail; Cohen, Helen; Goebel, Andreas

    2011-07-01

    This systematic investigation of the neurocognitive correlates of complex regional pain syndrome (CRPS) in a single case also reports agnosia for object orientation in the context of persistent CRPS. We report a patient (JW) with severe long-standing CRPS who had no difficulty identifying and naming line drawings of objects presented in 1 of 4 cardinal orientations. In contrast, he was extremely poor at reorienting these objects into the correct upright orientation and in judging whether an object was upright or not. Moreover, JW made orientation errors when copying drawings of objects, and he also showed features of mirror reversal in writing single words and reading single letters. The findings are discussed in relation to accounts of visual processing. Agnosia for object orientation is the term for impaired knowledge of an object's orientation despite good recognition and naming of the same misoriented object. This defect has previously only been reported in patients with major structural brain lesions. The neuroanatomical correlates are discussed. The patient had no structural brain lesion, raising the possibility that nonstructural reorganisation of cortical networks may be responsible for his deficits. Other patients with CRPS may have related neurocognitive defects. Crown Copyright © 2011. Published by Elsevier B.V. All rights reserved.

  14. Impaired recognition of social emotion in patients with complex regional pain syndrome.

    Science.gov (United States)

    Shin, Na Young; Kang, Do-Hyung; Jang, Joon Hwan; Park, Soo Young; Hwang, Jae Yeon; Kim, Sung Nyun; Byun, Min Soo; Park, Hye Youn; Kim, Yong Chul

    2013-11-01

    Multiple brain areas involved in nociceptive, autonomic, and social-emotional processing are disproportionally changed in patients with complex regional pain syndrome (CRPS). Little empirical evidence is available involving social cognitive functioning in patients with chronic pain conditions. We investigated the ability of patients with CRPS to recognize the mental/emotional states of other people. Forty-three patients with CRPS and 30 healthy controls performed the Reading Mind in the Eyes Test, which consists of photos in which human eyes express various emotional and mental states. Neuropsychological tests, including the Wisconsin Card Sorting Test, the stop-signal test, and the reaction time test, were administered to evaluate other cognitive functions. Patients with CRPS were significantly less accurate at recognizing emotional states in other persons, but not on other cognitive tests, compared with control subjects. We found a significant association between the deficit in social-emotion recognition and the affective dimension of pain, whereas this deficit was not related to the sensory dimension of pain. Our findings suggest a disrupted ability to recognize others' mental/emotional states in patients with CRPS. This article demonstrated a deficit in inferring mental/emotional states of others in patients with CRPS that was related to pain affect. Our study suggests that additional interventions directed toward reducing distressful affective pain may be helpful to restore social cognitive processing in patients with CRPS. Copyright © 2013 American Pain Society. Published by Elsevier Inc. All rights reserved.

  15. Correlates and importance of neglect-like symptoms in complex regional pain syndrome.

    Science.gov (United States)

    Wittayer, Matthias; Dimova, Violeta; Birklein, Frank; Schlereth, Tanja

    2018-05-01

    Neglect-like symptoms (NLS) are frequently observed in complex regional pain syndrome (CRPS). The clinical meaning of NLS, however, is largely unknown. Therefore, this study sets out to assess the importance of NLS for patient outcome and to explore their clinical correlates. We assessed NLS in a group of 53 patients with CRPS and compared the results to 28 healthy volunteers. To define the origin of the NLS reports, we tested the subjective visual midline, performed a limb-laterality recognition test, and quantitative sensory testing. In addition, psychological and pain assessment scales were completed. Tests were analyzed with univariate and multivariate approaches. After 6 months, patients were reassessed and the influence of NLS on pain outcome was determined. Most patients reported NLS in the questionnaire, whereas subjective visual midline and limb-laterality recognition test in contrast to previous studies did not reveal perceptual disturbances. Neglect-like symptom scores were associated with pain and pain catastrophizing in acute CRPS and anxiety and thermal sensory loss in chronic CRPS. Furthermore, high NLS scores had a negative impact on pain outcome after 6 months. Our results indicate that NLS have a different meaning in acute and chronic CRPS and might be of prognostic value. Possibly, treatment should focus on reducing NLS.

  16. Evaluation of brain metabolite in patients with complex regional pain syndrome by MR spectroscopy

    International Nuclear Information System (INIS)

    Iwashita, Narihito; Fukui, Mikio; Nitta, Kazuhito; Anzawa, Noriyuki; Tomie, Hisashi; Nakanishi, Miho; Matsumoto, Tomikichi; Nosaka, Shuichi

    2010-01-01

    Recently brain imaging studies have shown that patients with chronic pain have an altered cortical processing of nociceptive inputs. We evaluated brain metabolites in patients with complex regional pain syndrome (CRPS) using MR spectroscopy. Absolute concentrations of N-acetylaspartate (NAA) and choline (Cho) were measured in anterior cingulate (ACC) and prefrontal cortices (PFC) of patients and volunteers as matched control. Psychological aspects of patients were also evaluated with Hospital Anxiety and Depression (HAD) scale, in addition to the intensity of pain by visual analog scale. In the ACC, CRPS patients had a significant decrease of NAA and a significant increase of Cho compared to the control. Furthermore, patients with anxiety scored by HAD scale had reduced NAA concentration in ACC compared to the patients without anxiety. In the PFC, there was a reduction of NAA in the patients compared with that in control. No correlation was observed between intensity of pain and these metabolites. These results suggest that metabolite changes in ACC and PFC could reflect the pathogenesis of CRPS. (author)

  17. Abnormal Brain Responses to Action Observation in Complex Regional Pain Syndrome.

    Science.gov (United States)

    Hotta, Jaakko; Saari, Jukka; Koskinen, Miika; Hlushchuk, Yevhen; Forss, Nina; Hari, Riitta

    2017-03-01

    Patients with complex regional pain syndrome (CRPS) display various abnormalities in central motor function, and their pain is intensified when they perform or just observe motor actions. In this study, we examined the abnormalities of brain responses to action observation in CRPS. We analyzed 3-T functional magnetic resonance images from 13 upper limb CRPS patients (all female, ages 31-58 years) and 13 healthy, age- and sex-matched control subjects. The functional magnetic resonance imaging data were acquired while the subjects viewed brief videos of hand actions shown in the first-person perspective. A pattern-classification analysis was applied to characterize brain areas where the activation pattern differed between CRPS patients and healthy subjects. Brain areas with statistically significant group differences (q frontal gyrus, secondary somatosensory cortex, inferior parietal lobule, orbitofrontal cortex, and thalamus. Our findings indicate that CRPS impairs action observation by affecting brain areas related to pain processing and motor control. This article shows that in CRPS, the observation of others' motor actions induces abnormal neural activity in brain areas essential for sensorimotor functions and pain. These results build the cerebral basis for action-observation impairments in CRPS. Copyright © 2016 American Pain Society. Published by Elsevier Inc. All rights reserved.

  18. Psychological distress and stressful life events in pediatric complex regional pain syndrome

    Science.gov (United States)

    Wager, Julia; Brehmer, Hannah; Hirschfeld, Gerrit; Zernikow, Boris

    2015-01-01

    BACKGROUND: There is little knowledge regarding the association between psychological factors and complex regional pain syndrome (CRPS) in children. Specifically, it is not known which factors precipitate CRPS and which result from the ongoing painful disease. OBJECTIVES: To examine symptoms of depression and anxiety as well as the experience of stressful life events in children with CRPS compared with children with chronic primary headaches and functional abdominal pain. METHODS: A retrospective chart study examined children with CRPS (n=37) who received intensive inpatient pain treatment between 2004 and 2010. They were compared with two control groups (chronic primary headaches and functional abdominal pain; each n=37), who also received intensive inpatient pain treatment. Control groups were matched with the CRPS group with regard to admission date, age and sex. Groups were compared on symptoms of depression and anxiety as well as stressful life events. RESULTS: Children with CRPS reported lower anxiety and depression scores compared with children with abdominal pain. A higher number of stressful life events before and after the onset of the pain condition was observed for children with CRPS. CONCLUSIONS: Children with CRPS are not particularly prone to symptoms of anxiety or depression. Importantly, children with CRPS experienced more stressful life events than children with chronic headaches or abdominal pain. Prospective long-term studies are needed to further explore the potential role of stressful life events in the etiology of CRPS. PMID:26035287

  19. Cerebral glucose metabolism change in patients with complex regional pain syndrome. A PET study

    International Nuclear Information System (INIS)

    Shiraishi, Satoe; Kobayashi, Hidetoshi; Nihashi, Takashi

    2006-01-01

    The aim of this study was to examine abnormalities of the central nervous system in patients with chronic pain who were diagnosed with complex regional pain syndrome (CRPS). Brain activity was assessed using 18 F-fluorodeoxyglucose positron emission tomography. The data collected from 18 patients were compared with data obtained from 13 normal age-matched controls. Our results showed that glucose metabolism was bilaterally increased in the secondary somatosensory cortex, mid-anterior cingulated cortex (ACC) or posterior cingulated cortex (PCC) (or both), parietal cortex, posterior parietal cortex (PPC), and cerebellum as well as in the right posterior insula and right thalamus in our patients. In contrast, glucose metabolism was reduced contralaterally in the dorsal prefrontal cortex and primary motor cortex. Glucose metabolism was bilaterally elevated in the mid-ACC/PCC and the PPC, which correlated with pain duration. These data suggested that glucose metabolism in the brains of patients with CRPS changes dramatically at each location. In particular, glucose metabolism was increased in the areas concerned with somatosensory perception, possibly due to continuous painful stimulation. (author)

  20. Methodical Approaches To Analysis And Forecasting Of Development Fuel And Energy Complex And Gas Industry In The Region

    Directory of Open Access Journals (Sweden)

    Vladimir Andreyevich Tsybatov

    2014-12-01

    Full Text Available Fuel and energy complex (FEC is one of the main elements of the economy of any territory over which intertwine the interests of all economic entities. To ensure economic growth of the region should ensure that internal balance of energy resources, which should be developed with account of regional specifics of economic growth and energy security. The study examined the status of this equilibrium, indicating fuel and energy balance of the region (TEB. The aim of the research is the development of the fuel and energy balance, which will allow to determine exactly how many and what resources are not enough to ensure the regional development strategy and what resources need to be brought in. In the energy balances as the focus of displays all issues of regional development, so thermopile is necessary as a mechanism of analysis of current issues, economic development, and in the forward-looking version — as a tool future vision for the fuel and energy complex, energy threats and ways of overcoming them. The variety of relationships in the energy sector with other sectors and aspects of society lead to the fact that the development of the fuel and energy balance of the region have to go beyond the actual energy sector, involving the analysis of other sectors of economy, as well as systems such as banking, budgetary, legislative, tax. Due to the complexity of the discussed problems, the obvious is the need to develop appropriate forecast-analytical system, allowing regional authorities to implement evidence-based predictions of the consequences of management decisions. Multivariant scenario study on development of fuel and energy complex and separately industry, to use the methods of project-based management, harmonized application of state regulation of strategic and market mechanisms on the operational directions of development of fuel and energy complex and separately industry in the economy of the region.

  1. Mitochondrial Complex 1 Activity Measured by Spectrophotometry Is Reduced across All Brain Regions in Ageing and More Specifically in Neurodegeneration.

    Science.gov (United States)

    Pollard, Amelia Kate; Craig, Emma Louise; Chakrabarti, Lisa

    2016-01-01

    Mitochondrial function, in particular complex 1 of the electron transport chain (ETC), has been shown to decrease during normal ageing and in neurodegenerative disease. However, there is some debate concerning which area of the brain has the greatest complex 1 activity. It is important to identify the pattern of activity in order to be able to gauge the effect of age or disease related changes. We determined complex 1 activity spectrophotometrically in the cortex, brainstem and cerebellum of middle aged mice (70-71 weeks), a cerebellar ataxic neurodegeneration model (pcd5J) and young wild type controls. We share our updated protocol on the measurements of complex1 activity and find that mitochondrial fractions isolated from frozen tissues can be measured for robust activity. We show that complex 1 activity is clearly highest in the cortex when compared with brainstem and cerebellum (p<0.003). Cerebellum and brainstem mitochondria exhibit similar levels of complex 1 activity in wild type brains. In the aged brain we see similar levels of complex 1 activity in all three-brain regions. The specific activity of complex 1 measured in the aged cortex is significantly decreased when compared with controls (p<0.0001). Both the cerebellum and brainstem mitochondria also show significantly reduced activity with ageing (p<0.05). The mouse model of ataxia predictably has a lower complex 1 activity in the cerebellum, and although reductions are measured in the cortex and brain stem, the remaining activity is higher than in the aged brains. We present clear evidence that complex 1 activity decreases across the brain with age and much more specifically in the cerebellum of the pcd5j mouse. Mitochondrial impairment can be a region specific phenomenon in disease, but in ageing appears to affect the entire brain, abolishing the pattern of higher activity in cortical regions.

  2. Effect of vitamin E on protein bound carbohydrate complexes in radiation treated oral squamous cell carcinoma patients

    International Nuclear Information System (INIS)

    Chitra, S.; Shyamala Devi, C.S.

    2008-01-01

    Serum glycoproteins were evaluated in oral squamous cell carcinoma patients treated with radiotherapy and also the effect of vitamin E was studied. Cell surface glycoconjugates are important parameters in the detection of malignancy. Thus, the objective of the present study is to evaluate the efficacy of vitamin E on glycoproteins in oral cavity cancer patients treated with radiotherapy. The study includes 26 age and sex matched normal healthy individuals and 26 patients with squamous cell carcinoma of oral cavity. These patients were divided into two groups, one for radiotherapy alone (at a dosage of 6000 cGy in five fractions per week for a period of six weeks) and the other for radiotherapy plus vitamin E supplementation (at a dosage of 400 IU/day of vitamin E) for the entire period of radiotherapy. Levels of hexose, hexosamine, fucose and sialic acid were increased in oral squamous cell carcinoma patients and a significant decrease was observed in radiation treated patients when compared to control. The levels of glycoconjugates were significantly decreased in radiation treated patients supplemented with vitamin E. This measurement may be useful in assessing disease progression and identifying patients resistant to therapy and a possible role of vitamin E on reduction in glycoconjugate levels of radiation treated oral squamous cell carcinoma patients. (author)

  3. Differential Efficacy of Ketamine in the Acute versus Chronic Stages of Complex Regional Pain Syndrome in Mice

    Science.gov (United States)

    Tajerian, Maral; Leu, David; Yang, Phillip; Huang, Ting Ting; Kingery, Wade S; Clark, J David

    2015-01-01

    Background Complex regional pain syndrome (CRPS) is a painful, disabling and often chronic condition, where many patients transition from an acute phase with prominent peripheral neurogenic inflammation to a chronic phase with evident central nervous system (CNS) changes. Ketamine is a centrally-acting agent believed to work through blockade of N-methyl-D-aspartate (NMDA) receptors and is being increasingly used for the treatment of refractory CRPS, although the basis for the drug’s effects and efficacy at different stages of the syndrome remain unclear. Methods We used a mouse model of CRPS (n=8–12/group) involving tibia fracture/cast immobilization to test the efficacy of ketamine (2 mg/kg/day; 7 days) or vehicle infusion during acute (3weeks [3w] post-fracture) and chronic (7w post-fracture) stages. Results Acute phase fracture mice displayed elevated limb temperature, edema and nociceptive sensitization that were not reduced by ketamine. Fracture mice treated with ketamine during the chronic phase showed reduced nociceptive sensitization that persisted beyond completion of the infusion. During this chronic phase, ketamine also reduced latent nociceptive sensitization and improved motor function at 18 weeks post-fracture. No side effects of the infusions were identified. These behavioral changes were associated with altered spinal astrocyte activation and expression of pain-related proteins including NMDA receptor 2b (NR2b), Ca2+/calmodulin-dependent protein kinase ii (CaMK2), and brain-derived neurotrophic factor (BNDF). Conclusions Collectively, these results demonstrate that ketamine is efficacious in the chronic, but not acute stages of CRPS, suggesting that the centrally-acting drug is relatively ineffective in early CRPS when peripheral mechanisms are more critical for supporting nociceptive sensitization. PMID:26492479

  4. Anti tumor necrosis factor - alpha adalimumab for complex regional pain syndrome type 1 (CRPS-I): a case series.

    Science.gov (United States)

    Eisenberg, Elon; Sandler, Ifat; Treister, Roi; Suzan, Erica; Haddad, May

    2013-11-01

    Evidence suggests tumor necrosis factor-alpha (TNF-α) mediates, at least in part, symptoms and signs in complex regional pain syndrome (CRPS). Here, we present a case series of patients with CRPS type 1, in whom the response to the anti-TNF-α adalimumab was assessed. Ten patients with CRPS type 1 were recruited. Assessments were performed before treatment, at 1 week, and 1, 3, and 6 months following 3 biweekly subcutaneous injections (40 mg/0.8 mL) adalimumab (Humira(®) ) and included the followings: Pain intensity using a 0-10 cm visual analog scale; the Short Form of the McGill Pain Questionnaire; the Beck Depression Inventory; the SF-36 questionnaire and mechanical and thermal thresholds (Von frey hair and Thermal Sensory Analyzer, respectively). In addition to the description of individual patient responses, both intention to treat (ITT) and per-protocol (PP) analyses were performed for the entire group. Three subgroups of patients were identified (3 patients in each): "nonresponders", "partial responders", and "robust responders" in whom improvement in almost all parameters was noted. Both the ITT and PP analyses demonstrated only a trend toward improvement in mechanical pain thresholds following treatment (ITT χ² = 13.83, P = 0.008; PP χ² = 10.29, P = 0.036). These results suggest adalimumab, and possibly other anti-TNF-α, can be potentially useful in some (although not in all) patients with CRPS type 1. These preliminary results along with the growing body of evidence which points to the involvement of TNF-α in the pathogenesis of CRPS justify further studies in this area. © 2013 World Institute of Pain.

  5. Complete recovery from intractable complex regional pain syndrome, CRPS-type I, following anesthetic ketamine and midazolam.

    Science.gov (United States)

    Kiefer, Ralph-Thomas; Rohr, Peter; Ploppa, Annette; Altemeyer, Karl-Heinz; Schwartzman, Robert Jay

    2007-06-01

    To describe the treatment of an intractable complex regional pain syndrome I (CRPS-I) patient with anesthetic doses of ketamine supplemented with midazolam. A patient presented with a rapidly progressing contiguous spread of CRPS from a severe ligamentous wrist injury. Standard pharmacological and interventional therapy successively failed to halt the spread of CRPS from the wrist to the entire right arm. Her pain was unmanageable with all standard therapy. As a last treatment option, the patient was transferred to the intensive care unit and treated on a compassionate care basis with anesthetic doses of ketamine in gradually increasing (3-5 mg/kg/h) doses in conjunction with midazolam over a period of 5 days. On the second day of the ketamine and midazolam infusion, edema, and discoloration began to resolve and increased spontaneous movement was noted. On day 6, symptoms completely resolved and infusions were tapered. The patient emerged from anesthesia completely free of pain and associated CRPS signs and symptoms. The patient has maintained this complete remission from CRPS for 8 years now. In a patient with severe spreading and refractory CRPS, a complete and long-term remission from CRPS has been obtained utilizing ketamine and midazolam in anesthetic doses. This intensive care procedure has very serious risks but no severe complications occurred. The psychiatric side effects of ketamine were successfully managed with the concomitant use of midazolam and resolved within 1 month of treatment. This case report illustrates the effectiveness and safety of high-dose ketamine in a patient with generalized, refractory CRPS.

  6. Recommendations for a first Core Outcome Measurement set for complex regional PAin syndrome Clinical sTudies (COMPACT)

    Science.gov (United States)

    Grieve, Sharon; Perez, Roberto SGM; Birklein, Frank; Brunner, Florian; Bruehl, Stephen; Harden R, Norman; Packham, Tara; Gobeil, Francois; Haigh, Richard; Holly, Janet; Terkelsen, Astrid; Davies, Lindsay; Lewis, Jennifer; Thomassen, Ilona; Connett, Robyn; Worth, Tina; Vatine, Jean-Jacques; McCabe, Candida S

    2017-01-01

    Complex Regional Pain Syndrome (CRPS) is a persistent pain condition that remains incompletely understood and challenging to treat. Historically, a wide range of different outcome measures have been used to capture the multidimensional nature of CRPS. This has been a significant limiting factor in the advancement of our understanding of the mechanisms and management of CRPS. In 2013, an international consortium of patients, clinicians, researchers and industry representatives was established, to develop and agree on a minimum core set of standardised outcome measures for use in future CRPS clinical research, including but not limited to clinical trials within adult populations The development of a core measurement set was informed through workshops and supplementary work, using an iterative consensus process. ‘What is the clinical presentation and course of CRPS, and what factors influence it?’ was agreed as the most pertinent research question that our standardised set of patient-reported outcome measures should be selected to answer. The domains encompassing the key concepts necessary to answer the research question were agreed as: pain, disease severity, participation and physical function, emotional and psychological function, self efficacy, catastrophizing and patient's global impression of change. The final core measurement set included the optimum generic or condition-specific patient-reported questionnaire outcome measures, which captured the essence of each domain, and one clinician reported outcome measure to capture the degree of severity of CRPS. The next step is to test the feasibility and acceptability of collecting outcome measure data using the core measurement set in the CRPS population internationally. PMID:28178071

  7. Local and regional minimum 1D models for earthquake location and data quality assessment in complex tectonic regions: application to Switzerland

    International Nuclear Information System (INIS)

    Husen, S.; Clinton, J. F.; Kissling, E.

    2011-01-01

    One-dimensional (1D) velocity models are still widely used for computing earthquake locations at seismological centers or in regions where three-dimensional (3D) velocity models are not available due to the lack of data of sufficiently high quality. The concept of the minimum 1D model with appropriate station corrections provides a framework to compute initial hypocenter locations and seismic velocities for local earthquake tomography. Since a minimum 1D model represents a solution to the coupled hypocenter-velocity problem it also represents a suitable velocity model for earthquake location and data quality assessment, such as evaluating the consistency in assigning pre-defined weighting classes and average picking error. Nevertheless, the use of a simple 1D velocity structure in combination with station delays raises the question of how appropriate the minimum 1D model concept is when applied to complex tectonic regions with significant three-dimensional (3D) variations in seismic velocities. In this study we compute one regional minimum 1D model and three local minimum 1D models for selected subregions of the Swiss Alpine region, which exhibits a strongly varying Moho topography. We compare the regional and local minimum 1D models in terms of earthquake locations and data quality assessment to measure their performance. Our results show that the local minimum 1D models provide more realistic hypocenter locations and better data fits than a single model for the Alpine region. We attribute this to the fact that in a local minimum 1D model local and regional effects of the velocity structure can be better separated. Consequently, in tectonically complex regions, minimum 1D models should be computed in sub-regions defined by similar structure, if they are used for earthquake location and data quality assessment. (authors)

  8. Local and regional minimum 1D models for earthquake location and data quality assessment in complex tectonic regions: application to Switzerland

    Energy Technology Data Exchange (ETDEWEB)

    Husen, S.; Clinton, J. F. [Swiss Seismological Service, ETH Zuerich, Zuerich (Switzerland); Kissling, E. [Institute of Geophysics, ETH Zuerich, Zuerich (Switzerland)

    2011-10-15

    One-dimensional (1D) velocity models are still widely used for computing earthquake locations at seismological centers or in regions where three-dimensional (3D) velocity models are not available due to the lack of data of sufficiently high quality. The concept of the minimum 1D model with appropriate station corrections provides a framework to compute initial hypocenter locations and seismic velocities for local earthquake tomography. Since a minimum 1D model represents a solution to the coupled hypocenter-velocity problem it also represents a suitable velocity model for earthquake location and data quality assessment, such as evaluating the consistency in assigning pre-defined weighting classes and average picking error. Nevertheless, the use of a simple 1D velocity structure in combination with station delays raises the question of how appropriate the minimum 1D model concept is when applied to complex tectonic regions with significant three-dimensional (3D) variations in seismic velocities. In this study we compute one regional minimum 1D model and three local minimum 1D models for selected subregions of the Swiss Alpine region, which exhibits a strongly varying Moho topography. We compare the regional and local minimum 1D models in terms of earthquake locations and data quality assessment to measure their performance. Our results show that the local minimum 1D models provide more realistic hypocenter locations and better data fits than a single model for the Alpine region. We attribute this to the fact that in a local minimum 1D model local and regional effects of the velocity structure can be better separated. Consequently, in tectonically complex regions, minimum 1D models should be computed in sub-regions defined by similar structure, if they are used for earthquake location and data quality assessment. (authors)

  9. Are more complex physiological models of forest ecosystems better choices for plot and regional predictions?

    Science.gov (United States)

    Wenchi Jin; Hong S. He; Frank R. Thompson

    2016-01-01

    Process-based forest ecosystem models vary from simple physiological, complex physiological, to hybrid empirical-physiological models. Previous studies indicate that complex models provide the best prediction at plot scale with a temporal extent of less than 10 years, however, it is largely untested as to whether complex models outperform the other two types of models...

  10. An approach for a complex assessment of the geo-ecological risk from natural disasters in a geographic region

    International Nuclear Information System (INIS)

    Zlateva, Plamena; Stoyanov, Krasimir

    2009-01-01

    The paper proposes an approach for a complex assessment of the geo-ecological risk of a certain geographic region on the basis of quantitative and qualitative datum about the potential natural disasters. A fuzzy logic model is designed. The type of the threats, consequences and interdependencies between infrastructure objects are taken into account. The geographic region is considered as a complex system of interconnected and mutually influencing elements. The expected damages are directly and/or indirectly connected with life quality deterioration. Keywords: Risk, Geo-ecological risk, Damages, Threats, Vulnerabilities, Natural disasters

  11. Application of digital tomosynthesis in diagnosing the fractures or dislocations in irregular bones and regions with complex structures.

    Science.gov (United States)

    Tuerdi, Batuer; Wang, Hui; Zhang, Ying; Zhou, Hao; Zhang, Hao

    2015-01-01

    The application potential of digital tomosynthesis in diagnosing fractures or dislocations in irregular bones and regions with complex structures was evaluated. Digital radiography and tomosynthesis were performed in 121 patients, and the image quality, accuracy, sensitivity, and specificity were compared. The number of participants with a definite diagnosis of fracture and/or dislocation was 98. The ratio of excellent images, accuracy, sensitivity, and specificity of digital tomosynthesis were higher than that of direct radiography. Digital tomosynthesis could be applied in the diagnosis of fractures or dislocations in irregular bones and regions with complex structures. Copyright © 2015 Elsevier Inc. All rights reserved.

  12. [11C]-(R)-PK11195 positron emission tomography in patients with complex regional pain syndrome

    Science.gov (United States)

    Jeon, So Yeon; Seo, Seongho; Lee, Jae Sung; Choi, Soo-Hee; Lee, Do-Hyeong; Jung, Ye-Ha; Song, Man-Kyu; Lee, Kyung-Jun; Kim, Yong Chul; Kwon, Hyun Woo; Im, Hyung-Jun; Lee, Dong Soo; Cheon, Gi Jeong; Kang, Do-Hyung

    2017-01-01

    Abstract Complex regional pain syndrome (CRPS) is characterized by severe and chronic pain, but the pathophysiology of this disease are not clearly understood. The primary aim of our case–control study was to explore neuroinflammation in patients with CRPS using positron emission tomography (PET), with an 18-kDa translocator protein specific radioligand [11C]-(R)-PK11195. [11C]-(R)-PK11195 PET scans were acquired for 11 patients with CRPS (30–55 years) and 12 control subjects (30–52 years). Parametric image of distribution volume ratio (DVR) for each participant was generated by applying a relative equilibrium-based graphical analysis. The DVR of [11C]-(R)-PK11195 in the caudate nucleus (t(21) = −3.209, P = 0.004), putamen (t(21) = −2.492, P = 0.022), nucleus accumbens (t(21) = −2.218, P = 0.040), and thalamus (t(21) = −2.395, P = 0.026) were significantly higher in CRPS patients than in healthy controls. Those of globus pallidus (t(21) = −2.045, P = 0.054) tended to be higher in CRPS patients than in healthy controls. In patients with CRPS, there was a positive correlation between the DVR of [11C]-(R)-PK11195 in the caudate nucleus and the pain score, the visual analog scale (r = 0.661, P = 0.026, R2 = 0.408) and affective subscales of McGill Pain Questionnaire (r = 0.604, P = 0.049, R2 = 0.364). We demonstrated that neuroinflammation of CRPS patients in basal ganglia. Our results suggest that microglial pathology can be an important pathophysiology of CRPS. Association between the level of caudate nucleus and pain severity indicated that neuroinflammation in this region might play a key role. These results may be essential for developing effective medical treatments. PMID:28072713

  13. Pain increases during sympathetic arousal in patients with complex regional pain syndrome.

    Science.gov (United States)

    Drummond, P D; Finch, P M; Skipworth, S; Blockey, P

    2001-10-09

    To investigate the effect of sympathetic arousal on pain and vasomotor responses in healthy control subjects and patients with complex regional pain syndrome (CRPS), and to determine whether pain increases in patients with particular symptoms. In experiments 1 and 2, capsaicin was applied to the forearm of 24 healthy subjects to induce thermal hyperalgesia. Vascular responses were monitored and subjects rated thermal hyperalgesia before and after being startled (experiment 1), and before, during, and after mental arithmetic, breath holding, forehead cooling, the Valsalva maneuver, and a cold pressor test in experiment 2. In a third experiment, sensitivity to heat, cold, and mechanical stimulation was investigated in 61 patients with CRPS. Pain ratings and vascular and electrodermal responses were recorded after patients were startled and during forehead cooling. In experiment 1, thermal hyperalgesia decreased in healthy control subjects after they were startled, and digital blood vessels constricted symmetrically. In experiment 2, thermal hyperalgesia decreased during and after other forms of sympathetic arousal. However, in experiment 3, ratings of clinical pain increased during forehead cooling or after being startled in over 70% of patients with CRPS. Pain increased most consistently during forehead cooling in patients with cold allodynia or punctate allodynia. Digital blood vessels constricted more intensely on the symptomatic than the nonsymptomatic side in patients with CRPS during sympathetic arousal. Normal inhibitory influences on pain during sympathetic arousal are compromised in the majority of patients with CRPS. The augmented vasoconstrictor response in the symptomatic limb during sympathetic arousal is consistent with adrenergic supersensitivity. An adrenergic sensitivity in nociceptive afferents might contribute to pain and hyperalgesia during sympathetic arousal in certain patients with CRPS.

  14. Selective Fiber Degeneration in the Peripheral Nerve of a Patient With Severe Complex Regional Pain Syndrome

    Directory of Open Access Journals (Sweden)

    Adrien Yvon

    2018-04-01

    Full Text Available Aims: Complex regional pain syndrome (CRPS is characterized by chronic debilitating pain disproportional to the inciting event and accompanied by motor, sensory, and autonomic disturbances. The pathophysiology of CRPS remains elusive. An exceptional case of severe CRPS leading to forearm amputation provided the opportunity to examine nerve histopathological features of the peripheral nerves.Methods: A 35-year-old female developed CRPS secondary to low voltage electrical injury. The CRPS was refractory to medical therapy and led to functional loss of the forelimb, repeated cutaneous wound infections leading to hospitalization. Specifically, the patient had exhausted a targeted conservative pain management programme prior to forearm amputation. Radial, median, and ulnar nerve specimens were obtained from the amputated limb and analyzed by light and transmission electron microscopy (TEM.Results: All samples showed features of selective myelinated nerve fiber degeneration (47–58% of fibers on electron microscopy. Degenerating myelinated fibers were significantly larger than healthy fibers (p < 0.05, and corresponded to the larger Aα fibers (motor/proprioception whilst smaller Aδ (pain/temperature fibers were spared. Groups of small unmyelinated C fibers (Remak bundles also showed evidence of degeneration in all samples.Conclusions: We are the first to show large fiber degeneration in CRPS using TEM. Degeneration of Aα fibers may lead to an imbalance in nerve signaling, inappropriately triggering the smaller healthy Aδ fibers, which transmit pain and temperature. These findings suggest peripheral nerve degeneration may play a key role in CRPS. Improved knowledge of pathogenesis will help develop more targeted treatments.

  15. Impaired spatial body representation in complex regional pain syndrome type 1 (CRPS I).

    Science.gov (United States)

    Reinersmann, Annika; Landwehrt, Julia; Krumova, Elena K; Ocklenburg, Sebastian; Güntürkün, Onur; Maier, Christoph

    2012-11-01

    Recently, a shift of the visual subjective body midline (vSM), a correlate of the egocentric reference frame, towards the affected side was reported in patients with complex regional pain syndrome (CRPS). However, the specificity of this finding is as yet unclear. This study compares 24 CRPS patients to 21 patients with upper limb pain of other origin (pain control) and to 24 healthy subjects using a comprehensive test battery, including assessment of the vSM in light and dark, line bisection, hand laterality recognition, neglect-like severity symptoms, and motor impairment (disability of the arm, shoulder, and hand). 1-way analysis of variance, t-tests, significance level: 0.05. In the dark, CRPS patients displayed a significantly larger leftward spatial bias when estimating their vSM, compared to pain controls and healthy subjects, and also reported lower motor function than pain controls. For right-affected CRPS patients only, the deviation of the vSM correlated significantly with the severity of distorted body perception. Results confirm previous findings of impaired visuospatial perception in CRPS patients, which might be the result of the involvement of supraspinal mechanisms in this pain syndrome. These mechanisms might accentuate the leftward bias that results from a right-hemispheric dominance in visuospatial processing and is known as pseudoneglect. Pseudoneglect reveals itself in the tendency to perceive the midpoint of horizontal lines or the subjective body midline left of the centre. It was observable in all 3 groups, but most pronounced in CRPS patients, which might be due to the cortical reorganisation processes associated with this syndrome. Copyright © 2012 International Association for the Study of Pain. Published by Elsevier B.V. All rights reserved.

  16. Medical history and the onset of complex regional pain syndrome (CRPS).

    Science.gov (United States)

    de Mos, M; Huygen, F J P M; Dieleman, J P; Koopman, J S H A; Stricker, B H Ch; Sturkenboom, M C J M

    2008-10-15

    Knowledge concerning the medical history prior to the onset of complex regional pain syndrome (CRPS) might provide insight into its risk factors and potential underlying disease mechanisms. To evaluate prior to CRPS medical conditions, a case-control study was conducted in the Integrated Primary Care Information (IPCI) project, a general practice (GP) database in the Netherlands. CRPS patients were identified from the records and validated through examination by the investigator (IASP criteria) or through specialist confirmation. Cases were matched to controls on age, gender and injury type. All diagnoses prior to the index date were assessed by manual review of the medical records. Some pre-specified medical conditions were studied for their association with CRPS, whereas all other diagnoses, grouped by pathogenesis, were tested in a hypothesis-generating approach. Of the identified 259 CRPS patients, 186 cases (697 controls) were included, based on validation by the investigator during a visit (102 of 134 visited patients) or on specialist confirmation (84 of 125 unvisited patients). A medical history of migraine (OR: 2.43, 95% CI: 1.18-5.02) and osteoporosis (OR: 2.44, 95% CI: 1.17-5.14) was associated with CRPS. In a recent history (1-year before CRPS), cases had more menstrual cycle-related problems (OR: 2.60, 95% CI: 1.16-5.83) and neuropathies (OR: 5.7; 95% CI: 1.8-18.7). In a sensitivity analysis, including only visited cases, asthma (OR: 3.0; 95% CI: 1.3-6.9) and CRPS were related. Psychological factors were not associated with CRPS onset. Because of the hypothesis-generating character of this study, the findings should be confirmed by other studies.

  17. A prospective, multisite, international validation of the Complex Regional Pain Syndrome Severity Score.

    Science.gov (United States)

    Harden, R Norman; Maihofner, Christian; Abousaad, Elias; Vatine, Jean-Jacques; Kirsling, Amy; Perez, Roberto S G M; Kuroda, Maxine; Brunner, Florian; Stanton-Hicks, Michael; Marinus, Johan; van Hilten, Jacobus J; Mackey, Sean; Birklein, Frank; Schlereth, Tanja; Mailis-Gagnon, Angela; Graciosa, Joe; Connoly, Sara B; Dayanim, David; Massey, Michael; Frank, Hadas; Livshitz, Anatoly; Bruehl, Stephen

    2017-08-01

    Clinical diagnosis of complex regional pain syndrome (CRPS) is a dichotomous (yes/no) categorization, a format necessary for clinical decision making. Such dichotomous diagnostic categories do not convey an individual's subtle gradations in the severity of the condition over time and have poor statistical power when used as an outcome measure in research. This prospective, international, multicenter study slightly modified and further evaluated the validity of the CRPS Severity Score (CSS), a continuous index of CRPS severity. Using a prospective design, medical evaluations were conducted in 156 patients with CRPS to compare changes over time in CSS scores between patients initiating a new treatment program and patients on stable treatment regimens. New vs stable categorizations were supported by greater changes in pain and function in the former. Results indicated that CSS values in the stable CRPS treatment group exhibited much less change over time relative to the new treatment group, with intraclass correlations nearly twice as large in the former. A calculated smallest real difference value revealed that a change in the CSS of ≥4.9 scale points would indicate real differences in CRPS symptomatology (with 95% confidence). Across groups, larger changes in CRPS features on the CSS over time were associated in the expected direction with greater changes in pain intensity, fatigue, social functioning, ability to engage in physical roles, and general well-being. The overall pattern of findings further supports the validity of the CSS as a measure of CRPS severity and suggests it may prove useful in clinical monitoring and outcomes research.

  18. Motor dysfunction of complex regional pain syndrome is related to impaired central processing of proprioceptive information.

    Science.gov (United States)

    Bank, Paulina J M; Peper, C Lieke E; Marinus, Johan; Beek, Peter J; van Hilten, Jacobus J

    2013-11-01

    Our understanding of proprioceptive deficits in complex regional pain syndrome (CRPS) and its potential contribution to impaired motor function is still limited. To gain more insight into these issues, we evaluated accuracy and precision of joint position sense over a range of flexion-extension angles of the wrist of the affected and unaffected sides in 25 chronic CRPS patients and in 50 healthy controls. The results revealed proprioceptive impairment at both the patients' affected and unaffected sides, characterized predominantly by overestimation of wrist extension angles. Precision of the position estimates was more prominently reduced at the affected side. Importantly, group differences in proprioceptive performance were observed not only for tests at identical percentages of each individual's range of wrist motion but also when controls were tested at wrist angles that corresponded to those of the patient's affected side. More severe motor impairment of the affected side was associated with poorer proprioceptive performance. Based on additional sensory tests, variations in proprioceptive performance over the range of wrist angles, and comparisons between active and passive displacements, the disturbances of proprioceptive performance most likely resulted from altered processing of afferent (and not efferent) information and its subsequent interpretation in the context of a distorted "body schema." The present results point at a significant role for impaired central processing of proprioceptive information in the motor dysfunction of CRPS and suggest that therapeutic strategies aimed at identification of proprioceptive impairments and their restoration may promote the recovery of motor function in CRPS patients. Copyright © 2013 American Pain Society. Published by Elsevier Inc. All rights reserved.

  19. Is physiotherapy effective for children with complex regional pain syndrome type 1?

    Science.gov (United States)

    Bialocerkowski, Andrea E; Daly, Anne

    2012-01-01

    This study synthesized current research evidence on the effectiveness of physiotherapy for the management of children diagnosed with complex regional pain syndrome type 1 (CRPS-1), to provide up-to-date physiotherapy treatment recommendations, and to identify areas that require further investigation. Nine electronic databases were searched for quantitative studies that evaluated the effect of physiotherapy on children with CRPS-1. The methodological quality of the studies was evaluated using the Critical Review Form. Data were extracted regarding the study design, participant characteristics, types of outcome measures used, and physiotherapy technique used and its effectiveness. The search strategy identified 303 potential studies, of which 12 met the inclusion criteria (1 randomized controlled trial, 1 comparative study, 10 case series). The methodological quality of all studies was rated as poor to fair. The "stand-alone" value of physiotherapy could not be determined as physiotherapy was prescribed in conjunction with psychological and medical interventions. There is low volume and poor-to-fair quality evidence which suggests that physiotherapy prescribed with other interventions may lead to short-term improvement in the signs and symptoms of CRPS-1 or functional ability in children with CRPS-1, and the relapse rate may be moderately high. High-quality studies are required in this area. These studies should evaluate a package of care (which includes physiotherapy); they should investigate the effects of physiotherapy treatments that have proven effectiveness in adults with CRPS-1; they should use psychometrically sound measures to evaluate outcome; and the nature of physiotherapy should be detailed in future publications to enable replication in the clinical setting.

  20. Changes in plasma cytokines and their soluble receptors in complex regional pain syndrome.

    Science.gov (United States)

    Alexander, Guillermo M; Peterlin, B Lee; Perreault, Marielle J; Grothusen, John R; Schwartzman, Robert J

    2012-01-01

    Complex Regional Pain Syndrome (CRPS) is a chronic and often disabling pain disorder. There is evidence demonstrating that neurogenic inflammation and activation of the immune system play a significant role in the pathophysiology of CRPS. This study evaluated the plasma levels of cytokines, chemokines, and their soluble receptors in 148 subjects afflicted with CRPS and in 60 gender- and age-matched healthy controls. Significant changes in plasma cytokines, chemokines, and their soluble receptors were found in subjects with CRPS as compared with healthy controls. For most analytes, these changes resulted from a distinct subset of the CRPS subjects. When the plasma data from the CRPS subjects was subjected to cluster analysis, it revealed 2 clusters within the CRPS population. The category identified as most important for cluster separation by the clustering algorithm was TNFα. Cluster 1 consisted of 64% of CRPS subjects and demonstrated analyte values similar to the healthy control individuals. Cluster 2 consisted of 36% of the CRPS subjects and demonstrated significantly elevated levels of most analytes and in addition, it showed that the increased plasma analyte levels in this cluster were correlated with disease duration and severity. The identification of biomarkers that define disease subgroups can be of great value in the design of specific therapies and of great benefit to the design of clinical trials. It may also aid in advancing our understanding of the mechanisms involved in the pathophysiology of CRPS, which may lead to novel treatments for this very severe condition. Copyright © 2012 American Pain Society. Published by Elsevier Inc. All rights reserved.

  1. Rational pain management in complex regional pain syndrome 1 (CRPS 1)--a network meta-analysis.

    Science.gov (United States)

    Wertli, Maria M; Kessels, Alphons G H; Perez, Roberto S G M; Bachmann, Lucas M; Brunner, Florian

    2014-09-01

    Guidelines for complex regional pain syndrome (CRPS) 1 advocate several substance classes to reduce pain and support physical rehabilitation, but guidance about which agent should be prioritized when designing a therapeutic regimen is not provided. Using a network meta-analytic approach, we examined the efficacy of all agent classes investigated in randomized clinical trials of CRPS 1 and provide a rank order of various substances stratified by length of illness duration. In this study a network meta-analysis was conducted. The participants of this study were patients with CRPS 1. Searches in electronic, previous systematic reviews, conference abstracts, book chapters, and the reference lists of relevant articles were performed. Eligible studies were randomized controlled trials comparing at least one analgesic agent with placebo or with another analgesic and reporting efficacy in reducing pain. Summary efficacy stratified by symptom duration and length of follow-up was computed across all substance classes. Two authors independently extracted data. In total, 16 studies were included in the analysis. Bisphosphonates appear to be the treatment of choice in early stages of CRPS 1. The effects of calcitonin surpass that of bisphosphonates and other substances as a short-term medication in more chronic stages of the illness. While most medications showed some efficacy on short-term follow-up, only bisphosphonates, NMDA analogs, and vasodilators showed better long-term pain reduction than placebo. For some drug classes, only a few studies were available and many studies included a small group of patients. Insufficient data were available to analyze efficacy on disability. This network meta-analysis indicates that a rational pharmacological treatment strategy of pain management should consider bisphosphonates in early CRPS 1 and a short-term course of calcitonin in later stages. While most medications showed some efficacy on short-term follow-up, only bisphosphonates

  2. Research on the development efficiency of regional high-end talent in China: A complex network approach.

    Science.gov (United States)

    Zhang, Zhen; Wang, Minggang; Tian, Lixin; Zhang, Wenbin

    2017-01-01

    In this paper, based on the panel data of 31 provinces and cities in China from 1991 to 2016, the regional development efficiency matrix of high-end talent is obtained by DEA method, and the matrix is converted into a continuous change of complex networks through the construction of sliding window. Using a series of continuous changes in the complex network topology statistics, the characteristics of regional high-end talent development efficiency system are analyzed. And the results show that the average development efficiency of high-end talent in the western region is at a low level. After 2005, the national regional high-end talent development efficiency network has both short-range relevance and long-range relevance in the evolution process. The central region plays an important intermediary role in the national regional high-end talent development system. And the western region has high clustering characteristics. With the implementation of the high-end talent policies with regional characteristics by different provinces and cities, the relevance of high-end talent development efficiency in various provinces and cities presents a weakening trend, and the geographical characteristics of high-end talent are more and more obvious.

  3. Radiation Therapy Risk Factors for Development of Lymphedema in Patients Treated With Regional Lymph Node Irradiation for Breast Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Chandra, Ravi A. [Harvard Radiation Oncology Program, Boston, Massachusetts (United States); Miller, Cynthia L. [Harvard Medical School, Boston, Massachusetts (United States); Skolny, Melissa N. [Department of Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts (United States); Warren, Laura E.G. [Harvard Radiation Oncology Program, Boston, Massachusetts (United States); Horick, Nora [Department of Biostatistics, Massachusetts General Hospital, Boston, Massachusetts (United States); Jammallo, Lauren S.; Sadek, Betro T.; Shenouda, Mina N. [Department of Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts (United States); O' Toole, Jean [Department of Physical and Occupational Therapy, Massachusetts General Hospital, Boston, Massachusetts (United States); Specht, Michelle C. [Division of Surgical Oncology, Massachusetts General Hospital, Boston, Massachusetts (United States); Taghian, Alphonse G., E-mail: ataghian@partners.org [Department of Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts (United States)

    2015-03-15

    Purpose: We previously evaluated the risk of breast cancer-related lymphedema (LE) with the addition of regional lymph node irradiation (RLNR) and found an increased risk when RLNR is used. Here we analyze the association of technical radiation therapy (RT) factors in RLNR patients with the risk of LE development. Methods and Materials: From 2005 to 2012, we prospectively screened 1476 women for LE who underwent surgery for breast cancer. Among 1507 breasts treated, 172 received RLNR and had complete technical data for analysis. RLNR was delivered as supraclavicular (SC) irradiation (69% [118 of 172 patients]) or SC plus posterior axillary boost (PAB) (31% [54 of 172]). Bilateral arm volume measurements were performed pre- and postoperatively. Patients' RT plans were analyzed for SC field lateral border (relative to the humeral head), total dose to SC, RT fraction size, beam energy, and type of tangent (normal vs wide). Cox proportional hazards models were used to analyze associated risk factors for LE. Results: Median postoperative follow-up was 29.3 months (range: 4.9-74.1 months). The 2-year cumulative incidence of LE was 22% (95% confidence interval [CI]: 15%-32%) for SC and 20% (95% CI: 11%-37%) for SC plus PAB (SC+PAB). None of the analyzed variables was significantly associated with LE risk (extent of humeral head: P=.74 for <1/3 vs >2/3, P=.41 for 1/3 to 2/3 vs >2/3; P=.40 for fraction size of 1.8 Gy vs 2.0 Gy; P=.57 for beam energy 6 MV vs 10 MV; P=.74 for tangent type wide vs regular; P=.66 for SC vs SC+PAB). Only pretreatment body mass index (hazard ratio [HR]: 1.09; 95% CI: 1.04-1.15, P=.0007) and the use of axillary lymph node dissection (HR: 7.08, 95% CI: 0.98-51.40, P=.05) were associated with risk of subsequent LE development. Conclusions: Of the RT parameters tested, none was associated with an increased risk of LE development. This study underscores the need for future work investigating alternative RLNR risk factors for LE.

  4. Motor dysfunction in complex regional pain syndrome : the role of sensory processing and sensory-motor integration

    NARCIS (Netherlands)

    Bank, Paulina Johanna Maria

    2014-01-01

    In the chronic stage of Complex Regional Pain Syndrome (CRPS), motor disturbances are common and cause significant disability. The motor dysfunction of CRPS is a poorly understood phenomenon that is characterized predominantly by a decrease or loss of voluntary muscle control. This thesis aims to

  5. fMRI Reveals Distinct CNS Processing during Symptomatic and Recovered Complex Regional Pain Syndrome in Children

    Science.gov (United States)

    Lebel, A.; Becerra, L.; Wallin, D.; Moulton, E. A.; Morris, S.; Pendse, G.; Jasciewicz, J.; Stein, M.; Aiello-Lammens, M.; Grant, E.; Berde, C.; Borsook, D.

    2008-01-01

    Complex regional pain syndrome (CRPS) in paediatric patients is clinically distinct from the adult condition in which there is often complete resolution of its signs and symptoms within several months to a few years. The ability to compare the symptomatic and asymptomatic condition in the same individuals makes this population interesting for the…

  6. Investigating Reports of Complex Regional Pain Syndrome: An Analysis of HPV-16/18-Adjuvanted Vaccine Post-Licensure Data

    NARCIS (Netherlands)

    F.J.P.M. Huygen (Frank); K. Verschueren (Kristin); C. McCabe (Candida); J.-U. Stegmann (Jens-Ulrich); J. Zima (Julia); O. Mahaux (Olivia); L. Van Holle (Lionel); M.-G. Angelo (Maria-Genalin)

    2015-01-01

    textabstractComplex regional pain syndrome (CRPS) is a chronic pain disorder that typically follows trauma or surgery. Suspected CRPS reported after vaccination with human papillomavirus (HPV) vaccines led to temporary suspension of proactive recommendation of HPV vaccination in Japan. We

  7. Chronic pain and evoked responses in the brain: A magnetoencephalographic study in Complex Regional Pain Syndrome I and II

    NARCIS (Netherlands)

    Theuvenet, P.J.

    2012-01-01

    Complex Regional Pain Syndrome (CRPS) type I and II are chronic pain syndromes with comparable symptoms, only in CRPS II a peripheral nerve injury is present. No objective tests are currently available to differentiate the two types which hampers diagnosis and treatment. Non-invasive brain imaging

  8. How Discourses on Leisure Affect Regional Development in the Province of Fryslân : a Complex Adaptive Systems Perspective

    NARCIS (Netherlands)

    Meekes, Jasper; Parra Novoa, Constanza; de Roo, Gert

    2014-01-01

    Leisure is seen as an important factor for regional development in the province of Fryslân and many other predominantly rural and peripheral areas. However, planning for leisure, requiring high spatial quality, is a complex challenge. This is due to the fragmentation of leisure policy, but also to

  9. U-Pb age in zircon of intrusive granite at Acopiara complex, Crystal region, domain Central Ceara, Brazil

    International Nuclear Information System (INIS)

    Neri, T.F.O.; Hamelak, G.M.S.; Azevedo, L.R.; Mattos, I.C.; Verissimo, C.U.V.; Nogueira Neto, J.A.; Lima, M.N.

    2015-01-01

    Granitic body mineralogically composed by two micas, located at Crystal region, Ceara Central domain and intruded into lithotypes from Acopiara complex, provided an age of ∼526 Ma, indicating important period of magma generation of granitic composition associated with crustal anatexia, during Paleozoic

  10. Impact of spinal cord stimulation on sensory characteristics in complex regional pain syndrome type I - A randomized trial

    NARCIS (Netherlands)

    Kemler, MA; Reulen, JPH; Barendse, GAM; van Kleef, M; de Vet, HCW; van den Wildenberg, FAJM

    Background: A randomized trial was performed to assess the effect of spinal cord stimulation (SCS) on detection and pain thresholds for pressure, warmth, and cold and on the extent of mechanical hyperalgesia in patients with chronic complex regional pain syndrome type I. Methods: Fifty-four chronic

  11. Prevalence and Cost Analysis of Complex Regional Pain Syndrome (CRPS): A Role for Neuromodulation.

    Science.gov (United States)

    Elsamadicy, Aladine A; Yang, Siyun; Sergesketter, Amanda R; Ashraf, Bilal; Charalambous, Lefko; Kemeny, Hanna; Ejikeme, Tiffany; Ren, Xinru; Pagadala, Promila; Parente, Beth; Xie, Jichun; Lad, Shivanand P

    2017-09-29

    The diagnosis and treatment of complex regional pain syndrome (CRPS) is challenging and there is a paucity of data describing its overall cost burden and quantifying its impact on the US healthcare system. The aim of this study was to assess the prevalence and healthcare utilization costs associated with CRPS. A retrospective longitudinal study was performed using the Truven MarketScan® database to identify patients with a new indexed diagnosis of CRPS (Type I, II, or both) from 2001 to 2012. We collected total, outpatient, and pain prescription costs three years prior to CRPS diagnosis (baseline), at year of CRPS diagnosis, and eight-year post-CRPS diagnosis. A longitudinal multivariate analysis was used to model the estimated total and pain prescription cost ratios comparing patients diagnosed before and after CRPS. We included 35,316 patients with a newly indexed diagnosis of CRPS (Type I: n = 18,703, Type II: n = 14,599, Unspecified: n = 2014). Baseline characteristics were similar between the CRPS cohorts. Compared to two- and three-year baseline costs, one-year prior to diagnosis for all CRPS patients yielded the highest interquartile median [IQR] costs: total costs $7904[$3469, $16,084]; outpatient costs $6706[$3119, $12,715]; and pain prescription costs $1862[$147, $7649]. At the year of CRPS diagnosis, the median [IQR] costs were significantly higher than baseline costs: total costs $8508[$3943, $16,666]; outpatient costs $7251[$3527, $13,568]; and pain prescription costs $2077[$140, $8856]. Over the eight-year period after CRPS diagnosis, costs between all the years were similar, ranging from the highest (one-year) to lowest (seven-years), $4845 to $3888. The median total cumulative cost 8-years after CRPS diagnosis was $43,026 and $12,037 for pain prescription costs. [Correction added on 06 November 2017 after first online publication: the preceding sentence has been updated to demonstrate the median cumulative cost in replacement of the

  12. Application of UV-ozonization to treat complex cyanide and hydroponic solution. Ozone shigaisen heiyo mizushori hoho no oyorei

    Energy Technology Data Exchange (ETDEWEB)

    Wakou, H; Yasuda, M [Industrial Research Institute of Kanagawa Prefecture, Kanagawa (Japan)

    1993-04-15

    Water oxidizing treatment which simultaneously uses both ozone and ultraviolet rays is not widely used because of its large electric power consumption and inappropriate high concentration treatment. However, it is characterized by its small sludge production and non-residual oxidant after the treatment. Its existing examples of application comprise production of drinking water to be urgently used, superpure water to be used for the semiconductor production and water to be used in the cosmic space, disinfection of fish-breeding ponds, and deodorization of chemical factories. As a new purpose of use, it is applied to disinfection of nutrient liquid for the fertilizer. It is necessary to prohibit the discharge of unabsorbed and untreated nutrient liquid for the fertilizer. For the recycling utilization, it is further necessary to disinfect the pathogenic bacteria and prevent the accumulation of organic secretion from the roots. Disinfection could be made by applying the present treatment method to a cultivation of tomatoes with water. The sedimentation of ferrous rust could be prevented by using an appropriate ferrous complex in the nutrient liquid. The decomposition loss of complex was compensated with a quantitative equivalence. When cyanic plating waste water is made innocuous by chlorine or sodium hypophosphite, a large quantity of sludge is produced. However by applying the present treatment method to it, the cyanic complex could be decomposed, and separated and recovered as an insoluble matter. 11 refs., 3 figs.

  13. Multiple 5' ends of human cytomegalovirus UL57 transcripts identify a complex, cycloheximide-resistant promoter region that activates oriLyt

    International Nuclear Information System (INIS)

    Kiehl, Anita; Huang, Lili; Franchi, David; Anders, David G.

    2003-01-01

    The human cytomegalovirus (HCMV) UL57 gene lies adjacent to HCMV oriLyt, from which it is separated by an organizationally conserved, mostly noncoding region that is thought to both regulate UL57 expression and activate oriLyt function. However, the UL57 promoter has not been studied. We determined the 5' ends of UL57 transcripts toward an understanding of the potential relationship between UL57 expression and oriLyt activation. The results presented here identified three distinct 5' ends spread over 800 bp, at nt 90302, 90530, and 91138; use of these sites exhibited differential sensitivity to phosphonoformic acid treatment. Interestingly, a 10-kb UL57 transcript accumulated in cycloheximide-treated infected cells, even though other early transcripts were not detectable. However, the 10-kb transcript did not accumulate in cells treated with the more stringent translation inhibitor anisomycin. Consistent with the notion that the identified 5' ends arise from distinct transcription start sites, the sequences upstream of sites I and II functioned as promoters responsive to HCMV infection in transient assays. However, the origin-proximal promoter region III required downstream sequences for transcriptional activity. Mutation of candidate core promoter elements suggested that promoter III is regulated by an initiator region (Inr) and a downstream promoter element. Finally, a 42-bp sequence containing the candidate Inr activated a minimal oriLyt core construct in transient replication assays. Thus, these studies showed that a large, complex promoter region with novel features controls UL57 expression, and identified a sequence that regulates both UL57 transcription and oriLyt activation

  14. Regional differences in brain volume predict the acquisition of skill in a complex real-time strategy videogame.

    Science.gov (United States)

    Basak, Chandramallika; Voss, Michelle W; Erickson, Kirk I; Boot, Walter R; Kramer, Arthur F

    2011-08-01

    Previous studies have found that differences in brain volume among older adults predict performance in laboratory tasks of executive control, memory, and motor learning. In the present study we asked whether regional differences in brain volume as assessed by the application of a voxel-based morphometry technique on high resolution MRI would also be useful in predicting the acquisition of skill in complex tasks, such as strategy-based video games. Twenty older adults were trained for over 20 h to play Rise of Nations, a complex real-time strategy game. These adults showed substantial improvements over the training period in game performance. MRI scans obtained prior to training revealed that the volume of a number of brain regions, which have been previously associated with subsets of the trained skills, predicted a substantial amount of variance in learning on the complex game. Thus, regional differences in brain volume can predict learning in complex tasks that entail the use of a variety of perceptual, cognitive and motor processes. Copyright © 2011 Elsevier Inc. All rights reserved.

  15. Complex emergencies in the Eastern Mediterranean Region: Impact on tuberculosis control

    Directory of Open Access Journals (Sweden)

    Akihiro Seita

    2016-01-01

    Conclusion: Complex emergencies pose a significant negative impact on tuberculosis in the EMR. This issue should be raised in the global health and political arena. This is a time bomb for tuberculosis.

  16. Geology, petrology and geochronology of meridional and oriental regions of the Morungaba complex, SP

    International Nuclear Information System (INIS)

    Vlach, S.R.F.

    1985-01-01

    This work studies the Morungaba Intensive Complex, in Southwestern of Sao Paulo State. Formed principally by granitoid rocks with biotite. 31 granitoid facies with structural was recognized. Petrographic own characteristics. The rocks from Morungaba Complex was joint in three magmatics groups, denominated: Roby Gray and Porphyritic. Petrographic and mineralogical composition studies of this three groups were done. Geochranological studies by Rb/Sr and K/sr methods made possible to establish the ages and evolution of this rocks. This Complex formation and evolution are associated with the dioritic rocks presence. This work also concluded that the Morungaba Intrusive Complex represent the pos-orogenic wents from Brazilian Cycle. (C.D.G.) [pt

  17. Mediterranean land systems: Representing diversity and intensity of complex land systems in a dynamic region

    NARCIS (Netherlands)

    Malek, Ziga; Verburg, P.H.

    In the Mediterranean region, land systems have been shaped gradually through centuries. They provide services to a large and growing population in a region that is among the most vulnerable to future global change. The spatial extent and distribution of Mediterranean land systems is, however,

  18. The emerging architecture of a regional security complex in the Lake ...

    African Journals Online (AJOL)

    This article explores the emerging regional security architecture to fight terrorism and insurgency in the Lake Chad Basin (LCB). It diagnoses the evolution of the Lake Chad Basin Commission (LCBC) as a sub-regional organization that unites Chad, Cameroon, Niger and Nigeria. In particular, the article critically investigates ...

  19. Differential immune response of congenic mice to ultraviolet-treated major histocompatibility complex class II-incompatible skin grafts

    International Nuclear Information System (INIS)

    Vermeer, B.J.; Santerse, B.; Van De Kerckhove, B.A.; Schothorst, A.A.; Claas, F.H.

    1988-01-01

    The influence of ultraviolet (UVB) irradiation on the survival of H-2 class II-disparate skin grafts was studied in congenic mouse strains. Isolated skin was UVB irradiated in vitro at a dose of 40 mJ/cm 2 from both sides to remove Ia immunogenicity. Immediately after irradiation the skin was transplanted onto the flank of allogeneic mice. When B10.AQR grafts were transplanted onto B10.T(6R) recipients, a significant prolongation of the survival time was observed, while 50% of the UVB-treated grafts were not rejected at all. However, in the opposite direction--i.e., B10.T(6R) grafts onto B10.AQR recipients, no significant prolongation of the survival was observed. To test whether this effect was due to a difference in susceptibility of the donor skin to UVB irradiation or to a different immune response in the recipients, (B10.T(6R) x B10.AQR) grafts were transplanted onto the parent strains. Similar results were obtained, in that UVB-treated grafts did not show a prolonged survival in B10.AQR recipients, whereas a significant prolongation (50% of the grafts survived more than 100 days) was observed in B10.T(6R) recipients. UVB-treated (B10.T(6R) x B10.AQR)F1 grafts were also transplanted onto (B10.T(6R) x C57B1/10)F1, (B10.AQR x C57B1/10)F1, (B10.T(6R) x Balb/c)F1 and (B10.AQR x Balb/c)F1 recipients--but in none of these combinations was a prolonged survival time observed. These data suggest that, in contrast to all in vitro experiments, the abrogation of the immune response by UVB treatment of the stimulator cells is, in vivo, not a general phenomenon. The genetic constitution of the responder mice seems to play an important role in determining whether or not an immune response takes place

  20. Effector region of the translation elongation factor EF-Tu.GTP complex stabilizes an orthoester acid intermediate structure of aminoacyl-tRNA in a ternary complex.

    Science.gov (United States)

    Förster, C; Limmer, S; Zeidler, W; Sprinzl, M

    1994-01-01

    tRNA(Val) from Escherichia coli was aminoacylated with [1-13C]valine and its complex with Thermus thermophilus elongation factor EF-Tu.GTP was analyzed by 13C NMR spectroscopy. The results suggest that the aminoacyl residue of the valyl-tRNA in ternary complex with bacterial EF-Tu and GTP is not attached to tRNA by a regular ester bond to either a 2'- or 3'-hydroxyl group; instead, an intermediate orthoester acid structure with covalent linkage to both vicinal hydroxyls of the terminal adenosine-76 is formed. Mutation of arginine-59 located in the effector region of EF-Tu, a conserved residue in protein elongation factors and the alpha subunits of heterotrimeric guanine nucleotide-binding regulatory proteins (G proteins), abolishes the stabilization of the orthoester acid structure of aminoacyl-tRNA. PMID:8183898

  1. Complex regional pain syndrome type I in the upper extremity - how efficient physical therapy and rehabilitation are.

    Science.gov (United States)

    Zečević Luković, Tanja; Ristić, Branko; Jovanović, Zorica; Rančić, Nemanja; Ignjatović Ristić, Dragana; Cuković, Saša

    2012-08-01

    To evaluate the effects of early started combined therapy in Complex Regional Pain Syndrome-1 (CRPS-1) on the upper extremities. The study included 36 patients in the first stadium of CRPS-1 on the upper extremities The mean age of patients was 42.6±14.6, the majority of them (26 of 36) were females. The right side of the upper extremity was affected much more then the left side. They were treated by combined therapy including analgetics, electrotherapy, magneto therapy and kinesitherapy. The average length of observation was 172.1 days (from 90 to 250 days). The average length of treatment was 91.5±42.16 days. Intensity of pain, swelling of the extremity, the change in skin coloration and cutaneous manifestations were assessed three times, at the beginning of the treatment, after 6 weeks and at the end of the treatment. The pain was registered in all patients at visit 1 (average pain intensity was 5.70 ±1.44 on 100 mm visual analogue scale), and it was progressively decreased during the treatment from 3.60±1.22 at the second visit to 0.34±0.68 at the third visit. Vasodilatation was registered in 30 (83.33%) patients and skin temperature asymmetries was found in 21 (58.33%) patients. The difference of size was detected in 30 (83.33%) patients at the first visit compared to four (11.11%) patients at the end of the treatment. There were six (16.66%) patients without swelling at the beginning compared to 26 (72.22%) at the end of the treatment (p less than 0.000). Complete healing was achieved in 32 patients (88.88%). The carefully chosen physical agents in combination with analgesic and non-steroidal anti-inflammatory drugs may benefit in patients with CRPS-1 on the upper extremity if the treatment starts as soon as possible.

  2. Renewable Resources: a national catalog of model projects. Volume 2. Mid-American Solar Energy Complex Region

    Energy Technology Data Exchange (ETDEWEB)

    None

    1980-07-01

    This compilation of diverse conservation and renewable energy projects across the United States was prepared through the enthusiastic participation of solar and alternate energy groups from every state and region. Compiled and edited by the Center for Renewable Resources, these projects reflect many levels of innovation and technical expertise. In many cases, a critique analysis is presented of how projects performed and of the institutional conditions associated with their success or failure. Some 2000 projects are included in this compilation; most have worked, some have not. Information about all is presented to aid learning from these experiences. The four volumes in this set are arranged in state sections by geographic region, coinciding with the four Regional Solar Energy Centers. The table of contents is organized by project category so that maximum cross-referencing may be obtained. This volume includes information on the Mid-American Solar Energy Complex Region. (WHK)

  3. Physiotherapy for pain and disability in adults with complex regional pain syndrome (CRPS) types I and II.

    Science.gov (United States)

    Smart, Keith M; Wand, Benedict M; O'Connell, Neil E

    2016-02-24

    Complex regional pain syndrome (CRPS) is a painful and disabling condition that usually manifests in response to trauma or surgery. When it occurs, it is associated with significant pain and disability. It is thought to arise and persist as a consequence of a maladaptive pro-inflammatory response and disturbances in sympathetically-mediated vasomotor control, together with maladaptive peripheral and central neuronal plasticity. CRPS can be classified into two types: type I (CRPS I) in which a specific nerve lesion has not been identified, and type II (CRPS II) where there is an identifiable nerve lesion. Guidelines recommend the inclusion of a variety of physiotherapy interventions as part of the multimodal treatment of people with CRPS, although their effectiveness is not known. To determine the effectiveness of physiotherapy interventions for treating the pain and disability associated with CRPS types I and II. We searched the following databases from inception up to 12 February 2015: CENTRAL (the Cochrane Library), MEDLINE, EMBASE, CINAHL, PsycINFO, LILACS, PEDro, Web of Science, DARE and Health Technology Assessments, without language restrictions, for randomised controlled trials (RCTs) of physiotherapy interventions for treating pain and disability in people CRPS. We also searched additional online sources for unpublished trials and trials in progress. We included RCTs of physiotherapy interventions (including manual therapy, therapeutic exercise, electrotherapy, physiotherapist-administered education and cortically directed sensory-motor rehabilitation strategies) employed in either a stand-alone fashion or in combination, compared with placebo, no treatment, another intervention or usual care, or of varying physiotherapy interventions compared with each other in adults with CRPS I and II. Our primary outcomes of interest were patient-centred outcomes of pain intensity and functional disability. Two review authors independently evaluated those studies

  4. [Complexity of care and organizational effectiveness: a survey among medical care units in nine Lombardy region hospitals].

    Science.gov (United States)

    Pasquali, Sara; Capitoni, Enrica; Tiraboschi, Giuseppina; Alborghetti, Adriana; De Luca, Giuseppe; Di Mauro, Stefania

    2017-01-01

    Eleven medical care units of nine Lombardy Region hospitals organized by levels of care model or by the traditional departmental model have been analyzed, in order to evaluate if methods for complexity of patient-care evaluation represent an index factor of nursing organizational effectiveness. Survey with nine Nurses in managerial position was conducted between Nov. 2013-Jan. 2014. The following factors have been described: context and nursing care model, staffing, complexity evaluation, patient satisfaction, staff well-being. Data were processed through Microsoft Excel. Among Units analysed ,all Units in levels of care and one organized by the departmental model systematically evaluate nursing complexity. Registered Nurses (RN) and Health Care Assistants (HCA) are on average numerically higher in Units that measure complexity (0.55/ 0.49 RN, 0.38/0.23 HCA - ratio per bed). Adopted measures in relation to changes in complexity are:rewarding systems, supporting interventions, such as moving personnel within different Units or additional required working hours; reduction in number of beds is adopted when no other solution is available. Patient satisfaction is evaluated through Customer Satisfaction questionnaires. Turnover, stress and rate of absenteeism data are not available in all Units. Complexity evaluation through appropriate methods is carried out in all hospitals organized in levels of care with personalized nursing care models, though complexity is detected with different methods. No significant differences in applied managerial strategies are present. Patient's satisfaction is evaluated everywhere. Data on staffing wellbeing is scarcely available. Coordinated regional actions are recommended in order to gather comparable data for research, improve decision making and effectiveness of Nursing care.

  5. Solar and Stellar Active Regions:Cosmic laboratories for the study of Complexity

    OpenAIRE

    Vlahos, Loukas

    2008-01-01

    Solar active regions are driven dissipative dynamical systems. The turbulent convection zone forces new magnetic flux tubes to rise above the photosphere and shuffles the magnetic fields which are already above the photosphere. The driven 3D active region responds to the driver with the formation of Thin Current Sheets in all scales and releases impulsively energy, when special thresholds are met, on the form of nano-, micro-, flares and large scale coronal mass ejections. It has been documen...

  6. Complex Regional Pain Syndrome (CRPS type-1) in an Adolescent Following Extravasation of Dextrose Containing Fluid-an Underdiagnosed Case.

    Science.gov (United States)

    Subedi, Asish; Bhattarai, Balkrishna; Biswas, Binay K; Khatiwada, Sindhu

    2011-06-01

    Due to its complex pathophysiology and wide spectrum of clinical manifestations, the diagnosis of CRPS is often missed in the early stage by primary care physicians. After being treated by a primary care physician for 5 months for chronic cellulitis, a 16-year-old girl was referred to our hospital with features of type-1 CRPS of the right upper extremity. Inability to diagnose early caused prolonged suffering to the girl with all the consequence of CRPS. The patient responded well with marked functional recovery from multimodal therapy. Ability to distinguish CRPS from other pain conditions, referral for specialty care at the appropriate time and full awareness of this condition and its clinical features among various healthcare professionals are essential in reducing patient suffering and stopping its progression towards difficult-to-treat situations.

  7. Effective management models and methods of economic educations in regional industrial complexes

    Directory of Open Access Journals (Sweden)

    Andrey Gennadyevich Butrin

    2014-06-01

    Full Text Available In the article, the methodical bases of management by the integrated industrial enterprises is developed according to the indicators of sustainable economic development of the region. The scope of the research is the region as the difficult mesosystem consisting of logistic clusters. The subject matter of the research is the organizational and economic relations developing in the course of interaction of participants of the regional economy as mesosystems. The models and methods of management by the large economic systems in the economy of the industrially developed region are developed; the organizational and economic essence of a logistic cluster as the subject of the regional economy us revealed. The mechanism of management by the integrated enterprises with using the cluster approach, technologies of logistics, management of supply chains is offered. They allow to the management of an enterprises to make scientifically reasonable effective decisions developing programs of supply, economic production and realization of finished goods in the close connection with programs of regional economic development.

  8. Superfund record of decision (EPA Region 3): Southern Maryland Wood Treating Site, Hollywood, MD, September 8, 1995

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1995-09-01

    The decision document presents the selected remedial action for the Southern Maryland Wood Treating Site (`the Site`), in Hollywood, Maryland. This is the second and final phase of remedial action for the Site. This phase addresses soil and sediment contamination and non-aqueous phase liquids (`NAPLs`) which are the principal threats remaining at the Site and are a source of contamination to the ground water and surface water.

  9. Badass gullies: Fluvio-mass-movement gully complexes in New Zealand's East Coast region, and potential for remediation

    Science.gov (United States)

    Marden, Michael; Fuller, Ian C.; Herzig, Alexander; Betts, Harley D.

    2018-04-01

    This paper reviews gully erosion in the East Coast region of New Zealand's North Island and conceptualises fluvio-mass-movement gully complexes as badass gully systems. Tectonic setting and lithological control, with steep slopes and a climate influenced by tropical cyclones, predispose hill country in the East Coast region to gully erosion. The clearance of indigenous forest since the late 1800s has dramatically increased catchment erosion and paved the way for development of large-scale fluvio-mass-movement gully complexes. These features are a composite of fluvial and mass movement processes. They are conceptualised as 'badass' by not conforming to any existing gully model and by generating disproportionate results in East Coast catchment sediment cascades. Their remediation is discussed, but their nature means that prevention is better than a cure.

  10. Dosimetric complication probability and acoustic analysis of vocal cord region in oropharyngeal carcinoma treated with voice-sparing intensity modulated radiotherapy

    International Nuclear Information System (INIS)

    Jain, S.; Gupta, T.; Agarwal, J.P.; Baccher, G.; Shrivastava, S.K.; Reenadevi; Master, J.

    2008-01-01

    Radiation to larynx has long been associated with speech and voice dysfunction. The objective is to study dosimetric parameters and complication probability of vocal cord region (VCR) and the effect of voice-sparing (VS) in the patients treated with intensity modulated radiotherapy (IMRT). The secondary objective is to describe the post-radiation acoustic voice characteristics and correlate them with the dosimetric parameters. (author)

  11. Dusty cradles in a turbulent nursery: the SGR A east H II region complex at the galactic center

    Energy Technology Data Exchange (ETDEWEB)

    Lau, R. M.; Herter, T. L.; Adams, J. D. [Astronomy Department, Cornell University, 202 Space Sciences Building, Ithaca, NY 14853-6801 (United States); Morris, M. R. [Department of Physics and Astronomy, University of California, Los Angeles, 430 Portola Plaza, Los Angeles, CA 90095-1547 (United States)

    2014-10-20

    We present imaging at 19, 25, 31, and 37 μm of the compact H II region complex G-0.02-0.07 located 6 pc in projection from the center of the Galaxy obtained with SOFIA using FORCAST. G-0.02-0.07 contains three compact H II regions (A, B, and C) and one ultra-compact H II region (D). Our observations reveal the presence of two faint, infrared sources located 23'' and 35'' to the east of region C (FIRS 1 and 2) and detect dust emission in two of the three 'ridges' of ionized gas west of region A. The 19/37 color temperature and 37 μm optical depth maps of regions A-C are used to characterize the dust energetics and morphology. Regions A and B exhibit average 19/37 color temperatures of ∼105 K, and regions C and D exhibit color temperatures of ∼115 K and ∼130 K, respectively. Using the DustEM code, we model the SEDs of regions A-D and FIRS 1, all of which require populations of very small, transiently heated grains and large, equilibrium-heated grains. We also require the presence of polycyclic aromatic hydrocarbons in regions A-C in order to fit the 3.6, 4.5, 5.8, and 8.0 μm fluxes observed by Spitzer/IRAC. The location of the heating source for region A is determined by triangulation from distances and temperatures derived from DustEM models fit to SEDs of three different points around the region, and it is found to be displaced to the northeast of the center of curvature near the color temperature peak. Based on total luminosity, expected 1.90 μm fluxes, and proximity to the mid-IR color temperature peaks, we identify heating source candidates for regions A, B, and C. However, for region D, the observed fluxes at 1.87 and 1.90 μm of the previously proposed ionizing star are a factor of ∼40 times too bright to be the heating source and hence is likely just a star lying along the line of sight toward region D.

  12. Automatic system for ecological monitoring of ambient air in the region of energy complex 'Maritsa-Iztok'

    International Nuclear Information System (INIS)

    Vasilev, V.; Videnova, I.; Nedyalkov, N.

    2000-01-01

    This report presents the automatic system for ecological monitoring of ambient air in the region of the energy complex 'Maritza-Iztok', developed by CCS-Bulgaria, Bulgarian Academy of Sciences, Institute of Control and System Research. The automatic station takes the concentration of nitric oxides, sulfuric dioxide and dust, as well as the meteorological indicators: temperature and humidity, atmospheric pressure, wind direction and speed, sun heat and radiation. The data appears on a information board and is kept in a database

  13. Association of non-traumatic complex regional pain syndrome with adenocarcinoma lung on 99mTc-MDP bone scan

    International Nuclear Information System (INIS)

    Damle, Nishikant A.; Tripathi, Madhavi; Singhal, Abhinav; Bal, Chandrasekhar; Praveen Kumar; Kandasamy, Devasenathipathi; Jana, Manisha

    2012-01-01

    Complex regional pain syndrome (CRPS) is usually associated with trauma. Rarely, it may be seen in association with malignancies. We present here the bone scan and X-ray findings in the case of a 56-year-male-patient with adenocarcinoma lung who also had non-traumatic CRPS without involvement of the stellate ganglion. The case highlights the fact that spontaneous development of reflex sympathetic dystrophy may be associated with a neoplastic etiology. (author)

  14. Complex Regional Pain Syndrome Revived by Epileptic Seizure Then Disappeared Soon during Treatment with Regional Intravenous Nerve Blockade: A Case Report

    Directory of Open Access Journals (Sweden)

    Masahiko Sumitani

    2011-01-01

    Full Text Available We present a case of complex regional pain syndrome (CRPS, in which symptoms, including burning pain and severe allodynia, were alleviated by using a regional intravenous nerve blockade (Bier block combined with physiotherapy, but reappeared following an epileptic seizure. Symptoms disappeared again following control of epileptic discharges, as revealed by single-photon emission computed tomography (SPECT and electroencephalography (EEG results. Although systemic toxicity of a local anesthetic applied by Bier block was suspected as a cause of the first seizure, the patient did not present any other toxic symptoms, and seizures repeatedly occurred after Bier block cessation; the patient was then diagnosed as having temporal symptomatic epilepsy. This case suggests that symptoms of CRPS may be sustained by abnormal brain conditions, and our findings contribute to the understanding of how the central nervous system participates in maintaining pain and allodynia associated with CRPS.

  15. Complex regional pain syndrome related dystonia : exploratory metabolomics and therapeutic studies

    NARCIS (Netherlands)

    Plas, Anton Adriaan van der

    2013-01-01

    Dit proefschrift beschrijft de resultaten van aan aantal studies naar bewegingsstoornissen en pijn bij patiënten met complex regionaal pijnsyndroom (CRPS). Ten eerste werd het effect onderzocht van intrathecaal baclofen op verschillende pijnkwaliteiten bij CRPS-patiënten, de invloed bestudeerd van

  16. Surface Wind Regionalization over Complex Terrain: Evaluation and Analysis of a High-Resolution WRF Simulation

    NARCIS (Netherlands)

    Jiménez, P.A.; González-Rouco, J.F.; García-Bustamante, E.; Navarro, J.; Montávez, J.P.; Vilà-Guerau de Arellano, J.; Dudhia, J.; Muñoz-Roldan, A.

    2010-01-01

    This study analyzes the daily-mean surface wind variability over an area characterized by complex topography through comparing observations and a 2-km-spatial-resolution simulation performed with the Weather Research and Forecasting (WRF) model for the period 1992–2005. The evaluation focuses on the

  17. The system of innovative development of the agroindustrial complex in order to ensure the economic security of the region

    Directory of Open Access Journals (Sweden)

    T. I. Ovchinnikova

    2017-01-01

    Full Text Available The basis for innovative development of the agroindustrial complex is the goals, principles and methods that determine the economic security of the region. The category of “economic security”is often identified with the sustainability, competitiveness and risk-free economy of agricultural and processing enterprises. Ensuring the economically safe functioning of all industries and spheres of regional agribusiness is impossible without interconnection with science and education. The most important principles necessary for the formation in the regional and national agribusinesses of a developed economically secure market of scientific, technical and innovative products for agroindustrial purposes are the following: providing the scientific and research sphere of the agro-industrial complex with highly qualified personnel; ensuring real freedom and independence in the activities of research institutions; the formation of a common interdependent economic space and interest; organization of specialized market structures in the field of research and innovation development; development and application within the regional agro-industrial complex of a scientifically grounded economic mechanism for regulating the functioning and stimulating the development of the market for scientific and technical innovation products. Purposeful development of the civilized market of scientific, technical and innovative products of agro-industrial design with its corresponding structures and organizational-economic mechanism is an objective necessity of functioning of economic security of the national economy. The interests of the economic and food security of the region and the state as a whole need to increase the financing of the agricultural sector and the processing industry to a level that will overcome the investment and innovation crisis caused by sanctions. To this end, we believe it is necessary to finance the innovative investment agrarian fund at the

  18. Application of a complex assessment of landslide hazards in mountain regions

    Directory of Open Access Journals (Sweden)

    Kateryna E. Boyko

    2017-09-01

    Full Text Available The main regional factors of occurrence and activation of landslides within the mountain region were examined. As a result of study of recommendations made by experts, geologists, and gap analysis of existing methods of forecasting the landslide process, an algorithm of comprehensive assessment of landslide hazard areas based on the construction of models in a GIS environment was proposed. These models describe the spatial patterns of landslides. All factors determining the tendency of the studies area to the landslide process development were divided into actual factors, reflecting the regional peculiarities of the territory and forming the landslide-prone slopes (static model, as well as triggering factors, initiating the landslide process and determining its activity (dynamic model. The first cartographic model was built, showing the distribution of the deterministic indirect indicator of landslide hazard, i.e. stability index.

  19. Formation of covalent complexes between human O sup 6 -alkylguanine-DNA alkyltransferase and BCNU-treated defined length synthetic oligodeoxynucleotides

    Energy Technology Data Exchange (ETDEWEB)

    Brent, T.P.; Remack, J.S. (St. Jude Children' s Research Hospital, Memphis, TN (USA))

    1988-07-25

    Repair of chloroethylnitrosourea (CENU)-induced precursors of DNA interstrand cross-links by O{sup 6}-alkylguanine-DNA alkyltransferase (GAT or GATase) appears to be a factor in tumor resistance to therapy with this class of antineoplastic drugs. Since human GAT is highly specific for O{sup 6}-guanine, yet the probably cross-link structure is N{prime}-Guanine N{sup 3}cytosine ethane, rearrangement of the initial O{sup 6}-guanine adduct via O{sup 6},N{sup 1}ethanoguanine has been proposed. The authors suggested that GAT reaction with this intermediate would produce DNA covalently linked to protein through an ethane link from N{sup 1}-guanine to the alkylacceptor site on GAT. In preliminary studies they demonstrated a covalent complex between GAT and carmustine (BCNU)-treated DNA by a precipitation assay method. They have now developed a method for isolating the reaction product of BCNU-treated synthetic 14-mer ({sup 32}P)-labeled oligodeoxynucleotide and GAT using polyacrylamide gel electrophoresis. This approach can be used to characterize the adducts induced by CENUs that lead to complex formation with GAT.

  20. Does Dynamical Downscaling Introduce Novel Information in Climate Model Simulations of Recipitation Change over a Complex Topography Region?

    Science.gov (United States)

    Tselioudis, George; Douvis, Costas; Zerefos, Christos

    2012-01-01

    Current climate and future climate-warming runs with the RegCM Regional Climate Model (RCM) at 50 and 11 km-resolutions forced by the ECHAM GCM are used to examine whether the increased resolution of the RCM introduces novel information in the precipitation field when the models are run for the mountainous region of the Hellenic peninsula. The model results are inter-compared with the resolution of the RCM output degraded to match that of the GCM, and it is found that in both the present and future climate runs the regional models produce more precipitation than the forcing GCM. At the same time, the RCM runs produce increases in precipitation with climate warming even though they are forced with a GCM that shows no precipitation change in the region. The additional precipitation is mostly concentrated over the mountain ranges, where orographic precipitation formation is expected to be a dominant mechanism. It is found that, when examined at the same resolution, the elevation heights of the GCM are lower than those of the averaged RCM in the areas of the main mountain ranges. It is also found that the majority of the difference in precipitation between the RCM and the GCM can be explained by their difference in topographic height. The study results indicate that, in complex topography regions, GCM predictions of precipitation change with climate warming may be dry biased due to the GCM smoothing of the regional topography.

  1. The Disordered C-Terminus of Yeast Hsf1 Contains a Cryptic Low-Complexity Amyloidogenic Region

    Directory of Open Access Journals (Sweden)

    Jordi Pujols

    2018-05-01

    Full Text Available Response mechanisms to external stress rely on networks of proteins able to activate specific signaling pathways to ensure the maintenance of cell proteostasis. Many of the proteins mediating this kind of response contain intrinsically disordered regions, which lack a defined structure, but still are able to interact with a wide range of clients that modulate the protein function. Some of these interactions are mediated by specific short sequences embedded in the longer disordered regions. Because the physicochemical properties that promote functional and abnormal interactions are similar, it has been shown that, in globular proteins, aggregation-prone and binding regions tend to overlap. It could be that the same principle applies for disordered protein regions. In this context, we show here that a predicted low-complexity interacting region in the disordered C-terminus of the stress response master regulator heat shock factor 1 (Hsf1 protein corresponds to a cryptic amyloid region able to self-assemble into fibrillary structures resembling those found in neurodegenerative disorders.

  2. The Disordered C-Terminus of Yeast Hsf1 Contains a Cryptic Low-Complexity Amyloidogenic Region.

    Science.gov (United States)

    Pujols, Jordi; Santos, Jaime; Pallarès, Irantzu; Ventura, Salvador

    2018-05-06

    Response mechanisms to external stress rely on networks of proteins able to activate specific signaling pathways to ensure the maintenance of cell proteostasis. Many of the proteins mediating this kind of response contain intrinsically disordered regions, which lack a defined structure, but still are able to interact with a wide range of clients that modulate the protein function. Some of these interactions are mediated by specific short sequences embedded in the longer disordered regions. Because the physicochemical properties that promote functional and abnormal interactions are similar, it has been shown that, in globular proteins, aggregation-prone and binding regions tend to overlap. It could be that the same principle applies for disordered protein regions. In this context, we show here that a predicted low-complexity interacting region in the disordered C-terminus of the stress response master regulator heat shock factor 1 (Hsf1) protein corresponds to a cryptic amyloid region able to self-assemble into fibrillary structures resembling those found in neurodegenerative disorders.

  3. Clinical and evolving features of women diagnosed with precancerous cervical lesions, screened and treated in the Amazon region of Brazil

    Directory of Open Access Journals (Sweden)

    Patricia Rezende do Prado

    2014-09-01

    Full Text Available The objective of the study was to determine the dynamics of precancerous lesions in women of a cohort treated for cervical intraepithelial neoplasia (CIN and followed up over the next two years. The conditional probability of failure was calculated using the Kaplan-Meier method, and the raw and adjusted hazard ratios (HR were determined using Cox regression with a p-value entry of < 0.05. Of the 237 women who were treated, 51.5% were accompanied over 24 months, and treatment failed for 21.9% of those accompanied. Women who had five or more pregnancies (adjusted HR = 3.10, 95%CI: 1.28-7.51 or an initial histological diagnosis of CIN II/III demonstrated an independent risk of treatment failure (adjusted HR = 3.14, 95%CI: 1.20-8.19. Being in a stable relationship was a protective factor against treatment failure (adjusted HR = 0.47, 95%CI: 0.24-0.89. A history of more frequent pregnancies and a histological diagnosis of CIN II/III are directly correlated with risk of CIN treatment failure, whereas being in a stable relationship is inversely correlated with this risk.

  4. The Scc2/Scc4 complex acts in sister chromatid cohesion and transcriptional regulation by maintaining nucleosome-free regions

    Science.gov (United States)

    Lopez-Serra, Lidia; Kelly, Gavin; Patel, Harshil; Stewart, Aengus; Uhlmann, Frank

    2014-01-01

    The cohesin complex is at the heart of many chromosomal activities, including sister chromatid cohesion and transcriptional regulation1-3. Cohesin loading onto chromosomes depends on the Scc2/Scc4 cohesin loader complex4-6, but the chromatin features that form cohesin loading sites remain poorly understood. Here, we show that the RSC chromatin remodeling complex recruits budding yeast Scc2/Scc4 to broad nucleosome-free regions, that the cohesin loader itself helps to maintain. Consequently, inactivation of the cohesin loader or RSC complex have similar effects on nucleosome positioning, gene expression and sister chromatid cohesion. These results reveal an intimate link between local chromatin structure and higher order chromosome architecture. Our findings pertain to the similarities between two severe human disorders, Cornelia de Lange syndrome, caused by mutations in the human cohesin loader, and Coffin-Siris syndrome, resulting from mutations in human RSC complex components7-9. Both could arise from gene misregulation due to related changes in the nucleosome landscape. PMID:25173104

  5. Mirror box therapy added to cognitive behavioural therapy in three chronic complex regional pain syndrome type I patients : a pilot study

    NARCIS (Netherlands)

    Tichelaar, Y. I. G. Vladimir; Geertzen, Jan H. B.; Keizer, Doeke; van Wilgen, C. Paul

    Complex regional pain syndrome type I is a disorder of the extremities with disability and pain as the most prominent features. This paper describes the results of cognitive behavioural therapy combined with mirror box therapy in three patients with chronic complex regional pain syndrome type I.

  6. Sequential assignment of proline-rich regions in proteins: Application to modular binding domain complexes

    International Nuclear Information System (INIS)

    Kanelis, Voula; Donaldson, Logan; Muhandiram, D.R.; Rotin, Daniela; Forman-Kay, Julie D.; Kay, Lewis E.

    2000-01-01

    Many protein-protein interactions involve amino acid sequences containing proline-rich motifs and even poly-proline stretches. The lack of amide protons in such regions complicates assignment, since 1 HN-based triple-resonance assignment strategies cannot be employed. Two such systems that we are currently studying include an SH2 domain from the protein Crk with a region containing 9 prolines in a 14 amino acid sequence, as well as a WW domain that interacts with a proline-rich target. A modified version of the HACAN pulse scheme, originally described by Bax and co-workers [Wang et al. (1995) J. Biomol. NMR, 5, 376-382], and an experiment which correlates the intra-residue 1 H α , 13 C α / 13 C β chemical shifts with the 15 N shift of the subsequent residue are presented and applied to the two systems listed above, allowing sequential assignment of the molecules

  7. Cluster approach to realization of innovation development strategy for the agroindustrial complex of the region

    Directory of Open Access Journals (Sweden)

    Valentina Aleksandrovna Kundius

    2011-12-01

    Full Text Available This paper reviews cluster approach as an innovative management technology for the regional economy. The results of studying the theory and practice of clustering of the regional economy, the formation of agribusiness and food clusters in agribusiness are presented. Basic features and operation of the cluster systems are revealed and distinguished from other forms of cooperative and economic interactions between small and big business features, motivational components of integration into clusters. On the basis of scientific propositions, a model of regional economic clusters is formulated; specific territorial distribution and level of aggregation of clusters in the agricultural sector were distinguished. It is proposed to refer agroindustrial clusters to the clusters that represent the associations of organization of various fields in a single reproduction cycle from raw material to finished products sales including all stages of reproduction on the basis of innovation and investment activity. A structuring work on principles of agro-clusters was held, sustainable competitive advantage and the formation mechanisms of the development of agro-industrial clusters have been grounded.

  8. Biosorption of the metal-complex dye Acid Black 172 by live and heat-treated biomass of Pseudomonas sp. strain DY1: Kinetics and sorption mechanisms

    Energy Technology Data Exchange (ETDEWEB)

    Du, Lin-Na; Wang, Bing [College of Life Science, Zhejiang University, 310058, Hangzhou, Zhejiang Province (China); Li, Gang [Department of Agriculture and Biotechnology, Wenzhou Vocational College of Science and Technology, 325006 Wenzhou, Zhejiang Province (China); Wang, Sheng [College of Life Science, Zhejiang University, 310058, Hangzhou, Zhejiang Province (China); Crowley, David E., E-mail: crowley@ucr.edu [Department of Environmental Science, University of California, Riverside, CA 92521 (United States); Zhao, Yu-Hua, E-mail: yhzhao225@zju.edu.cn [College of Life Science, Zhejiang University, 310058, Hangzhou, Zhejiang Province (China)

    2012-02-29

    Highlights: Black-Right-Pointing-Pointer The maximum amount of Acid Black 172 sorption was about 2.98 mmol/g biomass. Black-Right-Pointing-Pointer Amine groups played a major role in the biosorption of Acid Black 172. Black-Right-Pointing-Pointer The reasons of increased dye sorption by heat-treated biomass were proposed. - Abstract: The ability of Pseudomonas sp. strain DY1 to adsorb Acid Black 172 was studied to determine the kinetics and mechanisms involved in biosorption of the dye. Kinetic data for adsorption fit a pseudo-second-order model. Increased initial dye concentration could significantly enhance the amount of dye adsorbed by heat-treated biomass in which the maximum amount of dye adsorbed was as high as 2.98 mmol/g biomass, whereas it had no significant influence on dye sorption by live biomass. As treated temperature increased, the biomass showed gradual increase of dye sorption ability. Experiments using potentiometric titration and Fourier transform infrared spectroscopy (FTIR) indicated that amine groups (NH{sub 2}) played a prominent role in biosorption of Acid Black 172. Scanning electron microscopy (SEM), atomic force microscopy (AFM) and transmission electron microscopy (TEM) analysis indicated that heat treatment of the biomass increased the permeability of the cell walls and denatured the intracellular proteins. The results of biosorption experiments by different cell components confirmed that intracellular proteins contributed to the increased biosorption of Acid Black 172 by heat-treated biomass. The data suggest that biomass produced by this strain may have application for removal of metal-complex dyes from wastewater streams generated from the dye products industry.

  9. Ecological safety of the Carpathian region as a process of oil and gas complexes functioning

    Directory of Open Access Journals (Sweden)

    Georgiy Rudko

    2002-09-01

    Full Text Available There have been considered the main ecological problems of Western Ukraine and changes of geological environment under the influence of oil and gas complexes functioning. Ecochemical investigations of the environment give us a possibility to reveal the areas with abnormal hydrocarbon concentration in the near-surface layers and in ground waters. On the basis of the investigation results there have been worked out organizational, technological and environmental measures to eliminate pollution or to reduce its negative influence on geological environment.

  10. Geology, petrography and geochronology of meridional and oriental regions from Morungaba complex, SP

    International Nuclear Information System (INIS)

    Vlach, S.R.F.

    1985-01-01

    The Morungaba Granitoid Complex, covering about 330 km 2 , crops out as an elongate irregular Massif trending SW-NE, in the southeast part of the State of Sao Paulo, southeast Brazil. Major constituents are biotite granitoids with subordinate diorites. Over thirty facies types, each with distinctive structural-petrographic features, were recognized during detailed mapping of part of the Massif (about 200 km 2 ), and mapped as groups of facies. Geochronological Rb/Sr data for several groups of associated facies are also presented. (author)

  11. Complex Approach to Thyroid Screening In Regions Adjacent to the Semipalatinsk Test Site Area

    International Nuclear Information System (INIS)

    Zhumadilov, Zh.Sh.; Musinov, D.R.; Vasikovsky, G.G.; Bobokhidze, D.A.; Zhigitaev, T.K.; Abisheva, G.N.

    1998-01-01

    It has been well documented that the thyroid gland is one of the most radiosensitive of organs, especially when exposure occurs during childhood. It is known as well that childhood exposure to radioactive iodine increases thyroid cancer risk. Conducting thyroid screening in regions adjacent to the Semipalatinsk Test Site (STS) area is very important for medical examination, data management and thyroid dose reconstruction. Our experience of thyroid screening based on our screening projects in Kurchatov and several regions adjacent to STS (more than 4,000 screened patients) allowed to work out the most appropriate screening protocol. A retrospective analysis of the results of surgical treatment of the 7,271 patients with thyroid abnormalities in the Semipalatinsk, Pavlodar and Ust-Kamenogorsk regions of Kazakstan and study the histological staging of 7,271 surgically removed thyroid glands was preceded by our thyroid screening projects. Ours is the first study in the Semipalatinsk region that covers the period 1966-1998.Taking into account the onset of population effective doses during 1962, it was decided to distinguish 6 periods of observation. It is known that basic effective equivalent doses for the majority of the region's population were established by radioactive events in the period 1949-1962. This explains our focus on the year 1962, but thyroid dose reconstruction matter as well as other radiation related problems are still in the progress. We need to get the accurate dosimetry data. Selection of study subjects based on the appropriate criteria needed to be adjusted and clarified in accordance with the main goal of the project and radiation related information. All specialists involved in the thyroid screening project, data management, data analyses and interpretation of the results must be trained and must be highly qualified specialists in this field of science and practice. The experiences in Nagasaki, Hiroshima and Chernobyl, and discussions with

  12. Biochemical indicators of nephrotoxicity in blood serum of rats treated with novel 4-thiazolidinone derivatives or their complexes with polyethylene glycol-containing nanoscale polymeric carrier

    Directory of Open Access Journals (Sweden)

    L. I. Kоbylinska

    2016-02-01

    Full Text Available The aim of this study was to compare the effect of new synthetic 4-thiazolidinone derivatives (potential anticancer compounds denoted as 3882, 3288 and 3833 and doxorubicin (positive control in free form and in their complexes with synthetic polyethylene glycol-containing nanoscale polymeric carrier on the biochemical indicators of nephrotoxicity in blood serum of rats. The concentration of total protein, urea, creatinine, glucose, ions of sodium, potassium, calcium, iron and chloride was measured. It was found that after injection of the investigated compounds, the concentration of sodium cations and chloride anions in blood serum was increased compared with control (untreated animals. Doxorubicin’s injection was accompanied by a decrease in the concentration of iron cations. The concentration of total protein, urea and creatinine decreased under the influence of the studied compounds. Complexation of these аntineoplastic substances with a synthetic polymeric nanocarrier lowered the concentration of the investigated metabolites substantially compared to the effect of these compounds in free form. The normalization of concentration of total protein, urea and creatinine in blood serum of rats treated with complexes of the studied compounds with the polymeric carrier comparing with increased concentration of these indicators at the introduction of such compounds in free form was found.

  13. Treatment outcome for a sample of patients with Class II division 1 malocclusion treated at a regional hospital orthodontic department.

    LENUS (Irish Health Repository)

    Burden, D J

    1998-01-01

    This retrospective study assessed the outcome of orthodontic treatment of 264 patients with Class II division 1 malocclusion (overjet greater than 6 mm). The sample comprised patients who had completed their fixed appliance orthodontic treatment at a regional hospital orthodontic unit in the Republic of Ireland. The PAR Index (Peer Assessment Rating) was used to evaluate treatment outcome using before and after treatment study casts. The results revealed that treatment for this particular type of malocclusion was highly effective with a very few patients failing to benefit from their orthodontic treatment.

  14. Illuminant direction estimation for a single image based on local region complexity analysis and average gray value.

    Science.gov (United States)

    Yi, Jizheng; Mao, Xia; Chen, Lijiang; Xue, Yuli; Compare, Angelo

    2014-01-10

    Illuminant direction estimation is an important research issue in the field of image processing. Due to low cost for getting texture information from a single image, it is worthwhile to estimate illuminant direction by employing scenario texture information. This paper proposes a novel computation method to estimate illuminant direction on both color outdoor images and the extended Yale face database B. In our paper, the luminance component is separated from the resized YCbCr image and its edges are detected with the Canny edge detector. Then, we divide the binary edge image into 16 local regions and calculate the edge level percentage in each of them. Afterward, we use the edge level percentage to analyze the complexity of each local region included in the luminance component. Finally, according to the error function between the measured intensity and the calculated intensity, and the constraint function for an infinite light source model, we calculate the illuminant directions of the luminance component's three local regions, which meet the requirements of lower complexity and larger average gray value, and synthesize them as the final illuminant direction. Unlike previous works, the proposed method requires neither all of the information of the image nor the texture that is included in the training set. Experimental results show that the proposed method works better at the correct rate and execution time than the existing ones.

  15. Age- and gender-related regional variations of human brain cortical thickness, complexity, and gradient in the third decade.

    Science.gov (United States)

    Creze, Maud; Versheure, Leslie; Besson, Pierre; Sauvage, Chloe; Leclerc, Xavier; Jissendi-Tchofo, Patrice

    2014-06-01

    Brain functional and cytoarchitectural maturation continue until adulthood, but little is known about the evolution of the regional pattern of cortical thickness (CT), complexity (CC), and intensity or gradient (CG) in young adults. We attempted to detect global and regional age- and gender-related variations of brain CT, CC, and CG, in 28 healthy young adults (19-33 years) using a three-dimensional T1 -weighted magnetic resonance imaging sequence and surface-based methods. Whole brain interindividual variations of CT and CG were similar to that in the literature. As a new finding, age- and gender-related variations significantly affected brain complexity (P gender), all in the right hemisphere. Regions of interest analyses showed age and gender significant interaction (P left inferior parietal. In addition, we found significant inverse correlations between CT and CC and between CT and CG over the whole brain and markedly in precentral and occipital areas. Our findings differ in details from previous reports and may correlate with late brain maturation and learning plasticity in young adults' brain in the third decade. Copyright © 2013 Wiley Periodicals, Inc.

  16. The Moroccan eastern region, a green energy complex for sustainable development and advanced decentralization

    Science.gov (United States)

    Belhaj, Siham; Bahi, Lahcen; Akhssas, Ahmed; Jalal El hamidi, Mohamed

    2017-04-01

    The Moroccan eastern region is characterized by: A total population 2,314,346 inhabitants (in 2014) (6.84% of the population of Morocco) by a density 24 inhabitants per km2. The population structure is as follows: 30% under 15 years of age, 50% of the population is under 25 years of age, 61% of working age (15-60 years), 9% in the third age group (over than 60 years). An urbanization rate of 58.5% with an economic profile GDP: 44.2 MMDH / year. GDP growth rate: 10.8% .The Oriental contribution to the formation of the national GDP is 4.9%, in the region we have the predominance of two activities: Tertiary (51.4%) and Secondary activities (22.3%). Concerning the clean resources of energy we can mention: - Abundant solar resources because the average radiation on a surface inclined at 30 ° is 2,082 kWh / (m2 / year); An important potential of the wind distributed in: offshore at sea along the Mediterranean facade (197 km of coast) and the onshore wind along the ridges of the mountains; Large biomass potential for biogas production; A precise zoning of the territories destined to shelter installations of production of the electricity of solar. We will in this work express the importance of this diversity of the clean energy resources -projects- cited in the region of the east to develop: Production of solar photovoltaic energy; Production of solar and thermal energy; Hydropower production; the valorization of biomass (biogas, biofuel, etc.); Production of geothermal energy; Keywords: Oujda, Sustainable Development, Energy

  17. Modelling internal boundary-layer development in a region with a complex coastline

    DEFF Research Database (Denmark)

    Batchvarova, E.; Cai, X.; Gryning, Sven-Erik

    1999-01-01

    , and the Colorado State University Regional Atmospheric Modelling System (CSU-RAMS) are tested by comparison with data gathered during a field study (called Pacific '93) of photochemical pollution in the Lower Fraser Valley of British Columbia, Canada. The data utilised here are drawn from tethered balloon flights......, free flying balloon ascents, and downlooking lidar operated from an aircraft flown at roughly 3500 m above sea level. Both models are found to represent the temporal and spatial development of the internal boundary-layer depth over the Lower Fraser Valley very well, and reproduce many of the finer...

  18. Impact of environmental diversity of hunting complexes in the Lublin region on ontogenetic quality indicators in roe deer (Capreolus capreolus).

    Science.gov (United States)

    Czyżowski, Piotr; Drozd, Leszek; Karpiński, Mirosław; Tajchman, Katarzyna; Goleman, Małgorzata; Wojtaś, Justyna; Zieliński, Damian

    2018-01-01

    Populations of game are not confined to single ecosystems but function within higher-order units, e.g. ecological landscape. The basis for the establishment of the hunting complexes was the assumption that the existing game hunting grounds, i.e. the basic units implementing game management, are too small and do not cover the natural areas inhabited by game populations. Roe deer are flexible species and easily adapt to various site conditions, so they inhabit many different habitats, from large forest complexes, through small in-field tree stands and shrubs, to treeless grounds and field monocultures. The aim of the study was to determine a possible impact of environmental conditions prevailing in the hunting complexes of the Regional Directorate of State Forests (RDLP in Lublin) on the ontogenetic quality of roe deer. The study was conducted on 518 European roe deer ( Capreolus capreolus ) aged from 4 to 7 years (379 bucks and 139 does) harvested within hunting seasons 2010/2011-2013/2014. The results have shown that animals originating from areas with greater forest cover and denser stands are characterised by lower values of the mean ontogenetic quality parameters (carcase weight, kidney fat index, chest girth, weight of antlers) in comparison with animals from typical agricultural areas with fragmented forest complexes. These results indicate that, even in the case of such a eurytopic species as the roe deer, the ontogenetic quality differs between individual hunting complexes. The study has proved that strategies for hunting management of the roe deer should take into account the impact of the landscape structure, which provides a rationale behind creation of hunting complexes.

  19. Pharmaco-epidemiological description of the population of the Marche Region (central Italy treated with the antipsychotic drug olanzapine

    Directory of Open Access Journals (Sweden)

    Fiorenzo Mignini

    2013-03-01

    Full Text Available BACKGROUND. In Italy, even though olanzapine has been discouraged for treatment of behaviour disorders in older patients affected by dementia, some physicians chose to prescribe for them. In response to this situation, the Italian Drug Agency (Agenzia Italiana del Farmaco, AIFA promulgated a cautionary note. MATERIALS AND METHODS. This study examined epidemiological indices for olanzapine prescriptions between 2004 and 2007 in the Marche Region of central Italy and in its provinces, to assess physician compliance with the AIFA note, and to determine whether there were differences in drug prescription between populations of the same territory, or differences based on gender or age group. RESULTS. Our analyses revealed high olanzapine use among young men and mature women, suggesting that these groups are most prone to psychotic symptoms. Analysis revealed that olanzapine prescription in elderly patients was reduced in some provinces, in line with the AIFA note. CONCLUSIONS. Prudent use of olanzapine prescription, in compliance with the AIFA note, was noted throughout the Region. Furthermore, this work offers details that may be useful in future studies of adverse drug reactions.

  20. Transport pathways and enhancement mechanisms within localized and non-localized transport regions in skin treated with low-frequency sonophoresis and sodium lauryl sulfate.

    Science.gov (United States)

    Polat, Baris E; Figueroa, Pedro L; Blankschtein, Daniel; Langer, Robert

    2011-02-01

    Recent advances in transdermal drug delivery utilizing low-frequency sonophoresis (LFS) and sodium lauryl sulfate (SLS) have revealed that skin permeability enhancement is not homogenous across the skin surface. Instead, highly perturbed skin regions, known as localized transport regions (LTRs), exist. Despite these findings, little research has been conducted to identify intrinsic properties and formation mechanisms of LTRs and the surrounding less-perturbed non-LTRs. By independently analyzing LTR, non-LTR, and total skin samples treated at multiple LFS frequencies, we found that the pore radii (r(pore)) within non-LTRs are frequency-independent, ranging from 18.2 to 18.5 Å, but significantly larger than r(pore) of native skin samples (13.6 Å). Conversely, r(pore) within LTRs increase significantly with decreasing frequency from 161 to 276 Å and to ∞ (>300 Å) for LFS/SLS-treated skin at 60, 40, and 20 kHz, respectively. Our findings suggest that different mechanisms contribute to skin permeability enhancement within each skin region. We propose that the enhancement mechanism within LTRs is the frequency-dependent process of cavitation-induced microjet collapse at the skin surface, whereas the increased r(pore) values in non-LTRs are likely due to SLS perturbation, with enhanced penetration of SLS into the skin resulting from the frequency-independent process of microstreaming. Copyright © 2010 Wiley-Liss, Inc.

  1. Transport Pathways and Enhancement Mechanisms within Localized and Non-Localized Transport Regions in Skin Treated with Low-Frequency Sonophoresis and Sodium Lauryl Sulfate

    Science.gov (United States)

    Polat, Baris E.; Figueroa, Pedro L.; Blankschtein, Daniel; Langer, Robert

    2011-01-01

    Recent advances in transdermal drug delivery utilizing low-frequency sonophoresis (LFS) and sodium lauryl sulfate (SLS) have revealed that skin permeability enhancement is not homogenous across the skin surface. Instead, highly perturbed skin regions, known as localized transport regions (LTRs), exist. Despite these findings, little research has been conducted to identify intrinsic properties and formation mechanisms of LTRs and the surrounding less-perturbed non-LTRs. By independently analyzing LTR, non-LTR, and total skin samples treated at multiple LFS frequencies, we found that the pore radii (rpore) within non-LTRs are frequency-independent, ranging from 18.2 – 18.5 Å, but significantly larger than rpore of native skin samples (13.6 Å). Conversely, rpore within LTRs increases significantly with decreasing frequency from 161 Å, to 276 Å, and to ∞ (>300Å) for LFS/SLS-treated skin at 60 kHz, 40 kHz, and 20 kHz, respectively. Our findings suggest that different mechanisms contribute to skin permeability enhancement within each skin region. We propose that the enhancement mechanism within LTRs is the frequency-dependent process of cavitation-induced microjet collapse at the skin surface, while the increased rpore values in non-LTRs are likely due to SLS perturbation, with enhanced penetration of SLS into the skin resulting from the frequency-independent process of microstreaming. PMID:20740667

  2. NEW MEMBERS OF THE SCORPIUS-CENTAURUS COMPLEX AND AGES OF ITS SUB-REGIONS

    Energy Technology Data Exchange (ETDEWEB)

    Song, Inseok [Department of Physics and Astronomy, The University of Georgia, Athens, GA 30602-2451 (United States); Zuckerman, B. [Department of Physics and Astronomy, University of California, Los Angeles, 475 Portola Plaza, Los Angeles, CA 90095-1547 (United States); Bessell, M. S. [Research School of Astronomy and Astrophysics, Institute of Advanced Studies, The Australian National University, ACT 2611 (Australia)

    2012-07-15

    We have spectroscopically identified {approx}100 G-, K-, and M-type members of the Scorpius-Centaurus complex. To deduce the age of these young stars we compare their Li {lambda}6708 absorption line strengths against those of stars in the TW Hydrae association and {beta} Pictoris moving group. These line strengths indicate that Sco-Cen stars are younger than {beta} Pic stars whose ages of {approx}12 Myr have previously been derived from a kinematic traceback analysis. Our derived age, {approx}10 Myr, for stars in the Lower Centaurus Crux and Upper Centaurus Lupus subgroups of ScoCen is younger than previously published ages based on the moving cluster method and upper main-sequence fitting. The discrepant ages are likely due to an incorrect (or lack of) cross-calibration between model-dependent and model-independent age-dating methods.

  3. The results of complex radiation-hygienic survey of the reference settlements in Mogilev region

    International Nuclear Information System (INIS)

    Ageeva, T.N.; Chegerova, T.I.; Shchur, A.V.; Shapsheeva, T.P.; Lipnitskij, L.V.

    2011-01-01

    The results of complex radiation-hygienic survey of the reference settlements located on the radioactively contaminated territory have been presents in the article. The four-year dynamics of the internal exposure doses of the reference settlements' inhabitants and their relationship with the 137 Cs content in foods consumed by the population have been shown. It was ascertained that there are still some isolated individuals with high doses of internal radiation among the surveyed population, which have the significant influence on the average annual radiation dose for the inhabitants and dose of its critical group. The external exposure individual doses of the inhabitants and the results of measuring of the gamma radiation dose rate in place of the settlements have been analyzed. It have been expressed the opinion about need entering adjustment in the measuring techniques of external doses. (authors)

  4. THE COMPLEX NORTH TRANSITION REGION OF CENTAURUS A: A GALACTIC WIND

    Energy Technology Data Exchange (ETDEWEB)

    Neff, Susan G. [NASA’s Goddard Space Flight Center, Laboratory for Observational Cosmology, Mail Code 665, Greenbelt, MD 20771 (United States); Eilek, Jean A. [Physics Department, New Mexico Tech, Socorro NM 87801 (United States); Owen, Frazer N., E-mail: susan.g.neff@nasa.gov [National Radio Astronomy Observatory, Socorro NM 87801 (United States)

    2015-04-01

    We present deep GALEX images of NGC 5128, the parent galaxy of Centaurus A. We detect a striking “weather ribbon” of far-UV (FUV) and Hα emission which extends more than 35 kpc northeast of the galaxy. This ribbon is associated with a knotty ridge of radio/X-ray emission and is an extension of the previously known string of optical emission-line filaments. Many phenomena in the region are too short-lived to have survived transit out from the inner galaxy; something must be driving them locally. We also detect FUV emission from the galaxy’s central dust lane. Combining this with previous radio and far-IR measurements, we infer an active starburst in the central galaxy which is currently forming stars at ∼2 M{sub ☉} yr{sup −1}, and has been doing so for 50–100 Myr. If the wind from this starburst is enhanced by energy and mass driven out from the active galactic nucleus, the powerful augmented wind can be the driver needed for the northern weather system. We argue that both the diverse weather system, and the enhanced radio emission in the same region, result from the wind’s encounter with cool gas left by one of the recent merger/encounter events in the history of NGC 5128.

  5. Evaluating the adequacy of a reference site pool for ecological assessments in environmentally complex regions

    Science.gov (United States)

    Ode, Peter R.; Rehn, Andrew C.; Mazor, Raphael D.; Schiff, Kenneth C.; Stein, Eric D.; May, Jason; Brown, Larry R.; Herbst, David B.; Gillette, D.D.; Lunde, Kevin; Hawkins, Charles P.

    2016-01-01

    Many advances in the field of bioassessment have focused on approaches for objectively selecting the pool of reference sites used to establish expectations for healthy waterbodies, but little emphasis has been placed on ways to evaluate the suitability of the reference-site pool for its intended applications (e.g., compliance assessment vs ambient monitoring). These evaluations are critical because an inadequately evaluated reference pool may bias assessments in some settings. We present an approach for evaluating the adequacy of a reference-site pool for supporting biotic-index development in environmentally heterogeneous and pervasively altered regions. We followed common approaches for selecting sites with low levels of anthropogenic stress to screen 1985 candidate stream reaches to create a pool of 590 reference sites for assessing the biological integrity of streams in California, USA. We assessed the resulting pool of reference sites against 2 performance criteria. First, we evaluated how well the reference-site pool represented the range of natural gradients present in the entire population of streams as estimated by sites sampled through probabilistic surveys. Second, we evaluated the degree to which we were successful in rejecting sites influenced by anthropogenic stress by comparing biological metric scores at reference sites with the most vs fewest potential sources of stress. Using this approach, we established a reference-site pool with low levels of human-associated stress and broad coverage of environmental heterogeneity. This approach should be widely applicable and customizable to particular regional or programmatic needs.

  6. Structural characterization of POM6 Fab and mouse prion protein complex identifies key regions for prions conformational conversion.

    Science.gov (United States)

    Baral, Pravas Kumar; Swayampakula, Mridula; Aguzzi, Adriano; James, Michael N G

    2018-05-01

    Conversion of the cellular prion protein PrP C into its pathogenic isoform PrP S c is the hallmark of prion diseases, fatal neurodegenerative diseases affecting many mammalian species including humans. Anti-prion monoclonal antibodies can arrest the progression of prion diseases by stabilizing the cellular form of the prion protein. Here, we present the crystal structure of the POM6 Fab fragment, in complex with the mouse prion protein (moPrP). The prion epitope of POM6 is in close proximity to the epitope recognized by the purportedly toxic antibody fragment, POM1 Fab also complexed with moPrP. The POM6 Fab recognizes a larger binding interface indicating a likely stronger binding compared to POM1. POM6 and POM1 exhibit distinct biological responses. Structural comparisons of the bound mouse prion proteins from the POM6 Fab:moPrP and POM1 Fab:moPrP complexes reveal several key regions of the prion protein that might be involved in initiating mis-folding events. The structural data of moPrP:POM6 Fab complex are available in the PDB under the accession number www.rcsb.org/pdb/search/structidSearch.do?structureId=6AQ7. © 2018 Federation of European Biochemical Societies.

  7. Brain electric correlates of strong belief in paranormal phenomena: intracerebral EEG source and regional Omega complexity analyses.

    Science.gov (United States)

    Pizzagalli, D; Lehmann, D; Gianotti, L; Koenig, T; Tanaka, H; Wackermann, J; Brugger, P

    2000-12-22

    The neurocognitive processes underlying the formation and maintenance of paranormal beliefs are important for understanding schizotypal ideation. Behavioral studies indicated that both schizotypal and paranormal ideation are based on an overreliance on the right hemisphere, whose coarse rather than focussed semantic processing may favor the emergence of 'loose' and 'uncommon' associations. To elucidate the electrophysiological basis of these behavioral observations, 35-channel resting EEG was recorded in pre-screened female strong believers and disbelievers during resting baseline. EEG data were subjected to FFT-Dipole-Approximation analysis, a reference-free frequency-domain dipole source modeling, and Regional (hemispheric) Omega Complexity analysis, a linear approach estimating the complexity of the trajectories of momentary EEG map series in state space. Compared to disbelievers, believers showed: more right-located sources of the beta2 band (18.5-21 Hz, excitatory activity); reduced interhemispheric differences in Omega complexity values; higher scores on the Magical Ideation scale; more general negative affect; and more hypnagogic-like reveries after a 4-min eyes-closed resting period. Thus, subjects differing in their declared paranormal belief displayed different active, cerebral neural populations during resting, task-free conditions. As hypothesized, believers showed relatively higher right hemispheric activation and reduced hemispheric asymmetry of functional complexity. These markers may constitute the neurophysiological basis for paranormal and schizotypal ideation.

  8. Are Complex Magnetic Field Structures Responsible for the Confined X-class Flares in Super Active Region 12192?

    Energy Technology Data Exchange (ETDEWEB)

    Zhang, Jun; Li, Ting; Chen, Huadong, E-mail: zjun@nao.cas.cn, E-mail: hdchen@nao.cas.cn [Key Laboratory of Solar Activity, National Astronomical Observatories, Chinese Academy of Sciences, Beijing 100012 (China)

    2017-08-10

    From 2014 October 19 to 27, six X-class flares occurred in super active region (AR) 12192. They were all confined flares and were not followed by coronal mass ejections. To examine the structures of the four flares close to the solar disk center from October 22 to 26, we firstly employ composite triple-time images in each flare process to display the stratified structure of these flare loops. The loop structures of each flare in both the lower (171 Å) and higher (131 Å) temperature channels are complex, e.g., the flare loops rooting at flare ribbons are sheared or twisted (enwound) together, and the complex structures were not destroyed during the flares. For the first flare, although the flare loop system appears as a spindle shape, we can estimate its structures from observations, with lengths ranging from 130 to 300 Mm, heights from 65 to 150 Mm, widths at the middle part of the spindle from 40 to 100 Mm, and shear angles from 16° to 90°. Moreover, the flare ribbons display irregular movements, such as the left ribbon fragments of the flare on October 22 sweeping a small region repeatedly, and both ribbons of the flare on October 26 moved along the same direction instead of separating from each other. These irregular movements also imply that the corresponding flare loops are complex, e.g., several sets of flare loops are twisted together. Although previous studies have suggested that the background magnetic fields prevent confined flares from erupting,based on these observations, we suggest that complex flare loop structures may be responsible for these confined flares.

  9. Low-complexity atlas-based prostate segmentation by combining global, regional, and local metrics

    Energy Technology Data Exchange (ETDEWEB)

    Xie, Qiuliang; Ruan, Dan, E-mail: druan@mednet.ucla.edu [The Department of Radiation Oncology, University of California Los Angeles, California 90095 (United States)

    2014-04-15

    Purpose: To improve the efficiency of atlas-based segmentation without compromising accuracy, and to demonstrate the validity of the proposed method on MRI-based prostate segmentation application. Methods: Accurate and efficient automatic structure segmentation is an important task in medical image processing. Atlas-based methods, as the state-of-the-art, provide good segmentation at the cost of a large number of computationally intensive nonrigid registrations, for anatomical sites/structures that are subject to deformation. In this study, the authors propose to utilize a combination of global, regional, and local metrics to improve the accuracy yet significantly reduce the number of required nonrigid registrations. The authors first perform an affine registration to minimize the global mean squared error (gMSE) to coarsely align each atlas image to the target. Subsequently, atarget-specific regional MSE (rMSE), demonstrated to be a good surrogate for dice similarity coefficient (DSC), is used to select a relevant subset from the training atlas. Only within this subset are nonrigid registrations performed between the training images and the target image, to minimize a weighted combination of gMSE and rMSE. Finally, structure labels are propagated from the selected training samples to the target via the estimated deformation fields, and label fusion is performed based on a weighted combination of rMSE and local MSE (lMSE) discrepancy, with proper total-variation-based spatial regularization. Results: The proposed method was applied to a public database of 30 prostate MR images with expert-segmented structures. The authors’ method, utilizing only eight nonrigid registrations, achieved a performance with a median/mean DSC of over 0.87/0.86, outperforming the state-of-the-art full-fledged atlas-based segmentation approach of which the median/mean DSC was 0.84/0.82 when applying to their data set. Conclusions: The proposed method requires a fixed number of nonrigid

  10. Estimation of PHI (γ,n) average probability for complex nuclei in the quasi-deuteron region

    International Nuclear Information System (INIS)

    Ferreira, M.C. da S.

    1977-01-01

    The average probabilities of (γ,n) reactions for complexe nuclei of 6 C 12 , 19 F 19 , 25 Mn 55 , 79 Au 197 and 92 U 238 , in the energy range from giant resonance end to photomesonic threshold (quasi-deuteron region), using values of cross sections per quantum equivalent to 300 Mev produced by Bremsstrahlung photons in the Frascati and Orsay accelerators were determined. The probabilities were also calculated using nuclear transparence for protons and neutrons, resultants from quasi-deuteron disintegration. The transparence formulaes were determined by optical model. (M.C.K.) [pt

  11. Photoacoustic microscopy of complex regional pain syndrome type I (CRPS-1) after stellate ganglion blocks in vivo

    Science.gov (United States)

    Zhou, Yong; Yi, Xiaobin; Xing, Wenxin; Hu, Song; Maslov, Konstantin I.; Wang, Lihong V.

    2015-03-01

    We used photoacoustic microscopy (PAM) to assist diagnoses and monitor the progress and treatment outcome of complex regional pain syndrome type 1 (CRPS-1). Blood vasculature and oxygen saturation (sO2) were imaged by PAM in eight adult patients with CRPS-1. Patients' hands and cuticles were imaged both before and after stellate ganglion block (SGB) for comparison. For all patients, both the vascular structure and sO2 could be assessed by PAM. In addition, more vessels and stronger signals were observed after SGB.

  12. Modern Political and Economic Aspects of the Oil and Gas Complex in the Southeast Asia Region

    Directory of Open Access Journals (Sweden)

    Valery I. Salygin

    2014-01-01

    Full Text Available AbstracUThe article reviews the problems caused by the conflict of interests between certain Southeast Asian countries and other states, China foremost, which aroused from oil and gas field development on disputable offshore sections. At the same time the positions of the region's leading transnational corporations in the field of oil and gas policy and their relationships with the countries-ASEAN (Association of South East Asian Nations members are outlined. Separately are represented the foreign policy stands of Indonesia, Vietnam, Brunei, Philippines and Malaysia on territorial disputes over offshore oil and gas fields. These processes are pushing both European and American business to abandon the conventional schemes and accept the new conditions of their activity in Southeast Asia.

  13. Doing more with less (data): complexities of resource flow analysis in the Gauteng City-Region

    Science.gov (United States)

    Culwick, Christina; Götz, Graeme; Butcher, Siân; Harber, Jesse; Maree, Gillian; Mushongera, Darlington

    2017-12-01

    Urban metabolism is a growing field of study into resource flows through cities, and how these could be managed more sustainably. There are two main schools of thought on urban metabolism—metabolic flow analysis (MFA) and urban political ecology (UPE). The two schools remain siloed despite common foundations. This paper reflects on recent research by the Gauteng City-Region Observatory (GCRO) into urban sustainability transitions in South Africa’s Gauteng City-Region, a large and sprawling urban formation that faces a host of sustainability challenges including water deficits, erratic electricity supply, stretched infrastructure networks and increasingly carbon-intensive settlement patterns. Three GCRO research projects are reviewed. Each project began with the assumption that data collection on the region’s metabolism could enable an MFA or MFA-like analysis to highlight where possible resource efficiency and sustainability gains might be achieved. However, in each case we confronted severe data-limitations, and ended up asking UPE-style questions on the reasons for and implications of the chronic paucity of urban metabolism data. We have been led to conclude that urban metabolism research will require much more than just assembling and modelling flows data, although these efforts should not be abandoned. A synthesis of MFA and UPE is needed, which simultaneously builds a deeper understanding of resource flows and the systems that govern these flows. We support the emerging approach in political-industrial ecology literature which values both material data on and socio-political insight into urban metabolism, and emphasises the importance of multi-disciplinary and multi-dimensional analysis to inform decision-making in urban sustainability transitions.

  14. Power of magic hands: parent-driven application of habit reversal to treat complex stereotypy in a 3-year-old.

    Science.gov (United States)

    Freeman, Kurt A; Duke, Danny C

    2013-08-01

    The authors assessed the effectiveness of habit reversal training (HRT) to treat a complex motor stereotypy in a healthy 3-year-old female. This data-based case study involved training parents in HRT to deliver the parent-driven intervention to the child. The frequency of the child's behaviors was estimated daily in 30-min intervals by her parents. Outcomes supported the effectiveness of the intervention, with the estimated frequency of the stereotypy decreasing from occurring during approximately 85% of recorded intervals to less than 2% over a period of 4 weeks. Further record keeping over 19 weeks suggested treatment gains were generally maintained over time. The current case study provides preliminary evidence supporting the effectiveness of modified HRT to reduce stereotypies in young children. Further, data suggest that the intervention may be extended to younger ages by teaching parents how to facilitate treatment delivery. PsycINFO Database Record (c) 2013 APA, all rights reserved.

  15. The outermost N-terminal region of tapasin facilitates folding of major histocompatibility complex class I

    DEFF Research Database (Denmark)

    Røder, Gustav Andreas; Geironson, Linda; Darabi, Anna

    2009-01-01

    ). Using a biochemical peptide-MHC-I-binding assay, recombinant Tpn(1-87) was found to specifically facilitate peptide-dependent folding of HLA-A*0201. Furthermore, we used Tpn(1-87) to generate a monoclonal antibody, alphaTpn(1-87)/80, specific for natural human Tpn and capable of cellular staining of ER......Tapasin (Tpn) is an ER chaperone that is uniquely dedicated to MHC-I biosynthesis. It binds MHC-I molecules, integrates them into peptide-loading complexes, and exerts quality control of the bound peptides; only when an "optimal peptide" is bound will the MHC-I be released and exported to the cell...... surface for presentation to T cells. The exact mechanisms of Tpn quality control and the criteria for being an optimal peptide are still unknown. Here, we have generated a recombinant fragment of human Tpn, Tpn(1-87) (representing the 87 N-terminal and ER-luminal amino acids of the mature Tpn protein...

  16. Complex Inflammation mRNA-Related Response in ALS Is Region Dependent

    Directory of Open Access Journals (Sweden)

    Sara Berjaoui

    2015-01-01

    Full Text Available Inflammatory changes are analyzed in the anterior spinal cord and frontal cortex area 8 in typical spinal-predominant ALS cases. Increased numbers of astrocytes and activated microglia are found in the anterior horn of the spinal cord and pyramidal tracts. Significant increased expression of TLR7, CTSS, and CTSC mRNA and a trend to increased expression of IL10RA, TGFB1, and TGFB2 are found in the anterior lumbar spinal cord in ALS cases compared to control cases, whereas C1QTNF7 and TNFRSF1A mRNA expression levels are significantly decreased. IL6 is significantly upregulated and IL1B shows a nonsignificant increased expression in frontal cortex area 8 in ALS cases. IL-6 immunoreactivity is found in scattered monocyte-derived macrophages/microglia and TNF-α in a few cells of unknown origin in ALS cases. Increased expression and abnormal distribution of IL-1β occurred in motor neurons of the lumbar spinal cord in ALS. Strong IL-10 immunoreactivity colocalizes with TDP-43-positive inclusions in motor neurons in ALS cases. The present observations show a complex participation of cytokines and mediators of the inflammatory response in ALS consistent with increased proinflammatory cytokines and sequestration of anti-inflammatory IL-10 in affected neurons.

  17. Trends in the structures development of the regional machine-building complex

    Directory of Open Access Journals (Sweden)

    Ershova I.V.

    2017-01-01

    Full Text Available In the process of market reforms of the Russian machine-building complex several distinct periods can be revealed. In this article the authors define periods of mass disintegration and spontaneous integration (since the beginning of the reforms until the financial crisis of 1996, post-crisis stabilization, directional specialization (2000-2008 and evolutionary development (since 2010. The economic consequences of the enterprises mergers and divisions are shown on the example of machine-building enterprises of the Middle Urals. The aim of this study is to substantiate the methodical approach to the selection of the optimal organizational structure for the machine-building business. The necessity of taking into account the extent of the personnel diversification and the production volume has been revealed for the optimum organizational structure determination in the machine-building associations. The authors have analyzed sales profitability of the 2745 machine-building enterprises, depending on the production scale and industry sector. The factors affecting the development of cooperative ties and outsourcing have been defined. The authors have made a conclusion that it is necessary to form technological chains as a new kind of business associations.

  18. Natural radionuclides in the Brazilian coast region: 1. Estuarine complex Cananeia-Iguape, Sao Paulo State

    Energy Technology Data Exchange (ETDEWEB)

    Franca, E.J. de; Ferreira, Fabiano S.; Silva Neto, Paulo C.; Farias, Emerson E.G. de; Figueira, Rubens C.L.; Ribeiro, Andreza P., E-mail: ejfranca@cnen.gov.br, E-mail: biologofabiano10@gmail.com, E-mail: ptpoli@yahoo.com.br, E-mail: emersonemiliano@yahoo.com.br [Centro Regional de Ciencias Nucleares do Nordeste (CRCN-NE/CNEN-PE), Recife, PE (Brazil)

    2015-07-01

    Mangrove forests are of utmost important ecosystems for biogeochemical transport processes in a global scale because of the preferential transport via sediments and organic matter from continents to oceans. Such ecosystems are the richest biodiversity areas, in which bioaccumulation of chemical substances can be expected for some species, in this case, there is a lack of knowledge of natural radionuclides accumulation in mangrove vegetation. This work encompasses the first results obtained for the Estuarine Complex Cananeia-Iguape, a peculiar coast area of the Sao Paulo State, Brazil. In 2011, leaf samples of Rhyzophora mangle and Laguncularia racemosa trees with perimeter at the breast height higher than 15 cm were collected in the conservation unit Parque Estadual Ilha do Cardoso. Sample preparation consisted of leaf washing, oven-drying, milling in porcelain mortar at the particle size lower than 0.5 mm. Portions of 10 g were transferred to polyethylene vials of appropriate geometry for the analysis by high resolution gamma-ray spectrometry. Reference materials were analyzed together to evaluate the quality of the analytical procedure. K-40 was preferentially allocated in leaves. Some accumulation in leaves was noticed for Pb-210 and Ac-228 depending on the species, indicating differences of radionuclide distribution in the mangrove vegetation. (author)

  19. Natural radionuclides in the Brazilian coast region: 1. Estuarine complex Cananeia-Iguape, Sao Paulo State

    International Nuclear Information System (INIS)

    Franca, E.J. de; Ferreira, Fabiano S.; Silva Neto, Paulo C.; Farias, Emerson E.G. de; Figueira, Rubens C.L.; Ribeiro, Andreza P.

    2015-01-01

    Mangrove forests are of utmost important ecosystems for biogeochemical transport processes in a global scale because of the preferential transport via sediments and organic matter from continents to oceans. Such ecosystems are the richest biodiversity areas, in which bioaccumulation of chemical substances can be expected for some species, in this case, there is a lack of knowledge of natural radionuclides accumulation in mangrove vegetation. This work encompasses the first results obtained for the Estuarine Complex Cananeia-Iguape, a peculiar coast area of the Sao Paulo State, Brazil. In 2011, leaf samples of Rhyzophora mangle and Laguncularia racemosa trees with perimeter at the breast height higher than 15 cm were collected in the conservation unit Parque Estadual Ilha do Cardoso. Sample preparation consisted of leaf washing, oven-drying, milling in porcelain mortar at the particle size lower than 0.5 mm. Portions of 10 g were transferred to polyethylene vials of appropriate geometry for the analysis by high resolution gamma-ray spectrometry. Reference materials were analyzed together to evaluate the quality of the analytical procedure. K-40 was preferentially allocated in leaves. Some accumulation in leaves was noticed for Pb-210 and Ac-228 depending on the species, indicating differences of radionuclide distribution in the mangrove vegetation. (author)

  20. UNIFORM INFALL TOWARD THE COMETARY H II REGION IN THE G34.26+0.15 COMPLEX?

    International Nuclear Information System (INIS)

    Liu, Tie; Wu, Yuefang; Zhang, Huawei

    2013-01-01

    Gas accretion is a key process in star formation. However, gas infall detections in high-mass, star-forming regions with high spatial resolution observations are rare. Here, we report the detection of gas infall toward a cometary ultracompact H II region ( C) in the G34.26+0.15 complex. The observations were made with the IRAM 30 m, the James Clerk Maxwell Telescope 15 m telescope, and the Submillimeter Array (SMA). The hot core associated with 'C' has a mass of ∼76 ± 11 M ☉ and a volume density of (1.1 ± 0.2) × 10 8 cm –3 . The HCN (3-2) and HCO + (1-0) lines observed by single dishes and the CN (2-1) lines observed by the SMA show redshifted absorption features, indicating gas infall. We found a linear relationship between the line width and optical depth of the CN (2-1) lines. Those transitions with larger optical depths and line widths have larger absorption areas. However, the infall velocities measured from different lines seem to be constant, indicating that the gas infall is uniform. We also investigated the evolution of gas infall in high-mass, star-forming regions. A tight relationship was found between the infall velocity and the total dust/gas mass. At stages prior to the hot core phase, the typical infall velocity and mass infall rate are ∼1 km s –1 and ∼10 –4 M ☉ yr –1 , respectively. While in more evolved regions, the infall velocity and mass infall rates can reach as high as several km s –1 and ∼10 –3 -10 –2 M ☉ yr –1 , respectively. Accelerated infall has been detected toward some hypercompact H II and ultracompact H II regions. However, the acceleration phenomenon is not seen in more evolved ultracompact H II regions (e.g., G34.26+0.15)

  1. Estimation of the ripple effects on a regional community of the formation of the nuclear energy science complex in Gyeongju

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Byung-Sik [Dankook Univ., Chungnam (Korea, Republic of). Dept. of Nuclear Engineering; Moon, Joo Hyun [Dongguk Univ. Gyeongju, Gyeongbuk (Korea, Republic of). Dept. of Nuclear Energy Engineering

    2017-05-15

    Korea has developed advanced nuclear technologies, including those for future nuclear energy systems and the safe management of spent nuclear fuel, and is about to make a decision as to whether to make a massive investment in the development R and D for commercialization of them. There is no area large enough to accommodate all the development R and D-related facilities together at Korea Atomic Energy Research Institute (KAERI) to perform the development R and Ds. KAERI seeks solutions to the space problem, which includes the construction of a nuclear energy science complex (NESC). Gyeongju is one of the potential sites. This study estimated the ripple effects on the regional community if the NESC is to be formed in Gyeongju using inter-regional input-output analysis. The estimation shows that the ripple effects to the regional community of the formation of the NESC in Gyeongju would be 1,086,633 billion Korean Won (KRW) for regional production inducement, 455,299 billion KRW for value-added inducement, and 9,592 persons for employment inducement.

  2. Regression-based approach for testing the association between multi-region haplotype configuration and complex trait

    Directory of Open Access Journals (Sweden)

    Zhao Hongbo

    2009-09-01

    Full Text Available Abstract Background It is quite common that the genetic architecture of complex traits involves many genes and their interactions. Therefore, dealing with multiple unlinked genomic regions simultaneously is desirable. Results In this paper we develop a regression-based approach to assess the interactions of haplotypes that belong to different unlinked regions, and we use score statistics to test the null hypothesis of non-genetic association. Additionally, multiple marker combinations at each unlinked region are considered. The multiple tests are settled via the minP approach. The P value of the "best" multi-region multi-marker configuration is corrected via Monte-Carlo simulations. Through simulation studies, we assess the performance of the proposed approach and demonstrate its validity and power in testing for haplotype interaction association. Conclusion Our simulations showed that, for binary trait without covariates, our proposed methods prove to be equal and even more powerful than htr and hapcc which are part of the FAMHAP program. Additionally, our model can be applied to a wider variety of traits and allow adjustment for other covariates. To test the validity, our methods are applied to analyze the association between four unlinked candidate genes and pig meat quality.

  3. Simulating flaring events in complex active regions driven by observed magnetograms

    Science.gov (United States)

    Dimitropoulou, M.; Isliker, H.; Vlahos, L.; Georgoulis, M. K.

    2011-05-01

    Context. We interpret solar flares as events originating in active regions that have reached the self organized critical state, by using a refined cellular automaton model with initial conditions derived from observations. Aims: We investigate whether the system, with its imposed physical elements, reaches a self organized critical state and whether well-known statistical properties of flares, such as scaling laws observed in the distribution functions of characteristic parameters, are reproduced after this state has been reached. Methods: To investigate whether the distribution functions of total energy, peak energy and event duration follow the expected scaling laws, we first applied a nonlinear force-free extrapolation that reconstructs the three-dimensional magnetic fields from two-dimensional vector magnetograms. We then locate magnetic discontinuities exceeding a threshold in the Laplacian of the magnetic field. These discontinuities are relaxed in local diffusion events, implemented in the form of cellular automaton evolution rules. Subsequent loading and relaxation steps lead the system to self organized criticality, after which the statistical properties of the simulated events are examined. Physical requirements, such as the divergence-free condition for the magnetic field vector, are approximately imposed on all elements of the model. Results: Our results show that self organized criticality is indeed reached when applying specific loading and relaxation rules. Power-law indices obtained from the distribution functions of the modeled flaring events are in good agreement with observations. Single power laws (peak and total flare energy) are obtained, as are power laws with exponential cutoff and double power laws (flare duration). The results are also compared with observational X-ray data from the GOES satellite for our active-region sample. Conclusions: We conclude that well-known statistical properties of flares are reproduced after the system has

  4. Intravenous regional block is similar to sympathetic ganglion block for pain management in patients with complex regional pain syndrome type I

    Directory of Open Access Journals (Sweden)

    M.S.A. Nascimento

    2010-12-01

    Full Text Available Sympathetic ganglion block (SGB or intravenous regional block (IVRB has been recommended for pain management in patients with complex regional pain syndrome type I (CRPS-I. Forty-five patients were initially selected but only 43 were accepted for the study. The present study evaluated the efficacy of IVRB produced by combining 70 mg lidocaine with 30 µg clonidine (14 patients, 1 male/13 females, age range: 27-50 years versus SGB produced by the injection of 70 mg lidocaine alone (14 patients, 1 male/13 females, age range: 27-54 years or combined with 30 µg clonidine (15 patients, 1 male/14 females, age range: 25-50 years into the stellate ganglion for pain management in patients with upper extremity CRPS-I. Each procedure was repeated five times at 7-day intervals, and pain intensity and duration were measured using a visual analog scale immediately before each procedure. A progressive and significant reduction in pain scores and a significant increase in the duration of analgesia were observed in all groups following the first three blocks, but no further improvement was obtained following the last two blocks. Drowsiness, the most frequent side effect, and dry mouth occurred only in patients submitted to SGB with lidocaine combined with clonidine. The three methods were similar regarding changes in pain intensity and duration of analgesia. However, IVRB seems to be preferable to SGB due to its easier execution and lower risk of undesirable effects.

  5. Banning is not enough: The complexities of oceanic shark management by tuna regional fisheries management organizations

    Directory of Open Access Journals (Sweden)

    Mariana Travassos Tolotti

    2015-07-01

    Full Text Available Recently, declining populations of several pelagic shark species have led to global conservation concerns surrounding this group. As a result, a series of species-specific banning measures have been implemented by Regional Fishery Management Organizations (RFMOs in charge of tuna fisheries, which include retention bans, finning bans and trading bans. There are both positive and negative aspects to most management measures, but generally, the positive aspects outweigh the negatives, ensuring the measure is beneficial to the resource and its users in the long term. Banning measures are a good first step towards the conservation of pelagic shark species, especially since they improve conservation awareness among fishers, managers and the public. Measures that impose total bans, however, can lead to negative impacts that may jeopardize the populations they were intended to protect. The majority of pelagic shark catches are incidental and most sharks die before they reach the vessel or after they are released. The legislation set out by RFMOs only prevents retention but not the actual capture or the mortality that may occur as a result. Managers should be fully aware that the development and implementation of mitigation measures are critical for a more effective conservation strategy.

  6. COMPLEX OF PATHOGENES ON VEGETABLE CROPS IN CONDITION OF CENTRAL REGION OF RUSSIA

    Directory of Open Access Journals (Sweden)

    L. T. Timina

    2015-01-01

    Full Text Available As a result of monitoring of causative agents of diseases of vegetable crops and studying of its species specification, the genus and species of fungi and bacteria, were found. Previously unknown in the Central region of Russia pathogens of carrot were identified: Sclerotinia nevales, Gleocladium roseum, Verticillium spp, Trichotecium roseum, Streptomyces scabies, F. nivale, F. chlamidosporum, F. equiseti, F. proliferatum, Chaetomium spp., Erysiphe umbelliferum, Erwinia carotovora. Main causative agents of diseases  of carrot during storage were also described: Alternaria infectoria, A. alternatа, A. arborescens, A. radicina, A. cheiranthi, A. corotiincultae, A. cinerariae, Embellisia spp., Nimbia spp., Cladosporium spp. It was found new pathogen for onion (Aspergillus niger, garlic (Fusarium semitectum, F. subglutinans, F. proliferatum, F.avenacium, red beet (Typhula ishikariensis, and radish (Drechslera Bondartseva.

  7. CONSTRAINING THE ABUNDANCES OF COMPLEX ORGANICS IN THE INNER REGIONS OF SOLAR-TYPE PROTOSTARS

    Energy Technology Data Exchange (ETDEWEB)

    Taquet, Vianney; Charnley, Steven B. [Astrochemistry Laboratory and The Goddard Center for Astrobiology, Mailstop 691, NASA Goddard Space Flight Center, 8800 Greenbelt Road, Greenbelt, MD 20770 (United States); López-Sepulcre, Ana; Ceccarelli, Cecilia; Kahane, Claudine [Univ. Grenoble Alpes, IPAG, F-38000 Grenoble (France); Neri, Roberto, E-mail: taquet@strw.leidenuniv.nl [Institut de Radioastronomie Millimétrique, Grenoble (France)

    2015-05-10

    The high abundances of Complex Organic Molecules (COMs) with respect to methanol, the most abundant COM, detected toward low-mass protostars, tend to be underpredicted by astrochemical models. This discrepancy might come from the large beam of the single-dish telescopes, encompassing several components of the studied protostar, commonly used to detect COMs. To address this issue, we have carried out multi-line observations of methanol and several COMs toward the two low-mass protostars NGC 1333-IRAS 2A and -IRAS 4A with the Plateau de Bure interferometer at an angular resolution of 2″, resulting in the first multi-line detection of the O-bearing species glycolaldehyde and ethanol and of the N-bearing species ethyl cyanide toward low-mass protostars other than IRAS 16293. The high number of detected transitions from COMs (more than 40 methanol transitions for instance) allowed us to accurately derive the source size of their emission and the COM column densities. The COM abundances with respect to methanol derived toward IRAS 2A and IRAS 4A are slightly, but not substantitally, lower than those derived from previous single-dish observations. The COM abundance ratios do not vary significantly with the protostellar luminosity, over five orders of magnitude, implying that low-mass hot corinos are quite chemically rich as high-mass hot cores. Astrochemical models still underpredict the abundances of key COMs, such as methyl formate or di-methyl ether, suggesting that our understanding of their formation remains incomplete.

  8. Electroencephalographic evoked pain response is suppressed by spinal cord stimulation in complex regional pain syndrome: a case report.

    Science.gov (United States)

    Hylands-White, Nicholas; Duarte, Rui V; Beeson, Paul; Mayhew, Stephen D; Raphael, Jon H

    2016-12-01

    Pain is a subjective response that limits assessment. The purpose of this case report was to explore how the objectivity of the electroencephalographic response to thermal stimuli would be affected by concurrent spinal cord stimulation. A patient had been implanted with a spinal cord stimulator for the management of complex regional pain syndrome of both hands for 8 years. Following ethical approval and written informed consent we induced thermal stimuli using the Medoc PATHWAY Pain & Sensory Evaluation System on the right hand of the patient with the spinal cord stimulator switched off and with the spinal cord stimulator switched on. The patient reported a clinically significant reduction in thermal induced pain using the numerical rating scale (71.4 % reduction) with spinal cord stimulator switched on. Analysis of electroencephalogram recordings indicated the occurrence of contact heat evoked potentials (N2-P2) with spinal cord stimulator off, but not with spinal cord stimulator on. This case report suggests that thermal pain can be reduced in complex regional pain syndrome patients with the use of spinal cord stimulation and offers objective validation of the reported outcomes with this treatment.

  9. CENTRAL REGION COMPONENT1, a Novel Synaptonemal Complex Component, Is Essential for Meiotic Recombination Initiation in Rice[C][W

    Science.gov (United States)

    Miao, Chunbo; Tang, Ding; Zhang, Honggen; Wang, Mo; Li, Yafei; Tang, Shuzhu; Yu, Hengxiu; Gu, Minghong; Cheng, Zhukuan

    2013-01-01

    In meiosis, homologous recombination entails programmed DNA double-strand break (DSB) formation and synaptonemal complex (SC) assembly coupled with the DSB repair. Although SCs display extensive structural conservation among species, their components identified are poorly conserved at the sequence level. Here, we identified a novel SC component, designated CENTRAL REGION COMPONENT1 (CRC1), in rice (Oryza sativa). CRC1 colocalizes with ZEP1, the rice SC transverse filament protein, to the central region of SCs in a mutually dependent fashion. Consistent with this colocalization, CRC1 interacts with ZEP1 in yeast two-hybrid assays. CRC1 is orthologous to Saccharomyces cerevisiae pachytene checkpoint2 (Pch2) and Mus musculus THYROID RECEPTOR-INTERACTING PROTEIN13 (TRIP13) and may be a conserved SC component. Additionally, we provide evidence that CRC1 is essential for meiotic DSB formation. CRC1 interacts with HOMOLOGOUS PAIRING ABERRATION IN RICE MEIOSIS1 (PAIR1) in vitro, suggesting that these proteins act as a complex to promote DSB formation. PAIR2, the rice ortholog of budding yeast homolog pairing1, is required for homologous chromosome pairing. We found that CRC1 is also essential for the recruitment of PAIR2 onto meiotic chromosomes. The roles of CRC1 identified here have not been reported for Pch2 or TRIP13. PMID:23943860

  10. Central region component1, a novel synaptonemal complex component, is essential for meiotic recombination initiation in rice.

    Science.gov (United States)

    Miao, Chunbo; Tang, Ding; Zhang, Honggen; Wang, Mo; Li, Yafei; Tang, Shuzhu; Yu, Hengxiu; Gu, Minghong; Cheng, Zhukuan

    2013-08-01

    In meiosis, homologous recombination entails programmed DNA double-strand break (DSB) formation and synaptonemal complex (SC) assembly coupled with the DSB repair. Although SCs display extensive structural conservation among species, their components identified are poorly conserved at the sequence level. Here, we identified a novel SC component, designated central region component1 (CRC1), in rice (Oryza sativa). CRC1 colocalizes with ZEP1, the rice SC transverse filament protein, to the central region of SCs in a mutually dependent fashion. Consistent with this colocalization, CRC1 interacts with ZEP1 in yeast two-hybrid assays. CRC1 is orthologous to Saccharomyces cerevisiae pachytene checkpoint2 (Pch2) and Mus musculus THYROID receptor-interacting protein13 (TRIP13) and may be a conserved SC component. Additionally, we provide evidence that CRC1 is essential for meiotic DSB formation. CRC1 interacts with homologous pairing aberration in rice meiosis1 (PAIR1) in vitro, suggesting that these proteins act as a complex to promote DSB formation. PAIR2, the rice ortholog of budding yeast homolog pairing1, is required for homologous chromosome pairing. We found that CRC1 is also essential for the recruitment of PAIR2 onto meiotic chromosomes. The roles of CRC1 identified here have not been reported for Pch2 or TRIP13.

  11. An Approach to Understanding Complex Socio-Economic Impacts and Responses to Climate Disruption in the Chesapeake Bay Region

    Science.gov (United States)

    Schaefer, R. K.; Nix, M.; Ihde, A. G.; Paxton, L. J.; Weiss, M.; Simpkins, S.; Fountain, G. H.; APl GAIA Team

    2011-12-01

    In this paper we describe the application of a proven methodology for modeling the complex social and economic interactions of a system under stress to the regional issues that are tied to global climate disruption. Under the auspices of the GAIA project (http://gaia.jhuapl.edu), we have investigated simulating the complex interplay between climate, politics, society, industry, and the environment in the Chesapeake Bay Watershed and associated geographic areas of Maryland, Virginia, and Pennsylvania. This Chesapeake Bay simulation draws on interrelated geophysical and climate models to support decision-making analysis about the Bay. In addition to physical models, however, human activity is also incorporated via input and output calculations. For example, policy implications are modeled in relation to business activities surrounding fishing, farming, industry and manufacturing, land development, and tourism. This approach fosters collaboration among subject matter experts to advance a more complete understanding of the regional impacts of climate change. Simulated interactive competition, in which teams of experts are assigned conflicting objectives in a controlled environment, allow for subject exploration which avoids trivial solutions that neglect the possible responses of affected parties. Results include improved planning, the anticipation of areas of conflict or high risk, and the increased likelihood of developing mutually acceptable solutions.

  12. Bringing up the rear: new premotor interneurons add regional complexity to a segmentally distributed motor pattern

    Science.gov (United States)

    Norris, Brian J.; Doloc-Mihu, Anca; Calabrese, Ronald L.

    2011-01-01

    Central pattern generators (CPGs) pace and pattern many rhythmic activities. We have uncovered a new module in the heartbeat CPG of leeches that creates a regional difference in this segmentally distributed motor pattern. The core CPG consists of seven identified pairs and one unidentified pair of heart interneurons of which 5 pairs are premotor and inhibit 16 pairs of heart motor neurons. The heartbeat CPG produces a side-to-side asymmetric pattern of activity of the premotor heart interneurons corresponding to an asymmetric fictive motor pattern and an asymmetric constriction pattern of the hearts with regular switches between the two sides. The premotor pattern progresses from rear to front on one side and nearly synchronously on the other; the motor pattern shows corresponding intersegmental coordination, but only from segment 15 forward. In the rearmost segments the fictive motor pattern and the constriction pattern progress from front to rear on both sides and converge in phase. Modeling studies suggested that the known inhibitory inputs to the rearmost heart motor neurons were insufficient to account for this activity. We therefore reexamined the constriction pattern of intact leeches. We also identified electrophysiologically two additional pairs of heart interneurons in the rear. These new heart interneurons make inhibitory connections with the rear heart motor neurons, are coordinated with the core heartbeat CPG, and are dye-coupled to their contralateral homologs. Their strong inhibitory connections with the rearmost heart motor neurons and the small side-to-side phase difference of their bursting contribute to the different motor and beating pattern observed in the animal's rear. PMID:21775711

  13. Hominoid chromosomal rearrangements on 17q map to complex regions of segmental duplication.

    Science.gov (United States)

    Cardone, Maria Francesca; Jiang, Zhaoshi; D'Addabbo, Pietro; Archidiacono, Nicoletta; Rocchi, Mariano; Eichler, Evan E; Ventura, Mario

    2008-01-01

    Chromosomal rearrangements, such as translocations and inversions, are recurrent phenomena during evolution, and both of them are involved in reproductive isolation and speciation. To better understand the molecular basis of chromosome rearrangements and their part in karyotype evolution, we have investigated the history of human chromosome 17 by comparative fluorescence in situ hybridization (FISH) and sequence analysis. Human bacterial artificial chromosome/p1 artificial chromosome probes spanning the length of chromosome 17 were used in FISH experiments on great apes, Old World monkeys and New World monkeys to study the evolutionary history of this chromosome. We observed that the macaque marker order represents the ancestral organization. Human, chimpanzee and gorilla homologous chromosomes differ by a paracentric inversion that occurred specifically in the Homo sapiens/Pan troglodytes/Gorilla gorilla ancestor. Detailed analyses of the paracentric inversion revealed that the breakpoints mapped to two regions syntenic to human 17q12/21 and 17q23, both rich in segmental duplications. Sequence analyses of the human and macaque organization suggest that the duplication events occurred in the catarrhine ancestor with the duplication blocks continuing to duplicate or undergo gene conversion during evolution of the hominoid lineage. We propose that the presence of these duplicons has mediated the inversion in the H. sapiens/P. troglodytes/G. gorilla ancestor. Recently, the same duplication blocks have been shown to be polymorphic in the human population and to be involved in triggering microdeletion and duplication in human. These results further support a model where genomic architecture has a direct role in both rearrangement involved in karyotype evolution and genomic instability in human.

  14. Giant cell tumor of cervicothoracic region treated by triple corpectomy from posterior only approach: A case report with review of literature

    Directory of Open Access Journals (Sweden)

    Rajat Mahajan

    2015-01-01

    Full Text Available Giant cell tumor (GCT is a benign aggressive tumor, which affects axial as well as a peripheral skeleton. It affects epiphysis of long bones and can result in pathological fractures. GCT affects cervical spine rarely and has been known to affect almost all vertebra in the human body. It has a predilection for fixed spine, that is, sacrum though it can affect mobile spine as well. GCT of cervicothoracic region poses a challenge for the surgeon because of the difficulty in approaching this region anteriorly. This situation is further compounded when GCT involves multiple contiguous vertebral bodies in this region and has already spread beyond the confines of its capsule. We report a case of GCT involving three vertebral bodies C7, D1, and D2 at cervicothoracic region who presented to us and was treated with triple corpectomy from the posterior only approach. This is the first ever case report of triple corpectomy and anterior reconstruction by a posterior only approach for GCT at the cervicothoracic junction to the best of author′s knowledge.

  15. Isolated local-regional recurrence following mastectomy for adenocarcinoma of the breast treated with radiation therapy alone or combined with surgery and/or chemotherapy

    International Nuclear Information System (INIS)

    Mendenhall, N.P.; Devine, J.W.; Mendenhall, W.M.; Million, R.R.; Bland, K.I.; Copeland, E.M. III

    1988-01-01

    The results of radiation therapy alone or combined with surgery and/or chemotherapy are reported for 47 patients who presented with local and/or regional recurrence without evidence of distant metastases following initial management of adenocarcinoma of the breast with radical or modified radical mastectomy (43) or simple mastectomy (4). Patients were treated between October 1964 and March 1983 at the University of Florida; all have a 2-year minimum follow-up and 42/47 (89%) have had follow-up for ≥5 years. The overall actuarial local-regional control rates were 80% at 2 years, 68% at 5 years, and 61% at 10 years. The 5-year actuarial local-regional control rates by site and extent of disease were as follows: single chest wall nodule, 92%; multiple chest wall nodules, 49%; regional lymph nodes, 66%; and multiple sites, 64%. The 5- and 10-year actuarial determinate disease-free survival rates for all patients were 41 and 17%, respectively. The 5- and 10-year actuarial survival rates for all patients were 50 and 34%, respectively. 22 refs.; 5 figs.; 5 tabs

  16. Analysing a Chinese Regional Integrated Healthcare Organisation Reform Failure using a Complex Adaptive System Approach

    Directory of Open Access Journals (Sweden)

    Wenxi Tang

    2017-06-01

    Full Text Available Introduction: China’s organised health system has remained outdated for decades. Current health systems in many less market-oriented countries still adhere to traditional administrative-based directives and linear planning. Furthermore, they neglect the responsiveness and feedback of institutions and professionals, which often results in reform failure in integrated care. Complex adaptive system theory (CAS provides a new perspective and methodology for analysing the health system and policy implementation.  Methods: We observed the typical case of Qianjiang’s Integrated Health Organization Reform (IHO for 2 years to analyse integrated care reforms using CAS theory. Via questionnaires and interviews, we observed 32 medical institutions and 344 professionals. We compared their cooperative behaviours from both organisational and inter-professional levels between 2013 and 2015, and further investigated potential reasons for why medical institutions and professionals did not form an effective IHO. We discovered how interested parties in the policy implementation process influenced reform outcome, and by theoretical induction, proposed a new semi-organised system and corresponding policy analysis flowchart that potentially suits the actual realisation of CAS.  Results: The reform did not achieve its desired effect. The Qianjiang IHO was loosely integrated rather than closely integrated, and the cooperation levels between organisations and professionals were low. This disappointing result was due to low mutual trust among IHO members, with the main contributing factors being insufficient financial incentives and the lack of a common vision.  Discussion and Conclusions: The traditional 'organised health system' is old-fashioned. Rather than being completely organised or adaptive, the health system is currently more similar to a s'emi-organised system'. Medical institutions and professionals operate in a middle ground between complete adherence

  17. Clinical Spectrum, Treatment and Relapse Patterns in 353 Patients with Squamous Cell Carcinoma of the Alveobuccal Complex Treated with a Curative Intent: A Retrospective Study.

    Science.gov (United States)

    Shukla, Nootan Kumar; Deo, S V Suryanarayana; Jakhetiya, Ashish; Nml, Manjunath; Sreenivas, Vishnubhatla; Thulkar, Sanjay; Bhasker, Suman; Sharma, Atul

    2018-03-01

    Oral cancer is one of the most common cancers in Indian subcontinent with alveobuccal complex as most common cancer sub site. Cancers of Alveobuccal complex provides maximum challenge and management guidelines are not clear. The aim of the present study is to provide comprehensive demographic, clinical and treatment outcome data of alveobuccal squamous cell carcinoma (SCC) patients treated at a tertiary care cancer center in North India. An analysis of prospectively maintained database in department of surgical oncology at Dr BRA-IRCH, AIIMS, Delhi, India was performed. All alveobuccal cancer patients who had undergone surgery from 1995 to 2010 were included for analysis. A total of 353 patients were included for analysis. Mean age was 49.75 years (SD ±12.04) with male and female ratio of 4:1. Composite resection without mandible was done in 25 % patients and 75 % underwent mandibular resection. Neck dissection was performed in 347 patients. Nodal deposits were identified in 124 (35.73 %) neck dissection specimens. Margin negative resection was performed in 89.5 % cases. After a median follow up of 30 months, 87 (24.64 %) patients developed disease relapse and 25 (7.08 %) patients developed second primaries. Overall 5-year disease free survival (DFS) was 57.65 % and 5 year overall survival (OS) was 59.86 %. Among Indian oral cancer patients alveobuccal complex is most common sub site. Majority presents in locally advanced stage and reasonably good outcomes can be achieved with quality control surgery and judicious use of radiotherapy.

  18. Tests of high-resolution simulations over a region of complex terrain in Southeast coast of Brazil

    Science.gov (United States)

    Chou, Sin Chan; Luís Gomes, Jorge; Ristic, Ivan; Mesinger, Fedor; Sueiro, Gustavo; Andrade, Diego; Lima-e-Silva, Pedro Paulo

    2013-04-01

    The Eta Model is used operationally by INPE at the Centre for Weather Forecasts and Climate Studies (CPTEC) to produce weather forecasts over South America since 1997. The model has gone through upgrades along these years. In order to prepare the model for operational higher resolution forecasts, the model is configured and tested over a region of complex topography located near the coast of Southeast Brazil. The model domain includes the two Brazilians cities, Rio de Janeiro and Sao Paulo, urban areas, preserved tropical forest, pasture fields, and complex terrain where it can rise from sea level up to about 1000 m. Accurate near-surface wind direction and magnitude are needed for the power plant emergency plan. Besides, the region suffers from frequent events of floods and landslides, therefore accurate local forecasts are required for disaster warnings. The objective of this work is to carry out a series of numerical experiments to test and evaluate high resolution simulations in this complex area. Verification of model runs uses observations taken from the nuclear power plant and higher resolution reanalyses data. The runs were tested in a period when flow was predominately forced by local conditions and in a period forced by frontal passage. The Eta Model was configured initially with 2-km horizontal resolution and 50 layers. The Eta-2km is a second nesting, it is driven by Eta-15km, which in its turn is driven by Era-Interim reanalyses. The series of experiments consists of replacing surface layer stability function, adjusting cloud microphysics scheme parameters, further increasing vertical and horizontal resolutions. By replacing the stability function for the stable conditions substantially increased the katabatic winds and verified better against the tower wind data. Precipitation produced by the model was excessive in the region. Increasing vertical resolution to 60 layers caused a further increase in precipitation production. This excessive

  19. [Cancers of the thyroid. Value of a regional registry on 627 patients diagnosed, treated and followed by a multidisciplinary team].

    Science.gov (United States)

    Delisle, M J; Schvartz, C; Theobald, S; Maes, B; Vaudrey, C; Pochart, J M

    1996-01-01

    Since 1966, data from 1536 patients with a thyroid carcinoma, living in the French region Champagne-Ardenne, a geographical area with 1,350,000 inhabitants were registered. The creation of a multidisciplinary group and the involvement of the general practitioners, allowed us to reach an exhaustive and continued registration process for the French administrative area of Marne and Ardennes (855,000 inhibitants, 627 patients). The sex-ratio F/M was 3.8 and the median ages were respectively equal to 46 [10-93] and 52 [13-82] in females and males. In the age groups 10-14 and 15-19, 3 cases and 13 cases were respectively registered. An history of external irradiation was noted in 2.9% of the patients. The study of the incidence around the Chooz nuclear plant (Ardennes) did not show an increase of the risk. For the French administrative area Marne and Ardennes, for the period 1975-1979, the incidence rates, standardized on the European population, were equal to 1.75/100,000 in males (SD = 0.15) and 6.38/100,000 (SD = 0.29) in females. These values among the highest from the data published by the other European registries should be explained by a more intensive diagnosis procedure and an improvement in the accuracy of histological diagnosis. An increase of the incidence rate was observed between the periods 1975-1983 and 1984-1992 from 1.04 to 2.05/100,000 and 4.99 to 6.39/100,000 in males and females respectively. This was associated with changes in clinical and histological features and an improvement in survival curves. For patients under the age of 19, we have compared both periods before and after the accident of Chernobyl. The incidence rates increased from 0.13 to 0.45/100,000 and 0.49 to 1.81/100,000 in the age groups 10-14 and 15-19 respectively. This change was at the order of magnitude to this observed in our adults population. We did not found the histological aggressiveness which characterized the Chernobyl-induced thyroid cancer in children. The knowledge of

  20. Perioperative factors affecting the occurrence of acute complex regional pain syndrome following limb bone fracture surgery: data from the Japanese Diagnosis Procedure Combination database.

    Science.gov (United States)

    Sumitani, Masahiko; Yasunaga, Hideo; Uchida, Kanji; Horiguchi, Hiromasa; Nakamura, Masaya; Ohe, Kazuhiko; Fushimi, Kiyohide; Matsuda, Shinya; Yamada, Yoshitsugu

    2014-07-01

    Complex regional pain syndrome (CRPS) describes a broad spectrum of symptoms that predominantly localize to the extremities. Although limb fracture is one of the most frequently reported triggering events, few large-scale studies have shown the occurrence of and factors associated with CRPS following limb fracture. This study aimed to show the occurrence and identify of those factors. Using the Japanese Diagnosis Procedure Combination database, we identified 39 patients diagnosed with CRPS immediately after open reduction and internal fixation (ORIF) for limb fracture from a cohort of 185 378 inpatients treated with ORIF between 1 July and 31 December of each year between 2007 and 2010. Patient and clinical characteristics such as age, gender, fracture site, duration of anaesthesia and use of regional anaesthesia were investigated by logistic regression analyses to examine associations between these factors and the in-hospital occurrence of CRPS after ORIF. The occurrence of CRPS was relatively high in fractures of the distal forearm, but low in fractures of the lower limb and in patients with multiple fractures. Generally females are considered to be at high risk of CRPS; however, we found a comparable number of male and female patients suffering from CRPS after ORIF for limb fracture. In terms of perioperative factors, a longer duration of anaesthesia, but not regional anaesthesia, was significantly associated with a higher incidence of CRPS. Although a limited number of CRPS patients were analysed in this study, reduced operative time might help to prevent the development of acute CRPS following limb fracture. © The Author 2013. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  1. Collaborative Observation and Research (CORE) Watersheds: new strategies for tracking the regional effects of climate change on complex systems

    Science.gov (United States)

    Murdoch, P. S.

    2007-12-01

    The past 30 years of environmental research have shown that our world is not made up of discrete components acting independently, but rather of a mosaic of complex relations among air, land, water, living resources, and human activities. Recent warming of the climate is having a significant effect on the functioning of those systems. A national imperative is developing to quickly establish local, regional, and national systems for anticipating environmental degradation from a changing climate and developing cost-effective adaptation or mitigation strategies. In these circumstances, the debate over research versus monitoring becomes moot--there is a clear need for the integrated application of both across a range of temporal and spatial scales. A national framework that effectively addresses the multiple scales and complex multi-disciplinary processes of climate change is being assembled largely from existing programs through collaboration among Federal, State, local, and NGO organizations. The result will be an observation and research network capable of interpreting complex environmental changes at a range of spatial and temporal scales, but at less cost than if the network were funded as an independent initiative. A pilot implementation of the collaborative framework in the Delaware River Basin yielded multi-scale assessments of carbon storage and flux, and the effects of forest fragmentation and soil calcium depletion on ecosystem function. A prototype of a national climate-effects observation and research network linking research watersheds, regional surveys, remote sensing, and ecosystem modeling is being initiated in the Yukon River Basin where carbon flux associated with permafrost thaw could accelerate global warming.

  2. Statistical downscaling of historical monthly mean winds over a coastal region of complex terrain. II. Predicting wind components

    Energy Technology Data Exchange (ETDEWEB)

    Kamp, Derek van der [University of Victoria, Pacific Climate Impacts Consortium, Victoria, BC (Canada); University of Victoria, School of Earth and Ocean Sciences, Victoria, BC (Canada); Curry, Charles L. [Environment Canada University of Victoria, Canadian Centre for Climate Modelling and Analysis, Victoria, BC (Canada); University of Victoria, School of Earth and Ocean Sciences, Victoria, BC (Canada); Monahan, Adam H. [University of Victoria, School of Earth and Ocean Sciences, Victoria, BC (Canada)

    2012-04-15

    A regression-based downscaling technique was applied to monthly mean surface wind observations from stations throughout western Canada as well as from buoys in the Northeast Pacific Ocean over the period 1979-2006. A predictor set was developed from principal component analysis of the three wind components at 500 hPa and mean sea-level pressure taken from the NCEP Reanalysis II. Building on the results of a companion paper, Curry et al. (Clim Dyn 2011), the downscaling was applied to both wind speed and wind components, in an effort to evaluate the utility of each type of predictand. Cross-validated prediction skill varied strongly with season, with autumn and summer displaying the highest and lowest skill, respectively. In most cases wind components were predicted with better skill than wind speeds. The predictive ability of wind components was found to be strongly related to their orientation. Wind components with the best predictions were often oriented along topographically significant features such as constricted valleys, mountain ranges or ocean channels. This influence of directionality on predictive ability is most prominent during autumn and winter at inland sites with complex topography. Stations in regions with relatively flat terrain (where topographic steering is minimal) exhibit inter-station consistencies including region-wide seasonal shifts in the direction of the best predicted wind component. The conclusion that wind components can be skillfully predicted only over a limited range of directions at most stations limits the scope of statistically downscaled wind speed predictions. It seems likely that such limitations apply to other regions of complex terrain as well. (orig.)

  3. Complexity in the scaling of velocity fluctuations in the high-latitude F-region ionosphere

    Directory of Open Access Journals (Sweden)

    M. L. Parkinson

    2008-09-01

    Full Text Available The temporal scaling properties of F-region velocity fluctuations, δvlos, were characterised over 17 octaves of temporal scale from τ=1 s to <1 day using a new data base of 1-s time resolution SuperDARN radar measurements. After quality control, 2.9 (1.9 million fluctuations were recorded during 31.5 (40.4 days of discretionary mode soundings using the Tasmanian (New Zealand radars. If the fluctuations were statistically self-similar, the probability density functions (PDFs of δvlos would collapse onto the same PDF using the scaling Psvs, τ=ταPvlos, τ and δvsvlosτ−α where α is the scaling exponent. The variations in scaling exponents α and multi-fractal behaviour were estimated using peak scaling and generalised structure function (GSF analyses, and a new method based upon minimising the differences between re-scaled probability density functions (PDFs. The efficiency of this method enabled calculation of "α spectra", the temporal spectra of scaling exponents from τ=1 s to ~2048 s. The large number of samples enabled calculation of α spectra for data separated into 2-h bins of MLT as well as two main physical regimes: Population A echoes with Doppler spectral width <75 m s−1 concentrated on closed field lines, and Population B echoes with spectral width >150 m s−1 concentrated on open field lines. For all data there was a scaling break at τ~10 s and the similarity of the fluctuations beneath this scale may be related to the large spatial averaging (~100 km×45 km employed by SuperDARN radars. For Tasmania Population B, the velocity fluctuations exhibited approximately mono fractal power law scaling between τ~8 s and 2048 s (34 min, and probably up to several hours. The scaling exponents were generally less than that expected for basic MHD

  4. Downscaling wind and wavefields for 21st century coastal flood hazard projections in a region of complex terrain

    Science.gov (United States)

    O'Neill, Andrea; Erikson, Li; Barnard, Patrick

    2017-01-01

    While global climate models (GCMs) provide useful projections of near-surface wind vectors into the 21st century, resolution is not sufficient enough for use in regional wave modeling. Statistically downscaled GCM projections from Multivariate Adaptive Constructed Analogues provide daily averaged near-surface winds at an appropriate spatial resolution for wave modeling within the orographically complex region of San Francisco Bay, but greater resolution in time is needed to capture the peak of storm events. Short-duration high wind speeds, on the order of hours, are usually excluded in statistically downscaled climate models and are of key importance in wave and subsequent coastal flood modeling. Here we present a temporal downscaling approach, similar to constructed analogues, for near-surface winds suitable for use in local wave models and evaluate changes in wind and wave conditions for the 21st century. Reconstructed hindcast winds (1975–2004) recreate important extreme wind values within San Francisco Bay. A computationally efficient method for simulating wave heights over long time periods was used to screen for extreme events. Wave hindcasts show resultant maximum wave heights of 2.2 m possible within the Bay. Changes in extreme over-water wind speeds suggest contrasting trends within the different regions of San Francisco Bay, but 21th century projections show little change in the overall magnitude of extreme winds and locally generated waves.

  5. The influence of patients' complexity and general practitioners' characteristics on referrals to outpatient health services in an Italian region

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    Francesca Valent

    2015-09-01

    Full Text Available BACKGROUND. Patient referrals to outpatient health services may affect both health outcomes and health expenditures. General practitioners (GP have a crucial role in driving the use of outpatient services and recognizing factors which affect referrals is important for health managers and planners. OBJECTIVES. We investigated patient- and physician-related determinants of patient referrals in an Italian region. METHODS. This was cross-sectional study based on the individual linkage of administrative databases from the health information system of the Friuli Venezia Giulia region. For each GP of the region, the association of the number of patient referrals to different types of outpatient services with the proportion of patients with chronic conditions, with the number of hospital admissions and drug prescriptions in 2012, and with GP's characteristics was investigated through multilevel multivariable Poisson regression models. RESULTS. Some chronic conditions (e.g., cancer, autoimmune diseases, endocrine diseases, digestive system diseases were positively associated with the number of referrals, as were hospital admissions and drug prescriptions. Time since GP's graduation was inversely related with referrals. CONCLUSION. Patient complexity and GP's experience affect referral rates. These factors should be considered in case of a reorganization of the general practice structure in Friuli Venezia Giulia.

  6. SPITZER ANALYSIS OF H II REGION COMPLEXES IN THE MAGELLANIC CLOUDS: DETERMINING A SUITABLE MONOCHROMATIC OBSCURED STAR FORMATION INDICATOR

    International Nuclear Information System (INIS)

    Lawton, B.; Gordon, K. D.; Meixner, M.; Sewilo, M.; Shiao, B.; Babler, B.; Bracker, S.; Meade, M.; Block, M.; Engelbracht, C. W.; Misselt, K.; Bolatto, A. D.; Carlson, L. R.; Hora, J. L.; Robitaille, T.; Indebetouw, R.; Madden, S. C.; Oey, M. S.; Oliveira, J. M.; Vijh, U. P.

    2010-01-01

    H II regions are the birth places of stars, and as such they provide the best measure of current star formation rates (SFRs) in galaxies. The close proximity of the Magellanic Clouds allows us to probe the nature of these star forming regions at small spatial scales. To study the H II regions, we compute the bolometric infrared flux, or total infrared (TIR), by integrating the flux from 8 to 500 μm. The TIR provides a measure of the obscured star formation because the UV photons from hot young stars are absorbed by dust and re-emitted across the mid-to-far-infrared (IR) spectrum. We aim to determine the monochromatic IR band that most accurately traces the TIR and produces an accurate obscured SFR over large spatial scales. We present the spatial analysis, via aperture/annulus photometry, of 16 Large Magellanic Cloud (LMC) and 16 Small Magellanic Cloud (SMC) H II region complexes using the Spitzer Space Telescope's IRAC (3.6, 4.5, 8 μm) and MIPS (24, 70, 160 μm) bands. Ultraviolet rocket data (1500 and 1900 A) and SHASSA Hα data are also included. All data are convolved to the MIPS 160 μm resolution (40 arcsec full width at half-maximum), and apertures have a minimum radius of 35''. The IRAC, MIPS, UV, and Hα spatial analysis are compared with the spatial analysis of the TIR. We find that nearly all of the LMC and SMC H II region spectral energy distributions (SEDs) peak around 70 μm at all radii, from ∼10 to ∼400 pc from the central ionizing sources. As a result, we find the following: the sizes of H II regions as probed by 70 μm are approximately equal to the sizes as probed by TIR (∼70 pc in radius); the radial profile of the 70 μm flux, normalized by TIR, is constant at all radii (70 μm ∼ 0.45TIR); the 1σ standard deviation of the 70 μm fluxes, normalized by TIR, is a lower fraction of the mean (0.05-0.12 out to ∼220 pc) than the normalized 8, 24, and 160 μm normalized fluxes (0.12-0.52); and these results are the same for the LMC and the

  7. OXA-Carbapenemases Present in Clinical Acinetobacter baumannii-calcoaceticus Complex Isolates from Patients in Kurdistan Region, Iraq.

    Science.gov (United States)

    Ganjo, Aryann R; Maghdid, Delshad M; Mansoor, Isam Y; Kok, Dik J; Severin, Juliette A; Verbrugh, Henri A; Kreft, Deborah; Fatah, M H; Alnakshabandi, A A; Dlnya, Asad; Hammerum, Anette M; Ng, Kim; Goessens, Wil

    2016-12-01

    In addition to intrinsic resistance in Acinetobacter baumannii, many different types of acquired resistance mechanisms have been reported, including the presence of VIM and IMP metallo β-lactamases and also of bla OXA-23-like and bla OXA-58-like enzymes. In the Kurdistan region of Iraq, the multiresistant A. baumannii-calcoaceticus complex is prevalent. We characterized the different mechanisms of resistance present in clinical isolates collected from different wards and different hospitals from the Kurdistan region. One hundred twenty clinical nonduplicate A. baumannii-calcoaceticus complex isolates were collected from four hospitals between January 2012 and October 2013. The identification of the isolates was confirmed by MALDI-TOF. The susceptibility to different antibiotics was determined by disk diffusion and analyzed in accordance to EUCAST guidelines. By PCR, the presence of bla OXA-51-like , bla OXA-23-like , bla OXA-24-like , and bla OXA-58-like genes was determined as well as the presence of the insertion element ISAba1. Clonal diversity was analyzed by pulsed-field gel electrophoresis (PFGE) using the restriction enzyme ApaI and, in addition, multilocus sequence typing (MLST) was performed on a selected subset of 15 isolates. All 120 A. baumannii isolates harbored bla OXA-51-like genes. One hundred one out of 110 (92%) imipenem (IMP)-resistant A. baumannii-calcoaceticus complex isolates additionally carried the bla OXA-23-like gene and four isolates (3%) were positive for bla OXA-24-like. All 101 bla OXA-23-like -positive isolates had the ISAba1 insertion sequence, 1,600 bp upstream of the bla OXA-23-like gene. The bla OXA-58-like gene was not detected in any of the 110 IMP-resistant strains. Eight different PFGE clusters were identified and distributed over the different hospitals. MLST analysis performed on a subset of 15 representative isolates revealed the presence of the international clone ST2 (Pasteur). Besides ST2 (Pasteur), also many other

  8. Effect of a new formulation of micronized and ultramicronized N-palmitoylethanolamine in a tibia fracture mouse model of complex regional pain syndrome.

    Directory of Open Access Journals (Sweden)

    Roberta Fusco

    Full Text Available Complex regional pain syndrome type 1 (CRPS-I is a disabling and frequently chronic condition. It involves the extremities and is a frequent consequence of distal tibia and radius fractures. The inflamed appearance of the affected CRPS-I limb suggests that local production of inflammatory mediators may be implicated in the ensuing etiology. A rodent tibia fracture model, characterized by inflammation, chronic unilateral hindlimb warmth, edema, protein extravasation, allodynia and hyperalgesia resembles the clinical features of patients with acute CRPS-I. N-palmitoylethanolamine (PEA, a member of the family of naturally-occurring N-acylethanolamines, is well-known for its ability to modulate inflammatory processes and regulate pain sensitivity. However, the large particle size and lipidic nature of PEA may limit its bioavailability and solubility when given orally. Micronized formulations are frequently used to enhance the dissolution rate of drug and reduce its variability of absorption when orally administered. The aim of this study was to assess the effects of a formulation of micronized and ultramicronized PEA (PEA-MPS, given orally in a mouse model of CRPS-I. CD-1 male mice were subjected to distal tibia fracture and divided into two groups: control and treated with PEA-MPS (PEA micronized 300 mg/kg and ultramicronized 600 mg/kg. Sensibility to pain was monitored in all mice throughout the course of the experiment. Twenty-eight days after tibia fracture induction animals were sacrificed and biochemical parameters evaluated. The PEA-MPS-treated group showed an improved healing process, fracture recovery and fibrosis score. PEA-MPS administration decreased mast cell density, nerve growth factor, matrix metalloproteinase 9 and cytokine expression. This treatment also reduced (poly-ADPribose polymerase activation, peroxynitrite formation and apoptosis. Our results suggest that PEA-MPS may be a new therapeutic strategy in the treatment of CRPS-I.

  9. Giant panda BAC library construction and assembly of a 650-kb contig spanning major histocompatibility complex class II region

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    Pan Hui-Juan

    2007-09-01

    Full Text Available Abstract Background Giant panda is rare and endangered species endemic to China. The low rates of reproductive success and infectious disease resistance have severely hampered the development of captive and wild populations of the giant panda. The major histocompatibility complex (MHC plays important roles in immune response and reproductive system such as mate choice and mother-fetus bio-compatibility. It is thus essential to understand genetic details of the giant panda MHC. Construction of a bacterial artificial chromosome (BAC library will provide a new tool for panda genome physical mapping and thus facilitate understanding of panda MHC genes. Results A giant panda BAC library consisting of 205,800 clones has been constructed. The average insert size was calculated to be 97 kb based on the examination of 174 randomly selected clones, indicating that the giant panda library contained 6.8-fold genome equivalents. Screening of the library with 16 giant panda PCR primer pairs revealed 6.4 positive clones per locus, in good agreement with an expected 6.8-fold genomic coverage of the library. Based on this BAC library, we constructed a contig map of the giant panda MHC class II region from BTNL2 to DAXX spanning about 650 kb by a three-step method: (1 PCR-based screening of the BAC library with primers from homologous MHC class II gene loci, end sequences and BAC clone shotgun sequences, (2 DNA sequencing validation of positive clones, and (3 restriction digest fingerprinting verification of inter-clone overlapping. Conclusion The identifications of genes and genomic regions of interest are greatly favored by the availability of this giant panda BAC library. The giant panda BAC library thus provides a useful platform for physical mapping, genome sequencing or complex analysis of targeted genomic regions. The 650 kb sequence-ready BAC contig map of the giant panda MHC class II region from BTNL2 to DAXX, verified by the three-step method, offers a

  10. UNIFORM INFALL TOWARD THE COMETARY H II REGION IN THE G34.26+0.15 COMPLEX?

    Energy Technology Data Exchange (ETDEWEB)

    Liu, Tie; Wu, Yuefang; Zhang, Huawei, E-mail: liutiepku@gmail.com, E-mail: ywu@pku.edu.cn [Department of Astronomy, Peking University, 100871 Beijing (China)

    2013-10-10

    Gas accretion is a key process in star formation. However, gas infall detections in high-mass, star-forming regions with high spatial resolution observations are rare. Here, we report the detection of gas infall toward a cometary ultracompact H II region ({sup C)} in the G34.26+0.15 complex. The observations were made with the IRAM 30 m, the James Clerk Maxwell Telescope 15 m telescope, and the Submillimeter Array (SMA). The hot core associated with 'C' has a mass of ∼76 ± 11 M{sub ☉} and a volume density of (1.1 ± 0.2) × 10{sup 8} cm{sup –3}. The HCN (3-2) and HCO{sup +} (1-0) lines observed by single dishes and the CN (2-1) lines observed by the SMA show redshifted absorption features, indicating gas infall. We found a linear relationship between the line width and optical depth of the CN (2-1) lines. Those transitions with larger optical depths and line widths have larger absorption areas. However, the infall velocities measured from different lines seem to be constant, indicating that the gas infall is uniform. We also investigated the evolution of gas infall in high-mass, star-forming regions. A tight relationship was found between the infall velocity and the total dust/gas mass. At stages prior to the hot core phase, the typical infall velocity and mass infall rate are ∼1 km s{sup –1} and ∼10{sup –4} M{sub ☉} yr{sup –1}, respectively. While in more evolved regions, the infall velocity and mass infall rates can reach as high as several km s{sup –1} and ∼10{sup –3}-10{sup –2} M{sub ☉} yr{sup –1}, respectively. Accelerated infall has been detected toward some hypercompact H II and ultracompact H II regions. However, the acceleration phenomenon is not seen in more evolved ultracompact H II regions (e.g., G34.26+0.15)

  11. Urinary excretion of platinum, arsenic and selenium of cancer patients from the Antofagasta region in Chile treated with platinum-based drugs

    Directory of Open Access Journals (Sweden)

    Román Domingo A

    2012-04-01

    Full Text Available Abstract Background Arsenic exposure increases the risk of non-cancerous and cancerous diseases. In the Antofagasta region in Chile, an established relationship exists between arsenic exposure and the risk of cancer of the bladder, lung and skin. Platinum-based drugs are first-line treatments, and many works recognise selenium as a cancer-fighting nutrient. We characterised the short-term urinary excretion amounts of arsenic, selenium and platinum in 24-h urine samples from patients with lung cancer and those with cancer other than lung treated with cisplatin or/and carboplatin. As - Se - Pt inter-element relationships were also investigated. Results The amounts of platinum excreted in urine were not significantly different between patients with lung cancer and those with other cancers treated with cisplatin, despite the significant variation in platinum amounts supplied from platinum-based drugs. In general, the analytical amounts of excreted selenium were greater than those for arsenic, which could imply that platinum favours the excretion of selenium. For other types of cancers treated with drugs without platinum, excretion of selenium was also greater than that of arsenic, suggesting an antagonist selenium-anti-cancer drug relationship. Conclusions Regards the baseline status of patients, the analytical amounts of excreted Se is greater than those for As, particularly, for cisplatin chemotherapy. This finding could imply that for over the As displacement Pt favours the excretion of Se. The analytical amounts of excreted Se were greater than those for As, either with and without Pt-containing drugs, suggesting an antagonist Se-anti-cancer drug relationship. However, it seemed that differences existed between As - Se - Pt inter-element associations in patients treated for lung cancer in comparison with those treated for cancer other than lung. Therefore, knowledge obtained in this work, can contribute to understanding the arsenic cancer

  12. Case Study of High-Dose Ketamine for Treatment of Complex Regional Pain Syndrome in the Pediatric Intensive Care Unit.

    Science.gov (United States)

    Pasek, Tracy Ann; Crowley, Kelli; Campese, Catherine; Lauer, Rachel; Yang, Charles

    2017-06-01

    Complex regional pain syndrome (CRPS) is a life-altering and debilitating chronic pain condition. The authors are presenting a case study of a female who received high-dose ketamine for the management of her CRPS. The innovative treatment lies not only within the pharmacologic management of her pain, but also in the fact that she was the first patient to be admitted to our pediatric intensive care unit solely for pain control. The primary component of the pharmacotherapy treatment strategy plan was escalating-dose ketamine infusion via patient-controlled-analgesia approved by the pharmacy and therapeutics committee guided therapy for this patient. The expertise of advanced practice nurses blended exquisitely to ensure patient and family-centered care and the coordination of care across the illness trajectory. The patient experienced positive outcomes. Copyright © 2017 Elsevier Inc. All rights reserved.

  13. Regulation of peripheral blood flow in Complex Regional Pain Syndrome: clinical implication for symptomatic relief and pain management

    Directory of Open Access Journals (Sweden)

    Coderre Terence J

    2009-09-01

    Full Text Available Abstract Background During the chronic stage of Complex Regional Pain Syndrome (CRPS, impaired microcirculation is related to increased vasoconstriction, tissue hypoxia, and metabolic tissue acidosis in the affected limb. Several mechanisms may be responsible for the ischemia and pain in chronic cold CPRS. Discussion The diminished blood flow may be caused by either sympathetic dysfunction, hypersensitivity to circulating catecholamines, or endothelial dysfunction. The pain may be of neuropathic, inflammatory, nociceptive, or functional nature, or of mixed origin. Summary The origin of the pain should be the basis of the symptomatic therapy. Since the difference in temperature between both hands fluctuates over time in cold CRPS, when in doubt, the clinician should prioritize the patient's report of a persistent cold extremity over clinical tests that show no difference. Future research should focus on developing easily applied methods for clinical use to differentiate between central and peripheral blood flow regulation disorders in individual patients.

  14. Issues of human resources management in the enterprises of the machine-building complex of the Tyumen region

    Directory of Open Access Journals (Sweden)

    Lez’er Victoria

    2018-01-01

    Full Text Available This article, the authors have considered theoretical-methodological and practical aspects of human resource management in the process of restructuring enterprises of the machine-building complex of the Tyumen region. Based on the study of the evolution of theories concerning the human factor in the economy, the systematization and generalization of the provisions contained therein, the system of categories in the field of human resource management is substantiated. The basic principles of such management have been identified and supplemented, the tasks facing the enterprise management have been clarified, new tools for human resource management have been proposed, to ensure the completeness, continuity and validity of the decisions made in the field of human resources management in the restructuring of industrial enterprises.

  15. Impact of three-phase bone scintigraphy on the diagnosis and treatment of complex regional pain syndrome type I or reflex sympathetic dystrophy.

    Science.gov (United States)

    Shehab, Dia; Elgazzar, Abdelhamid; Collier, B David; Naddaf, Sleiman; Al-Jarallah, Khalid; Omar, Abdelmoneim; Al-Mutairy, Moudi

    2006-01-01

    To determine the impact of three-phase bone scintigraphy (TPBS) on the diagnosis and management of complex regional pain syndrome type I (CRPSI) or reflex sympathetic dystrophy (RSD). Twenty consecutive patients with a recent clinical evidence of CRPSI were referred for TPBS as part of their routine management plan. All patients underwent neurological examinations with special attention to the evaluation of clinical features of vasomotor, sudomotor, motor and sensory dysfunction. Patients were followed prospectively. When both the clinical and TPBS results supported the diagnosis of CRPSI, patients were started on treatment. Of the 20 patients, TPBS supported the diagnosis of RSD in 9 who were treated with steroids and physiotherapy. Complete follow-up was available for 7 of them and all had a satisfactory response to treatment. For the remaining 11 patients RSD was diagnosed clinically but not confirmed by TPBS. On follow-up there was no evidence that TPBS failed to identify RSD in these 11 patients. The results indicate that TPBS confirmed the clinical diagnosis of RSD, and, more importantly, had a significant impact on its management.

  16. Assessment of contralateral neck failure in 229 cases of carcinoma of the tonsillar region treated with techniques designed to spare contralateral parotid function

    International Nuclear Information System (INIS)

    O'Sullivan, B.; Warde, P.; Grice, B.; Goh, C.; Keane, T.; Payne, D.; Liu, F-F.; McLean, M.; Waldron, J.; Cummings, B.

    1996-01-01

    Purpose/Objective: Radiation-induced xerostomia is a frequent cause of morbidity in head and neck cancer patients. To minimize this complication unilateral techniques (UT) designed to treat the primary tumor and ipsilateral neck have been used for many years in selected cases at our institution. Although such techniques exclude the contralateral parotid from the high dose target volume, they also leave the contralateral neck nodes untreated. The purpose of the study was to evaluate the risk of failure in the opposite neck. Materials and Methods: We identified 229 patients treated with UT from a series of 641 cases with carcinoma of the tonsillar region treated with curative intent between 1970 and 1991. Detailed documentation of the tumor, the radiation dosimetry, the sites of failure, and outcome including local, regional, and distant failure, and late complications, were performed. Actuarial 5-year plots were used to calculate local control, regional control, and survival rates. Results: Median age was 61 years (74 females/155 males); median follow-up 8 years (range 6 months to 21 years). AJCC (1992) T categories were T1:73, T2:120, T3:30, T4:6. The N category distribution was: N0:136, N1:53, N2a:29, N2b:8, and N3:8 cases. Base of tongue and palate were involved in 49 and 82 cases respectively. Irradiation techniques consisted of ipsilateral wedge pairs with Cobalt of 6MV photons in 210 cases (92%), while the remainder were electrons with or without photons. Customized compensators were used in the majority of cases in addition to the use of wedge filters. 75% received 50 Gy in 4 weeks, 10% received 60 Gy in 6 weeks, while the remainder received other doses intended to be curative. A radioactive implant was also used in 20 patients. The 5-year actuarial rates were as follows: overall local control: 76%, regional node control: 80%; cause specific survival: 80%. A total of 7 patients manifested regional disease in the opposite neck (crude rate of 3% or 7 of 229

  17. Intrathecal Bupivacaine Monotherapy with a Retrograde Catheter for the Management of Complex Regional Pain Syndrome of the Lower Extremity.

    Science.gov (United States)

    McRoberts, W Porter; Apostol, Catalina; Haleem, Abdul

    2016-01-01

    Complex regional pain syndrome (CRPS) presents a therapeutic challenge due to its many presentations and multifaceted pathophysiology. There is no approved treatment algorithm and clinical interventions are often applied empirically. In cases of CRPS where symptoms are localized to an extremity, a targeted treatment is indicated. We describe the use of intrathecal bupivacaine monotherapy, delivered through a retrograde catheter, in the treatment of CRPS affecting the lower extremity. The patient, a 57-year-old woman with a history of failed foot surgery, was seen in our office after 2 years of ineffective treatments with local blocks and neurolytic procedures. We advanced therapy to moderately invasive procedures with an emphasis on neuromodulation. A combined central and peripheral stimulation technique that initially provided 75% pain relief, failed to provide lasting analgesia. We proceeded with an intrathecal pump implant. Based on the results of dorsal root ganglion (DRG) mapping, L5-S1 was identified as the optimal target for therapy and a retrograde catheter was placed at this level. Various intrathecal medications were tested individually. An intrathecal morphine trial was ineffective (visual analog scale [VAS] 7), while intrathecal clonidine provided excellent pain relief (VAS 0) that was limited by severe side effects. Bupivacaine provided 100% analgesia with tolerable side effects (lower extremity weakness and minor bladder incontinence) and was selected for intrathecal infusion. After 14 months, bupivacaine treatment continued to control pain exacerbations. We conclude that CRPS patients benefit from early identification of the predominant underlying symptoms and a targeted treatment with moderately invasive techniques when less invasive techniques fail. Intrathecal bupivacaine, bupivacaine monotherapy, retrograde catheter, complex regional pain syndrome (CRPS), dual stimulation, dosal root ganglion (DRG) testing.

  18. The use of modern methods for complex studies of the hydrotechnical structures of the Barents Sea region

    Directory of Open Access Journals (Sweden)

    Mel'nikov N. N

    2017-03-01

    Full Text Available The Barents region hydrotechnical structures (HTS as part of the bulk earth dams and levees tailings of mining enterprises in terms of requirements of the responsible entities have been considered. The brief review of emergencies and accidents of HTS with an analysis of their causes and geo-ecological consequences has been fulfilled. The necessity and urgency of the application of modern techniques for comprehensive research and monitoring of the HTS state have been shown: geo-fluid mechanics computer modeling, subsurface georadar sensing, GPS geodetic measurements, optical and radar satellite imagery. Joint use of GPR and satellite imagery in combination with traditional engineering-geological, hydro-geological and geodetic studies allows obtaining a more complete picture of the HTS state taking into account local and regional geological and fluid dynamic processes. The system structure of HTS complex researches which creates a scientific and technical basis for researching the geologic-geophysical environment, shifts, deformations and power influence has been developed. This allows to reveal the hidden filtration and deformation zones in HTS at early stages of their formation and in due time to make the administrative decision on prevention and localization of any emergency. Application of modern methods for HTS complex researches will allow to receive operational information on their state, parametrical sizes of volume, angular and linear deformations and movements, intensity of natural and technogenic influence. The obtained data have to be integrated in the "Database and Parameters" geoportal by means of which their logical processing and comparison to standard and extreme values has to be carried out. On this basis expert assessment of the current and expected state of HTS is carried out and the operating decisions including on development, in case of need, of preventive and protective measures are made

  19. C-terminal region of DNA ligase IV drives XRCC4/DNA ligase IV complex to chromatin

    International Nuclear Information System (INIS)

    Liu, Sicheng; Liu, Xunyue; Kamdar, Radhika Pankaj; Wanotayan, Rujira; Sharma, Mukesh Kumar; Adachi, Noritaka; Matsumoto, Yoshihisa

    2013-01-01

    Highlights: •Chromatin binding of XRCC4 is dependent on the presence of DNA ligase IV. •C-terminal region of DNA ligase IV alone can recruit itself and XRCC4 to chromatin. •Two BRCT domains of DNA ligase IV are essential for the chromatin binding of XRCC4. -- Abstract: DNA ligase IV (LIG4) and XRCC4 form a complex to ligate two DNA ends at the final step of DNA double-strand break (DSB) repair through non-homologous end-joining (NHEJ). It is not fully understood how these proteins are recruited to DSBs. We recently demonstrated radiation-induced chromatin binding of XRCC4 by biochemical fractionation using detergent Nonidet P-40. In the present study, we examined the role of LIG4 in the recruitment of XRCC4/LIG4 complex to chromatin. The chromatin binding of XRCC4 was dependent on the presence of LIG4. The mutations in two BRCT domains (W725R and W893R, respectively) of LIG4 reduced the chromatin binding of LIG4 and XRCC4. The C-terminal fragment of LIG4 (LIG4-CT) without N-terminal catalytic domains could bind to chromatin with XRCC4. LIG4-CT with W725R or W893R mutation could bind to chromatin but could not support the chromatin binding of XRCC4. The ability of C-terminal region of LIG4 to interact with chromatin might provide us with an insight into the mechanisms of DSB repair through NHEJ

  20. Strong topographic sheltering effects lead to spatially complex treeline advance and increased forest density in a subtropical mountain region.

    Science.gov (United States)

    Greenwood, Sarah; Chen, Jan-Chang; Chen, Chaur-Tzuhn; Jump, Alistair S

    2014-12-01

    Altitudinal treelines are typically temperature limited such that increasing temperatures linked to global climate change are causing upslope shifts of treelines worldwide. While such elevational increases are readily predicted based on shifting isotherms, at the regional level the realized response is often much more complex, with topography and local environmental conditions playing an important modifying role. Here, we used repeated aerial photographs in combination with forest inventory data to investigate changes in treeline position in the Central Mountain Range of Taiwan over the last 60 years. A highly spatially variable upslope advance of treeline was identified in which topography is a major driver of both treeline form and advance. The changes in treeline position that we observed occurred alongside substantial increases in forest density, and lead to a large increase in overall forest area. These changes will have a significant impact on carbon stocking in the high altitude zone, while the concomitant decrease in alpine grassland area is likely to have negative implications for alpine species. The complex and spatially variable changes that we report highlight the necessity for considering local factors such as topography when attempting to predict species distributional responses to warming climate. © 2014 John Wiley & Sons Ltd.

  1. The place of occupational therapy in rehabilitation strategies of complex regional pain syndrome: Comparative study of 60 cases.

    Science.gov (United States)

    Rome, L

    2016-10-01

    The purpose of the study was to assess the value of combining occupational therapy (OT) with physical therapy (PT) for the rehabilitation of complex regional pain syndrome (CRPS) and to measure its effectiveness on activities of daily life. Sixty patients with CRPS type 1 were recruited and interviewed between September 1, 2014 and February 1, 2015. Thirty patients had undergone PT and thirty had undergone PT+OT. They were administered the short-form of the "Assessment of Life Habits" questionnaire (v.3.0 LIFE-H) created in Canada. This questionnaire consists of 16 items exploring activities of daily living, which were used to compare the effectiveness of the two rehabilitation protocols. The results of each test were submitted to the Wilcoxon test. After confirming the complexity of CRPS in terms of its etiology, clinical signs and progression, rehabilitation was effective, especially for pain. The patients who received PT+OT had on average 10% better dressing and undressing function, 25% better for meal preparation, and 20% better on personal care than those who underwent PT only. In CRPS, OT combined with PT brings a real benefit in restoring the essential activities of daily life. This strategy could be implemented as soon the diagnosis confirmed and continued for a very long time. It helps to avoid the risk of dependence on third parties. Copyright © 2016 SFCM. Published by Elsevier Masson SAS. All rights reserved.

  2. Linking Bayesian and agent-based models to simulate complex social-ecological systems in semi-arid regions

    Directory of Open Access Journals (Sweden)

    Aloah J Pope

    2015-08-01

    Full Text Available Interdependencies of ecologic, hydrologic, and social systems challenge traditional approaches to natural resource management in semi-arid regions. As a complex social-ecological system, water demands in the Sonoran Desert from agricultural and urban users often conflicts with water needs for its ecologically-significant riparian corridors. To explore this system, we developed an agent-based model to simulate complex feedbacks between human decisions and environmental conditions in the Rio Sonora Watershed. Cognitive mapping in conjunction with stakeholder participation produced a Bayesian model of conditional probabilities of local human decision-making processes resulting to changes in water demand. Probabilities created in the Bayesian model were incorporated into the agent-based model, so that each agent had a unique probability to make a positive decision based on its perceived environment at each point in time and space. By using a Bayesian approach, uncertainty in the human decision-making process could be incorporated. The spatially-explicit agent-based model simulated changes in depth-to-groundwater by well pumping based on an agent’s water demand. Changes in depth-to-groundwater feedback to influence agent behavior, as well as determine unique vegetation classes within the riparian corridor. Each vegetation class then provides varying stakeholder-defined quality values of ecosystem services. Using this modeling approach allowed us to examine effects on both the ecological and social system of semi-arid riparian corridors under various scenarios. The insight provided by the model contributes to understanding how specific interventions may alter the complex social-ecological system in the future.

  3. Outcomes of patients with loco-regionally recurrent or new primary squamous cell carcinomas of the head and neck treated with curative intent reirradiation at Mayo Clinic

    International Nuclear Information System (INIS)

    Curtis, Kelly K.; Ross, Helen J.; Garrett, Ashley L.; Jizba, Theresa A.; Patel, Ajay B.; Patel, Samir H.; Wong, William W.; Halyard, Michele Y.; Ko, Stephen J.; Kosiorek, Heidi E.; Foote, Robert L.

    2016-01-01

    We reviewed outcomes of patients with loco-regionally recurrent (LRR) or new primary (NP) squamous cell carcinoma of the head and neck (SCCHN) treated at our institution with reirradiation (RRT). Patients received definitive RRT (DRRT) or post-operative RRT following salvage surgery (PRRT) from 2003 to 2011. Measured survival outcomes included loco-regional relapse free survival (LRFS) and overall survival (OS). Among 81 patients (PRRT, 42; DRRT, 39), median PRRT and DRRT doses were 60 Gy (12–70 Gy) and 69.6 Gy (48–76.8 Gy). The majority of patients received IMRT-based RRT (n = 77, 95 %). With median follow-up of 78.1 months (95 % CI, 56–96.8 months), 2-year OS was 53 % with PRRT and 48 % with DRRT (p = 0.12); 23 % of patients were alive at last follow-up. LRFS at 2 years was 60 %, and did not differ significantly between PRRT and DRRT groups. A trend toward inferior LRFS was noted among patients receiving chemotherapy with RRT versus RRT alone (p = 0.06). Late serious toxicities were uncommon, including osteoradionecrosis (2 patients) and carotid artery bleeding (1 patient, non-fatal). OS of PRRT- and DRRT-treated patients in this series appears superior to the published literature. We used IMRT for the majority of patients, in contrast to several series and trials previously reported, which may account in part for this difference. Future studies should seek to improve outcomes among patients with LRR/NP SCCHN via alternative therapeutic modalities such as proton radiotherapy and by incorporating novel systemic agents

  4. [Effects of therapeutic complexes including balneoradonokinesitherapy, electromyostimulation and low-frequency magnetotherapy on regional blood flow in patients with postrraumatic gonarthritis].

    Science.gov (United States)

    Raspopova, E A; Udartsev, E Iu

    2006-01-01

    Balneoradonokinesitherapy alone and its combination with electrostimulation and low-frequency magnetotherapy were used for the treatment of regional blood flow disorders in 76 patients with posttraumatic gonarthritis. Balneoradonokinesitherapy in combination with electromyostimulation improved blood circulation. When low-frequency magnetotherapy was added to the latter complex, the regress of regional blood flow disorders of a damaged extremity was most significant.

  5. Complex tibial fractures are associated with lower social classes and predict early exit from employment and worse patient-reported QOL: a prospective observational study of 46 complex tibial fractures treated with a ring fixator.

    Science.gov (United States)

    Elsoe, Rasmus; Larsen, Peter; Petruskevicius, Juozas; Kold, Søren

    2018-04-01

    The long-term outcomes following complex fractures of the tibia are reported to carry a risk of knee pain, malalignment, articular injury and post-traumatic osteoarthritis. The main objective of this study was to account for the patient-reported quality of life (QOL) 12 months after ring fixator removal in patients with a complex tibial fracture. Secondary objectives included a review of the socio-economic characteristics of the patient group and the rate of return to work in the study period. A prospective follow-up study was conducted of 60 patients with complex fractures of the tibia treated with ring external fixation. Patient-reported outcomes, radiological outcomes and socio-economic status including employment status of the patients were obtained 12 months after frame removal. Forty-six patients completed the assessment 12 months after frame removal (77%). The mean age of the patient at the time of fracture was 54.6 years (range 31-86). There were 19 males and 27 females. At 12 months after frame removal, the mean EQ5D-5L index was 0.66 (CI 0.60-0.72). The mean EQ5D-5L VAS was 69 (CI 61-76). When this was compared to the established reference population from Denmark, the study population showed a significantly worse EQ5D-5L index. The majority of patients (87%) were in the lower social classes suggesting a higher degree of social deprivation in the study population. Twenty-seven per cent of patients who were employed prior to injury had returned to employment at approximately 19 months following fracture. The onset of post-traumatic osteoarthritis was present in the knee joint in 29% of patients following a proximal intra-articular fracture, whereas osteoarthritis was present at the ankle joint in 35% of patients following a distal intra-articular fracture 12 months after frame removal. This study indicates that at 12 months after frame removal there are poorer patient-reported QOL as when compared to reference populations. Furthermore, this study

  6. One-year experience of a regional service model of teleconsultation for planning and treatment of complex thoracoabdominal aortic disease.

    Science.gov (United States)

    Chisci, Emiliano; de Donato, Gianmarco; Fargion, Aaron; Ventoruzzo, Giorgio; Parlani, Gianbattista; Setacci, Carlo; Ercolini, Leonardo; Michelagnoli, Stefano

    2018-03-01

    The objective of this study was to report the methodology and 1-year experience of a regional service model of teleconsultation for planning and treatment of complex thoracoabdominal aortic disease (TAAD). Complex TAADs without a feasible conventional surgical repair were prospectively evaluated by vascular surgeons of the same public health service (National Health System) located in a huge area of 22,994 km 2 with 3.7 million inhabitants and 11 tertiary hospitals. Surgeons evaluated computed tomography scans and clinical details that were placed on a web platform (Google Drive; Google, Mountain View, Calif) and shared by all surgeons. Patients gave informed consent for the teleconsultation. The surgeon who submits a case discusses in detail his or her case and proposes a possible therapeutic strategy. The other surgeons suggest other solutions and options in terms of grafts, techniques, or access to be used. Computed tomography angiography, angiography, and clinical outcomes of cases are then presented at the following telemeetings, and a final agreement of the operative strategy is evaluated. Teleconsultation is performed using a web conference service (WebConference.com; Avaya Inc, Basking Ridge, NJ) every month. An inter-rater agreement statistic was calculated, and the κ value was interpreted according to Altman's criteria for computed tomography angiography measurements. The rate of participation was constant (mean number of surgeons, 11; range, 9-15). Twenty-four complex TAAD cases were discussed for planning and operation during the study period. The interobserver reliability recorded was moderate (κ = 0.41-0.60) to good (κ = 0.61-0.80) for measurements of proximal and distal sealing and very good (κ = 0.81-1) for detection of any target vessel angulation >60 degrees, significant calcification (circumferential), and thrombus presence (>50%). The concordance for planning and therapeutic strategy among all participants was complete in 16 cases. In

  7. Complex Reconstruction After Sarcoma Resection and the Role of the Plastic Surgeon: A Case Series of 298 Patients Treated at a Single Center.

    Science.gov (United States)

    Leckenby, Jonathan I; Deegan, Rachel; Grobbelaar, Adriaan O

    2018-01-01

    More than 1000 new patients present to the London Sarcoma Unit each year and between 5% and 10% require plastic surgery intervention. Advancements in radiotherapy and chemotherapy protocols combined with higher expectations for limb preservation has led to increased reconstructive challenges. Frequently, primary closure is achievable; however, larger tumors often require specialist reconstruction. A retrospective chart review of all referred patients from the London Sarcoma Unit requiring reconstruction between February 2006 and January 2015 was performed. Patients who underwent primary amputation were excluded. The total number of operations performed was 298 and the mean follow-up was 16 months (12-46 months). 51% of patients had major comorbidities. Patients could be separated into early (0-1 week postoperatively, n = 167) and late reconstructions (>1 week postoperatively, n = 131). 32 patients were reconstructed with skin grafts, 137 patients were managed with regional flaps and 129 patients were treated with free flaps. A patient with 3 or more major comorbidities resulted in a significantly increased risk of reconstructive failure (P < 0.05). Our experience has lead us to adhere to the following guidelines: (1) All patients should be reviewed in a multidisciplinary team meeting. (2) After primary excision, patients should be managed with a vacuum dressing until margins are clear. (3) Definitive reconstruction should be performed by a specialist reconstructive surgeon.

  8. Bodily Sensory Inputs and Anomalous Bodily Experiences in Complex Regional Pain Syndrome: Evaluation of the Potential Effects of Sound Feedback

    Directory of Open Access Journals (Sweden)

    Ana Tajadura-Jiménez

    2017-07-01

    Full Text Available Neuroscientific studies have shown that human's mental body representations are not fixed but are constantly updated through sensory feedback, including sound feedback. This suggests potential new therapeutic sensory approaches for patients experiencing body-perception disturbances (BPD. BPD can occur in association with chronic pain, for example in Complex Regional Pain Syndrome (CRPS. BPD often impacts on emotional, social, and motor functioning. Here we present the results from a proof-of-principle pilot study investigating the potential value of using sound feedback for altering BPD and its related emotional state and motor behavior in those with CRPS. We build on previous findings that real-time alteration of the sounds produced by walking can alter healthy people's perception of their own body size, while also resulting in more active gait patterns and a more positive emotional state. In the present study we quantified the emotional state, BPD, pain levels and gait of twelve people with CRPS Type 1, who were exposed to real-time alteration of their walking sounds. Results confirm previous reports of the complexity of the BPD linked to CRPS, as participants could be classified into four BPD subgroups according to how they mentally visualize their body. Further, results suggest that sound feedback may affect the perceived size of the CRPS affected limb and the pain experienced, but that the effects may differ according to the type of BPD. Sound feedback affected CRPS descriptors and other bodily feelings and emotions including feelings of emotional dominance, limb detachment, position awareness, attention and negative feelings toward the limb. Gait also varied with sound feedback, affecting the foot contact time with the ground in a way consistent with experienced changes in body weight. Although, findings from this small pilot study should be interpreted with caution, they suggest potential applications for regenerating BDP and its related

  9. Bodily Sensory Inputs and Anomalous Bodily Experiences in Complex Regional Pain Syndrome: Evaluation of the Potential Effects of Sound Feedback

    Science.gov (United States)

    Tajadura-Jiménez, Ana; Cohen, Helen; Bianchi-Berthouze, Nadia

    2017-01-01

    Neuroscientific studies have shown that human's mental body representations are not fixed but are constantly updated through sensory feedback, including sound feedback. This suggests potential new therapeutic sensory approaches for patients experiencing body-perception disturbances (BPD). BPD can occur in association with chronic pain, for example in Complex Regional Pain Syndrome (CRPS). BPD often impacts on emotional, social, and motor functioning. Here we present the results from a proof-of-principle pilot study investigating the potential value of using sound feedback for altering BPD and its related emotional state and motor behavior in those with CRPS. We build on previous findings that real-time alteration of the sounds produced by walking can alter healthy people's perception of their own body size, while also resulting in more active gait patterns and a more positive emotional state. In the present study we quantified the emotional state, BPD, pain levels and gait of twelve people with CRPS Type 1, who were exposed to real-time alteration of their walking sounds. Results confirm previous reports of the complexity of the BPD linked to CRPS, as participants could be classified into four BPD subgroups according to how they mentally visualize their body. Further, results suggest that sound feedback may affect the perceived size of the CRPS affected limb and the pain experienced, but that the effects may differ according to the type of BPD. Sound feedback affected CRPS descriptors and other bodily feelings and emotions including feelings of emotional dominance, limb detachment, position awareness, attention and negative feelings toward the limb. Gait also varied with sound feedback, affecting the foot contact time with the ground in a way consistent with experienced changes in body weight. Although, findings from this small pilot study should be interpreted with caution, they suggest potential applications for regenerating BDP and its related bodily feelings in

  10. The rubber hand illusion in complex regional pain syndrome: preserved ability to integrate a rubber hand indicates intact multisensory integration.

    Science.gov (United States)

    Reinersmann, Annika; Landwehrt, Julia; Krumova, Elena K; Peterburs, Jutta; Ocklenburg, Sebastian; Güntürkün, Onur; Maier, Christoph

    2013-09-01

    In patients with complex regional pain syndrome (CRPS) type 1, processing of static tactile stimuli is impaired, whereas more complex sensory integration functions appear preserved. This study investigated higher order multisensory integration of body-relevant stimuli using the rubber hand illusion in CRPS patients. Subjective self-reports and skin conductance responses to watching the rubber hand being harmed were compared among CRPS patients (N=24), patients with upper limb pain of other origin (N=21, clinical control group), and healthy subjects (N=24). Additionally, the influence of body representation (body plasticity [Trinity Assessment of Body Plasticity], neglect-like severity symptoms), and clinical signs of illusion strength were investigated. For statistical analysis, 1-way analysis of variance, t test, Pearson correlation, with α=0.05 were used. CRPS patients did not differ from healthy subjects and the control group with regard to their illusion strength as assessed by subjective reports or skin conductance response values. Stronger left-sided rubber hand illusions were reported by healthy subjects and left-side-affected CRPS patients. Moreover, for this subgroup, illness duration and illusion strength were negatively correlated. Overall, severity of neglect-like symptoms and clinical signs were not related to illusion strength. However, patients with CRPS of the right hand reported significantly stronger neglect-like symptoms and significantly lower illusion strength of the affected hand than patients with CRPS of the left hand. The weaker illusion of CRPS patients with strong neglect-like symptoms on the affected hand supports the role of top-down processes modulating body ownership. Moreover, the intact ability to perceive illusory ownership confirms the notion that, despite impaired processing of proprioceptive or tactile input, higher order multisensory integration is unaffected in CRPS. Copyright © 2013 International Association for the Study

  11. Regional-dependent intestinal permeability and BCS classification: elucidation of pH-related complexity in rats using pseudoephedrine.

    Science.gov (United States)

    Fairstein, Moran; Swissa, Rotem; Dahan, Arik

    2013-04-01

    Based on its lower Log P value relative to metoprolol, a marker for the low/high-permeability (P(eff)) class boundary, pseudoephedrine was provisionally classified as BCS low-permeability compound. On the other hand, following oral administration, pseudoephedrine fraction dose absorbed (F(abs)) and systemic bioavailability approaches 100%. This represents a challenge to the generally recognized P(eff)-F(abs) correlation. The purpose of this study was to elucidate the underlying mechanisms behind the confusion in pseudoephedrine's BCS classification. Pseudoephedrine's BCS solubility class was determined, and its physicochemical properties and intestinal permeability were thoroughly investigated, both in vitro and in vivo in rats, considering the complexity of the whole of the small intestine. Pseudoephedrine was found to be unequivocally a high-solubility compound. All of the permeability studies revealed similar phenomenon; at any given intestinal segment/pH, the permeability of metoprolol was higher than that of pseudoephedrine, however, as the intestinal region becomes progressively distal, and the pH gradually increases, pseudoephedrine's permeability rises above that of metoprolol in the former segment. This unique permeability pattern likely explains pseudoephedrine's complete absorption. In conclusion, pseudoephedrine is a BCS Class I compound; no discrepancy between P(eff) and F(abs) is involved in its absorption. Rather, it reflects the complexity behind P(eff) when considering the whole of the intestine. We propose to allow high-permeability classification to drugs with P(eff) that matches/exceeds the low/high class benchmark anywhere throughout the intestinal tract and not restricted necessarily to the jejunum.

  12. Community-randomized trial of lambdacyhalothrin-treated hammock nets for malaria control in Yanomami communities in the Amazon region of Venezuela.

    Science.gov (United States)

    Magris, M; Rubio-Palis, Y; Alexander, N; Ruiz, B; Galván, N; Frias, D; Blanco, M; Lines, J

    2007-03-01

    We conducted a community-randomized controlled trial in an area of moderate malaria transmission in the Amazon region, southern Venezuela, home of the Yanomami indigenous ethnic group. The aim was to compare the malaria incidence rate in villages with lambdacyhalothrin-treated hammock nets (ITHN) or with placebo-treated hammock nets (PTHN). In both arms of the study, intensive surveillance for early case detection was maintained and prompt malaria treatment was administered. Baseline data were collected before the intervention and a population of around 924 Yanomami was followed for 2 years. Despite the recent introduction of nets in the Yanomami villages and the adverse natural conditions in the area, the nets were accepted enthusiastically by the study population, used conscientiously and looked after carefully. The malaria incidence rate per thousand person-years at risk was 114.6 in the IHTN group and 186.8 in the PTHN group. The adjusted rate ratios indicated that ITHN prevent 56% [IRR: 0.44, 95% confidence interval (CI): 52-59%] of new malaria cases. ITHN reduced the prevalence of parasitaemia by 83% [relative risks (RR): 0.17, 95% CI: 47-100%], according to a cross-sectional survey carried out during the high transmission season. The prevalence of splenomegaly and anaemia was too low to detect any possible reduction as a result of ITHN. The main conclusion of the present study is that ITHN can reduce malaria incidence in the area and it is the most feasible method for malaria control in a forested area where indigenous villages are scattered over a large territory. This is the first community-level epidemiological trial to show that ITHN are highly effective against malaria transmitted by Anopheles darlingi.

  13. SU-D-204-07: Retrospective Correlation of Dose Accuracy with Regions of Local Failure for Early Stage Lung Cancer Patients Treated with Stereotactic Body Radiotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Devpura, S; Li, H; Liu, C; Fraser, C; Ajlouni, M; Movsas, B; Chetty, I [Henry Ford Health System, Detroit, MI (United States)

    2016-06-15

    Purpose: To correlate dose distributions computed using six algorithms for recurrent early stage non-small cell lung cancer (NSCLC) patients treated with stereotactic body radiotherapy (SBRT), with outcome (local failure). Methods: Of 270 NSCLC patients treated with 12Gyx4, 20 were found to have local recurrence prior to the 2-year time point. These patients were originally planned with 1-D pencil beam (1-D PB) algorithm. 4D imaging was performed to manage tumor motion. Regions of local failures were determined from follow-up PET-CT scans. Follow-up CT images were rigidly fused to the planning CT (pCT), and recurrent tumor volumes (Vrecur) were mapped to the pCT. Dose was recomputed, retrospectively, using five algorithms: 3-D PB, collapsed cone convolution (CCC), anisotropic analytical algorithm (AAA), AcurosXB, and Monte Carlo (MC). Tumor control probability (TCP) was computed using the Marsden model (1,2). Patterns of failure were classified as central, in-field, marginal, and distant for Vrecur ≥95% of prescribed dose, 95–80%, 80–20%, and ≤20%, respectively (3). Results: Average PTV D95 (dose covering 95% of the PTV) for 3-D PB, CCC, AAA, AcurosXB, and MC relative to 1-D PB were 95.3±2.1%, 84.1±7.5%, 84.9±5.7%, 86.3±6.0%, and 85.1±7.0%, respectively. TCP values for 1-D PB, 3-D PB, CCC, AAA, AcurosXB, and MC were 98.5±1.2%, 95.7±3.0, 79.6±16.1%, 79.7±16.5%, 81.1±17.5%, and 78.1±20%, respectively. Patterns of local failures were similar for 1-D and 3D PB plans, which predicted that the majority of failures occur in centraldistal regions, with only ∼15% occurring distantly. However, with convolution/superposition and MC type algorithms, the majority of failures (65%) were predicted to be distant, consistent with the literature. Conclusion: Based on MC and convolution/superposition type algorithms, average PTV D95 and TCP were ∼15% lower than the planned 1-D PB dose calculation. Patterns of failure results suggest that MC and convolution

  14. Two putative subunits of a peptide pump encoded in the human major histocompatability complex class 2 region

    International Nuclear Information System (INIS)

    Bahram, S.; Arnold, D.; Bresnahan, M.; Strominger, J.L.; Spies, T.

    1991-01-01

    The class 2 region of the human major histocompatibility complex (MHC) may encode several genes controlling the processing of endogenous antigen and the presentation of peptide epitopes by MHC class 1 molecules to cytotoxic T lymphocytes. A previously described peptide supply factor (PSF1) is a member of the multidrug-resistance family of transporters and may pump cytosolic peptides into the membrane-bound compartment where class 1 molecules assemble. A second transporter gene, PSF2, was identified 10 kilobases (kb) from PSF1, near the class 2 DOB gene. The complete sequences of PSF1 and PSF2 were determined from cDNA clones. The translation products are closely related in sequence and predicted secondary structure. Both contain a highly conserved ATP-binding fold and share 25% homology in a hydrophobic domain with a tentative number of eight membrane-spanning segments. Based on the principle dimeric organization of these two domains in other transporters, PSF1 and PSF2 may function as complementary subunits, independently as homodimers, or both. Taken together with previous genetic evidence, the coregulation of PSF1 and PSF2 by γ interferon and the to-some-degree coordinate transcription of these genes suggest a common role in peptide-loading of class 1 molecules, although a distinct function of PSF2 cannot be ruled out

  15. Usefulness of asymmetry score on quantitative three-phase bone scintigraphy in the evaluation of complex regional pain syndrome

    International Nuclear Information System (INIS)

    Sampath, Santhosh; Mittal, Bhagwant Rai; Arun, Sasikumar; Sood, Ashwani; Bhattacharya, Anish; Sharma, Aman

    2013-01-01

    Complex regional pain syndrome (CRPS) is primarily a clinical diagnosis. Diagnostic imaging in CRPS can be used, especially to exclude other disorders. The sensitivity and specificity of three phase bone scintigraphy (TPBS) for the diagnosis of CRPS is variable throughout the literature. To establish a simple and effective quantitative approach to help in the diagnosis of CRPS by TPBS. TPBS done in patients (n = 68) with suspected CRPS was analyzed retrospectively. They were classified into bone scan positive group (BSP), bone scan negative group (BSN) and non-CRPS group based on diffusely increased periarticular uptake, symmetrical uptake, and focal uptake respectively. Asymmetry score (AS) was also measured between the affected and unaffected side. 16 patients showed focal uptake, 37 were in BSP group with mean AS score of 1.57 ± 0.5 and 15 were in BSN group with mean AS score of 1.01 ± 0.05. The mean AS was significantly different (P < 0.0001). AS of 1.06 had sensitivity and specificity of 96.43% and 100% respectively (P = 0.0001). There was a trend of negative correlation between the AS and the duration, r = −0.21; however, it was not statistically significant (P = 0.28). TPBS should be considered in the evaluation of CRPS to rule out patients who have focal involvement, not diagnostic of CRPS (~24% in this study). Quantitative AS of 1.06 can be included to support visual interpretation in the delayed phase

  16. Enhanced pain and autonomic responses to ambiguous visual stimuli in chronic Complex Regional Pain Syndrome (CRPS) type I.

    Science.gov (United States)

    Cohen, H E; Hall, J; Harris, N; McCabe, C S; Blake, D R; Jänig, W

    2012-02-01

    Cortical reorganisation of sensory, motor and autonomic systems can lead to dysfunctional central integrative control. This may contribute to signs and symptoms of Complex Regional Pain Syndrome (CRPS), including pain. It has been hypothesised that central neuroplastic changes may cause afferent sensory feedback conflicts and produce pain. We investigated autonomic responses produced by ambiguous visual stimuli (AVS) in CRPS, and their relationship to pain. Thirty CRPS patients with upper limb involvement and 30 age and sex matched healthy controls had sympathetic autonomic function assessed using laser Doppler flowmetry of the finger pulp at baseline and while viewing a control figure or AVS. Compared to controls, there were diminished vasoconstrictor responses and a significant difference in the ratio of response between affected and unaffected limbs (symmetry ratio) to a deep breath and viewing AVS. While viewing visual stimuli, 33.5% of patients had asymmetric vasomotor responses and all healthy controls had a homologous symmetric pattern of response. Nineteen (61%) CRPS patients had enhanced pain within seconds of viewing the AVS. All the asymmetric vasomotor responses were in this group, and were not predictable from baseline autonomic function. Ten patients had accompanying dystonic reactions in their affected limb: 50% were in the asymmetric sub-group. In conclusion, there is a group of CRPS patients that demonstrate abnormal pain networks interacting with central somatomotor and autonomic integrational pathways. © 2011 European Federation of International Association for the Study of Pain Chapters.

  17. Investigating Reports of Complex Regional Pain Syndrome: An Analysis of HPV-16/18-Adjuvanted Vaccine Post-Licensure Data

    Science.gov (United States)

    Huygen, Frank; Verschueren, Kristin; McCabe, Candida; Stegmann, Jens-Ulrich; Zima, Julia; Mahaux, Olivia; Van Holle, Lionel; Angelo, Maria-Genalin

    2015-01-01

    Complex regional pain syndrome (CRPS) is a chronic pain disorder that typically follows trauma or surgery. Suspected CRPS reported after vaccination with human papillomavirus (HPV) vaccines led to temporary suspension of proactive recommendation of HPV vaccination in Japan. We investigated the potential CRPS signal in relation to HPV-16/18-adjuvanted vaccine (Cervarix®) by database review of CRPS cases with independent expert confirmation; a disproportionality analysis and analyses of temporality; an observed versus expected analysis using published background incidence rates; systematic reviews of aggregate safety data, and a literature review. The analysis included 17 case reports of CRPS: 10 from Japan (0.14/100,000 doses distributed) and seven from the United Kingdom (0.08/100,000). Five cases were considered by independent experts to be confirmed CRPS. Quantitative analyses did not suggest an association between CRPS and HPV-16/18-adjuvanted vaccine. Observed CRPS incidence after HPV-16/18 vaccination was statistically significantly below expected rates. Systematic database reviews using search terms varying in specificity and sensitivity did not identify new cases. No CRPS was reported during clinical development and no unexpected results found in the literature. There is not sufficient evidence to suggest an increased risk of developing CRPS following vaccination with HPV-16/18-adjuvanted vaccine. Post-licensure safety surveillance confirms the acceptable benefit-risk of HPV-16/18 vaccination. PMID:26501109

  18. [Comparable disorder of the body schema in patients with complex regional pain syndrome (CRPS) and phantom pain].

    Science.gov (United States)

    Reinersmann, A; Haarmeyer, G S; Blankenburg, M; Frettlöh, J; Krumova, E K; Ocklenburg, S; Maier, C

    2011-09-01

    In patients with complex regional pain syndrome (CRPS) a disruption of the body schema has been shown in an altered cortical representation of the hand and in delayed reaction times (RT) in the hand laterality recognition task. However, the role of attentional processes or the effect of isolated limb laterality training has not yet been clarified. The performance of healthy subjects (n = 38), CRPS patients (n = 12) and phantom limb pain (PLP) patients (n = 12) in a test battery of attentional performance (TAP) and in a limb laterality recognition task was compared and the effect of limb laterality training in CRPS patients and healthy subjects evaluated. The RTs of both CRPS and PLP patients were significantly slower than those of healthy subjects despite normal TAP values. The CRPS and PLP patients showed bilaterally delayed RTs. Through training RTs improved significantly but the RTs of CRPS patients remained slower than those of healthy subjects. In this study an equal disruption of the body schema was found in both CRPS and PLP patients which cannot be accounted for by attentional processes. For CRPS patients this disorder cannot be fully reversed by isolated limb laterality recognition training.

  19. Establishing the characteristics for patients with chronic Complex Regional Pain Syndrome: the value of the CRPS-UK Registry.

    Science.gov (United States)

    Shenker, Nicholas; Goebel, Andreas; Rockett, Mark; Batchelor, James; Jones, Gareth T; Parker, Richard; de C Williams, Amanda C; McCabe, Candida

    2015-05-01

    The long-term prognosis of patients with Complex Regional Pain Syndrome (CRPS) is unknown with no reported prospective studies from the United Kingdom longer than 18 months. The CRPS-UK Network aims to study this by use of a Registry. The aims of this article are, to outline the CRPS-UK Registry, assess the validity of the data and to describe the characteristics of a sample of the UK CRPS population. A web-based CRPS-UK Registry was developed and made accessible to centres experienced in diagnosing and managing patients with CRPS. Pragmatic annual follow-up questions were agreed. Up until July 2013, the Registry has recruited 240 patients. A blinded, validation study of 20 consecutive patients from two centres (10 each) demonstrated 95.6% completion and 99.4% accuracy of a random sample of the recorded data. These patients had chronic disease (median duration: 29 months); 72.5% were female (2.6:1), with a mean age at symptoms onset of 43 years, and were left-handed more than expected (21.8% versus 10% in the general population). Patients reported a delayed diagnosis, with the median time between symptom onset and diagnosis of 6 months. In all, 30 patients (12.5%) had multiple limb involvement and (83.3%) had a contiguous spread of CRPS. CRPS-UK Registry is a validated method for actively recruiting well-characterised patients with CRPS to provide further information on the long-term outcome.

  20. Novel Signs and Their Clinical Utility in Diagnosing Complex Regional Pain Syndrome (CRPS): A Prospective Observational Cohort Study.

    Science.gov (United States)

    Kuttikat, Anoop; Shaikh, Maliha; Oomatia, Amin; Parker, Richard; Shenker, Nicholas

    2017-06-01

    Delays in diagnosis occur with complex regional pain syndrome (CRPS). We define and prospectively demonstrate that novel bedside tests measuring body perception disruption can identify patients with CRPS postfracture. The objectives of our study were to define and validate 4 bedside tests, to identify the prevalence of positive tests in patients with CRPS and other chronic pain conditions, and to assess the clinical utility (sensitivity, specificity, positive predictive value, negative predictive value) for identifying CRPS within a Fracture cohort. This was a single UK teaching hospital prospective cohort study with 313 recruits from pain-free volunteers and patients with chronic pain conditions.Four novel tests were Finger Perception (FP), Hand Laterality identification (HL), Astereognosis (AS), and Body Scheme (BS) report. Five questionnaires (Brief Pain Inventory, Upper Extremity Functional Index, Lower Extremity Functional Index, Neglect-like Symptom Questionnaire, Hospital Anxiety and Depression Score) assessed the multidimensional pain experience. FP and BS were the best performing tests. Prospective monitoring of fracture patients showed that out of 7 fracture patients (total n=47) who had both finger misperception and abnormal BS report at initial testing, 3 developed persistent pain with 1 having a formal diagnosis of CRPS. Novel signs are reliable, easy to perform, and present in chronic pain patients. FP and BS have significant clinical utility in predicting persistent pain in a fracture group thereby allowing targeted early intervention.

  1. A CRPS-IgG-transfer-trauma model reproducing inflammatory and positive sensory signs associated with complex regional pain syndrome.

    Science.gov (United States)

    Tékus, Valéria; Hajna, Zsófia; Borbély, Éva; Markovics, Adrienn; Bagoly, Teréz; Szolcsányi, János; Thompson, Victoria; Kemény, Ágnes; Helyes, Zsuzsanna; Goebel, Andreas

    2014-02-01

    The aetiology of complex regional pain syndrome (CRPS), a highly painful, usually post-traumatic condition affecting the limbs, is unknown, but recent results have suggested an autoimmune contribution. To confirm a role for pathogenic autoantibodies, we established a passive-transfer trauma model. Prior to undergoing incision of hind limb plantar skin and muscle, mice were injected either with serum IgG obtained from chronic CRPS patients or matched healthy volunteers, or with saline. Unilateral hind limb plantar skin and muscle incision was performed to induce typical, mild tissue injury. Mechanical hyperalgesia, paw swelling, heat and cold sensitivity, weight-bearing ability, locomotor activity, motor coordination, paw temperature, and body weight were investigated for 8days. After sacrifice, proinflammatory sensory neuropeptides and cytokines were measured in paw tissues. CRPS patient IgG treatment significantly increased hind limb mechanical hyperalgesia and oedema in the incised paw compared with IgG from healthy subjects or saline. Plantar incision induced a remarkable elevation of substance P immunoreactivity on day 8, which was significantly increased by CRPS-IgG. In this IgG-transfer-trauma model for CRPS, serum IgG from chronic CRPS patients induced clinical and laboratory features resembling the human disease. These results support the hypothesis that autoantibodies may contribute to the pathophysiology of CRPS, and that autoantibody-removing therapies may be effective treatments for long-standing CRPS. Copyright © 2013 International Association for the Study of Pain. Published by Elsevier B.V. All rights reserved.

  2. High-resolution spatial databases of monthly climate variables (1961-2010) over a complex terrain region in southwestern China

    Science.gov (United States)

    Wu, Wei; Xu, An-Ding; Liu, Hong-Bin

    2015-01-01

    Climate data in gridded format are critical for understanding climate change and its impact on eco-environment. The aim of the current study is to develop spatial databases for three climate variables (maximum, minimum temperatures, and relative humidity) over a large region with complex topography in southwestern China. Five widely used approaches including inverse distance weighting, ordinary kriging, universal kriging, co-kriging, and thin-plate smoothing spline were tested. Root mean square error (RMSE), mean absolute error (MAE), and mean absolute percentage error (MAPE) showed that thin-plate smoothing spline with latitude, longitude, and elevation outperformed other models. Average RMSE, MAE, and MAPE of the best models were 1.16 °C, 0.74 °C, and 7.38 % for maximum temperature; 0.826 °C, 0.58 °C, and 6.41 % for minimum temperature; and 3.44, 2.28, and 3.21 % for relative humidity, respectively. Spatial datasets of annual and monthly climate variables with 1-km resolution covering the period 1961-2010 were then obtained using the best performance methods. Comparative study showed that the current outcomes were in well agreement with public datasets. Based on the gridded datasets, changes in temperature variables were investigated across the study area. Future study might be needed to capture the uncertainty induced by environmental conditions through remote sensing and knowledge-based methods.

  3. The Santa Izabel Complex, Gavião Block, Brazil: Components, geocronology, regional correlations and tectonic implications

    Science.gov (United States)

    Medeiros, Eder Luis Mathias; Cruz, Simone Cerqueira Pereira; Barbosa, Johildo Salomão Figueiredo; Paquette, Jean Louis; Peucat, Jean Jacques; Jesus, Silvandira dos Santos Góes Pereira de; Barbosa, Rafael Gordilho; Brito, Reinaldo Santana Correia de; Carneiro, Mauricio Antônio

    2017-12-01

    Cratons, as well as the basement of their marginal orogens, may represent important sites of research regarding the formation and evolution of Archean continental crusts. The Gavião Block is one of the oldest terranes in South America with rocks aged up to 3.6 Ga. Among the Archean units that outcrop in the southern sector of this block is the Santa Izabel Complex, which for the most part is located in the São Francisco Craton, close to its limit with the Araçuaí-West Congo Orogen. This complex has generally been described as comprising ortho- and paraderived rocks that were metamorphosed in high amphibolite facies. Studies in the southern region of this complex have shown the main components: (i) orthogneisses, whose protoliths are the Mesoarchean rocks of the Santa Izabel Magmatic Suite; and (iii) migmatites. and (iv) amphibolitic and metaultramafic enclaves. U-Pb studies (LA-ICPMS and SHRIMP) performed on zircons of the paleosome in metatexites and inherited zircons in migmatites indicate crystallization ages between 3091 ± 24 and 3136 ± 8 Ma for the rocks of the Santa Izabel Magmatic Suite. Inherited zircons aged ca. 3.4 Ga in paleosomes demonstrate the influence of older continental crust in the formation of these rocks. For the Caraguatai Magmatic Suite, the alignment of zircons and monazites suggests a crystallization age around 2.6 Ga. The Rhyacian migmatites were divided into metatexites and diatexites. Diatexites were divided into: (i) discontinuous boudinated early diatexites, which are parallel to stromatic metatexites, composing the gneissic banding. These rocks have diffuse metamorphic banding and features that suggest the action of mylonitization processes; and (ii) late diatexites, forming more continuous bodies, which truncate the gneissic banding. The migmatization occurred in two stages, with time interval between ca. 2.1 Ga and 2.07 Ga. The structural framework reveal the existence of four progressive Rhyacian deformation phases (Dn to Dn

  4. Evaluation of hydrophilic permeant transport parameters in the localized and non-localized transport regions of skin treated simultaneously with low-frequency ultrasound and sodium lauryl sulfate.

    Science.gov (United States)

    Kushner, Joseph; Blankschtein, Daniel; Langer, Robert

    2008-02-01

    The porosity (epsilon), the tortuosity (tau), and the hindrance factor (H) of the aqueous pore channels located in the localized transport regions (LTRs) and the non-LTRs formed in skin treated simultaneously with low-frequency ultrasound (US) and the surfactant sodium lauryl sulfate (SLS), were evaluated for the delivery of four hydrophilic permeants (urea, mannitol, raffinose, and inulin) by analyzing dual-radiolabeled diffusion masking experiments for three different idealized cases of the aqueous pore pathway hypothesis. When epsilon and tau were assumed to be independent of the permeant radius, H was found to be statistically larger in the LTRs than in the non-LTRs. When a distribution of pore radii was assumed to exist in the skin, no statistical differences in epsilon, tau, and H were observed due to the large variation in the pore radii distribution shape parameter (3 A to infinity). When infinitely large aqueous pores were assumed to exist in the skin, epsilon was found to be 3-8-fold greater in the LTRs than in the non-LTRs, while little difference was observed in the LTRs and in the non-LTRs for tau. This last result suggests that the efficacy of US/SLS treatment may be enhanced by increasing the porosity of the non-LTRs.

  5. Patterns of Cell Activity in the Subthalamic Region Associated with the Neuroprotective Action of Near-Infrared Light Treatment in MPTP-Treated Mice

    Directory of Open Access Journals (Sweden)

    Victoria E. Shaw

    2012-01-01

    Full Text Available We have shown previously that near-infrared light (NIr treatment or photobiomodulation neuroprotects dopaminergic cells in substantia nigra pars compacta (SNc from degeneration induced by 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP in mice. The present study explores whether NIr treatment changes the patterns of Fos expression in the subthalamic region, namely, the subthalamic nucleus (STN and zona incerta (ZI; both cell groups have abnormally overactive cells in parkinsonian cases. BALB/c mice were treated with MPTP (100–250 mg/kg or saline either over 30 hours followed by either a two-hour or six-day survival period (acute model or over five weeks followed by a three-week survival period (chronic model. NIr and MPTP were applied simultaneously. Brains were processed for Fos immunochemistry, and cell number was estimated using stereology. Our major finding was that NIr treatment reduced (30–45% the increase in Fos+ cell number evident in the STN and ZI after MPTP insult. This reduction was concurrent with the neuroprotection of dopaminergic SNc cells shown previously and was evident in both MPTP models (except for the 2 hours survival period which showed no changes in cell number. In summary, our results indicated that NIr had long lasting effects on the activity of cells located deep in the brain and had repaired partially the abnormal activity generated by the parkinsonian toxin.

  6. Age remains the first prognostic factor for loco-regional breast cancer recurrence in young (<40 years) women treated with breast conserving surgery first

    International Nuclear Information System (INIS)

    Bollet, Marc A.; Sigal-Zafrani, Brigitte; Mazeau, Valerie; Savignoni, Alexia; Rochefordiere, Anne de la; Vincent-Salomon, Anne; Salmon, Remy; Campana, Francois; Kirova, Youlia M.; Dendale, Remi; Fourquet, Alain

    2007-01-01

    Purpose: To ascertain the loco-regional recurrence (LRR) rate and its major prognostic factors in patients younger than 40 and to determine the influence of age on the features of breast cancer and its treatment in two age groups: ≤35 years and [36-39] years. Methods and materials: Between 1985 and 1995, 209 premenopausal women, younger than 40, were treated for early breast cancers with primary breast conserving surgery followed by radiotherapy ± chemotherapy. Median age was 37 years with 66 patients (32%) ≤35 years and 143 older (68%). Median follow-up was 12 years. Tumours' characteristics were: cT1 in 75%, pN0 in 60%. Results: LRR rate was 38% at 10 years, contralateral breast cancer rate 12%. Age was the only prognostic factor for LRR. The relative risk of LRR increased by 7% for every decreasing year of age. The annual risk of local recurrence peaked between 2 and 3 years after the initial diagnosis and returned to the level of contra-lateral breast cancer at 10 years. The younger population had infiltrating carcinomas that were significantly more commonly ductal, less commonly lobular, and of higher grade - they received chemotherapy more often. Conclusion: Using conventional methods we could find no explanation as to why age remained the most important prognostic factor for breast cancer LRR. Known prognostic factors such as involved surgical margins seemed erased by adequate radiotherapy doses

  7. Disdrometer-based C-Band Radar Quantitative Precipitation Estimation (QPE) in a highly complex terrain region in tropical Colombia.

    Science.gov (United States)

    Sepúlveda, J.; Hoyos Ortiz, C. D.

    2017-12-01

    An adequate quantification of precipitation over land is critical for many societal applications including agriculture, hydroelectricity generation, water supply, and risk management associated with extreme events. The use of rain gauges, a traditional method for precipitation estimation, and an excellent one, to estimate the volume of liquid water during a particular precipitation event, does not allow to fully capture the highly spatial variability of the phenomena which is a requirement for almost all practical applications. On the other hand, the weather radar, an active remote sensing sensor, provides a proxy for rainfall with fine spatial resolution and adequate temporary sampling, however, it does not measure surface precipitation. In order to fully exploit the capabilities of the weather radar, it is necessary to develop quantitative precipitation estimation (QPE) techniques combining radar information with in-situ measurements. Different QPE methodologies are explored and adapted to local observations in a highly complex terrain region in tropical Colombia using a C-Band radar and a relatively dense network of rain gauges and disdrometers. One important result is that the expressions reported in the literature for extratropical locations are not representative of the conditions found in the tropical region studied. In addition to reproducing the state-of-the-art techniques, a new multi-stage methodology based on radar-derived variables and disdrometer data is proposed in order to achieve the best QPE possible. The main motivation for this new methodology is based on the fact that most traditional QPE methods do not directly take into account the different uncertainty sources involved in the process. The main advantage of the multi-stage model compared to traditional models is that it allows assessing and quantifying the uncertainty in the surface rain rate estimation. The sub-hourly rainfall estimations using the multi-stage methodology are realistic

  8. Relationship Between HbA1c and Complex Regional Pain Syndrome in Stroke Patients With Type 2 Diabetes Mellitus

    Science.gov (United States)

    2016-01-01

    Objective To investigate the relationship between glycosylated hemoglobin A (HbA1c) and complex regional pain syndrome (CRPS) in stroke patients with type 2 diabetes mellitus (T2DM). Methods A retrospective chart review was performed of stroke patients from January 2012 to December 2013. We reviewed 331 patients and included 200 in the analysis. We divided them into CRPS and non-CRPS groups and compared them by age, gender, stroke lesion, cause of stroke, duration of T2DM, HbA1c (%), National Institutes of Health Stroke Scale score, affected shoulder flexor muscle strength, Fugl-Meyer Assessment score, motricity index, Functional Independence Measure, Korean version of Modified Barthel Index, blood glucose level on admission day, duration from stroke onset to HbA1c check, and duration from stroke onset to three-phase bone scan for CRPS diagnosis. Thereafter, we classified the patients into five groups by HbA1c level (group 1, 5.0%–5.9%; group 2, 6.0%–6.9%; group 3, 7.0%–7.9%; group 4, 8.0%–8.9%; and group 5, 9.0%–9.9%) and we investigated the difference in CRPS prevalence between the two groups. Results Of the 200 patients, 108 were in the CRPS group and 92 were in the non-CRPS group. There were significant differences in HbA1c (pCRPS prevalence (pCRPS prevalence and thus that uncontrolled blood glucose can affect CRPS occurrence in stroke patients with diabetes. PMID:27847707

  9. Diagnostic Performance of Three Phase Bone Scan for Complex Regional Pain Syndrome Type 1 with Optimally Modified Image Criteria

    Energy Technology Data Exchange (ETDEWEB)

    Kwon, Hyun Woo; Paeng, Jin Chul; Nahm, Francins Sahngun; Kim, Seog Gyun; Zehra, Tanzeel; Oh, So Won; Lee, Hyo Sang; Kang, Keon Wook; Chung, June Key; Lee, Myung Chul; Lee, Dong Soo [Seoul National Univ. College of Medicine, Seoul (Korea, Republic of)

    2011-12-15

    Although the three phase bone scan (TBPS) is one of the widely used imaging studies for diagnosing complex regional pain syndrome type 1 (CRPS 1), there is some controversy regarding the TPBS image criteria for CRPS 1. In this study, we modified the image criteria using image pattern and quantitative analysis in the patients diagnosed using the most recent consensus clinical diagnostic criteria. The study included 140 patients with suspected CRPS 1 (CRPS 1, n=79; non CRPS, n=61; mean age 39{+-}15 years) who underwent TPBS. The clinical diagnostic criteria for CRPS 1 revised by the Budapest consensus group were used for confirmative diagnosis. Patients were classified according to flow/pool and delayed uptake (DU) image patterns, and the time interval between the initiating event and TPBS (TI{sup eventscan)}. Quantitative analysis for lesion to contralateral ratio (LCR) was performed. Modified TPBS image criteria were created and evaluated for optimal diagnostic performance. Both increased and decreased periarticular DU were significant image findings for CRPS 1 (CRPS 1 positive rate=73% in the increased DU group, 75% in the decreased DU group). The TI{sup eventscand}id not differ significantly between the different image pattern groups. Quantitative analysis revealed an LCR of 1.43 was the optimal cutoff value for CRPS 1 and diagnostic performance was significantly improved in the increased DU group (area under the curve=0.732). Given the modified image criteria, the sensitivity and specificity of TPBS for diagnosing CRPS 1 were 80% and 72%, respectively. Optimally modified TPBS image criteria for CRPS 1 were suggested using image pattern and quantitative analysis. With the criteria, TPBS is an effective imaging study for CRPS 1 even with the most recent consensus clinical diagnostic criteria.

  10. The association between ACE inhibitors and the complex regional pain syndrome: Suggestions for a neuro-inflammatory pathogenesis of CRPS.

    Science.gov (United States)

    de Mos, M; Huygen, F J P M; Stricker, B H Ch; Dieleman, J P; Sturkenboom, M C J M

    2009-04-01

    Antihypertensive drugs interact with mediators that are also involved in complex regional pain syndrome (CRPS), such a neuropeptides, adrenergic receptors, and vascular tone modulators. Therefore, we aimed to study the association between the use of antihypertensive drugs and CRPS onset. We conducted a population-based case-control study in the Integrated Primary Care Information (IPCI) database in the Netherlands. Cases were identified from electronic records (1996-2005) and included if they were confirmed during an expert visit (using IASP criteria), or if they had been diagnosed by a medical specialist. Up to four controls per cases were selected, matched on gender, age, calendar time, and injury. Exposure to angiotensin converting enzyme (ACE) inhibitors, angiotensin II receptor antagonists, beta-blockers, calcium channel blockers, and diuretics was assessed from the automated prescription records. Data were analyzed using multivariate conditional logistic regression. A total of 186 cases were matched to 697 controls (102 confirmed during an expert visit plus 84 with a specialist diagnosis). Current use of ACE inhibitors was associated with an increased risk of CRPS (OR(adjusted): 2.7, 95% CI: 1.1-6.8). The association was stronger if ACE inhibitors were used for a longer time period (OR(adjusted): 3.0, 95% CI: 1.1-8.1) and in higher dosages (OR(adjusted): 4.3, 95% CI: 1.4-13.7). None of the other antihypertensive drug classes was significantly associated with CRPS. We conclude that ACE inhibitor use is associated with CRPS onset and hypothesize that ACE inhibitors influence the neuro-inflammatory mechanisms that underlie CRPS by their interaction with the catabolism of substance P and bradykinin.

  11. Role of NFkappaB in an animal model of complex regional pain syndrome-type I (CRPS-I).

    Science.gov (United States)

    de Mos, Marissa; Laferrière, André; Millecamps, Magali; Pilkington, Mercedes; Sturkenboom, Miriam C J M; Huygen, Frank J P M; Coderre, Terence J

    2009-11-01

    NFkappaB is involved in several pathogenic mechanisms that are believed to underlie the complex regional pain syndrome (CRPS), including ischemia, inflammation and sensitization. Chronic postischemia pain (CPIP) has been developed as an animal model that mimics the symptoms of CRPS-I. The possible involvement of NFkappaB in CRPS-I was studied using CPIP rats. Under sodium pentobarbital anesthesia, a tourniquet was placed around the rat left ankle joint, producing 3 hours of ischemia, followed by rapid reperfusion (IR injury). NFkappaB was measured in nuclear extracts of muscle and spinal cord tissue using ELISA. Moreover, the anti-allodynic (mechanical and cold) effect was tested for systemic, intrathecal, or intraplantar treatment with the NFkappaB inhibitor pyrrolidine dithiocarbamate (PDTC). At 2 and 48 hours after IR injury, NFkappaB was elevated in muscle and spinal cord of CPIP rats compared to shams. At 7 days, NFkappaB levels were normalized in muscle, but still elevated in spinal cord tissue. Systemic PDTC treatment relieved mechanical and cold allodynia in a dose-dependent manner, lasting for at least 3 hours. Intrathecal-but not intraplantar-administration also relieved mechanical allodynia. The results suggest that muscle and spinal NFkappaB plays a role in the pathogenesis of CPIP and potentially of human CRPS. Using the CPIP model, we demonstrate that NFkappaB is involved in the development of allodynia after a physical injury (ischemia and reperfusion) without direct nerve trauma. Since CPIP animals exhibit many features of human CRPS-I, this observation indicates a potential role for NFkappaB in human CRPS.

  12. “New” Scythian Complex of the 3rd Century BC on the Right Bank of the Lower Dniester Region

    Directory of Open Access Journals (Sweden)

    Sergey N. Razumov

    2017-09-01

    Full Text Available The article deals with the new attribution of the materials from barrow 20, excavated in 1975 near Semenovka village on the right bank of the Dniester liman, Belgorod-Dnesterovsky district, Odessa region, Ukraine. The only burial of this barrow was still considered as the monument of Babino culture (aka Multi-Cordoned Ware culture of the first quarter of the 2nd millennium BC. The ceramic and metal artifacts found under the barrow were considered during the study of the material culture of the Scythians of the last third of the 1st millennium BC. The thorough analysis of the stratigraphy, planigraphy, funeral rite and artifacts showed that barrow 20 near Semenovka village was built instantaneously, and in fact it is Scythian. A cenotaph was the main complex of the barrow. It came with not only the armament items (iron-socketed arrowheads, spearheads and sockets of spears, horse harness (bronze frontlet with axe-shaped blade and a hook, bronze ringed beads, iron bits and iron snaffle ring, iron round pendants, glass cup, remains of the funeral feast as a ceramic breakage (Rhodes, Sinop, Cos, Cnidus amphorae, two pottery jars and molded vessel, but also with the burial of a dependent person lying crouched on his left side, his head in the eastern sector, in the catacomb. Depth of the fixing of these findings corresponded to the level of the ancient horizon on which the two-sided mainland ejected from the burial construction. Based on the Rhodes amphora marked with the eponym Άγήσιππος of - manufacturer - Έπίγονος 1, the barrow dates back to the last third or last quarter of the 3rd century BC.

  13. Diagnostic Performance of Three Phase Bone Scan for Complex Regional Pain Syndrome Type 1 with Optimally Modified Image Criteria

    International Nuclear Information System (INIS)

    Kwon, Hyun Woo; Paeng, Jin Chul; Nahm, Francins Sahngun; Kim, Seog Gyun; Zehra, Tanzeel; Oh, So Won; Lee, Hyo Sang; Kang, Keon Wook; Chung, June Key; Lee, Myung Chul; Lee, Dong Soo

    2011-01-01

    Although the three phase bone scan (TBPS) is one of the widely used imaging studies for diagnosing complex regional pain syndrome type 1 (CRPS 1), there is some controversy regarding the TPBS image criteria for CRPS 1. In this study, we modified the image criteria using image pattern and quantitative analysis in the patients diagnosed using the most recent consensus clinical diagnostic criteria. The study included 140 patients with suspected CRPS 1 (CRPS 1, n=79; non CRPS, n=61; mean age 39±15 years) who underwent TPBS. The clinical diagnostic criteria for CRPS 1 revised by the Budapest consensus group were used for confirmative diagnosis. Patients were classified according to flow/pool and delayed uptake (DU) image patterns, and the time interval between the initiating event and TPBS (TI eventscan) . Quantitative analysis for lesion to contralateral ratio (LCR) was performed. Modified TPBS image criteria were created and evaluated for optimal diagnostic performance. Both increased and decreased periarticular DU were significant image findings for CRPS 1 (CRPS 1 positive rate=73% in the increased DU group, 75% in the decreased DU group). The TI eventscand id not differ significantly between the different image pattern groups. Quantitative analysis revealed an LCR of 1.43 was the optimal cutoff value for CRPS 1 and diagnostic performance was significantly improved in the increased DU group (area under the curve=0.732). Given the modified image criteria, the sensitivity and specificity of TPBS for diagnosing CRPS 1 were 80% and 72%, respectively. Optimally modified TPBS image criteria for CRPS 1 were suggested using image pattern and quantitative analysis. With the criteria, TPBS is an effective imaging study for CRPS 1 even with the most recent consensus clinical diagnostic criteria.

  14. High-Frequency Repetitive Sensory Stimulation as Intervention to Improve Sensory Loss in Patients with Complex Regional Pain Syndrome I.

    Science.gov (United States)

    David, Marianne; Dinse, Hubert R; Mainka, Tina; Tegenthoff, Martin; Maier, Christoph

    2015-01-01

    Achieving perceptual gains in healthy individuals or facilitating rehabilitation in patients is generally considered to require intense training to engage neuronal plasticity mechanisms. Recent work, however, suggested that beneficial outcome similar to training can be effectively acquired by a complementary approach in which the learning occurs in response to mere exposure to repetitive sensory stimulation (rSS). For example, high-frequency repetitive sensory stimulation (HF-rSS) enhances tactile performance and induces cortical reorganization in healthy subjects and patients after stroke. Patients with complex regional pain syndrome (CRPS) show impaired tactile performance associated with shrinkage of cortical maps. We here investigated the feasibility and efficacy of HF-rSS, and low-frequency rSS (LF-rSS) to enhance tactile performance and reduce pain intensity in 20 patients with CRPS type I. Intermittent high- or low-frequency electrical stimuli were applied for 45 min/day to all fingertips of the affected hand for 5 days. Main outcome measures were spatial two-point-discrimination thresholds and mechanical detection thresholds measured on the tip of the index finger bilaterally. Secondary endpoint was current pain intensity. All measures were assessed before and on day 5 after the last stimulation session. HF-rSS applied in 16 patients improved tactile discrimination on the affected hand significantly without changes contralaterally. Current pain intensity remained unchanged on average, but decreased in four patients by ≥30%. This limited pain relief might be due to the short stimulation period of 5 days only. In contrast, after LF-rSS, tactile discrimination was impaired in all four patients, while detection thresholds and pain were not affected. Our data suggest that HF-rSS could be used as a novel approach in CRPS treatment to improve sensory loss. Longer treatment periods might be required to induce consistent pain relief.

  15. Regional Analysis of Long-term Local and Synoptic Effects on Wind Velocity and Energy Patterns in Complex Terrain

    Science.gov (United States)

    Belu, R.; Koracin, D. R.

    2017-12-01

    Investments in renewable energy are justified in both environmental and economic terms. Climate change risks call for mitigation strategies aimed to reduce pollutant emissions, while the energy supply is facing high uncertainty by the current or future global economic and political contexts. Wind energy is playing a strategic role in the efforts of any country for sustainable development and energy supply security. Wind energy is a weather and climate-dependent resource, having a natural spatio-temporal variability at time scales ranging from fraction of seconds to seasons and years, while at spatial scales is strongly affected by the topography and vegetation. Main objective of the study is to investigate spatio-temporal characteristics of the wind velocity in the Southwest U.S., that are relevant to wind energy assessment, analysis, development, operation, and grid integration, by using long-term multiple meteorological tower observations. Wind velocity data and other meteorological parameters from five towers, located near Tonopah, Nevada, operated between 2003 to 2008, and from three towers are located in Carson Valley, Nevada, operated between 2006 and 2014 were used in this study. Multi-annual wind speed data collected did not show significant increase trends with increasing elevation; the differences are mainly governed by the topographic complexity, including local atmospheric circulations. Auto- and cross-correlations show a strong coherence between the wind speed and direction with slowly decreasing amplitude of the multi-day periodicity with increasing lag periods. Besides pronounced diurnal periodicity at all locations, detrended fluctuation analysis also showed significant seasonal and annual periodicities, and long-memory persistence with similar characteristics. In spite of significant differences in mean wind speeds among the towers, due to location specifics, the relatively high auto- and cross-correlation coefficients among the towers indicate

  16. High frequency repetitive sensory stimulation as intervention to improve sensory loss in patients with complex regional pain syndrome (CRPS I

    Directory of Open Access Journals (Sweden)

    Marianne eDavid

    2015-11-01

    Full Text Available Achieving perceptual gains in healthy individuals, or facilitating rehabilitation in patients is generally considered to require intense training to engage neuronal plasticity mechanisms. Recent work, however, suggested that beneficial outcome similar to training can be effectively acquired by a complementary approach in which the learning occurs in response to mere exposure to repetitive sensory stimulation (rSS. For example, high-frequency repetitive sensory stimulation (HF-rSS enhances tactile performance and induces cortical reorganization in healthy subjects and patients after stroke. Patients with complex regional pain syndrome (CRPS show impaired tactile performance associated with shrinkage of cortical maps. We here investigated the feasibility and efficacy of HF-rSS, and low-frequency rSS (LF-rSS to enhance tactile performance and reduce pain intensity in 20 patients with CRPS type I. Intermittent high or low frequency electrical stimuli were applied for 45min/day to all fingertips of the affected hand for 5 days. Main outcome measures were spatial 2-point-discrimination thresholds and mechanical detection thresholds measured on the tip of the index finger bilaterally. Secondary endpoint was current pain intensity. All measures were assessed before and on day 5 after the last stimulation session. HF-rSS applied in 16 patients improved tactile discrimination on the affected hand significantly without changes contralaterally. Current pain intensity remained unchanged on average, but decreased in 4 patients by 30%. This limited pain relief might be due to the short stimulation period of 5 days only. In contrast, after LF-rSS, tactile discrimination was impaired in all 4 patients, while detection thresholds and pain were not affected. Our data suggest that HF-rSS could be used as a novel approach in CRPS treatment to improve sensory loss. Longer treatment periods might be required to induce consistent pain relief.

  17. DNA-PK dependent targeting of DNA-ends to a protein complex assembled on matrix attachment region DNA sequences

    International Nuclear Information System (INIS)

    Mauldin, S.K.; Getts, R.C.; Perez, M.L.; DiRienzo, S.; Stamato, T.D.

    2003-01-01

    Full text: We find that nuclear protein extracts from mammalian cells contain an activity that allows DNA ends to associate with circular pUC18 plasmid DNA. This activity requires the catalytic subunit of DNA-PK (DNA-PKcs) and Ku since it was not observed in mutants lacking Ku or DNA-PKcs but was observed when purified Ku/DNA-PKcs was added to these mutant extracts. Competition experiments between pUC18 and pUC18 plasmids containing various nuclear matrix attachment region (MAR) sequences suggest that DNA ends preferentially associate with plasmids containing MAR DNA sequences. At a 1:5 mass ratio of MAR to pUC18, approximately equal amounts of DNA end binding to the two plasmids were observed, while at a 1:1 ratio no pUC18 end-binding was observed. Calculation of relative binding activities indicates that DNA-end binding activities to MAR sequences was 7 to 21 fold higher than pUC18. Western analysis of proteins bound to pUC18 and MAR plasmids indicates that XRCC4, DNA ligase IV, scaffold attachment factor A, topoisomerase II, and poly(ADP-ribose) polymerase preferentially associate with the MAR plasmid in the absence or presence of DNA ends. In contrast, Ku and DNA-PKcs were found on the MAR plasmid only in the presence of DNA ends. After electroporation of a 32P-labeled DNA probe into human cells and cell fractionation, 87% of the total intercellular radioactivity remained in nuclei after a 0.5M NaCl extraction suggesting the probe was strongly bound in the nucleus. The above observations raise the possibility that DNA-PK targets DNA-ends to a repair and/or DNA damage signaling complex which is assembled on MAR sites in the nucleus

  18. The mineralogy and geochemistry of quartz-tourmaline schlieren in the granites of the Primorsky Complex, Western Baikal Region

    Science.gov (United States)

    Savel'eva, V. B.; Bazarova, E. P.; Kanakin, S. V.

    2014-12-01

    Quartz-tourmaline schlieren have been found within rapakivi-like granites of the Early Proterozoic Primorsky Complex in the Western Baikal Region. These rocks are biotite leucogranites with normal alkalinity (A/CNK = 1.00-1.04); a high iron mole fraction (92-95%); a K2O/Na2O value of about 2.0; relatively high F, Li, Rb, Cs, Sn, Pb, Th, and U contents; and low Ba, Sr, Eu, Zn, Sc, and V contents. The schlieren composed of quartz and tourmaline with relics of feldspar also contain fluorite, rare muscovite, chlorite, and accessory rutile, ilmenite, zircon, monazite, xenotime, and bastnäsite. B2O3 and F contents in the schlieren are 2.29-2.63 and 0.30-0.47 wt %, respectively. Fe2O3 (4.8-5.4 wt %), F, and H2O contents are higher in these schlieren than in the host granite, while SiO2, CaO, Na2O, K2O, and P2O5 contents are lower than in host rocks. K2O/Na2O values decrease in the schlieren down to 0.4. Enrichment of the schlieren in Fe and other ore elements (Zn, Co, Cu, Sn, etc.), together with B, F, H2O, and Na, suggests that they crystallized from fluid-saturated melt segregated from aluminosilicate melt in the apical part of a shallow-seated intrusion. The formation of tourmaline may be related to the interaction of the fluid with feldspars in the crystallizing granites; it was accompanied by a separation of fluid F-CO2. Quartz precipitated at the next stage, due to the acidic character of the aqueous fluid. In general, the relationships of minerals in the schlieren indicate distinct fractionation of LREE, HREE, and Y in the fluid-saturated melt.

  19. Insecticide-treated net ownership and utilization and factors that influence their use in Itang, Gambella region, Ethiopia: cross-sectional study

    Directory of Open Access Journals (Sweden)

    Watiro AH

    2016-05-01

    Full Text Available Aklilu Habte Watiro,1 Worku Awoke,2 1Médecins Sans Frontières OCA (MSF Holland Ethiopia Mission, Addis Ababa, 2Department of Epidemiology, School of Public Health, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia Background: Malaria remains a major public health problem in Ethiopia. Consequently, Ethiopia designed the 2011–2015, Malaria Prevention and Control Strategic Plan to fight the vector. It was discovered that most of the studies conducted on the use of insecticide-treated nets (ITNs were not in line with the strategic plan of the country. This study aimed to assess ITN ownership and utilization, and includes barriers related to its use among the target-area population at household (HH level. Materials and methods: A cross-sectional design was employed in Itang for this study. Data were collected by trained nurses through face-to-face interview and observation. A total of 845 participants were selected through multistage sampling, and the size was determined by using a single-population proportion formula. EPI Info and SPSS was used for analysis, and all necessary statistical association was computed in order to explain the outcome variable through explanatory variables of this study. Results: Among 845 HHs interviewed, 81.7% (690 had at least one ITN, while 52.3% (361 had used the ITN the night preceding the data-collection day. HH awareness of malaria prevention, number of ITNs, family size, number of family members sharing sleeping area/beds, sleeping patterns of adolescents, HH-head age, and inconvenience of using ITNs were found to be barriers to the use of ITNs in this study. Conclusion and recommendation: The study concluded that very few HHs owned ITNs and there was very low usage of ITNs. In recommendation, the regional health bureau and district health office should consider bigger nets that can accommodate family members who share the same sleeping area/bed in the area. Keywords: consistent

  20. Dissection of the D-region of the human major histocompatibility complex by means of induced mutations in a lymphoblastoid cell line

    International Nuclear Information System (INIS)

    DeMars, R.; Chang, C.C.; Rudersdorf, R.A.

    1983-01-01

    Twenty-six human lymphoblastoid cell mutants that had lost expressions of HLA-DR were created with a two-step procedure: (i) A mutant from which one entire haplotype had been physically deleted by gamma-rays was isolated by means of immunoselection against cells expressing a specific HLA-B antigen. (ii) This heterozygous deletion mutant was irradiated with gamma-rays or treated with ICR 191, a frameshift mutagen, and mutants that no longer expressed the remaining DR1 antigen were selected with a monoclonal antibody directed against a monomorphic DR determinant. Monoclonal antibody GENOX 3.53 was used to show that four of the gamma-ray induced DR-null mutants did not express the cis-linked MB1/MT1 locus. Since MB1/MT1 was still expressed in the other 16 gamm-ray induced and 6 ICR 191-induced DR-null mutants, the separate loss of expression of MB1/MT1 and DR1 is strong evidence that the DR1 and MB1/MT1 alloantigens are under separate genetic control in the cells we used. Since DR-null mutants bound SB2-specific monoclonal antibody ILR1, whether or not they expressed MB1/MT1, the results mean that gamma-rays resolved the genetic determinants for DR1, MB1/MT1, and SB2. Additional complexity of determinants encoded by D-region genes is indicated by the following results. The amount of MB1/MT1 antigen that was detected with ELISA tests for binding of GENOX 3.53 antibody to cells varied inversely with the number of expressed copies of DR or of a locus near DR. This could result from an increased amount of MB1/MT1 antigen or from increased binding accessibility of GENOZ 3.53-reactive antigen in DR-null mutants. Monoclonal antibodies CC 11.23 and CC 6.4 displayed patterns of binding to parental and diverse mutant cells that differed from that of GENOX 3.53, suggesting the existence of at least one additional D-region antigen that is neither SB, DR, nor MB/MT

  1. Prognostic Value of Plasma Epstein-Barr Virus DNA for Local and Regionally Advanced Nasopharyngeal Carcinoma Treated With Cisplatin-Based Concurrent Chemoradiotherapy in Intensity-Modulated Radiotherapy Era.

    Science.gov (United States)

    Chen, Wen-Hui; Tang, Lin-Quan; Guo, Shan-Shan; Chen, Qiu-Yan; Zhang, Lu; Liu, Li-Ting; Qian, Chao-Nan; Guo, Xiang; Xie, Dan; Zeng, Mu-Sheng; Mai, Hai-Qiang

    2016-02-01

    This study aimed to evaluate the prognostic value of plasma Epstein-Barr Virus DNA (EBV DNA) for local and regionally advanced nasopharyngeal carcinoma (NPC) patients treated with concurrent chemoradiotherapy in intensity-modulated radiotherapy (IMRT) era.In this observational study, 404 nonmetastatic local and regionally advanced NPC patients treated with IMRT and cisplatin-based concurrent chemotherapy were recruited. Blood samples were collected before treatment for examination of plasma EBV DNA levels. We evaluated the association of pretreatment plasma EBV DNA levels with progression-free survival rate (PFS), distant metastasis-free survival rate (DMFS), and overall survival rate (OS).Compared to patients with an EBV DNA level advanced NPC patients treated with IMRT and cisplatin-based concurrent chemotherapy. Future ramdomized clinical trials are needed to further evaluate whether plasma EBV DNA levels could be applied to guide concurrent chemotherapy regimen for local and regionally advanced NPC patients.

  2. Dandruff: How to Treat

    Medline Plus

    Full Text Available ... the causes, which appear to be complex. The most effective way to treat and control dandruff is ... when outdoors and seeking shade whenever possible. For most people, dandruff does not require medical attention. However, ...

  3. Dandruff: How to Treat

    Medline Plus

    Full Text Available ... C. Fox Award and Lectureship Grants from outside organizations Health Volunteers Overseas Grant Honorary International Society Meeting ... complex. The most effective way to treat and control dandruff is to use dandruff shampoo and scalp ...

  4. Dandruff: How to Treat

    Medline Plus

    Full Text Available ... Rotation PICMED Grant Professionalism Award Resident-Fellow QI Project Award Resident International Grant Resident Scholarship to Legislative ... are still studying the causes, which appear to be complex. The most effective way to treat and ...

  5. Dandruff: How to Treat

    Medline Plus

    Full Text Available ... Mohs AUC MyDermPath+ Psoriasis Patient education resources Practice Management Center Coding and reimbursement Coding MACRA Fee schedule ... complex. The most effective way to treat and control dandruff is to use dandruff shampoo and scalp ...

  6. Treatment of Patients With Complex Regional Pain Syndrome Type I With Mannitol: A Prospective, Randomized, Placebo-Controlled, Double-Blinded Study

    NARCIS (Netherlands)

    Perez, R.S.G.M.; Pragt, E.; Geurts, J.J.G.; Zuurmond, W.W.A.; Patijn, J.; van Kleef, M.

    2008-01-01

    To assess the effects of intravenous administration of the free radical scavenger mannitol 10% on complaints associated with complex regional pain syndrome Type I (CRPS I), a randomized, placebo-controlled, double-blinded trial was performed. Forty-one CRPS I patients according to the Bruehl et al

  7. Modified Graded Motor Imagery for Complex Regional Pain Syndrome Type 1 of the Upper Extremity in the Acute Phase: A Patient Series

    Science.gov (United States)

    Lagueux, Emilie; Charest, Joelle; Lefrancois-Caron, Eve; Mauger, Marie-Eve; Mercier, Emilie; Savard, Kim; Tousignant-Laflamme, Yannick

    2012-01-01

    Complex regional pain syndrome (CRPS) is a pathologic condition in which the painful experience is disproportionate in time and intensity in comparison with the inciting event. At present, the pathophysiology of CRPS is not well understood. Several studies have indicated that cortical reorganization plays a role in the persistence of the symptoms.…

  8. Oxidative Stress in Complex Regional Pain Syndrome (CRPS): No Systemically Elevated Levels of Malondialdehyde, F2-Isoprostanes and 8OHdG in a Selected Sample of Patients

    NARCIS (Netherlands)

    Fischer, S.G.L.; Perez, R.S.G.M.; Nouta, J.; Zuurmond, W.W.A.; Scheffer, P.G.

    2013-01-01

    Exaggerated inflammation and oxidative stress are involved in the pathogenesis of Complex Regional Pain Syndrome (CRPS). However, studies assessing markers for oxidative stress in CRPS patients are limited. In this study, markers for lipid peroxidation (malondialdehyde and F2-isoprostanes) and DNA

  9. Human papillomavirus vaccines, complex regional pain syndrome, postural orthostatic tachycardia syndrome, and autonomic dysfunction - a review of the regulatory evidence from the European Medicines Agency

    DEFF Research Database (Denmark)

    Jefferson, Tom; Jørgensen, Lars

    2017-01-01

    Recent concerns about a possible association between exposure of young women to human papillomavirus (HPV) vaccines and two "dysautonomic syndromes" (a collection of signs and symptoms thought to be caused by autoimmunity) - complex regional pain syndrome (CRPS) and postural orthostatic tachycardia...

  10. Monitoring of radionuclides in the forest ecosystems of the Krasnoyarsk region in the 30 km area around the mining and chemical complex

    International Nuclear Information System (INIS)

    Dement'eva, D.V.; Bolsunovskij, A.Ya.

    2010-01-01

    The study addresses accumulation of radionuclides by mushrooms and berry shrubs in the forest ecosystems around the mining and chemical complex (MCC, Krasnoyarsk region, Russia). Results of determination of radionuclide levels in mushrooms and shrubs were used to calculate transfer factors. (authors)

  11. Composition and seasonal phenology of a nonindigenous root-feeding weevil (Coleoptera: Curculionidae) complex in northern hardwood forests in the Great Lakes Region

    Science.gov (United States)

    R. A. Pinski; W. J. Mattson; K. F. Raffa

    2005-01-01

    Phyllobius oblongus (L.), Polydrusus sericeus (Schaller), and Sciaphilus asperatus (Bonsdorff) comprise a complex of nonindigenous root-feeding weevils in northern hardwood forests of the Great Lakes region. Little is known about their detailed biology, seasonality, relative abundance, and distribution patterns....

  12. Complex regional pain syndrome type I : Use of the International Association for the Study of Pain diagnostic criteria defined in 1994

    NARCIS (Netherlands)

    Reinders, M.F.; Geertzen, J.H.B.; Dijkstra, P.U.

    2002-01-01

    Objectives: The objective was to assess the reported use in recent publications of the diagnostic criteria for complex regional pain syndrome type I (CRPS 1) proposed by the International Association for the Study of Pain (IASP) in 1994. Methods: A literature search of MEDLINE (January 1996 to July

  13. Effects of 4D-Var Data Assimilation Using Remote Sensing Precipitation Products in a WRF Model over the Complex Terrain of an Arid Region River Basin

    Directory of Open Access Journals (Sweden)

    Xiaoduo Pan

    2017-09-01

    Full Text Available Individually, ground-based, in situ observations, remote sensing, and regional climate modeling cannot provide the high-quality precipitation data required for hydrological prediction, especially over complex terrains. Data assimilation techniques can be used to bridge the gap between observations and models by assimilating ground observations and remote sensing products into models to improve precipitation simulation and forecasting. However, only a small portion of satellite-retrieved precipitation products assimilation research has been implemented over complex terrains in an arid region. Here, we used the weather research and forecasting (WRF model to assimilate two satellite precipitation products (The Tropical Rainfall Measuring Mission: TRMM 3B42 and Fengyun-2D: FY-2D using the 4D-Var data assimilation method for a typical inland river basin in northwest China’s arid region, the Heihe River Basin, where terrains are very complex. The results show that the assimilation of remote sensing precipitation products can improve the initial WRF fields of humidity and temperature, thereby improving precipitation forecasting and decreasing the spin-up time. Hence, assimilating TRMM and FY-2D remote sensing precipitation products using WRF 4D-Var can be viewed as a positive step toward improving the accuracy and lead time of numerical weather prediction models, particularly over regions with complex terrains.

  14. Development of a symptoms questionnaire for complex regional pain syndrome and potentially related illnesses: the Trauma Related Neuronal Dysfunction Symptoms Inventory

    NARCIS (Netherlands)

    Collins, S.; van Hilten, J.J.; Marinus, J.J.; Zuurmond, W.W.A.; de Lange, J.J.; Perez, R.S.G.M.

    2008-01-01

    Collins S, van Hilten JJ, Marinus J, Zuurmond WW, de Lange JJ, Perez RS. Development of a symptoms questionnaire for complex regional pain syndrome and potentially related illnesses: the Trauma Related Neuronal Dysfunction Symptoms Inventory. Objective: To develop a questionnaire to evaluate

  15. Low-Dose Intravenous Immunoglobulin Treatment for Long-Standing Complex Regional Pain Syndrome: A Randomized Trial.

    Science.gov (United States)

    Goebel, Andreas; Bisla, Jatinder; Carganillo, Roy; Frank, Bernhard; Gupta, Rima; Kelly, Joanna; McCabe, Candy; Murphy, Caroline; Padfield, Nick; Phillips, Ceri; Sanders, Mark; Serpell, Mick; Shenker, Nick; Shoukrey, Karim; Wyatt, Lynne; Ambler, Gareth

    2017-10-03

    Two small trials suggest that low-dose intravenous immunoglobulin (IVIg) may improve the symptoms of complex regional pain syndrome (CRPS), a rare posttraumatic pain condition. To confirm the efficacy of low-dose IVIg compared with placebo in reducing pain during a 6-week period in adult patients who had CRPS from 1 to 5 years. 1:1 parallel, randomized, placebo-controlled, multicenter trial for 6 weeks, with an optional 6-week open extension. Patients were randomly assigned to 1 of 2 study groups between 27 August 2013 and 28 October 2015; the last patient completed follow-up on 21 March 2016. Patients, providers, researchers, and outcome assessors were blinded to treatment assignment. (ISRCTN42179756). 7 secondary and tertiary care pain management centers in the United Kingdom. 111 patients with moderate or severe CRPS of 1 to 5 years' duration. IVIg, 0.5 g/kg of body weight, or visually indistinguishable placebo of 0.1% albumin in saline on days 1 and 22 after randomization. The primary outcome was 24-hour average pain intensity, measured daily between days 6 and 42, on an 11-point (0- to 10-point) rating scale. Secondary outcomes were pain interference and quality of life. The primary analysis sample consisted of 108 eligible patients, 103 of whom had outcome data. Mean (average) pain scores were 6.9 points (SD, 1.5) for placebo and 7.2 points (SD, 1.3) for IVIg. The adjusted difference in means was 0.27 (95% CI, -0.25 to 0.80; P = 0.30), which excluded the prespecified, clinically important difference of -1.2. No statistically significant differences in secondary outcomes were found between the groups. In the open extension, 12 of the 67 patients (18%) who received 2 IVIg infusions had pain reduction of at least 2 points compared with their baseline score. Two patients in the blinded phase (1 in the placebo and 1 in the IVIg group) and 4 in the open IVIg phase had serious events. Results do not apply to patients who have had CRPS for less than 1 year or more

  16. Systemic inflammatory mediators in post-traumatic complex regional pain syndrome (CRPS I) - longitudinal investigations and differences to control groups.

    Science.gov (United States)

    Schinkel, Christian; Scherens, A; Köller, M; Roellecke, G; Muhr, G; Maier, C

    2009-03-17

    The Complex Regional Pain Syndrome I (CRPS I) is a disease that might affect an extremity after trauma or operation. The pathogenesis remains yet unclear. It has clinical signs of severe local inflammation as a result of an exaggerated inflammatory response but neurogenic dysregulation also contributes to it. Some studies investigated the role inflammatory mediators and cytokines; however, few longitudinal studies exist and control groups except healthy controls were not investigated yet. To get further insights into the role of systemic inflammatory mediators in CRPS I, we investigated a variety of pro-, anti-, or neuro-inflammatory mediators such as C-Reactive Protein (CRP), White Blood Cell Count (WBC), Interleukins 4, 6, 8, 10, 11, 12 (p70), Interferon gamma, Tumor-Necrosis-Factor alpha (TNF-a) and its soluble Receptors I/II, soluble Selectins (E,L,P), Substance-P (SP), and Calcitonin Gene-Related Peptide (CGRP) at different time points in venous blood from patients with acute (AC) and chronic (CC) CRPS I, patients with forearm fractures (FR), with neuralgia (NE), and from healthy volunteers (C). No significant changes for serum parameters investigated in CRPS compared to control groups were found except for CC/C (CGRP p = 0.007), FR/C (CGRP p = 0.048) and AC/CC (IL-12 p = 0.02; TNFRI/II p = 0.01; SP p = 0.049). High interindividual variations were observed. No intra- or interindividual correlation of parameters with clinical course (e.g. chronification) or outcome was detectable. Although clinically appearing as inflammation in acute stages, local rather than systemic inflammatory responses seem to be relevant in CRPS. Variable results from different studies might be explained by unpredictable intermittent release of mediators from local inflammatory processes into the blood combined with high interindividual variabilities. A clinically relevant difference to various control groups was not notable in this pilot study. Determination of systemic inflammatory

  17. Systemic inflammatory mediators in post-traumatic Complex Regional Pain Syndrome (CRPS I - longitudinal investigations and differences to control groups

    Directory of Open Access Journals (Sweden)

    Schinkel Ch

    2009-03-01

    Full Text Available Abstract Objectives The Complex Regional Pain Syndrome I (CRPS I is a disease that might affect an extremity after trauma or operation. The pathogenesis remains yet unclear. It has clinical signs of severe local inflammation as a result of an exaggerated inflammatory response but neurogenic dysregulation also contributes to it. Some studies investigated the role inflammatory mediators and cytokines; however, few longitudinal studies exist and control groups except healthy controls were not investigated yet. Methods To get further insights into the role of systemic inflammatory mediators in CRPS I, we investigated a variety of pro-, anti-, or neuro-inflammatory mediators such as C-Reactive Protein (CRP, White Blood Cell Count (WBC, Interleukins 4, 6, 8, 10, 11, 12 (p70, Interferon gamma, Tumor-Necrosis-Factor alpha (TNF-α and its soluble Receptors I/II, soluble Selectins (E, L, P, Substance-P (SP, and Calcitonin Gene-Related Peptide (CGRP at different time points in venous blood from patients with acute (AC and chronic (CC CRPS I, patients with forearm fractures (FR, with neuralgia (NE, and from healthy volunteers (C. Results No significant changes for serum parameters investigated in CRPS compared to control groups were found except for CC/C (CGRP p = 0.007, FR/C (CGRP p = 0.048 and AC/CC (IL-12 p = 0.02; TNFRI/II p = 0.01; SP p = 0.049. High interindividual variations were observed. No intra-or interindividual correlation of parameters with clinical course (e.g. chronification or outcome was detectable. Conclusion Although clinically appearing as inflammation in acute stages, local rather than systemic inflammatory responses seem to be relevant in CRPS. Variable results from different studies might be explained by unpredictable intermittent release of mediators from local inflammatory processes into the blood combined with high interindividual variabilities. A clinically relevant difference to various control groups was not notable in this

  18. [Prevalence and Co-prevalence of Complex Regional Pain Syndrome (CRPS) and Carpal Tunnel Syndrome (CTS) in Hand Rehabilitation].

    Science.gov (United States)

    Neubrech, F; Gentzsch, T; Kotsougiani, D; Bickert, B; Kneser, U; Harhaus, L

    2016-06-01

    In the current literature, there are reports of associations between complex regional pain syndromes (CRPS) and carpal tunnel syndromes (CTS). The aim of this study was to determine the prevalence of both disease patterns in hand rehabilitation patients and to investigate whether there is a correlation between CTS and CRPS. Furthermore, differences in the healing process of patients with and without additional CTS, and the effectiveness of the rehabilitative therapy for both diseases, were investigated. The computerised medical records of 791 patients in the years 2009-2015 who had been in hand rehabilitation were retrospectively analysed. At the beginning and end of rehabilitation, measurements were made of pain by visual analogue scales (VAS, 0-10), grip strength and finger mobility (mean distance from finger pulp to palmar D2-D5). The clinical course was statistically analysed. CRPS diagnosis was confirmed clinically by a pain therapist, CTS diagnosis was confirmed by neurological and neurophysiological examination. Surgical therapy was performed despite CRPS diagnosis. The prevalence of CRPS was 161/1000 and of CTS 62/1000; the co-prevalence of the 2 diagnoses was 24/1000 (pCRPS group, after a mean of 8 (1-21) weeks of rehabilitative therapy, mean pain was reduced from 5 (1-10) to 3 (0-9), grip strength improved from 10 (0-39)kg to 18.5 (2.5-45.5)kg and finger mobility increased from 2.9 (0-7.6)cm to 1.8 (0-7.8)cm. In the CRPS+CTS group, after a mean of 6.8 (3-23) weeks of rehabilitative therapy, mean pain was reduced from 5 (0-8) to 2.6 (0-5), grip strength improved from 9.7 (2.4-25.5)kg to 17.4 (0.9-47.4)kg and finger mobility increased from 2.7 (0-5.3)cm to 1.7 (0-5.3)cm. Improvement over the period of rehabilitation was significant in both groups, though the period of therapy was significantly shorter in the CRPS+CTS group. CRPS and CTS are often associated. Rehabilitative therapy was effective for CRPS- and CRPS+CTS patients. © Georg Thieme Verlag KG

  19. Impact of ictal/postictal regional cerebral blood flow patterns on the management of patients with complex partial seizures

    International Nuclear Information System (INIS)

    Borbely, K.; Toth, M.; Solyom, A.; Balogh, A.; Juhos, V.; Neuwirth, M.; Halasz, P.

    2002-01-01

    Aims: RCBF SPECT has been proved to be a sensitive and specific method in the pre-surgical evaluation of patients with complex partial seizures (CPS). Ictal minus interictal rCBF analysis is a routine part in the assessment of epileptogenic foci. During ictal/postictal rCBF studies changes might appear not only in the epileptogenic area. The precise note of the time of the tracer injection for SPECT is the key in interpreting the brain perfusion changes. We studied ictal/postictal rCBF patterns in the brain tissue within, adjacent to, and remote from the epileptogenic foci in 64 patients with CPS. Methods: The assessment included neurological examination, ictal semiology, interictal and ictal electrophysiological recording, MRI, and neuropsychological evaluation. Baseline, ictal and/or postictal SPECT studies were carried out with a standard technique for each patient. SPECT data were analysed visually and by a special region of interests (ROIs) program. Circular ROIs were placed over the basal ganglia, thalamus, frontal, temporal, parietal, occipital cortex, and cerebellum. ROIs were normalized to the whole brain average. The statistical analysis was considered significant at P<0.05. MRI was positive in 46 patients, while in 18 cases there were no abnormalities. SPECT results were compared to electrophysiological and surgical findings. Results: The baseline SPECT demonstrated a significant hypoperfusion (P<0.05) in the epileptogenic area (EA) in 37/64 (57.81%) cases. 54/64 (84.38%) of the ictal studies showed a marked hyperperfusion (P<0.005) in the EA with low cerebellar tracer uptake (P<0.05). In 26/64 (40.63%) patients the early postictal studies demonstrated moderate or high tracer uptake in the EA (P<0.05) with diffuse perfusion abnormalities in the surrounding tissue. Late postictal studies (14/64, 21.88%) showed hypoperfusion (P<0.05) in the EA with moderate or high tracer uptake in the surrounding tissue. The results of the ictal/postictal studies

  20. COMPLEX EVALUATION OF THE NUMBER DYNAMICS OF COLONIAL WATERBIRD COMMUNITIES (THE CASE OF SOME ISLANDS OF SIVASH REGION

    Directory of Open Access Journals (Sweden)

    Matsyura A.V.

    2011-12-01

    Full Text Available The problem of the mathematical analysis of the number dynamics of the nesting waterbirds for the islands of the south of Ukraine is examined. The algorithm of the evaluation of changes in the number of island birds is proposed. Data of the long-term monitoring of the number of birds were analyzed according to this algorithm. The necessity of the implementation of the statistical indices together with the graphic representation of island birds’ turnover is proved. The trends of population dynamics are determined for the key species. The discussed procedure of the complex evaluation is proposed for the management planning of the island bird species and their habitats. The performed analysis of the number dynamics of the key-stone breeding island birds showed that, with the exception of little tern, the population status and the prognosis of number are sufficiently favorable. From the data of long-term monitoring we came up with the conclusion about the existence of island habitats with carrying capacity to maintain the additional number of breeding birds. In the case of unfavorable conditions like strengthening of anthropogenic press, concurrent interrelations, deficiency of feed resources or drastic reduction of breeding biotopes, the birds due to turnover are capable to successfully react even without reducing their number and breeding success. The extinction rate of the breeding bird species from the island sites directly correlates with the number of breeding species. For the species with equal abundance, the extinction probability is higher for birds, whose numbers are unstable and characterized by significant fluctuations. This testifies the urgency of the constant monitoring and analysis of the number dynamics of breeding bird species in region. The suggested procedure of analysis is recommended for drawing up of management plans and performing of prognoses of number of breeding island bird species. More detail analysis with use of

  1. Complex refractive indices in the near-ultraviolet spectral region of biogenic secondary organic aerosol aged with ammonia

    Energy Technology Data Exchange (ETDEWEB)

    Flores, J. M.; Washenfelder, Rebecca; Adler, Gabriela; Lee, H-J; Segev, Lior; Laskin, Julia; Laskin, Alexander; Nizkorodov, Sergey; Brown, Steven; Rudich, Yinon

    2014-05-14

    Atmospheric absorption by brown carbon aerosol may play an important role in global radiative forcing. Brown carbon arises from both primary and secondary sources, but the mechanisms and reactions for the latter are highly uncertain. One proposed mechanism is the reaction of ammonia or amino acids with carbonyl products in secondary organic aerosol (SOA). We generated SOA in situ by reacting biogenic alkenes (α-pinene, limonene, and α-humulene) with excess ozone, humidifying the resulting aerosol, and reacting the humidified aerosol with gaseous ammonia. We determined the complex refractive indices (RI) in the 360 – 420 nm range for these aerosols using broadband cavity enhanced spectroscopy (BBCES). The average real part (n) of the measured spectral range of the NH3-aged α-pinene SOA increased from n = 1.50 (±0.01) for the unreacted SOA to n = 1.57 (± 0.01) after a 1.5h exposure to 1.9 ppm NH3; whereas,the imaginary component (k) remained below k < 0.001 (± 0.002). For the limonene and α-humulene SOA the real part did not change significantly, and we observed a small change in the imaginary component of the RI. The imaginary component increased from k = 0.0 to an average k= 0.029 (± 0.021) for α-humulene SOA, and from k < 0.001 (± 0.002) to an average k = 0.032 (±0.019) for limonene SOA after a 1.5 h exposure to 1.3 and 1.9 ppm of NH3, respectively. Collected filter samples of the aged and unreacted α-pinene SOA and limonene SOA were analyzed off-line with nanospray desorption electrospray ionization high resolution mass spectrometry (nano-DESI/HR-MS), and in-situ with a Time-of-Fligh Aerosol Mass Spectrometer, confirming that the SOA reacted and that various nitrogen-containing reaction products formed. If we assume that NH3 aging reactions scale linearly with time and concentration, then a 1.5 h reaction with 1 ppm NH3 in the laboratory is equivalent to 24 h reaction with 63 ppbv NH3, indicating that the observed aerosol absorption will be limited

  2. Bisphosphonates Inhibit Pain, Bone Loss, and Inflammation in a Rat Tibia Fracture Model of Complex Regional Pain Syndrome.

    Science.gov (United States)

    Wang, Liping; Guo, Tian-Zhi; Hou, Saiyun; Wei, Tzuping; Li, Wen-Wu; Shi, Xiaoyou; Clark, J David; Kingery, Wade S

    2016-10-01

    Bisphosphonates are used to prevent the bone loss and fractures associated with osteoporosis, bone metastases, multiple myeloma, and osteogenesis deformans. Distal limb fractures cause regional bone loss with cutaneous inflammation and pain in the injured limb that can develop into complex regional pain syndrome (CRPS). Clinical trials have reported that antiresorptive bisphosphonates can prevent fracture-induced bone loss, inhibit serum inflammatory cytokine levels, and alleviate CRPS pain. Previously, we observed that the inhibition of inflammatory cytokines or adaptive immune responses attenuated the development of pain behavior in a rat fracture model of CRPS, and we hypothesized that bisphosphonates could prevent pain behavior, trabecular bone loss, postfracture cutaneous cytokine upregulation, and adaptive immune responses in this CRPS model. Rats underwent tibia fracture and cast immobilization for 4 weeks and were chronically administered either subcutaneously perfused alendronate or oral zoledronate. Behavioral measurements included hindpaw von Frey allodynia, unweighting, warmth, and edema. Bone microarchitecture was measured by microcomputed tomography, and bone cellular activity was evaluated by static and dynamic histomorphometry. Spinal cord Fos immunostaining was performed, and skin cytokine (tumor necrosis factor, interleukin [IL]-1, IL-6) and nerve growth factor (NGF) levels were determined by enzyme immunoassay. Skin and sciatic nerve immunoglobulin levels were determined by enzyme immunoassay. Rats with tibia fractures developed hindpaw allodynia, unweighting, warmth, and edema, increased spinal Fos expression and trabecular bone loss in the lumbar vertebra and bilateral distal femurs as measured by microcomputed tomography, increased trabecular bone resorption and osteoclast surface with decreased bone formation rates, increased cutaneous inflammatory cytokine and NGF expression, and elevated immunocomplex deposition in skin and nerve

  3. The Complex Stratigraphy of the Highland Crust in the Serenitatis Region of the Moon Inferred from Mineral Fragment Chemistry

    Science.gov (United States)

    Ryder, Graham; Norman, Marc D.; Taylor, G. Jeffrey

    1997-01-01

    rocks do not contribute significantly to the fragment population. Nor do ferroan anorthosites contribute more than a tiny part of even the plagiociase fragment population. A few mineral fragments that are consistent with the cryptic low-K Fra Mauro chemical component were found, and these appear to be from gabbroic sources. The mineral fragment populations cannot be mixed in their observed proportions to produce the whole rock composition, because the fragments are more refractory and deficient in Ti, P, and alkalis. A preferential contribution to the melt from a rock similar to sodic ferrogabbro can partly resolve the discrepancy. The population of mineral fragments requires a very diverse population of igenous rocks that are not all related to each other, demonstrating the existence of a complex crust built of numerous separate igneous plutons. Many of these plutons may have crystallized at shallow depths. The chemical composition of the melt breccias, in combination with the mineral fragment data and an understanding of the cratering process, suggests that the deepest crust sampled by the Serenitatis impace (not necessarily the deepest crust) was basaltic in composition, including KREEP and gabbroic rocks like sodic ferrogabbro, and lacking abundant olivine-rich material. These were overlain by Mg-suite rocks of varied types, including norites and troctolites that supplied most of the olivine mineral fragments. Granulities, which are metamorphosed and more feldspathic breccias, were abundant near the surface. Remote sensing indicates that the entire Serenitatis region lacks ferroan anorthosite, consistent with the results of our study.

  4. ITS all right mama: investigating the formation of chimeric sequences in the ITS2 region by DNA metabarcoding analyses of fungal mock communities of different complexities.

    Science.gov (United States)

    Bjørnsgaard Aas, Anders; Davey, Marie Louise; Kauserud, Håvard

    2017-07-01

    The formation of chimeric sequences can create significant methodological bias in PCR-based DNA metabarcoding analyses. During mixed-template amplification of barcoding regions, chimera formation is frequent and well documented. However, profiling of fungal communities typically uses the more variable rDNA region ITS. Due to a larger research community, tools for chimera detection have been developed mainly for the 16S/18S markers. However, these tools are widely applied to the ITS region without verification of their performance. We examined the rate of chimera formation during amplification and 454 sequencing of the ITS2 region from fungal mock communities of different complexities. We evaluated the chimera detecting ability of two common chimera-checking algorithms: perseus and uchime. Large proportions of the chimeras reported were false positives. No false negatives were found in the data set. Verified chimeras accounted for only 0.2% of the total ITS2 reads, which is considerably less than what is typically reported in 16S and 18S metabarcoding analyses. Verified chimeric 'parent sequences' had significantly higher per cent identity to one another than to random members of the mock communities. Community complexity increased the rate of chimera formation. GC content was higher around the verified chimeric break points, potentially facilitating chimera formation through base pair mismatching in the neighbouring regions of high similarity in the chimeric region. We conclude that the hypervariable nature of the ITS region seems to buffer the rate of chimera formation in comparison with other, less variable barcoding regions, due to shorter regions of high sequence similarity. © 2016 John Wiley & Sons Ltd.

  5. STATISTICAL ASSESSMENT OF THE INFLUENCE OF THE INVESTMENT IN INFRASTRUCTURE COMPLEX ON ECONOMIC SITUATION IN THE REGION

    Directory of Open Access Journals (Sweden)

    Nina A. Malinovskaya

    2014-01-01

    Full Text Available The article deals with the problem of assessing the impact of infrastructure investment on the economic situation of the region. It is suggested that economic and social effects of, as well as instant and deferred. Using regression analysis allowed us to estimate the nature of different types of effects that affect the economic system of the region.

  6. Transforming Your Regional Economy through Uncertainty and Surprise: Learning from Complexity Science, Network Theory and the Field

    Science.gov (United States)

    Holley, June

    The field of regional development blossomed in the last decade, as researchers and practitioners increasingly asserted that the region was the most effective geographic unit for supporting the excellence and innovation of entrepreneurs. See, for example, the many studies by the European Union and the work by Michael Porter.

  7. Wireless peripheral nerve stimulation for complex regional pain syndrome type I of the upper extremity: a case illustration introducing a novel technology.

    Science.gov (United States)

    Herschkowitz, Daniel; Kubias, Jana

    2018-04-13

    Complex regional pain syndrome (CRPS) is a debilitating painful disorder, cryptic in its pathophysiology and refractory condition with limited therapeutic options. Type I CRPS with its variable relationship to trauma has often no discernible fractures or nerve injuries and remains enigmatic in its response to conservative treatment as well as the other limited interventional therapies. Neuromodulation in the form of spinal cord and dorsal root ganglion stimulation (SCS, DRGS) has shown encouraging results, especially of causalgia or CRPS I of lower extremities. Upper extremity CRPS I is far more difficult. To report a case of upper extremity CRPS I treated by wireless peripheral nerve stimulation (WPNS) for its unique features and minimally invasive technique. The system does not involve implantation of battery or its connections. A 47 year old female patient presented with refractory CRPS I following a blunt trauma to her right forearm. As interventional treatment in the form of local anesthetics (Anesthesia of peripheral branches of radial nerve) and combined infusions of ketamine/lidocaine failed to provide any significant relief she opted for WPNS treatment. Based on the topographic distribution, two electrodes (Stimwave Leads: FR4A-RCV-A0 with tines, Generation 1 and FR4A-RCV-B0 with tines, Generation 1), were placed along the course of radial and median nerves under ultrasonography monitoring and guided by intraoperative stimulation. This procedure did not involve implantation of extension cables or the power source. At a frequency of 60 Hz and 300 μs the stimulation induced paresthesia along the distribution of the nerves. Therapeutic relief was observed with high frequency (HF) stimulation (HF 10 kHz/32 μs, 2.0 mA) reducing her pain from a visual analogue scale (VAS) score of 7-4 postoperatively. Three HF stimulations programs were provided at the time of discharge, as she improved in her sensory impairment to touch, pressure and temperature at her first

  8. Delayed diagnosis and worsening of pain following orthopedic surgery in patients with complex regional pain syndrome (CRPS).

    Science.gov (United States)

    Lunden, Lars K; Kleggetveit, Inge P; Jørum, Ellen

    2016-04-01

    Complex regional pain syndrome (CRPS) is a serious and disabling chronic pain condition, usually occurring in a limb. There are two main types, CRPS 1 with no definite nerve lesion and CRPS 2 with an identified nerve lesion. CRPS 1 and 2 may occur following an injury (frequently following fractures), surgery or without known cause. An early diagnosis and start of adequate treatment is considered desirable for patients with CRPS. From the clinical experience of the principal investigator, it became apparent that CRPS often remained undiagnosed and that the clinical conditions of many patients seemed to be worsened following orthopedic surgery subsequent to the initial eliciting event. The aim of the present retrospective study of 55 patients, all diagnosed with either CRPS 1 or 2, was to evaluate the time from injury until diagnosis of CRPS and the effect on pain of orthopedic surgical intervention subsequent to the original injury/surgery. Clinical symptoms with an emphasis on pain were assessed by going through the patients' records and by information given during the investigation at Oslo University Hospital, where the patients also were examined clinically and with EMG/neurography. Alteration in pain was evaluated in 27 patients who underwent orthopedic surgery subsequent to the eliciting injury. Of a total of 55 patients, 28 women and 27 men (mean age 38.7 (SD 12.3), 38 patients were diagnosed with CRPS type 1, and 17 with CRPS type 2. Mean time before diagnosis was confirmed was 3.9 years (SD1.42, range 6 months-10 years). The eliciting injuries for both CRPS type 1 and type 2 were fractures, squeeze injuries, blunt injuries, stretch accidents and surgery. A total of 27 patients (14 men and 13 women) were operated from one to 12 times at a later stage (from 6 months to several years) following the initial injury or any primary operation because of fracture. A total of 22 patients reported a worsening of pain following secondary surgical events, while four

  9. The Industrial and Logistics Port Complex of Açu and its impacts on the drainage system and the urban structure of the Northern- Fluminense Region

    Directory of Open Access Journals (Sweden)

    Larissa Carneiro Rangel

    2014-02-01

    Full Text Available The construction of the Industrial and Logistics Port Complex of Açu will result in an accelerated process of urbanization directly related to population growth. When it no longer supports agricultural and livestock activities to meet the port activities, the region will have its urban, hydrological and economic dynamics changed. Given the fragility of the Quaternary Coastal, geomorphology of the region, these areas have occupation problems, and are subject to constant flooding. Therefore, it is necessary to make geomorphology studies of the area study so that development is can be planned, avoiding future environmental and territorial and urban problems.

  10. Source tagging modeling study of heavy haze episodes under complex regional transport processes over Wuhan megacity, Central China

    International Nuclear Information System (INIS)

    Lu, Miaomiao; Tang, Xiao; Wang, Zifa; Gbaguidi, Alex; Liang, Shengwen; Hu, Ke; Wu, Lin; Wu, Huangjian; Huang, Zhen; Shen, Longjiao

    2017-01-01

    Wuhan as a megacity of Central China was suffering from severe particulate matter pollution according to previous observation studies, however, the mechanism behind the pollution formation especially the impact of regional chemical transport is still unclear. This study, carried out on the Nested Air Quality Prediction Modeling System (NAQPMS) coupled with an on-line source-tagging module, explores different roles regional transport had in two strong haze episodes over Wuhan in October 2014 and quantitatively assesses the contributions from local and regional sources to PM 2.5 concentration. Validation of predictions based on observations shows modeling system good skills in reproducing key meteorological and chemical features. The first short-time haze episode occurred on 12 October under strong northerly winds, with a hourly PM 2.5 peak of 180 μg m −3 , and was found to be caused primarily by the long-range transport from the northern regions, which contributed 60.6% of the episode's PM 2.5 concentration (versus a total of 32.7% from sources in and near Wuhan). The second episode lasted from the 15–20 October under stable regional large-scale synoptic conditions and weak winds, and had an hourly PM 2.5 peak of 231.0 μg m −3 . In this episode, both the long-distance transport from far regions and short-range transport from the Wuhan-cluster were the primary causes of the haze episode and account for 24.8% and 29.2% of the PM 2.5 concentration respectively. Therefore, regional transport acts as a crucial driver of haze pollution over Wuhan through not only long-range transfer of pollutants, but also short-range aerosol movement under specific meteorological conditions. The present findings highlight the important role of regional transport in urban haze formation and indicate that the joint control of multi city-clusters are needed to reduce the particulate pollution level in Wuhan. - Highlights: • Regional transport impacts studied on two haze

  11. Soluble form of membrane attack complex independently predicts mortality and cardiovascular events in patients with ST-elevation myocardial infarction treated with primary percutaneous coronary intervention

    DEFF Research Database (Denmark)

    Lindberg, Søren; Pedersen, Sune H; Mogelvang, Rasmus

    2012-01-01

    The complement system is an important mediator of inflammation, which plays a pivotal role in atherosclerosis and acute myocardial infarction (AMI). Animal studies suggest that activation of the complement cascade resulting in the formation of soluble membrane attack complex (sMAC), contributes...

  12. Methodology to Model and Understand the Complexities of Social, Economic,and Governance Interactions for Regional Assessment in Kenya

    Science.gov (United States)

    2012-07-01

    narcotics trafficking in Mexico , complex commuter rail systems, and nuclear weapons proliferation. Systemigrams provide us with “a basis for systems...1997-1998. Not only did the flooding destroy bridges, roads, and crops, but it also created epidemics of cholera and malaria (CIA, 2011). In a large

  13. Differential Gene Expression Patterns in Developing Sexually Dimorphic Rat Brain Regions Exposed to Antiandrogenic, Estrogenic, or Complex Endocrine

    DEFF Research Database (Denmark)

    Lichtensteiger, Walter; Bassetti-Gaille, Catherine; Faass, Oliver

    2015-01-01

    -Mix (estrogenic mixture) with 4 estrogenic chemicals (bisphenol A, 4-methylbenzylidene camphor, 2-ethylhexyl 4-methoxycinnamate, and butylparaben), a complex mixture, AEP-Mix, containing the components of A-Mix and E-Mix plus paracetamol, and paracetamol alone, were administered by oral gavage to rat dams from...

  14. Bisphosphonates for treatment of Complex Regional Pain Syndrome type 1: A systematic literature review and meta-analysis of randomized controlled trials versus placebo.

    Science.gov (United States)

    Chevreau, Maxime; Romand, Xavier; Gaudin, Philippe; Juvin, Robert; Baillet, Athan

    2017-07-01

    Complex Regional Pain Syndrome Type 1 is a severely disabling pain syndrome with no definite established treatment. We have performed a systematic literature review and meta-analysis of all randomized controlled trials to assess the benefit of bisphosphonates on pain and function in patients with Complex Regional Pain Syndrome Type 1. A systematic literature search was performed in the Medline, Embase and Cochrane databases. Two authors selected independently blinded randomized trials comparing bisphosphonates to placebo on short-term (J30 to J40) and medium term pain (M2-M3), safety and function in patients with CRPS 1. The methodological quality of the studies was analyzed. Data were aggregated using the method of the inverse of the variance. 258 articles were identified. Four trials of moderate to good quality comprising 181 patients (90 in the bisphosphonate group and 91 in the placebo group) were included in this meta-analysis. Short-term pain Visual Analog Scale was significantly lower in the bisphosphonate group versus the placebo group (SMD=-2.6, 95%CI [-1.8, -3.4], Ppain (SMD=-2.5, 95%CI [-1.4, -3.6], Ppain in patients with Complex Regional Pain Syndrome type 1. Other studies are needed to determine their effectiveness. Copyright © 2017. Published by Elsevier SAS.

  15. Genomic Anatomy of a Premier Major Histocompatibility Complex Paralogous Region on Chromosome 1q21–q22

    Science.gov (United States)

    Shiina, Takashi; Ando, Asako; Suto, Yumiko; Kasai, Fumio; Shigenari, Atsuko; Takishima, Nobusada; Kikkawa, Eri; Iwata, Kyoko; Kuwano, Yuko; Kitamura, Yuka; Matsuzawa, Yumiko; Sano, Kazumi; Nogami, Masahiro; Kawata, Hisako; Li, Suyun; Fukuzumi, Yasuhito; Yamazaki, Masaaki; Tashiro, Hiroyuki; Tamiya, Gen; Kohda, Atsushi; Okumura, Katsuzumi; Ikemura, Toshimichi; Soeda, Eiichi; Mizuki, Nobuhisa; Kimura, Minoru; Bahram, Seiamak; Inoko, Hidetoshi

    2001-01-01

    Human chromosomes 1q21–q25, 6p21.3–22.2, 9q33–q34, and 19p13.1–p13.4 carry clusters of paralogous loci, to date best defined by the flagship 6p MHC region. They have presumably been created by two rounds of large-scale genomic duplications around the time of vertebrate emergence. Phylogenetically, the 1q21–25 region seems most closely related to the 6p21.3 MHC region, as it is only the MHC paralogous region that includes bona fide MHC class I genes, the CD1 and MR1 loci. Here, to clarify the genomic structure of this model MHC paralogous region as well as to gain insight into the evolutionary dynamics of the entire quadriplication process, a detailed analysis of a critical 1.7 megabase (Mb) region was performed. To this end, a composite, deep, YAC, BAC, and PAC contig encompassing all five CD1 genes and linking the centromeric +P5 locus to the telomeric KRTC7 locus was constructed. Within this contig a 1.1-Mb BAC and PAC core segment joining CD1D to FCER1A was fully sequenced and thoroughly analyzed. This led to the mapping of a total of 41 genes (12 expressed genes, 12 possibly expressed genes, and 17 pseudogenes), among which 31 were novel. The latter include 20 olfactory receptor (OR) genes, 9 of which are potentially expressed. Importantly, CD1, SPTA1, OR, and FCERIA belong to multigene families, which have paralogues in the other three regions. Furthermore, it is noteworthy that 12 of the 13 expressed genes in the 1q21–q22 region around the CD1 loci are immunologically relevant. In addition to CD1A-E, these include SPTA1, MNDA, IFI-16, AIM2, BL1A, FY and FCERIA. This functional convergence of structurally unrelated genes is reminiscent of the 6p MHC region, and perhaps represents the emergence of yet another antigen presentation gene cluster, in this case dedicated to lipid/glycolipid antigens rather than antigen-derived peptides. [The nucleotide sequence data reported in this paper have been submitted to the DDBJ, EMBL, and GenBank databases under

  16. Ecological Catastrophes in the steppe? Landscape Archaeology at the mining and metallurgical complex of Kargaly (Region of Orenbourg, Russia

    Directory of Open Access Journals (Sweden)

    Vicent García, Juan M.

    2000-06-01

    Full Text Available Kargaly is one of the most important centers of mining and metallurgy in the great Eurasian steppe. Dr. E.N. Chernykh and his team (Institute of Archaeology, Russian Academy of Sciences, Moscow and various researchers at the CSIC and other Spanish institutions have developed a joint project to undertake a comprehensive study of the site's two main phases of occupation, the Bronze Age (2nd millenium BC and the first Russian industrialization (1745-1900 AD. The Russian members of the joint team are in charge of the archaeological investigations, while the Spanish members are studying metallurgical and mining technology and production, on the one hand, and the environmental context and impact of these activities, on the other. This article presents the research design and first results of the Palaeoenvironmental research at Kargaly. This work has two aspects. The first consisted of obtaining one of the most complete palaeoenvironmental data sets from the steppes through both the systematic sampling of archaeological sites to recover charcoal, seeds, fruits and pollen and the taking of palynological cores from natural deposits, on the other Both sampling programs were supported by radiocarbon dates. The second aspect, to which the greater part of this article is devoted, was dedicated to contextualizing the palaeobotanical evidence by studying the present-day landscape, with particular attention to understanding the processes which shape the variability of the pollen rain. Our purpose was to obtain explicit and measurable calibrative criteria which would enable us to answer the palaeoenvironmental questions raised by our archaeological and archaeometallurgical research. These questions include, most importantly, the following: what was the extent of forest (the energy base for the mining/metallurgical complex during the Bronze Age? and how do we evaluate subsistence practices? (an issue related to the origins of agriculture on the

  17. The molecular complex associated with the Galactic H II region Sh2-90: a possible site of triggered star formation

    Science.gov (United States)

    Samal, M. R.; Zavagno, A.; Deharveng, L.; Molinari, S.; Ojha, D. K.; Paradis, D.; Tigé, J.; Pandey, A. K.; Russeil, D.

    2014-06-01

    Aims: We investigate the star formation activity in the molecular complex associated with the Galactic H ii region Sh2-90. Methods: We obtain the distribution of the ionized and cold neutral gas using radio-continuum and Herschel observations. We use near-infrared and Spitzer data to investigate the stellar content of the complex. We discuss the evolutionary status of embedded massive young stellar objects (MYSOs) using their spectral energy distribution. Results: The Sh2-90 region presents a bubble morphology in the mid-infrared. Radio observations suggest it is an evolved H ii region with an electron density ~144 cm-3, emission measure ~ 6.7 × 104 cm-6 pc and an ionized mass ~55 M⊙. From Herschel and CO (J = 3 - 2) observations we found that the H ii region is part of an elongated extended molecular cloud (H2 column density ≥ 3 × 1021 cm-2 and dust temperature 18-27 K) of total mass ≥ 1 × 104 M⊙. We identify the ionizing cluster of Sh2-90, the main exciting star being an O8-O9 V star. Five cold dust clumps, four mid-IR blobs around B stars, and a compact H ii region are found at the edge of the bubble. The velocity information derived from CO data cubes suggest that most of them are associated with the Sh2-90 region. One hundred and twenty-nine low mass (≤3 M⊙) YSOs have been identified, and they are found to be distributed mostly in the regions of high column density. Four candidate Class 0/I MYSOs have been found. We suggest that multi-generation star formation is present in the complex. From evidence of interaction, time scales involved, and evolutionary status of stellar/protostellar sources, we argue that the star formation at the edges of Sh2-90 might have been triggered. However, several young sources in this complex are probably formed by some other processes. Full Table 5 is only available at the CDS via anonymous ftp to http://cdsarc.u-strasbg.fr (ftp://130.79.128.5) or via http://cdsarc.u-strasbg.fr/viz-bin/qcat?J/A+A/566/A122

  18. Development of innovation complexes as a mechanism of technologies transfer and an instrument of social-economic policy in the region

    Directory of Open Access Journals (Sweden)

    A. F. Sukhovey

    2010-09-01

    Full Text Available In this article is developed a role of innovation complexes of a region at the base of analysis of foreign and domestic experience of organization science-technological complexes. Main reasons, braking innovation transformations in Russia are cleared. For example of Russia it is shown, that unsystematic forming objects of innovation infrastructure without interaction with needs of development region and state its science-technical and industrial potential do not taken to positive change at economy and do not help to activation of innovation processes. Peculiarity different innovation complexes as instrument of social-economic policy, its participation at decision, those actual problems as overcoming of decline traditional branches of industry, forming high-tech sector, rise of outlaying districts, rise of competitive ability of industry were cleared. It is given special attention to possibility of innovation complexes as effective mechanism passing of technologies, allowing to create favorable conditions to subjects of innovation activity and to speed up process “research — production”. Measures to foundation of effective innovation infrastructure as one conditions of acceleration innovation development in Russia are offered.

  19. Revision of fleas of the genus Plocopsylla belonging to the 'angusticeps-lewisi' complex in the Andean biogeographic region, with the description of a new species.

    Science.gov (United States)

    Sanchez, J; Beaucournu, J-C; Lareschi, M

    2015-06-01

    In Argentina, the Andean biogeographic region accommodates the most diverse population of fleas in the country. The Craneopsyllinae (Siphonaptera: Stephanocircidae) represent one of the most commonly found subfamilies in this region and show some endemism and high diversity. Plocopsylla is the most diverse genus of Craneopsyllinae; it includes 10 species mainly distributed in the Patagonian subregion, which parasitize sigmodontine rodents (Rodentia: Cricetidae). We describe and illustrate the morphology of the aedeagus in species of Plocopsylla that belong to the 'angusticeps-lewisi' complex. This character is of diagnostic value in differentiating among species. A new species of this complex, Plocopsylla (Plocopsylla) linardii sp. n., is described and identified by the shape and chaetotaxy of the distal arm of sternite IX, as well as by the shape of the median dorsal lobe of the aedeagus. New host associations for this complex and range extensions for most of its species are reported. Plocopsylla (P.) silewi is recorded for the first time in Argentina. The southern limits of the distributions of Plocopsylla (P.) lewisi and Plocopsylla (P.) wilesi are extended to Santa Cruz Province. The angusticeps-lewisi complex is found for the first time in San Juan Province. The information may be useful in epidemiological studies of flea-borne diseases. © 2015 The Royal Entomological Society.

  20. Visual motion imagery neurofeedback based on the hMT+/V5 complex: evidence for a feedback-specific neural circuit involving neocortical and cerebellar regions

    Science.gov (United States)

    Banca, Paula; Sousa, Teresa; Catarina Duarte, Isabel; Castelo-Branco, Miguel

    2015-12-01

    Objective. Current approaches in neurofeedback/brain-computer interface research often focus on identifying, on a subject-by-subject basis, the neural regions that are best suited for self-driven modulation. It is known that the hMT+/V5 complex, an early visual cortical region, is recruited during explicit and implicit motion imagery, in addition to real motion perception. This study tests the feasibility of training healthy volunteers to regulate the level of activation in their hMT+/V5 complex using real-time fMRI neurofeedback and visual motion imagery strategies. Approach. We functionally localized the hMT+/V5 complex to further use as a target region for neurofeedback. An uniform strategy based on motion imagery was used to guide subjects to neuromodulate hMT+/V5. Main results. We found that 15/20 participants achieved successful neurofeedback. This modulation led to the recruitment of a specific network as further assessed by psychophysiological interaction analysis. This specific circuit, including hMT+/V5, putative V6 and medial cerebellum was activated for successful neurofeedback runs. The putamen and anterior insula were recruited for both successful and non-successful runs. Significance. Our findings indicate that hMT+/V5 is a region that can be modulated by focused imagery and that a specific cortico-cerebellar circuit is recruited during visual motion imagery leading to successful neurofeedback. These findings contribute to the debate on the relative potential of extrinsic (sensory) versus intrinsic (default-mode) brain regions in the clinical application of neurofeedback paradigms. This novel circuit might be a good target for future neurofeedback approaches that aim, for example, the training of focused attention in disorders such as ADHD.

  1. Upregulation of adhesion complex proteins and fibronectin by human keratinocytes treated with an aqueous extract from the leaves of Chromolaena odorata (Eupolin).

    Science.gov (United States)

    Phan, T T; Allen, J; Hughes, M A; Cherry, G; Wojnarowska, F

    2000-01-01

    The fresh leaves and extract of the plant Chromolaena odorata are a traditional herbal treatment in developing countries for burns, soft tissue wounds and skin infections. We have previously shown that the extract had an effect on the growth and proliferation of keratinocytes and fibroblasts in culture. This study has demonstrated that Eupolin extract increased expression of several components of the adhesion complex and fibronectin by human keratinocytes. Using indirect immunofluorescence we found increased expression (dose-dependent) of laminin 5, laminin 1, collagen IV, and fibronectin. The expression of the b1 and b4 integrins was upregulated by the extract at low concentrations (0.1 and 1 microg/ml), but the expression was decreased at higher doses of Eupolin (10 microg-150 microg/ml). A number of clinical studies carried out by Vietnamese and international medical investigators have demonstrated the efficacy of this extract on the wound healing process. In this study we have shown that Eupolin stimulated the expression of many proteins of the adhesion complex and fibronectin by human keratinocytes. The adhesion complex proteins are essential to stabilise epithelium and this effect could contribute to the clinical efficacy of Eupolin in healing.

  2. OXA-carbapenemases present in clinical acinetobacter baumannii-calcoaceticus complex isolates from patients in kurdistan region, Iraq

    NARCIS (Netherlands)

    Ganjo, A.R. (Aryann R.); D.M. Maghdid (Delshad); Mansoor, I.Y. (Isam Y.); Kok, D.J. (Dik J.); J.A. Severin (Juliëtte); H.A. Verbrugh (Henri); D. Kreft; Fatah, M.H.; Alnakshabandi, A.A.; Dlnya, A. (Asad); Hammerum, A.M. (Anette M.); Ng, K. (Kim); W.H.F. Goessens (Wil)

    2016-01-01

    markdownabstractIn addition to intrinsic resistance in Acinetobacter baumannii, many different types of acquired resistance mechanisms have been reported, including the presence of VIM and IMP metallo β-lactamases and also of blaOXA-23-like and blaOXA-58-like enzymes. In the Kurdistan region of

  3. Which complexity of regional climate system models is essential for downscaling anthropogenic climate change in the Northwest European Shelf?

    Science.gov (United States)

    Mathis, Moritz; Elizalde, Alberto; Mikolajewicz, Uwe

    2018-04-01

    Climate change impact studies for the Northwest European Shelf (NWES) make use of various dynamical downscaling strategies in the experimental setup of regional ocean circulation models. Projected change signals from coupled and uncoupled downscalings with different domain sizes and forcing global and regional models show substantial uncertainty. In this paper, we investigate influences of the downscaling strategy on projected changes in the physical and biogeochemical conditions of the NWES. Our results indicate that uncertainties due to different downscaling strategies are similar to uncertainties due to the choice of the parent global model and the downscaling regional model. Downscaled change signals reveal to depend stronger on the downscaling strategy than on the model skills in simulating present-day conditions. Uncoupled downscalings of sea surface temperature (SST) changes are found to be tightly constrained by the atmospheric forcing. The incorporation of coupled air-sea interaction, by contrast, allows the regional model system to develop independently. Changes in salinity show a higher sensitivity to open lateral boundary conditions and river runoff than to coupled or uncoupled atmospheric forcings. Dependencies on the downscaling strategy for changes in SST, salinity, stratification and circulation collectively affect changes in nutrient import and biological primary production.

  4. Improvement of the complex mechanism of state administration of E-government process on the regional level

    Directory of Open Access Journals (Sweden)

    K. G. Kondakov

    2017-03-01

    Suggested structure of the Department will contribute to the improvement of administrative relations between national and regional administration levels. According to the offered structure, main tasks of the structural sub-divisions in the above-mentioned Department have also been defined.

  5. Regional Differences in Brain Volume Predict the Acquisition of Skill in a Complex Real-Time Strategy Videogame

    Science.gov (United States)

    Basak, Chandramallika; Voss, Michelle W.; Erickson, Kirk I.; Boot, Walter R.; Kramer, Arthur F.

    2011-01-01

    Previous studies have found that differences in brain volume among older adults predict performance in laboratory tasks of executive control, memory, and motor learning. In the present study we asked whether regional differences in brain volume as assessed by the application of a voxel-based morphometry technique on high resolution MRI would also…

  6. Cortical Regions Recruited for Complex Active-Learning Strategies and Action Planning Exhibit Rapid Reactivation during Memory Retrieval

    Science.gov (United States)

    Voss, Joel L.; Galvan, Ashley; Gonsalves, Brian D.

    2011-01-01

    Memory retrieval can involve activity in the same sensory cortical regions involved in perception of the original event, and this neural "reactivation" has been suggested as an important mechanism of memory retrieval. However, it is still unclear if fragments of experience other than sensory information are retained and later reactivated during…

  7. Nature and regional significance of unconformities associated with the Middle Ordovician Hagan K-bentonite complex in the North American midcontinent

    Science.gov (United States)

    Kolata, Dennis R.; Huff, W.D.; Bergstrom, Stig M.

    1998-01-01

    Stratal patterns of the Middle Ordovician Hagan K-bentonite complex and associated rocks show that the Black River-Trenton unconformity in the North American midcontinent formed through the complex interplay of eustasy, sediment accumulation rates, siliciclastic influx, bathymetry, seawater chemistry, and perhaps local tectonic uplift. The unconformity is diachronous and is an amalgamated surface that resulted from local late Turinian lowstand exposure followed by regional early Chatfieldian transgressive drowning and sediment starvation. The duration of the unconformity is greatest in southern Wisconsin, northern Illinois, and northern Indiana, where the Deicke and Millbrig K-bentonite Beds converge at the unconformity. On the basis of published isotopic ages for the Deicke and Millbrig beds, it is possible that in these regions erosion and non-deposition spanned a period of as much as 3.2 m.y. Two broad coeval depositional settings are recognized within the North American midcontinent during early Chatfieldian time. 1) An inner shelf, subtidal facies of fossiliferous shale (Spechts Ferry Shale Member and Ion Shale Member of the Decorah Formation) and argillaceous lime mudstone and skeletal wackestone (Guttenberg and Kings Lake Limestone Members) extended from the Canadian shield and Transcontinental arch southeastward through Minnesota, Wisconsin, Iowa, and Missouri. 2) A seaward, relatively deep subtidal, sediment-starved, middle shelf extended eastward from the Mississippi Valley region to the Taconian foreland basins in the central and southern Appalachians and southward through the pericratonic Arkoma and Black Warrior basins. In the inner shelf region, the Black River-Trenton unconformity is a composite of at least two prominent hardground omission surfaces, one at the top of the Castlewood and Carimona Limestone Members and the other at the top of the Guttenberg and Kings Lake Limestone Members, both merging to a single surface in the middle shelf region

  8. QRS Complex Enlargement as a Predictor of Ventricular Arrhythmias in Patients Affected by Surgically Treated Tetralogy of Fallot: A Comprehensive Literature Review and Historical Overview

    Science.gov (United States)

    Bassareo, Pier Paolo; Mercuro, Giuseppe

    2013-01-01

    Tetralogy of Fallot (TOF) is a congenital heart disease frequently treated by surgical repair to relieve symptoms and improve survival. However, despite the performing of an optimal surgical repair, TOF patients are at times characterized by a poor long-term survival rate, likely due to cardiac causes such as ventricular arrhythmias, with subsequent sudden death. In the 80s it was irrefutably demonstrated that QRS prolongation ≥180 msec at basal electrocardiogram is a strong predictor for refining risk stratification for ventricular tachycardia in these patients. The aim of this research was to undertake a review of all studies conducted to assess the impact of QRS duration on the development of life-threatening ventricular arrhythmias in repaired TOF subjects. PMID:23509638

  9. Long term follow-up of bifurcation aneurysms treated with braided stent assisted coiling and complex T- and Y- stent constructs.

    Science.gov (United States)

    Cheung, Nicholas K; Chiu, Albert Hy; Cheung, Andrew; Wenderoth, Jason D

    2018-06-01

    Stent assisted coil embolization (SACE) of bifurcation aneurysms is challenging. Heterogeneous results have been achieved to date, but largely for laser cut stents. While braided stents offer multiple technical advantages, their long term efficacy has yet to be validated. To report the first long term 18 month results for the durability of bifurcation aneurysms treated with braided stents. Over a 4 year period, 59 consecutive patients with 60 bifurcation aneurysms underwent elective braided SACE across three Australian neurovascular centers. 17 of these aneurysms underwent T- or Y-shaped stent constructs. All patients had immediate, 6 month and 18 month clinical and radiological follow-up. Radiological assessment was made on modified Raymond-Roy occlusion scores while clinical assessment was based on the modified Rankin Scale. Subgroup analysis of 17 aneurysms treated with multi-stent constructs was conducted. 6 month follow-up data were available for 59 aneurysms and 18 month follow-up data for 58 aneurysms. Satisfactory aneurysm occlusion was achieved in 97% at inception and at 6 months, and 98% at 18 months. Good neurological outcomes were achieved in 95% at 18 months. Similar satisfactory results were achieved with the multi-stent construct cohort. Intraprocedural thromboembolic events were recorded in 5% and delayed events in 2%. Technical complications were found in 5%. All complication rate was 13%. Braided SACE was safe, efficacious, and durable at the long term 18 month follow-up, including for multi-stent constructs. Preliminary results indicate favorable clinical and radiological outcomes compared with laser cut stents. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  10. Transport Pathways and Enhancement Mechanisms within Localized and Non-Localized Transport Regions in Skin Treated with Low-Frequency Sonophoresis and Sodium Lauryl Sulfate

    OpenAIRE

    Polat, Baris E.; Figueroa, Pedro L.; Blankschtein, Daniel; Langer, Robert

    2010-01-01

    Recent advances in transdermal drug delivery utilizing low-frequency sonophoresis (LFS) and sodium lauryl sulfate (SLS) have revealed that skin permeability enhancement is not homogenous across the skin surface. Instead, highly perturbed skin regions, known as localized transport regions (LTRs), exist. Despite these findings, little research has been conducted to identify intrinsic properties and formation mechanisms of LTRs and the surrounding less-perturbed non-LTRs. By independently analyz...

  11. EMD-RBFNN Coupling Prediction Model of Complex Regional Groundwater Depth Series: A Case Study of the Jiansanjiang Administration of Heilongjiang Land Reclamation in China

    Directory of Open Access Journals (Sweden)

    Qiang Fu

    2016-08-01

    Full Text Available The accurate and reliable prediction of groundwater depth is the basis of the sustainable utilization of regional groundwater resources. However, the complexity of the prediction has been ignored in previous studies of regional groundwater depth system analysis and prediction, making it difficult to realize the scientific management of groundwater resources. To address this defect, taking complexity diagnosis as the research foundation, this paper proposes a new coupling forecast strategy for evaluating groundwater depth based on empirical mode decomposition (EMD and a radial basis function neural network (RBFNN. The data used for complexity analysis and modelling are the monthly groundwater depth series monitoring data from 15 long-term monitoring wells from 1997 to 2007, which were collected from the Jiansanjiang Administration of Heilongjiang Agricultural Reclamation in China. The calculation results of the comprehensive complexity index for each groundwater depth series obtained are based on wavelet theory, fractal theory, and the approximate entropy method. The monthly groundwater depth sequence of District 8 of Farm Nongjiang, which has the highest complexity among the five farms in the Jiansanjiang Administration midland, was chosen as the modelling sample series. The groundwater depth series of District 8 of Farm Nongjiang was separated into five intrinsic mode function (IMF sequences and a remainder sequence by applying the EMD method, which revealed that local groundwater depth has a significant one-year periodic character and an increasing trend. The RBFNN was then used to forecast and stack each EMD separation sequence. The results suggest that the future groundwater depth will remain at approximately 10 m if the past pattern of water use continues, exceeding the ideal depth of groundwater. Thus, local departments should take appropriate countermeasures to conserve groundwater resources effectively.

  12. Cooperation networks and innovation: A complex system perspective to the analysis and evaluation of a EU regional innovation policy programme

    OpenAIRE

    Russo, Margherita; Rossi, Federica

    2008-01-01

    Recent developments in innovation theory and policy have led policymakers to assign particular importance to supporting networks of cooperation among heterogeneous economic actors, especially in production systems composed of small and medium enterprises. Such innovative policies call for parallel innovations in policy analysis, monitoring and assessment. Our analysis of a policy experiment aimed at supporting innovation networks in the Italian region of Tuscany intends to address some issues...

  13. Reproducible association with type 1 diabetes in the extended class I region of the major histocompatibility complex

    DEFF Research Database (Denmark)

    Viken, M.K.; Blomhoff, A.; Olsson, M.

    2009-01-01

    parent homozygous for these loci, were genotyped for 137 polymorphisms. We found novel associations on the DRB1(*)0401-DQA1(*)03-DQB1(*)0302 haplotypic background with eight single nucleotide polymorphisms (SNPs) located within or near the PRSS16 gene. In addition, association at the butyrophilin (BTN......(*)03-DQA1(*)0501-DQB1(*)0201 haplotype, and this study aimed to fine-map the associated region also on the DRB1(*)0401-DQA1(*)03-DQB1(*)0302 haplotype, characterized by less extensive linkage disequilibrium. To exclude associations secondary to DRB1-DQA1-DQB1 haplotypes, 205 families with at least one......)-gene cluster, particularly the BTN3A2 gene, was observed by multilocus analyses. We replicated the associations with SNPs in the PRSS16 region and, albeit weaker, to the BTN3A2 region, in an independent material of 725 families obtained from the Type 1 Diabetes Genetics Consortium. It is important to note...

  14. Interpretation of complex electromagnetic data in seismically active regions: Case study of the Chuya Depression, Mountain Altai

    Science.gov (United States)

    Nevedrova, N. N.; Pospeeva, E. V.; Sanchaa, A. M.

    2011-01-01

    A procedure for the simultaneous interpretation of magnetotelluric and near-field transient electromagnetic sounding (MTS and NF TEMS, respectively) data is proposed. The advantages of the complex interpretation are demonstrated by specific examples. In accordance with the interpretation of the field data, geoelectrical sections of the lithosphere in the western part of the Chuya Depression are constructed. A reduction in the depth to the conductive crustal layer in the epicentral zone is found, and the geoelectrical boundary in the upper part of the paleozoic basement is revealed.

  15. Comparison of risk of local-regional recurrence after mastectomy or breast conservation therapy for patients treated with neoadjuvant chemotherapy and radiation stratified according to a prognostic index score

    International Nuclear Information System (INIS)

    Huang, Eugene H.; Strom, Eric A.; Perkins, George H.; Oh, Julia L.; Chen, Allen M.; Meric-Bernstam, Funda; Hunt, Kelly K.; Sahin, Aysegul A.; Hortobagyi, Gabriel N.; Buchholz, Thomas A.

    2006-01-01

    Purpose: We previously developed a prognostic index that stratified patients treated with breast conservation therapy (BCT) after neoadjuvant chemotherapy into groups with different risks for local-regional recurrence (LRR). The purpose of this study was to compare the rates of LRR as a function of prognostic index score for patients treated with BCT or mastectomy plus radiation after neoadjuvant chemotherapy. Methods and Materials: We retrospectively analyzed 815 patients treated with neoadjuvant chemotherapy, surgery, and radiation. Patients were assigned an index score from 0 to 4 and given 1 point for the presence of each factor: clinical N2 to N3 disease, lymphovascular invasion, pathologic size >2 cm, and multifocal residual disease. Results: The 10-year LRR rates were very low and similar between the mastectomy and BCT groups for patients with an index score of 0 or 1. For patients with a score of 2, LRR trended lower for those treated with mastectomy vs. BCT (12% vs. 28%, p = 0.28). For patients with a score of 3 to 4, LRR was significantly lower for those treated with mastectomy vs. BCT (19% vs. 61%, p = 0.009). Conclusions: This analysis suggests that BCT can provide excellent local-regional treatment for the vast majority of patients after neoadjuvant chemotherapy. For the few patients with a score of 3 to 4, LRR was >60% after BCT and was <20% with mastectomy. If these findings are confirmed in larger randomized studies, the prognostic index may be useful in helping to select the type of surgical treatment for patients treated with neoadjuvant chemotherapy, surgery, and radiation

  16. CONTINUOUS SENSORY ANALGESIA HELPS THE DIFFERENTIAL DIAGNOSIS AND THE TREATMENT OF COMPLEX REGIONAL PAIN SYNDROME (CRPS/RSD

    Directory of Open Access Journals (Sweden)

    Krunoslav Margić

    2001-11-01

    Full Text Available Background. CRPS/RSD still offers more questionsthen answers. The initial events and pathophysiology are unknown,the treatment is unsuccessful and the results are poor.The authors have transmitted their experiences with continuoussensory analgesia of brachial plexus in the treatment ofheavy injured hands to the treatment of CRPS. Efficient analgesia,control of vegetative nerve system and painless exercisesare of outmost importance in the treatment of CRPS.Patients and methods. From 1996 to 1998 we have used continuoussensory analgesia in the treatment of 8 patients withCRPS of the upper extremity. All of them were treated fewmonths after injury.Results. Two to four years after treatment six of eight havebeen ranged as good result (only temporary pain judged onsubjective pain scale as 2; ROM of wrist higher than 50%of normal, lack of 30° of ROM of fingers; hand and key gripgreater than 50% of normal hand.

  17. Tricky Treats

    Centers for Disease Control (CDC) Podcasts

    The Eagle Books are a series of four books that are brought to life by wise animal characters - Mr. Eagle, Miss Rabbit, and Coyote - who engage Rain That Dances and his young friends in the joy of physical activity, eating healthy foods, and learning from their elders about health and diabetes prevention. Tricky Treats shows children the difference between healthy snacks and sweet treats.

  18. Physiological complexity of acute traumatic brain injury in patients treated with a brain oxygen protocol: utility of symbolic regression in predictive modeling of a dynamical system.

    Science.gov (United States)

    Narotam, Pradeep K; Morrison, John F; Schmidt, Michael D; Nathoo, Narendra

    2014-04-01

    Predictive modeling of emergent behavior, inherent to complex physiological systems, requires the analysis of large complex clinical data streams currently being generated in the intensive care unit. Brain tissue oxygen protocols have yielded outcome benefits in traumatic brain injury (TBI), but the critical physiological thresholds for low brain oxygen have not been established for a dynamical patho-physiological system. High frequency, multi-modal clinical data sets from 29 patients with severe TBI who underwent multi-modality neuro-clinical care monitoring and treatment with a brain oxygen protocol were analyzed. The inter-relationship between acute physiological parameters was determined using symbolic regression (SR) as the computational framework. The mean patient age was 44.4±15 with a mean admission GCS of 6.6±3.9. Sixty-three percent sustained motor vehicle accidents and the most common pathology was intra-cerebral hemorrhage (50%). Hospital discharge mortality was 21%, poor outcome occurred in 24% of patients, and good outcome occurred in 56% of patients. Criticality for low brain oxygen was intracranial pressure (ICP) ≥22.8 mm Hg, for mortality at ICP≥37.1 mm Hg. The upper therapeutic threshold for cerebral perfusion pressure (CPP) was 75 mm Hg. Eubaric hyperoxia significantly impacted partial pressure of oxygen in brain tissue (PbtO2) at all ICP levels. Optimal brain temperature (Tbr) was 34-35°C, with an adverse effect when Tbr≥38°C. Survivors clustered at [Formula: see text] Hg vs. non-survivors [Formula: see text] 18 mm Hg. There were two mortality clusters for ICP: High ICP/low PbtO2 and low ICP/low PbtO2. Survivors maintained PbtO2 at all ranges of mean arterial pressure in contrast to non-survivors. The final SR equation for cerebral oxygenation is: [Formula: see text]. The SR-model of acute TBI advances new physiological thresholds or boundary conditions for acute TBI management: PbtO2≥25 mmHg; ICP≤22 mmHg; CPP≈60-75

  19. Drainage isolation and climate change-driven population expansion shape the genetic structures of Tuber indicum complex in the Hengduan Mountains region.

    Science.gov (United States)

    Feng, Bang; Zhao, Qi; Xu, Jianping; Qin, Jiao; Yang, Zhu L

    2016-02-24

    The orogenesis of the Qinghai-Tibetan Plateau and the Quaternary climate changes have played key roles in driving the evolution of flora and fauna in Southwest China, but their effects on higher fungi are poorly addressed. In this study, we investigated the phylogeographic pattern of the Tuber indicum species complex, an economically important fungal group distributed in the Hengduan Mountains region. Our data confirmed the existence of two distinct lineages, T. indicum and T. himalayense, within this species complex. Three geographic groups (Groups W, N and C) were revealed within T. indicum, with Group W found in the paleo-Lancang River region, while Groups N and C corresponded to the two banks along the contemporary Jinsha River, suggesting that rivers have acted as barriers for gene flow among populations from different drainages. Historical range expansion resulted from climate changes was inferred in Group C, contributing to the observed gene flow among geographic populations within this group. Although no significant geographic structure was identified in T. himalayense, evidence of drainage isolation for this species was also detected. Our findings demonstrate that both topographic changes and Quaternary climate oscillations have played important roles in driving the genetic structures of the T. indicum species complex.

  20. Statistical downscaling of historical monthly mean winds over a coastal region of complex terrain. I. Predicting wind speed

    Energy Technology Data Exchange (ETDEWEB)

    Curry, Charles L. [Canadian Centre for Climate Modelling and Analysis, Environment Canada, University of Victoria, Victoria, BC (Canada); School of Earth and Ocean Sciences, University of Victoria, Victoria, BC (Canada); Kamp, Derek van der [School of Earth and Ocean Sciences, University of Victoria, Victoria, BC (Canada); Pacific Climate Impacts Consortium, University of Victoria, Victoria, BC (Canada); Monahan, Adam H. [School of Earth and Ocean Sciences, University of Victoria, Victoria, BC (Canada)

    2012-04-15

    Surface wind speed is a key climatic variable of interest in many applications, including assessments of storm-related infrastructure damage and feasibility studies of wind power generation. In this work and a companion paper (van der Kamp et al. 2011), the relationship between local surface wind and large-scale climate variables was studied using multiple regression analysis. The analysis was performed using monthly mean station data from British Columbia, Canada and large-scale climate variables (predictors) from the NCEP-2 reanalysis over the period 1979-2006. Two regression-based methodologies were compared. The first relates the annual cycle of station wind speed to that of the large-scale predictors at the closest grid box to the station. It is shown that the relatively high correlation coefficients obtained with this method ar